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Dr Prasun Sagar
Dr Sandeep Rai is very polite, humble and extremely competent diabetologist. I am very satisfied with treatment given to my uncle. I highly recommend him.
Diabetes is a disorder of metabolism, the way the body uses digested food for energy. The digestive tract breaks down carbohydrates, sugars and starches found in many foods, into glucose, a form of sugar that enters the bloodstream. Diabetes develops when the body doesn't make enough insulin or is not able to use insulin effectively, or both.
The two main types of diabetes are:
Type 1 Diabetes: Type 1 diabetes typically occurs in children and young adults, though it can appear at any age. In the past, type 1 diabetes was called juvenile diabetes or insulin-dependent diabetes mellitus.
Heredity plays an important part in determining who is likely to develop type 1 diabetes. Genes are passed down from biological parent to child.
Type 2 Diabetes: Type 2 diabetes develops most often in middle-aged and older people who are also overweight or obese. The disease, once rare in youth, is becoming more common in overweight and obese children and adolescents. Type 2 diabetes is caused by a combination of factors, including insulin resistance, a condition in which the body's muscle, fat, and liver cells do not use insulin effectively.
Physical Inactivity, Obesity, and Diabetes: Physical inactivity and obesity are strongly associated with the development of type 2 diabetes. People who are genetically susceptible to type 2 diabetes are more vulnerable when these risk factors are present. About 80 percent of people with type 2 diabetes are overweight or obese.
An imbalance between caloric intake and physical activity can lead to obesity, which causes insulin resistance and is common in people with type 2 diabetes. Central obesity, in which a person has excess abdominal fat, is a major risk factor not only for insulin resistance and type 2 diabetes but also for heart and blood vessel disease, also called cardiovascular disease (CVD). This excess belly fat produces hormones and other substances that can cause harmful, chronic effects in the body such as damage to blood vessels.
So, measuring your waist is a quick way of assessing your diabetes risk. This is a measure of abdominal obesity, which is a particularly high-risk form of obesity. Women have a higher risk of developing type 2 diabetes if their waist measures 80cm (31.5 inches) or more. Asian men with a waist size of 89cm (35 inches) or more have a higher risk, as do white or black men with a waist size of 94cm (37 inches) or more.
Simple Steps to Lower Your Risk: Making a few lifestyle changes can dramatically lower the chances of developing type 2 diabetes. The same changes can also lower the chances of developing heart disease and other life taking cancers.
- Control Your Weight: Being overweight increases the chances of developing type 2 diabetes seven-fold. Being obese makes you 20 to 40 times more likely to develop diabetes than someone with a healthy weight. Losing weight can help if your weight is above the healthy-weight range. Check your BMI. Losing 7 to 10 percent of your current weight can cut your chances of developing type 2 diabetes in half.
- Get Moving and Turn Off the Television: Inactivity promotes type 2 diabetes. Working your muscles more often and making them work harder improves their ability to use insulin and absorb glucose. This puts less stress on your insulin-making cells.
- Tune Up Your Diet: Four dietary changes can have a big impact on the risk of type 2 diabetes-
Choose whole grains and wholegrain products over highly processed carbohydrates.
- Skip the sugary drinks, and choose water, coffee, or tea instead.
- Choose good fats instead of bad fats.
- Limit red meat and avoid processed meat; choose nuts, whole grains, poultry, or fish instead.
If you are already suffering from diabetes, then do take a walk everyday and adopt healthy eating habits. Along with that relieve your stress and take proper doses of insulin or medications as prescribed by your doctor.
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.
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.
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.
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:
- Rapid acting insulin: The onset of action in this type of insulin is rapid and it lasts for a short duration, about two hours.
- 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.
- 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.
- 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?
- Low blood sugar level
- Scars and lumps from extensive usage of insulin injection
- Rashes can be found in the area the insulin is injected or sometimes, all over the body
- Weight gain when you start using insulin initially
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 &amp; 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.
5. 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.
6. 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.
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:
- Shedding pounds
- Eating less salt
- Maintaining a strategic distance from liquor and tobacco
- Exercising regularly
A low-protein diet can decrease the amount of lost protein in the urine and increase the protein levels in the blood. Never begin a low-protein diet without talking to your physician. In case you have a concern or query you can always consult an expert & get answers to your questions!
Type 2 diabetes is commonly seen in adults, but nowadays its prevalence is rapidly increasing in young adults and even teenagers. It is a chronic disorder that adversely affects the way your body processes and metabolizes the glucose (blood sugar).
In Type 2 Diabetes, your body either resist the effects of insulin, a hormone that controls the sugar flow into the cells or does not produce adequate insulin to maintain a normal glucose level. Incorporating a healthy living, with the focus being on eating healthy and exercising regularly (for about 30-45 minutes) can help keep Diabetes Type 2 in check.
- Take small and frequent meals i.e. 4-6 times a day spread across regular time intervals. Also, carry a quick fix of carbs that can come to aid when the sugar levels drop.
- Foods rich in fiber and complex carbohydrates, such as bread, vegetables, fruits and whole grain cereals should be at the top of the priority food list. Stay away from fatty or fried food.
- Keep a check on your glucose level regularly at home with the help of a blood glucose meter.
- A three monthly HBA1C test (three-month average blood sugar) can help to know overall blood sugar control.
- Limit consumption of alcohol and completely cut down on tobacco.
- Get up from your couch and hit the nearest jog course or do the exercise of your choice. There is no substitute to physical activities if you are on your way to control Diabetes; be if any type.
- Assess cholesterol and blood pressure count periodically.
- Because of nerve damage and poor blood circulation, your foot may have to bear the brunt of this disorder as well. Take good care of your feet. Check your feet for swelling, red spots and blisters; wear special shoes with a soft pair of socks that can keep your feet dry. Get your feet examine by special instruments for blood circulation and sensation in feet.
- Diabetes damages oral health as well. Visit a dentist for a gum and tooth checkup at least a couple of times in a year.
- Get your kidneys and retina tested as diabetes may weaken the blood vessels of these areas.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Got my lipid profile and Blood sugar (fasting) done. Hope they are normal CHOL: 118.0 TG: 94.0 HDL: 44.0 LDL CHOLESTEROL (DIRECT): 55.20 T.Lipid: 530.0 FBS: 94.0.
Whats the best time to do exercise. I am 36 and diabetic. I like weightlifting. It gives me that knock out for a good sleep. Please advise if am doing the wrong thing.
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.
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.