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Diabetes is a disorder that is characterized by an inability of the pancreas to produce enough insulin or effectively utilize the insulin produced by the body. Insulin is the hormone that is produced by the pancreas to metabolize sugar in the body, the sugar that is present in the food that you consume.
Diabetes is commonly classified into two types: Type 1 and Type 2 diabetes.
In Type 1 diabetes, the cells in the pancreas do not produce insulin in the required amounts; this disorder usually tends to occur in children. Type 2 diabetes generally occurs in people who are above 40 years of age; this type is characterized by an inability of the body to efficiently utilize the insulin produced by the pancreas.
How can diabetes affect your kidneys?
Too much glucose, also called sugar, in your blood from diabetes damages your kidneys’ filters. If the filters are damaged, a protein called albumin, which you need to stay healthy, leaks out of your blood and into your urine. Damaged kidneys do not do a good job of filtering wastes and extra fluid from your blood. The wastes and extra fluid build up in your blood and make you sick.
Diabetes is a leading cause of kidney disease. Diabetic kidney disease is the medical term for kidney disease caused by diabetes. Diabetic kidney disease affects both kidneys at the same time.
Signs of Kidney Disease in Patients with Diabetes
- Albumin/protein in the urine
- High blood pressure
- Ankle and leg swelling, leg cramps
- Going to the bathroom more often at night
- High levels of BUN and creatinine in blood
- Less need for insulin or antidiabetic medications
- Morning sickness, nausea and vomiting
- Weakness, paleness and anemia
What are the possible complications?
- End-stage kidney failure: If this occurs then you would need kidney dialysis or a kidney transplant.
- Cardiovascular diseases: Diabetics have an increased risk of developing cardiovascular diseases, such as heart disease, stroke and peripheral arterial disease. If you have diabetes and diabetic kidney disease, your risk of developing cardiovascular diseases is increased further.
- High blood pressure: Kidney disease has a tendency to increase blood pressure. In addition, increased blood pressure has a tendency to make kidney disease worse. Treatment of high blood pressure is one of the main treatments of diabetic kidney disease.
What to do?
- It is essential to get your urine checked at least once every year to detect signs of kidney damage.
- Some other symptoms that you may experience are swelling in the ankles, weight gain and a rise in your blood pressure.
- The first step to treat kidney damage caused by diabetes is to get your blood sugar levels under control.
- You should also avoid consuming medications that can cause damage to the kidneys.
- A kidney transplant or dialysis may be advised if the damage to kidneys is significant. If you wish to discuss about any specific problem, you can consult a nephrologist.
Menu planning for diet of indian toddlers:
Indian diet plan for toddler
In the above given chart, the outer 6 boxes represent the different food groups. This chart will help you in planning your own menu based on your convenience and timing for your baby. Follow the following tips for planning a healthy menu for your toddler.
The trick is to simply add at least 1 item from each group through out the day. Ofcourse you can use a particular group more than 2 times too. But in order to maintain variety in terms of taste and nutrition, its important to plan from each group. Ex – you can plan for rice in the afternoon and oats in the evening menu. Both the items belong to the cereal group and are equally healthy.
Make your choices of food from the given food group more interesting for the kid. Ex – instead of feeding your baby with rice and milk every day, introduce variety. Plan for rice and curd, or lightly lemon flavored rice, mix rice with mung dal from pulses group to add protein and variety to your kids menu.
After your kid turns 15 – 16 months old, you can mix up 2 or more food groups together. Ex – oats porridge with apple. Here oats cover the cereal group, milk will cover up for protein and apple will cover the fruits group. Some kids with good digestibility can tolerate the mixed groups concept right from 12 month on wards.
Cereal group – This group includes cereals like rawa (semolina), ragi, rice, oats, wheat and its products like brown bread, wheat based biscuits. These cereals are easy to digest. Initially its best to grind the food product, or mash it well to avoid choking. Some kids take time to learn to chew.
