Dr. Anurag Bajpai

Type 1 diabetes is commonly referred to as juvenile diabetes and is mostly witnessed among young people. It can also occur in adults. In this condition, the body doesn’t produce enough insulin or completely stops producing insulin. The immune system, which saves the body from foreign microbes, attacks the cells that are responsible for producing insulin. The treatment methods include taking insulin shots, oral insulin intake, taking healthy diet, increased physical activity and controlling blood pressure and cholesterol levels.

Type 2 diabetes is a condition wherein the body refuses to use insulin in order to carry glucose to each and every cell of the body. The pancreas try to produce more insulin in order to counter the condition but soon give up due to an increased blood pressure. The treatment plan includes medication, making lifestyle changes, and controlling blood-sugar and cholesterol levels.

Gestational diabetes is observed in many pregnant women. The hormones produced during pregnancy can block insulin to be used by the body. While insulin resistance is common during pregnancy, failure of the pancreas to fill in the additional insulin in the body can result in gestational diabetes. Women who are overweight are more likely to develop this condition. Although gestational diabetes goes automatically after the baby is born, it often recurs in the form of type 2 diabetes in a later stage of life.

Risk factors for diabetes

1. Weight: Being overweight is a primary risk factor for diabetes. An increased amount of adipose tissue increases the risk of insulin resistance by the body. It is therefore essential to shed as much weight as one can to avoid diabetes.
2. Inactivity: Immobility increases the risk of diabetes in a person. It stacks up glucose in the body, making it difficult for the body to use glucose and convert it into energy. A daily routine which is devoid of physical activity ensures fat storage in the body, which can turn into type 2 diabetes.
3. Family history: Diabetes, especially type 2, is closely linked with family history. If a person has diabetes, it is very likely that his immediate family or extended family has a history of diabetes.
4. Ethnicity: African-Americans, people from the Indian subcontinent, Latinos, etc., are more likely to suffer from diabetes compared to their American or European counterparts. Lifestyle and eating habits are the major reasons for diabetes in these races.
5. Age: Age has a direct correlation with diabetes. The age group of 45–65 is considered to be more diabetes-prone. Inactivity, immobility, and an increase of sugar intake are some of the primary reasons for developing diabetes in this age group.

Type diabetes

Every woman likes to look into the mirror and find not an extra strand of hair on her face, be it the upper lip or near the ears. While it is not uncommon for women to have hair on these and other areas, most women resort to multiple ways to get rid of this. The pattern of this unnecessary hair growth is very similar to the pattern seen in males normally.

This condition of excessive hair growth is known as hirsutism and can be caused by multiple causes, as listed below.

1. Genetic or racial: While the European women have a more clean face that is free of hair, the Mediterranean and Indian women are highly likely to have more facial hair growth. There is also a strong family history relation, and it is hereditary.
2. Androgens (testosterone): This is a male hormone, essential for the development of male sexual characters. Though it is present in very minute amounts in all women, in some, there could be higher than these minimal levels, leading to minor masculine characters, facial hair being one of them.
3. Hormonal imbalances: There are multiple hormonal issues which can manifest as increased facial hair growth. The two most common ones include polycystic ovarian syndrome (PCOS) and adrenal conditions including tumours, Cushing's syndrome, and hyperplasia. In all these cases, there is increased amount of androgens, leading to excessive facial hair.
4. Medication side effect: Some medications like testosterone, cyclosporine, anabolic steroids, and Minoxidil also lead to increased amounts of facial hair in women. Some other medications used to treat migraines, seizures, schizophrenia, and hypertension can also cause hirsutism. This is indirectly due to increased levels of male hormones in the system, producing these effects.
5. Birth control pills: These also affect the hormone levels and lead to increased facial hair.
6. Obesity: Most women with facial hair are also on the heavier side, and most people have a reduction in hair once weight is managed.

Treatment: The underlying cause should be treated for controlling hair growth. If there is an inducing medication, an alternative should be looked at. While hormone levels can be altered, in most cases, not much can be done. These need to be dealt with using one of the following methods - depilatory creams, waxing, plucking, shaving, laser reduction, electrolysis, and weight loss.

When reading through the above, it is obvious that a lot of causes for hirsutism point towards hormones. This also helps identify hormonal abnormalities in the earlier stages. This helps to identify hormonal disorders in their earlier stages, which are managed with lesser complications. The next time you feel there is more hair on your chin or cheeks, get your hormone levels checked. In case you have a concern or query you can always consult an expert & get answers to your questions!​

The body has multiple chemicals called hormones, which regulate many of its functions. Increased or decreased levels of these hormones affect various functions including metabolism, growth and sexual functions. Thyroxin produced by the thyroid (situated in the front of the neck) is one such hormone, which has a significant role to play in metabolism.

