Dr. Kunal Chawla

What is High Blood Pressure?

High blood pressure or hypertension is a condition caused when the force of the blood against the arterial walls exceeds drastically than what it normally is. A blood pressure reading exceeding 140/90 over a prolonged period of time is considered to be ‘high blood pressure’ or diagnosed as ‘hypertension’.

What is Diabetes?

Diabetes is characterized by extremely high levels of blood glucose (blood sugar) in the body, either due to the insufficient secretion of insulin by the pancreas or reduced sensitivity of the body to insulin. This makes your body unable to break down the sugars. At first glance, these two conditions seem completely unrelated, but, according to certain studies, the two conditions do have similar outcomes and could be inter-dependent.

The Connect-

According to the American Diabetes Association, the combination of hypertension and type 2 diabetes is particularly lethal and can significantly raise a person's risk of having a heart attack or stroke. Having type 2 diabetes and high blood pressure also increases your chances of developing other diabetes-related diseases, such as kidney disease, and retinopathy (eye blood vessels), which may cause blindness. There is substantial overlap between diabetes and hypertension, reflecting substantial overlap in their etiology and disease mechanisms. Genetic structure, Obesity, inflammation, oxidative stress, and insulin resistance are thought to be the common pathways. A prospective cohort study in the United States reported that type 2 diabetes mellitus was almost 2.5 times as likely to develop in subjects with hypertension as in subjects with normal blood pressure.

In the Hong Kong Cardiovascular Risk Factor Prevalence Study, only 42% of people with diabetes had normal blood pressure and only 56% of people with hypertension had normal glucose tolerance. There are many minor lifestyle changes that can lower your blood pressure and blood sugar. A brisk walk for 30 to 40 minutes every day, or any aerobic activity can make your heart healthier. In addition to lowering blood pressure and blood sugar, physical activity can strengthen the heart muscle and may reduce arterial stiffness. You may need minor modifications in your diet like, cutting out sugar salt, high-fat meats etc. You can take several servings of vegetables, low-fat dairy products, leans meats and fish or meat substitutes, fruits, whole (not processed) foods, whole-grain pastas, breads, and brown rice etc. While some people can improve their type 2 diabetes and hypertension with lifestyle changes, most require medication.

Depending on their overall health, some people may need more than one medication to reduce their risk. Consult your doctor to choose best possible medicines for your diabetes and/or blood pressure control. In case you have a concern or query you can always consult an expert & get answers to your questions!

In spite of adequate sunshine throughout the year, deficiency of Vitamin D has become common in India. And, a deficiency in Vitamin D is believed to be a risk factor for developing type 2 diabetes.

Vitamin D is a fat-soluble vitamin which performs various vital functions such as keeping up the health of bones and joints and assisting the immune system of the body. It plays a critical role in the metabolism of calcium, and the lack of this vitamin can lead to a series of diseases such as cancer, type 2 diabetes and cardiovascular complications.

How is Vitamin D related to diabetes?
Vitamin D aids in improving the body's sensitivity to insulin, which is a hormone meant for regulating blood sugar levels. Thus, this vitamin can reduce the risk of insulin resistance which is often considered a warning sign of type 2 diabetes.

Some experts believe that Vitamin D can regulate the production of insulin in the pancreas. Moreover, it has other health benefits too that can have an impact on the regulation of blood sugar levels. Some of the benefits include:

1. Assisting weight loss- One of the major risk factors for diabetes is obesity. Many studies indicate that having adequate levels of Vitamin D can help in reducing the parathyroid hormone levels, which can promote weight loss and reduce the risk of obesity.
2. Regulating appetite- Vitamin D can raise the level of hormone Leptin, which is responsible for controlling the fat storage in the body. It helps in triggering the sensation of satiety which would make you eat less thereby lowering hunger levels.
3. Reducing fat around the visceral organs- When there are adequate levels of Vitamin D, it can help in lowering the levels of cortisol which is a stress hormone produced by the adrenal glands. This hormone is responsible for performing many important functions including regulating blood pressure. When the cortisol level is under control, it helps in reducing the abdominal or visceral fat which is detrimental to health and has an adverse effect on type 2 diabetes.

Where can you get vitamin D from?
Vitamin D is found in some food items such as healthy fats and sea fish. It is also produced by the body when our skin comes in contact with the UV-B rays of the sun as the cholesterol derivative is converted into Vitamin D. You will be surprised to know that every cell and tissue present in the body acts as a Vitamin D protein receptor.

There are two forms of Vitamin D- Vitamin D2 and Vitamin D3. D3 is synthesized by the human body when the sun rays fall on the skin. This form is 300% more potent than D2, which is the plant-synthesized form that is available as supplements.

If you are at risk of vitamin D deficiency, better bask in the sun for 10 - 15 minutes every day, or start taking supplements as advised by your doctor. In case you have a concern or query you can always consult an expert & get answers to your questions!

Diabetes is a lifestyle disease that results in high blood sugar levels in the body. It basically means that the body is either insensitive to insulin or the insulin production levels in the body go down. The various symptoms of diabetes are blurred vision, weight loss and hunger.

