Dr.GOPALA KRISHNAM RAJU AMBATI

People who suffer from high blood sugar can find it quite hard to keep their sugar levels in check. While the common practice is to maintain a low carbohydrate diet that is useful on the whole, there are other alternative diet options as well. The food items mentioned below either help by lowering sugar level or by increasing insulin sensitivity.

Items to include in your diet

1. Starch: One of the items that help lower sugar levels is resistant starch. Starches are long chains of glucose and are found in food items such as bananas, potatoes, oats and various others. There are a few varieties that pass through digestion unchanged and are not absorbed as glucose in the blood. They are known as resistant starch. This type of starch is also known to increase insulin sensitivity significantly. They help in transfering glucose from the bloodstream into cells thus lowering sugar level and offering energy to the individual after meals. It is advised to not consume potatoes, but take a resistant starch supplement since potatoes contain digestible carbohydrates that increase sugar level.
2. Ceylon Cinnamon: This is another great ancient remedy that has many compounds that prevent sugar from entering the bloodstream. It also enhances insulin sensitivity. Other great alternatives include cashews and almonds. These dry fruits are rich in Magnesium which is a mineral that ensures blood sugar regulation.
3. Fenugreek: A powerful herb that is also a good source of soluble fiber. It has several compounds that are known to improve blood sugar control.
4. Shirataki noodles: They are very low in carbohydrates and high in fiber. Keeping your carbohydrate consumption low is very important for diabetes management. So, these Japanese noodles help in doing so. Since they contain mostly glucomannan, an indigestible fiber, Shirataki noodles help in reducing blood sugar levels after meals while improving other metabolic health factors in diabetics.
5. Dark Chocolate: Another good option is cocoa in dark chocolate. The cocoa comes from the cocoa plant and contains flavanols. Cocoa is known to improve insulin resistance and overall blood sugar regulation. However, dark chocolate does contain a little sugar so you would want to go in for 85% cocoa or more. Treat this item as a cheat item for those days when you need to cheat with your diet since this has a neutral effect. Switching to dark chocolate immediately is best for those who are addicted to chocolate. It will serve as a neutral item at worst and will help with blood sugar regulation at best.
6. Apple cider vinegar: Another beneficial item to add to your diet is apple cider vinegar. It is an ancient folk remedy that is known to increase glucose metabolism by increasing the sugar uptake from blood into cells.

These items are known to be very helpful for lowering blood sugar levels and keeping it in check. It is advised to consult your doctor and seek his approval before you add any of these items to your regular diet. 

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

According to most experts, depression and diabetes have been intricately connected in a vicious cycle. While the prolonged and sustaining nature of diabetes directly makes one vulnerable to the bouts of depression, doctors tend to locate traces of depression in the family history of an individual in order to diagnose the roots of diabetes. It won't be too far-fetched to state that both causes as well as affects the other.

If you have diabetes, either type 1 or type 2, you have an increased risk of developing depression. And if you're depressed, you may have a greater chance of developing type 2 diabetes. The good news is that diabetes and depression can be treated together. And effectively managing one can have a positive effect on the other.

How Diabetes and Depression Correlated?                    
There are myriad ways in which diabetes affects depression and vice versa.

Firstly, tackling such a long drawn disease and its various pitfalls might cause a lot of anxiety to one and lead to depression. Whereas on the other hand, depression reduces the zeal to live and thus results in poor lifestyle choices which in turn causes weight gain, unhealthy food habits, physical inactivity. As we are well aware, all these have the potential to wreak havoc for any patient of diabetes. 

Similarly, diabetes ushers in various other health complications, adversely impacting one's productivity. This may cause depression in a lot of people. 

On the flipside, depression impedes one's ability and enthusiasm to work or communicate, this in turn intervenes with one's monitoring of diabetes. Since these two extremely malevolent diseases have such close connections, medical science recommends ways to grapple with both. The rigors of managing diabetes can be stressful and lead to symptoms of depression.

Diabetes can cause complications and health problems that may worsen symptoms of depression.

Depression affects your ability to perform tasks, communicate and think clearly. This can interfere with your ability to successfully manage diabetes.

Treatment: Depression is just like any other illness, it can be treated. Treatment can lift the depression and improve diabetes control.

