Articles on diabetes management

Few Things to Know if You Are Taking Insulin Injections for Your Diabetes

Sheetal Aversekar, Diabetologist
WHAT IS INSULIN?Insulin is a hormone produced by your body which keeps the blood sugar level under control. It is given as an injection in type 1 ( Insulin dependent/Juvenile diabetes) and is sometimes needed in the more common form of type 2 diabetes also. Many people fear insulin injections because of misconceptions regarding possible harm due to it. Following are a few common misconceptions/doubts which I have come across amongst patients and I have tried to clear them in a concise manner. SITE OF ADMINISTRATIONInsulin should be injected at one of the 3 preferred sites i.e., Abdomen, arms and thighs (in its order of preference). Sometimes ,it is advised to be injected over buttocks , however, this site is uncommon.Do not inject in the calf or forearms.In the preferred sites also, there are specific areas where it can be injected. Eg.It should be given 2 inches away from the umbilicus, if you are injecting over abdomen. You must learn about the proper sites from your doctor.HOW TO ADMINISTER?The injection should be given by pinching the skin and pushing the needle vertically (or sometimes at an angle as decided by your doctor) so that it reaches just below your skin and not deeper down in your muscles.Injecting without pinching the skin may cause it to enter your muscle and cause a sudden drop in your blood sugar levels.If you need to mix 2 different types of insulin in a single syringe, make sure you always pull in the clear insulin( with a yellow patch on the bottle) first,  followed by the cloudy insulin( with a green patch on the bottle).ROTATE THE SITESIt is crucial to rotate the sites of injection, rather than giving the injections  at the same site for months together.If this is not followed, then you will notice that the skin at that site becomes lumpy (called as lipohypertrophy) and your blood sugar control becomes erratic.You should know how to and how frequently to rotate the insulin sites.DO NOT MASSAGE/EXERCISE AFTER INJECTING INSULINDo not massage the area where you inject insulinAlso,do not exercise that part of your body after injection. Eg. Do not inject insulin over thighs if you are planning to go jogging immediately. Arms/abdomen would be a better site in such cases. It may cause a sudden drop in the blood sugar otherwise.FOOD INTAKE AFTER INJECTIONDepending on the type of insulin, your doctor will advise you to keep a specific time gap between injection and food intake.Shortening this gap will cause inadequate post food blood sugar control and lengthening this gap it will cause you to develop  a low sugar before you start your meal.Also,the dose needs to be adjusted according to your food intake. Eg. If you are feeling sick and are not going to eat your regular amount, you must reduce your dose.USE CORRECT SYRINGESIf  you are taking insulin by manually filling it in syringes,make sure you are using the correct syringe for the correct insulin.The commonly prescribed insulin is of the concentration of 40 U/ML for which a syringe  with a red cap is required.Sometimes your doctor may prescribe a more concentrated insulin (i.e 100 U/ML) for which a syringe with an orange cap is used.If  you interchange the syringes, your blood sugar may range from very high to dangerous lows. The concentration is usually mentioned on the insulin bottle.DO NOT SKIP DOSES/DO NOT OVERDOSEMany people skip their usual doses of insulin if their pre food sugar is in the range of 70s or 80s, fearing a hypoglycaemia (low blood sugar). Doing this will drastically increase your sugar level after food  You should reduce your dose rather than skipping it completely during such times.Also, if you have missed a dose, do not take double the dose in your next shot as this may cause a severe hypoglycaemia.What is required is that you should check your blood sugar level before the next meal and add an adequate correcting dose over and above the regular dose.IDENTIFY THE WARNING SIGNSYou should know how to identify the warning signs of hypoglycaemia so that adequate corrective measures can be taken at the earliest.The usual symptoms include increased hunger, sweating, palpitations, shivering(tremors). However, children and old people may have vague symptoms like increases sleepiness, fatiguability, nightmares, changed behaviour.Severe hypoglycaemia may lead to fits (seizures) and unconsciousness, but it is rareIt is beyond the scope of this article to go into minute details. Eg.by how much should you reduce/increase your dose during specific situations? Why are you given 3 insulin shots whereas your neighbour is doing fine with just 1? Exactly how many minutes should you wait after injection so that you can start your meal? It goes without saying that you need to consult your doctor regarding more specific details. Every individual with diabetes is unique with his/her own set of problems. After all, diabetes is a condition in which one plus one may not necessarily be 2! Hence, It is always better to be well-informed.

