Identifying and Treating Diabetes Joint Pain | Sweet Clinics

Diabetes and joint pain

Diabetes and joint pain are considered to be independent conditions. Joint pain may be a response to an illness, injury, or arthritis. It can be chronic (long-term) or acute (short-term). Diabetes is caused by the body not using the hormone insulin correctly, or insufficient production of it, which affects blood sugar levels. What would a hormone and blood sugar-related condition have to do with joint health?

Diabetes is associated with widespread symptoms and complications. According to the Centers for Disease Control and PreventionTrusted Source, 47 percent of people with arthritis also have diabetes. There is an undeniably strong link between the two conditions.

Understanding diabetic arthropathy

Diabetes can damage joints, a condition called diabetic arthropathy. Unlike pain caused by immediate trauma, the pain of arthropathy happens over time. Other symptoms include:

• thick skin
• changes in the feet
• painful shoulders
• carpal tunnel syndrome

A joint is the place where two bones come together. Once a joint wears down, the protection it provides is lost. Joint pain from diabetic arthropathy comes in different forms.

Diabetes & Knee Replacement Surgery: What You Need to Know..? | Sweet Clinics

Leading a diabetic life is by no means an easy task; add to that the need of a knee replacement surgery can at times create a lot of confusion. If you are reading this article chances are you or someone you know has diabetes and want to know if a TKR safe for diabetic, will there be post surgery complications. In this article we hope to address most of the misconceptions surrounding knee replacement for diabetics and what can be done to prevent pre & post surgery trauma.Firstly, it’s important to know advancements in knee replacement surgery has come a long way. In the early days when a incision in the muscle was required to reach the joint replacement, which also required blood transfusion. Consequently, the recovery was painful and took about a month to recover. However, with the latest Painless and Minimal-Stitch knee replacement surgery most normal patients start walking on the same day and are back to normal life in a week’s time. This surgery is safe for diabetic patients aswell as long as it is performed under the guidance of experienced knee replacement surgeon and certain pre and post operative parameters are met.So let’s get down to it.

How does Diabetes Affect Joint Replacement Surgery?
Surgery and anesthesia used during a surgery creates an inflammation in the operated region initiates an autoimmune response by the body by the release of adrenaline, noradrenaline, cortisol, glucagon and other hormones. In patients with uncontrolled diabetes this can increases insulin resistance and glucose levels in the body. This can trigger significant hyperglycemia and can lead to deep tissue infection. Eventually, affecting surgical outcomes.Any surgical procedure no matter how safe puts immense stress on the human body. Diabetic patients inherently have weakened immune system, muscles and body tissues. This weakness affects the overall recovery post surgery.

Pre- Knee Replacement Surgery Measures for Diabetes patients?
“Being fully prepared for a surgery is half the battle won”.

We cannot emphasis enough on this, when it comes to diabetic & Hyperglycemic patients. Be it type-1 or type-2 diabetes a rigorous pre-op regime has to be laid out depending on the patients medical history with the objective of controlling diabetes and reducing risks.

Medical Management: When you first visit your orthopaedic a detailed screening for Diabetes and related co-morbid conditions is important. Accordingly, working with your diabetologist a plan is put in place to prepare you and your body for the surgery is important. This might require medical management of blood sugar levels and any other problems like high blood pressure, renal impairment etc. these need to be brought to stable levels to go ahead for surgery. Apart from medical management your doctor might suggest certain diet and physiotherapy to prepare for the surgery.

Diet: Type-2 diabetes is primarily a lifestyle disease and controlling your diet to reduce your HbA1c level (levels around 8% or less should suffice) plays a vital role in surgical outcomes. So what should your diet include… foods which are rich in antioxidants and have anti-inflammatory properties are essential to help mange surgical (inflammatory) stress on the body. Its highly recommended to consult a surgical dietitian who can help you get the best diet to prepare for a knee surgery.

Exercise: This is something which is suggested to even normal patients. Diabetics, generally have weak muscles, its critical to undergo muscle strengthening program before surgery. Studies have shown that pre-op exercise significantly eases and reduces recovery period. When you undergo knee replacement surgery under Dr. Shailendra Patil our Physiotherapist helps you with a home exercise program before and after surgery.

Post- Knee Replacement Surgery Measures for Diabetes patients?
Post surgery a diabetic patient with most parameters in control can start walking within a day or two. The medical management of diabetic and co-morbid conditions continue to avoid any post surgery complications, that may arise. The exercise and diet plan continues for a few months until the patient is back to his normal life.So as you have read by now that diabetic patients can undergo knee replacement surgery in a safe manner as long as it is done under professional care by your Knee surgeon and diabetologist. Especially minimally invasive techniques which involves less cutting and sticking and handling of tissue makes surgery and recovery very smooth, even diabetic patient's don’t get any healing problems post surgery. 

All You Wanted to Know About Diabetes: A Scientific Elucidation |Sweet Clinics

WHAT IS DIABETES?
Diabetes is a disease in which blood glucose levels are above normal. Most of the food we eat is broken down into glucose, or sugar, which are oxidised by our tissues to produce energy. The pancreas, an organ that lies near the stomach, secretes a hormone called insulin. Insulin pumps in glucose from our blood into the cells of our bodies. When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin well as it should. This causes sugar to build up in your blood.

Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. There is no diabetes cure developed so far.

HOW BLOOD SUGAR IS NORMALLY CONTROLLED IN OUR BODY?
The Blood Sugar is tightly regulated between 70 to 110mg/dL in fasting state and 100 to 140mg/dL in post meal state. At any random state Blood Sugar is maintained below 180 mg/dL. This is done by the balanced action of some hormones; some of which tend to increase blood sugar while some tend to decrease.Hormones that increase blood sugar are Glucagon, steroids, Adrenaline, Somatostatin, Thyroid hormones, Growth Hormone etc.

The only hormone that reduces blood sugar is the INSULIN. Whenever there is a tendency of the blood sugar to rise above the permissible level, Insulin is secreted from the pancreas and the sugar from the blood is pushed inside the cells by insulin and the balance is achieved.

WHAT IS INSULIN?
Insulin is a protein hormone secreted from Pancreas. It is released from pancreas in two patterns.A constant secretion of insulin takes place throughout the day irrespective of meals which ensures that blood sugar in fasting state is under limits. This continuous Insulin secretion pattern is called the BASAL insulin.

On the top of this whenever there is any intake of food, Insulin senses the transient rise in blood sugar and is secreted in a pulsatile manner with each meals to bring down the post meal rise in blood sugar. This pulsatile pattern of Insulin release is called PRANDIAL Insulin.

When the doctors treat patients with insulin, they always try to match the above mentioned pattern of Insulin levels in the blood which is often difficult.

WHAT ARE MY RISKS FOR DEVELOPING DIABETES?
Roughly it can be extrapolated from researches on Diabetic genes that,

If your mother is Diabetic: You have 19% chances to develop diabetes
If your father is Diabetic: you have 14% chances to develop diabetes
If both the parents are Diabetic: You have 25% chances to develop diabetes
If your sister or brother is Diabetic: You have 75% chances of developing diabetes
If your twin is Diabetic: You have 99% chance of developing diabetes.
WHAT ARE THE SYMPTOMS AND SIGNS OF DIABETES?

People who think they might have diabetes must visit a physician for diagnosis. They might have SOME or NONE of the following diabetes symptoms

Frequent urination
Excessive thirst
Unexplained weight loss
Extreme hunger
Sudden vision changes
Tingling or numbness in hands or feet
Feeling very tired much of the time
Very dry skin
Sores that are slow to heal
More infections than usual.
Nausea, vomiting, or stomach pains may accompany some of these symptoms in the abrupt onset of insulin-dependent diabetes, now called type 1 diabetes.