Looking after your diabetes will help decrease the risk of getting depression. If you already have depression, good diabetes management will help lessen the negative impacts it can have. Depression is no different to any of the other complication of diabetes. It is a genuine illness for which you need to seek help and support from health professionals.

The treatment for depression and diabetes involves a coordinated approach that monitors both diabetes control and the symptoms of depression. It is about finding the treatment that works best for each person. For example, people with diabetes and mild depression may find that regular physical activity improves depressed moods and also helps control blood glucose levels.

Helping Yourself.

If you suspect you might have depression, take control of your health by:

• Going to a doctor or other health professional
• Getting involved in social activities
• Engaging in regular moderate physical activity
• Learning about depression and diabetes
• Very particular about medicines prescribed for Diabetes
• Eating healthily and including a wide variety of nutritious foods
• Achieving and maintaining healthy weight
• Limiting your alcohol intake
• Getting help, support and encouragement from family and friends
• Asking your doctor to check your blood pressure, cholesterol and blood glucose levels. If you wish to discuss about any specific problem, you can ask a free question.

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.

What is insulin therapy?
Insulin is a hormone that is responsible for keeping the level of sugar in the blood under control. It is the primary therapy used for the treatment of any type of diabetes. The dependence on insulin depends on the balance between the actual production of insulin in the body and the resistance of the body cells to the insulin produced. People, who suffer from diabetes type 1, need insulin injections lifelong. The requirement for insulin therapy in people suffering from type 2 diabetes solely depends upon the declining function of the beta-cells over time.

What are the types of insulin available in the market?
The various types of insulin available in the market are:

1. Rapid acting insulin: The onset of action in this type of insulin is rapid and it lasts for a short duration, about two hours.
2. Short acting or regular insulin: The onset of action is moderate, and it starts acting within half an hour, and the duration of action ranges from 3 to 6 hours.
3. Intermediate acting insulin: It takes about 2 to 4 hours for the onset of action of this type of insulin and the effect can remain for about 18 hours.
4. Long acting insulin:  The duration of action of this type of insulin can last up to about an entire day.

How is it taken?
Insulin injections can be self-injected using a syringe, a needle, a cartridge system, or a pre-filled pen system. Devices for inhaling insulin, quick-acting insulin and insulin pumps are also available at medical stores and pharmacies. Insulin is injected subcutaneously, into your muscles. Try to ensure that you inject around the same area every time, but choose a different spot to ensure less scarring. The best areas to inject insulin are thighs, buttocks, arms and belly. If you take regular insulin, it is advised to take it half an hour before a meal.

What are the possible side effects?

1. Low blood sugar level
2. Scars and lumps from extensive usage of insulin injection
3. Rashes can be found in the area the insulin is injected or sometimes, all over the body
4. Weight gain when you start using insulin initially

If you wish to discuss about any specific problem, you can ask a free question.

Women tend to develop high levels of blood sugar during their pregnancy (especially within the 24th and 28th weeks), irrespective of whether they already had suffered from diabetes prior to their pregnancy. However, gestational diabetes, if not taken proper care of, might escalate the risks of developing diabetes in the near future for both the mother and the child, accompanied by complications in pregnancy or labor. Gestational diabetes is usually characterized by mild symptoms such as excessive urge to urinate, excessive thirst, blurred vision and fatigue.

Causes:
Insulin, a hormone produced by the pancreas, allows for the utilization of the glucose for energy. The food consumed is broken down by the digestive tract of the body, converting carbohydrates into glucose before releasing it into the bloodstream. The glucose is then absorbed by the cells to be used as an energy source. Now, at the time of pregnancy, the placenta (organ nourishing the fetus) connecting the baby to the blood supply also produces various other hormones in high levels, for instance, estrogen and human placental lactogen. Most of these hinder the normal functioning of insulin in the cells, hence raising the blood sugar count. With subsequent growth of the baby, the placenta keeps on producing more amounts of such insulin resistant hormones to an extent that they are capable of meddling with the development of the baby.

Treatment:
1. Monitoring the blood sugar count at least four to five times a day and keeping it under control might help to ease the complication.
2. A healthy diet consisting of whole grains, vegetables and fruits in the right proportion and limiting sugar or other highly refined carbs meets the nutrition and fiber requirement of the body. Guard against additional weight gain during pregnancy as that hampers the entire process.
3. Exercise or regular physical activities help to normalize blood sugar level by boosting glucose absorption in the cells. Furthermore, exercises also enhance the sensitivity of the cells towards insulin. This means that only a little amount of insulin production by your body would be enough for the transportation of sugar.
4. Medication, If exercise and diet fall inadequate, insulin injections are often administered to control blood sugar count.
5. Keeping the baby under close observation with the help of repeated ultrasound and other tests to record its growth and development is an essential part of the treatment plan. If you wish to discuss about any specific problem, you can ask a free question.

