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DIABETES
WHAT IS DIABETES ?
Diabetes Mellitus (DM) often only known as diabetes is a condition where the blood sugar level is higher.
In order to determine whether or not a patient has diabetes it is required to conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used however plasma glucose measurements are preferred because of their simplicity and are hence recommended.
A fasting blood glucose level between 100 and 130 mg/dl and post prandial (two hours after meal) level of 150 -200 signifies impaired glucose tolerance (IGT)
Glucose levels higher than these indicate diabetes.
Diabetes is a disease in which the body does not produce enough insulin (type 1) or is unable to use the available insulin efficiently (type 2)
India has the dubious distinction of having the largest number of people with diabetes. There are several factors responsible for it.
 Lack of exercise
Genetic predisposition to diabetes
Abdominal obesity
Lack of awareness
Reluctance to visit a medical practitioner
Studies have shown that for every person known to have diabetes, there are more than 2 people who have diabetes but are unaware of it therefore timely routine checks are important for early diagnosis.
COMMON SYMPTOMS OF DIABETES
Frequent urination
Excessive thirst
Tiredness
Weight loss, although appetite often increases (especially in Type 1 diabetes)
Itchiness, especially around the genitals
Recurrent infections on the skin, e.g. boils.
Extreme hunger
Unusual weight loss
Increased fatigue
Irritability
Blurry vision
People with Type 1 diabetes usually develop these symptoms within days or weeks.
In Type 2 diabetes, these symptoms often don't show for years. Many are diagnosed by chance through routine medical check-ups.
Many people do not exhibit these "typical" signs and symptoms even though they have diabetes, which necessitates routine check-ups.
Heredity plays a part in diabetes, but only 10 per cent of people with Type 1 have a family history of diabetes. For Type 2, this rises to 30 per cent.
The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.
TYPES OF DIABETES
TYPE 1 DIABETES
It is usually seen in young people and results from the body’s inability to produce enough insulin. It is associated with Ketoacidosis. It is seen in relatively younger people.
TYPE 2 DIABETES
When you have type 2 diabetes , your body is unable to properly or develops resistance to insulin and hence though insulin is present sugar levels rise. Many of the foods we eat – such as bread, potatoes, rice, pasta, milk and fruit – are converted into sugar and give us the energy we need to maintain life. Insulin gets the sugar into the cells, but if you have type 2 diabetes foods are converted to glucose but it cannot be utilized by the cells and hence the glucose remains in the blood and does not enter into the cells where it should have been present. Type 2 diabetes is seen mostly in patients above 40 years of age.
Gestational diabetes
It's associated with pregnancy and symptoms usually disappear after birth. If you get gestational diabetes, you have an increased risk of developing one of the main types of diabetes later in life. Gestational diabetes mellitus (GDM) is present in around 3-4% of all pregnancies.
Gestational diabetes mellitus (GDM) can be associated with significant morbidity and mortality in the foetus and newborn.
Impaired glucose tolerance (IGT) or Pre-diabetes It is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. However if you have IGT the chances of becoming a diabetic later in life are more, unless the present rise in glucose levels is only because of stress or some other environmental changes.
Secondary diabetes It is a state when diabetes is caused as the result of some other condition or reason, e.g. inflammation of the pancreas, or by the use of certain medication such as diuretics or steroids (a very common cause).
ONE SHOULD TEST FOR DIABETES IF THEY
Are over 40 years of age
Are overweight
Have a family history of diabetes
Have given birth to a baby that weighed more than 4 kg / 9 lbs
Have hypertension
TREATMENT
Lowering blood glucose to within normal limits is of primary concern, apart from this if the patient is hypertensive lowering blood pressure is equally important, treatment also depends on whether retinopathy, nephropathy are present (only in chronic cases)
Untreated
Diabetes should be treated as soon as diagnosed as untreated diabetes and high sugar levels can cause a good many complications.
COMPLICATIONS MAY BE ACUTE / CHRONIC
Acute complications
Low glucose level, caused by treatment with insulin or oral hypoglycemic drugs. Diabetic acidosis, a life-threatening condition caused by the lack of insulin.
Late-stage diabetic complications
Retinopathy (eye disease) that can cause blindness.
Diabetic nephropathy that can lead to kidney failure.
Diabetic neuropathy (nerve disease) that can cause foot ulcers and foot infections .
Atherosclerosis (hardening of the arteries), particularly in smokers and those with high blood pressure.
Diabetic complications can be avoided by proper blood glucose control.
It has been observed that individuals who have higher blood pressure or smoke or have higher cholesterol levels have a much higher risk for developing atherosclerosis and heart attack.
In fact, many persons with Type II diabetes already show the presence of the long term complications associated with diabetes at the time of diagnosis. It is now widely accepted that if diabetes is detected early and adequate steps are taken, it may be possible to significantly delay the onset and progression of these complications.
Late-stage complications do not usually develop for 10-15 years with Type 1 diabetes.
In Type 2 diabetes, however, symptoms can appear close to the time of actual diagnosis because the disease may go undetected for a longer period of time.
Glucose is created when your body breaks down food to use for use as energy.
Your body uses glucose as its main source of fuel with the help of a hormone called insulin.
Insulin acts like a key to unlock the body’s cells, so glucose can enter and serve as fuel for the cells.
