Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

Diabetes is often called the silent killer. This is because you would not even know when it sneaks up on you. It may not have any symptoms initially but once you have it, you would need lifelong administration of drugs. Diabetes or diabetes mellitus, is a metabolic disease in which sugar does not get metabolized properly in the body. This means that the blood sugar levels continue to be high, threatening the normal functioning of the body.

Types of Diabetes

There are three types of diabetes. These are:

Type 1 Diabetes: this is a condition in which in which the body does not produce insulin at all. Patients suffering from this condition may need to take insulin supplements for the rest of their life, in order to properly metabolize sugar in the body. This is a very rare, genetic condition.

Type 2 Diabetes: this is a condition in which the insulin product is impaired and there is not enough insulin in the body for metabolizing sugars properly. This leads to high blood sugar and eventually, the symptoms of diabetes.

Gestational Diabetes: This is an affliction of pregnant women. Some women s bodies may not be able to produce enough insulin at the time of pregnancy and therefore they have excess sugar in their blood stream. Gestational diabetes may be harmful for both the mother and the baby.

Diabetes Treatment in Ayurveda

For Ayurvedic treatment of diabetes, the first step is usually dietary planning and lifestyle change. Adopting a more active lifestyle, and a healthy, balanced diet low on sugars and starches, is a must. You must begin by avoiding sugars in all forms. This means you will have to get rid of rice, potatoes, white bread, sugar coated cereals, bananas, colocasia and much more. Add a lot of green leafy vegetables to your diet to improve your nutritional status and metabolism. In addition to these, also add some herbs to your diet. Ayurvedic herbs that act as natural medicine for diabetes include turmeric, bitter gourd, gurmar leaves, bael, fenugreek and many more.

Apart from diabetes Ayurvedic treatment, you could also practice yoga, which can help you improve your health. Several yogic asanas help massage your internal organs so that they are healthier and can function much better. Some of the asanas are especially beneficial for the pancreas, which produce insulin. You may have to make some changes to your lifestyle as well. For starters, you will have to maintain a more active lifestyle. You will also have to avoid sleeping in the daytime. Avoid smoking and consuming alcohol and take extra care of your feet.

Here are a few home remedies that may help cure diabetes naturally:

Juice of Bitter Gourd:

You may consume 30ml of fresh juice of Karela/ bitter melon every day early in the morning. You can also mix it with other things to make simple recipes and consume it.

How to prepare:

Separate the seeds and mix the fruit in the mixer. Add a little bit of water and mix it in the blender. Use a sieve to obtain the juice.

Small and thin pieces of the bitter gourd are cut. Fry them with some mustard oil and the required quantity of salt. Add green chillies and onions to the pan and heat the mixture for 10-15 minutes.

Aloe Vera and Ground bay leaf:

The mixture of aloe vera gel (1 tbsp), ground bay leaf (1/2 tsp), and turmeric (1/2 tsp) is recommended to be taken twice a day before lunch and dinner for effective hyperglycaemic control.

Methi Seeds:

Methi seeds, also known as Fenugreek seeds, when taken by itself or in combination with other Ayurvedic herbs, can act as an effective remedy to lower the symptoms of diabetes.

How to prepare:

Grind a few Methi seeds and turmeric together and take it with a glass of milk at least twice a day.

Soak fenugreek seeds in warm water overnight followed by chewing it in the morning.

Soak 4tbsp of fenugreek seeds in about 300ml of water overnight and chew it the following morning.

Prepare chapattis with fenugreek seed powder

Jamun Seeds:

The powdered seeds of Eugenia jambolana (about 1 tsp) should be taken twice a day with lukewarm water. Jamun has the beneficial property of not allowing the starch in food to get converted into sugar.

Amla:

Amla juice (Embelica officinalis) (20 ml) two times a day is beneficial for a diabetic patient. You may also use powdered  Amla  powder and consume it twice a day.

Banyan Tree Bark:

A decoction of the bark of banyan tree is taken (50 ml) twice a day.

Preparation method: 20 gm of the banyan tree bark is boiled in 4 glasses of water. Evaporate the water until only about one glass of the decoction is remaining and drink it when it is warm.

Cinnamon Powder:

Cinnamon powder is probably considered as one of the most important home remedies.

How to prepare: Add 3-4 Tbsp of cinnamon powder and add to one litre of water and boil the same for about 20 minutes. Strain this mixture and cool the same. It is recommended to consume it every day.

Diabetes Cure In Ayurveda 

Diabetes is growing to be the epidemic of modern days. The challenge here is it is not just about managing your sugar levels, but the whole lot of symptoms that diabetes brings with it. From bones to teeth to kidneys to wounds, diabetes affects all body systems. It is therefore very essential to watch out for symptoms of diabetes and curb it in its early stages. This will help control diabetes significantly along with its effects on the whole body.

