As the years clock by, we doctors develop the art of keeping the emotional response to death at arm`s length as this is not an infrequent occurrence. Trauma and grief gives way to disappointment and frustration. But when it strikes close to our hearts and homes, all the well-engineered defenses built over decades come crashing down like a sandcastle on the beach obliterated by a giant wave.
Nothing you did not know, but when you are confronted with writing the obituary of a friend or a close relative, when messages fly around the world, twitter tingles and Facebook jingles and we sit huddled and comfort each other and vow to be there for each other, somewhere from the ivory towers of the great institutions of the land to the occasional friend, there are the pangs of guilt – have we done enough?
Diabetes affects every part of the human body, but what often is in the blind side is the psychological and emotional issues surrounding it. The issue is complex and whether it is a cause or effect or both is a matter of research and debate. The disease needs frequent monitoring, interventions, numerous clinic and hospital visits and after a while control becomes difficult. Both high and low blood sugar takes a great toll on the human mind and the emotional response to them is not the same for everyone. Relationships suffer and sometimes one can see the personality of a diabetic changing multiple times a day. As much as close friends and family support can be crucial, they can also be a source of stress as care can be perceived as intrusion, which is counterproductive. This can lead to neglect and a downward spiral of the condition and be eventually fatal.
Thus diabetes control is much beyond controlling the blood sugar and its complications. The last decade has seen a paradigm shift in medical practise from intuitive medicine to more precision medicine. There has been interest and emergence of newer digital technology to help monitor and treat patients better, most of whom are truly inspirational and welcoming.
The challenge is to build not just medical and allied support, but also to community support using traditional, modern, digital and non-digital means which is robust, affordable, trustworthy and most importantly not too intrusive keeping in mind the individual, families and carers so that life can be lived. Though there is a need for uniformity of global care, there will be geographical and resource diversity, which has to be managed with innovation and excellence. It is this equilibrium in healthcare that we have set out to achieve and implement which is the guiding force in our endeavour.