Milk and milk products group – As the name suggests this group includes all varieties with milk. Cows milk has the best digestibility. Hence it is preferable to give you kids cow’s milk. You can later introduce him with milk products like cheese, curd, buttermilk and paneer. Cheese on brown bread is a good snacking option for your 2+ year old toddler. They relish it.
Non – vegetarian protein group – This group includes chicken, eggs and fish. I would really recommend you to start your kid a little late with fish. May be after he is 2 +. This will ensure his digestion capacity. It is not that kids do not eat fish before this age. There are individual differences and food preferences. All you need to do is ensure about your kids digestion capacity,
And allergic reactions to these foods.
Dals and pulses group – Start with easily digestible dals like mung dal. Once they are tolerated well by the kid, you can then move forward to slowly introduce her with all the other varieties of dals, and pulses. Make sure the first time you try any new pulse, it should be diluted enough. If your baby has any sign of intolerance towards these foods, like change in color of stool, hard stool or watery stool or gases or stomach ache after the intake, reintroduce the food after a week in a diluted form
Fruits and vegetables – The fruits and vegetables that are mentioned under the groups in the above info graphic diagram, can be used in any form. You can mash the fruits, make juice out of it, pressure cook the fruit for 1 whistle and then mash it (apple). Or you can hand over them as slices to your kids. So they also learn to eat on their own. You can use vegetables in soup forms or cooked vegetable form, just the way you consume it at home. Make sure you add little or no spices to the preparation. You can introduce the spices and masala for the baby after she is 2.5 + years of age.
Fats and sugars – This group is placed in the center on purpose. Although you need to use very little amount of fats and sugar for your toddler, but please do not ignore this group. Your baby really needs good fats for better digestion. Don’t forget that these little ones also require tasty foods just like us. You can add sugar or jaggery to their food preparations.
Note – You need to feed your growing toddler every 2- 3 hrs, don’t wait for them to signal for hunger. Kids get really cranky and irritated if they go without food for long. To become a smart mom, you need to set your timetable accordingly. Keep your busiest hours for their milk feeds. But do not over do milk. Excess milk feeds and no solid will make her/ him hate food. They may also get loose motions, uncontrolled bladder. They would become cranky if you don’t give them enough solids. And the kid will want to stick to you at all
Here is an indian diet plan for toddlers for your reference.
Time and menu:
- 7.00 am (after waking up): 1 glass milk + 4 soaked almonds
- 9.00 am Breakfast: Choose any 1 from the mentioned options: Rawa kheer / ragi kheer / vermicilly kheer, Soft cooked rawa upama with finely chopped carrots, Soft cooked mung dal chilla with grated carrots and finely chopped spinach, Curd with soaked poha, (add a little salt or sugar as per your kids taste), Soft dosa or idli with sambar
- 11.00 am: 2-4 slices of apple / orange / water melon /musk melon / pomogranate / papaya / 2 wheat based biscuits / ragi flakes (handful) (any seasonal fruit)
- 1.00 pm: Lunch (choose any 1 from the mentioned options)- Curd rice / dal + rice / sambar + rice / milk + rice / vegetable pulav / kadhi + rice / lemon flavored rice, Vegetable khichadi, Daliya upama (soup consistency), Vermicilly upama, Soft cooked roti or phulka with toru / bottle gourd / palak / methi / potato vegetable
- 2.30 pm: Buttermilk (optional) / ragi kanji
- 4.00 pm: Choose any 1 from thementioned options- Oats porridge with chopped apple or banana, Fruit smoothie with almond or walnut (at room temperature), Milkshakes, Hot milk with 4 biscuits, Aata laddu – 2 small, Dry fruit chikki, Sliced / boiled veggies like carrot, broccoli with curd dip, Tacos with vegetable based greek yogurt dip, Home made wheat cake piece
- 6.00 pm: Spinach soup / carrot soup / tomato soup / mix vegetable soup / corn soup (grind corn kernel in a mixer) / fruit juice during warm climate
- 8.00 pm: Dinner (choose any suitable option from breakfast or lunch menu)
- 10.00 pm: Bedtime- 1 glass milk + 4 soaked almonds
Note – The above mentioned diet plan is a general diet plan. This indian diet plan for toddlers meets the nutritional requirement of an average indian toddler. Some foods may or may not be suitable to some kids, in such a case a personalized approach is necessary.