Controlling Diabetes Is Like Playing Cricket

Dr. Sachin Chittawar, Endocrinologist
Type 2 Diabetes is a day to day affair in our locality. The recent upsurge in diabetic patients has given the disease a complete new status. Patients start thinking of doom, look for instant cures and end up being stressed and worried. People are more concerned with the diagnosis rather than management and control of sugar level in the body.Like diabetes, cricket is also a common day to day affair. Look at the popularity of T20 /IPL When I say diabetes is like cricket, I end up making it a simple disease with fixed targets and a common goal to achieve. The fixed 20 overs go with our lifespan and type 2 diabetes mostly come after 10 overs are gone.In T20 mostly, the run rate becomes the primary aspect to win a match and it becomes indispensable especially when the first 10 overs are gone. The required run rate needs to be followed. Like cricket, in diabetes your run rate for fasting sugar should be within the range of 100 to 125 mg % and after meals it should be below 180 mg%. The average glucose of last 3 months should be around 7%. When we score as per the runs required per over, we have a strong possibility of winning the match. The same rule stands for diabetes. We need to keep blood sugars in range to avoid complications which is equivalent of losing the cricket match.What is meant by losing a match in diabetes? We should play to win the match against diabetes to avoid, delay or prevent the microvascular complications like retinopathy, nephropathy, neuropathy.Changes in blood sugar levels can cause the following complications:Uncontrolled sugar levels can cause changes in retina leading to blindness.Urinary protein loss in the form of microalbuminuria can lead to poor renal functions which means dialysis and even renal transplant.Feet can become numb and you can lose your sense of touch. This leads to injuries even while doing daily activities. The skin around the feet has no immunity which gives way to infection, gangrene and in severe cases amputation of foot.This vicious cycle can be completely avoided by playing the match according to the run rate fixed. However, do keep in mind that as run rate changes as per certain factors, it is the same for diabetes. Your sugar levels would be best decided keeping your age, gender, co-morbid illnesses, etc. all into consideration. No two goals would be the same. Just as your favourite batsman would have different run rate according to the current status of the match, your sugar levels would be different from another individual.The best way to know your run rate, is to consult your endocrinologist. The need of the hour is playing with zeal and with a clear idea about your goals. Just as India is the cricket capital, let’s all strive to make the country a diabetes-free capital too. Let the cricket spirit win! Chak de India!

I Have Diabetes, Why Do I Need to See My Eye Doctor?

