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 a condition where the blood sugar level rises in your body either due to less insulin level in the body or reduced sensitivity of the body to insulin. The foods you eat have a major role in controlling your blood sugar levels. You need to pick your foods wisely to prevent your blood sugar levels from spiking.


The various foods that you should be eating if you have diabetes are:

1. Dark chocolate: chocolate contains good amounts of flavonoids that help in improving insulin sensitivity and limits food cravings. It also reduces your chances of heart attack.

2. Blueberries: blueberries are rich in fiber that helps you in managing your blood sugar levels. They also contain anthocyanins that assist in regulating your blood sugar levels.

3. Fish: fish is rich in omega 3 fatty acids that reduce inflammation in the body, thus reducing your chances of heart problems. Fish is also a good source of protein that helps you in feeling fuller.

4. Olive oil: olive oil is rich in antioxidants that help in reducing your chances of heart diseases and diabetes.

5. Oranges: make sure you eat plenty of oranges as they are rich in vitamin c and they reduce the risk of diabetes. You may also opt for broccoli or strawberries.

The various foods you should avoid are:

1. White rice: white rice is a refined grain which, when consumed, tends to spike your blood sugar levels. You can instead opt for brown rice.

2. Bananas: banana may contain vitamins and minerals, but are also rich in carbohydrates. Instead, opt for fruits like berries that are not only rich in fiber and antioxidants, but also have a low glycemic index.

3. Sugary foods: the term sugary foods is used to describe foods such as pastries, cakes, and cookies. These foods are carbohydrate rich and do not contribute much in making the body healthy. Instead, replace them with natural foods such as chickpeas and peanuts.

4. Dried fruit: various dried fruits contain a high concentration of sugar, which happens due to the dehydration process by which they are formed. So replace them with fresh fruits such as guava and peaches to control your blood sugar levels.

Amongst all other dry fruits, almonds and walnuts can be had in moderation as they contain essential fatty acids and do not affect blood sugars.

Foods to Eat and Avoid When You Have Diabetes

With sedentary lifestyle, refined and processed food habits, obesity and diabetes is the new age epidemic. India, in fact, is being termed as the diabetes capital of the world given the huge rise in the number of cases over the last couple of decades.
There are well established risk factors for diabetes and if these can be managed, then the chance of delaying onset, controlling progress and containing complications are highly possible. Read on to know how simple things can be effective in preventing and managing diabetes.


Weight control: Obesity is the most important risk factor for developing diabetes. A person with normal BMI is 20 to 40 times less likely to develop diabetes than an overweight person. Losing about 10% of the excess weight can help prevent diabetes by more than 50%. Check with your doctor what should be the ideal recommended weight for you and draw up a routine (diet, exercise, etc.) that will help you achieve and stay around that weight range.
Exercise: All methods of exercise help in moving the muscles, which is drastically reduced given our sedentary lifestyle. Moving the muscle (as much and as often as possible) ensures they absorb more glucose and reduce the stress on insulin production. Something as simple as brisk walking for 30 minutes is good enough to reduce the chances of developing diabetes by 50%.
Don t be a couch potato: If watching television is your favourite pastime, it is time to change it. This puts people at risk of developing obesity, heart disease and diabetes. Also, watching television is usually associated with overeating, further adding to the risk of diabetes.
Fibrous foods: Eating fibrous fruits and vegetables as compared to refined and fried foods helps prevent diabetes. 
Whole grains vs processed foods: When you have to choose between a pizza and a bowl of brown rice, go for the latter.
Good fats vs bad fats: Polyunsaturated fatty acids are found in vegetable oils, nuts, and seeds and help control diabetes. Trans fats present in margarine and baked foods are best avoided.
Non-vegetarian foods: If you have a choice, pick fish and poultry versus red meat (processed or otherwise). The fish is rich in Omega-3 fatty acids and helps control inflammation.
Leave the whites: Get off white rice, white refined sugar and white flours. Include brown rice, brown or demerara sugar and wheat flour instead. 
Smoking: Quit smoking and you will note how beneficial it is in preventing diabetes. 
Alcohol: Moderate amount helps in effective functioning of the insulin.
If you have a family history or have risk factors, follow the above to prevent diabetes.

Diabetes - 10 Easy Steps To Help You Prevent it 

Diabetes is probably one of the worst enemies of human health. Why? That is because unlike many other diseases which make you aware of their presence in your body instantly, diabetes is a silent attacker. So, you may continue to be unaware of the disease for a very long time, before you suddenly realize that something is wrong with your body one day. And then tests reveal that you are afflicted with diabetes.

In order to make sure that this doesn't happen to you, you have to keep an eye on the symptoms of diabetes because prevention, no matter how tedious it is, is always better than the cure. Here is a look at the usual but often ignored signs which indicate that you might be suffering from diabetes.