Important tips to consider while following this indian diet plan for toddlers:
• Milk intake:
Give your toddler the regular milk when he wakes up in the morning. Give him 100 to 200 ml of milk in the morning and in case he/she is allergic to milk and milk products, you can replace milk with a whole fruit, almond milk, or soya milk. If your child has crossed 2 years of age, you may consider adding health drinks such as pediasure to his milk. Make sure to give your toddler full cream milk and he/ she requires milk energy to support his body’s functions and to grow into a powerful adult with time. In the evening, give your toddler 100-50 ml of milk depending on his preference. Yes, do value his preference as many toddlers simply hate the taste of milk. You can’t help as i’m sure many of you also hated milk in your childhood. Use your imaginations, make them tasty smoothies or milkshakes
• Water intake
A toddler’s daily water intake may typically consist of at least 5 cups of water. This includes the juices, milk, and other fluids that your toddler consumes throughout the day.
Make sure you give your toddler wholewheat or brown bread or bread that is fortified with vitamins and minerals.
• Fruits and vegetables
You may opt for cooked or pureed food. Cooked or pureed vegetables with bland flavors are the best options for toddlers. These may include vegetables such as pumpkin, potato, sweet potato, squash, carrots, and butternut. Try with mashed food items. It’s better to feed ytout toddler steamed vegetables and pulses
• Homemade food:
Today’s nuclear family setups coupled with an increase in the opportunities for women employment, time has become a scare resource for today’s families. It is always better to avoid tinned and packaged foods as they contain preservatives that may be detrimental to your child’s health. Make sure you invest some time to secure your child’s health and prepare meals at home. We are sure love will help you find that time!
• Oatmeal cereals
It is a good idea to help your child build healthy eating habits since a very young age. You may introduce oatmeal cereals at a very early stage as they are healthy breakfast options and your child is most likely to develop an acceptance for oatmeal cereals as well as other complex carbohydrates.
• Portion intake
1 tablespoon of each food: the rule of thumb. At one time, a one-year old child should be fed 1 tbsp of cooked cereal, pureed fruit, pureed cereal, cooked meat, cooked vegetable, one egg and ½ cup of milk and dairy products. On a similar line, a 2-year old child should be given 2 tablespoons of different foods at a time. And as you can already guess, 3 tablespoons of different foods at a time constitute the perfect dietary portions for a 3-year old child.
• Nutritious snacks
Your kid will eat when he/she is hungry and will stop when he/ she feels full. Sometimes, you may consider providing nutritious snacks to your kid. This does not mean that you have to put a lot of extra effort in preparing healthy snacks as a lot of healthy yet no-hassle snacks are available in the market. Prepare some finger-friendly, bit-size foods and your toddler will take the responsibility of feeding himself/ herself:
• Thinly-sliced fresh fruit
• Low-sugar breakfast cereals
• Mini muffins with whole grain crackers
• Shredded cheese
• 2-4 ounces of pure fruit juice, with one part juice being mixed with two parts of water.
• Start with pureed or strained vegetables such as green beans, squash, or carrots.
Some common mistakes that you should avoid:
• Making your child drink more than 16-24 ounces of milk per day.
• Forcing your child to eat when he/ she is not hungry.
• Allowing your child to eat sugary snacks
Don’t get in to a habit of worrying about your kid’s food. The only thing that you should observe is whether your child is gaining weight with time and whether he is remaining active throughout the day. Too much of restrictions in his/ her diet or too much of ‘çarefree’ attitude may actually harm your child’s health. Refer this indian diet plan for toddlers and enjoy your child’s meal times, be a little creative and allow him to enjoy his/ her creative side as well.
When I do any kind of neck or any exercise I feel like everything around me is moving. It gives me a lot of problem. So please tell me the reason behind this problem and how can I get relief from it?
- Kidney disease can affect children in various ways, ranging from treatable disorders without long-term consequences to life-threatening conditions.