Graves’ disease is one of the main causes of hyperthyroidism, where there is excessive production of thyroid hormones. Graves’ disease is an autoimmune disorder, wherein the body reacts against its own tissues. It is very common in women than men, especially after 20 years of age. Family history also has a strong correlation in developing Graves’ disease. The high levels of thyroid hormone increase the rate of metabolism, thereby altering weight, mental energy levels, physical stamina, and also mood.

Thyroid hormone is related to metabolism and more amount of it lead to higher metabolism. This causes the following symptoms.

1. Intolerance to heat
2. Excessive sweating
3. Nervousness and anxiety
4. Inability sleep, as the mind is always excited
5. Increased appetite (sometimes despite weight loss) due to higher metabolism
6. Irregular menstrual cycles
7. Palpitations (rapid, loud heartbeat)
8. Irregular heartbeats (tachyarrhythmia)
9. Fine tremors of the extended arms
10. Breast enlargement in men, known as gynecomastia
11. Extreme moodiness, causing irritability and anger
12. Inability to focus and concentrate
13. General fatigue and shortness of breath with any exertion
14. Increased frequency of bowel movements

In addition, the eye symptoms are quite diagnostic including:

1. Protrusion of the eyes (exophthalmos), giving an impression that they are going to fall out
2. Double vision
3. Excessive tearing
4. Increased irritation in the eyes

Diagnosis: The first symptom would be the presence of an enlarged thyroid gland (front of the neck above the collarbone), and the some of the above symptoms would be present.
In addition, tests to check for thyroid gland functioning including T3 and T4 levels would reveal increased amounts of hormone in the blood stream.
As a confirmatory test, the radioactive iodine uptake test also is done, which will indicate increased uptake by the thyroid gland. This indicates that the gland is functioning at an increased pace and requires additional iodine for the production of thyroid hormones.

Treatment: There are two approaches to it, one to control the symptoms and the other to control the thyroid gland per se.

1. Beta blockers are very useful in controlling rapid heart rate and anxiety.
2. Prednisone may be used to control eye irritation and swelling
3. Antithyroid drugs are used to control the production of thyroid
4. Radioactive iodine is given orally to control excessive thyroid production
5. In severe cases, thyroid gland may be surgically removed partially or completely

Graves’ disease is not life-threatening and once symptoms are controlled, the patient’s quality of life improves drastically.

Diabetes is a state where the body suffers from lack of energy due to poor metabolic state. This is construed as depression in many patients as they already feel lethargic and subdued. The fatigued state of body in diabetes can be alleviated by exercise which raises endorphins - substances which are released in the body especially by exercise - providing us the necessary elation so much necessary for our recovery

Managing diabetes may make a person feel alone and set apart from their friends and family due to the number of dietary restrictions they need to follow. Additionally, if the person has trouble controlling their blood sugar level, it may make him frustrated and anxious. Over time, these negative emotions can build up into depression.

Depression can make a person lose his sense of purpose and can make regular tasks feel like too much to handle. Thus, a depressed person may stop taking care of himself. The lack of energy can lead to a loss of appetite or unhealthy snacking. This can trigger fluctuations in blood sugar levels that worsen diabetes.

Thus, depression and diabetes have a cyclic relationship. The good news is that these two diseases can be treated together and managing one of these diseases can have a positive effect on the other as well.

Here are a few ways to treat diabetes and depression:

Regular Exercise

Regular exercise is very beneficial towards treating, both depression and diabetes. Exercise helps regulate blood sugar levels and hence can help control diabetes. It also helps in reducing excess weight, which can enhance your self image and make you feel happier. Simultaneously, it also releases endorphins or the 'feel good' brain chemical. This can help alleviate depression symptoms.

A Balanced Diet

A balanced diet is essential for good health and can help manage, both these disorders. Along with a balanced diet, there is also a need to abstain from snacking between meals. Reducing the amount of sugar in your meals helps stabilize blood sugar level and control fluctuations. Stable blood sugar level keep a person from becoming increasingly anxious and can thus prevent depression.

Restful Sleep

A good night's sleep can treat, both diabetes and depression. If you have proper sleep, you will awake feeling refreshed and energetic. This positive energy balances the negativity of depression, lowers the urge to snack and helps in stabilizing blood sugar level.

