Articles on gestational diabetes

Common Myths About Diabetes

Dr. Sudhindra Kulkarni, Diabetologist
The World Health day is celebrated on 7th of April every year. The theme this year is Beat Diabetes. The number of people being diagnosed with diabetes is on the rise and so are the myths surrounding the condition. Here, we help you break some common misbeliefs to help you manage diabetes better.Diabetes is not a serious disease.You cannot afford to take diabetes lightly. But this doesn't mean that life comes to an end once you are diagnosed with it. In fact, I suggest that you don’t wait to get diagnosed with diabetes, to take it seriously. This is especially true for people who are at high risk of developing diabetes.If you are overweight or obese, you will eventually develop Type-2 diabetes.People, who have a genetic propensity, are overweight, follow a sedentary lifestyle and are suffering from hypertension should not wait for diabetes to be diagnosed and then take control measures.People with diabetes should completely eliminate sugar, starchy foods like rice and potato from their diet.Even if you are diagnosed with diabetes, there is no need to completely eliminate anything from your diet. What you presently eat—the type and quality, your activity and stress levels and your weight will primarily determine number of calories you need, which will be the basis for your diet plan. Control and moderation are the key words.Once I begin to take medicines to control sugar, my diabetes will always be under control and I won’t have to visit the doctor.Taking medicines does not eliminate the need for regular monitoring and consulting the doctor.In fact, the need increases because the doctor will need to evaluate how your body is responding to the medicines and will accordingly alter the dosage.

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.

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..

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.

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

Diabetes and Pregnancy - Your Lifestyle Matters!

Dr. Sujoy Dasgupta, Gynecologist/Obstetrician
India is nowadays considered the “Diabetic Capital” of the world. The rate at which diabetes is increasing in modern societies is, indeed, a matter of concern. Diabetes does not merely mean increased and sometimes uncontrolled blood sugar. It affects various organs and systems of our body , particularly affecting heart (coronary artery disease), brain (stroke), eye (retinopathy), kidney (nephropathy), blood pressure (hypertension), liver (fatty liver), nerves (neuropathy), increased risk of infection and even some cancers. Obesity and diabetes go hand-in-hand. So, the main control measures are life style changes (controlling weight, diet, exercise, avoidance of alcohol and smoking); drugs (oral drugs and insulin) and monitoring by physician.Sexual Dysfunction: Diabetes is a major cause of sexual dysfunction in both male and female. It can reduce the libido (sexual desire) by altering the sex hormone levels. In case of male, Erectile Dysfunction (ED) is sometimes the first symptom of diabetes. So, if a male suffers from ED, rather than taking drugs directly from medicine shops, the cause of ED must be evaluated, particularly diabetes. Often patients do not know that they are diabetic but when the cause of ED is investigated, diabetes is discovered incidentally. It can also affect the nerves and thus can worsen the sexual problems. In female, it can lead to decreased arousal leading to avoidance of sexual activity. In some cases, it is responsible for premature ejaculation (PE) in males. Thus any person with sexual problems, should be evaluated for diabetes. Control of diabetes often resolves the problem. Menstrual problems: Obesity and diabetes together can affect hormone balance leading to irregular menstruations ranging from periods occurring at every 2-3 months, sometimes too frequently (every 10-15 days), scanty flow and sometimes heavy flow. This is particularly true in case of polycystic ovarian syndrome (PCOS) which can affect various organs and systems of the body. In PCOS, insulin is there in the body but it cannot function properly and ultimately it leads to diabetes. In some cases, this high blood sugar may be responsible for appearance of excessive hair growth (male-like hairs) in females. Even in some cases, diabetes may be associated with increased thickening of the endometrium (the inner lining of the uterus). In the worst cases, these women may have cancers in endometrium. So, women with menstrual problem need proper evaluation. Reduction in weight and control of blood sugar help to control menstrual problems. Infertility: As mentioned above, PCOS is a common cause of infertility. Similarly, diabetes and obesity can lead to problems in ovulation and thus creates problems in having pregnancy. Control of weight and blood sugar lead to successful conception in most cases. Similarly in male, high blood sugar can affect sperm production and thus impairs male fertility. Sexual dysfunction can aggravate the problem. Infection also plays a important role.Infection: Diabetes is notorious for increasing susceptibility to infection and often interferes with eradication of infection. In female, the infections may lead to vaginal white discharge and even in severe cases can block the fallopian tubes leading to infertility permanently. In male, it can cause phimosis (tight foreskin) and sometimes infection of sperm conducting-passage leading to infertility. So, male and female with genital infection must be evaluated for diabetes. Proper control of blood sugar and antibiotics are needed to control these. Pregnancy problems: Women diagnosed with diabetes are encouraged to control blood sugar before pregnancy. Otherwise there will be problems for mother as well the baby. Diabetes can cause miscarriage, preterm labour and worsens maternal problems like hypertension, nephropathy and retinopathy in pregnancy. It can lead to sudden unexplained death of the baby inside the uterus. The baby can have excessive weight (that leads to its diabetes in later life) and other problems like low blood sugar at birth, problems in breathing, problems in brain and problems in heart etc. So, proper control of blood sugar is needed before pregnancy and should be continued throughout pregnancy. GDM: Some women may have normal blood sugar before pregnancy but may develop diabetes in pregnancy. This is called gestational diabetes (GDM). It is also associated with increased risk of complications to mother and baby. 50% women with GDM can develop diabetes in later life. So, women with repeated miscarriage, still birth and very large baby should be evaluated for diabetes. Treatment must be continued throughout pregnancy.To summarize, diabetes is not only responsible for diseases of heart and brain but it can affect your reproductive life, particularly sexual function, conception and pregnancy. So, if you suffer from these problems, do not hesitate to check blood sugar. If diabetes is detected, there is no need to worry as proper control will solve all these problems. 