- Acute kidney disease develops suddenly, lasts a short time, and can be serious with long-lasting consequences, or may go away completely once the underlying cause has been treated.
- Chronic kidney disease (CKD) does not go away with treatment and tends to get worse over time.
Kidney disease in children can be caused by
- birth defects
- hereditary diseases
- nephrotic syndrome
- systemic diseases
- urine blockage or reflux
A health care provider diagnoses kidney disease in children by completing a physical exam, asking for a medical history, and reviewing signs and symptoms. To confirm diagnosis, the health care provider may order one or more of the following tests:
- urine tests
- blood test
- imaging studies
- kidney biopsy
Treatment for kidney disease in children depends on the cause of the illness.
- Children with a kidney disease that is causing high blood pressure may need to take medications to lower their blood pressure. Improving blood pressure can significantly slow the progression of kidney disease. As kidney function declines, children may need treatment for anemia and growth failure.
- Children with kidney disease that leads to kidney failure must receive treatment to replace the work the kidneys do. The two types of treatment are dialysis and transplantation.
- For children with CKD, learning about nutrition is vital because their diet can affect how well their kidneys work. Parents or guardians should always consult with their child’s health care team before making any dietary changes.
What are the Symptoms Associated with Pediatric Kidney Disease?
Kidney disease often goes undetected in the general population, but children and adolescents are at an even greater risk due to the nature of the causes of the diseases and the ambiguity of the symptoms.
Children might not be aware of some of the changes that are impacting their body and will not always let their parents know of potential issues.
Common symptoms for children are:
- Swelling (even mild) of the hands and feet and/or puffiness around the eyes caused by excess fluid build-up, to the point where the child’s ability to move around normally is compromised
- After initial swelling, socks or a belt can leave an indentation in the skin that will persist
- Lack of or decrease in appetite.
- In children with ESRD it is especially important to keep their appetite up because transplant eligibility is based partially on growth.
- Decreased or increased frequency of urination. Children who can normally use the toilet without assistance may suddenly begin to wet the bed at night
- Long-lasting changes in the color of the urine such as unusually dark or red, which can indicate blood, and changes in appearance of urine such as extra foam that can indicate protein
- Headaches resulting from high blood pressure
- Flu-like Symptoms such as nausea, vomiting, weakness, fatigue, loss of appetite
- Stunted or poor growth as compared to similar age group peers
- Difficulty concentrating and poor school performance
Another potential indicator of pediatric kidney disease is family history of kidney disease. Genetic related disease is much more common in children than in adults. If there is family history, it is a good idea to get a check-up.
In parents that are pregnant with a child with polycystic kidney disease a common symptom is decreased amniotic fluid.
Looking at the list of common symptoms it is easy to see how CKD can go undiagnosed. As a parent or caregiver, it is important to have conversations with your children to understand the severity and duration of the symptoms and follow up with pediatric nephrologist.
Trust is something which one keep up the faith and kindness of loyalties towards an individual or an objects which is really an abstract, that means which can't be seen or felt physically. But it could be in one to one conscious world which can even gets broken when the trust can't come in action or to one real believe in it's nature which suppose to be, thus this could play an important role in human life in various forms of its period
Trust also plays a good value in all relationship like child to parents husband to wife lovers themselves one to one patient to doctors employee to management teachers to students and vice versas to all.
This is an confidence where it could be well played to the periods of life cycle and its various phases, and if this gets failure by one it looses others genuineness and quality of the contents involved and may be very difficult to soothen the wounded souls. Sometimes time and period also may reverse the effectiveness of the loss of trust and also gaining the trust too.
Hi Doctor, My daughter is 22 months old. I have a question over her diet. As summers are at peak, my baby is not eating or drinking any thing, she only takes Lactogen- Stage 4, which is a cause of worry for me. She is becoming very weak now a days. As she is not eating properly, she is getting irritated and crying all the time. I request your help to get a solution for her healthy diet during summers. Thank You!
