Managing Diabetes - Easier than you thought

The aim of managing Diabetes is to keep blood glucose levels as close to the target range as possible. It can also refer to dealing  with short term events such as high & low blood sugar to controlling over the long and short term complications. Diabetic people should focus on some important point regarding the management of Diabetes as given below;

Monitoring blood sugar level- Diabetes is asymptomatic so people dont realise that the sugar levels are high. A blood glucose monitor is an excellent tool for managing diabetes. - Many people are very familiar with its uses, but of course it would be new for others. Diabetes Doctor in Delhi say that testing before & after meals can be useful technique for measuring how different meals affects your sugar levels & help to improve our diet & dosage.

Take a balanced Diet -Follow a healthy eating plan that’s naturally rich in nutrient and low in fat as well as calories. A balanced diet contains fruits (apples, apricot, pears, plums, peaches, grapes), green vegetables and whole grain. In fact, Diabetic diet is the best eating plan for everyone said by Diabetologist in Delhi.    

Exercise Regularly- Exercise is good for everyone, specially for people with diabetes. It’s also an important part of diabetes treatment because exercise can improve your body capability to respond to Insulin. So exercise daily, which helps to lose extra fat from the body and makes you more active and also keeps you in good mood.

Medication- Type 2 Diabetes can help blood glucose levels from rising too high. Some of us may be able to keep our blood glucose levels in the right range without needing medication, but the majority of people with type 2 diabetes take some form of medication.

Weight loss- More your abdominal fat, the more resistant to insulin your bodies become & therefore our glucose levels increases, losing weight & reducing your abdominal fat can increase the Insulin sensitivity. So it’s very important to manage your weight according to your height.

Vegetables are a boon for Diabetics

Green vegetables play a major role in our diet. They are natural multivitamins as they provide us vitamins, minerals & fibers.These are very necessary for a healthy body as they reduce levels of bad cholesterol, improve vision, boost our immunity and help in maintaining weight. They are the good source of fiber & water, which keeps our digestive system good. 

Advantages:

• Low Calories- Eat as much as you want
• Rich in Vitamins, Micronutrients and Antioxidants
• Plenty of Iron Calcium and other Minerals
• Easily available - require minimum processing
• Round the year availability
• Help in weight loss
• Increase HDL Cholesterol - protect heart

Dark Leafy vegetable-Rich in Vitamin A, B, C & K , magnesium, iron, protein, potassium, calcium, dietary fiber are good for diabetic patient. Leafy green include spinach, kale, broccoli, asparagus, amgula, romaine lettuce. Millions of people around the world have an increased risk of blindness, and other health problems because of adequate dietary vitamin A from leafy vegetables. Lutein & zeaxanthin, carotenoids found in these, play an important role for muscular region of the retina.

Tomatoes contain Lycopene, an anti-oxidant, rich in calcium, phosphorus, Vitamin A, C & K, Folate, Potassium & dietary fiber. All tomato based product are low in carbohydrates.

Bell peppers-These are available in various colours-yellow, red, orange, green &purple. They are also packed with vitamins A and C, potassium, phosphorus, calcium & dietary fiber.

Carrots-Rich in antioxidants beta carotene, vit A, B, C & K, magnesium, folate & dietary fiber. It comes under low to moderate GI vegetables and control blood glucose having lower risk of weight gain.They are good choice if you have diabetes as vitamins content helps protect your eyes from diabetes retinopathy or damage to the blood vessels in the eye from long term diabetes. They are a great low carbohydrates, crunchy snack.

Green vegetables have very low calory content and can be consumed freely by Diabetics, even excessive consumption of these does not cause high Blood Sugar levels or weight gain.

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.

Enjoy life and Festivities -Happy Diwali

Diwali symbolizes everything good that is their in life that we may cherish.Victory of Good over evil, Enlightening of Darkness within and obviously all that is associated with such a festival is happiness , meeting friends and relatives, Gifts, Sweets and Good food.

