Dr. Shradha Doshi

At the point when our bodies process the protein we eat, the procedure creates waste products. In the kidneys, millions of tiny blood vessels act as filters since they have even tinier holes in them. As blood flows through these vessels, little molecules such as waste items may press through the gaps. These waste items turn out to be a part of the urine. Helpful substances such as protein and red blood cells are too enormous to go through the gaps in the filter and stay in the blood.

Diabetes and kidneys: Diabetes can harm the kidneys. Abnormal amount of glucose make the kidneys filter a lot of blood. After a couple of years, they begin to spill and helpful protein is thereby lost in urine. Having low protein levels in the urine is called micro albuminuria.

Medication: When kidney disease is analyzed on time, during micro albuminuria, a few medications may keep kidney disease from getting worse. Having elevated levels of protein in the urine is called macro albuminuria. When kidney disease is looked up some other time during macro albuminuria, end-stage renal disease (ESRD) usually follows.

Causes: Strain on the organs may cause the kidneys to lose their filtering capacity. Waste items then begin to develop in the blood. Finally, the kidneys start to fail. This failure, ESRD, is intense. A patient with ESRD needs a kidney transplant or a blood filtration by a machine (dialysis).

Other complications: Individuals with diabetes will probably have other kidney-related issues such as bladder infections and nerve damages in the bladder.

Preventing complications: Not everybody with diabetes goes through a kidney disease. Elements that can impact kidney disease improvement include genetics, blood sugar control and blood pressure. The more a person keeps diabetes and blood pressure under control, the lower the chances of getting a kidney disease.

Keeping your glucose levels high can counteract diabetic kidney problems. Research has demonstrated that blood glucose control diminishes the danger of micro albuminuria by 33%. For individuals who suffer from micro albuminuria have now a reduced danger of advancing to macro albuminuria. Different studies have recommended that blood glucose control can reverse micro albuminuria.

Treatment: Essential treatments for kidney infection include control of blood glucose and blood pressure. Blood pressure dramatically affects the rate at which the condition progresses. Indeed, even a gentle increase in blood pressure can rapidly aggravate a kidney infection. Four approaches to bring down your blood pressure are:

1. Shedding pounds
2. Eating less salt
3. Maintaining a strategic distance from liquor and tobacco
4. Exercising regularly

A low-protein diet can decrease the amount of lost protein in the urine and increase the protein levels in the blood. If you wish to discuss about any specific problem, you can ask a free question.

You pass by that cake shop and happen to glance at a sumptuous chocolate cake, and then realization dawns on you that you are not allowed to eat simple sugar. Why? The answer to it is diabetes, for which you only have your pancreas to blame. Situated behind the stomach in your body, the pancreas is an organ whose role is to produce hormones and enzymes that aid in the digestive process. One of the hormones that the pancreas produces is insulin which is required by the body to metabolize sugar that is present in various foods.

So, if your pancreas does not produce the required amount of insulin or fails to utilize insulin effectively, it leads to accumulation of glucose in your blood. The improper functioning of the pancreas leads to diabetes. There are four types of diabetes and they are classified with respect to the manner in which the pancreas mal-functions:

1. Type 1 Diabetes In this type, the immune system of the body wrongly attacks the insulin producing beta cells of the pancreas. This impairs the ability of the pancreas to secrete insulin, thus leading to Type 1 diabetes. However, even after extensive research in this field, the exact triggers haven’t been found yet.
2. Type 2 Diabetes: Type 2 Diabetes develops when the body becomes resistant to insulin. It can either mean that the pancreas is producing less than normal insulin or the body is not being able to utilize the produced insulin effectively. Factors such as a poor diet and lack of exercise increase the risks of Type 2 Diabetes.
3. Pre-diabetes: Pre-diabetes is a condition wherein the blood sugar levels are higher than normal, but not high enough to be considered as ‘diabetes’. It can again occur due to a reduced secretion of insulin or the inability of the body to utilize the insulin effectively.
4. Gestational Diabetes This type of diabetes can develop only during pregnancy. This occurs primarily as the placenta, that connects the fetus with the body’s blood supply, produces hormones that impair the functioning of insulin. This type of diabetes can affect both the mother and the child.

Another common link
Pancreatitis is a condition that is marked by an inflammation of the pancreatic cells. This inflammation can damage the beta cells that produce insulin, thus resulting in diabetes. Factors that contribute to it are a poor diet, lack of exercise, presence of excessive calcium in the blood or excessive alcohol consumption.

How can you avoid the same?
It is best that you incorporate lifestyle changes if you have any of these disorders, and talk to your doctor about a treatment plan. Making a few simple lifestyle changes such as eating healthy, avoiding smoking and exercising on a regular basis can reduce the chances of you suffering from both diabetes and any other pancreatic problems. If you wish to discuss about any specific problem, you can consult a doctor.