WHAT ARE THE TYPES OF DIABETES?
Type 1 diabetes, which was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, may account for about 5% of all diagnosed cases of diabetes.

Type 2 diabetes, which was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, may account for about 90% to 95% of all diagnosed cases of diabetes.

Gestational diabetes is a type of diabetes that only pregnant women get. If not treated, it can cause problems for mothers and babies. Gestational diabetes develops in 2% to 10% of all pregnancies but usually disappears when a pregnancy is over. Top Diabetes Doctors in Navi Mumbai

Other specific types of diabetes (like diabetes insipidus) resulting from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses may account for 1% to 5% of all diagnosed cases of diabetes.

Diabetes And The Eye | Sweet Clinics

The Importance Of Eye Care For Diabetics

India has a problem with diabetes, and it’s getting worse. And that means serious problems for many people’s eyesight.

What Is Diabetic Retinopathy?

Diabetic retinopathy is diabetes-related damage to blood vessels that nourish the light-sensitive retina of the eye. This damage can occur from either type 1 or
type 2 diabetes, and the longer you have the disease, the greater your risk for vision problems. In its early stages, diabetic retinopathy has no symptoms. But as the condition progresses, the retina become swollen and blood vessels begin to leak fluid and blood into the interior of the eye, causing symptoms that include:

Blurred vision and/or poor night vision
Spots floating in your vision
Darks streaks that block your vision
Partial or significant vision loss
Though there are treatments that can help limit vision loss from diabetic retinopathy, early detection and timely treatment are critical. But the best cure is prevention.

What You Can Do

First of all, it’s important to know that though obesity is a major risk factor for type 2 diabetes, you don’t have to be significantly overweight to develop the condition. Popular actor Tom Hanks’ recent announcement that he’s been diagnosed with type 2 diabetes is proof of that. This month, during American Diabetes Month and Diabetic Eye Disease Month, make a point to actively encourage all patients and customers you come in contact with to:

Schedule a routine physical exam that includes a blood test to rule out diabetes or pre-diabetes.
Have a dilated eye exam by an optometrist or ophthalmologist to rule out early signs of diabetic eye disease.
It’s That Simple.
By helping people become more aware of the dangers of diabetes and take preventative steps to avoid the disease and its complications, you’ll be helping
others enjoy a greater quality of life…and you just might save someone’s eyesight.

Diabetes And The Eye | Sweet Clinics

The Importance Of Eye Care For Diabetics

India has a problem with diabetes, and it’s getting worse. And that means serious problems for many people’s eyesight.

What Is Diabetic Retinopathy..?

Diabetic retinopathy is diabetes-related damage to blood vessels that nourish the light-sensitive retina of the eye. This damage can occur from either type 1 or
type 2 diabetes, and the longer you have the disease, the greater your risk for vision problems. In its early stages, diabetic retinopathy has no symptoms. But as the condition progresses, the retina become swollen and blood vessels begin to leak fluid and blood into the interior of the eye, causing symptoms that include:

Blurred vision and/or poor night vision
Spots floating in your vision
Darks streaks that block your vision
Partial or significant vision loss
Though there are treatments that can help limit vision loss from diabetic retinopathy, early detection and timely treatment are critical. But the best cure is prevention.

What You Can Do

First of all, it’s important to know that though obesity is a major risk factor for type 2 diabetes, you don’t have to be significantly overweight to develop the condition. Popular actor Tom Hanks’ recent announcement that he’s been diagnosed with type 2 diabetes is proof of that. This month, during American Diabetes Month and Diabetic Eye Disease Month, make a point to actively encourage all patients and customers you come in contact with to:

Schedule a routine physical exam that includes a blood test to rule out diabetes or pre-diabetes.
Have a dilated eye exam by an optometrist or ophthalmologist to rule out early signs of diabetic eye disease.
It’s That Simple.
By helping people become more aware of the dangers of diabetes and take preventative steps to avoid the disease and its complications, you’ll be helping
others enjoy a greater quality of life…and you just might save someone’s eyesight.

Diabetes Foot Care Tips will help you to keep your feet healthy : Sweet Clinics

Keep Your Blood Sugar in Target Range – 

Do not walk bare foot even at home – Keep two separate pairs of footware for home & outdoors.
Inspect your feet everyday for blisters, cuts, redness, swelling, dryness, ingrown toenails, corns & callosities- use mirror to see bottom of foot.

Use special diabetes footware. Prefer using Ketto type sandels & shoes instead of slippers.
Wash your feet daily with warm water & mild soaps – check & confirm temperature of water with elbow before inserting feet into it. After washing, dry them thoroughly , even inter digit space.
Apply moisturizers on feet & lower leg to avoid dryness of skin – don’t apply between toes.
Cut toe nails carefully after bath when they are soft – avoid cutting cuticle & digging under toenails with sharp objects.

Use cotton or wool socks – change them daily, avoid too tight socks.
Wear properly fitting shoes with ample of cushioning. It is preferable to use leather shoes than synthetic material.
Always inspect your shoes or footwear for objects like metal pins, coins etc before wearing it.

Be physically more active – it increases blood supply to feet.
Do not cross legs for longer period while sitting, In spare free time move your feet up & down and rotate at ankle joint.
Quit smoking.
If you see cuts, corns, callosities, redness, blackening or delayed healing in minor cuts seek medical attention or consult your diabetes doctor immediately. Routine foot care & prompt attention to injuries can prevent foot problems from threatening your life and amputations.

Awareness is Prevention.

Diabetologists in Mumbai for Top notch Services in India

One of the most commonly heard condition is diabetes across the world, which is the increase of blood sugar level commonly termed as ‘blood sugar’. Our body consumes blood glucose as the dominant form of energy from the food we eat. A hormone named insulin helps glucose from food get into your cells to be used for energy. Sometimes your body doesn’t make enough or any insulin or doesn’t use insulin glucose your blood stream lead to several health problems. Though! There is permanent care for diabetes, it can be managed to live healthy and long.

What are the Different Types of Diabetes?

The different types of diabetes treated in India under the Top Diabetologists in Navi Mumbai are as follows.

·         Type1 and Type2 Diabetes: These are one of the most common diabetes types, in type1 your body doesn’t make insulin leading to the destruction of the cell producing insulin in your pancreas. It is mostly found in children and these children are being administered with insulin every day. Type 2 diabetes can be developed at any stage unlike Type1 and in this case body doesn’t make or use insulin well.

·         Gestational Diabetes: It is developed in women during pregnancy in almost every case it goes away after the baby is born but they still have a greater chance of developing type2 diabetes later in life.

·         Monogenic Diabetes: Certain mutation causes alteration in a single gene leading to monogenic forms of diabetes. Also known as neonatal diabetes mellitus it form 1-4 in all the diabetes forms.

Symptoms

Common diabetes symptoms are:

•           Unusual weight loss or gain

•           Excessive thirst and appetite

•           Blurred vision

•           Fatigue

•           Increased urination

•           Nausea and vomiting

•           Dry mouth

•           Slow healing sores or cuts

Top Diabetes Clinics in Navi Mumbai

India is known for its advances medical facilities, Top Diabetes Clinics in Navi Mumbai provides comprehensive care to the patients and is known for its international standards for years now. Some of the best diabetes care centers in Navi Mumbai are as follows:  are

1.      Sweets Clinics in Vashi, Mumbai

2.      Apollo Sugar Clinic

3.      Stemrx Bioscience Solutions

4.      Swastik Clinic

5.      Isttavic Health Care

6.      Apollo Spectra Hospital

7.      Jiwadaya Healthcare Pvt Ltd.

8.      Lifespan Diabetes Clinic

9.      Laxmi Multispeciality Hospital & Icu

1.  AyurDiet Cure.

Best Diabetes Specialists in Navi Mumbai

Today, many global patients book their diabetes surgery and treatments at Top Diabetes Clinics in Vashi, Mumbai. We are one of the leading medical value partner having association with the best healthcare facilities and the top diabetes specialists across the country and assisting patients to get cure for diabetes.