Even if you have Diabetes you can still enjoy these festivities and even have a small bite of everything you love..try not to overdo have a little bit of all that is there to be had on such occasions.

The important thing is to enjoy and feel the festivities.

Happy Diwali & Festivities to all our readers from Diabetologist Dr Rajesh Kesari and team members of Total Care Control - Diabetes Care Centre 

Navratri and Diabetes

Navratri and diabetes

The celebrations in Navratri draws the excitement among people and among the devotees it’s the time for nine days fasting. Fasting will help in cleansing and detoxifying your body and mind.

  

Being a diabetic, you should avoid excess of festive food as well as fasting. Diabetics are more prone to health risk. As it is the personal choice it is not desirable not to eat for a long time in fact small frequent meals are advisable to maintain the blood glucose level. Include more of fruits, vegetables and salads.

Consult your Diabetologist in Delhi before fasting 

You may need a change in medication or dosage modification of some medicines or Insulin if you have to fast. Some antidiabetic medicines (like Glimipiride, Gliclazide, Glibenclamide, Glipizide, etc..), and short acting and premixed Insulins are prone to cause hypoglycemia in absence of sufficient food intake whereas others may not. 

Choose wisely

Usually in fasting high calorie food intake is more like pakoras, papad, pooris, tikka, sabudana, buckwheat flour, etc.  All these are calorie rich and can quickly shoot up the blood glucose.

Try to include food cooked in less oil, and cooking methods to be adopted should be baking, grilling, or in non-stick pan

Also during fasting avoid caffeine beverages as they can be dehydrating and lead to difficulties, and hydrate yourself with plenty of water and beverages like lemon water, coconut water and buttermilk whole day.

One should check the blood glucose levels frequently when on fasting as you should be more careful about your health. Listed below few points which will help you to manage your diabetes well during fasting:

·         Drink any beverage or eat fruit after every 2 hour.

·         Consume milk and its products after every short interval.

·        Do consult your Diabetologist before fasting Don’t miss your medicine

·         If you feel hypoglycaemia or low sugar levels immediately take some form of sugar.

·         Modify the dose of  insulin as per the sugar levels

Stress and Diabetes

WHAT IS STRESS?

Stress is a natural feeling that is created in the mind, and is the way the body responds to a particular threat. Stress triggers physiological, emotional and chemical reactions in the body through a complex signaling pathway between neurons and body cells-either mental or physical. Physically it can be injury or illness and mentally problems in personal or professional life.

In our lives reason of stress can be many - family, job, finance, relationship or illness. If someone is having stress, it may cause following symptoms:

•          Changes in eating habits- Loss of appetite or binge eating
•          Disturbance in sleep
•          Weight gain or loss
•          Anxiety - Becomes nervous easily
•          Muscle tension
•          Feeling depressed
•          Increased irritability-Anger
•          Common problems like constipation, diarrhea, indigestion
•          Loss of interest in sex
•          Feeling weak
•          Sweating

Stress & Diabetes

Managing the stress with diabetes is essential as it can alter the blood glucose levels. Generally mental stress raises the glucose level in diabetics but with type 1 diabetes it show the varied reactions, like in stress there glucose levels can go down and it may leads to hypoglycemia.

The relationship between diabetes and stress has other causes like:

• —  Lifestyle changes
• —  Fear of diabetes related complications in future
• —  Frustration of having diabetes
• —  Depressed about following the diabetic diet
• —  Worry about blood glucose levels
• —  Distress of insulin dependence
• —  Lack of family support
• —  Challenges in social group
• —  Increased Financial burden
• —  Medication

How can Stress Be Harmful?

Diabetes management can get disturbed by stress due to elevated blood glucose levels, provoking negative thoughts, difficulty in decision making, or changing eating habits. Continued stress also leads to elevated levels of Cholesterol, raises Blood Pressure and increases Heart rate. These all work together to push a Diabetic person into vicious cycle of poor control and increasing complications. So Stress management should be an inherent part of any Diabetes management plan.