Diabetic men usually are prone to suffering from erectile dysfunction, i.e., they are unable to maintain an erection while having sex. If you are suffering from diabetes for a long time, your nerves and blood vessel might get damaged. That will cause you to suffer from erectile dysfunction. Almost 35% to 75% diabetic men suffer from erectile dysfunction. This situation becomes more serious with age.

Causes: It involves various factors like impairment in the nerves, blood vessels, and also cause problems in proper muscle functioning. You need healthy blood vessels, nerves, as well as healthy male hormones and sexual desire to get an erection. Diabetes damages the nerves and blood vessels responsible for an erection. So even if you have the required amount of hormones and the desire, you might not be able to get a proper erection.

Treatment: If you are suffering from diabetes, and have a condition of erectile dysfunction, then the most common treatment for you is Sildenafil. Other medications, which you can take are tadalafil, avanafil, and vardenafil. But keep in mind that if you have any heart problems, then you should refrain from taking any of these medicines as they will further complicate situations for you. Consult your doctor in this case to know which will be the best treatment for you to cure erectile dysfunction. Other treatment methods are as follows:

1. Intracavernous injection therapy
2. Vacuum erection devices
3. Venous constriction device
4. Intraurethral therapy
5. Penile prostheses

The dosage of these medicines depends upon weight of the patient as well as presence or absence of other co-morbid conditions like hypertension, dyslipidemia, cardiac problems, kidney/liver diseases, etc. Prescription of these medicines also depends on the other medications that the patient is taking as these ED medicines have a lot of adverse drug-interactions. Hence, one must always consult a doctor before starting these medications.

The Role of Counselling for Treating Erectile Dysfunction:

Erectile dysfunction can be caused by psychological factors and once a man experiences erectile dysfunction it can have a major impact on their emotional well-being. A man may feel a loss of manhood, a loss of confidence, low self-esteem, angry and depressed and it may also affect his relationship or sexual encounters. Therefore, counselling is a crucial part of treatment in order to address these issues.
Does psychosexual counselling work?

Psychosexual counselling is most effective when a man's sexual partner is willing to be part of the treatment. Studies have shown that for men with stress-related ED, when the partner is involved in the therapy, the problem is resolved 50%-70% of the time. When the man must go through counselling alone, the results are less successful.

Psychosexual counselling is unlikely to work if a man drops out of treatment after just one or two sessions.

Sometimes, several sessions of psychosexual counselling can be helpful if a man is due to receive medical or surgical treatment for ED. A counsellor can help guide a couple towards agreeing on treatment, or help them improve their sexual communication and lovemaking skills. A man may benefit from counselling on his own regarding how to talk to his partner about penile injections or a vacuum constriction device, which are both treatments for ED. If you wish to discuss about any specific problem, you can consult a doctor.

Diabetes is a systemic disease that affects almost every part of your body. Of these, the digestive system is the most badly affected. While gastrointestinal disorders are commonly experienced by everyone, diabetics have a much higher risk of suffering from indigestion, food poisoning, gallstones and ulcers. Some of the most common gastrointestinal problems experienced by diabetics are:

1. Gastroparesis: High blood sugar levels can damage the vagus nerve that controls the emptying of the stomach. As a result fo this damage, the muscles of the stomach and intestines do not work optimally leading to a condition known as Gastroparesis. This is a condition where the stomach is not able to empty itself properly and the digestion process is slowed down. Gastroparesis can cause bloating, nausea, pain in the abdomen, heart burn and a loss of appetite. It can also cause undigested food in the stomach to harden and form lumps that block food from moving into the intestines. This disease cannot be cured but can be managed with medication and a special diet.
2. Ulcers: Stomach ulcers can be described as open sores that develop on the inner lining of the stomach, oesophagus and beginning of the small intestine. These ulcers form as a result of bacterial infections. Diabetes weakens a person’s immune system thus reducing their ability to fight these infections and increasing the risk of developing ulcers. Diabetes also increases the risk of bleeding from these ulcers and secondary infections that may arise from it.
3. Yeast infections: Diabetics are extremely vulnerable to yeast infections. This is aggravated by fluctuation in blood sugar levels and can extend from the mouth to the oesophagus. Common symptoms of this type of yeast infection are pain in the throat and difficulty swallowing. It may also cause heartburn and intestinal bleeding if left untreated.
4. Celiac sprue: This condition creates gluten allergies and causes the inflammation and thinning of the small intestine’s mucosa. In some cases, this condition may interfere with the absorption of food and lead to diarrhoea and weight loss.
5. Diabetic diarrhoea: Patients who have been suffering from diabetes for a few years may experience an increased urge to pass stools frequently. This is usually related to gastric problems in the colon which cause fluids to move at a faster than normal speed through the small bowel and colon. It may also be caused due to the secretion of fluids in the colon and improper absorption of food. If you wish to discuss about any specific problem, you can consult a doctor.