The best diabetes surgeon in Mumbai, have been recognized internationally for their skills, expertise and care. These surgeons are committed to offer continuous quality improvement, evidence based medications, curative and preventive medicine at an ethnically based affordable state of the art environment at the top diabetes clinics in Mumbai.

Risks and Causes of Prediabetes - Sweet Clinics

Risks and causes of prediabetes

Prediabetes is defined when the blood sugar is elevated than the normal values but not yet high enough to be diagnosed as diabetes . It is the pre-diagnosis of diabetes. Without lifestyle changes, people with prediabetes are very likely to progress to developing type 2 diabetes.

Diagnosis of categories of prediabetes
Impaired glucose tolerance and Impaired fasting glucose are two entities in the causes of prediabetes

Impaired glucose tolerance (IGT) is diagnosed if 2 hour post glucose load plasma glucose is between 140-199 mg/dl with a fasting plasma glucose value in the non-diabetic range.
Impaired fasting glucose (IFG) is diagnosed if fasting plasma glucose is between100-125 mg/dl
Individuals in these two categories have increased risk of progressing to diabetes and are also considered to be at high risk of cardiovascular disease.Diabetologist in vashi .

Risk factors
The same factors that increase the risk of developing type 2 diabetes increase the risk of developing prediabetes. These factors include:

Being overweight or obese: The more fatty tissue that is present, the less sensitive to glucose the cells become. This is one of the major causes of prediabetes.

Excess fat around the abdominal region: For women, a waist size over 35 inches is linked to a higher prevalence of prediabetes. For men, a waist size over 40 inches is considered a risk.

Age: Prediabetes can develop in anyone of any age, but the risk of pre-diabetes is thought to rise after the age of 45 years. This may be due to inactivity, poor diet, and a loss of muscle mass, which typically declines with age.

Diet: Excess carbohydrate, especially sweetened foods or beverages, can impair insulin sensitivity over time. Diets high in red or processed meats are also linked to the development of prediabetes.

Sleep patterns: People with obstructive sleep apnea have an increased risk of developing prediabetes.

Family history: Having an immediate relative with type 2 diabetes significantly increases the risk of developing prediabetes

Stress: During periods of stress the body releases the hormone cortisol into the blood stream, raising blood glucose levels.

Gestational diabetes: Women who develop gestational diabetes during pregnancy, and their children, are at a higher risk of developing the condition.

Polycystic ovary syndrome (PCOS): Women with PCOS are more susceptible to insulin resistance, which can lead to prediabetes,

Ethnicity: The risk of developing pre-diabetes tends to be higher for African-Americans, Native Americans, Hispanics, Pacific Islanders, and Asian Americans. The reason remains unclear.
Causes of prediabetes

In prediabetes & Type 2 diabetes, cells become resistant to the action of insulin, and pancreas is unable to make enough insulin to overcome this resistance. Instead of moving into the cells where it’s needed for energy, sugar builds up in the bloodstream. Exactly why this happens is uncertain, although it’s believed that genetic and environmental factors play a role in the development of prediabetes& diabetes . Being overweight is strongly linked to the development of type 2 diabetes, but not everyone with type 2 is overweight.

Eating healthy food, losing weight and staying at a healthy weight, and being physically active can help you bring your blood glucose level back into the normal range.

Diabetic Seizures – What Are They? Symptoms, Causes & Treatments - Sweet Clinics

A seizure can be quite serious and can be a scary experience for not just the person experiencing it but for the people around. While seizures are caused due to many reasons, one of the prime reasons for a seizure to occur is when people have epilepsy. Amongst the different types of seizures, diabetic seizures can sometimes turn into an emergency quite quickly. Proven to be fatal in nature, a diabetic seizure is a serious medical condition which is caused due to extremely low levels of blood sugar.

 On National Epilepsy Day, we tell you everything about diabetic seizures, their symptoms, causes and treatments.

Diabetic Seizure: All you need to know
Epilepsy is a seizure disorder that occurs due to an electrical storm in the brain. Mostly, people who have recurrent or repetitive seizures can experience loss of consciousness, abnormal behaviour, disruption of senses, or all of the above. Though most causes of epilepsy are not known, studies have indicated that they can occur or trigger due to loud noises, rigorous physical stimulation, or even small as flickering light, loud noises, or physical stimulation.

 There is no relationship between epilepsy and diabetes, or the research is still not able to prove. Therefore, anybody that has a seizure must test to find the exact cause.

 A diabetic seizure occurs when the sugar levels in the blood are extremely low (below 30 mg/dL). The brain needs glucose to function properly. When there is a drop in the blood sugar, the actions of the neurons in the brain decrease and the person experiences a seizure.

 Please note high blood sugar can also cause seizure activity in the brain. Extremely high blood sugar levels in the brain can cause hyperexcitability of the neurons, thus leading to a short circuit in the brain and seizure. While this is quite uncommon, it is equally dangerous.

What are the causes?
There are multiple causes for a diabetic seizure to occur. It can happen due to too much insulin being injected, or because not having regular meals, or even not eating right after an insulin shot. Sometimes, drinking too much alcohol too can cause a drop in the blood sugar, thus leading to seizure. Here are the common things that can cause a drop in the blood sugar levels and lead to a seizure:

– Due to insulin shock, or insulin reaction

– Not eating the right meals

– Too much intake of alcohol as it lowers liver glucose production

– Rigorous exercise

 Symptoms of Diabetic Seizures

When entering the first stages of seizure, the person may show some of the following signs:

– Sweating

– Confusion

– Drowsiness

– Bodily shakes

– Rapid and unexpected emotional changes

– Weakness in the muscles

– Anxiety

– Changes in vision

– Loss of ability to speak clearly



A diabetic seizure happens when blood sugar is low, and the person can experience the following symptoms: 

– Uncontrollable body movements

– Unconsciousness

– Staring into space



While at night, if a person experiences a diabetic seizure, a person may wake up with the following symptoms: 

– Confusion

– Severe headache

– Sweating


Prevention of Diabetic Seizures
The best way to prevent a diabetic seizure is by having proper control of your blood sugar levels. Here are ways to avoid or prevent low blood sugar seizures:

– Do not skip or take big gaps in between meals. A steady intake of food is necessary as it helps in maintaining the sugar levels

– Take your medications on time and ensure you inject the right amount of insulin

– If you wish to consume alcohol, make sure you eat something along with it. Moreover, limit the consumption as much as possible

– Exercising is good for your sugar levels. However, excessive activity can drop your sugar levels. Keep a snack with you all the time and check your sugar before bedtime.

– Monitor your blood sugar levels regularly and eat when you notice a drop in your blood sugar levels

Treatment of Diabetic Seizures
One of the essential things to do when a person experiences diabetic seizure is to provide immediate treatment to him/her. However, in the process, there are two factors to be considered:

– Prevent any form of injury

– Get enough glucose in the body

 During the early stages, when the seizure has not occurred, but you notice the symptoms, it is best to manage by giving at least 15 grams of fast glucose and recheck the blood in the next 10 minutes. You can provide:

– Glucose tablets

– Juices

– Snacks such as crackers or bars

 Please ensure the person can swallow food items before you offer them, otherwise, it might choke them.