Dr. Manoj Rai Mehta, Ophthalmologist
Diabetes (Sugar) is a disease that is protean in its manifestations.  It potentially affects each and every cell of the body.  Damage to the microscopic blood vessels of the body-capillaries is the hall mark of this disease process.  Eye happens to be the only organ in the body where blood vessels of every size can be seen and observed for diabetes induced changes.  Eye is the mirror of the body.  Changes in the eye reflect changes in the other organs and systems to a fair extent.In the initial years an annual check up may be sufficient, but as the duration increases a more frequent follow up may be required.      Diabetes can affect eyes in many ways-starting with frequent lid infections and sty formation. Dry Eye Disease may be an association.  Cataract formation at younger age and Glaucoma (kala motia) are other well known associations.  Diabetic Retinopathy is probably the most important complication that needs to be managed by the eye surgeons.  Hemorrhagic spots, small vessel aneurysms, deposition of fat residues in layers of retina, formation of cob web like new vessels on the retina that have a tendency to bleed (due to poor wall strength), retinal oedema, even frank bleeding into the eye can be seen at different stages.  Saving vision becomes a priority in diabetic retinopathy which is a progressive disorder and not completely reversible in many aspects.          Strict "parameter based" "metabolic control" of Diabetes is of prime importance.1) Blood sugar profile (monthly); Target- Fasting <100 mg/dl and all readings < 180mg/dlInvolves taking 8 readings before and after major meals in a day2) Hb a1C (quarterly);  Target- 6.5%3)Lipid Profile (annually): No hyper-lipidemia  4)Blood Pressure; Strict Target 130/80 (ACE inhibitor drugs to be added)5) 24 hour urinary proteins (annually)Retinal examination will require +90 D examination of the macula, Indirect Ophthalmoscopy.  OCT (optical coherence tomography) and FFA (fundus fluoresceine angigraphy) may be required for evaluation, treatment and follow up.Intra vitreal injections and green laser therapy may be required to tackle different situations in retinopathy.Regular interaction with the diabetologist and ophthalmologist can lead to preservation of sight for a long time.    

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.

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.

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

6 Common Myths About Diabetes

Sheetal Aversekar, Diabetologist
      1. ONLY OLDER PEOPLE GET DIABETESEarlier, diabetes occurring in children and youngsters was considered to be type 1 (juvenile/ insulin dependant) diabetes. However the scenario is fast changing nowNowadays, unhealthy lifestyles are causing a lot of youngsters to develop the more common variety of type 2 diabetes. Today, it is not uncommon for teenagers or people in their 20s and 30s to be detected as being  type 2 diabetic.        2. DIABETES MEDICINES SHOULD NOT BE TAKEN FOR LONG AS THEY DAMAGE KIDNEYSMany people stop their diabetes medicines once their blood reports are normal, fearing damage by long term usage of medicinesThe truth is that stopping medicines will again cause the blood sugar level to rise and an uncontrolled blood sugar may damage not only the kidneys, but also eyes, nerves, heart, liver in the long run     3. MY FASTING AND 2 HOUR POST LUNCH REPORTS ARE WITHIN NORMAL LIMITS, SO I SHOULD NOT WORRYYour sugar level at other times of the day or on other days may not be within limits. Hence, you need to do a blood test called as HbA1c every 3 months which will tell you if you are well controlled in general over the past 3 monthsApart from that, lipid profile, kidney function tests, liver function tests, eye examination, feet examination should be done at least once a year or in some cases, more frequently, to detect any complications of diabetes at an early stage        4. DIABETES AFFECTS ONLY THOSE WHO EAT MORE SUGARUnfortunately, all Indians have a  risk of developing type 2 diabetes ( we are genetically more prone). However, it is not only the sugar intake but an unhealthy lifestyle which decides whether you will develop diabetes or not. This includes irregular meal and sleep timings, over intake of fast food/ oily food leading to weight gain, lack of adequate exerciseHealthy habits need to be inculcated right from childhood. For all the mothers out there, a chubby child is NOT a healthy child!      5. A SPECIAL DIET IS REQUIRED FOR DIABETICSThis may be true in certain special cases as decided by your doctor. However, most diabetics need to follow a healthy dietary and lifestyle pattern which should be followed even by non-diabeticsWhat is more important is to have small frequent meals rather than 3 heavy meals, increasing fibre intake in the form of fresh fruits and vegetables, avoiding processed food( tinned/ready to eat meals/ bakery foods), increasing water intake, ensuring adequate sleep and having a brisk walk for 30-40 minutes daily with appropriate footwearCrash diets should not be attempted as they will do more harm than good      6. INSULIN WILL DAMAGE MY BODYInsulin is an injection which needs to be taken daily in some individuals with diabetes. Your doctor will prescribe it only if your diabetes cannot be controlled by tablets, either on a temporary or a permanent basisIt is the best medicine to control blood sugar levels and if taken in the right dose and if precautions are followed, it will cause no harmNowadays, better varieties of insulins and insulin needles with a very fine tip are available which make the injections almost painless