Psychotherapy

Psychotherapy or in particular cognitive behavioral therapy has been proven beneficial towards treating depression. This in turn gives a person the motivation needed to manage his diabetes as well.

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

Keeping the blood sugar at the recommended level can be a challenging task at times. While timely medication is a key prerequisite for controlling diabetes, lifestyle changes plays an important role in keeping the blood sugar under control.

Here is a list of simple yet effective ways of managing diabetes.

1. Food
   • Portion size and carbohydrate count: Carbohydrates are the single most important food element that impacts the level of blood sugar in body. People taking insulin shots should ensure that the portion size of carbohydrates does not exceed the recommended level. Maintaining a diary to keep a check on the carbohydrate count can help in this case.
   • Balanced diet: For people suffering from diabetes, it is necessary to have a good mix of fruits, vegetables, fat, starch and protein in each meal. Carbohydrates should be consumed in the form of fruits and whole grains. A doctor advice in this matter can be of great help.
   • Avoid sweetened beverages: Sweetened beverages with high sucrose and fructose content have high-calorie content that can directly impact the blood-sugar level. Refraining from these sweetened drinks is a must for diabetes patients.
2. Exercise
   • Make an exercise plan: Exercising for half hour on a daily basis is highly beneficial for diabetes patients. It makes sense to consult a doctor about the type of exercise that can be done regularly. The right mix of aerobic, cardio and muscle exercise should do the trick.
   • Stay hydrated: Staying hydrated is very important during exercise. Dehydration can bring down the blood-sugar level drastically.
   • Be prepared: Carrying a small dose of glucose or a snack can come in handy. In case the blood-sugar level drops to an alarming level while exercising, the glucose will ensure that it brings it back to normal quickly.
3. Alcohol
   • Follow the doctor’s instruction: Alcohol is known to cause a lot of complications for diabetic patients. For people whose diabetes is under control, make sure that the doctor gives his go ahead for alcohol consumption.
   • Drink carefully: If you get a doctors nod to drink make sure that dry wines and light beer are consumed. These drinks tend to have lesser calories and carbohydrates. Their impact on the blood-sugar level, therefore, becomes minimal.
4. Stress
   • Pattern: Stress greatly increases the blood-sugar level. While it is difficult to be stress-free, try to look for a pattern by checking the blood-sugar level after prolonged stress. This will help to identify a pattern which can then be addressed with methods such as yoga, hobby practicing, laughter therapy, etc.
   • Get help: Stress management is not an easy task. If stress cannot be controlled with a conventional approached, it makes sense to get professional help to reduce stress.

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

Thyroid disorders are associated with the thyroid gland. A thyroid gland is a butterfly-shaped gland situated right at the base of one’s neck. The role of the thyroid gland is to carry out numerous metabolic processes within the body. The brain regulates the functioning of the thyroid gland through a feedback mechanism. There are a number of disorders, both severe and trivial, which could affect the thyroid gland.

Main symptoms of thyroid disorders:

1. Weight loss and weight gain

2. Changes in heart rate (arrhythmia)

3. Hair loss

4. Frequent mood swings

5. Swollen neck

6. Sudden bouts of moderate to high fever

Other symptoms include:

1. Numbness or a tingling sensation in the hands

2. Constipation

3. Abnormalities or irregularities in menstruation

4. Brittle nails and dry skin

5. Blurred vision

6. Weakened muscle tone and frequent tremors in the body

Treatment Options:

Intake of thyroid hormone pills may prove beneficial. Once you start with the treatment, you may notice significant improvement within the first two or three weeks. Generally, once affected by thyroid disorders, one might have to be on these medications his/her entire life. Over time, this treatment procedure should result in lowering of the cholesterol levels, increased energy; but in certain cases, might throw up side effects in the form of sudden and unexplained weight loss.

Anti-thyroid medications help reduce and regulate the secretion of the thyroid hormone, thus treating certain thyroid disorders (such as hyperthyroidism).

Beta blockers are drugs help in reducing high blood pressure, heart palpitations and controlling heart rate.

In severe cases, such as enlargement of the thyroid gland, surgery is advised by the doctor, in which the thyroid gland is removed. Tumors or thyroid nodules are also treated by this surgical process.

In cases of thyroid cancer, besides the surgical procedure, radioactive iodine therapy (radioiodine) is recommended. This therapy helps destroy the thyroid gland and other thyroid (malignant) cells which may be taking up iodine. However, the side effects of this technique are minimal. This procedure helps to destroy those tissues which may not have been removed by the surgery. If the thyroid cancer has spread to the lymph nodes or to other parts within the body, this particular mode of treatment can be very effective.

