Articles on american diabetes association

Your First Year With Diabetes

Dr. Ravindranath, Diabetologist
Your first time with diabetes: Making you win the fight against diabetes!A 12-month plan for surviving diabetesThe most frightening moment for most people with diabetes is when they are first diagnosed. They are filled with questions: What can I eat? What should I do? Is there a plan for me to follow? While some people get a plan from their doctor, most people do not.Your First Year with Diabetes is the plan for everyone. It walks you step-by-step through a first-30-days survival plan, then shows a month-by-month program for what comes next. Everything from a basic explanation of diabetes, what you can eat right away, and instructions on how to check glucose, to a deeper knowledge about diabetes nutrition, avoiding complications, and better management of the disease is included in this plan.Diabetes can be overwhelming and the first 12 months can be particularly rough to go through. There are so many things to be considered, so many plans to follow, and so much of your lifestyle that needs changing. It can leave you feeling that it is an impossible feat. Your First Year With Diabetes gives you detailed advice, tips and tricks that are meant to make it possible for you to make small, attainable lifestyle changes that when added up will transform diabetes into a manageable disease.The first 28 daysThe first 28 days are broken down into daily advice and guidelines. Some of the topics you'll read about are as follows: Mind Matters - This gives you a new outlook and mental approach to the disease by re-thinking your state of mind.Diagnosis - This simplifies the many types of diabetes, the effects on your body and the types of testing available and moreEat Wisely - The importance of eating healthy to control your glucose levels is truly explained in layman's terms as well as the basic guidelines.Get Active - Yes... you've heard it before... but it is important and you'll get a new take on this.Check Glucose - Your options for glucose testing, how they work and the one most suitable for your needs. A Tough Pill To Swallow - Do you take the medication? How does it affect you? This is an excellent discussion with great information.Your Safety Net - The discussion of the importance of having people that support you. But it doesn't stop after the 28 days... it continues to give you weekly guidelines for the rest of the year. 