If you are taking more bathroom breaks than usual, and if the rate of going to the loo is increasing gradually with time, it can well be a sign of diabetes. When you are suffering from diabetes, your body becomes less efficient in breaking down the consumed food into sugars and utilising it. Therefore, a lot of sugar gets saturated in your bloodstream and your body gets rid of it by flushing it out through urination.
If you urinate a lot, it is self-evident that you would also feel very thirsty all the time. In some cases, the patients don't realize their problem and drink chocolate milk or aerated drinks which have sweet flavours. This leads to excess sugar in your body again, and the problem continues. So all in all, if you feel very thirsty all the time, get yourself checked.
You might lose weight, and it may really seem like a great thing in the beginning but it is not. When a person has diabetes, he is likely to lose his weight because of the decreasing water level in his body as well as the inability of the body to break down food into more suitable forms.
If you are tired all the time, and by all the time we mean even after getting up from a long and good night's sleep, you may have diabetes. The reason for this is that fatigue comes to you when your body cannot produce enough energy from the food you consume, and this happens only when you have diabetes.
If your cuts and bruises heal slower than ever, you definitely are a victim of diabetes. This is because the immunity and clotting system of your body don't work well when there is a saturation of sugars in your body.

5 Signs That You're Suffering from Diabetes

When the sugar concentration in the blood increases suddenly and unreasonably, the resulting condition is known as diabetes. Sugar or glucose is generally used in order to provide much needed energy to our bodies. But when the pancreas dysfunctions, it leads to a problem in the insulin production. As a result, glucose or sugar gets directly absorbed into the blood, instead of getting absorbed by insulin. And this leads to the condition of diabetes.

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 produces 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.

As an ancient science based on lifestyle related treatment methods that include herbs, massages and life changing tweaks, Ayurveda also provides various methods of managing this ailment. Here's how!

Bitter Gourd: Known as an ingredient that is rich in antioxidants, this can be consumed to take care of diabetes. You will need to first remove the peel of at least four to five bitter gourds before crushing them to create a paste. This paste has to be put through a sieve so that the juice of the gourds can be extracted. You will then have to drink this juice every morning, on an empty stomach.
Cinnamon: From treating coughs and colds to diabetes and other serious ailments, this is a wonder spice that can be found in most Indian kitchens. You can start by boiling a litre of water and letting it simmer on the gas for about twenty minutes. Thereafter, you can add three teaspoons of cinnamon powder to this simmering water. Strain this mixture and drink the entire batch every day to clear out the toxins.
Fenugreek Seeds: For this, you will need to take about four to five tablespoons of fenugreek seeds. These will have to be soaked in a glass of water or about 250ml of water, overnight. In the morning, the softened seeds will need to be crushed before the mixture is strained. The water that escapes should be collected and ingested every day for a period of two months.
Turmeric: Turmeric is a powerful and well-known ingredient that is used for curing and managing many ailments. You will need to mix about half a teaspoon of turmeric powder with one teaspoon of amla powder as well as half a tablespoon of methi seeds or fenugreek seeds powder. This concoction will have to mixed in half a glass of water and taken daily on an empty stomach. This can be used by patients suffering from heart ailments as well.
Diet: Cereals like ragi, corn, kulit, green millet, and barley are known to beneficial for patients suffering from diabetes. Leafy greens are also a must for such patients along with protein-rich foods like soya beans.

Diabetes - The Ayurvedic Remedies! 

At present 3 out of the 5 people are suffering from diabetes and it is the 7th leading cause of death worldwide. Moreover, it is no more restricted just to adults and affects children as well. Diabetes is a metabolic disease resulting in increase in the level of glucose in the body. Glucose is a source of energy for the cells making up the muscles and other tissues in the body. But if the level of glucose goes up, it shows the sign of danger. Diabetes is of 2 types: 

1. Type 1: body fails to produce insulin.
2. Type 2: Body fails to produce enough insulin which is required by the body.

There are no definite signs of diabetes. It simply varies from person to person. In many of the cases it goes unnoticed. Such signs are as follows:

1. Sudden weight loss: You might experience a sudden weight loss of 5 to10 kgs within a month. This happens when sugar metabolism ceases very quickly.  Insufficient insulin prevents the body from taking in glucose in the body cells from the blood to use as energy. In such a scenario the body starts burning fat and muscle for energy. This results in weight loss.

2. Intense hunger: The cells in your body might not get enough energy either due to absence or improper functioning of insulin in your blood. This makes you hungry quite often.

3. Excessive urination and thirst: Due to diabetes, the glucose level in the body goes up. The kidneys are overloaded with the burden of working overtime for filtering and absorbing the excess glucose in your body. The excess sugar, which the kidney cannot store is excreted out of your body. This makes you urinate frequently.  Due to frequent urination the body gets dehydrated which makes you feel thirsty more often.

4. Blurred vision: Due to the high level of glucose in your body tissues gets pulled away from the lens of the eyes. This results in vision issues. If not treated on time, it may even lead to blindness.

5. Increased fatigue: The cells in your body might not get enough energy either due to absence or improper functioning of insulin in your blood. This makes you restless more often and you may even feel too weak to do your regular activities.

If you notice any of these signs, get the level of sugar in your checked and take the required remedies. It is good to get it treated as early as possible rather than facing immense trouble in future.

5 Common Signs of Diabetes That Often Go Unnoticed

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