A glass half full

As a pharmacist, one of my favourite ways to help my patients is by guiding them to the next step.


Many of my patients often are simply looking for a little guidance on which route to follow:


“Do I need to see a doctor about my itchy scalp?”


“Do I need to go make an appointment with my doctor for this sore, or can I treat it with something over the counter?”


“My diarrhoea and stomach cramps are getting worse – is there anything better I could use?”


Two weeks ago, a regular patient of mine came to the pharmacy and asked for my help. Unfortunately, 6 or 7 people were waiting for prescriptions and she had to wait for 15 minutes before I could attend to her. What’s worse is that I could only spend a limited time with her due to another influx of patients waiting for prescriptions. Anyway, to cut to the chase, she had been told by her doctor that she was “pre-diabetic” because her blood sugar levels were consistently borderline. She was very worried about eventually that she may become diabetic and wanted to see if there was anything she could do to stop that from happening. Her doctor suggested to work on her diet, but she read somewhere about a supplement that she could use to control her blood sugar levels. Because I was time-constrained, I had to cut my conversation short and gave her only some simple advice on the best way forward.


One of the things I don’t like working as a pharmacist is that sometimes we cannot spend enough time with a patient before we had to rush off to our next task.


As she is a follower of my weekly emails, I wanted to dedicate this email to her and give her a little bit more insight into how to manage her “pre-diabetic” state.


Being told that you could develop diabetes can make you feel overwhelmed and anxious. It doesn’t help when there are social stigmas associated with diabetes, which can be difficult to digest. People can choose to respond by feeling disbelief, doubt, disappointment, anger or depression. Although, acknowledgement and understanding your response is important, having better knowledge of diabetes can also help ease some of the stress and anxiousness.


The first thing everyone needs to know is that developing diabetes is not an overnight process. Our body has a natural compensative function called the homeostatic mechanism that counteracts when our blood sugars go up. However, this function usually being compromised in people with type 2 diabetes. This is usually caused by several risk factors over some time before you get there. When you are at the “pre-diabetic” phase, these factors can often be reversed upon a healthy lifestyle and help you take control.


I’ve seen a lot of my patients blame themselves when they are diagnosed with a particular health condition. We need to understand that having diabetes isn’t your fault or a personal failure. It also isn’t just the result of your diet. I’ve known many people who don’t watch what they eat or drink and don’t get diabetes. Always remember don’t be too hard on yourself. Take it as a learning curve to a life long commitment to a healthier lifestyle. Especially during this early stage that you can have the biggest impact on your health and possibly reverse your “pre-diabetic” phase.


Another piece of advice that I always give to patients who are diagnosed with diabetes is not to let it take over your life. Challenging yourself to work with your diagnosis is the key to a healthier you. You are always in control and can live life on your terms.


Although embracing the good is a must, you also need to learn that you’ll be faced with challenges, and sometimes it isn’t easy. Just like a week ago, when a patient of mine shared her frustration that, despite eating well, regular exercise, and religiously taking her medicines, her blood sugar levels remained high. I asked her to keep a simple food diary to record everything he ate and drank. Yesterday, she came back to the pharmacy and shared her food diary with me. To my surprise, she was skipping breakfast. Although she was eating plenty of fresh fruits and vegetables, many of them were high in carbohydrates. Too many carbohydrates are usually a culprit for a spike in blood sugar level because the body breaks down carbohydrates into simple sugars that circulate in our blood. It also looked like she wasn’t combining protein, carbohydrates, and fats in her meals to keep her blood sugar level steady.


Again, this information might seem too much to take in initially, but the more you ask and learn from your doctor, dietician and pharmacist, you will eventually have a better understanding of making some evidence-based lifestyle changes which can have a huge improvement to your diabetes or pre-diabetes management.


When it comes to managing diabetes, most people know that exercise and diet are critical in keeping blood sugar level in check. However, not many people understand that the timing of your meals can be everything when it comes to stabilising your blood sugars.


Here are some strategies you could use to help keep blood sugar in check:


1) Do not skip breakfast


Skipping breakfast may seem like you’re saving yourself from extra calories. The problem is that it can end up backfiring because you may find yourself extra hungry at lunch and consume greater portions and crave towards starchy food. When you skip breakfast, your blood sugar level will drop too low to trigger your body to release stored sugar into the bloodstream. This will spike your sugars and making it difficult to keep your blood sugar level in check.


2) Avoid eating before bedtime


I know how hard it is to think twice before reaching into your pantry for a cookie or two before bedtime. But avoiding snacking before bed not only can prevent your blood sugar level from spiking in the middle of the night; also it can prevent you from getting disturbed sleep patterns. If you cannot resist the urge to snack before bed, then I would strongly recommend food that will keep you full without sending your blood sugars surging – such as carrot or celery sticks, fruit, or plain Greek yogurt.


3) Eat frequent but small meals


Eating small meals frequently can prevent your blood sugars from fluctuating and hence allowing you to keep your sugar and energy level stable throughout the day.


4) Eat before and after exercise


Exercise is a fantastic way to keep your blood sugar level in check. However, long, an intense workout can sometimes cause a significant drop in your sugar levels. This is the reason why I always suggest a snack (such as a banana) a couple of hours before doing moderate-intensity exercise to help stabilise your sugar levels.


The bottom line is that being diagnosed with either “pre-diabetes” or type 2 diabetes is not the end of the world. There are always two sides to things, and it depends on which side you’ve chosen to see it through. Seeing it as an opportunity to be committed to your health, to develop self-awareness, and to learn how to make livelong lifestyle changes for good is the best way forward and possibly the best thing you could do to your health.


Once again, my team and I are always here if anyone wants a chat about their health.


In much health and happiness,


Chris Pharmacist