Dr. Jagruti Parikh

Diabetes refers to a medical condition where the glucose level in your blood increases. It usually happens if there is an excess amount of glucose in your body and your body is unable to utilize it efficiently. In this condition your pancreas either stops producing insulin or fails to produce the requisite amount and hence prevents glucose from entering the cells of your body. This in turn affects your blood glucose level. Millions of people around the globe are affected by diabetes irrespective of their gender or age. For most people diabetes is generally a lifelong medical condition and can affect your health seriously if it gets severe. There are many stages and types of diabetes, such as Type 1 diabetes, Type 2 diabetes, Gestational diabetes, Pre-diabetes, Diabetes Mellitus and Diabetes Insipidus. Not all diabetes can be prevented but some of the above mentioned ones can be prevented with proper care. Below mentioned are eight tips to prevent diabetes

1. Eating the right portion: The primary key for preventing diabetes is choosing the right amount of food. Eating the right portions can help you to stay away from diabetes. Consider seeking advice from a nutritionist or dietician for knowing the exact portion size you should eat according to your age.

2. Exercise on a regular basis: Exercising regularly for at least half an hour a day can help you to prevent diabetes. You may consider walking or running exercises.

3. Choose the right food: Opt for whole grains as this can help you to maintain your blood sugar level and keep diabetes at bay. Also, try and avoid red meat as it contains high levels of iron which can affect insulin production and increase your chances of developing diabetes.

4. Get rid of obesity: If your BMI is more than thirty then you are suffering from obesity. Obesity increases your chances of developing diabetes. So in order to prevent diabetes you should work at maintaining a balanced weight.

5. Avoid carbonated drinks: Carbonated drinks contain high levels of sugar. This can increase your chances of developing diabetes. So you should try and avoid drinks like colas.
Following the above mentioned tips can help you to avert diabetes.

It is important for you to know how pregnancy affects your thyroid gland. The thyroid hormone plays an important role during pregnancy in the development of the baby and also regarding the health of the mother. If you suffer from thyroid problems during pregnancy, you should take medicines and certain thyroid function tests.

How pregnancy affects normal thyroid function?
The pregnancy hormones known as human chorionic gonadotropin or hCG and estrogen lead to increased thyroid hormone levels in your blood. The hCG made by the placenta stimulates the thyroid to produce excessive hormones. Increased estrogen leads to higher levels of the thyroxine binding globulin, which transports the thyroid hormone in the blood.

Because of these normal hormonal changes, thyroid function tests are difficult to perceive during pregnancy. The thyroid hormone is very important for the normal development of a baby’s nervous system and brain. During the first trimester of pregnancy, the foetus depends on the supply of thyroid from the mother via the placenta.

In healthy women, the thyroid enlarges during pregnancy. An enlarged thyroid can indicate a thyroid disease, which should be diagnosed immediately. Thyroid problems are difficult to diagnose during pregnancy because of the increased hormone levels, increased thyroid size, fatigue and other factors.

Hyperthyroidism in pregnancy
Hyperthyroidism may occur in pregnancy because of Graves’ disease where enough thyroid hormones are not produced. Graves’ disease is an autoimmune disorder in which the immune system attacks the cells and organs of the body instead of fighting bacteria or viruses. With Graves’ disease, an antibody is released by the immune system called the thyroid stimulating immunoglobulin or TSI. This causes the thyroid gland to produce excess thyroid hormone. In many cases, the antibody is also associated with eye problems like bulging, irritation and puffiness. Graves’ disease commonly appears during pregnancy, but women with this disease from before may actually observe improvements in the symptoms during the second and third pregnancy trimesters. The remission or the disappearance of the symptoms of Graves’ disease may occur due to the general suppression of the immune system, which occurs during early pregnancy. The disease is likely to recur and worsen in a few months after the delivery. It is important for pregnant women with Graves’ disease to be monitored carefully.

Hypothyroidism during pregnancy may lead to a developmental delay in the child. Sometimes, hormone therapy is given to women who are at the borderline stage in thyroid function during pregnancy or just before pregnancy. The treatment of the condition aims at maintaining a proper and balanced thyroid hormone level in the body.

Diabetes is a serious disease, but if properly managed is not life threatening. Diabetes can be explained as the body’s inability to regulate insulin production. This leads to fluctuations in blood sugar levels. This disease affects every part of the body including the skin. For some people, a rash is among the first few symptoms of diabetes. Most diabetic patients suffer from a skin condition at some point or the other. Here are a few common skin ailments that affect diabetic patients.