Hello Actually from yesterday I feel ball like below left side near kidney. Some times I feel tight at the same place .I also feel vomiting continues, and more I Wake up early morning. I feel slide pain in my lower abdomen sometimes. Is the pain gradual or sudden? Gradual Any nausea or vomiting? No Any recent weight loss? No Any loss of appetite: No Any bloating of stomach: Yes.
How to deal with muscle cramps. I'm a mixed martial artist and due to heavy and hardcore practice and exercises I have to deal daily with muscle cramps starting from shoulders to legs.
Hello. I recently got married and we are trying to conceive ever since. I missed my period and its been 5 days since. We did a home pregnancy urine test with VELOCIT with the first urine of the morning. However the device showed as negative. What should I do. Should I get a blood test done to determine pregnancy?
Dr. I am a solder in army and My knee is paining very sever I can not say to my unit Dr. Becoz my training will bi delayed so pls recommend me some precautions.
I've been having really painful periods. It is especially painful because of the cramps and the constipation. There's a really sharp pain whenever I try to poop or pass gas. My period has been getting stronger and I've also been getting a lot of fatigue. I looked it up and I think I have endometriosis.
Arachnoiditis is a sort of inflammation of the defensive layers of the spinal canal. You can envisage it as the scar tissues that enlarge in the arachnoid lining. Also the lining can turn out to be inflamed due to the recurrent intervention on the spine, a lot of surgeries can lead to the scarring, for instance. It can also expand due to definite type of the spinal infections as well as due to the chemicals of epidural steroid injections, particularly if these kinds of chemicals get into the spinal fluid.
As the disease increases day by day, the symptoms also become bigger in magnitude. A lot of people who are suffering from this type of problems are incapable of working. Further due to Arachnoiditis the following symptoms are likely to happen
- Grounds of the nerve roots to plod together
- The nerve pain
- The numbness
- The tingling
Radio Frequency rhizotomy is primarily effectual on the joint pain. Patients who are good candidates for the RF have the pain whilst they're doing activities that increase the stress of the spine. Also the RF blocks all the nerves around the joint from sending the pain signals to the brain, as well as that pain free period normally lasts around one year. In that time, patients have to learn regarding the postural correction as well as the good body mechanics. RF presents the patients an option to get back their mobility as well as provide training regarding the movements of their daily lives with the less pain.
The details of information about drugs which might help arachnoiditis:
There are lots of pain management treatments available. Further patients might try the medications to find out the pain relief. A number of options are:
- The NSAIDs ( one kind of the anti-inflammatory drugs)
- The corticosteroids kind of drugs
- The anti-spasm type of the drugs
- Also an anti-convulsant drugs as well as
- The narcotic type of the pain relievers
A number of these types of medications might be given with a spinal pump. That is the little device which is entrenched under the skin and it then distributes the medication straightly to the inflamed area.
Also the patients might also take the spinal cord stimulation. On the other hand, the natural type of the treatments can assist, also, as well as it can often be utilized in conjunction with the prescribed type of the medication. You can also consult with your doctor about your options regarding your treatments.
Bone issues are very common. From infection to inflammation to injuries to mere old age, bone issues are very common. Arthritis can happen with any of these conditions. The healing of this has two aspects one is to heal and reduce the pain and the second is to address the underlying condition. The range of motion needs to be improved, and further damage to the bones should be arrested.
Ayurveda identifies two types of joint problems, one is due to poorly nourished bones, which are prone to damage and the second is the over accumulation of toxins, leading to joint pain and stiffness. This joint pain would be further aggravated by damp weather.
Ayurveda also believes that the overdose of vaata leads to bone issues. So food items aimed at reducing vaata should be included so that balance is restored. There is more than one component to this healing. Food, lifestyle changes, herbs, and exercise manage bone issues, arthritis and the pain. Let’s see how.
- Food: Eating whole grains, fresh fruits and vegetables, as well as a calcium rich diet is very essential for healing bones. Eat freshly cooked food items and include a lot of dairy products.
