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Dr. Utsav is a passionate and hard working Diabetologst with a sharp mind for meticulous details for managing critical patients.
Diabetes currently affects more than 62 million Indians, which is more than 7.1% of the adult population. The average age of onset is 42.5 years. Nearly 1 million Indians die due to diabetes every year.
According to the Indian Heart Association, India is projected to be home to 109 million individuals with diabetes by 2035. A study by the American Diabetes Association reports that India will see the greatest increase in people diagnosed with diabetes by 2030. The high incidence is attributed to a combination of genetic susceptibility plus adoption of a high-calorie, low-activity lifestyle by India's growing middle class. The age of onset of Type 2 Diabetes is falling and this condition is now not uncommon among children, adolescents, and young adults even at the age of ten.
At least 68 percent of people age 65 or older with diabetes die from some form of heart disease, and 16% die of stroke.
- Adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes.
- The American Heart Association considers diabetes to be one of the seven major controllable risk factors for cardiovascular disease.
A close link exists between diabetes and cardiovascular disease (CVD), which is the most prevalent cause of morbidity and mortality in diabetic patients. People with diabetes, particularly Type 2 Diabetes, may have the following conditions that contribute to their risk for CVD
- High blood pressure (hypertension)
- Abnormal cholesterol and high triglycerides
- Lack of physical activity
- Poorly controlled blood sugars
Many studies have found biological mechanisms associated with DM that independently increase the risk of CVD in diabetic patients. Therefore, targeting CV risk factors in patients with diabetes is critical to minimize the long-term CV complications of the disease. Diabetes is treatable, but even when glucose levels are under control it greatly increases the risk of heart disease and stroke.
How does one know whether suffering from problems or not? Are the symptoms different than in the Non-Diabetic? Angina is chest pain or discomfort that occurs if your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. One may feel pain in the shoulders, arms, neck, jaw, or back. Angina pain often mimics the discomfort of indigestion. However, angina tends to get worse with activity and go away with rest. Emotional stress also can trigger this pain. In case of Myocardial Infarction, there is a complete blockage of one of the blood vessels supplying blood to heart muscle resulting in damage to the cardiac muscles. In this case, symptoms of angina persist with cold sweat, breathlessness & shortness of breath, fatigue, lightheadedness or sudden dizziness. Although the symptoms may vary from person to person.
Some people who have diabetes may have no signs or symptoms of heart disease and can witness a “silent” heart attack. Diabetes-related nerve damage that blunts pain reception and may explain why symptoms aren't noticed. Thus, people who are diabetic should undergo regular medical check-ups. Tests may reveal a problem much before they witness it. Early diagnosis and management can reduce or delay imminent complications.
40%-75% of individuals with diabetes and no overt signs of coronary artery disease (CAD) suffer from diastolic dysfunction, referred to as diabetic cardiomyopathy which is a result of failure of heart to relax completely after each contraction. This, in itself, may not present with symptoms in its early stages. However, later in progression one may have weakness, shortness of breath, a severe cough, fatigue, and swelling of the legs and feet.
Prevention is always better than cure. If you have high cholesterol, high blood pressure, or diabetes, you can take steps to lower your risk for heart disease. By living a healthy lifestyle, you can help keep your blood pressure, cholesterol and blood sugar in normal levels and lower your risk for heart disease and heart attack. A healthy lifestyle includes the following:
- Eating a healthy diet. (DASH Diet)
- Maintaining a healthy weight. (BMI <25)
- Getting enough physical activity. (30 min of walk daily, 5 days a week )
- Quitting smoking or other forms of tobacco.
- Limiting alcohol use.
- Keeping one’s Blood sugars, BP, cholesterol under control.
How many physical benefits of exercise can you think of? There might be more than you thought: the physical benefits of exercise are numerous but include decreased falls, increased strength, reduce the risk of heart disease, and helps to maintain healthy bones and joints. In addition to the benefits, exercise has no negative side effects, what a great drug of choice!
The benefits of exercise are not just physical, but psychological as well. Exercise can help lower anxiety and depression. Exercise classes have an additional social aspect that can help with loneliness, which is prevalent in older adults. Health is not purely physical; the mental aspect is also essential. Exercise can help with both, but is often forgotten about, making it a vastly underutilized resource.
The importance of exercise cannot be understated. Exercise should be treated as a form of health care itself. Without access to appropriate exercise, older adults lack access to vital health care. With all the side effects of a sedentary lifestyle, active aging is necessary for the health of older adults. Thankfully, active aging through exercise can reverse a sedentary lifestyle.
As doctors begin to prescribe exercise as a preventative treatment, further cost efficient and effective exercise classes are needed. No matter who you are or what your situation, you should have access to exercise. This is a worldwide issue especially as unhealthy diets and sedentary lifestyles continue to increase. Exercise can begin to reverse this trend and improve the lives of people everywhere. Everyone deserves preventative health care. Everyone deserves exercise.
