Almost every man and woman craves to have a child they can call their own. This makes an inability to procreate one of the most dreaded situations. Infertility can be defined as the inability to conceive a child within 12 months of biologically appropriately timed intercourse. Infertility exacts a huge psychological toll on the person.

Infertility often triggers depression in a person. This may be acute and result from specific events such as the holidays, family celebrations of the news of a someone else having conceived a child or could be cyclic and coincide with phases of their fertility cycle. This depression could lead to problems at work and communication with the spouse.

Infertility can also make a person feel helpless and affect their self esteem. Infertility accompanied by depression can trigger the feeling of having lost control over one s life and can make people withdraw into themselves.

An infertile person may also often feel guilty and make them blame themselves and their prior actions for the condition. This leads them to question their worthiness of being a good spouse and potential parent. A woman who has suffered from an STD earlier or has undergone an abortion earlier can become obsessed with blaming herself for being infertile. 

This affects their daily lives and ability to work. An infertile person may also feel guilty for having robbed their partner of the chance to become a parent. This can put a strain on their relationship and in many cases lead to a broken marriage.

When they find themselves unable to conceive a child, a couple may try to time their intercourse with ovulation tools, such as an ovulation thermometer etc. and may try different positions, some of which may be fairly uncomfortable. They may also end up having intercourse more often than desired. In order to prevent sperm from leaking out of the vagina, a woman may also find herself lying in an awkward supine position after intercourse. A combination of all these factors makes the act a chore and with time can lead to a loss of libido.

Infertility can also trigger anger against life for having been treated unfairly or towards other parents. This may also be displaced towards their family and friends leading to situations where they feel ostracized and unsupported.

When dealing with infertility, it is important to understand that neither partner is to blame. Infertility is a physiological condition and can be treated in most cases. It is important for both partners to support each other during this process and if need be consult a counselor.

Infertility - Its Impact on a Person's Mental Health


Many overweight and obese people have darkened and a rather flaky texture behind neck, darkening in armpits and other parts of body with creases and folds like elbows, knees or knuckles. This is commonly mistaken as smudge of dirt, uncleanliness or lack of hygiene. Some people think that it is due to repeated friction caused by necklace or chains etc. In fact it is a sign of'diabetes' which is already developed or might develop in future.

This darkening is due to excessive cell growth and differentiation of fibroblasts caused by excess of insulin in the body especially in obese individuals and type 2 diabetes patients.

In obese individuals and type 2 diabetes patients excess amount of fat especially abdominal fat (tummy fat) causes resistance to action of insulin secreted by pancreas and tends to hamper its action. In return, body produces more and more insulin from pancreas to keep blood sugar under control. This excess amount of insulin secreted by body promotes this skin cell growth leading to the visible condition called'acanthosis nigricans' in medical terms.

After producing excess amount of insulin pancreas start exhausting, this converts into diabetes. At this stage diabetes can be prevented by simple lifestyle modifications &amp; focussed weight loss.

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Are Dark Cracks Behind Neck A Sign Of Diabetes?

'Congratulations! You're pregnant!' Almost all women long to hear these words and nothing should come in the way, even diabetes. So, if you are a Type 1 or Type 2 diabetic, here are a few things you should keep in mind to have a healthy baby.

1. Your blood sugar must be monitored regularly-
The most important thing you can do to have a healthy baby is to keep your blood sugar as close to normal before and during your pregnancy. Testing is recommended a minimum of four times a day. Glucose passes through the mother's blood to the fetus and hence if your blood sugar fluctuates, so will your baby's. High blood sugar levels are especially harmful during the first 8 weeks of pregnancy when the baby's brain, heart, kidneys and lungs are formed.

2. Your pregnancy is considered high risk-
High blood sugar levels can increase the risk of a miscarriage as well as the risks of your baby being born with birth defects. Diabetes can also increase the risk of developing preeclampsia during the second half of your pregnancy. This could result in a C section or premature birth. Thus, maintain regular checkups and keep your doctor in the loop of all your activities.

3. You should watch out for signs of ketosis-
When you have low blood sugar, the body produces ketones that can be passed on from you to your baby. This production of ketones is a result of the body's burning of fat instead of glucose to provide energy and can develop a condition called ketosis. Symptoms you should watch out for are stomach aches, nausea, fatigue, muscle stiffness, frequent urination and fruity breath.

