Meet your doctor atleast once in 2 weeks for faster control of Diabetes!

Meeting your Diabetes Doctor more frequently keeps your Sugar levels under better control and faster…

According to the results of a study published in the Archives of INTERNAL MEDICINE September issue. Researchers analyzed data of more than 26000 diabetic patients the years 2000 and 2009, with uncontrolled Blood Glucose, Total & LDL Cholesterol levels and high Blood Pressure . They concluded that those patients who visited their Diabetes doctors more frequently were faster to control their Blood Glucose levels- those who visited their doctors on average once in a week or once in 2 weeks were able to achieve HbA1c levels of 7% or less ( indicating Good Control) in just 4.4 months as compared to others who took average of 24.9 months  ( more than 2 years) to achieve same levels ; time to control BP to levels 130/85 was 1.3 months as compared to 13.9 months ( more than a year) for those who rarely visited their doctors, time to control  LDL Cholesterol to less than 100 mg/dl was 5.1 months versus 32.8 months ( almost three years) for the same contingents.  Not only this but also noticeable was that doubling the time between physician encounters  led to an increase in time to control these parameters, clearly showing that  frequent visits are necessary to bring Blood Sugar levels under control. An abstract of this article is available here..

When the Glucose and cholesterol levels are high pancreas is working under the considerable pressure of High Glucose and Lipids – which are toxic to the pancreas and decrease its ability to secrete the all important hormone Insulin. This is akin to flogging a sick horse to run faster. But once you bring Blood Sugar levels under control the pancreas is able to cope up with the increased workload fairly well and its easier to manage and maintain the same Blood Glucose levels.

Diabetes in Summers

What has the weather got to do with Diabetes control? seems an obvious question. Summer season has different implications in different parts of the world.. There are many factors which influence the management of Diabetes in this period of time.

Food:

Western

In the Colder countries summers bring plenty of fruits and vegetables which are highly recommended for Diabetics, Green leafy vegetables, fresh berries, available in plenty and  good for diabetics. Vegetables , specially salads have almost zero calories, they can be had as much as desired, help increase HDL ( the ‘Good Cholesterol’) and keep sugar down as they are of Low Glycemic Index and would decrease the absorption of foods consumed with them.

Indian

In most of the Indian subcontinent (except the north which may have climate similar to the western countries) A lot of refreshing drinks are consumed during the summers. Care must be taken to avoid Sugarcane juice – which is very popular in North India, as well as other sugar containing beverages and aerated drinks like the popular Colas, lemon, mango and fruit drinks. ‘Chach’ or buttermilk is one of the best thirst quenching drinks for diabetics in the scorching hot weather, lemonade should be taken either with salt and masala or with sugar substitutes .

Generally appetite is decreased in the hot weather which goes in favour of Diabetes control.

Infections & Dehydration

This season also causes a lot of diseases related to Gastrointestinal system like Diarrhea, vomiting – leading to loss of water and salts from the body. Children are more prone to such diseases. These may complicate into Diabetic Ketoacidosis if not treated promptly, remember sometimes even Diabetics on Oral medicines may have to be given insulin injections to prevent such complications.

Uncontrolled Diabetes may predispose to the frequent infections of stomach and throat which are prevalent in summers.

Dehydration specially due to Stomach infections frequently causes hypoglycemia as people do not tolerate food and liquids Oral rehydration solutions are helpful.

Plenty of water is lost due to sweating and evaporation- Drink adequate water and prevent dehydration.

Some FAQs :

Is the usual ORS Solution recommended for Diabetics?

In case of Dehydration – The same ORS solution may be recommended  as all the essential salts together with glucose are lost with body fluids-.

Are fresh fruit juices good for diabetics?

Fresh fruits would be preferable to Fresh fruit juices, but freshly made fruit juices are not bad for consumption in Diabetics.

Diabetes and Lohri

Lohri is celebrated all over North India with great enthusiasm. It is a celebration of Truth and Justice as also time to celebrate harvest. Lohri coincides with the coldest period of winters.

A celebration by all means for all Diabetics as well. Even before the day ( or rather) night of Lohri lots of sweets are consumed- Patti, gajjaks are caramalized Sugar or jaggery with roasted ground nuts, til- sesame seeds and other spices and seeds. Most of the Indian diabetics are suffering from Diabetes type 2, most of the gajjaks are high in calories and contain sucrose. They would cause sudden rise in blood sugar levels, Persons with Diabetes or prediabetes are advised to restrain themselves from consuming sweet patti's or gajjaks. As the tradition has it- People gather around a pyre, Sing dance and enjoy...feasting on groundnuts with pattis, rewari's or popcorns while occasionally throwing then in the fire symbolically.