WHO defines health as a complete sense of physical, mental and social well being. And probably one thing that caters to all the above is exercise. Do it regularly and stay healthy.
Happy World Health Day To Everyone!
What is a stroke?
Stroke happens when the blood supply to part of the brain is cut off. Without blood, brain cells can be damaged or die. This damage can have different effects depending on where it happens in the brain. It can affect people’s body, mobility and speech, as well as how they think and feel.
Learn How To Prevent A Stroke
Here are six steps anyone can take to reduce the risk and the danger of stroke:
2. Be physically active and exercise regularly.
3. Maintain a healthy diet high in fruit and vegetable and low in salt to stay a healthy state and keep blood pressure low.
4. Limit alcohol consumption.
5. Avoid cigarette smoke. If you smoke, seek help to stop now.
6. Learn to recognize the warning signs of a stroke.
Stroke is treatable.
Stroke is a complex medical issue. But there are ways to significantly reduce its impact. Recognizing the signs of stroke early, treating it as a medical emergency with admission to a specialized stroke unit, and access to the best professional care can substantially improve outcomes.
The right care makes a difference, but many people are not getting the stroke treatment they need.
6 key facts about stroke treatment
1. Early recognition makes a big difference.
Knowing the signs of stroke and getting treatment quickly saves lives and improves recovery. If you think someone may have had a stroke, do this FAST check:
Face – Is one side drooping?
Arms – Raise both arms. Is one side weak?
Speech – Is the person able to speak? Are words jumbled or slurred?
Time – Act quickly and seek emergency medical attention immediately.
Stroke Warning Signs
a) Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
b) Sudden confusion, trouble speaking or understanding
c) Sudden trouble seeing in one or both eyes
d) Sudden trouble walking, dizziness, loss of balance or coordination
If you notice one or more of these signs, don't wait. Stroke is a medical emergency.
2. Around 1 in 10 more people make an excellent recovery when cared for in a specialized stroke unit. If we consider an isolated blood vessel, blood flow to the brain tissue can be hampered in two ways:
a) the vessel clogs within (ischemic stroke)
b) the vessel ruptures, causing blood to leak into the brain (hemorrhagic stroke)
All patients with stroke (ischaemic or haemorrhagic) should be admitted to a specialized stroke unit, which involves a designated ward with a specialized team.
3. Clot-busting drugs (tPA or thrombolysis) increase the chance of a good outcome by 30%.³
Clot-busting drugs break up blood clots. This treatment can be administered up to 4.5 hours of symptom onset in many patients with ischaemic stroke. The earlier it is given, the greater the effect.
4. Clot retrieval treatment increases the chance of a good outcome by more than 50%.4
Clot retrieval treatment (mechanical thrombectomy) involves removing a blood clot and can improve survival rates and reduce disability for many people with ischaemic stroke caused by large artery blockage.
5. Rehabilitation is a critical step in the treatment process.
Rehabilitation starts in the hospital as soon as possible following a stroke. It can improve function and help the survivor regain as much independence as possible over time.
6. One in four survivors will have another stroke.
Treatments that prevent another stroke include drugs to lower blood pressure and cholesterol, antiplatelet therapies, anticoagulation for atrial fibrillation, surgery or stenting for selected patients with severe carotid artery narrowing.
Lifestyle changes can also greatly reduce the risk of another stroke. Changes include eating well, being physically active, being tobacco-free, managing stress, and limiting alcohol consumption.
Join the fight against stroke.
Stroke affects us all. Let’s take action, drive awareness, and push for better access to stroke treatments.
Exam stress affects most students in varying ways. It is important to manage this stress and find little ways of helping to eliminate the risk of burnout.
For some students, exams can be a breeze; revision is second nature to them and they could ace an exam with their eyes closed. But for others, sweaty palms and heart palpitations are just a part of the territory, and it seems that nothing is more impossible than sitting down and revising. Here are some handy tips that can help to dissipate stress and make sure you can get through exam season.
1. Take regular breaks and schedule in fun things to look forward to
Even the most intense exam timetables will allow a little time for a study break. This can include 20-minute breaks during your revision day, and longer activities that you can look forward to. Go out for dinner with friends, go to the cinema, attend a gig, anything that you like doing in your spare time that will take your mind off exams. Spending a little time away from the books will leave you feeling more refreshed and relaxed the next time you revise.
2. Exercise and get outdoors
Easily one of the most frustrating things about exam season is that it seems to occur just as the weather brightens up. Use this to your advantage and go out for a walk, or a run, or head to the gym or swimming pool. As well as keeping you healthy, exercise is known to boost your mood and can help to make you more productive while revising.