All You Wanted to Know About Diabetes: A Scientific Elucidation

Dr. Tanoy Bose, Internal Medicine
It is an interesting observation that during my day to day consultation with my patients I have found every third person to be suffering from Diabetes and almost every alternate patient has got somebody in their family who is suffering from Diabetes. This extremely high prevalence of Diabetes is evident only in our country.The management of Diabetes is getting eased off over last few decades due to immense research work which is being done in the discipline of Diabetes throughout the globe. In spite of so much of development, hurdles remain profound in managing Diabetes. These hurdles are ignorance and ill –information regarding Diabetes among citizens and foremost of all are the misconceptions regarding Diabetes.I can presume that whichever Physician a patient consults, he gets quite a bit of information regarding management of Diabetes and in most of the cases it is quite unlikely that there will be any difference of opinion. The problem remains in dedication of adequate time to explain each and everything about Diabetes which is hardly given by any physician nowadays. Even I take 45 mins to examine and give adequate consultation to a Diabetic patient. All the physicians want their patient to keep on doing well without any ups and downs. But even then, be due to inadequate sharing of information from the physicians part or due to negative typecasting of the doctor fraternity by the media, it is hard to find a patient to sustain his/her treatment with a single Physician. The trust never develops and that is quite unfortunate. If one does not have adequate confidence on the qualification and credibility of the doctors’ management skills then the overall treatment gets a hard beating.The motto behind authoring this Diabetes Manual is quite simple. It is to make things very clear and lucid regarding Diabetes. The size of the manual is quite large and it is being delivered with basic information regarding Diabetes. The adverse events of Diabetic Medicines have been incorporated and also I have ensured that the Targets in management of Diabetes is also well elucidated which is a very important information. Facts and facets regarding Insulin should be very clear. Most of the people are afraid of Insulin. The two most important reasons behind this fear is first of all it is in injectable form and most of us are afraid of injections and secondly a myth is imbibed among the common people that usage of insulin is a tell-tale sign of end stage of Diabetes which is actually a big negative idea. Even it took pains to break the ice while initiating insulin to my mother who is a 12 year long diabetic and that now when her blood glucose is under control, she is disbelieving the laboratory reports.Whatever, I have immense faith in the readers of this article as I hope to incorporate correct information regarding diabetes and break the myths. It is strongly recommended that you should consult your physician and Diabetologist for proper management of Diabetes and in case of any discrepancy of information provided in this composition.FEW FACTS ABOUT DIABETES:4,09,00,000 diabetics were there in India in 2007By 2025 , 80% of World’s Diabetics will be in IndiaOne person is dying due to diabetes every 10 seconds in this world.Every 10 seconds, two new cases of Diabetes are being detected.Diabetes in the most common cause of non-traumatic lower limb amputation.Almost 1 out of 2 patients will be found suffering from Diabetes related complications at the time of Diagnosis of diabetes for the first time.WHAT IS DIABETES?Diabetes is a disease in which blood glucose levels are above normal. Most of the food we eat is broken down into glucose, or sugar, which are oxidised by our tissues to produce energy. The pancreas, an organ that lies near the stomach, secretes a hormone called insulin. Insulin pumps in glucose from our blood into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin well as it should. This causes sugar to build up in your blood. Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. There is no diabetes cure developed so far.HOW BLOOD SUGAR IS NORMALLY CONTROLLED IN OUR BODY?The Blood Sugar is tightly regulated between 70 to 110mg/dL in fasting state and 100 to 140mg/dL in post meal state. At any random state Blood Sugar is maintained below 180 mg/dL. This is done by the balanced action of some hormones; some of which tend to increase blood sugar while some tend to decrease.Hormones that increase blood sugar are Glucagon, steroids, Adrenaline, Somatostatin, Thyroid hormones, Growth Hormone etc. The only hormone that reduces blood sugar is the INSULIN. Whenever there is a tendency of the blood sugar to rise above the permissible level, Insulin is secreted from the pancreas and the sugar from the blood is pushed inside the cells by insulin and the balance is achieved.WHAT IS INSULIN?Insulin is a protein hormone secreted from Pancreas. It is released from pancreas in two patterns.A constant secretion of insulin takes place throughout the day irrespective of meals which ensures that blood sugar in fasting state is under limits. This continuous Insulin secretion pattern is called the BASAL insulin.On the top of this whenever there is any intake of food, Insulin senses the transient rise in blood sugar and is secreted in a pulsatile manner with each meals to bring down the post meal rise in blood sugar. This pulsatile pattern of Insulin release is called PRANDIAL Insulin.When the doctors treat patients with insulin, they always try to match the above mentioned pattern of Insulin levels in the blood which is often difficult.WHAT ARE MY RISKS FOR DEVELOPING DIABETES?Roughly it can be extrapolated from researches on Diabetic genes that,If your mother is Diabetic: You have 19% chances to develop diabetesIf your father is Diabetic: you have 14% chances to develop diabetesIf both the parents are Diabetic: You have 25% chances to develop diabetesIf your sister or brother is Diabetic: You have 75% chances of developing diabetesIf your twin is Diabetic: You have 99% chance of developing diabetes.WHAT ARE THE SYMPTOMS AND SIGNS OF DIABETES?People who think they might have diabetes must visit a physician for diagnosis. They might have SOME or NONE of the following diabetes symptomsFrequent urinationExcessive thirstUnexplained weight lossExtreme hungerSudden vision changesTingling or numbness in hands or feetFeeling very tired much of the timeVery dry skinSores that are slow to healMore infections than usual.Nausea, vomiting, or stomach pains may accompany some of these symptoms in the abrupt onset of insulin-dependent diabetes, now called type 1 diabetes.WHAT ARE THE TYPES OF DIABETES?Type 1 diabetes, which was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, may account for about 5% of all diagnosed cases of diabetes. Type 2 diabetes, which was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, may account for about 90% to 95% of all diagnosed cases of diabetes. Gestational diabetes is a type of diabetes that only pregnant women get. If not treated, it can cause problems for mothers and babies. Gestational diabetes develops in 2% to 10% of all pregnancies but usually disappears when a pregnancy is over. Other specific types of diabetes (like diabetes insipidus) resulting from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses may account for 1% to 5% of all diagnosed cases of diabetes.WHAT ARE THE RISK FACTORS FOR DIABETES?Risk factors for type 2 diabetes includeOlder age,Obesity,Family history of diabetes,Prior history of gestational diabetes,Impaired glucose tolerance,Physical inactivity, andRace/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risk for type 2 diabetes.Any history of Polycystic Ovarian Disease in females (PCOD)History of stress Risk factors are less well defined for type 1 diabetes than for type 2 diabetes, but autoimmune, genetic, and environmental factors are involved in development of this type of diabetes.Gestational diabetes occurs more frequently in African Americans, Hispanic/Latino Americans, American Indians, and people with a family history of diabetes than in other groups. Obesity is one of the associated causes of diabetes with higher risk . Women who have had gestational diabetes have a 35% to 60% chance of developing diabetes in the next 10–20 years. Other specific types of diabetes, which may account for 1% to 5% of all diagnosed cases, result from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses.WHAT ARE THE COMPLICATIONS OF DIABETES?Most of the complications of Diabetes are chronic. High blood Glucose tends to damage numerous enzymes and proteins of our body necessary for important functions and hence many organs are ultimately damaged. We called this as TARGET ORGAN DAMAGE (TOD).The important target organs are Kidneys (Both), Eyes, Heart, Brain, Nerves and Arteries.Here are a few terrifying facts regarding Diabetes related complications.Diabetes is the commonest cause of non-traumatic lower limb amputation.A diabetic may suffer heart attack without any pain (Silent Myocardial Infarction).Diabetics suffer heart attack 10 years younger than their peers.Diabetes aggravates the process of deposition of fats and lipids in arterial walls causing accelerated atherosclerosis resulting in arterial blockade. This sudden arterial blockade may occur in brain circulation causing stroke, in Heart Circulation causing heart Attack or in Peripheral arterial system causing gangrene.Diabetes affects long and thin nerves of the legs there by causing tingling and results in numb limbs.Diabetes slowly damages both the kidneys resulting in dependence on Haemodialysis and Renal Transplant.Diabetes is one of the leading causes of blindness either due to premature cataract or retinopathy.Most importantly, these complications remain completely asymptomatic in early stage and manifest only at a later stage when options of treatment are limited.Any infection, ulcer, bacterial infestation, wounds do not heal easily in diabetics not only due to excessive bacterial multiplication but also due to poor quality of tissue which had already been damaged by uncontrolled blood sugar.HOW DO I KNOW IF I HAVE ALREADY DEVELOPED ANY COMPLICATION DUE TO DIABETES?Usually complications do not alarm you when they start developing. They manifest only when they have already caused considerable irreversible damage.a. If your eyes are involved:   i. Dimness of vision   ii. Frequent eye infections   iii. Frequent change of spectacles   iv. Coloured hallows around lightb. If your nerves are involved:   i. Tingling or numbness of soles of feet   ii. Instability or sense of imbalance while walking   iii. Sense of walking over a cotton surface   iv. Pain and burning sensation of legs   v. Weakness while getting up from seating position or breaking stairs.   vi. Slippage of slippers from feet   vii. Development of painless ulcer over any part of foot especially pressure points.c. If your Kidneys are involved:   i. Unintentional weight gain   ii. Swelling of both lower legs especially early morning   iii. Decrease in urine output   iv. Swelling of face and often whole body   v. Loss of appetite and distaste to foodd. If your heart is involved:   i. Shortness of breath   ii. Breathlessness while exertion   iii. Chest pain   iv. Palpitation   v. Sudden shortness of breath at mid of night (paroxysmal nocturnal dyspnoea)   vi. Progressive swelling of feete. If your brain is involved:   i. Sudden black out   ii. Sudden loss of sensorium or syncope   iii. Sudden onset weakness of any part of the body or slurring of speechf. If your arteries are involved:   i. Pain while walking but relieved on rest   ii. Development of leg ulcers   iii. Pain while elevating the legs above bed   iv. Change of colour of the legs.It is worth mentioning that if these complications are identified early in their course, they can be well managed and the progress can be arrested, delayed and even in some cases reversed. So it is important to get a diabetes test if you notice any of the symptoms.To summarise, I would like to convey a very simple message to everybody who is suffering or living with a person of Diabetes that one should be alert, well educated and oriented and never ever disregard the importance of maintenance of optimum control of diabetes. Remember, if diabetes goes out of control, one will never feel any change in their day to day lifestyle but one should be very careful about the payback of the poor control even before the old age sets in. And that is going to hit very hard inside one's mind, pocket and health.Note: Another article on Treatment of Diabetes with detail of drugs used is in pipeline.

