Dr. Ramesh Goyal

Diabetes is the major cause of Kidney Disease!

Hello friends welcome back to Lybrate I am Dr Hanish Gupta and today I will be talking about diabetes and kidney diseases. Friends all over the world a large number of patients are started to have dialysis, a large number of patients are undergoing kidney failure. This hasn't happened suddenly but has happened because of 2 common causes known as diabetes and blood pressure. Diabetes forms the biggest cause of Kidney failure and kidney diseases and today for any stage of kidney illness diabetes is the number one cause for the people of USA. India is also fast approaching that scenario.

People believe that in diabetes when they get their kidney function test done and it comes out to be normal they think everything is fine which isn't the case. Kidney starts the sign of deterioration with diabetes very early on and it is very important for the Dr to detect if there is any kidney issue or not. The test required here is the urine test. In very early stage of diabetes there is microalbuminuria in urine which is the passage of protein from the body in very small amount, that is the result stage of kidney failure. That is also the right time to save further complications of kidney infection.

People keep in getting their kidney function test and believe their kidney is fine on the basis of that. But it is actually the urine ACR done by standardized methods in laboratories that gives the right diagnosis. The important thing is that not only test but also the signs and symptoms that tell us about the kidney condition. People believe that it is the amount of urine passage that decides this factor but the most important sign is swelling over the body. Simple signs like loss of appetite can also detail about kidney failure.When kidney has started deteriorating patient observed a tremendous amount of relief in sugar control, thus patient believes that diabetes condition is improving but that is not the case it is actually kidney deterioration that brings down the sugar level. The reason for this is  that insulin is eliminated from the kidney and when kidney is undergoing deterioration the time period for which insulin remains in the body increases which is called as increase in the half life of insulin. So with that points keep your kidneys healthy and keep diabetes under control.

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PCOS is an abbreviation for Polycystic Ovarian Syndrome. It is a problem that is caused in women when their hormones are out of balance. It affects menstrual periods and can even hinder conception when aggravated to an advanced stage. Many women having PCOS develop small cysts on their ovaries. These cysts might not be harmful, but they lead to hormonal imbalances. 

Common symptoms include:

1. Gain of weight or Weight loss problems
2. Acne
3. Excess hair on body and face
4. Irregularities in periods
5. Fertility problems
6. Depression

It is possible for most women with PCOS who fail to attain pregnancy easily to use other treatments to get pregnant. Using In vitro fertilization (IVF) is one such mode of treatment. The procedure is helpful if done within the age of forty. You should undergo IVF only in a high quality clinic under the supervision of an experienced doctor.

There is a considerable amount of risk of having a higher order multiple pregnancy due to treatment of PCOS infertility using injectable gonadotrophins. Recent developments have allowed the patients to maintain high rates of pregnancy while simultaneously controlling the risk of multiple pregnancy. A variant of the standard IVF treatment known as Blastocyst embryo transfer is useful in the control of multiple birth rates. Generally, success rates for IVF treatment in cases where infertility is caused due to PCOS is quite high.

IVF Protocols for PCOS
There are two simulation protocols that are commonly used with PCOS:

1. Ganirelix with Lupron trigger protocol: Used to avoid ovarian hyperstimulation syndrome.
2. PCOS down-regulation protocol

This protocol combines:

1. Oral Contraceptive Pills
2. Metformin

A calendar is followed for the down regulation protocol for PCOS. Before starting with Lupron, a dosage ( 500 mg, 3 times a day) of metformin is followed daily. After this, oral contraceptive pills are prescribed for around 21 days. Lupron coincides with the last 3 pills of birth control. 

Lupron is a subcutaneous injection of a medicine that is taken once daily. Simulation of the ovaries is initiated after 6 or 7 days without using pills. It is very important with polycystic ovary that the dose of FSH hormone is properly controlled and that the ovarian response is cautiously monitored. Over response to the treatment can cause ovarian hyperstimulation syndrome. This should be avoided.

5 reasons you should include bajra in your diet

1. Powerful for controlling diabetes: 

Pearl millet is very powerful in controlling diabetes. Because of its high fibre content, it tends to digest slowly and release glucose at a slower rate as compared to other foods. This helps in maintaining healthy blood sugar levels for a long period of time.

2. Weight loss:

 Being high in fibre content, it takes a longer time for the grain to move from the stomach to the intestines. This way, bajra curbs hunger for a long span of time.

3. Reduces cholesterol: 

It contains phyto chemical, which is called phytic acid believed to increase cholesterol metabolism. It also stabilises the level of cholesterol in the body.

4. Helps in digestion:

 Bajra is rich in insoluble fibre that aids digestion. It also reduces secretion of bile acids and is linked to a lowered risk of gallstone formation.

5. Helps prevent cancer: 

Bajra has cancer-protecting properties. A study showed that regular intake of bajra protects pre-menopausal women from developing breast cancer.