From sweet to bitter: A day in the life of diabetic patients in UAE

Dubai: As we observe the World Diabetes Day on November 14, it is evident that this lifestyle disease is reaching epidemic proportions in the country.

According to the 2017 statistics of the International Diabetes Federation (IDF), about 17.3 per cent of the UAE population between the age of 20 and 79 has type 2 diabetes.

While health officials formulate policies to cut down the prevalence, there’s plenty in terms of minor lifestyle tweaks an individual can do to prevent or manage diabetes.

Gulf News followed the routine of two Type 2 diabetics. While Sunshine Masalunga, a Filipina executive living in Dubai has been disciplined and motivated to manage her condition, Khalid Mahmood, an Egyptian engineer from Sharjah has not been able to keep up to his workout schedules and suffers from bouts of hyper- or hypo glycemia (high or low blood sugar) sometimes.

From the simple decision of choosing a sensible breakfast or making sure to walk up the stairs to squeezing in some physical activity in a busy schedule, there are a lot of challenges a diabetic faces to keep the blood sugar steady. Something an average non-diabetic might take for granted in their daily routine.

The diagnosis

Sunshine Masalunga, 36, mother of two sons aged 14 and 5, and a type 2 diabetic, has not only managed to reduce her medication but also bring down her HbAIC or glycated haemoglobin, an indicator of blood sugar levels for three months. She works from 8am to 7pm and yet manages to squeeze in a workout at home every day in the evening.

Masalunga was diagnosed with gestational diabetes (GD) while pregnant with her second son, Zion in 2012. She registered a blood sugar of 200 mgdl (milligram per decalitre), said Dr Zia Ul Hassan consultant endocrinologist at International Modern Hospital and North West Clinic.

“This is a precursor for type 2 diabetes, so I went on a strict diet,” recalled Masalunga. She cut out fried food and started a strict walking schedule during her pregnancy and the GD disappeared after the birth of her son.

“However, soon after I got careless and began to feed my cravings for French-fries and fried chicken, chocolate cakes and all other foods. I got lazy about exercising,” said Masalunga who was diagnosed with type 2 diabetes in 2017 as her blood sugar after meals stood at 200 mgdl.

“I knew something was wrong as I had this uncontrolled itching on my body at night and was plagued by hunger and thirst pangs. But the diagnosis shocked me and I was determined to get back good health,” said Masalunga who immediately cut back on eating out, included more portions of vegetables and fibre in her diet, even as she began having 500 mg of metformin with lunch and dinner.

Slowly and surely with determination, Masalunga completely eliminated her need for medicines after a year bringing her HBA1 C level to 4.4. “The doctor stopped my medicines for some time. Now my HBA1c level is 5.4 and I have been advised metformin 500 mg for maintenance only,” she said

“I get up 5am, prepare breakfast and lunch for my sons, drop them to the school bus at 6.30, return and get ready to go to work. I carry my brown rice for lunch and choose a healthy vegetable, or lean chicken with salad from the office canteen. I have cut down on all snacks. For work out, I always take the stairs to work and after I return in the evening, I make it a point to work out at home. I have downloaded many exercise routines and vary them to keep my interest levels up. For dinner I have only a wholemeal sandwich with tuna or vegetables,” said Masalunga.

She loves chocolates and fries and allows herself an occasional treat once a week. “I don’t stop myself and satisfy my craving by having a small portion and that prevents me from bingeing.”

In the last two years Masalunga has lost 8kg weight and is incredibly proud of her achievements. “My BMI is 19.7 and now I feel happy to help others. One of my friends from the US who was recently diagnosed with diabetes called me for advise and based on my own experience I was able to guide her,” said Masalunga.

Battling diabetes for over a decade

Khalid Mahmood, 43 knows the difference between managing diabetes and letting oneself go. Diagnosed with type 2 diabetes since the age of 32, Mahmoud, the father of two sons recently stopped exercises and his healthy diet routine

in 2007 when Mahmoud was diagnosed with type 2 diabetes, he weighed over 90kg and immediately set to work. “I was prescribed two doses of insulin. I lived in Saudi Arabia where I joined a gym and underwent personal training. My weight came down to 80kg and the doctor stopped my insulin and put me on new-age diabetes drugs and one dose of insulin post dinner,” he recalled

After relocating to Sharjah from Saudi Arabia six months ago, Mahmoud’s health suffered as he was unable to exercise or regularise his meal patterns.

Mahmoud gets up at 7am, checks his blood sugar and gets ready for work.

For breakfast, he has a lettuce sandwich with wholemeal bread and walks to his workplace located 30 minutes away from home.

For lunch, he has two wholemeal sandwiches with some vegetables and occasionally chicken.

His main meal is dinner which includes rice, chicken, vegetables and occasional grilled meat which is usually at 8pm.

He takes a new age diabetes medication three times a day with every meal and also an insulin injection post-dinner but is facing erratic blood sugar levels because of neglecting regular exercise and proper nutrition.

“I know I am going wrong as I must have this meal for lunch. But since my relocation, I have neither been able to find a gym nor been able to balance nutrition for all three meals. On weekends, I try to include beans, salads and traditional Egyptian fare in my food,” said Mahmoud who is not able to resist his sweet tooth. “I love Umm Ali, doughnuts and cinnamon rolls. I am working on controlling my cravings,” he added.

As a result Mahmoud’s HbA1c levels reached 8 and his weight has crept up. “Sometimes my fasting blood sugar is about 200 mgdl which is high and occasionally I also suffer from low sugar bouts, so I always carry some lozenges which I have in case I feel low or tired at work,” said Mahmoud.

Dr Waed Jaber, Specialist Internal Medicine at Medcare Hospital, Sharjah, who Mahmoud has contacted last week said: “Mahmoud needs to do rapid walking for 150 minutes per week as per the global recommendation for minimum exercise in a week, until he gets back to his work-out schedule. His large dinner at the end of the day is spiking his blood glucose level. He needs to avoid that and have smaller meals with high intake of fibre such as salads and vegetables during the day and a lighter meal in the evening. He needs to cut out on all sweets and processed foods. To satisfy his sweet tooth he can have small portion of fruits with low glycaemic index such as berries, apple and guavas.”

What is HbA1C?

HbA1c or glycated haemoglobin is an indicator of an individual’s blood sugar levels for three months. The haemoglobin protein in our red blood cells combines with a molecule of glucose and turns into glycated haemoglobin. In non-diabetics, HbA1c is between 5.2 to 5.5, it is about 5.5 to 6 in pre-diabetics and in cases of people with diabetes, the HbA1c reading can be anything beginning from 6 up to 14. The higher the HbA1c the more severe is the diabetic condition of the patient.