How to Manage Type 2 Diabetes

Ms. Swati Kapoor, Dietitian/Nutritionist
Type 2 diabetes is caused due to resistance developed by our body cells towards insulin produced by the body. This leads to a rise in blood glucose level as the cells natural tendency to absorb insulin as much reduces, preventing the body from using glucose effectively, resulting in excess sugar levels in the body. Type 1 diabetes is genetic but Type 2 diabetes is a lifestyle disease most commonly caused by obesity. The good news is that because Type 2 diabetes is not genetic and can be controlled, managed and sometimes even be reversed completely.Recent study on diabetes suggests that you could reverse your diabetes to normal. That means you could balance you blood sugar levels in the body. The study by Newcastle Magnetic Resonance Centre at Newcastle University in England says that eating less calories about 600 per day for three months could reverse the diabetes. In the study, 11 people with type 2 diabetes for four years were put on a 600 calorie diet with leafy green vegetables and liquid diet which reversed the diabetes of 7 people.We believe that you dont have to go on such a strict low calorie diet that can damage your daily nutrition intake. Read here to understand what is a  balanced diet and how it is essential for our healthy well being. Diabetes Type 2 can be controlled and managed through healthy diet and exercise without reducing the calorie intake to such low levels. A person diagnosed with Type 2 diabetes needs a special diet chart that ensures that mostly food with low glycemic index should be included. Here is a list of foods that you must include and also avoid.5 High GI Foods                                              5  Low GI FoodsPotatoes                                                            Green VegetablesRice                                                                    LentilsSweets                                                               Fruits (Citrus)Packaged Juice                                                    OatsPasta                                                                   Brown Rice

All About Diabetes

Dr. Amitabh Khanna, Diabetologist
Diabetes mellitus, commonly referred to as diabetes, is a medical condition associated with abnormally high levels of glucose (or sugar) in the blood (hyperglycemia).Glucose is a type of sugar found in certain foods such as honey and some, but not all, fruits. It is also the form of sugar that all sugary and starchy foods are converted to in the body after digestion. Glucose is used by the body to make energy.Normally, blood glucose levels are tightly controlled by insulin, a chemical signaling substance (hormone) that is produced by a gland near your stomach called the pancreas. Insulin lowers the blood glucose level because it stimulates the body to make use of glucose.When the amount of glucose in the blood increases, for example, after eating food, insulin is released from the pancreas to normalize the glucose level. However, in patients with diabetes mellitus, the elevated glucose levels cannot be normalized. This causes abnormally high levels of blood glucose, which ultimately leads to the presence of glucose in the urine (glucosuria).What are the causes of Diabetes?The various types of diabetes are different disorders with different causes:Type 1 Diabetes: This type of diabetes is an autoimmune disease. Your immune system turns on itself and destroys the insulin-producing cells in your pancreas. Although type 1 diabetes usually develops in childhood or teen years, it can appear later.Type 2 Diabetes: In this type, your pancreas makes some insulin, but not enough. Your cells also can become resistant to insulin's effects, keeping insulin from escorting enough glucose into your body's cells. Type 2 diabetes generally develops after age 40. However, doctors are seeing a rise in childhood type 2 diabetes that parallels the rise in obesity among youth. A form of type 2 diabetes, gestational diabetes, develops during 2 percent to 5 percent of pregnancies. In gestational diabetes, your body doesn't effectively use the insulin you produce. The cause may be metabolic changes that occur due to the effects of hormones in pregnancy. Gestational diabetes usually disappears after pregnancy, but more than half of women who experience it eventually develop permanent type 2 diabetes.How do you get Diabetes?There are two main types of diabetes mellitus. These are known as type 1 and type 2.Type 1 diabetes mellitus used to be called insulin-dependent diabetes mellitus, or juvenile-onset diabetes mellitus, because it usually begins in childhood or adolescence. In type 1 diabetes mellitus, the pancreas releases no insulin at all because the body has destroyed the cells that produce it (islet cells). The patient therefore relies on treatment with insulin.Type 2 diabetes mellitus is the most common form of diabetes. It used to be called non-insulin dependent diabetes mellitus, or adult onset diabetes because it usually begins in adulthood. In type 2 diabetes, patients can still produce insulin, but they do not produce enough and/or their bodies cannot use it properly.Another form of diabetes, known as gestational diabetes, occurs in some women during pregnancy. It is a temporary condition caused by pregnancy and usually occurs in the later stages, once the baby has formed but is still growing.How serious is Diabetes?The early symptoms of untreated diabetes mellitus are related to the elevated blood glucose levels. Excess glucose in the blood ultimately results in high levels of glucose being present in the urine (glucosuria). This increases the urine output, which leads to dehydration and increased thirst. Other symptoms include extreme tiredness, weight loss, blurred vision, itchy skin and repeated minor infections such as thrush and boils.People with type 1 diabetes must be treated with insulin in order to stay alive. If uncontrolled for many years, diabetes mellitus can lead to more serious health problems:Blood vessel damage within the eye (retinopathy). This can lead to blindness.Kidney disease (nephropathy) or kidney failure.Nerve damage (neuropathy) especially of the hands and feet, causing tingling, numbness and weakness.Narrowing of the blood vessels due to fatty deposits (atherosclerosis). This increases the risk of heart attack, stroke and poor blood flow in the legs.Uncontrolled gestational diabetes can result in a large baby and a difficult birth. It can also increase the risk of developing type 2 diabetes later in life.What are the symptoms of Diabetes?The symptoms are due to persistent high levels of sugar in the circulating blood. These symptoms are :Frequent urination - When blood sugar is too high, your kidneys can't absorb the excess glucose. The glucose leaks into urine, pulling water with it.Extreme thirst - The process of dehydration makes you thirsty.Blurry vision - High blood sugar may cause new blood vessels to form and may damage old blood vessels on the retina at the back of your eye.Weight loss - To make up for the lost fuel, your body burns fat reserves, and you may lose weight.Fatigue - When your cells don't get enough glucose, their primary fuel source, fatigue results.Hunger - Burning of fat reserves also may make you hungryTreatment for DiabetesAs symptoms of diabetes tend to show up much later than the condition occurs in your body, it is advisable to have your blood sugar levels diagnosed periodically.Type 1 diabetes can be treated with exercise, insulin and a balanced diet.Type 2 diabetes is first treated with weight reduction, a          diabetic diet and exercise. Weight reduction and exercising increases the body’s sensitivity to insulin, thus controlling blood sugar elevations.When these methods fail to lower the blood sugar levels, oral medications are used. If oral diabetes medications are insufficient and do not help lower the glucose levels in blood, insulin treatment is used.Diabetes ExerciseExercising regularly can help regulate the blood sugar levels and lose weight. A heavy workout is not necessary and a walk or a moderate workout of 30 minutes would do. People who are under oral medications and insulin therapy must check their blood glucose levels before and after exercising. While doing heavy workouts, check the sugar level every 15 minutes. Also, if the sugar level becomes low during the exercise session, take a light snack to compensate for it. Use fruits or salads instead of snacks.Diabetes DietDiet plays a vital role in controlling diabetes. Avoid junk food as it contains lots of fat building materials and the sugar content in such foods will always be high. Always maintain a balanced diabetes diet, increasing the intake of low-glycemic foods. Such foods include fruits such as apples, oranges and pears; grains like oatmeal, barley, peanuts and granola; and vegetables such as broccoli, asparagus, green leafy vegetables, beans and peas.A balanced diet low in fat, carbohydrates and cholesterol is ideal for diabetes. High-glycemic foods like potatoes, pasta and white bread which are rich in carbohydrates, must be avoided, as they easily enter the bloodstream and get converted to glucose very fast. For the required carbohydrates intake, diabetic patients can depend on foods like chicken, turkey and sea foods which are low in starch. Salads are a good way to get the required vitamins. Try eating 4-5 small meals a day than three large meals and drink at least 8 glasses of water a day to flush out those harmful toxins from your body and to keep your body healthy..

