Coping with diabetes, hypertension, a day at a time……complexity of lifelong medication

“Personally, I have been finding it difficult to manage the prescriptions and I have resorted to skipping doses, so that I manage to survive on the little I get to buy the meds. I am sometimes lucky to get handouts to buy insulin from well wishers,” a heartbreaking insight into the life of a diabetic.

By Catherine Murombedzi

A specialist in diabetes said there is no cure, but medication and the Dos and Dont’s, to manage the diseases with coping mechanisms inorder to lower the risks.

“Diabetes mellitus and hypertension are sometimes called lifestyle diseases, because they usually are related to overweight, obesity, high cholesterol levels, lack of exercises, and general lack of fitnes,” said Dr Enock Mayida.

The two also follow family blood lines, if parents or grandparents had it, one has a certain significant percentage of developing High Blood Pressure (HBP) and Blood Sugar,” said Dr Mayida.

Dr Mayida said exercises and correct diet were a prerequisite to managing these conditions.

“Regular exercises, keeping fit, healthy diet ….low salt, low sugar, low fat (cooking oil) diet are a prerequisite. Keeping one’s weight in check is encouraged, one must have a normal body mass index (BMI) value.

Regular BP and blood sugar checks, at least once in 2 weeks. One can purchase a machine to check as and when it is necessary. In that way, the increase in BP and Blood Sugar can be detected early and managed. There is need for quick treatment for those diagnosed, to avoid complications,” Dr Mayida emphasised.

Diabetes is a disease in which the body does not control the amount of glucose (a type of sugar) in the blood and the kidneys make a large amount of urine. This disease occurs when the body does not make enough insulin or does not use it the way it should.

Rarely do we care to write on fellow journalists, how they feel after hospitalisation. We merely end up urging them to get well soon with a dash of, “get well soon, you are in my prayers.”

Two female journalists, Vanessa Gonye, a young woman in her 20s and Ropafadzo Mapimhidze, in her late 50s, are testimonials of fighters who have been in and out of hospital.
A chat with the duo revealed the daily battles behind the smiles. Resilience to manage each day as it comes.

“Being diabetic is one of the worst conditions and I would never wish it on anyone.
To start with, the medication is a bit complex especially if you are on insulin which is also quite expensive.
One may need amounts ranging from US$30 to over US$350 for a month’s supply, depending on the types of insulin used.

Personally, I have been finding it difficult to manage and have resorted to skipping doses so that I manage to survive on the little I get to buy the meds. I am sometimes lucky to get handouts to buy insulin from well-wishers,” said Gonye.

She speaks of the assistance she gets which makes the going manageable.
“There are times I get support from Dr John Mangwiro, who sometimes gives insulin donations to diabetics, we (with my sister who is also diabetic) somehow manage, otherwise our medication alone, combined, is way more than my salary. Being diabetic means we are supposed to follow a more traditional diet and more ‘sophisticated’ quantities which are to be taken frequently.
I would say diabetes is a very confusing and difficult condition,” said Gonye.

Gonye is a Type One diabetic, which means she self injects insulin daily.

HEREDITARY

“Ours is hereditary diabetes, there is a history of diabetes from both parents. We are Type One diabetes, which is mostly hereditary. To start with, the medication is a bit complex especially if you are on insulin which is also quite expensive,” said Gonye.

Mapimhidze has to take several life medications and the treatment burden is not easy.

“I was diagnosed with diabetes in 2006, I had started losing weight, taking a lot of water yet was always thirsty. I would take Coke upon Coke and took 6 bottles one day. It was after a visit to a clinic in Warren Park that I was diagnosed and started taking medication. Diabetes is very complex, one needs wholesome correct diet, take medication religiously, a stable mindset because attending a funeral can upset one. A recent bereavement where I attended a funeral where four family members perished in a road accident upset my sugar balance. Secondly, came the Tynwald students disaster where one of the students was a neighbour’s child. I fell ill from crying,” said Mapimhidze.

COPING MECHANISMS

“With most of the coping mechanisms depending on money, the going is tough.
So it is impossible to cope with the traditional diet, it is expensive to buy mhunga, zviyo, brown rice, lean milk.In my small garden I grow vegetables but due to water shortages, I keep the patch minimal. I buy two viles of insulin, I have hypertension too, that is life meds. As a pensioner, my medical bills are not met on my monthly pension equivalent to US$40. Its a struggle with no medical insurance. At times I feel like giving up, but I still have very young grandchildren.
The frequent meals at times are not available, said Mapimhidze.

At times, she is exhausted and loses her temper easily.

“Diabetes makes me lose temper. I find myself lashing out for minor issues, I only find that it was uncalled for. I need to exercise and I do take walks. Being a freelance journalist, I eat what I kill, I have to score on my laptop. At times I become forgetful and miss giving myself a jab.

PROHIBITIVE COST

“Diabetes is complex. The sugar stripes to check my sugar levels are expensive costing US$25 for 50 stripes and I require 100 stripes because I need to check before meals and before bed so I am only able to do so twice.
I sometimes plan on meetings, the scheduled day, am not feeling well and fail to attend.

“Colleagues may think that I am not reliable, yet I am OK this hour and under the weather without notice. I hope one day, there will be funding for non communicable diseases, (NCDs) just as there is anti retroviral therapy (ART) for people living with HIV. With clinics not within walking distances, either one needs fuel or bus fare to pay for a ride to the clinic near. With diabetes, its taking a day at a time,” lamented Mapimhidze.

The more medications arise as one takes more life medications, the higher the risk of those drugs interacting dangerously with each other. Multiple medications can cause confusion, light headedness and even internal bleeding — all dangerous and injurious conditions. (webmd.com › medication)

Taking more than five meds becomes a Polypharmacy and one needs to be directed by the doctor on times to take the drugs inorder to minimise drug interactions. It is for this reason that people on life meds are urged not to self prescribe anything besides what the doctor ordered.
Dr Mayida said sudden health scares can come, but they are very rare in those who monitor their health.

MANAGEMENT

“Diabetes and hypertension management is by way of antihypertensives and blood sugar tablets and insulin. One has to be aware of possible complications, seeking early assistance is always advisable when such occurs,” warned Dr Mayida.
To mitigate in the diabetes management, The Merck Foundation has to date trained 30 000 students from medical universities on clinical diabetes and hypertension management programme.
Launched in 2019, Merck Diabetes Blue Print Project saw 470 doctors from 40 countries complete two-year Master Degree and Master course in Diabetes and Endocrinology.
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