One of the most common scenarios that most people are faced with is a constant feeling of tiredness and lethargy even after you have had a full night’s sleep. The questions popping in your mind right about now is, why is this happening? Why does the lethargic feeling fail to leave you even after you had a proper 8 hours sleep? Why is your sleep getting into the way of your professional productivity? Though there are a number of different explanations to this constant feeling of cloudiness throughout the day, hence, experts in the field have listed down some of the factors that prove to be the major causes behind this condition.

Some of these most common and powerful reasons are listed below.

1. Thyroid: The moment your thyroid levels start soaring, you will automatically find it difficult to keep up with the pace that your day to day life demands. The thyroid gland, which is placed right in front of the throat, is the size of the knot on your tie. This gland produces a hormone. When the activity of the thyroid gland, it starts secreting more and more of the hormones, leading to a condition termed as hyperthyroidism. The same gland when underperforms, it starts holding back the hormone secretion, leading to a condition called hypothyroidism. In both the cases the metabolism of the body slows down, leading to an increased level of tiredness even after proper sleep.
2. Anaemia: Another leading cause of that nagging feeling of sleepiness and draining energy is Anaemia. Anaemia causes a certain amount of fatigue in an individual. The main cause influencing this situation is the lack of presence of enough red blood cells. The main function of these red blood cells is to transfer oxygen constantly from the long to the cells and tissues. A break in this process leads to you feeling weak and also short of breath.
3. Diabetes: Diabetes poses a serious threat to the all over functioning of your body. It is termed as the slow killer and constantly works towards undermining the level of energy a normal individual can hold. This adversely affects your day to day life, including your performance at work and also performing your daily chores at home. The glucose in your body serves as a fuel for your daily activities. Since patients with type 2 diabetes cannot use this rising glucose in their blood properly, they end up being more tired than they ought to be.

Other conditions that lead to the same draining feeling and constant tiredness even after lot of sleep are depression, rheumatoid arthritis, chronic fatigue, sleep apnea, sleep inertia, periodic limb movement disorder, constant exposure to computer screens, tv screen, monitors, etc. There are a whole bag of other factors that lead to the constant feeling of tiredness that you are feeling. Before the end of the day, you are drained, your productivity drops and you cannot wait to hit the bed, and the same is the condition when you get out of bed. Consulting a general physician will not only help you put a finger on the cause, but also cure it with proper treatment.

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While it is well known that smoking causes lung cancer, heavy smokers with diabetes are also at increased risk of death from causes other than lung cancer, according to a study being presented next week at the annual meeting of the radiological society of north america (rsna).

Diabetes is a chronic illness in which there are high levels of glucose in the blood. More than 29 million people in the u. S. Have diabetes, up from the previous estimate of 26 million in 2010, according to a report released by the centers for disease control and prevention. One in four people with diabetes doesn't know he or she has it. Having diabetes can also put people at risk for numerous other health complications.

To determine the extent to which diabetes is associated with deaths from lung cancer, other cancers, and other causes among heavy smokers, researchers examined the risk for all-cause mortality among people with and without diabetes within the national lung screening trial (nlst), a massive, multicenter trial that compared low-dose helical ct with chest x-ray for early detection of lung cancer in current and former heavy smokers.

" in our study, we found a statistically significant link between diabetes and all-cause deaths, non-lung cancer deaths and lung cancer deaths in women" said kavita garg, m. D, professor of radiology from the university of colorado -- denver.

For the study, Dr. Garg and colleagues looked at data from 53, 454 participants in the nlst and identified 5, 174 participants who reported having diabetes at screening.

They conducted an analysis of the relative risk for overall mortality, lung cancer mortality, and non-lung cancer mortality associated with diabetes, adjusting for age, gender, body mass index (bmi), and pack-years of smoking. Over the course of the study, there were 3, 936 total deaths, including 1, 021 from lung cancer and 826 from cancers not of the lung.