All About Diabetes

Ms. Harpreet Pasricha, Dietitian/Nutritionist
(Management through Diet, Super foods and Facts)Diabetes is a common life-long health condition and it is a group of metabolic diseases in which the person has high blood glucose, either because insulin production is inadequate, or because the body's cells do not respond properly to insulin, or both. Diabetes are classified into three groups i.e.-Type I Diabetes- The body does not produce insulin. People usually develop type 1 diabetes often in early adulthood or teenage years.Type II Diabetes- is the most common form of diabetes. The body does not produce enough insulin for proper function, or the cells in the body do not react to insulin.Gestational Diabetes-This type affects females during pregnancy. Some women have very high levels of glucose in their blood, and their bodies are unable to produce enough insulin to transport all of the glucose into their cells, resulting in progressively rising levels of glucose.It is possible to lead a normal and healthy life by following certain prudent diabetes diet tips, in addition to exercise and prescribed medicines. Here are tips for a diabetes diet that will prove helpful in controlling    blood sugar levels:Make wise food choices: The best tip for a diabetes diet focuses on choosing healthy food options instead of foods full of fats, carbohydrates, starch, sugar, and so on. For example, eat wheat pasta, brown rice and wheat bread instead of eating white rice, multigrain bread and so on.Limit concentrated sweets: Substituting sugary foods with other healthy alternatives such as fruit instead of ice-cream, fruit juices, desserts and so on.Limit consumption of alcohol: Alcoholic drinks have no nutritional value, but contain a lot of empty calories which directly leads to weight gain and other complications.Choose foods with healthful fats: Instead of butter or vegetable oil use olive oil and nuts (almonds, walnuts) which are helpful in lowering chances of heart attack, stroke, and diabetes. Avoid fried foods, eat baked or grilled food.Exercise makes everything better: Exercise reduces the severity of the disease and significantly reduces the risk of long-term complications. Encourage regular exercise for 20-30 minute 3-4 times each week. This can include walking, jogging, swimming, playing sports such as tennis, volleyball, and basketball.Small changes equal big results: you can make a big difference with healthy lifestyle changes. The most important thing you can do for your health is to lose weight. We as qualified Nutritionist suggest you that losing weight can help you lower your blood sugar considerably, as well as lower your blood pressure and cholesterol levels. It’s not too late to make a positive change, even if you’ve already developed diabetes.Take Care of Your Diabetes Every Day: No matter what type of diabetes medication you use, this will give you excellent tips on taking care of your diabetes every day. We qualified Nutritionists say, most people with diabetes should try to maintain their weight by having a proper diet in a combination and also keep their blood sugar level as close as possible to the level of someone who does not have diabetes by keeping a check on the glucometer on regular basis.Management of Diabetes through Super Foods:Here are 10 super foods that will help minimize blood sugar and even throw your disease into reverse.Vegetables: Packed with powerhouse nutrients, vegetables are naturally low in calories, and they're full of fiber, so they're plenty filling. Fruit: Best of all, fruit is loaded with antioxidants that help protect your nerves, your eyes, your heart, and Diabetes. Beans: Beans are just about your best source of dietary fiber, which not only makes you feel full longer, it actually slows digestion and keeps blood sugar from spiking after a meal. This effect is so powerful that it can even lower your overall blood sugar levels.Cereal: The best food for a diabetes diet focuses on choosing healthy food options instead of foods full of fats, carbohydrates, starch, sugar, and so on. For example, eat wheat pasta, brown rice, and wheat bread instead of eating white rice, multigrain bread and so on.Nuts: Nuts are also one of the best food sources of vitamin E, an antioxidant that protects cells and may help prevent nerve and eye damage. They are rich in fiber and magnesium, both of which may help regulate your blood sugar.Olive oil: Instead of butter or vegetable oil use olive oil and  nuts (almonds, walnuts)  which are helpful in lowering chances of heart attack, stroke and  diabetes. Avoid fried foods; eat baked or grilled food.Cinnamon. Cinnamon is good for lowering your blood sugar. Components in cinnamon help the body use insulin more efficiently, so more glucose can enter cells. So go ahead and add powdered cinnamon to your whole wheat flour, oatmeal, baked apples, or even chicken dishes.Some of the Facts and MythsMyth: People with diabetes should eat special diabetic foods.Fact: A healthy meal plan for people with diabetes is generally the same as a healthy diet for anyone – low in fat, moderate in salt and sugar, with meals based on whole grain foods Such as Brown Rice, Wheat bread and wheat pasta, vegetables and fruit.Myth: Diabetes is not that serious of a disease.Fact: If you manage your diabetes properly by keeping a regular check-up of your blood glucose level, proper exercise and eat healthy and functional food, you can prevent or delay diabetes complications.Myth: Eating too much sugar causes diabetes.Fact: Type 1 diabetes is caused by improper insulin-production by cells of the pancreas, which is unrelated to sugar consumption. Type 2 diabetes results from the body's inability to respond to insulin normally. Although the tendency to get type 2 diabetes is genetically inherited in most cases, eating too much sugar (or foods with sugar, like candy or regular soda) can cause weight gain, which can increase the risk of developing the disease.Myth: Insulin cures diabetes.Fact: Taking insulin helps manage diabetes, but doesn't cure it. Insulin helps get glucose out of the bloodstream and into the cells, where it can be used for energy. This helps keep blood sugar levels under control, but taking insulin doesn't correct the underlying cause infact healthy diet in proper combination can work.A well-qualified Nutritionist can guide you in a better way and clear all misconception related to diabetes so that you could climb the ladder of success.Here in our diet clinic, we give a tailor made diet which is a proper combination of nutrients and we provide functional foods that will help naturally in curing diabetes from the roots.It's not about your diabetes — it’s about your life