Types of Thyroid Disorders:

1. Hypothyroidism: This is a condition characterized by an underactive thyroid gland. In this case, sufficient thyroid hormone is not secreted in the body.

2. Hyperthyroidism: This is characterized by an overactive thyroid gland, that results in overproduction of the thyroid hormone.

3. Thyroid cancer: It is a type of cancer of the thyroid gland.

4. Goiter: This is a disorder wherein the thyroid gland gets abnormally enlarged.

5. Thyroid nodules: This is marked by swelling of the thyroid gland.

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

Hypoglycemia, commonly referred to as low blood sugar is the condition of the body, when the level of blood sugar falls down below the normal level. This accounts for clumsiness, feeling shaky, feeling confused, losing consciousness, serious seizure. Severe lowering of blood sugar may cause death. You are likely to feel exhausted and very hungry. The symptoms usually show quite quickly.

Hypoglycemia is commonly caused due to diabetes medicine like insulin, sulfonylureas or biguanides. Starving for long hours, over straining the body or extreme alcohol consumption may lead to hypoglycemia. Failure of the kidneys, liver diseases, metabolism disorders also lead to hyperglycemia.

Fall in the the blood-sugar level must be taken very seriously and never be ignored. If you feel the symptoms of lowered blood sugar, it is advised that you immediately take a sugar test. You must also indulge in high calorie food items such as sweets or chocolates. You need to increase the glucose intake, so that the blood-sugar level rises up.

Here are some steps you should follow to control hyperglycemia.

Keep away from the practices which lead to hyperglycemia: The best way of keeping away from hyperglycemia is by taking all measures which would avoid the condition to develop. The medical schedule of diabetic patients should be closely monitored and optimized by the patient's caregivers. Their lifestyle should be kept under check. It should be ensured that the patients do not skip meals. Insulin should be avoided as much possible.

1. Discuss problems with the patient: Patients and their guardians must be properly educated about the disease, and what important steps they should take, in spite of all kinds of prevention treatments they take. Teach them about the symptoms and the steps to be taken in case of any emergency. Use of glucose tablets should be encouraged. They must know that the process is ongoing. Every patient is different from another and hyperglycemia differs from person to person.
2. Use glucagon: Glucagon is basically a hormone which stimulates the liver to release pre-stored glucose all over your bloodstream in case your blood-sugar level falls down steadily. Glucagon is usually injected, and kits are available. Prescribed by doctors, glucagon can be used to treat a person who has fallen unconscious after a fatal reaction due to insulin. You should consult an expert before buying a glucagon kit.

Hypoglycemia is a serious problem. Lowering or fall in your blood-sugar level must never be ignored, and measures must be taken to regain your sugar balance immediately. For more information regarding hypoglycemia, comment in this section.

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

Cushing syndrome or round face syndrome, as some like to call it, is a hormonal disorder that is relatively uncommon. It is all about the stress hormone called Cortisol and how it can throw off the body systems. Read on to know the causes and symptoms of this disorder. But first of all, let us know what exactly is the Cushing syndrome?

When an individual's body is exposed more to a particular hormone called Cortisol, he/she may develop a condition called as Cushing syndrome. This can lead to unusual and uncomfortable symptoms. However, this condition of hypercortisolism is completely curable and the patients can continue to lead a normal life. Cushing syndrome is more common in women than in men and occurs mostly between the age of 25 to 40.

Symptoms of cushing syndrome

1. Excessive weight gain and obesity
2. Fatty deposits that tend to accumulate in the midsection, face (causing moon facies) or between the shoulders and upper back causing a hump
3. Fatigue and muscle weakness
4. Thinning skin that is prone to bruises easily
5. Purple stretch marks on the arms, thighs, abdomen and breast
6. Cognitive dysfunction with increased anxiety, irritability and depression
7. Women can experience extra facial and body hair with irregular or absent periods
8. High blood pressure and high blood sugar levels
9. Low sex drive and erectile dysfunction
10. Weak bones and osteoporosis
11. Children with this ailment tend to obese and experience slow growth rate

Causes of Cushing Syndrome
As mentioned above the major cause of Cushing syndrome is the high production of Cortisol. This hormone is produced by the adrenal gland that sits on top of your kidneys. The prime reasons of over-production of Cortisol can be:

1. High-stress levels
2. Malnutrition
3. Alcoholism
4. Depression, panic disorder and high levels of emotional stress
5. Athletic training

Also, another prime cause of this syndrome is the use of corticosteroid medications, such as prednisone, in high doses for a long period. These prescriptions are often given for conditions of asthma, organ transplant, lupus and rheumatoid arthritis. A tumor in the pituitary gland that is located at the base of the brain or a tumor in the adrenal glands can also lead to excessive production of Cortisol, thereby leading to Cushing Syndrome.

