Diabetes Care - Special Care

Diabetes is a very common problem these days. Every 6^th-8^th person may suffer from Diabetes in metros like Delhi. Most of have friends, neighbors or relatives with Diabetes. Diabetes is not just an episodic disease- it’s a lifestyle and lifetime disease. People who suffer from Diabetes have to deal with it day in and day out. Diabetes affects every aspect of life- be it work, Personal life, sexual life, financial life, Future security of the individual and dependents.

A special aspect of Diabetes treatment and management is the personal involvement of the patient- his or her family members in the outcome of the disease and manifestations of its complications.

Unlike other medical conditions Diabetes cannot be controlled and managed only by medicines or injections. It requires profound understanding and engagement of the patients themselves. Diet and lifestyle choices play a very important part in the treatment and management of Diabetes.

Diet & Lifestyle 

What we choose to eat or the way we choose to travel and work may have a visible impact on the blood sugar levels and the onset of complications of diabetes or their prevention. No amount of medication can be a substitute for Lifestyle modification.

Some right choices which positively affect the control of diabetes and help prevent complications are:

Right Choice- PREFER	Wrong Choice- AVOID
Green leafy vegetables	Starchy foods like Potatoes
Fresh Green vegetables	Tubers like Arbi
Fruits / Salads / Sprouts	Sweets/ Table Sugar/ Honey / Jams
Less processed foods -Pasta Al Dente, semi boiled rice	Over boiled rice / Pasta
Foods rich in dietary fibres- Atta , Multigrain  Atta	Refined wheat flour- Maida
Whole Grains- Dalia, Oats	Fast food
Roasted whole grain snacks	Fried snacks
Walk daily- Exercise /  Swimming / Gym/ Games	Spend time in font of TV in armchair
Climb / descend on stairs	Use lift

Liver- NOT to be ignored in Diabetes

Sleeping, Thinking, Dreaming, Relaxing Enjoying...whatever you may think of  Or even Cannot be thought of requires energy. The most vital organs of our body like Heart & Brain do not have any energy sources of their own- so they rely on the Glucose present in the blood stream for their energy needs.

Liver stores Glucose from the Blood when its in abundance- that is after meals with the help of hormone Insulin, and gives it back to the blood whenever the levels of Blood Glucose start falling with the help of Glucagon which is a hormone produced by the pancreas just as Insulin. Insulin also acts as a restrainer to prevent excessive release of stored glucose from the liver into the bloodstream. In normal non -diabetic individuals, Insulin and Glucagon hormones work in perfect coordination to keep Blood glucose levels within a very tight range. But with the onset of Diabetes- in particular Type 2 Diabetes Mellitus liver fails to recognize the signals of insulin and keeps on pouring glucose into the blood stream- irrespective of the requirements. This causes the high fasting blood glucose levels- that is early in the mornings or before meals. Many highly effective Diabetes medications like Metformin act on this mechanism to control the fasting Blood Glucose levels.

More than 2/3rds of Diabetes suffer from some ailment of the Liver. A very common problem faced by many Diabetics is the Fatty Liver- more scientifically Non Alcoholic Fatty Liver Disease. This is the result of fat deposits around the functional units of liver-the Hepatocytes- these are highly specialized cells responsible for all the chemical juggling and mixing performed by the liver which keeps us alive.

Slowly and steadily the cells of liver get damaged and are replaced by scar tissues- causing fibrosis and ultimately Cirrhosis of the Liver. This is a serious condition which may end up in liver failure end Hepatocellular Carcinoma as well- a form of Liver Cancer.As this condition is completely asymptomatic individuals may not pay any attention to it and progress to end stage Liver disease.

But prevention and treatment of this condition may be rather simple and easy:

Change dietary habits:

• Take plenty of green vegetable
• Fruits
• Whole grains
• Avoid Fats
• Avoid to much Alcohol
• Fried foods
• Cream , Butter & Oil

Be physically active

• Indulge in sports activities
• Loose weight

All these efforts would not only help normalize fatty liver but help in controlling Diabetes as well. Do consult your doctor is you are overweight, your sugar levels are not controlled or have family history of Diabetes, High Blood Pressure, Liver Disease as all these may be risk factors.

Fatty Liver can only be diagnosed with help of Blood Tests and Ultrasonography of Liver, even moderately raised liver enzymes may be indicative of this problem and require a thorough workup.