How Diabetes Affects Your Oral and Dental Health

Dr. Prashant Ojha
Diabetes is term used to describe a group of metabolic disorders, distinguised by altered glucose tolerance and impaired carbohydrate metabolism.Oral and dental manifestation of diabetesEnlarge gingiva- The affected tissue may be inflamed, in which case the gums are red, soft, shiny and bleed easily. Gingivitis may be localised or generalised, and can be caused by systemic diseases especially diabetes.Mutiple periodontal abcess- Classic description of undiagnosed /poorly controlled diabetes patients is mutiple periodontal abcess, leading to rapid destruction of periodontal support. Case reports on life-threatening deep neck infection from a periodontal abscess and fatal palatal ulcers exemplify the severity of these conditions.Altered  taste sensation- Patients have a blunted taste response, which displays a degree of specificity to glucose, is partially reversed after correction of hyperglycemia, and is independent of somatic or autonomic nerve function. This taste abnormality may influence the premorbid choice of nutrients, with a preference for sweet-tasting foods, thereby exacerbating hyperglycemia.Alteration in microflora of oral cavity- Patients with diabetes are more susceptible to developing oral bacterial infections. They are well known to have an impaired defense mechanism hence considered to be immuno-compromised. Diabetics with diabetic complications and poor metabolic control are more prone to spreading and recurrent bacterial infectionIncreases dental caries- Few studies have reported on the incidence of root-surface caries as a significant problem in older patients with diabetes.It is well known that patients with diabetes are susceptible to oral infections that lead to tooth decay and loss.Salivary secretion dysfunction, periodontal and sensory disorders could increase the likelihood of developing new and recurrent dental caries and tooth lossDecreases salivary flowBurning mouth and tongue- Oral dysesthesia or burning mouth syndrome (BMS) is a painful condition affecting the oral cavity (palate, tongue, throat and gingivae). Other abnormal oral sensations may coexist with the burning mouth sensation such as tingling, numbness, dryness or sore mouth at the same time8.Increases chance of dry socket after dental extraction.Lichen planus- There are also indications that patients with elevated salivary glucose levels carry candida intraorally more often than those with lower glucose levels. The implication being that diabetes may be related to the pathogenesis of lichen planus. The evi-dence for an immunological defect  and deficient leukocyte functions superimposed on the metabolic abnormality of diabetes seems increasingly convincing.Impaired wound healing- Poor soft tissue regeneration and delayed osseous healing in patients with diabetes are known complications during oral surgery. Therefore, the management and treatment of patients with diabetes undergoing oral surgery is more complex. It was reported that delayed vascularisation, reduced blood flow, a decline in innate immunity, decreased growth factor production, and psychological stress may be involved in the protracted wound healing of the oral cavity mucosa in patients with diabetes.Median rhomboid glossites.Destructive periodontal diseases- Periodontal disease is the most prevalent oral complication in diabetes patients and has be enlabeled the "sixth complication of diabetes mellitus". Oral candidosis- is an opportunistic infection frequently caused by Candida albicans species. Many predisposing factors can lead to this infection; these include smoking, xerostomia and endocrine and metabolic diseases.There are several clinical implications. These include:A lack of awareness of oral complications among both diabetics and health providers. An understanding of the way diabetes affects oral health is necessary for both clinicians and patients, therefore research in this field should be encouraged.The need for regular follow-up of patients with diabetes mellitus by both dentist and physicians. The major role that dentists should play in recognising the signs and symptoms of diabetes and their oral complications.Advice and counselling for diabetic smokers regarding smoking cessation. Vigorous treatment of oral infection either bacterial or fungal in these patients, especially if they have poor glycaemic control.