Diabetes Complications-

Long-term complications of diabetes develop gradually. The longer you have diabetes   and the less controlled your blood sugar   the higher the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening. Possible complications include:

Cardiovascular disease. Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis). If you have diabetes, you are more likely to have heart disease or stroke.
Nerve damage. Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in your legs. This can cause tingling, numbness, burning or pain. Left untreated, you could lose all sense of feeling in the affected limbs. 
Kidney damage. The kidneys contain millions of tiny blood vessel clusters (glomeruli) that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.
Eye damage. Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. 
Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. These infections may ultimately require toe, foot or leg amputation.
Skin conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.
Hearing impairment. Hearing problems are more common in people with diabetes.
Alzheimer's disease. Type 2 diabetes may increase the risk of Alzheimer's disease. 
The following are some of the basic must do's if you have diabetes. These can go a long way in preventing adverse diabetic side effects.

Diet: Whether diabetic or not, it is always important to watch your diet. You are what you eat. Eat what your body needs, reduce refined foods, processed foods and increase the amount of whole grains and fruits and vegetables. Eating small frequent meals goes a long way in managing sugar levels than binging at one meal and starving the rest of the day. Reduce intake of saturated fats; include more lean meats. Choose grilling and steaming over frying and roasting. Diet is very important in diabetes. Recommended foods - Healthy carbohydrates, Fiber-rich foods, Heart-healthy fish and Good fats. Foods to avoid - Saturated fats, Trans fats, Cholesterol and Sodium
Exercise: Every week, make sure about 2 hours is dedicated to physical activity. This could include any exercise of your choice, brisk walking, swimming, cycling, aerobics, hiking, jogging, skipping, gymnastics, or playing games like football or basketball. While in most cases, the person can do these on their own, in some people, supervision may be required.
Watch your weight: For a diabetic person, controlling weight to a desirable level of BMI of 18 and 23 is very important. Obesity is one of the predisposing factors for diabetes, and reducing weight controls the onset of diabetes and helps the progression of symptoms in diabetics.
Smoking: Another risk factor for diabetes onset, quitting is the best option. If not feasible, reducing smoking and gradually quitting should be aimed at. Not just diabetes, the effects on overall health will be evident almost immediately after quitting.
Stress management: One of the main risk factors for diabetes, there is no getting away from stress. Everybody has their stresses but the trick is to manage it well. Whether it is music or meditation or medication or counselling, make sure stress levels are managed. This also helps prevent diabetic complications like heart disease and stroke and promotes well-being.
Constant Checkups: Periodic check-up of blood sugar levels, cholesterol levels, eye exam, dental checkup, foot checkup to test for nerve damage are all extremely important. Take your medications regularly without fail.
Diabetes requires a change in lifestyle, which may seem tedious initially. But after a while, it will become the norm and then diabetic control does not feel like something additional that is to be done.

Diabetes - 6 Ways You Can Prevent it

What complications are associated with diabetes?

Diabetes is a serious disorder which happens when your body has an unreasonably high level of blood sugar, which further leads to harmful effects. Diabetes has a wide variety of complications associated with it, and they start to build up slowly and gradually. Some of the common complications are:

Retinopathy

In simple words, diabetes leads to eye damage by making the eye exposed and prone to severe eye disorders like cataracts and glaucoma. If you have retinopathy, then you may also have face the consequence loss of vision or permanent blindness.

Skin conditions

During diabetes, your skin health is bound to degrade to a large extent. Your skin will become thin in texture and more prone to cuts and breakages due to internal skin cell damage. Thus, the skin gets more exposed to the bacterial and viral infections and its healing process also slows down as the cell division takes longer than usual.

Nephropathy

Nephropathy refers to kidney damage which is caused due to diabetes. The kidneys act as a filter system to the body and they filter out waste materials from the blood. Diabetes causes damage to the blood vessels of the kidneys which may further result in serious kidney disorders and may increase the risks of a sudden kidney failure.

Cardiovascular diseases

This means that if you are having excessive diabetes, then you are at a risk of having a major heart attack or a heart stroke. Additionally, increased blood sugar levels also lead to other heart-related diseases like chest pain, narrowing of arteries etc.

Neuropathy

It is a complication related to the nervous system of your body. The complication generally occurs in the legs as there is a numbness, burning or tingling sensation in the legs. This happens due to the extra sugar in the body, which damages the walls of the blood vessels. In the worst case scenario, you can lose sensation in the legs.

However, it is always desirable that you go and visit a doctor if the conditions persist for a longer time. Additionally, you can also depend upon some domestic care measures to bring your blood sugar levels under control.



What complications are associated with diabetes?