Diabetes comes no way in dampening Festive spirits ... make a wise choice Groundnuts, Popcorns would not raise blood sugar, they can be eaten normally. Avoid lot of sweets- gajjaks even though they may be made of jaggery which most of the people do not consider to be Sugar it contains almost as much calories as table sugar.

Wishing you all a Happy Lohri and Winter Festivals

Dr Rajesh Kesari

Diabetes – More than just Blood Sugar

Diabetes – More than just Blood Sugar

Diabetes is more famous as ‘Blood Sugar’ in common parlance- Even doctors may also ask- Do you have Blood Sugar? But little do we know that Diabetes is a lot more than just rise in Blood Sugar levels. Diabetes actually is more about Energy storage and use- about growth and development. As one of the hypothesis of development of Diabetes goes- ‘the thrifty genes theory’- our ancestors were too dependent on the vagaries of weather, rain, floods , famines for food ; During the times of a good harvest they would eat well and their bodies make huge stores of energy inside ( as fats) - which would help them survive famines and floods. But with the onset of farming, food security increased – food became available throughout the year to all, but the body is still working in its old ways- conserving energy and depositing it as fat.
Fats are the most concentrated form of energy in our body, 1 gm of fat provides 9 kcals, more than twice as much as 1 gm of glucose. A 60 kg male may have upto 15 Kg of fat while a female of same weight may have up to 20 kg of fat. 20 Kg of fat can provide sufficient heat to boil 1800 litres of water or make 9000 cups of tea!
Hormone insulin has a pivotal role to play in the process of fat storage and utilization. After intake of meals Insulin not only decreases blood glucose but also promotes storage of digested fats into fat cells ( storage department of fat). During absence of fats in the blood insulin promotes their utilization from fat stores. This is why many Diabetics are obese (specifically those suffering from type 2 Diabetes). This type of Diabetes is caused due to insulin resistance i.e.. body cells become resistant to the actions of insulin- hence more and more of insulin is required to bring about the same glucose lowering - the excessive insulin results in large fat deposits- which themselves cause more insulin resistance and destroy the insulin producing beta cells in pancreas because of toxic effects of fat; this forms a vicious cycle which ends up in clinical Diabetes and its numerous side effects.
Insulin also encourages protein formation – proteins are the building blocks of our body. Presence of insulin in blood stimulates, whereas its deficiency causes destruction of proteins- This is the reason that mothers with Pregnancy induced Diabetes have large babies ( Due to excessive insulin because of insulin resistance) whereas Type I Diabetics are generally thin ( since they do not have insulin of their own).
Its not necessary for a Diabetic to completely stop eating sweets, bread, rice etc. Whats more important is the how the food gets digested and absorbed by intestines. Partially cooked foods would not be immediately absorbed and slowly increase blood glucose, Long grain rice like Basmati also gives slower rise in glucose, Breads with dietary fibre and whole grains may also prevent sudden rise of glucose levels, Green vegetables and fruits are also slowly absorbed. A diabetic has to be innovative and find things suitable both for the palate and the body, this is not difficult- leave alone impossible.
Exercise perhaps is one of the boons that a Diabetic enjoys. Perhaps there would be very few conditions afflicting the human body where a pleasant stroll could double up as treatment. Exercise not only helps consume the excess glucose and fat it increases blood flow to heart, muscles of legs, kidneys, decreases blood cholesterol, increases protective cholesterol. Exercise works as a medicine- it increases insulin sensitivity, which helps the body to more avidly respond to insulin and decreases its total quantity.
Every Diabetic’s foremost need and responsibility is to understand the disease, this condition requires continuous attention, application of the patients creative mind, innovation- what to eat? When to eat? How to prepare? How to increase physical activity? These questions have to be answered by each Diabetic individually, off course with the help of a Doctor or a trained professional.
Diabetes requires Total control- for total success.
Wishing all Diabetics Good control over Diabetes, Healthy and happy life on the occasion of World Diabetes day.

Dr. Rajesh Kesari M.D



Diabetestotalcontrol.com- Dedicated to Diabetes care of Indians in India and all over theWorld
www.diabetestotalcontrol.com

Corn & Wheat flakes for Diabetics

Question. Are Corn and wheat flakes good for Diabetics

Answer: Highly processed ready to eat Corn or wheat flakes may not be the best option for Diabetics- they have high glycemic index so they get absorbed into the system readily and give high post meal blood sugar peaks, But if the same flakes are taken in a less processed form ( simlpy put- those flakes which need some cooking to be done and cannot be had straight from the box) are a good breakfast option for Diabetics - rich in fibres and of low glycemic index hence they slowly get absorbed in the blood and do not cause peaks of blood sugar.

Diabetestotalcontrol.com- Dedicated to Diabetes care of Indians in India and all over theWorld