Participants with diabetes tended to be older, reported more pack-years of smoking, and had a higher bmi than those without diabetes. There were 650 deaths (12.6 percent of patients) among participants with diabetes and 3, 286 deaths (6.8 percent of patients) among participants without diabetes.

" we found that diabetes doubles the risk for all-cause mortality and non-lung cancer mortality among heavy smokers" Dr. Garg said" we also found that women with diabetes have an increased risk of lung-cancer mortality, but did not find the same effect in men"

The researchers continue to analyze data in an effort to better understand the underlying cause. In the meantime, Dr. Garg emphasizes the importance of taking control of diabetes and undergoing lung cancer screening if you're a smoker.

" patients have to take care of their diabetes to maximize the benefit of ct screening for lung cancer" she said" it truly makes a magnitude of difference in mortality risk"

Diabetes mellitus is a group of diseases where the body does not adequately produce insulin, use insulin properly, or both. Insulin plays a crucial role in allowing blood sugar into the cells to be used for energy. There are two main types: type 1 and type 2 diabetes.
A woman running in the park with her dog
Staying healthy by exercising and eating well is recommended for people with diabetes.

People with diabetes have abnormally high levels of blood sugar. This can damage many organs in the body if left untreated. The national institute of diabetes and digestive and kidney diseases recommend the following steps to manage diabetes:

 Make healthy choices in eating
 Engage in regular physical activity or exercise
 Take medications, if required.

Healthy eating is important in keeping blood sugar levels at a healthy level. The healthy range is 80 to 130 mg/dl before meals or below 180 mg/dl after meals, according to the american diabetes association.

People with type 1 diabetes require insulin. Various insulin delivery systems and protocols are used to manage blood sugar both between and at meal times.

People with type 2 diabetes often manage their condition with diet and exercise, and with medications as needed to keep blood sugar within the target range. These medications vary in how they work.

People with diabetes will have different treatment plans, and they will respond to food, exercise, and medication differently.

It is important to consult with a doctor to get individualized recommendations on target blood sugar levels, medications, diet, and exercise.
How do carbohydrates affect diabetes?

Carbohydrates are an important source of energy for the body. Carbohydrates are found in foods that have starches and natural or added sugars. Examples are grains, vegetables and legumes, fruit, dairy products, and sweets.

Carbohydrates are broken down by the digestive system into sugar. When the digested sugar enters the blood, the body produces a hormone called insulin. Insulin helps the sugar enter cells. Once the cells absorb the sugar, blood sugar levels fall.

People with diabetes have an impaired ability to produce insulin, use insulin, or both.

People with type 1 diabetes cannot produce insulin, so they take insulin to make sure the cells can get the sugar they need for energy.

People with type 2 diabetes are often insulin resistant. They also often have difficulty producing enough insulin to keep their blood sugar in the normal range.
Counting carbohydrates

Carbohydrate counting is a way of keeping track of the carbohydrates in the daily diet. A person with diabetes who uses carbohydrate counting to manage their diet sets an amount of carbohydrate to eat for meals and snacks.
Foods containing carbohydrates
Bread, pasta, rice, and potatoes are all sources of carbohydrates.

The american diabetes association suggest a target of about 45 to 60 grams of carbohydrate per meal. This recommendation may vary depending on other factors such as gender, weight goals, and blood sugar target goals.

The three different types of carbohydrates are starch, sugar, and fiber.

Starches are complex carbohydrates found in starchy vegetables such as peas, potatoes, and corn. Beans and whole grains are also complex carbohydrates.

Fiber comes from plants and cannot be digested. Fiber is found in foods such as vegetables, fruit, whole grains, legumes, and nuts.

Unlike other carbohydrates, fiber does not raise blood sugar, and it can help to slow the digestion of meals. This helps to minimize spikes in blood sugar. It is recommended to eat between 20 to 35 grams of fiber per day.

Sugar is a carbohydrate. It is generally absorbed into the body more quickly. There are natural sugars found in milk and fruit. There may also be added sugars in canned fruits, baked goods, and processed foods.

There are also carbohydrates in non-starchy vegetables such as lettuce, peppers, cucumber, mushrooms, and many others. There are fewer carbohydrates in these foods because they have a high water content. For example, a half cup of cucumber has around 2 grams of carbohydrate.

The type and amount of carbohydrate will affect post-meal blood sugar levels.

