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Diabetes and DEMM

By Petra Bridgemohan
Retired public health Optometrist

For people living with diabetes, please do not add to pandemic stress of public health systems.

With most of  our public health doctors and nurses and paraclinical staff redeployed to Covid crisis care (which we see is getting worse with the Omicron impact), the chronic diseases population, especially diabetics, must  do  their part to help reduce stress.

We can do our part by taking control of our diabetes/general health as we have been shown at many of the diabetic/chronic disease clinics in the past. Good diabetic management is your responsibility, especially since you are the most at risk population (both breakthrough vaxx & unvaxxed) of over 50 years.

DEMM (Diet/Exercise/Medication/Monitor)


Focus on preparing proper diabetic planned diet for the whole family especially in  festive seasons. Do not overeat or break your diabetic diet. These diets allow most foods, just in proper proportions and proper preparation. Check with your health centre dietician or the Diabetic Association of T&T (facebook.com/diabetestt) , or online resources research such as the American Diabetes Association (diabetes.org). It cannot be eat drink and be merry, for tomorrow you may die! Many do not die after such excesses but only add to the stress of the health care system. For busy parents, make  it family mealtime. Become diabetic lifestyle chefs.


Just 20 mins of a brisk daily walking exercise around the home, up and down your steps, no gym needed. End of day in the cool/evening nighttime, say after news, under the night stars, as part of good physical and mental health wellness. Think how lucky we are to have open air spaces at home for exercises. Maintain a regular daily routine and increase times incrementally.


Maintain proper usage as prescribed by your doctor. Those on insulin are more at risk. Always aim to keep one month’s supply as stock. Call your doctor if any symptoms happen; note even the small things are often ignored until they become serious. Early intervention is key here, and while clinics and GP visits are at reduced facetime, you can still call your GP with routine checkup vitals info.


Self-test BP/diabetes kits or your local pharmacy can also help. Record readings especially over festive periods. Write the numbers down. Doctors want to know numbers and what time of day before or after meals/snacks.

Vision self-checks remain one of easiest (but least used) ways to  monitor. Every  diabetic knows their vision gets cloudy or blurry when blood sugar levels are out of control.

Cover one eye to check the other eye’s vision. Do this separately. If the TV/cell phone /newsprint looks blurry, make a doctor’s appointment, then an eye appointment after. Note your sugar readings and time of day. Did you take  your  daily meds?

Optometrists can evaluate basic retinal changes with the AMSLER chart, a simple grid pattern chart used to highlight retinal level changes, for age-related, macular issues. It is just as useful as a self-monitoring tool for diabetics, in between comprehensive eyecare and diabetic review with diabetic teams.

Check https://retinaleyecare.com/amsler-grid/ for an at home test to detect changes.

The longer you have been a diabetic and the less you manage, the greater the risk of complications. So, you must self-manage, except for cases of urgent care presentations where sugar reading levels are in excess of 250. The poorer the management, the greater the risk.