Since blood is part of the cardiovascular system, and diabetes is a condition in which the level of glucose in the blood is higher than normal, then is certainly some relationship between the two.

Diabetes and cardiovascular system diseases has been recognized to be closely related to each other due to the so-called insulin resistance syndrome or metabolic syndrome. Some examples of the commonly diagnosed cardiovascular disease are coronary heart disease, stroke, high blood pressure and other heart conditions.

Diabetes is considered a major risk factor in cardiovascular diseases. Other factors that contribute to the possibility of acquiring cardiovascular diseases in diabetic patients include hypertension, smoking, and dyslipidemia.

How Diabetes Causes Cardiovascular Problems?

1. Hypertension: Hypertension in diabetes is considered a major contributor to the increase in mortality from cardiovascular diseases. Diabetic patients, especially those with Type 2, need to always have their blood pressure checked every visit to the doctor. Self-monitoring at home is also a must to maintain and control the rise of blood pressure. The American Diabetes Association recommends a target blood pressure of not more than 130/85 mm Hg to maintain a good level of blood pressure.
2. Arteriosclerosis and Atherosclerosis: Arteriosclerosis is the stiffening or hardening of the artery walls while Atherosclerosis is the narrowing of the artery because of plaque build-up. Atherosclerosis is a form of hardening of the blood vessels/arteries, caused by fatty deposits and local tissue reaction in the walls of the arteries. Diabetes is a documented high risk factor for the development of both Atherosclerosis, Arteriosclerosis. Heart disease and stroke, arising mainly from the effects of atherosclerosis, account for 65 percent of deaths among diabetics.
3. Hyperglycemia: Hyperglycemia means high (hyper) glucose (gly) in the blood (emia). Your body needs glucose to properly function. Your cells rely on glucose for energy. Hyperglycemia is a defining characteristic of diabetes, when the blood glucose level is too high because the body isn't properly using or doesn't make the hormone insulin. There is a growing recognition that diabetes belongs to a special category of risk factors because it markedly increases risk of CVD. This increase is partly the result of the pernicious effects of persistent hyperglycemia on the vasculature and partly due to the coexistence of other metabolic risk factors.
4. Smoking: Smoking has been determined dangerous to our health. Studies show that smoking indeed increase risk of premature death and cardiovascular disease in diabetic patients.
5. Atrial Fibrillation: Atrial Fibrillation means an irregular and rapid heart rate which can increase the risk of stroke, heart failure and other cardiac issues. Individuals with diabetes are at an increased risk of developing atrial fibrillation. This risk is higher among patients with a longer duration of treated diabetes and poorer glycemic control.

Individuals with insulin resistance or diabetes in combination with one or more of these risk factors are at even greater risk of heart disease or stroke. However, by managing their risk factors, patients with diabetes may avoid or delay the development of heart and blood vessel disease. Your health care provider will do periodic testing to assess whether you have developed any of these risk factors associated with cardiovascular disease. If you wish to discuss about any specific problem, you can consult a doctor.

Diabetes is a metabolic disorder that results in high blood sugar levels in the body. It basically means that the body is either insensitive to insulin or the insulin production levels in the body go down. The various symptoms of diabetes are blurred vision, weight loss and hunger.

Some other symptoms of diabetes are:

1. Excessive urine output
2. Wounds that take time to heal
3. Yeast infections
4. You may experience fatigue on a regular basis
5. Frequent Mood Changes

Diabetes is also known as a Lifestyle disease. From the food you eat to the amount of activity, they are all connected to diabetes prevention. The various modifications that you may carry out to prevent diabetes are:

