BY Dr. Sanjiva Wijesinha


I hadn’t seen my old classmate Brian for several years and then met him recently at a friend’s birthday party. He was the same cheery chap I remembered – although I couldn’t help noticing that he’d lost a little hair and gained weight since I last saw him.

While helping ourselves to dessert, Brian waited while I served myself a small scoop of ice cream; he then helped himself to a much larger serving – and ruefully noted that he didn’t want to serve more because he is diabetic.

Usually, I don’t discuss medical matters or offer free consultations at dinner parties. But I was intrigued by my diabetic friend serving himself a huge bowl of ice cream so I asked him: “How long have you had diabetes, Brian?”

“Oh I was diagnosed with it about five years ago; but I take my tablets every day,” he declared.

“And when did you last take a blood test?” I asked.

He replied, dismissively: “I don’t bother about blood tests. When I was diagnosed initially, the doctor prescribed some tablets, which I’ve been taking regularly – although I do forget to take them on some days.”

I asked him how he procured his tablets since all medications used to treat diabetes are only available on prescription.

Brian told me that when he was diagnosed initially, he’d been advised to take metformin tablets twice a day with his morning and evening meals. He buys these tablets from a friendly pharmacist (who supplies them without a prescription)… and he’s been taking the same dose for the past five years.

And he felt it was unnecessary to consult his doctor again… yes, since that first day!

I’m reluctant to provide unsolicited medical advice to my friends. However, Brian seemed to be a time bomb waiting to explode. So as we enjoyed our ice cream, I said: “Brian, if you have diabetes, you must manage it carefully with regular blood tests to know whether you need to modify the dose or even change the medicines you’re taking.”

“Why don’t you drop in to see me next week so I can arrange for you to take some blood tests? We can then have a chat about how you can look after yourself – because uncontrolled diabetes makes you vulnerable to heart attacks and kidney failure,” I elaborated.

Brian’s cavalier attitude to this serious disease worried me because diabetes is a condition that needs careful management.

The prime objective is to ensure that a high concentration of sugar in the blood does not damage vital organs such as the heart, kidneys and eyes. We can do this by reducing the quantum of sugar entering the body through what we eat and drink, and control the amount of glucose that’s already in the blood.

And the only way we can know that our blood sugar level is under control is by measuring it.

Fortunately, there is a test that tells us what the average blood sugar level in our body has been over the past three months. This test – to measure the amount of glycosylated haemoglobin (HbA1c) in the blood – doesn’t require the patient to fast and is easily done.

It also enables the physician who’s treating you to alter the dose or type of medication that has been prescribed.