He was losing weight, 8 kg now in 2 months. as asked he checked his sugar and it was about 400mg/dl. He was admitted, and started on insulin. There was no-one in the family with diabetes and he was pretty young, only 30. There is distrust and confusion. Why? how? what? Insulin?? People who cared for him took him to another doctor and then another. Finally a flicker of hope in the form of a famous Ayurveda doctor who has “cured” some people fo diabetes. The promise of cure and a cultural belief on Ayrurveda amongst people all around is a lure. No that did not help. His sugars remained high!
After 4 years he is sitting in my clinic. He has been grappling with the questions, which leads him to the internet, another modern invention by science which somehow is trusted more than scientific medicine. He has seen youtube videos on carbohydrate restrictive diets which are the most trending videos now.
His major concern is he is not gaining weight. He is not thinking about long term diabetes complications like kidney failure and blindness, foot ulcer and amputation, heart disease and stroke…those are not in his “thought radar”.
I asked him what he does understand about diabetes…he attributed his high sugars to stress! He was exercising a lot, eating right and still the sugars were high, so it must be stress. He did not attribute it to something abnormal inside his body, pancreas, liver, muscle, adipose tissue, kidneys…dysfunction of any or all contributes to high sugars. The youtube videos are too simplistic and mostly completely off the mark.
This is the most common scenario. People with diabetes are struggling to grasp the meaning of it all.
We talked for a long time yesterday about what is carbohydrate, what is glucose, why is it needed by the body, how is glucose handles in the body, what goes wrong in glucose handling in diabetes, why should we bring the glucose levels down in diabetes, what are the various ways in which we can bring the glucose down, which is the safest method for a given person…..
There is a lot of information asymmetry between doctors and patients. Doctors read a lot of studies and find it difficult to convey all of that to patients. Instead sometimes they just “tell” them what to do-take medicines, check sugars. Why? Because I say so. But this paternalistic attitude may not always work.
Also doctors do not understand what thoughts haunt their patients sometimes and unless those are addressed the communication between them is not productive.
Only when this information asymmetry is taken care of, patients can understand how to make right choices about their own health.
There is a huge amount of research going on in Diabetes. I am trying to out it across on social media. Watch for these—
https://www.facebook.com/DoorToCare/
instagram.com/doortoendocrinecare
instagram.com/drbeenabansal
door to care 
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