Diabetes and Oral Health

Dr. Pankaj Rao, Dentist
How Does Diabetes Affect the Mouth?People who have diabetes know the disease can harm the eyes, nerves, kidneys, heart and other important systems in the body. Did you know diabetes can also cause problems in your mouth?People with diabetes are at special risk for periodontal (gum) disease, an infection of the gum and bone that hold the teeth in place. Periodontal disease can lead to painful chewing difficulties and even tooth loss. Dry mouth, often a symptom of undetected diabetes, can cause soreness, ulcers, infections, and tooth decay. Smoking makes these problems worse.What can I do?Good blood glucose control is key to controlling and preventing mouth problems. People with poor blood glucose control get gum disease more often and more severely than people whose diabetes is well controlled. Daily brushing and flossing, regular dental check-ups and good blood glucose control are the best defense against the oral complications of diabetes.What happens if I have plaque?Plaque that is not removed hardens over time into tartar and collects above your gum line. Tartar makes it more difficult to brush and clean between your teeth. Your gums become red and swollen, and bleed easily—signs of unhealthy or inflamed gums, called gingivitis.When gingivitis is not treated, it can advance to gum disease called periodontitis. In periodontitis, the gums pull away from the teeth and form spaces, called pockets, which slowly become infected. This infection can last a long time. Your body fights the bacteria as the plaque spreads and grows below the gum line. Both the bacteria and your body’s response to this infection start to break down the bone and the tissue that hold the teeth in place. If periodontitis is not treated, the gums, bones, and tissue that support the teeth are destroyed. Teeth may become loose and might need to be removed. If you have periodontitis, your dentist may send you to a periodontist, an expert in treating gum disease.How will I know if I have mouth problems from diabetes?Check your mouth for signs of problems from diabetes. If you notice any problems, see your dentist right away. Some of the first signs of gum disease are swollen, tender, or bleeding gums. Sometimes you won’t have any signs of gum disease. You may not know you have it until you have serious damage. Your best defense is to see your dentist twice a year for a cleaning and checkup.How can I prepare for a visit to my dentist?Plan ahead. Talk with your doctor and dentist before the visit about the best way to take care of your blood glucose during dental work.You may be taking a diabetes medicine that can cause low blood glucose, also called hypoglycemia. If you take insulin or other diabetes medicines, take them and eat as usual before visiting the dentist. You may need to bring your diabetes medicines and your snacks or meal with you to the dentist’s office.You may need to postpone any nonemergency dental work if your blood glucose is not under control.If you feel nervous about visiting the dentist, tell your dentist and the staff about your feelings. Your dentist can adapt the treatment to your needs. Don’t let your nerves stop you from having regular checkups. Waiting too long to take care of your mouth may make things worse.How does smoking affect my mouth?Smoking makes problems with your mouth worse. Smoking raises your chances of getting gum disease, oral and throat cancers, and oral fungal infections. Smoking also discolors your teeth and makes your breath smell bad.Smoking and diabetes are a dangerous mix. Smoking raises your risk for many diabetes problems. If you quit smoking,you will lower your risk for heart attack, stroke, nerve disease, kidney disease, and amputationyour cholesterol and blood pressure levels might improveyour blood circulation will improveIf you smoke, stop smoking. How can I keep my mouth healthy?You can keep your mouth healthy by taking these steps:Keep your blood glucose numbers as close to your target as possible. Your doctor will help you set your target blood glucose numbers and teach you what to do if your numbers are too high or too low.Eat healthy meals and follow the meal plan that you and your doctor or dietitian have worked out.Brush your teeth at least twice a day with fluoride toothpaste. Fluoride protects against tooth decay.Aim for brushing first thing in the morning, before going to bed, and after each meal and sugary or starchy snack.Use a soft toothbrush.Gently brush your teeth with the toothbrush angled towards the gum line.Use small, circular motions.Brush the front, back, and top of each tooth. Brush your tongue, too.Change your toothbrush every 3 months or sooner if the toothbrush looks worn or the bristles spread out. A new toothbrush removes more plaque.Drink water that contains added fluoride or ask your dentist about using a fluoride mouth rinse to prevent tooth decay.Ask your dentist about using an anti-plaque or anti-gingivitis mouth rinse to control plaque or prevent gum disease.Use dental floss to clean between your teeth at least once a day. Flossing helps prevent plaque from building up on your teeth. When flossing,slide the floss up and down and then curve it around the base of each tooth under the gumsuse clean sections of floss as you move from tooth to toothAnother way of removing plaque between teeth is to use a dental pick or brush—thin tools designed to clean between the teeth. You can buy these picks at drug stores or grocery stores.If you wear dentures, keep them clean and take them out at night. Have them adjusted if they become loose or uncomfortable.Call your dentist right away if you have any symptoms of mouth problems.See your dentist twice a year for a cleaning and checkup. Your dentist may suggest more visits if you need them. Follow your dentist’s advice.If your dentist tells you about a problem, take care of it right away.Follow any steps or treatments from your dentist to keep your mouth healthy.Tell your dentist that you have diabetes.Tell your dentist about any changes in your health or medicines.Share the results of some of your diabetes blood tests, such as the A1C test or the fasting blood glucose test.Ask if you need antibiotics before and after dental treatment if your diabetes is uncontrolled.If you smoke, stop smoking.Diabetes causes its own problemsPlaque is the “bad guy” of gum disease. But things are not helped by your diabetes. This is because:Diabetes can weaken your mouth's germ fighting powers.High blood glucose levels can make gum disease worse.Diabetes may cause damage to the blood vessels supplying your gums.If you have an infection from gum disease this can make your diabetes harder to control (usually causing your blood glucose levels to go up).Warning signs of gum diseaseBecause gum disease is often painless, you may not know you have a problem until you have some serious damage. Regular check-ups at your dentist are your best weapon, but you can also help prevent it from happening by looking out for the early warning signs of gum disease. These are:Bleeding gums when you brush or floss. Bleeding from your gums is not normal. Even if your gums don't hurt, get them checkedRed, swollen, or tender gumsGums that have pulled away from your teeth. Part of the tooth's root may show, or your teeth may look longerPus between your teeth and gums (when you press on the gums)Bad breathAdult teeth that are loose or moving away from each otherChanges in the way your teeth fit when you biteChanges in the fit of partial dentures or bridgesIf you have any of the above, visit your dentist as soon as possible.Brush and flossThe three main steps to fight gum disease are brushing, flossing, and seeing your dentist regularly. Brush twice a day and floss at least once a day. Ask your dentist to show you the correct way to brush and floss. Here are some tips.BrushingA toothbrush can only clean one or two teeth at a time. Allow about 3 minutes of brushing to clean all your teeth well.Use a brush with soft bristles and rounded ends. Soft bristles are less likely to hurt your gums.Angle the brush to the gum line, where teeth and gums meet.Move the brush back and forth with short strokes. Use a gentle, scrubbing motion.Brush the outside surfaces of the teeth. Do the same for the backs of teeth and chewing surfaces.Lightly brush the rough surface of your tongue to remove germs and freshen your breath.Brush your gums too.Get a new toothbrush when the bristles are worn or bent (about every 3 to 4 months).FlossingFew people really enjoy flossing. But if you don't floss, you're only doing half the job of cleaning your teeth and gums. Flossing cleans away plaque and bits of food from between your teeth and below the gum line. It gets places your brush can't reach. Floss once a day.Break off about 18 inches of floss and wind most of it around one of your middle fingers. Wind the rest around the same finger of the other hand.Hold the floss tightly between your thumbs and index fingers. Leave about an inch of floss between them.Use a gentle sawing motion to get the floss between your teeth. Never snap the floss into the gums (this can cut your gums).When you get the floss to the gum line, curve it into a C-shape against one tooth. Scrape up and down on the sides of each tooth to remove plaque.As floss gets worn and dirty, move to a clean section and continue. Don't forget the backsides of your rear teeth.When you're finished brushing and flossing, rinse your mouth with water.If you have arthritis in your hands, trouble moving your fingers, or bridgework in your mouth, a floss holder might help. Ask your dentist about ways to make flossing easier for you.Oral InfectionsAn oral infection is a cluster of germs causing problems in one area of your mouth. Here are some warning signs.Swelling or pus around your teeth or gums or any place in your mouth. Swelling can be large, or as small as a pimple.Pain in the mouth or sinus area that doesn't go away.White or red patches on your gums, tongue, cheeks or the roof of your mouth.Pain when chewing.Teeth that hurt when you eat something cold, hot or sweet, or when you chew.Dark spots or holes in your teeth.Infections can make your blood sugar hard to control. By planning ahead and discussing a plan of action with your dentist and doctor, you will be prepared to handle needed adjustments.Fungal InfectionsHaving diabetes means you are more prone to fungal infections such as thrush. If you tend to have high blood sugar levels or take antibiotics often, you are even more likely to have this problem. Thrush makes white (or sometimes red) patches in areas of your mouth. These can get sore or turn into ulcers.Thrush likes moist spots that may be chafed or sore, for example, under poorly fitting dentures. Smoking and wearing dentures all day and night can increase the risk of thrush. Quitting smoking and limiting the time dentures are worn can reduce the risk of getting thrush. If you think you have a fungal infection, talk to your dentist or doctor.Poor HealingIf your diabetes is poorly controlled, you heal more slowly and you increase your chance of infection after dental surgery. To give yourself the best shot at healing well, keep your blood sugar under control before, during, and after surgery.References - https://www.niddk.nih.gov/health-information/diabetes/preventing-diabetes-problems/keep-mouth-healthy2) http://www.diabetes.org/living-with-diabetes/treatment-and-care/oral-health-and-hygiene/more-on-the-mouth.html?referrer=https://www.google.com.sa/