5 Important Dietary Tips to Prevent Diabetes

Mr. V Ravichandran, Physiotherapist
What is Diabetes?It is a condition whereby the amount of glucose in an individual’s blood is too high due to the body unable to utilise it properly. This is because the pancreas produces little or no insulin to help glucose to enter the body’s cells.Insulin is a hormone produced by the pancreas that helps to regulate the amount of glucose in blood. After a meal, our blood glucose levels will tend to rise. Therefore, insulin is secreted to break down the glucose into energy for the body to use, thus maintaining anormal blood sugar level. However, people with diabetes whom has little or no insulin produced by the pancreas, blood glucose levels remain high and they will feel tired easily as glucose is not broken down to energy for the body to use.Types of DiabetesType 1:Known as an auto-immune disease, where the body’s immune system attacks the insulin producing cells of the pancreas. People with Type 1 diabetes cannot produce insulin and require lifelong insulin injections for survival.This disease can occur at any age, mostly in children and young adultsComplications are sudden and life-threateningType 2:Mostly associated with hereditary factors and lifestyle risk factors such as poor diet, insufficientphysical activity and being obese.Body cannot properly use the insulin. Body become resistant to insulin.Occurs more frequent to people of age OVER THAN 40 YEARS OLD, particularly those who are overweight andphysically active.Can be controlled with proper diet and exercise but most diabetics need oral medication.Gestational Diabetes Mellitus (GDM)Occurs in about 2-5% of all pregnanciesWomen who were not diagnosed to have diabetes previously will show high blood glucose levels during pregnancy.Signs and Symptoms of DiabetesAlways lethargicFrequent UrinationSudden weight lossWounds that won’t heal or take very long to healSexual problemsConstantly hungryBlurry visionNumb or tingling hands or feetAlways thirstyVaginal infectionsComplications of DiabetesSleep apneaStrokeLung diseaseLiver diseaseCancerGallstonesArthritisGoutHeart diseaseGuidelines to Blood Glucose Levels:Random blood glucose level (Normal): < 7.8 mmol/LRandom blood glucose level (Diabetic): ≥ 11.1 mmol/LFasting blood glucose level (Normal): ≤ 6.0 mmol/LFasting blood glucose level (Diabetic): ≥ 7.0 mmol/LWhat can be done?InsulinInsulin jabs are mainly applicable for individuals with Type 1 diabetes.There are short and long acting types of insulin jabsAlways keep all insulin bottles with a spare one in fridge when not in useHealthy LifestyleDo exercises regularly such as cycling, swimming and many other activities which allows the body to use up the glucose in the bodies, therefore lowering the blood glucose levels in the body.Get a proper diet. Do not smoke. It worsens the narrowing of blood vessels already caused by diabetes. This will then reduceblood flow to many organs and this may lead to many serious complications.Limit alcohol intake. Alcohol interferes with meal plans and blood glucose control especially if taking insulin or other medications for diabetes.Eat More of..Healthy fats from raw nuts, olive oil, fish oils, flax seeds, whole milk dairy, or avocadosFruits and vegetables—ideally fresh, the more colourful the better; whole fruit rather than juicesHigh-fibre cereals and breads made from whole grains or legumesFish and shellfish, organic, free-range chicken or turkeyHigh-quality protein such as eggs, beans, milk, cheese, and unsweetened yoghurtEat Less of..Trans fats from partially hydrogenated or deep-fried foodsPackaged and fast foods, especially those high in sugar, baked goods, sweets, chips, dessertsWhite bread, sugary cereals, refined pastas or riceProcessed meat and red meat from animals Low-fat products that have replaced fat with added sugar, such as fat-free yoghurt 

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