3. Don’t (always) listen to others
As the old saying goes: "comparison is the thief of joy". While it is helpful to discuss topics with fellow students and often to revise together, try not to compare other peoples' revision to your own. Chances are you’re doing just fine, and listening to other people talk about what they’ve learnt will only stress you out and may make you feel like you aren't progressing as well as them. Plus, if they themselves are stressed this can rub off on to you and other people’s stress is not what you need right now.
4. Speak to someone
If the stress gets to a point where it is overwhelming, and is affecting your day-to-day life, try and speak to someone about it. Your university or school should have a service where you can speak to people about your concerns, and will be able to offer more advice on how to manage it. If that seems like too big a step, open up to a family member or a friend about the pressure you feel. You’ll be amazed to know that you aren’t alone in feeling like this.
10 quick ways to help eliminate exam stress
- Watch a film, a TV show or listen to a podcast or comedian that makes you laugh.
- Drink some herbal tea or a hot chocolate. It’s a well known fact that hot drinks are known to soothe the soul (avoid too much caffeine though!).
- A shower or a bath can help to relieve stress.
- Cook or bake something. Just the thought of having something delicious to eat can bring you joy. As a bonus side note, try and cook something healthy too. You can’t feed your mind well, if you don’t feed your body well.
- Get some sleep. The virtues of a good night’s sleep during exam season should not be underestimated.
- Keep things in perspective. Yes, exams are important. But you are so much more than your exam results.
- Avoid other stressed people. You know the ones I mean. The ones with cue cards outside of the exam hall, frantically trying to remember key dates and equations. They will do nothing for your stress levels.
- Avoid the exam "post-mortem”. You don’t need to know how other people fared in the exam. You’ve done your best, you can’t go back and change your answers so the second you step out of the exam hall, focus on your next exam.
- Be flexible. While having a revision time table is one of the best tools in your arsenal for exam success, don’t be too hard on yourself if you don’t stick to it. If you accidentally oversleep, don’t write the day off.
- Write down everything you feel like you need to do and try and tick one thing off. Just the act of feeling like you are in control of your revision can help.
Insomnia is a sleep disorder that is characterized by difficulty falling and/or staying asleep. People with insomnia have one or more of the following symptoms:
Difficulty falling asleep
Waking up often during the night and having trouble going back to sleep
Waking up too early in the morning
Feeling tired upon waking
There are two types of insomnia: primary insomnia and secondary insomnia.
Primary insomnia: Primary insomnia means that a person is having sleep problems that are not directly associated with any other health condition or problem.
Secondary insomnia: Secondary insomnia means that a person is having sleep problems because of something else, such as a health condition (like asthma, depression, arthritis, cancer, or heartburn); pain; medication they are taking; or a substance they are using (like alcohol).
Causes of acute insomnia can include:
Significant life stress (job loss or change, death of a loved one, divorce, moving)
Emotional or physical discomfort
Environmental factors like noise, light, or extreme temperatures (hot or cold) that interfere with sleep.
Some medications (for example those used to treat colds, allergies, depression, high blood pressure, and asthma) may interfere with sleep
Interferences in normal sleep schedule (jet lag or switching from a day to night shift, for example)
Causes of chronic insomnia include:
Depression and/or anxiety
Pain or discomfort at night
Good Sleep Habits for Beating Insomnia
Good sleep habits, also called sleep hygiene, can help you get a good night's sleep and beat insomnia. Here are some tips:
Try to go to sleep at the same time each night and get up at the same time each morning.
Try not to take naps during the day, because naps may make you less sleepy at night.
Avoid prolonged use of phones or reading devices ("e-books") that give off light before bed. This can make it harder to fall asleep.
Avoid caffeine, nicotine, and alcohol late in the day. Caffeine and nicotine are stimulants and can keep you from falling asleep. Alcohol can cause waking in the night and interferes with sleep quality.
Get regular exercise. Try not to exercise close to bedtime, because it may stimulate you and make it hard to fall asleep. Experts suggest not exercising for at least three to four hours before the time you go to sleep.
Don't eat a heavy meal late in the day. A light snack before bedtime, however, may help you sleep.
Make your bedroom comfortable. Be sure that it is dark, quiet, and not too warm or too cold. If light is a problem, try a sleeping mask. If noise is a problem, try earplugs, a fan, or a "white noise" machine to cover up the sounds.
Follow a routine to help you relax before sleep. Read a book, listen to music, or take a bath.
Avoid using your bed for anything other than sleep or sex.
If you can't fall asleep and don't feel drowsy, get up and read or do something that is not overly stimulating until you feel sleepy.
If you find yourself lying awake worrying about things, try making a to-do list before you go to bed. This may help you to not focus on those worries overnight