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Tribune News Network
Doha
A MISDIAGNOSIS could have had fatal consequences for Ali, a Qatari man with Down's syndrome, but today his story is an example of the important role Hamad Medical Corporation's (HMC) National Diabetes Center is playing in helping patients manage their disease.
Ali (35) was initially diagnosed with Type 2 diabetes by his local doctor after complaining of fatigue and increased thirst. A blood test confirmed that he was diabetic and Ali was prescribed oral hypoglycemic drugs. Oral hypoglycemic agents are the group of drugs taken to lower the blood glucose level of a person with Type 2 diabetes; the medication is rarely used to treat Type 1 diabetes.
In February, Ali was admitted to Hamad General Hospital's (HGH) Emergency Department with diabetic ketoacidosis and diagnosed with Type 1 diabetes. Diabetic ketoacidosis is a serious condition that can lead to a diabetic coma or even death. It occurs when the body cannot use glucose as a fuel source and instead uses fat for energy. As a result, chemicals called ketones build up in the blood and urine. In high levels, ketones are poisonous.
"Doctors who do not specialise in the diagnosis and treatment of diabetes are not always aware of the possibility of adult-onset Type 1 diabetes. Some adult patients who present with symptoms such as frequent urination and extreme thirst are misdiagnosed with Type 2 diabetes. This is particularly common when the patient is overweight or has a family history of diabetes," said Manal Othman, director of Diabetes Education at HMC.
While both Type 1 and Type 2 diabetes result in high blood sugar and can have many of the same symptoms and long-term consequences, the treatment strategies are different. A misdiagnosis can have serious consequences.
Upon discharge from the Emergency Department, Ali began working with a physician, dietitian and patient educator at HGH's National Diabetes Center. He was given more information about the insulin regime started in the Emergency Department and received guidance and education on an appropriate meal plan. Within six months, Ali's glycosylated haemoglobin (HbA1c) was normal.
"For both Type 1 and Type 2 diabetes, our first priority is helping the patient understand their condition and also the treatment. For patients who require insulin injections, we help them learn the proper technique and also how to store their insulin and dispose of needles. We also work with the patient's family and teach them how to inject the insulin. From there the patient is provided with guidance and support around diet and exercise and we watch to identify any health problems and challenges the patient is facing in managing their condition," said Othman.
According to Othman, diabetes treatment is individual and can vary greatly from patient to patient. She said one aspect that remains the same is the team effort with which the clinicians at the National Diabetes Center approach patient care.
"We work together to first get the patient's sugar level stable and then to support them with their day to day care. From there the focus is prevention of long-term complications. Diabetic patients who don't, or are unable to, control their blood sugar level risk chronic complications such as heart attack and stroke, blindness, kidney failure and amputation," she added.
According to Othman, the goal of the National Diabetes Center is to provide patients with the guidance and support required to manage their own health. She said that patients are the most important actor in managing their own care.
"Our role is to give patients the support and education they need to manage their diabetes. We encourage patients to quit smoking and to maintain a healthy weight. To make the lifestyle changes required to stabilise their sugar level. Our job is to be their health coach. We answer questions and provide advice about medication, diet and physical activity. It is up to the patient to make the best choices every day," said Othman.