 However, if the person’s sugar levels are dropped extremely, then you must follow the guidelines:

– Get medical help

– Help the person to the floor and make enough space near the person

– Make sure you track things such as how long did the seizure last, how was the person acting before, how did the body move

– Ensure you stay with them until proper help arrives

– Do not give them anything to eat unless they are completely awake

– Loosen the clothes around the neck and waist

– Check for any injuries

 One of the easiest ways to treat diabetic seizures is to not let it occur in the first place. This can be done with regular monitoring of blood sugar levels. Moreover, a person living with diabetes must always carry glucose tablets or any source of sugar handy at all times. best diabetologist in Navi Mumbai  If at all you or someone near you experience the symptoms, simply providing the source can bring back the sugar levels to normal. Another way to prevent emergencies is by wearing an emergency bracelet or a card that others can see, become aware of the condition and are able to help.

 While all the above are short-term solutions, it is important to accept that diabetes has no cure, and it is progressive in nature. Therefore, it is your responsibility to manage your condition. On National Epilepsy Day, we remind you to make sure to discuss the possibility of diabetic seizures with your doctor.

Do you know your diabetes targets...?

Do you know your diabetes targets?

Dealing with diabetes can get overwhelming at times. You have to keep your blood sugar within a certain range, maintain a particular weight, monitor blood pressure levels, cholesterol levels and a lot more. Yet most of us aren’t even aware of the targets that we must be at. We keep striving to reach a goal without even knowing what the accurate goal is. Knowing the range we must be at for all these is essential for effectively treating diabetes. Also, diabetics need to constantly monitor certain levels on a daily basis. Since the doctor is not available daily, it is imperative to know what targets we must be at for good health.

Keep in mind that diabetes is a condition which requires a customised treatment per case. So even though you may be aware of a normal range of levels, the doctor may want you to maintain a more specific target. There are several factors that can influence blood sugar levels and thus need to be monitored regularly. Thus, knowing the specific targets that keep your blood glucose levels in the normal range is crucial for good diabetic control.

Factors that influence blood sugar and recommended targets

There are several factors that can impact blood sugar levels and need to be monitored carefully. The levels included here are the normal range that is considered healthy. However, you should talk to your doctor for advice on more specific targets that should be maintained.

Blood sugar levels

This is the number one focus for all diabetics! Keeping blood sugar levels within the normal range at all times is crucial for good health.

Fasting levels: Taken early morning before a meal, the fasting blood test reveal the effectiveness of medicines in controlling sugar at night. The healthy range is 80-110 mg/dl while a level between 111-125 mg/dl is considered borderline. However, anything over 125 is not healthy and needs correction.

Post meal:This test is done 2 hours after eating to judge how blood sugar levels react to the food being consumed. A target between 120-140 mg/dl is considered healthy with levels below 200 considered fair in some cases. Anything over 200 is a cause for concern and may require changes in the diet plan or medication.

HbA1c test: This is the most trusted vale for diabetics. Also known as Glycated haemoglobin, this level indicates the blood sugar levels over a span of three months. It is considered to be most reliable as it accounts for unexpected fluctuations in glucose levels. In healthy people, HbA1c level is less than 6%. Studies suggest that complication can be prevented or delayed if Hb1c levels are maintained below 7 %

HbA1c level of 8 % or above indicates that better control of blood sugar level is required.

Blood pressure

Blood pressure levels should ideally be 130/80 mm/Hg. Elevated levels at 140/90 is considered borderline high, with anything higher than that requiring food and lifestyle changes.

Lipid Profile

Measuring the levels of good and bad cholesterol levels for diabetes is essential as they not only impact blood sugar levels but can also warn of serious illnesses. Heart problems, hypertension, liver damage etc. can be diagnosed early by monitoring these levels. The ideal values should be:

HDL-cholesterol (Good cholesterol): This number should be higher than 60mg/dl for healthy heart function and not lower than 40 mg/dl at any time.

LDL-cholesterol (Bad cholesterol): Ideally, LDL levels should not exceed 100 mg/dl. However, in otherwise healthy adults a value up to 129 is also accepted. A value of 130 or more outs one at increased risk for chronic ailments.

Total cholesterol: A good judge of overall cholesterol health, total cholesterol values should of under 200mg/dl is considered ideal.

Triglycerides: This level should be maintained at under 150mg/dl while some doctors may accept a value up to 200, anything higher than that is a concern.Best diabetologist in vashi

Body Mass Index

Obesity is a leading cause for diabetes. Maintaining a healthy weight can help one keep their sugar levels in control. While a weighing scale gives you an idea if you are overweight, Body mass Index (BMI) is preferred as it accounts for total body fat. A BMI value of 20-23 is considered best though up to 25 is accepted, higher than 25 puts one at an increased risk for chronic ailments such as heart disease, hypertension etc.

Waist Hip Ratio

Did you know that your body shape can also have a bearing on diabetes? People with higher fat concentrated around their waist (apple shaped bodies) are said to be more at risk for diabetes and other chronic ailments as compared to people with more fat concentrated around their hips (pear shaped).

So we see there are several factors that can have an impact in keeping diabetes under control. Talk to your doctor and find out what your targets are so that you can focus on achieving them.

DIABETES AND DEPRESSION – A CRY FOR HELP

“The mind is its own place, and in itself, can make heaven of hell, and a hell of heaven”.

“Let’s talk”, launched on April 7th, 2017, with a spotlight on depression, seems to be a fitting theme on World Health Day. According to WHO statistics, nearly 350 million people suffer from depression worldwide and it is also the leading cause of disability. Those suffering from any chronic illnesses such as kidney and heart disease, lupus, HIV/AIDS, and, of course, diabetes, are more prone to depression.

Depression is twice as common in people with diabetes. The problem is bifacial; those with diabetes are at increased risk of developing depression, due to its chronic nature and subsequent complications, while those who are depressed are at risk of getting diabetes. The predominance of poor lifestyle decisions, unhealthy food habits, smoking and alcohol, less physical activity, and weight gain when one is depressed, are all risk factors for diabetes.
The rise in incidences of depression could be due to the pressures of modern living, materialism, a competitive environment, occupational and family demands. Physical and mental health are closely interlinked which is why diabetes and depression can be a double whammy. Depression can be attributed to many factors, such as genetic, brain biochemistry, stressful life events, trauma, and strained interpersonal relationships, apart from chronic stress.
Diabetes and depression can be likened to two sides of a coin, wherein there is a biological and behavioural link. On the one hand, the over-activation of stress hormones, such as cortisol and ACTH can aggravate sugar levels. On the other side of the coin, lack of self-care, which is invariable when one is depressed, can lead to poor health outcomes. Some individuals may get overwhelmed with the challenges of managing diabetes on a daily basis, which can lead to depression.

What is depression and what are the risk factors?

It is normal to feel grief at the loss of a loved one, or show emotional reactivity to some distressing situation, but when it takes longer than usual to return to normal, look out for warning signs. If it has been at least 2 months since a major life event has occurred, or if there has not been any such major life event but one is experiencing several of these symptoms, it may be DEPRESSION:-

Feeling sad or empty most of the time for at least two weeks.
Diminished interest or pleasure in the usual activities.
Crying spells without reason.
Low self-esteem or feelings of guilt.
Difficulty in sleeping or excessive sleepiness throughout the day.
Poor appetite or eating excessively.
Unusual fatigue and loss of energy.
Difficulty concentrating on normal activities.
Feeling agitated, lethargic or slow.
Weight gain or weight loss, without any effort.
Recurrent thoughts of death or suicidal ideas.
If these symptoms are generally making one feel dysfunctional by coming in the way of social and personal relationships and hindering one’s responsibilities at work, one could be depressed.