Do You Really Have Diabetes?

Mr. Mahesh Krishnamurthy, Ayurveda
Diabetes is on the lips of every person above the age of 25. It is a situation that everyone wants to avoid but without having to cut off from their habits. Its a situation of indulging in your habits and vices without being watched and praying that all be well.Before we embark on a journey of “Let’s fight diabetes” as hospitals and laboratories advertise, can we spend sometime to understand how our body functions?Our body has a digestive system. It comprises of the stomach, liver, kidneys, pancreas, spleen and the small and large intestines. The human body is designed, like every other animal’s body, to function in harmony. Note this statement down… “The human body is designed to function in harmony”. Stress causes variations in the body, and the body still tries to maintain a balance despite all odds.The body, changes its functioning to accommodate itself to the new you who is living in stress, the altered process. These changes are reflected in the blood as sugar variations and in some cases, urine sugars also are indicated.There are certain symptoms which are considered indicators of diabetes;1. Frequent urination2. Excessive thirst3. Increased hunger4. Weight loss5. FatigueWell, here are some facts you will like to know;1. Frequently Urination - May also happen when your bladder does not collapse completely. It may not be an error proof diagnosis in detecting diabetes. What is error proof though is the fact that if you were a diabetic, passing sugars through your urine, your urine will attract ants.
2. Excessive thirst - Can be caused by bent up anger. When you feel angry and want to bad mouth someone but stop in the nick of time, your fiery words are retained in the mouth, this causes your salivary glands to swell and it stops secreting saliva. Feel your chin. If it feels hard, chances are that you’re holding onto anger. Poke your right hand fingers into your chin and feel the saliva squirt and lo… your dry mouth symptom is gone.
 Practice this once or twice daily and within a few days, your dry mouth symptom may be gone.3. Increased hunger - The precursor to diabetes is a fatty liver. A fatty liver is a low metaboliser. This means, the food to energy conversion rate is poor, and you feel fatigued after eating. The common mistake and also a habit is that we eat when we are tired. This is wrong. Instead, recline or lie down until your body feels comfortably rested, fresh, hungry and and ready to digest its next meal.
4. A sudden loss of weight indicates that your liver is unable to process the foods you are giving your body. It instead converts the body’s fat deposits into glucose and tries to fill the body’s energy requirement. This consumption of fat causes loss of weight. It’s not an alarming condition if detected early and appropriate steps taken. Moderation in diet, both in quantity and quality and eating when hungry can bring encouraging changes in the body. You can prevent diabetes.
5. Fatigue - Usually occurs when we eat untimely meals and also overeat. There are two reasons for us to feel fatigue;  a. Anger - causes excess bile secretions from the gall bladder, excess enzyme secretions in the liver, excess insulin secretion from the pancreas, stronger acid secretions in the stomach and intestines. This causes fatigue in the body.  b. A sense of low self worth - can cause you to gobble up food and create a fat pad around yourself which is a way of nurturing and caring for yourself. Though this is not the best way, it serves you and you continue to indulge until you’re diagnosed with a disorder.
Your body is a very intelligent and self healing one. Provide the conditions to it and it will bounce back in the fastest and best way.Get your checks done thoroughly. Question your doctor and clarify yourself in every way without leaving anything to doubt. Avoid starting off your medicines. Try natural methods of moderating your diet, lifestyle and bring more happiness and cheer into your life. Engage your mind healthy and exercise your body regularly. You’ll surely see encouraging results.— Mahesh Krishnamurthy