Some other symptoms of diabetes are:

1. Excessive urine output
2. Wounds that take time to heal
3. Yeast infections
4. You may experience fatigue on a regular basis
5. Frequent Mood Changes

Diabetes is also known as a Lifestyle disease. From the food you eat to the amount of activity, they are all connected to diabetes prevention. The various modifications that you may carry out to prevent diabetes are:

1. Exercise: You should exercise on a regular basis as it increases your overall wellbeing. It helps you to lose weight and allows you to maintain optimal blood sugar levels. It can also improve your body's sensitivity to insulin to prevent blood sugar problems. Exercise helps in increasing endorphin levels in the body which are responsible for keeping you happy and satiated, thereby avoiding depression and over-eating.
2. Eat more whole grains: Unlike simple carbohydrates, whole grains are complex carbohydrates that raise your blood sugar steadily instead of spiking it suddenly. Avoid refined grains as most of the important nutrients are stripped from refined grains. A Well-balanced diet with adequate amounts of PUFA/MUFA help in increasing the insulin sensitivity, reducing cholesterol and heart problems, etc.
3. Eat a lot of fiber: If you have type 2 diabetes, you should be, including high-fiber foods in your diet is a healthy way to control high blood sugar. Fiber does not raise blood glucose levels. Because it is not broken down by the body, the fiber in an apple or a slice of whole grain bread has no effect on blood glucose levels because it isn't digested. The grams of fiber can actually be subtracted from the total grams of carb you are eating if you are using carbohydrate counting for meal planning. Fiber helps you in feeling satiated, thus prevents you from overeating. It also improves your blood sugar levels and decreases your chances of getting affected by heart disease.
4. Lose weight: You should aim to maintain a healthy weight level as it also decreases the risk of diabetes. It also helps in improving your cardiovascular health. Follow a regimen, which is based on a balanced diet and moderate amount of exercise. Losing weight is the best way to keep diabetes away. Weight is something that we can keep under control. The waist size of men and women should not be more than 150 cm and 90 cm respectively. Always maintain your ideal body weight as per your BMI (Body Mass Index). Globally, obesity is one of the leading causes of diabetes.
5. Avoid sugary drinks: With ten teaspoons of sugar in every 12-ounce can or bottle, sweet drinks can send your blood sugar soaring and boost your risk for weight gain, high blood pressure, stroke, and heart disease. One sugary drink a day adds 150 empty calories and 40 to 50 grams of blood-sugar-raising carbohydrates to your diet, and can lead to a weight gain of 15 pounds per year. Switching to healthier drinks can save hundreds of calories and a lot of carbohydrates.
6. Avoid Stress: When you are stressed, your blood sugar levels rise. Stress hormones like epinephrine and cortisol kick in since one of their major functions is to raise blood sugar to help boost energy when it's needed most. You can't fight danger when your blood sugar is low, so it rises to help meet the challenge. Both physical and emotional stress can prompt an increase in these hormones, resulting in an increase in blood sugars and diabetes. Ensuring a stress-free life is very important if you want to stay away from diabetes. Avoid stress by going out for garden-walks, indulging in social causes/activities, yoga, meditation, etc.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Diabetic neuropathy is a nerve disorder caused by diabetes. The high blood sugar from diabetes affects the nerves and over time increases a person's risk for nerve damage. Keeping blood sugar levels within the target range recommended by your doctor helps prevent diabetic neuropathy.

Types of Diabetic Neuropathy:
Diabetic neuropathy can be classified as Peripheral, Autonomic, Proximal, or Focal. Each affects different parts of the body in various ways...

Peripheral neuropathy, the most common type of diabetic neuropathy, causes pain or loss of feeling in the toes, feet, legs, and hands.

Autonomic neuropathy affects the nerves that control involuntary body functions such as digestion, bowel and bladder function, sexual response, and perspiration. It can also affect the nerves that serve the heart and control blood pressure, as well as nerves in the lungs and eyes. Autonomic neuropathy can also cause hypoglycemia unawareness, a condition in which people no longer experience the warning symptoms of low blood glucose levels.

Proximal neuropathy causes pain in the thighs, hips, arms, or buttocks and leads to weakness in the legs and hands, resulting in difficulty in walking, standing, picking up objects, buttoning your clothes, etc.

Focal neuropathy results in the sudden weakness of one nerve or a group of nerves, causing muscle weakness or pain. Any nerve in the body can be affected.

How Diabetes Causes Damage to the Nervous System?
There are several factors that are likely to contribute to nerve damage through diabetes...

• High blood glucose, a condition associated with diabetes, causes chemical changes in nerves. These changes impair the nerves' ability to transmit signals. 
• High glucose levels affect many metabolic pathways in the nerves, leading to an accumulation of a sugar called sorbitol and depletion of a substance called myoinositol. These changes are the mechanism that causes nerve damage. Nitric oxide dilates blood vessels. In a person with diabetes, low levels of nitric oxide may lead to constriction of blood vessels supplying the nerve, contributing to nerve damage.
• Presence of mechanical injury like carpal tunnel syndrome in a diabetic patient worsens its symptoms and prognosis
• inherited traits increase susceptibility to nerve disease
• lifestyle factors, such as smoking or alcohol use

Symptoms:

1. Numbness, burning sensations, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
2. Either hypersensitivity to touch or insensitivity, even to hot and cold temperatures
3. Weakness in muscles and loss of reflexes
4. indigestion, nausea, or vomiting
5. diarrhea or constipation
6. dizziness or faintness due to a drop in blood pressure after standing or sitting up
7. problems with urination
8. Changes in gait and balance
9. Injuries that are taking longer to heal and are more prone to infections

Prevent Diabetic Nerve Damage:
Keeping your blood sugar levels in your target range, set with your doctor, may help prevent nerve damage from ever developing. The best way to do this is by checking your blood sugar and adjusting your treatment. It is also important to get to and stay at a healthy weight by exercising and eating healthy foods.

In case you have a concern or query you can always consult an expert & get answers to your questions!