This is how most people’s bodies maintain a fairly normal amount of sugar in the bloodstream.
That’s not the case with type 2 diabetes.
People with type 2 diabetes can’t maintain normal sugar levels.
This happens either because the body doesn’t make enough insulin, or because the body can’t use its own natural insulin properly—a process called insulin resistance.
High blood sugar sets off processes that can lead to complications like heart, kidney or eye disease, or other serious problems.
The good news is that healthy eating, exercise, and, possibly, medication can help.
HEALTHY TIPS FOR DIABETICS
Eat three regular meals a day no more than six hours apart.
Here’s why:
Eating at regular times helps your body control blood glucose levels.
Limit sugars and sweets like sugar, regular pop, desserts, candy, jam.
Reason:
The more sugar you eat the higher your blood glucose will be.
Limit the amount of high fat food you eat like fried foods, chips and pastries.
Reason: High fat foods may cause weight gain. A healthy weight helps control blood glucose levels.
Eat more high fiber foods.
Reason: High fiber foods may help you feel full and may lower blood glucose and cholesterol levels.
Drink water if you are thirsty.
Reason: Drinking regular pop and fruit juice will raise your blood glucose.
Add physical activity to your life.
Reason: Regular physical activity will improve your blood glucose management.
ALCOHOL & DIABETES
Drinking moderate amounts of alcohol may be acceptable for people with diabetes.
Discuss drinking alcohol with your healthcare team.
A moderate amount of alcohol is one to two drinks a day.
Drinking alcohol is not recommended if you:- Have high triglycerides (blood fats), have high blood pressure, have liver problems, are pregnant or breastfeeding. If you choose to drink alcohol, remember to drink with your meal or snack and not on an empty stomach To sip your drink slowly or dilute it with diet ginger ail, club soda or water Liqueurs,
Please note:sweet wine and dessert wines have a lot of sugar.
When you have diabetes it is important to take good care of your feet. High Blood glucose levels may eventually lead to poor blood flow and loss of feeling in your feet, which can lead to foot problems.
You can prevent problems with your feet by:
Keeping your blood glucose levels in your target range
Washing daily with warm (not hot!) water and pat dry
Checking your feet every day for sores, injuries, red and warm areas on the skin, change in colour, strange odor and other problems. Don’t forget to look at the bottom of your feet for sores or blisters
Wearing shoes with good support and socks that fit well and that do not hurt your feet
Not walking barefoot
Asking your diabetes educator how to cut your toenails properly
Using lotion on the soles to keep the skin soft and prevent dry, cracked skin
Avoiding crossing your legs, squatting or kneeling for long periods of time
Avoiding using heating pads, hot water bottles or campfires to warm your feet
Talk to your healthcare team if you:
Soak your feet
Use corn removal products
Have concerns about your feet
Notice that cuts and sores are not healing well
Measure HbA1c regularly that is after every 3-4 months.
The results of this test are an average of your overall blood glucose levels over the past 120 days.
HOW CAN WE HELP (Treatment at Jalan Healthcare)
Our aim is to primarily control you blood sugar levels with homoeopathy and reduce your dependence on allopathic medication. Allopathic medicines unfortunately continue to have side effects when used for some time. Also increasing resistance to the ongoing allopathic medicine calls for an inevitable increase in the required dosage to control your diabetes.
Homoeopahty on the other hand is absolutely safe and does not involve painful or difficult methods of treatment. The dosage may be as low as once per week ensuring compliance and complete control over diabetes. Gradually we taper the dosage of your allopathic medicines to achieve a state wherein no allopathic treatment may be required.
HYPOGLYCEMIA (What causes a low blood glucose level ? )
Low blood glucose may be caused by:
More physical activity than usual
Not eating on time
Eating less than you should have
Taking too much medication
The effects of drinking alcohol
Low blood glucose can happen quickly, so it is important to take care of it right away.
If your blood glucose drops very low you may: Become confused and disoriented, Lose consciousness, Have a seizure.
How do I treat a low blood glucose?
If you are experiencing the signs of a low blood glucose level, check your blood glucose immediately. If you don't have your meter with you, treat the symptoms anyway it is better to be safe.
Eat or drink a fast-acting carbohydrate (15 grams):
15 g of glucose in the form of glucose tablets
15 ML (3 teaspoons) or 3 packets of table sugar dissolved in water
175 ML (3/4 cup) of juice or regular soft drink
15 ML (1 tablespoon) of honey
Wait 10 to 15 minutes, and then check your blood glucose again.
If it is still low:- Treat again If your next meal is more than one hour away, or you are going to be active, eat a snack, such as a half-sandwich or cheese .
High blood glucose
What is high blood glucose?
When the amount of blood glucose (sugar in your blood) is higher than the normal range it is called high blood glucose or hyperglycemia.
What are the signs of high blood glucose?
When your blood glucose rises above 200mg/dl, you may:
Be thirsty
Urinate more often
Be tired
What causes high blood glucose (hyperglycemia)?
High blood glucose can result when food, activity and medications are not balanced. High blood glucose may happen when you are sick or under stress.
What do I do if I have high blood glucose?
Call or see your doctor, you may need to:
Adjust your medication and/or insulin
Adjust your meal plan
Increase your physical activity.
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What is Diabetes?