- Lifestyle: A regular sleep schedule, which is in sync with the biological clock, is very essential. Also eat at regular intervals with the meals getting lighter as the day goes by. Exercise, even in the form of brisk walk, helps soothe joints and keeps them agile.
- Massages: Oil massages like Abhyanga are very essential to prevent joint problems. They also help in reducing toxins, which are quite high in chronic conditions like arthritis. These oils can be applied directly on the joints too to improve lubrication, movement and reduce pain.
- Go anti ama: There is another component known as ama, which is an equivalent of toxins. The diet and lifestyle should be aimed at reducing ama, which gets accumulated with age in the form of digestive toxins. Eat food products that are easy to digest, consume ama reducing spices like turmeric and pepper, avoid daytime napping and exercise regularly.
In addition, the following herbs are known to be beneficial for bone health.
- Ashwagandha: It has rich anti-inflammatory properties, produces effects equivalent to steroids and helps in controlling joint pain and inflammation. Swelling and movement are also improved with its regular use.
- Boswellia: Combined with Ashwagandha, this is another wonder drug that helps reduce bone inflammation. It suppresses release of chemicals responsible for inflammation and helps control pain and swelling.
- Turmeric: One of the most acclaimed anti-inflammatory agents, it releases multiple enzymes and thereby controls inflammation.
So, for bone pain and arthritis, an NSAID is not the only remedy.
Foreplay refers to the preliminary acts preceding the sexual intercourse. Foreplay isn’t given much importance although it is the crucial part of the entire sexual experience.
Why is it important?
Biological Perspective: From the biological perspective, it is extremely important, especially for a woman to indulge in foreplay. Foreplay enhances the arousal, thus causing the erection of the clitoris. The clitoris functions similar to that of the penis. The rushing of blood to the clitoris leads to its erection which is necessary to achieve an orgasm. Foreplay also elicits vaginal wetness which makes the proceeding penetrative sex easier and painless for both, the man and the woman. The lack of vaginal wetness causes the sexual intercourse to be rather painful and sometimes involve some amount of bleeding. Contrary to the popular myth, foreplay is equally important for both the sexes. According to research, men and women both reported of achieving better orgasms when there was a greater build-up of sexual arousal.
Psychological Perspective: From the psychological perspective, foreplay instills the feeling of security and causes less vulnerability. The lack of foreplay apparently gives a sense of being neglected and denies the emotional assurance needed by most. Research shows foreplay enhances the relationship of the couple outside the bedroom. Foreplay is essentially important in long term relationships as it helps in enhancing the feelings of togetherness. Foreplay is also important in letting the partner feel they have your attention and care. It is essential in instilling psychological security and emotional wellness.
Also, it is necessary to achieve mutual pleasure from the sexual act and hence, attention must be given to the need of both the partners for a fulfilling experience. Foreplay is important in achieving orgasm, especially for women who do not necessarily achieve an orgasm through penetrative sex. With everything said and done, there is nothing wrong with an occasional skipping of the foreplay if that is what both the partners want. It is important to see what each partner is getting out of the entire sexual experience and work according to it.
Tips to have a great foreplay-
- Aim for the area around the lips: People mostly focus on the plump part of the lips, ignoring a sensual, arousing sweet spot which borders the lips. Your lips and its periphery contain several blood vessels. Slowly brushing through that area will give you a tingling, almost ticklish sensation that will run through your spine.
- The little triangle: The entire neck region is a highly erogenous spot. This includes the ears and the spot behind it, the neck and the shoulders. However, the junction where the collarbone meets your neck, the little triangle, has a thinner skin enveloping it. Linger around the spot a little longer maybe, before running down to the more obvious erogenous regions.
- Trail the thighs: The area around your thighs is home to one of the most explosive nerves that can simply make your breath go into hyper-drive. Start with supple, soft kisses around your thighs, with stray light strokes. This excites your genital area more because the nerves on the thighs directly lead to the genitals. This move will probably have your partner asking for more.
- Talk dirty: This act can have your partner flying off the handles if done right. You may want to test the temperature first in order to know what degree of talks does your partner like. Whether he is into low-key dirty talks or full-blown adjectives.