Diagnosis and treatment
Diagnosis is done by your doctor to determine the cause of the excess production of the hormone. Tests can include:

1. Blood Test or imaging scans
2. Dexamethasone suppression test
3. 24-hour urinary free cortisol test
4. Late-night salivary cortisol level

Treatment will vary with the actual cause of the disorder. Medications to decrease cortisol levels or block them can be given.

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

The thyroid is a small gland that controls metabolism and growth. Silent thyroiditis is a common autoimmune disorder that affects the thyroid gland. It causes an inflammation of the thyroid gland and is characterized by mild symptoms of hyperthyroidism and hypothyroidism. It is known as Silent thyroiditis because this condition is not painful in any way. Silent thyroiditis is also known as lymphocytic thyroiditis or subacute lymphocytic thyroiditis.The cause of this condition is unknown and hence it is not possible to prevent it. This is one of the least common disorders to affect the thyroid gland. However, middle aged women are at the highest risk of suffering from this condition. Other risk factors include a family history of thyroid disorders, certain autoimmune diseases, removal of the adrenal gland or treatment for cancer.

Some of the symptoms of silent thyroiditis are:

1. Fatigue
2. Increased sensitivity to heat and cold
3. Erratic bowel movements
4. Irregular menstrual periods
5. Increased appetite
6. Palpitations
7. Irritability and nervousness
8. Unexplained weight loss
9. Excessive sweating

If you notice such symptoms, you must consult a doctor. To determine a silent thyroiditis diagnosis, a thorough physical examination and a few tests are required. The physical examination focuses on the size of the thyroid gland, heart rate and presence of tumors if any. A blood test will also be required to check thyroid hormone levels such as T3, T4 and TSH levels. Your doctor may also ask for an ultrasound of the thyroid gland and an imaging test to determine iodine radioactive uptake.

Silent thyroiditis has a good prognosis and patients usually recover within one year. The acute phase typically lasts only three months. Most patients do not require any form of treatment for this condition but regular checkups are advised to keep track of the disease. In rare cases, medical treatment may be required. For example, if the patient complains of increased heart palpitations or excessive sweating, beta blockers may be prescribed to lower the heart rate. The patient is advised to get plenty of rest and avoid any stressful situations.

In some cases, silent thyroiditis may lead to permanent hypothyroidism. In such cases, medication may be prescribed to normalize the thyroid hormone levels. In some cases, thyroid hormone replacement therapy may also be advised. Surgery and radioactive iodine treatment a not required to treat silent thyroiditis. However, even after the symptoms subside, a close follow up is required to check thyroid hormone levels. In case you have a concern or query you can always consult an expert & get answers to your questions!

Diabetes is a chronic condition where glucose level of your body rises too high. There are two types of diabetes type 1 and type 2. In case of type 1 diabetes, the body fails to produce insulin and people suffering from this condition have to depend on insulin injections for the rest of their life. In case of type 2 diabetes the body produces less amount of insulin which is not enough for the proper functioning of the body. This type of diabetes can be kept under control by following a healthy diet and practicing exercise regularly.

Why diabetic wounds can cause severe problems?
Diabetes can cause a number of complications that makes it harder for certain wounds to heal. These include:

1. Nerve damage: Until a cut or blister worsens and becomes inflamed, in case of neuropathy, you will not experience the pain. Diabetics often suffer from neuropathy, making it difficult for wounds to heal.
2. Weak immune system: A minor wound may even get severe and become infected if your immune system fails to exercise its natural defenses.
3. Narrow arteries: Blocked arteries may cause severe wounds which becomes difficult to heal. Clogged arteries make it difficult for the blood to flow to the affected area which slows the process of wound healing.

Treating a diabetic wound
You can follow the methods mentioned below to avoid getting infected:

1. Taking care of the wound immediately. If the wound is not cleaned and taken care of, letting bacteria to build up, it can lead to infection.
2. Avoid using soaps and hydrogen peroxide to irritate the injury. Use antibiotic lotions to prevent infection and use a sterile bandage to keep the affected area covered.
3. Consult your doctor before any minor problems turn to larger ones
4. Since the bottom of the foot is a common place for developing blisters and calluses in case of diabetic people, try to keep pressure off the wound as it slowly heals.

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