diabetic delites

“I “ declared the woman , “have diabetes. I have had it for the last 10 years”. I checked her blood sugar value. It was 430.
“Your sugar is very high!” I said.
She smiled smugly. “It has never been below 400”.
“These other values are also high. You seem to have diabetes , high blood pressure and high cholesterol.”
“I don’t know about all that doctor. I ate biriyani before coming. That is why my weight and cholesterol are is high. I always become tense before seeing a doctor.”
I decided to give her the benefit of the doubt. “Do you take any tablets for the diabetes?”
“Yes,” she said , “sometimes, when I feel the sugar is high or I have drunk a Coke.”
I protested, “you cannot control your sugars based on feelings! Nor can you drink Coke.”
I could see she was not convinced. But she was willing to try. I gave her a diabetic diet sheet and asked her to follow it. “You also have to walk for an hour a day for the medications to work.”
“Can I walk up and down my hallway? “ She asked.
To me, that did not seem very practical. After all how long could a hallway be? There was the additional problem of interruptions, telephone calls, family members, the milk man-----.
“No” I said firmly, “you have to walk outside the house.”
She returned a week later. The sugar value had gone upto 500. She had put on weight as well. She had adhered to the diet. She said,” doctor it is not possible to eat all that you gave me. With my regular food as well, I am not able to eat all that.”
“The diet”, I said “is all that you get to eat. It is not in addition to what you already eat.”
Live and learn. The next 5 patients received detailed instructions on diet. It was “instead of” and not “in addition to.”
She came a week later. The sugars were still high and we were fast approaching the 100 kilo mark. In desperation I sent for her husband. Pot belied, obese with curry stains on the front of his shirt. I guess the large size of his paunch prevented him from eating his food without dripping it!
“Your wife urgently needs to exercise. She cannot go out to walk and there seems to be no park nearby. I want you to get her a treadmill or a cross trainer.”
He looked at me. “Shall I fire the servants?” we seemed to be talking at cross purposes.
“Why?” I asked.
“If she washes all the clothes and cleans the house—is that not enough?”
“No “ I said “it is not.” I had visions of trying to tackle the resultant back ache, painful knees and fungal infections of the fingers.
A month later she was brought in a state of collapse. The sugar was 63, but she was as fat as ever.
“What happened?”
I asked.
“Well,” said the husband , “today is the day she fasts.”
I had a bad feeling. “Did she take her medication?”
“Oh yes. I make sure she never misses a single dose.”
The next half hour was spent trying to explain that she should not fast. Even is she does, she should not take her medication as well. They were like recalcitrant children. . They found ways around every situation. They had an answer for everything. Within days the sugar was back to 430.
“Does she eat only 2 chappatis for dinner?”
“Yes “ he said “look.”
They were the biggest chapattis I had seen, the size of a thali meals plate.
“Does she use the treadmill?”
“Yes doctor,” it is a convenient shape and size to hang our undergarments.”
I don’t know why and how but she managed to maintain her weight (97 kg) and her sugar (330-450) for the next five years. Last I heard she was going to Mumbai to look after her grand children.
Maybe there is a lesson in this. Ideal body weight, controlled sugars and blood pressure—these are all myths. How you live and when you die – it is in the stars.