Diabetes care in Bongaigaon

• Type 2 diabetes. The most common type. The body still makes insulin but does not respond to it well. It is linked to family history, extra weight around the waist, low activity, poor sleep and stress. People of South Asian origin often develop it at a younger age and a lower body weight.
• Type 1 diabetes. The body makes very little or no insulin, so insulin injections are needed from the start. It usually begins in childhood or early adulthood but can start at any age.
• Diabetes in pregnancy. High sugar first found in pregnancy (gestational diabetes) or diabetes that was present before pregnancy. See Diabetes in pregnancy.
• Monogenic and other types. Rarer forms caused by a single gene change, by pancreas disease, or by medicines such as steroids. These sometimes need a different treatment, so finding the type matters.
• Prediabetes. Sugar higher than normal but below the diabetes level (fasting 100 to 125 mg/dL or HbA1c 5.7% to 6.4%). This is the ideal time to act, because changes now can delay or prevent diabetes.

Many people have no symptoms for years. When symptoms do appear, they can include:

• Passing urine often, especially at night
• Feeling very thirsty
• Tiredness, weakness
• Weight loss without trying
• Blurred vision
• Slow-healing cuts, frequent skin, gum or urine infections
• Tingling or burning in the feet

• Adults aged 30 and above, every year or as advised
• Anyone with a parent, brother or sister with diabetes
• People with a large waist (90 cm or more in men, 80 cm or more in women)
• People with high blood pressure, high cholesterol, fatty liver or PCOS
• Women who had diabetes in a past pregnancy or a baby weighing more than 3.5 kg
• Anyone with the symptoms above

1. Detailed history. Your symptoms, family history, food habits, work hours, sleep, other illnesses and every medicine you take.
2. Examination. Weight, waist, BP, pulse, feet, skin and signs of complications.
3. Tests in the clinic. HbA1c and finger-prick sugar during the visit. A diabetic foot check for nerve feeling and blood flow. ECG and echo when your heart needs a look, which is common in people who have had diabetes for some years.
4. Blood and urine tests. Usually kidney function, urine albumin, cholesterol and others as needed. You can do these at a lab of your choice.
5. Your plan. Medicines with clear timings, a food plan built around what you eat at home, an activity goal, and a schedule for sugar checks.
6. Complication screening. A yearly plan for eyes, kidneys, feet and heart, so problems are found while they are still small.

Dr. Das decides which tests you need after he has examined you, so you only do the tests that help.

Treatment is different for each person. It usually includes:

• Food: regular meals, smaller rice portions, more vegetables, dal and protein, fewer sweets and sweet drinks. We work with your usual meals rather than giving a foreign diet chart.
• Activity: most adults benefit from about 150 minutes of brisk walking or similar activity a week, spread over most days, plus some muscle-strengthening work.
• Medicines: tablets, injections or insulin, chosen for your type of diabetes, your kidney and heart health, your weight and your budget.
• Monitoring: home sugar checks or CGM, and HbA1c every 3 months until stable.
• Protection: BP and cholesterol control, foot care, and vaccines as advised.

• Bring your medicines (or strips), your sugar meter or diary and reports from the last year
• If a fasting test may be needed, ask us before the visit how to manage your morning dose
• Write down any low sugar episodes: time, reading and what you were doing

You leave with written medicine timings, sugar targets, food and activity advice, and a follow-up date. Most people are reviewed every 1 to 3 months until sugar is steady, then every 3 to 6 months. You can WhatsApp sugar readings and reports between visits.