1. Exercise: You should exercise on a regular basis as it increases your overall wellbeing. It helps you to lose weight and allows you to maintain optimal blood sugar levels. It can also improve your body's sensitivity to insulin to prevent blood sugar problems. Exercise helps in increasing endorphin levels in the body which are responsible for keeping you happy and satiated, thereby avoiding depression and over-eating.
2. Eat more whole grains: Unlike simple carbohydrates, whole grains are complex carbohydrates that raise your blood sugar steadily instead of spiking it suddenly. Avoid refined grains as most of the important nutrients are stripped from refined grains. A Well-balanced diet with adequate amounts of PUFA/MUFA help in increasing the insulin sensitivity, reducing cholesterol and heart problems, etc.
3. Eat a lot of fiber: If you have type 2 diabetes, you should be, including high-fiber foods in your diet is a healthy way to control high blood sugar. Fiber does not raise blood glucose levels. Because it is not broken down by the body, the fiber in an apple or a slice of whole grain bread has no effect on blood glucose levels because it isn't digested. The grams of fiber can actually be subtracted from the total grams of carb you are eating if you are using carbohydrate counting for meal planning. Fiber helps you in feeling satiated, thus prevents you from overeating. It also improves your blood sugar levels and decreases your chances of getting affected by heart disease.
4. Lose weight: You should aim to maintain a healthy weight level as it also decreases the risk of diabetes. It also helps in improving your cardiovascular health. Follow a regimen, which is based on a balanced diet and moderate amount of exercise. Losing weight is the best way to keep diabetes away. Weight is something that we can keep under control. The waist size of men and women should not be more than 150 cm and 90 cm respectively. Always maintain your ideal body weight as per your BMI (Body Mass Index). Globally, obesity is one of the leading causes of diabetes.
5. Avoid sugary drinks: With ten teaspoons of sugar in every 12-ounce can or bottle, sweet drinks can send your blood sugar soaring and boost your risk for weight gain, high blood pressure, stroke, and heart disease. One sugary drink a day adds 150 empty calories and 40 to 50 grams of blood-sugar-raising carbohydrates to your diet, and can lead to a weight gain of 15 pounds per year. Switching to healthier drinks can save hundreds of calories and a lot of carbohydrates.
6. Avoid Stress: When you are stressed, your blood sugar levels rise. Stress hormones like epinephrine and cortisol kick in since one of their major functions is to raise blood sugar to help boost energy when it's needed most. You can't fight danger when your blood sugar is low, so it rises to help meet the challenge. Both physical and emotional stress can prompt an increase in these hormones, resulting in an increase in blood sugars and diabetes. Ensuring a stress-free life is very important if you want to stay away from diabetes. Avoid stress by going out for garden-walks, indulging in social causes/activities, yoga, meditation, etc. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

Diabetic neuropathy is a nerve disorder caused by diabetes. The high blood sugar from diabetes affects the nerves and over time increases a person's risk for nerve damage. Keeping blood sugar levels within the target range recommended by your doctor helps prevent diabetic neuropathy.

Types of Diabetic Neuropathy:
Diabetic neuropathy can be classified as Peripheral, Autonomic, Proximal, or Focal. Each affects different parts of the body in various ways...

Peripheral neuropathy, the most common type of diabetic neuropathy, causes pain or loss of feeling in the toes, feet, legs, and hands.

Autonomic neuropathy affects the nerves that control involuntary body functions such as digestion, bowel and bladder function, sexual response, and perspiration. It can also affect the nerves that serve the heart and control blood pressure, as well as nerves in the lungs and eyes. Autonomic neuropathy can also cause hypoglycemia unawareness, a condition in which people no longer experience the warning symptoms of low blood glucose levels.

Proximal neuropathy causes pain in the thighs, hips, arms, or buttocks and leads to weakness in the legs and hands, resulting in difficulty in walking, standing, picking up objects, buttoning your clothes, etc.

Focal neuropathy results in the sudden weakness of one nerve or a group of nerves, causing muscle weakness or pain. Any nerve in the body can be affected.

How Diabetes Causes Damage to the Nervous System?
There are several factors that are likely to contribute to nerve damage through diabetes...

• High blood glucose, a condition associated with diabetes, causes chemical changes in nerves. These changes impair the nerves' ability to transmit signals. 
• High glucose levels affect many metabolic pathways in the nerves, leading to an accumulation of a sugar called sorbitol and depletion of a substance called myoinositol. These changes are the mechanism that causes nerve damage. Nitric oxide dilates blood vessels. In a person with diabetes, low levels of nitric oxide may lead to constriction of blood vessels supplying the nerve, contributing to nerve damage.
• Presence of mechanical injury like carpal tunnel syndrome in a diabetic patient worsens its symptoms and prognosis
• inherited traits increase susceptibility to nerve disease
• lifestyle factors, such as smoking or alcohol use

Symptoms:

1. Numbness, burning sensations, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
2. Either hypersensitivity to touch or insensitivity, even to hot and cold temperatures
3. Weakness in muscles and loss of reflexes
4. indigestion, nausea, or vomiting
5. diarrhea or constipation
6. dizziness or faintness due to a drop in blood pressure after standing or sitting up
7. problems with urination
8. Changes in gait and balance
9. Injuries that are taking longer to heal and are more prone to infections

Prevent Diabetic Nerve Damage:
Keeping your blood sugar levels in your target range, set with your doctor, may help prevent nerve damage from ever developing. The best way to do this is by checking your blood sugar and adjusting your treatment. It is also important to get to and stay at a healthy weight by exercising and eating healthy foods.

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

Exercising, eating healthy and maintaining a healthy weight are the golden rules to keep diabetes at bay.

Soak the ladyfingers overnight and drink this water along with breakfast to keep diabetes in check.

If you are on insulin, make sure you have three proper meals with light snacks in between.