Dr. Jagruti Parikh

The body produces a number of chemicals called hormones which are essential for the regulation of various functions including growth and metabolism. These hormones are produced by endocrine glands which are located in various parts of the body. One such important gland is the pituitary gland which produces the important growth hormone. This is essential for regulating optimal growth during the growing years and for maintaining proper amounts of body fat, muscles, and bones in the later years of life.

Causes: Deficiency of the growth hormones can occur due to a number of causes, some of which are listed below. It can be congenital (present at birth) or acquired later in life.
The congenital issue could be due to problem in the pituitary gland structure, leading to complete absence or reduced secretion of the hormone.
With age, there is a decrease in the amount of secretion. However, infections, injuries, brain tumors, surgery and radiation can also lead to altered amounts of secretion.

Symptoms: While growth hormone deficiency can occur at any age, symptoms differ depending on the age when the deficiency sets in.
In the early ages:

• Lower rate of growth for a given age
• Delayed developmental milestones
• Delayed onset of puberty
• Short stature/reduced height
• Younger looking compared to other children their age
• Fat deposition around the waist
• Delayed dental development

When the deficiency sets in during the later years, there is

• Low energy levels, constant tiredness
• Decreased strength
• Decreased exercise tolerance
• Decreased overall muscle mass
• Thin and dry skin
• Increased fat deposition and weight gain around the waist
• Changes in social behavior including alternate cycles of anxiety and depression
• Lack of motivation
• History of pituitary tumors
• High levels of fat and cholesterol

The diagnosis depends on the age of the person

• Blood tests are carried out to check the hormone levels in circulation
• In children, in addition to the hormone levels, x-rays to see the status of growth plates is very helpful.
• An insulin hypoglycemia test where insulin is given intravenously to see the levels of the growth hormone after 30 minutes.
• Total cholesterol levels, low-density lipoprotein (LDL) cholesterol, apolipoprotein B, and triglyceride levels can be used to supplement the above tests.
• CT scan and/or MRI of the brain may be needed if tumors are suspected.

Treatment: Once diagnosed, replacement therapy is given as shots a few times a week under the skin. This restores normal growth and helps in controlling the symptoms in adults too.
In cases of tumor, radiation or surgery may be required, but most cases are managed with hormone replacement.
Watch out for the symptoms if your child has delayed developmental milestones and early intervention can help restore growth and function to normal levels.

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

Our body cells are responsible for the essential breakdown of food into energy, as it is vital for our body functioning. Cells break down food into glucose and then convert glucose into energy through insulin, which is an important hormone in the body. Diabetes is associated with the inappropriate functioning of insulin and can be classified into two types: Type I and Type 2 Diabetes. In type I Diabetes, the body does not make enough insulin. In type 2 diabetes, the cell do not use insulin properly.

Both conditions cause blood glucose levels to rise in the body. Diabetes is more than one disease as it poses serious health risks. People with diabetes are at risk of developing a host of problems such as stroke, hypertension, nerve damage, skin, eyes and kidney problems. High amount of blood sugar level can cause damage to the blood vessels leading to blocked arteries restricting blood flow to the heart. Poor blood glucose control can lead to high blood pressure and other blood lipid abnormalities including high levels of HDL (good cholesterol) and triglycerides.

The link between cardiovascular disease and diabetes is well established by medical science. It is estimated that 65% of people with diabetes die of heart disease, which makes it a leading cause of all deaths among diabetic patients. Doctors refer to this connection as DHD- Diabetic Heart Disease. The term Diabetic Heart Disease covers coronary heart disease; narrowing of the arteries, heart failure; minimising heart’s capacity to pump enough blood and diabetic cardiomyopathy; alteration in the structure and function of the heart.

A sedentary lifestyle with little or no physical activity, smoking, stressful life and unhealthy eating habits all contribute to weight gain, high cholesterol, high blood pressure, heart diseases and diabetes. Thus, weight and lifestyle issues management is the best way to prevent and control such health risks.

Let’s look at some simple but effective ways towards a healthy lifestyle:

1. Physical exercise: Adopt a 30-minute exercise rule to remain healthy and fit. For diabetic patients, a morning and evening walk is highly recommended. You could walk, run, gym, climb stairs, do yoga, aerobics or other physical activity that interests you.
2. Eat healthy: Avoid fried and packaged foods as they are full of fats, salt and sugar. Include seasonal vegetables and fruits in your diet and drink plenty of water. Dieticians recommend eating a heart-healthy diet including superfoods like broccoli, spinach, berries and fibre rich meal.
3. Weight management: Keeping weight under check is an effective way to prevent the risk of heart diseases. Consult a dietician for a customised diet plan as per your medical condition.
4. Be positive: Stress is a silent killer and a major contributor to all lifestyle diseases. Remain calm and manage your negative thoughts to overcome stress.

Health is the ultimate treasure you have! Preserve it. In case you have a concern or query you can always consult an expert & get answers to your questions!

Always maintain a diary of your sugar readings for your doctor. This will help him adjust your insulin doses and prevent low sugar attacks.

Patients with diabetes are likely to suffer from nerve damage. This condition is known as diabetic neuropathy. An increase in the blood-sugar level can damage nerve fibres, especially in the legs and feet. Diabetic neuropathy is a common complication for people suffering from diabetes.

Types of neuropathy

1. Peripheral neuropathy: This is the most frequently occurring form of diabetic neuropathy. It can affect the legs, feet, hands and arms of a person. Some of the common symptoms include numbness in the leg or arm, cramps, reduced reflexes and muscle weakness. This is accompanied by other problems such as joint pain, ulcers, and deformities.
2. Autonomic neuropathy: This part of the nervous system controls the intestines, heart, stomach, lungs, eyes and sex organs. Diabetes can wreak havoc in these vital organs. Some of the common symptoms include bladder problems, vomiting, nausea, erectile malfunction, fluctuation in body temperature, decreased or increased sweating, and irregular heart rate.
3. Radiculoplexus neuropathy: This form of neuropathy affects the nerves in areas such as the thighs, legs, buttocks, etc. This condition is mostly witnessed in people suffering from type 2 diabetes. The symptoms are often observed on one side of the body, which includes abdominal swelling, pain in the thigh, hip and buttock, weight loss, difficulty in getting up from a particular position.
4. Mononeuropathy: This form of neuropathy attacks a particular nerve and is mostly found in older adults. It doesn’t have any long-term implications. Some of the symptoms include paralysis of the face, pain in the chest, difficulty in focusing the eye, and pain in the foot.

Risk factors of diabetic neuropathy

1. Being overweight: An increase in body weight increases the chances of diabetic neuropathy. A body mass index (BMI) of greater than 24 is considered to be alarming for a patient suffering with diabetes.
2. Smoking: Smoking narrows the arteries, thereby reducing the flow of blood to the feet and the legs. This increases the chance of diabetic neuropathy.
3. Kidney disease: Diabetes can cause great damage to the kidneys, which increases the level of toxins in the body. This situation can aggravate to diabetic neuropathy.
4. Poor control of blood-sugar levels: A poor control of blood-sugar levels is the biggest risk factor of diabetic neuropathy. Keeping the blood-sugar level under control helps the nerves to maintain a healthy condition.

Common complications of diabetic neuropathy

1. Digestive problems: Nerve damage can lead to diseases such as diarrhoea, bloating, nausea, vomiting and a loss of appetite. It can also result in a disease called gastroparesis; this is a disease which doesn’t let the stomach empty at its usual rate.
2. Limb loss: Gradual nerve damage can affect the limbs of the body. Diabetic neuropathy slowly damages the soft tissues and the skin, which eventually results in the loss of a limb.

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