Foods that digest more slowly, such as those with a lot of fiber, and those eaten as a mixed meal, digest more slowly. They can help to prevent post-meal spikes in blood sugar. Large amounts of carbohydrates eaten at one time will raise blood sugar more than smaller amounts.
Is eating rice healthy with diabetes?

High-carbohydrate foods like grains, cereals, pasta, rice, and starchy vegetables are not forbidden, but they should be eaten in moderation.

Rice is a high-carbohydrate grain, but it can be incorporated into meals in appropriate amounts.

One-third of a cup of rice has 15 grams of carbohydrate. That accounts for one-fourth to one-third of the amount of carbohydrate recommended for a single meal, if the target is 45-60 grams of carbohydrate per meal.

Meals that also include healthy proteins and fats can help to slow the impact of the rice on blood sugar levels.
Are some types of rice healthier than others?

Some grains are better than others for managing diabetes.

A scale called the" glycemic index" measures how quickly food is digested into sugar and absorbed in the blood. High glycemic foods raise blood sugar faster and should be eaten in limited portions, or eaten with lower glycemic index foods.

White rice is more processed and it has a higher glycemic index than brown rice, although the index of brown rice can vary with type and brand.

Different varieties of rice have different glycemic indexes. Some long grain rice varieties, converted rice, and basmati rice varieties are lower on the gi scale than white rice.

Puffed rice cereal and rice cakes are sometimes thought of as diet foods, but they have a high glycemic index and they are not ideal for healthy meals.

Foods that are high in fiber offer many health benefits. They help with blood sugar control, they promote bowel health, and they may lower cholesterol.

Whole grains have more fiber than other grains. It is important to check the label to check the fiber content.
Tips for preparing rice

Some brown rice varieties are unprocessed and have more fiber. They can be part of a balanced meal when eaten in proper portions. Mixing brown rice with other foods can help to balance blood sugar levels. Examples include legumes, such as red beans, or protein and healthy fats.
A bowl of brown rice
Brown rice may have a lower glycemic index than white rice.

Brown rice takes longer to cook than white rice, but the cooking process is simple. People can cook brown rice in a pot or rice cooker at a ratio of 1.5 cups of water per 1 cup of rice.

The instructions are as follows:

 Bring rice and water to a boil in an uncovered pot
 Cover the pot and simmer for about 20 minutes
 Turn off heat and let the covered pot sit for at least 10 minutes.

Rice can be mixed with seasonings, herbs, vegetables, and nuts such as slivered almonds.

Brown rice can be stored in a refrigerator and used for leftovers. People can reheat brown rice on the stove or microwave and serve with beans and salsa for a quick meal.

Care must be taken with storage, because cooked rice left at room temperature can develop toxins that lead to food poisoning.
Nutritious and delicious alternatives to rice

Because rice is high in carbohydrates, it should be accompanied by other foods.

Vegetables are high in fiber, vitamins, and other nutrients. Vegetables are made of carbohydrates, but at a much lower level than grains.

Eating foods that are lower in carbohydrates and higher in fiber can make meals more satisfying. For example, one-half cup of rice has 22 grams of carbohydrate. In contrast, one cup of squash only has 8 grams of carbohydrate.

Many foods can serve as substitutes for rice.

Examples include cauliflower, mushrooms, and eggplant. Quinoa contains the same amount of carbohydrates as rice, but it has more protein, and some types have more fiber.
Recipes for rice substitutes

A number of recipes are available for rice substitutes. Here are two examples:
1. Cauliflower" rice"

Ingredients:

 Oil
 Onions
 Cauliflower
 Lemon
 Seasoning.

Pulse the florets of a cauliflower in the food processor. Then heat the cauliflower in a pan with oil and onions. Saut until the onions are golden brown and the cauliflower is soft for about 3 to 5 minutes.

Season to taste with salt, pepper, lemon juice, and herbs.

Full recipe from the food network.
2. Cilantro lime quinoa

Ingredients:

 Canola oil
 Onion
 Garlic
 Quinoa
 Low-sodium chicken broth
 Juice of limes
 Fresh cilantro.

Saut the onion and garlic with oil in a skillet. Reduce the heat and stir in the quinoa. Stir quinoa and cook for 2 minutes. Add chicken broth and lime juice and bring to a boil. Then reduce heat and simmer for 15 minutes. Stir in more lime juice and add chopped cilantro.