1. Bacterial infections: A weakened immune system makes diabetics more vulnerable to bacterial infections than normal. These bacterial infections can be typically seen in the form of styles on the eyelid, boils, carbuncles and nail infections. They usually make the skin around the infected area red, inflamed and painful. Most skin bacterial skin ailments can be treated with antibiotic creams and pills.
2. Fungal infections: One of the most common fungal infections that diabetic patients suffer from is known as Candida albicans. This ailment is characterised by a red, itchy rash that is surrounded by small blisters. It is caused by yeast-like fungus and usually found in moist areas like the armpits or between the toes. Other fungal infections that affect diabetic patients include ringworm, jock itch, athlete’s foot and vaginal yeast infections.
3. Itchy skin: Diabetics often suffer from itchiness that could be triggered by yeast infections, dry skin and poor circulation. People with poor circulation will find their calves and feet to be the itchiest part of the body, While poor circulation and yeast infections may need medical attention, dry skin can be easily treated by keeping the skin internally and externally hydrated along with the use of a mild moisturising soap.
4. Vitiligo: This is a skin condition where the melanin producing cells in the skin are destroyed. This leads to a patchy appearance that can be typically seen on the hands, face and chest. Vitiligo is considered to be an autoimmune disease like diabetes and has no known cause or cure. Sunscreen is a must for diabetic patients suffering from vitiligo as the unpigmented skin has no protection from UV radiation.
5. Diabetic blisters: Patients with severe diabetes may also suffer from diabetic blisters. These blisters usually occur on the extremities of the body and resemble blisters caused by burns. They are usually pain-free and heal on their own.
6. Disseminated granuloma annular: This condition is characterised by a ring or arc shaped areas on the skin. They can usually be seen on the fingers and ears but may also occur in the chest and abdomen. This rash may be reddish or skin coloured. Medical treatment is not generally required for this condition.

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

Cushing’s syndrome occurs due to abnormally high levels of the hormone cortisol. This can happen for a variety of reasons. The most common cause is overuse of corticosteroid medications.

Causes:

Your adrenal glands produce cortisol. It helps with a number of your body’s functions, including:

1. regulating blood pressure and the cardiovascular system

2. reducing the immune system’s inflammatory response

3. converting carbohydrates, fats, and proteins into energy

4. balancing the effects of insulin

5. responding to stress

Your body may produce high levels of cortisol for a variety of reasons, including:

1. high stress levels, including stress related to an acute illness, surgery, injury, or pregnancy, especially in the final trimester

2. athletic training

3. malnutrition

4. alcoholism

5. depression, panic disorders, or high levels of emotional stress

The most common cause of Cushing’s syndrome is the use of corticosteroid medications, such as prednisone, in high doses for a long period. High doses of injectable steroids for treatment of back pain can also cause this syndrome.

Other causes include:

1. a pituitary gland tumor in which the pituitary gland releases too much adrenocorticotropic hormone, which is also known as Cushing’s disease

2. ectopic ACTH syndrome, which causes tumors that usually occur in the lung, pancreas, thyroid, or thymus gland

3. an adrenal gland abnormality or tumor

Symptoms of Cushing’s Syndrome:

The most common symptoms of this condition are:

• weight gain
• obesity
• fatty deposits, especially in the midsection, the face and between the shoulders and the upper back (causing a buffalo hump)
• purple stretch marks on the breasts, arms, abdomen, and thighs
• thinning skin that bruises easily
• skin injuries that are slow to heal
• acne
• fatigue
• muscle weakness
• increased thirst
• increased urination
• bone loss
• depression
• an increased incidence of infections

Women may also notice extra facial and body hair, as well as absent or irregular menstruation.

Men may also have:

• erectile dysfunction
• a loss of sexual interest
• decreased fertility

Children with this condition are generally obese and have a slower rate of growth. In case you have a concern or query you can always consult an expert & get answers to your questions!

Preventive Diabetology:

Health care is not just about telling patients what to do, it is about truly engaging them.

Providing them smart communication so that they can closely monitor them selves - this will unable early diagnosis of health issues through constant monitoring, before they become more serious.

The idea of maintaining people's well being rather then reacting to an episode makes sense.   

It is not communication for sick care but it is communication for care so that you don't fall sick.

These communications will help in better continuum of care,  further bridging the gap between the patient and doctor. The aim is to proactively keep people well rather than react when they become ill.