About diabetes: an interview with Dr Muyela
For many people, Type 2 diabetes can be difficult to cope with. But the good news is that much of it is within our control. In this interview, Vice Chairperson of the Diabetes Association of Botswana, Dr Charles
Muyela shares his insight about the condition, treating and managing diabetes, and offers hope for those who have gotten the diagnosis.
THANK YOU FOR YOUR TIME. CAN YOU SHARE A BIT OF YOUR BACKGROUND?
I’m Dr Charles Muyela, Currently a Postgraduation student at the University of Botswana, Faculty of Medicine, specialising in Public Health Medicine. I did my 5 years of undergraduate at the University of Botswana, School of Medicine, attained a bachelor of surgery and medicine. I’m currently the Vice Chairperson of the Diabetes Association of Botswana, and have been with the association since 2014. I’m also Secretary General of the Botswana Doctors Union.
PLEASE COULD YOU GIVE A BRIEF INTRODUCTION TO DIABETES?
Diabetes is a health condition, where by your sugar in your blood is high. When eat food, that food is converted and absorbed into the body as sugar or glucose. For this glucose or sugar to be used as energy by the body or the cells of the body, a hormone called insulin produced by the pancreas is needed. The insulin acts like a key, that unlocks a lock on the cells of the body, that allows the cells to able to use this sugar or glucose. If this insulin is not produced enough or insulin is unable to unlock the lock that allows the sugar to enter the cell, the sugar or glucose remains in the blood. Over time this sugar or glucose becomes more and more, eventually leading to a high sugar level. This high sugar level then leads to complications within the body.
WHAT COMPLICATIONS AND HEALTH PROBLEMS CAN DIABETES CAUSE?
Some of the complications that can be experience by patients who have diabetes can be divided into two. Microvascular or those that affect the small blood vessels or Macrovascular or those that affect the large blood vessels of the body. Some of the microvascular complications can by eye problems like cataracts and glaucoma, kidney problems like kidney injury or kidney failure or nerve problems like numbness of the hands or pin and needle felling in the feet. Some of the macrovascular complications can be brain problems like stroke or cognitive impairment, heart problems like heart attack or heart failure and slow healing of wounds where wounds that develop take a long time to heal or become worse and need surgery.
HOW DO PEOPLE WITH DIABETES TEST THEIR GLUCOSE LEVELS?
People with diabetes can test for glucose or check their sugar level at home, or at their nearest clinic or laboratory. The finger can be pricked, and some droplets of blood put on a
glucose testing strip that is connected to a device that reads your sugar level instantly or some blood can be drawn from your vein and sent via a test tube to the laboratory to be tested for sugar or glucose level.
WHAT OTHER CHECKS DO PEOPLE WITH DIABETES NEED?
Because diabetics can develop complications as a result of diabetes, they need to be screened to make sure that they are not developing these complications and if they are, these complications treated as soon as possible as not to get worse. They would need a foot exam at once year, as diabetes can cause nerve problems that can lead to loss pain or feeling, making developing sores easy, and progression without notice very likely. An eye exam at the diagnosis of diabetes and every year after that, as diabetes can cause eye problems. Kidney test at least once a year to see if the kidneys are still working well, as diabetes can lead to kidney problems. Dental or tooth and gum exams/checks at least every 6 months as diabetes can make developing gum disease easier and tooth decay more likely.
What medicines do people with diabetes need for blood glucose control?
Depending on the type of diabetes a person has or how long they have had it or how well controlled it is, they may have to either take pills or an injection or both.
DO PEOPLE WITH DIABETES NEED TO CHANGE THEIR MEDICINES OVER TIME?
Yes, if they have had diabetes for a very long time, or the current medication is not controlling their sugar well or when they are not happy or tolerating the current medication they are taking.
ARE NON-MEDICINE MEASURES JUST AS IMPORTANT FOR PEOPLE WITH DIABETES?
Yes definitely. Both exercise and diet are very important. Exercising can improve your sugar levels and a poor diet can make it difficult to control your sugar even when you are on medication.
WHAT IS THE ANNUAL CYCLE OF CARE WHEN IT COMES TO DIABETES?
This basically means taking care of yourself through the year, to limit the worsening of your diabetes. Making sure you avoid certain harmful practices like smoking which can increase your risk of complications from diabetes. Exercising at least 4 times a week, with each session being at least 30mins, making sure you take your medication as prescribed by your GP and following your diet plan as recommended by your dietitian or nutritionist. Going into to see your GP as scheduled, where you will have your blood pressure checked, make sure you don’t have hypertension, foot exam done, eye exam done, kidney test done, as well as your blood fats or cholesterol and triglycerides checked. A test called HbA1c would be done, which will be able to check how your sugar control has been for the past 3 months. Your weight, waist circumference and body mass index or measure of proportion of fat in your body will also be measured, high measurements would worsen your diabetes or reduced measurements would help improve your diabetes sugar levels. The GP would also check if your medication is taking you well, and needs to be changed or even stopped. He will also screen for depression, as diabetes can be a heavy disease on an individual, and refer you for appropriate help. Lastly to see the dentist twice a week, to make sure your oral cavity is healthy and manage you accordingly.