Importance of Diabetes Diet

Ms. Swati Kapoor, Dietitian/Nutritionist
Some diseases can be a slow poison, offering few or no warning signs to alert you early. One such disease is diabetes. Not only does diabetes affect almost 422 million people worldwide, but 25 percent don’t even know they have it.So,before you understand its importance in terms of diet. Let’s first draw your attention what actually leads to diabetes and what can be done to control or prevent it in long run.   Talk about DIABETESOnce the food is digested, it breaks down into glucose(form of sugar), which generally provides energy and powers our cells. Insulin, a hormone produced in pancreas, moves the glucose from the blood to the cells. However, if there is not enough insulin or the insulin isn't working properly, then the glucose stays in the blood and causes blood sugar levels to rise.There are three main types of diabetes:Type 1-is characterized by the lack of insulin production.Type 2-results from the body’s ineffective use of insulin.According to World health organization, it is potentially preventable in comparison to type 1 diabetes.Gestational diabetes-It is characterized by hyperglycaemia or raised blood sugar level with values above normal during pregnancy.   Risk FactorsBeing overweightNot getting enough physical activityHaving a parent or sibling with diabetesHaving high blood pressure, having low HDL(good cholesterol) or high triglycerides or pre-diabetes.  Measures Taken to PREVENT it!!!!There are only three ways by which one can prevent or reduce the risk of diabetes. But make sure they seems small but a person who is suffering from it , should follow it patiently from months to years to get best results out of them. So here are the biggest strength for Diabetes or Prediabetes.DietPhysical ActivityMedication.Lets focus on only diet for this session and understand how this can play a major role in diabetes management irrespective of individual’s age, gender and complications.  Diabetes Diet PlanFood can either promote diabetes or help prevent it, depending on how it affects the body’s ability to process glucose.People should avoid foods that cause a sudden spike in blood sugar levels and those that raise cholesterol, such as processed foods, foods high in saturated fats or with trans fats, and foods with added sugars and syrups.Processed foods as well as items high in fat or sugar not only can disrupt the balance between glucose and insulin, resulting in inflammation, but can also contribute to risk factors such as being overweight.Also it is important to know about foods to avoid with diabetes.Carbs, too, need to be watched. While they are necessary to fuel the body, some carbohydrates raise blood glucose levels more than others. "The glycemic index GI measures how a carbohydrate-containing food raises blood glucose in the body."Read more information on Good carbohydrates and Bad carbohydrates.Low GI measure foods raise blood glucose levels in blood slowly and keep you full for longer. High GI foods on the other hand include foods which cause a sudden spike in blood sugar levels and do not keep stomach full for sufficient time.There is no specific diabetes diet. The important thing is to follow a meal plan that is tailored to personal preferences and lifestyle and helps achieve goals for blood glucose, cholesterol and triglycerides levels, blood pressure, and weight management.A Diabetes diet is virtually the same as a healthy diet for anyone. Eat reasonably sized portions to avoid gaining weight, and includeLow GI fruits and vegetables like broccoli, mushrooms, green vegetables, apples, oranges, pear, watermelon, pineapple, guavas etc.Go strict with bananas, chikoos, grapes and mangoes.Get to know more about fruits for diabetic.whole grains rather than processed ones: fish and lean cuts of meat; beans and legumes; and liquid oils.Limit saturated fats and high-calorie snacks and desserts like chips, cake, and icecream, and stay away from trans fats altogether.      Thumb rule for DiabeticPlanning a Diabetes diet is not "what one eats", but also when one eats.You should not give long gaps between meals. A gap of more than 3 hrs can in-stabilize body glucose levels which could be dangerous for a diabetic.Regular monitoring of one’s sugar levels before going to bed and after waking up can help one keep a check on the levels and its consequences.If one checks blood glucose at bedtime and find it to be low, for example below 6 millimoles, it is advisable to take some long-acting carbohydrate before retiring to bed to prevent night-time hypoglycemia.So it is not only the quantity or quality of meals that is to be managed but also the timings of consuming meals which has to be taken care of.A well planned Diabetes diet with all these guidelines followed properly, can help a  diabetic, lead a normal life with control over diabetes!

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.