4. You need Vitamins and Supplements-
Most women require vitamin and mineral supplements at the time of pregnancy. Of these, folic acid, iron, calcium and vitamin D are the most important. These supplements help in the healthy growth of the baby.

5. You should exercise regularly-
Maintaining a regular physical activity routine is very important for diabetics who are expecting a baby. This will help you regularize your blood sugar, relieve stress and strengthen your heart. Avoid activities that increase your risk of falling and aim for at least thirty minutes of daily exercise such as walking, swimming or yoga.

6. Check your medication-
Some medication can be detrimental during pregnancy such as cholesterol and blood pressure medication. Consult your doctor to find a suitable alternative if needed. You may also need to change the kind of insulin you take and its frequency and amount. As you get closer to the delivery date, your insulin requirement may even double or triple.

The key to preventing complications during pregnancy is controlling your diabetes. So take your insulin regularly, maintain regular checkups and eat healthy. You need to be seen by your obstetrician more frequently. Your pregnancy will be monitored closely by more frequent ultrasounds and NST. If your sugar level remains under control and pregnancy is advancing well, a natural onset of pains is aimed for and normal delivery is expected.

Diabetes - How To Handle It While Pregnancy?

Performing physical activities on a daily basis always have its benefits, but doing exercise in a well-planned manner is essential for those people who suffer from either type-1 or type-2 diabetes. Becoming more active helps lower blood sugar levels and keep diabetes under control.

Relation between exercise and sugar levels
The food we consume contains sugars which are stored in our blood in the form of glucose. This glucose is absorbed by the muscles in our body, but body fat is the enemy of this absorption process. An obese person is prone to type-2 diabetes since excessive amounts of fat are present in the body which does not allow the muscles to absorb the glucose from the blood. This results in more glucose or sugar level in the blood which leads to diabetes.

By regularly exercising, a person not only burns his/her excessive body fat, but also makes use of the muscles in his body thus allowing the muscles to absorb the glucose present in the blood readily. This helps reduce the sugar level in the blood. Moreover, doing exercise on a regular basis helps increase insulin sensitivity. It helps cells to use available insulin in taking up glucose during and after physical activity.

Understanding blood glucose reaction
The duration for which you perform physical activities will determine your blood glucose level. Physical activity has its effect on your blood glucose level and can keep it in check for up to 24 hours by increasing your body s insulin sensitivity. Every individual needs to monitor how his body responds to physical exercise by regularly monitoring the blood sugar level before and after exercise or as advised by the doctor.
Once you are familiar with the results you achieve with respect to duration and types of exercises you perform you shall be able to control your blood sugar levels more effectively and prevent your sugar levels from going either too high or too low.

Hypoglycemia and physical activity
People who have diabetes should be prepared to treat hypoglycemia or low blood sugar level. Hypoglycemia is more common in people with type-1 diabetes, and people with type-2 diabetes are at lesser risk unless they are on insulin. Individuals who experience Hypoglycemia during or after exercise should consult a doctor immediately.

If you choose to resume your exercise routine, make sure you take a break and treat your low blood sugar level. Once your sugar level gets normal, you can begin your physical activity. What you need to know is that a drop, in sugar level, can occur just after exercise or even long after exercise.

Chances of a drop, in sugar level, occur in those diabetic people who either take insulin, skip meals, or exercise for too long or too hard. If you are finding it hard to keep your sugar level in check, consult a doctor immediately and follow his advice diligently.

In order to avoid hypoglycaemia, you can eat a fruit or nuts before exercise. It is also very important to hydrate yourself during the exercise. Ideally, take a fruit half hour before exercising. Keep yourself hydrated during the workout. Avoid energy drinks.

Why Exercising Is Important In Reducing Sugar Level In Blood?

The adrenal glands, which sit above the kidneys, are very important to your body as they secrete many important hormones. These hormones are required to regulate many functions within the body. The two most important hormones that these glands produce are  cortisol  and  aldosterone . When your body suffers from the condition of Addison s disease, the glands end up producing very little amounts of these hormones. This will result in many functions in the body being adversely affected.