Risk factors for depression include:
Family history of depression
Abuse, either physical, sexual or emotional
Death or loss of a loved one
Conflict due to interpersonal relationships, outside or within the family
Major life events such as marriage, losing one’s job, divorce, relocating, etc.
Certain medications taken for other conditions may trigger depression.
Apart from these, studies have shown that women and older people are more vulnerable and likely to get depressed.
Those with diabetes should be screened for depression regularly, as it can largely go undetected. Hence, appropriate detection and early intervention will help resolve complex health problems. In the larger picture, self-management and good control of diabetes could decrease the risk of depressive symptoms and complications.
Despite so much progress and awareness regarding treatment of depression, prognosis continues to be poor, perhaps due to the following reasons:

Stigma regarding ‘mental illnesses’
Feelings of worthlessness and failure that prevents one from acknowledging that one is depressed.
Financial constraints that act as a barrier to effective treatment.
Negative perceptions about side effects of anti-depressants.
Management of depression:
Management of depression and diabetes should be a collaborative effort which involves the following aspects:
Professional help.
A combination of cognitive behavior therapy and medication has been found to be effective in combating depression.
Social support from family, friends and support groups help in lessening feelings of isolation.
Proper adherence to the diabetes regimen in the form of healthy diet, regular medication and physical exercise.
Regular assessments by the concerned physician as well as mental health professionals have the twin benefits of alleviating feelings of depression as well as controlling sugars.

Apart from all these, involving oneself in pleasurable activities and following a structured lifestyle will be greatly beneficial for those who are going through ‘low’ phases. However, despite one’s best efforts, sometimes it’s easy to be weighed down by lethargy and low energy levels due to diabetes and depression. So do set realistic goals for yourself, take small steps, stay motivated, and do not give up! As Margaret Thatcher put it, “You may have to fight a battle more than once to win it.”

UNDERSTANDING INSULIN RESISTANCE – THE KEY CONSPIRATOR

UNDERSTANDING INSULIN RESISTANCE – THE KEY CONSPIRATOR

Don’t be scared about the highly technical terminology. I would make it easy for you to understand what it means and how to remain healthy.

Human body, though a very complex machine is not that difficult to understand. I have made it easy for you to understand in my earlier article –

Simplifying the most complex machine – human body

The body has an inbuilt mechanism to maintain energy balance. Any interference from our end leads to weight gain and the same is explained in another article –

Why am I putting on weight?

Role of Insulin

Glucose is the basic source of energy for every cell of the body. The glucose generated through digestion of carbohydrates in our food reaches cells via blood. Now at the level of cells for uptake of this glucose another component is required and that is insulin. Insulin is a hormone produced in our body by pancreas. This is an inbuilt check to ensure that glucose enters the cells only if required. The excessive glucose gets converted to fat and is stored as reserve largely in abdomen.



What is insulin resistance?

Insulin resistance is a condition in which though body has a sufficient amount of insulin it is not able to function properly. It means that for completing its task (which is uptake of glucose by cells), body would require larger amount of insulin. Its analogues to have incompetent people in an organization, you would need more people to complete the same task that can be done by fewer people.

What causes insulin resistance?

There are number of causes that lead to insulin resistance including genetic factors. A person with his first degree relatives having diseases like diabetes, heart disease etc would be at higher risk of having insulin resistance. Genetic factors are beyond our control.
Additionally there are number of other external factors that we can intervene with. Obesity specifically abdominal obesity is the biggest risk factor. There are number of scientific publications on this issue. I have proposed a simple marker to identify if you are having abdominal obesity – Index of central obesity. All this research papers can be accessed here.

The simple message from all this research is that limit your waist size to half of your height. If you are 5 feet 8 inches tall (68 inches), you should limit your waist size to 34 inches.



How does insulin resistance harm you?

Insulin resistance is the key conspirator behind number of diseases. People with resistance would need more insulin in their blood for proper uptake of glucose. This would lead to burden on pancreas leading to deficiency of insulin which will lead to diabetes. Additionally high levels of insulin in blood lead to atherosclerosis (thickening on your blood vessels) which causes blockages in arteries. If the arteries supplying your heart are affected, you can get heart attack, if the arteries supplying brain are affected, it can lead to paralysis. High levels of insulin in blood also lead to cholesterol problems which further increase risk of atherosclerosis. Disease like kidney failure, gangrene etc are also largely due to atherosclerosis. This conglomeration of various risk factors is called metabolic syndrome.

How to prevent and treat insulin resistance?

The best way to prevent insulin resistance is controlling your tummy size – limit your waist size to half of your height.
Control your weight. The ideal weight can be simply calculated by subtracting 100 from your height in cm. If your height is 176 cm, the ideal weight for you is 76 kg.
Regular exercise is improves the sensitivity of insulin. Daily brisk walk of 45 minutes is ideally recommended, more the better.
One should take healthy diet with less of fat and high proteins. Simple carbohydrates (sweets) should be avoided.
Insulin resistance is treated by physicians using drugs like Metformin.


Conclusion

Simply by understanding the basics of Insulin resistance, you can prevent or treat it before it causes deadly diseases like diabetes, high blood pressure, heart attack, paralysis etc. Control your weight, limit your waist size, have a healthy diet and exercise regularly, that’s the key to being healthy.

GESTATIONAL DIABETES LEVELS AMONG PREGNANT MOTHERS - SWEET CLINICS

Introduction

Gestational diabetes mellitus (GDM) is a condition of high blood glucose levels are detected for the first trimester during pregnancy.  GDM is very common and some studies have reported that 10-20% of pregnant women in India have GDM.

Who are at risk of GDM?

Older women
Overweight or obese.
Family history of diabetes
If there was a previous history of Gestational Diabetes.
Screening and diagnosis of hyperglycemia in pregnancy

 All pregnant women should be screened at the first visit to antenatal clinic. Early in pregnancy screening is done usually at the booking visit to see if the woman already has diabetes complicating pregnancy which she did not know about. Screening can be done using either fasting plasma (FPG), glycosylated hemoglobin (A1C),or random plasma glucose(RPG). If a woman has high blood sugars early in pregnancy (FPG>7mmol/l (126 mg/dl), A1c >6.5% or RPG >11.1 mmol/l(200mg/dl) then she should be treated as having pre-existing diabetes.

All women who have normal blood glucose levels of sugar early in pregnancy should be screened again with an oral glucose tolerance test (OGTT) between 24-28 weeks of the pregnancy to rule out GDM. They should come to the centre in fasting state at least 8 hrs-10 hrs and should not consume anything except water before the test. Fasting blood and urine are collected, 75 gms of oral glucose is given to drink in 300 ml of water. Blood is then drawn at one and two hrs of the glucose load. If fasting plasma glucose is between 92-125mg/dl or 1 hr of glucose load >180mg/dl or 2 hrs level is >153mg/dl (International Association of Diabetes and Pregnancy Study Group, IADPSG criteria) the woman is said to have Gestational Diabetes.