Exercise has a considerable number of benefits to offer people who have diabetes. As a result of doing exercise on a regular basis, the blood sugar level stays in check. Managing diabetes without indulging in any physical activity is near to no good as exercise is the backbone of diabetes treatment. Here are the ten exercises that prove to be great for people with diabetes.

Walking: Walking is considered to be one of the best exercises for treating diabetes and the most prescribed physical activity for people with Type 2 diabetes. A daily brisk walking of at least 30 minutes can be the easiest way of increasing one s physical activity level.
Running/jogging: By jogging or running daily, people can control their blood pressure and ensure good heart condition. It proves to be extremely beneficial for diabetes people who often develop risks of heart attacks or high blood pressure.
Weight training: As regular weight training helps in building the muscle mass, opting for this becomes necessary for people with Type 2 diabetes. Because losing muscle mass means difficulty in maintaining the blood sugar levels.
Tai Chi: Tai Chi helps in relaxing the body and mind as well as ensures trouble-free body movements. Tai Chi plays a crucial role in reducing stress and nerve damage, which is a common complication in diabetes.
Swimming: Swimming helps in relaxing and stretching the muscles, without exerting any pressure on the joints, which is why it is a great exercise for diabetic people. Often diabetic people lose sensation in their feet, which makes swimming the best option for them.
Yoga: Helping in lowering the body fat, improving the nerve function, and fighting the insulin resistance, yoga can benefit people suffering from diabetes in a lot of ways. By controlling the stress, it indirectly helps in lowering the blood sugar levels.
Stationary bicycling: A form of aerobic exercise, stationary bicycling ensures a strong heart and well-functioning lungs. Burning lots of calories, it improves the blood flow to the legs, which is important for diabetic people.
Water aerobics: Water aerobics, too, has a lot of benefits to offer to the diabetic people in terms of regaining the right body balance and strengthening the muscles.
Playing: For those who enjoy playing tennis or basketball, treating diabetes with exercise can be an easy job. All one has to do is play rigorously on a daily basis, and the body will stay fit and the blood sugar levels well controlled.
Dancing: Dancing can be a great way of doing exercise for the diabetic people as it helps in improving the flexibility of the body, reducing stress and lowering the blood sugar levels.
By including exercise as a regular part of their daily life, people with diabetes can not only experience positive effects on their diabetic condition but can also achieve an overall good health with desired fitness.

10 Exercises That Will Surely Help Diabetic Patients!

Diabetes is a metabolic disorder, chiefly caused by insulin fluctuation in the body. A study shows that, 1 out of 3 people suffering from diabetes are likely to develop a skin condition sooner or later; and in some cases, these skin problems serve as symptoms of diabetes. Although these skin problems can be cured easily if treated early, proper care must be administered at all times. Here are 7 skin conditions that affect diabetics:

1. Bacterial infection

Although anyone can get a bacterial infection, people suffering from diabetes are likelier to contract them. Usual bacterial skin problems that tend to trouble diabetics are boils, lumps near the eyelids, nail infections and carbuncles. Diabetics are also prone to infections deep in the skin and of the underlying tissues. The affected area is usually warm, red and swollen.

2. Fungal infections

People who have diabetes have an increased risk of contracting the fungal infection, especially the one known as candida Albicans. The fungus tends to create a red, itchy rash, which is surrounded by blisters and scales. These are usually found in warm places of the body like the armpits, or between the fingers of the hand or perhaps even the toes. Common fungal infections in diabetic people include athlete's foot, jock itch and ringworm.

3. Tingling and itching

Among the many causes of itching, diabetes is one. Yeast infection, dry skin and poor circulation are the primary causes of itching among patients of diabetes. Usually, the lower part of the leg tends to itch the most, if poor circulation is to be blamed.

4. Skin problems related to neuropathy

Diabetes can be the cause of nerve damage in some cases; and neuropathy is a common symptom of diabetes. This type of damage can cause a loss of sensation in a part of the body. On event of an injury, one may not be able to feel it. As a result, an open sore or wound, if left unattended, can develop into an infection.

5. Digital sclerosis

Digital sclerosis, a condition marked by tight, waxy, thick skin that develops on the back of the hand, is common among people who have type 1 diabetes. In this condition, the joints of the fingers get stiff and, thus, lose their mobility and elasticity. Skin of the toes, forehead and knees may also get affected.

6) xerosis

Xerosis is another common skin condition that accompanies diabetes. In this condition, the skin becomes very dry and itchy.

7) acanthosis nigricans

Acanthosis nigricans is the condition where diabetics get darkening of skin leading to skin tags around neck and armpits.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: Does Hormonal Imbalance Hint the Risk of Diabetes?
 

7 Skin Problems Diabetes Gives You

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