Once again, Dr. R. Fernando, an 80 year old diabetologist, staunch believer of treating pre-diabetics aggressively, encouraged us to to do the same in our practice.
In my once a month wellness day in my private practice, I noticed that most of the patients have fasting capillary blood sugar between 103-140. They are either known diabetics or "healthy" individuals. I have always emphasized on strict lifestyle modification.
What convinced me really is the idea that perhaps diabetes is a disease of the lipids and not the sugar or perhaps disease of the heart and consequently dysglycemia. Truth is, most of my patients who developed diabetes, had, in the past, impaired lipid levels and they were not followed up strictly, so that 5 to 10 years after they come to me already with high sugar levels and a coronary problem.
It is a cry for us Family Physicians to move. We may have come 100 years earlier but who knows, what if treating those 90 and above will lower the incidence of diabetes or perhaps delay its onset? Wouldn't it be nice if the world has less diabetics?
This calls for an evidence based research and I will begin in my patients, today and now....!
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