Weight gain during pregnancy

All pregnant women should gain some weight during pregnancy and the recommended weight gain is decided by the Pre-pregnancy body mass index (BMI)

                               BMI = Weight (kg)/ Height in m2

Changes of body weight based on BMI

< 18.5 Underweight
18.5-22.9 Normal
23-24.9 Overweight
>25 Obese
(According to Asian Indian guidelines1)

Recommended weight gain according to pre pregnancy BMI

BMI Weight gain
<18.5 12.5-18 Kg
18.5-24.9 11.5-16 KG
25-29.9 7-11.5 KG
>30.0 5-7 KG
Managing Gestational Diabetes

Gestational Diabetes levels can be managed through balanced and healthy diet, medication and exercise. Medication is usually indicated if blood sugars do not come to normal with diet and exercise. Recommended levels of glucose are fasting<90mg/dl(5.0 mmol/l),1 hr<140mg/dl(<7.8 mmol/l),2 hrs <120mg/dl(<6.7 mmol/l)

General guidelines for healthy eating

Generally good nutrition is important during pregnancy and en effective way to manage gestational diabetes levels. A dietitian can guide to take portion size, right amount of protein, fat and carbohydrate.

Here are some general tips:-

Eat variety of foods distributing calories, carbohydrate and taking enough protein
4-5 serving of vegetables is recommended
Adequate fluids 2-3 liters should be taken but however water has to be restricted if there is  pedal edema.
Iron rich foods should be included. Eg: – Greens
Consume 650 ml of milk/ day to meet calcium requirements.
Avoid direct sugars, artificial sweeteners.
Avoid Alcohol and tobacco.
Use a combination of oils Eg: – Mono unsaturated fats and Poly unsaturated fats
Include plant protein like pulses, dhal etc.
Restrict animal protein like red meat.
Healthy plate

One way to decide how much to eat to divide the plate is given below. Up to half plate should contain vegetables and fruits, about one quarter of plate should be starch or grains and the reminder protein and calcium rich foods.

Physical Activity

Aerobic activity of moderate intensity for 30mins/day on most days of the week has shown benefits in metabolic control. Start with light to moderate exercise. Any simple physical activity is better than no activity.

Insulin

Insulin is indicated when target blood glucose levels are not attained with diet and physical activity. Different types of insulin is prescribed by the Diabetologist.

Materials required for insulin injection

Insulin
Syringe or pen type needle.
Denatured spirit
Cotton.
General guidelines for patient on bottle type insulin

Insulin must be refrigerated, not frozen
Store away from heat
It must be rolled between two hands before using.
Common site for taking Insulin are upper part of thigh. You may not want to use abdomen during pregnancy, hence arms and legs are preferred.
If refrigerator not available (ex. in villages) Insulin can be stored in clay pot.
Each bottle type contains 400 units
If using 100 u insulin then use a 100u  syringe
If using 40u  insulin then use a 40u  syringe.
General guidelines for patients on pen type insulin

The pens can be stored at room temperature while in use.
Should not get exposed to direct sunlight
Pen needle can be used 4-5 times without sterilization.
Each pen contains 300 units of insulin.
Insulin pens are available in two basic types, disposable and reusable.
 Insulin pens are portable,discreet and convient to carry,

How I Keep Stress From Affecting My Diabetes - Sweet Clinics

How I Keep Stress From Affecting My Diabetes

A few health issues, a couple of family worries, general anxiety about the state of the world. And while I know I’m not alone, I also know that stress can spell particular trouble for people with type 2 diabetes, raising blood sugars and making it more difficult to stay on track with medications, diet and exercise.

It can also lead you to reach for food, alcohol, or cigarettes. Anything to calm you down.

In the old days, my anxieties turned me to food. I would do okay during the day – I counted carbs and calories and avoided sweet treats. But around midnight, stressed out and unable to sleep, I’d find myself standing before the open refrigerator, scanning the shelves for something, anything to eat. Cold pasta, left-over cheesecake, cake icing from a can.

This habit locked me in a vicious cycle: up until one or two a.m., by morning I’d rise exhausted with higher than normal sugars, which made me more irritable and anxious and even less able to cope with my stressors.

Since that time, I’ve uncovered a few tactics to help me avoid the refrigerator blues. While I don’t always succeed in managing my anxieties, I try not to let them sabotage my diabetes care. They include:

Be kind to yourself.  If you’re stressed, you’re probably also deep into self-criticism, telling yourself you should be stronger, calmer, more in control and on and on. But this is the time to see the positive, even if it means sticking Post-It affirmations on your bathroom mirror to keep you in a better frame of mind.
Up your self-care. Remember those lemon scented candles you got from your cousin for Christmas? Now is the time to put them to use, along with a foot rub from your husband or a pedicurist and a long bathtub soak. Treat yourself gently and well.

Question yourself. Before undermining your diabetes care, ask if eating that ice cream bar is truly in your best interest, and whether it is going to make you feel better. If not, try to think about what might truly help. Writing down your thoughts in a notebook might be useful, as could talking problems over with a friend or a therapist.

Get moving. By now everyone knows that exercise relieves stress. If you’re in an exercise program, don’t stop. But if you’re feeling too worked up to follow a high energy regimen, go for something that you can handle at the moment. Think slow nature walks, yoga, or tai-chi.

Consider meditation. Mindfulness meditation has been scientifically proven to lower your heart rate and cut stress.  And it’s really not hard to begin. For me, I simply remain in bed for five to ten minutes before I rise, close my eyes, relax my body and concentrate on keeping my mind clear. As stray worries drift by, I observe them neutrally, then let them go. At first it may seem strange and unfamiliar, but if you keep with it, it really can help.

Staying calm isn’t easy. Stress – good and bad -- is part of life. But if it’s getting in the way of your diabetes care, talk to your doctor. Nothing is worth more than your good health.

Taking Care of Your Diabetes Means Taking Care of Your Heart - Sweet Clinics

Taking Care of Your Diabetes Means Taking Care of Your Heart

Diabetes and Heart Disease
Woman talking to doctor
For people with diabetes, heart disease can be a serious health problem. Many people don’t know that having diabetes means that you have a greater chance of having heart problems such as a heart attack or stroke. Taking care of your diabetes can also help you take care of your heart. Use the tools in this tip sheet to help. They are:

A list of things you can do such as eating healthy foods and getting more active.
A form to write down and track your A1C, blood pressure, and cholesterol numbers.

What you can do now
Ask your health care team these questions:
What can I do to lower my chances of getting heart disease?
What should my goals be for A1C, blood pressure, and cholesterol?
What can I do to reach these goals?
Should I take medicine that can protect my heart such as aspirin or a statin?

Man eating bowl of cereal
Eat well.
Eat foods that are high in fiber such as whole grain breads and cereals, brown rice, lentils, beans, fruits, and vegetables.
Eat foods with heart-healthy fats such as fish, nuts, seeds, and avocado.
Eat foods low in saturated and transfats such as lean meat, chicken without the skin, fish, and non-fat or low-fat milk, yogurt, and cheese.
Use oils when cooking food instead of butter, cream, shortening, lard, or stick margarine.
Limit desserts such as cookies and ice cream to only 1 or 2 times a week.
Eat smaller amounts of foods that are high in fat, sugar, or salt. For example, if you want french fries, order the kid-sized portion.
Bake, broil, or grill food instead of frying.
Do not add salt to food.Diabetes Heart care clinic in vashi
Stop smoking.