Diabetes – Food Misconceptions & a Way to Improve Your Nutrition

Dr. Anupama Yadav Iyer, Dietitian/Nutritionist
Nutrition Education plays a very important role for Diabetics because it is a lifelong disorder. Diabetes can be prevented / controlled by eating right with healthy lifestyle changes!In order to enable a Diabetic to lead a healthy and good quality lifestyle, free from complications, adequate information about diet & knowledge about insulin and drugs are very important.As a Doctor and a Dietitian, I counsel a lot of diabetic patients who come to me for dietary advice.I believe that Diabetics can enjoy their meals, the key is to balance their diet.A common factor among diabetics is their misconceptions linked with their food habits. Certain queries are very common for diabetic patients, like-Can you eat rice if you are Diabetic?Freshly cooked rice has higher Glycemic Index (GI), which means that it raises the blood sugar level quickly. But rice, when cooled, develops resistant starch, meaning it does not get digested quickly.Hence, cooled rice can definitely be eaten in moderation by diabetics.Will eating Fruit increase my Sugar?Fruits and vegetables are regulatory foods, meaning they are rich in vitamins, minerals, and anti-oxidants. Except for some high GI fruits (which also can be consumed in moderation), fruits should be consumed daily by diabetics to combat nutritional deficiencies.Should I be avoiding Desserts?Diabetics  can enjoy desserts occasionally if they combine it with a balanced diet and regular exercise.Can I eat whatever I want, and then compensate it by medicine?Carbohydrate foods are broken down into glucose. Even when you are on medications, over-eating just simple carbohydrates can cause the rise of blood glucose levels over the recommended target. You need to control what you eat. You need to regularly follow the diet plan. You cannot use medicine to compensate for over-eating. The key is a balanced diet.Will it help if I eat food high on protein?Too much protein from an animal source may actually cause insulin resistance, a key factor in Diabetics. The excess protein is converted into fat and it affects the renal functions. So it is important to follow the recommended daily allowances of protein, even from the plant sources.Should I avoid milk and milk products, as they are high in fat?For vegetarians, milk and milk products are excellent sources of calcium and protein. Hence low-fat milk and milk products or cow milk without cream should definitely be included in your diet.Should I avoid nuts as I am overweight, as it can lead to weight gain?Nuts like almonds and walnuts are excellent sources of omega 3 fatty acids, which fights inflammation and supports the brain the heart health. Hence these nuts, in moderation, should definitely be a part of your diet.If I feast on one day, and to keep sugar in check, can I fast the next day?A regular eating pattern helps to regularize blood sugar levels. Try to eat roughly the same amount of calories every day. So, fasting and feasting is to be avoided.">All diabetics need to follow the following rules in order to improve their quality of living.For overweight diabetics, the most important lifestyle change required is to lose weight. Losing just 5% to 10% of body weight can help lower blood sugar considerably.Weight loss is achieved by making healthy eating choices and exercising regularly.A diabetes diet is a healthy eating plan that is high in nutrients, low in fat & moderate in calories. It is balanced in terms of carbohydrates, proteins, fats, minerals & vitamins.Carbohydrates have a big impact on the blood-sugar level, hence the type of carbohydrate selected is crucial to keep the sugar levels even. Focus on high-fiber options like whole grains, fruits, vegetables, oats, etc.To recall, the Glycemic Index (GI) tells us how quickly the food raises the blood sugar in our system. High GI foods are low in fiber and protein. Some high GI foods are white rice, white pasta, white bread, sweets, chips and many other processed foods & sugary drinks.Studies show that eating too much animal protein may actually cause insulin resistance, which is a key factor in Diabetes. Plant-based proteins are the best bets. Low-fat milk & milk products, sprouts, lentils, beans, pulses & nuts should be included according to the daily recommended allowances.The best fats are unsaturated fats, which come from plant & fish sources, and are liquid at room temperature.Fruits and vegetables are regulatory foods with nutrients and vitamins. Except for some high GI fruit (banana, mango, etc), fruit should be consumed daily by diabetics to combat the nutritional deficiencies.Diabetics should-start their day with a good breakfast. eat regular small meals.adjust the number of carbohydrates in their meals based on the type of insulin prescribed, taking the help of a dietician.not exercise on an empty stomach, or when the sugar levels are very high.Cooking methods are also very important in order to preserve the nutrients in food.Diabetics can definitely enjoy their meals by balancing their diet, eating in moderation, choosing the right cooking method and exercising regularly.

Myths & Facts About Diabetes

Aparna Indoria
1. Diabetes is always inherited.There does seem to be a genetic element to both type 2 diabetes and obesity, which is why they can sometimes run in families. However, environmental factors, including diet and exercise, play a huge part In the development of both these conditions. It is important for everyone to eat healthy and exercise regularly to reduce the risk of developing type 2 diabetes or obesity.2. Type 2 diabetes is not always caused by lack of insulin because some people with diabetes do not need to take insulin.In type 2 diabetes, the body has increased insulin needs due to the reduced responsiveness or insensitivity of body cell to insulin, and the pancreas cannot produce enough insulin to meet these increased needs of the body. The diet, exercise and drug treatments for type 2 diabetes attempt to both overcome insulin insensitivity and to stimulate more insulin secretion. Ultimately, however, the ability to stimulate the cells of the pancreas to produce more insulin is not enough and insulin injections are usually needed to achieve good control of blood glucose.3. A high level of blood glucose is normal for some people.This is untrue. People with diabetes should always try and keep their level of blood glucose as close to the normal range as is possible and convenient. High levels of blood glucose lead to an increased risk of eye, heart, Kidney and foot problems.4. Insulin use causes weight gain.Without sufficient insulin, digested food and muscle tissue are broken down and turned into glucose (sugar) by liver. This excess sugar is lost in the urine, an unnatural process not found in people without diabetes. Improved blood glucose control will reduce this loss of sugar in urine, and the calories retained are stored as extra fat, as in people without diabetes. Weight gain can also occur if too much insulin is being taken and extra calories are being taken to prevent or treat low blood glucose level.5. People with diabetes cannot drink alcohol.Drinking a moderate amount of alcohol with food has no adverse effect on blood glucose or insulin levels in people with type 1 or type 2 diabetes. However alcohol can cause low glucose levels, If taken on an empty stomach or in excess. Beer contains a lot of carbohydrate, which counters the effects of the alcohol in causing hypos, but leads to weight gain if drunk regularly. People with or without diabetes can benefit from the heart protective effects of light to moderate intake of alcohol, red wine is beneficial.