by Dr. Takira Glasgow BSc(McGill), MBBS(UWI), MSc IM Dist.(UK), MSc Diabetes Dist. (UK), PGDip Obesity & Weight Management(UK)

As seen in the Voice newspaper 8th November 2025

The daily routine of blood glucose management may feel as Sisyphean as leaving an imprint on a world that will forget. Before you surrender to fatalism and declare that resistance is futile,

consider whether you have completed all of the steps of (type 2 diabetes) management and followed good advice.

The Diagnosis?

When you discover that a first degree relative has been diagnosed with diabetes, check on your blood glucose early and annually in your adult life. You should seek information about your risk factors such as overweight and obesity, being sedentary and pre-diabetes. In addition, know that related symptoms, most often frequent urination, excessive thirst and yeast infections can be improved with blood glucose control. Remember that your lifespan (up to ten additional years) and your quality of life will be better if your diabetes is managed well early on.

If you suspect that you have diabetes you will be encouraged to confirm the diagnosis.

The Confirmation

An official laboratory blood test can confirm your diagnosis. Your physician will also recommend general baseline blood tests to check on your starting point and to make sure there is no other related disease. There are different target blood glucose readings for before your meals (fasting) and randomly during the day that will be clarified for you. When you start your prescription, check and record your blood glucose readings to confirm for yourself that your blood glucose improved with the medications. Speak to your physician about your specific goals.

Very rarely there are side effects; the list that you find online is not likely to happen to you, but simply indicate how well these medications have been studied. However, if there is any cough, swelling of lips or ankles, or any other concern, speak to your physician. Do not give up at this point; be patient with the process.

The Adjustment

When you have been diagnosed with diabetes something must change. You want to be on the minimum necessary doses of medications to get your blood glucose controlled. This means that you should review the positive habits that can be added to your daily life such as adding salad to your meals or adding on daily exercise. Negative habits need to be removed such as smoking, alcohol use and eating ultra-processed foods.

A word about denial: if you do not internalise the truth that high blood glucose may result in complications over time that affect your quality of life and longevity, then the adjustment may not happen. A 1% A1c reduction can lower the risk of retinopathy by 37% and kidney disease by 21% according to the ADA. Perhaps you try to avoid expense, but the amount spent now is an investment in your future health.

A medical condition does not define you, but it will become more intrusive if you pretend it is not there. Just because you feel well that does not mean that you are well. As you move along your every day life and you are busy, try adding just one positive change at a time.

The Follow Up

Persons who get to this stage of management are to be congratulated. If you persisted with your medications and monitoring with physician feedback, your blood glucose will have improved. You may have had setbacks and not been discouraged; this is not about perfection. The next step is this: it is not sufficient to take the same doses of medications daily over many years and not check that your readings are still at target and low variability. Follow up with your physician to stay on track and to identify and manage any complications early.

Keep a calendar and cover different aspects of diabetes management annually, such as ophthalmology exams, nutritionist advice and reinforcement, podiatrist exam, dental review and other general reviews such as prostate/cervical health and breast issues. Your diabetes physician will direct and centre you, while respecting your level of autonomy.

The Challenges:

Unfortunately detractors can be found outside or within your health clinics. They will boast loudly that they continue to do as they please, skip or toss medications, drink alcohol, and eat everything. They mock discipline, reverse blame of diabetes complications onto medications, and distort information to influence you. They do not know your individual medical situation and you do not know theirs, nor will they share in any responsibility if you get sick. They not only do themselves a disservice, but also those around them who are striving towards better health.

Beyond this, there can be practical struggles with costs and availability of medications and glucose strips. Concessions are available within the healthcare system and some have persevered and accessed them. Additionally, help is available from many sources- from health aides and nurses to your physicians and pharmacists, the SLDHA and the Ministry.

There is purpose in the journey; when you are ready there are persons in place to help.

Your diabetes management is not futile.