What You Should Do Right Away

Chapter 14 · Vihang Rahul Vasa

Kaizen: the Japanese idea of small, continuous improvement every day, popularised by Masaaki Imai.

This chapter is my Kaizen list: the small things to start today, one at a time:

• Keep a regular check on your plasma glucose (blood sugar) levels: fasting, post-meal, and periodic HbA1c (glycated haemoglobin) tests.

• Take the basic medication prescribed by your doctor. Do not skip, do not self-medicate.

• Never overdose on medicine thinking you will recover faster. Medicine works at its own pace: patience is key.

• Always remember: both very low and very high plasma glucose (blood sugar) can be dangerous. Very low plasma glucose (blood sugar), hypoglycaemia, can become a medical emergency within minutes, so learn to recognise it and treat it promptly. Very high plasma glucose (blood sugar) can also cause serious harm and may need urgent medical attention (see Chapter 25 for both, and Chapter 28: the people around you should know the signs too).

• As a simple precaution, always carry a small candy or a juice box with you: your safety net for a low. The steps I follow when a low strikes are in Chapter 25.

• Never abruptly stop or reduce your medication, even if your readings appear normal. When results are positive, it only means you are doing something right: there is no need to change your regime unless advised by your diabetes specialist doctor.

• Advice from friends, family, and well-wishers comes from love, not from training. Never change your food or your medicines because of it: that is your doctor’s job.

• Refrain from reading excessive information from the internet and self-medicating. The internet is full of conflicting advice. Read if you must, but let your doctor validate anything before you act on it, not a search engine, and not Artificial Intelligence (AI). (I tell what happened to me in Chapter 15.)

• Live a disciplined lifestyle: it is an important part of managing diabetes, and it works alongside your medicines, never instead of them.

One more check that few people know about: in India, tuberculosis (TB) and diabetes often travel together. If you ever have a cough lasting beyond two weeks, unexplained evening fever, unexplained night sweats, or unexplained weight loss: consult your doctor without delay and get checked for TB. Your doctor will decide the tests: usually a chest X-ray and a sputum test for active disease; a blood test called the Interferon-Gamma Release Assay (IGRA) shows whether you have met the TB bacteria (tubercle bacilli), but not whether the infection is active or sleeping, and is used when your doctor advises it.

Driving and low plasma glucose (blood sugar). A low plasma glucose (blood sugar) while driving can put your life and other people’s lives at risk. Check your plasma glucose (blood sugar) before a long drive, keep something sweet within reach in the vehicle, and never drive if you feel the warning signs of a low: stop safely, treat it, and wait until you are fully recovered. If lows are frequent, discuss driving with your doctor.

Your Medicine List and Your SOAP (Subjective, Objective, Assessment, Plan) Report: Carry Both From Day One

Here is one small habit that can make a life-saving difference: prepare a complete list of all the medicines you are currently taking: names, dosages, and timing. Keep this list in your phone, share it with a close family member or friend so it is on their phone too, and keep a printed copy in your wallet. In an emergency, when you may not be in a position to speak, this list will speak for you. It will help any doctor, even one who has never seen you before, treat you quickly and safely.

The medicine list is the first half of a habit. The second half is one page from your doctor. Many doctors write their notes in a structured format called SOAP: Subjective (what you told them), Objective (what they measured: blood pressure, weight, your latest results), Assessment (your diagnoses, listed plainly), and Plan (every medicine with dose and timing, the tests due, the next review). Ask your family doctor or your treating doctor to write you a short SOAP-style summary, one page, updated at every major review, and keep it with your medicine list, in your phone and in your wallet. In an emergency, a doctor who has never seen you reads it in thirty seconds and knows exactly where to start. It is just as useful before surgery (see Chapter 26), when travelling (see Chapter 53), and for any second opinion. In my experience, doctors are happy to do this; you only have to ask.

Illustration: Chapter 14 illustrated summary. Small, steady habits include prescribed care, plasma glucose checks, preparation for lows, a medicine list, and a doctor's SOAP summary: Subjective, Objective, Assessment, Plan.

Chapter 14 Small, steady habits include prescribed care, plasma glucose checks, preparation for lows, a medicine list, and a doctor's SOAP summary: Subjective, Objective, Assessment, Plan. Keep phone and wallet copies. Changes remain doctor-led.

Chapter at a glance: an AI-generated illustration to be read with the chapter, not instead of it. The people shown are not real.