How do you know your loved one is suffering from Addison s disease?
Addison s disease develops overtime and doesn t happen immediately. However, you would be able to notice some of the following symptoms:
Drop in blood pressure which may result in fainting as well
Development of darker skin due to hyperpigmentation
Development of hypoglycemia or low blood sugar
Unexpected weight loss and a decreased appetite in general 
Craving for salt
Extreme fatigue
Irritability and depression
Vomiting, nausea and diarrhea 
Muscle and joint pains
Abdominal pains
Of these, if you start seeing a combination of frequent hyperpigmentation, muscle and joint pains, nausea, vomiting, abdominal pain, extreme fatigue and unexplained weight loss, you should take your loved one to the doctor immediately as these are telltale signs of Addison s disease.


Diagnosis
There are no ways to self-diagnose this disease as it requires proper medical tests. Some of the medical tests that may be advised for this are:
Blood tests: These are done to measure the levels of sodium, potassium and cortisol in your blood.
ACTH tests: This is a test to determine the exact levels of  cortisol  in your blood and whether it is being produced normally or not.
Hypoglycemia test: This is a test to measure whether adrenal glands are producing enough hormones to regulate insulin. If blood sugar is low, it will indicate problems with the adrenal glands.
Imaging tests: Other tests, such as CT scans may also be prescribed to detect problems within your adrenal glands.


Steps to manage Addison s disease 
Pay regular visits to your doctor: This is very important along with regular tests and checkups as other dependent functions may be damaged and suddenly become life threatening. It may fall on you to take your loved one to a doctor regularly for this reason.
Carry bracelets which have your medical information: If your loved one has a tendency to faint due to the problems caused by Addison s disease, it is important that you ensure they always carry bracelets with medical information with them. This way, strangers will be able to recognize the problem and get help quickly in emergency situations. 
Always keep extra medications: This is a very important point as missing a couple of daily doses and medication can result in sudden deterioration of your loved one's  condition. Have all other forms of administering medications handy as well such as syringes among others.

Addison's disease - How to Support a Loved One Suffering from it?

Gestational diabetes is also known as gestational mellitus diabetes (gdm). It is a prevalent disorder which affects pregnant women and the main cause of this condition is the imbalance in the functioning of the insulin, which mainly happens due to the presence of human placental lactogen. Expecting mothers show a raise in their blood sugar level, especially during the last trimester of their pregnancy. Women who do not have a medical history of diabetes can also be affected with this condition.

Prominent symptoms of gestational pregnancy include:
Gestational diabetes does not have any prominent symptoms; it can only be diagnosed through proper and professional screening of blood sugar level. You should immediately consult a doctor if you have any of the following symptoms:
1. Increased level of blood sugar
2. Trouble to concentrate
3. Recurrent headaches
4. Increased thirst
5. Blurry vision
6. Sudden weight loss
7. Decrease in low blood sugar level
8. Anxiety
9. Dizziness
10. Pangs of hunger
11. Pale skin and dry skin
12. Excessive sweating
13. Persistent weakness

How can you manage gestational diabetes?
Modification of lifestyle pattern, healthy food habits and moderate physical exercise can help minimize the risk of gestational diabetes in expecting mothers.
In order to manage gestational diabetes, the following things should be followed:
1. The treatment when accompanied with balanced diet and routine exercises, reduces the occurrence of health problems in both mother and child.
2. A routine screening for type ii diabetes should be conducted throughout the pregnancy, to ensure early detection and treatment of the same.
3. A diet rich in fiber and whole grains minimizes the risk of diabetes in pregnancy, fresh fruits and vegetables are also known to check the blood sugar level in expecting mother, minimizing the occurrence of health problem in both mother and child.
4. Giving up the use of cigarettes and other forms of tobacco may reduce the chances of gestational diabetes in female smokers.

How does gestational diabetes affect pregnancy?
Gestational diabetes is harmful for both the expecting mother and the child. It increases the risk of complications in pregnancy that can prove to be fatal.
Potential risks of gestational pregnancy include:
1. Increased risk of needing a c-section
2. Miscarriage
3. Preeclampsia and high blood pressure
4. Preterm chance of birth.

Gestational Diabetes

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