Be active.
Be active for 30 minutes or more each day. It’s okay to be active for 10 minutes at a time, 3 times a day.
Walk, dance, swim, or ride a bike.
Man and woman talking in park
Take your medicine.
Take medicines the way your doctor or health care team tells you to.
Do not stop taking your medicines until you talk to your doctor.
Ask your pharmacist or doctor any questions you have about your medicines.
Cope with stress as best you can.
Ask for help if you feel down. Talk to a mental health counselor, member of the clergy, friend, or family member who will listen to your concerns.
Tell your family members and friends how they can best help and support you.
Here's one more way to take care of your heart: Learn the warning signs of a heart attack and stroke.
Signs of a heart attack may include pressure, squeezing, fullness, and pain in the chest or upper body. You may also have shortness of breath.
The signs of a heart attack for a woman may be different than a man. Signs for a woman can include nausea and vomiting, being tired all the time (sometimes for days), and pain in the back, shoulders, and jaw.
Signs of a stroke may include weakness on one side and trouble walking, seeing, or speaking.
you are having a heart attack or stroke.
Acting fast can save your life.
Your Diabetes Record Form
Use this form to keep track of your A1C, blood pressure, and cholesterol numbers. These terms are explained below the Diabetes Record Form.
Write down the date and results for each test or blood pressure check you get.
Take this form with you on your health care visits. Show it to your health care team.
Talk about your goals and how you are doing.

Even naturally sweet drinks may increase diabetes risk - Sweet Clinics

Even naturally sweet drinks may increase diabetes risk

While researchers already knew that drinks with added sugar could increase a person's risk of type 2 diabetes, a new study suggests that the same may be true for naturally sweet drinks, such as 100% fruit juices, as well as artificially sweetened beverages, such as "diet" soft drinks.
bottles of fruit juice
A new study suggests that even 100% natural fruit juices may increase the risk of diabetes.
Research has shown that drinking soft drinks with added sugar can increase a person's risk of developing type 2 diabetes by affecting subtle metabolic mechanisms.

But are "diet" soda and 100% fruit juices that contain a natural level of fructose but no added sugar any healthier?

The evidence surrounding diet soda and its effect on diabetes risk has been conflicting. Some studies suggest that it might have an impact, while others report that there is no association between the two.

Most people believe that naturally sweet drinks are healthful. However, recent research has shown that they are not nearly as good for us as we think. One study that we covered on Medical News Today in July this year, for instance, indicated that they could increase a person's risk of cancer.

Now, research from an international team of investigators from Harvard T. H. Chan School of Public Health in Boston, MA and Fudan University in Shanghai, China, suggests that all sugary drinks, including natural fruit juices and artificially sweetened beverages, could increase diabetes risk.

However, the study, which appears in the journal Diabetes Care, also offers some hope. It notes that people can decrease this risk by replacing sugary drinks of any kind with non-sweetened beverages, such as water, tea, and coffee.

"The study provides further evidence demonstrating the health benefits associated with decreasing sugary beverage consumption and replacing these drinks with healthier alternatives like water, coffee, or tea."



Sugary drinks linked to 16% increase in risk

colleagues analyzed data collected over 22–26 years from 76,531 women enrolled in the Nurses' Health Study between 1986–2012, 81,597 women enrolled in the Nurses' Health Study II between 1991–2013, and 34,224 men from the Health Professionals' Follow-up Study, enrolled between 1986–2012.

The researchers gave the participants questionnaires that asked them how often they consumed certain foods and beverages. By analyzing the results, the study authors found out how often participants drank certain sugary drinks and were able to calculate any changes in their drink consumption patterns.

The researchers found that people who increased their total intake of soft drinks with added sugars and naturally sweet fruit drinks by over 4 ounces (oz) per day over 4 years saw an associated diabetes risk increase of 16% over the following 4 years.

However, those who increased their total intake of artificially sweetened beverages — such as diet soda — by the same quantity over the same period saw an associated 18% increase in the risk of developing type 2 diabetes.

These associations remained in place even after the researchers adjusted for confounding variables, including body mass index (BMI), different dietary changes, and relevant lifestyle habits.

The investigators caution, however, that the finding regarding artificially sweetened beverages may be unreliable because it remains unclear which way the association runs. They explain that people who know that they are already at high risk of developing diabetes may switch from sugary drinks to diet sodas to try and mitigate that risk.


10% weight loss could send type 2 diabetes into remission

New evidence suggests that moderate weight loss soon after diagnosis could send type 2 diabetes into remission.

Moreover, the study authors also point out the risk of surveillance bias in their research. This refers to the fact that people who are at high risk of developing diabetes are more likely to undergo screenings for diabetes, therefore receiving a diagnosis sooner than other individuals.Famous diabetologist in vashi

Overall, the research suggests that people might want to consider caution about their intake of sweet drinks of all kinds. It also found that switching to unsweetened drinks could help reduce diabetes risk.

More specifically, replacing one daily serving of a sweet drink with water or unsweetened coffee or tea was associated with a 2–10% lower risk of type 2 diabetes.

"The study results are in line with current recommendations to replace sugary beverages with noncaloric beverages free of artificial sweeteners".

Nor should people overestimate the benefits of natural juices. "Although fruit juices contain some nutrients, their consumption should be moderated," he stresses.

Type - 1 Diabetes - Sweet clinics

Hba1c calculator.Diabetes Definition

type 1 diabetes.diabetes diet
Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy.

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Don’t ignore these 5 lesser known signs of pre-diabetes - Sweet clinics Diabetologist in Navi Mumbai

Pre-diabetes has become a raging concern in India with an increasing number of cases being diagnosed. 60% of Prediabetics go on to develop Diabetes.

In addition, common symptoms like increased thirst and urination, increased hunger and blurry vision, may have become well known, but it is important to note that these symptoms do not arise overnight, but tend to build up gradually. Further, there are some additional symptoms that may be indicative of high blood sugar, which one would not even think to associate with pre-diabetes.

This could be a major reason why a majority of pre-diabetes cases are still undiagnosed. Here we bring you some of the lesser known symptoms of pre-diabetes that can help you with a timely diagnosis and better management of this condition.

Your vision seems to be changing

You may have heard that blurry vision is a sign of blood sugar levels being higher than normal, but did you know that a sudden improvement in your vision can also indicate abnormal sugar levels? According to research studies, high sugar levels can lead to movement in the bodily fluids including the eyes. This can lead to changes in the vision which may be blurry or more defined. However, the instant you observe any sudden changes in your eyesight, it is advisable to go in for a consultation.

UTI seems to be a frequent occurrence

UTI or Urinary Tract Infection can also be a symptom of elevated sugar levels. Especially if this condition becomes a recurrent concern, doctors advise to instantly check blood glucose levels. When sugar levels in the blood and urine are high, the genitals are more prone to bacterial and yeast infections, upping the risk for UTI.

Skin is constantly itchy

A skin condition is clearly a dermatological issue right, how can it relate to blood sugar? This is a common thought as a large number of people are still unaware of the connection of sugar levels and skin health. High sugar levels can slow down the blood and oxygen circulation in the body, leading to an increase in itchiness especially around the hands, feet and genital areas. If you notice any rashes or experience constant itchiness which doesn’t seem to subside after a couple of days, it may be time to check your sugar levels.

Your TV volume is louder than before

One of the least known symptoms of pre-diabetes is often changes in hearing levels. Without realising you may find yourself talking louder so as to encourage people to talk back at a louder volume. The volume of your music station may be set a little higher than before cause your hearing isn’t as good. In a country as noisy as India, it is easy to attribute this to external sounds.top diabetologist in Vashi However, it may also be a sign of high blood sugar which can damage the nerves of the inner ear, affecting your ability to hear.

Sleep comes with loud snores

Yes, if you find your partner suddenly complaining about your loud snoring (something you swear you don’t do), it may be time to check your sugar levels. A large number of people with higher sugar levels than normal also develop a sleep disorder known as sleep apnea which leads to disturbed sleep, snoring and often tiredness during the day.

