Posted by Tanya Shah
Last year, a 19-year-old female came to the Nyaya Health clinic with symptoms consistent with a bladder infection. However, she appeared to be unusually ill for what is normally a simple infection to treat and cure. Further testing in our laboratory revealed that she had insulin-dependent (Type I) diabetes. Partly due to the previous lack of a healthcare facility in the area, she had never before been diagnosed with this chronic and severe but treatable illness.
Upon identifying her diabetic condition, Nyaya providers educated the patient about how to manage her illness. Our pharmacy provides her with free insulin and insulin syringes to bring home to control her diabetes. Presently, she walks about two hours every two weeks to the Nyaya Health clinic for a new supply.
Our pharmacist, Tara Man Kunwar, enters information into the pharmacy database after providing the free medication.
During these visits, the Nyaya staff also checks her blood sugar levels and adjusts the insulin dosage as needed, since regular monitoring is critical for stabilizing her condition. However, this bi-weekly checkup is non-ideal because these readings cannot capture daily fluctuations that can be important for dosage adjustment. The possibility of her falling into a diabetic coma because of blood sugar levels that are too low is a very real concern for us.
To improve this situation, the Nyaya staff are working to procure a glucometer for this patient, which would allow her to monitor and record her blood sugar levels at home daily. This way, we could better monitor her condition and make sure that she is actually receiving the correct dose of insulin based on her daily recordings. She would be thoroughly trained on how to use the glucometer and the protocol for timely measurements and daily recordings. Such a device is fairly standard for diabetic patients in wealthier countries and is an essential feature of appropriate diabetic care. However, given the long travel distances here, the glucometer may be truly life-saving for our patient. As Nyaya Health expands its services and reach, we will continuously assess the most appropriate and efficient tools for chronic disease management in the community.
An uplifting sidenote to this story: In the process of learning about her condition and how to manage it, our patient has become interested in a career in health care. She is now considering training as an auxiliary nurse midwife once she completes her current schooling.