So while it is advisable to look out for common pre-diabetes symptoms, it is essential not to ignore any of the above-mentioned signs either as enable timely diagnosis, it is recommended to get a timely diagnosis and treatment from a Diabetologist, as Prediabetes with proper treatment and lifestyle changes can be reversed.

Arthroscopic Release of Frozen Shoulder Problems in Diabetics By Sweet Clinics..!!

Diabetics in India have an additional burden of joint problem in addition to their systemic problems of nerves, eyes, blood vessels, kidneys etc. Diabetics are prone to develop a condition of the shoulders called primary frozen shoulder. It can affect both shoulders in a small percentage of people. It usually resolves over a period of time but can leave behind a lasting deficit of certain movements.

Middle aged diabetics also develop tears of the rotator cuff and this can lead to a secondary frozen shoulder. Rotator cuff is group of tendons on top of the shoulder which help to stabilize the joint.

They can develop calcium deposition in the rotator cuff tendons.

They are prone to develop Gouty arthritis in their shoulders like in any other joints since Gout has an association with diabetes. Gout is a condition due to consumption of uric acid which is a by product of the digestion of red meat.

In this article I shall discuss frozen shoulder.

Definition-

Frozen shoulder (Adhesive capsulitis, periathritis) is a condition characterized by a loss all movements at the true shoulder joint. There is pain initially. Pain settles down and there remains stiffness which sets in over a short period of time. Clever people may recall a traumatic incident. In others it may come on slowly. Stiffness may be permanent. The movement that is maximally affected is external rotation (rotating the arm outwards away from the body). This results in inability to reach behind the head with the hand to tie the hair. When both shoulders are affected elderly women are in an embarrassing situation. Overhead activities are also affected as the degree of elevation of the arm is reduced.

Anatomy

The shoulder is the most mobile joint in the body. Its function is to position the arm in space to reach out to objects and deliver them to the mouth for eating and for other actions. The shoulder is a ball and socket joint formed by the upper end of the humerus (arm bone) and the socket formed by the glenoid of the shoulder blade. It is lined by a bag like capsule. The capacity of this joint is about 15- 20 cc. In frozen shoulder the capacity is reduced to 2- 3 cc. The movements at the shoulder joint occur synchronously with that at joint between the shoulder blade and the torso and are compensated to some extent by this.

History of frozen shoulder-

Only in the last few years has the ideal treatment been suggested. It is a relatively rare disorder of the shoulder and in a population of 20 shoulder patients there may be one or two with this condition.

However many doctors and orthopaedic surgeons label any painful condition as a frozen shoulder and advice physiotherapy. This can make the condition worse.

Recent advances

It has been recently discovered that the answer to frozen shoulder lies in the genes. These genes may also be associated with Diabetes mellitus. The alterations in these genes and chromosomes lead to a distorted response to wound healing and scar tissue formation. Exuberant scar tissue forms in response to trauma. The remodeling of scar tissue collagen is less. When more scar tissue forms in the capsule of the shoulder joint, the normally possible movements are grossly reduced. Diabetics also develop nodules in their palms and feet, another evidence of the exaggerated healing process.

Standard treatment-

This is a combination of physiotherapy and steroid injections when the condition is initially painful. Physio can be done at home. The standard Orthopaedic treatment has been a manipulation under anaesthesia. This carries a theoretical risk of fracture but has not been validated in practice.best diabetologist in navi mumbai

A manipulation is contraindicated when a x ray reveals that the bone is very osteoporotic. It is also contra indicated in diabetics as more exuberant scar tissue will form in response to the crude method.

Since I have pointed out that sometimes rotator cuff tears can coexist with a frozen shoulder, the ideal management for a frozen shoulder would be an arthroscopic release of the contracted structures within the joint. An arthroscope is an instrument used to look into joints through tiny key hole incisions. The benefits are less pain after surgery and faster rehabilitation. Since scar tissue formation is minimized, chances of recurrence are less and greater are the chance of retaining the full range of movement achieved during the procedure. The range of movement achieved after the release has to be maintained with physiotherapy. In case there is some tear of the rotator cuff, repair can be done at a later stage.

Diabetes and Heart Disease: What Is The Relationship Between Them...?

A link between Heart Disease and Diabetes

Diabetes is a chronic disease that is marked by high blood glucose levels. Over a period of time, the elevated sugar in the blood leads to arterial damage that causes them to stiffen and harden. This is known as Atherosclerosis. High sugar levels also lead to plaque formation as those with diabetes also have high cholesterol levels. When the arteries get damaged due to plaque, the body sends platelets to try to repair the wall. Due to the narrowing of the arteries, this leads to a blockage which stops the oxygen from reaching the heart and the brain and ultimately results in a heart attack or a stroke. It is interesting to note that high cholesterol levels have already occurred before the elevation of sugar levels. Therefore, heart disease has already manifested before the onset of diabetes.Diabetologists in Vashi  .

Risk Factors of Diabetes and Heart Disease

There are several risk factors when it comes to diabetes and the heart. Here are some of them.

Family History

Those who have a family history of diabetes and heart disease are at a very high risk. They should be extra careful about their diet, medicines, and exercise. Those with Type 2 diabetes are at a risk of having a silent heart attack or a heart attack without any symptoms.

High Cholesterol Levels

The LDL levels (bad cholesterol) determine the timeline of the onset of heart disease. LDL has been considered one of the most important factors in determining vulnerability to cardiovascular problems.

Smoking

Smoking causes constriction and tightening of the blood vessels, thereby reducing blood flow to the heart and the brain. Those who smoke and are diabetics, increase their risks of developing heart problems exponentially.

High Blood Pressure

This is another significant risk factor for diabetes and heart disease. Chronically elevated blood pressure levels cause a majority of heart attacks.

Obesity

Obesity is linked to high blood pressure, high cholesterol levels, and diabetes. Even those who appear lean or thin but have a high amount of belly fat are at an increased risk of developing heart disease.

Sedentary Lifestyle

Those who are not active physically and have diabetes tend to develop heart problems at a much earlier age than their counterparts who are diabetics but who exercise.

Age

Those who develop diabetes earlier in life have an increased risk of developing cardiovascular problems. Also, as one gets older, the odds of suffering from heart disease increase.

Unhealthy Diet

A diet rich in fats, processed foods and with fewer quantities of fresh fruits and vegetables is bad for diabetes and for the heart. Following such a unhealthy diet will definitely cause diabetes and heart disease.

Stress

People with diabetes already respond negatively to stress as their sugar levels become high due to anxiety. Stress can indirectly increase the risk of developing heart problems as it makes one overeat or smoke or drink more.

Gender

More men develop heart problems under the age of 55 years. Women suffer more from cardiac issues once they cross 55 years of age.

Symptoms of a Heart Attack

Many people who have diabetes suffer from ‘silent heart attacks’ due to the nerve damage related to their high sugar levels. This is why regular screening is essential for all those who have diabetes. There are some symptoms to watch out for. If you suffer from any of the following, call the ambulance immediately.

Chest pain is one of the most common symptoms of a heart attack. It is also known as Angina. It feels like a pressure or painful squeezing of the chest. One might feel it in the arms, neck, back or the jaws.
Nausea and lightheadedness
Shortness of breath
Sweating
Fatigue
Indigestion
Loss of balance or dizziness
Trouble seeing things or having double vision
Confusion
Sudden severe headache
Prevention of Diabetes and Heart Disease
There are a lot of things you can do to manage your diabetes and stop or delay the onset of heart problems. The risks are reduced by introducing lifestyle changes, medicines, and increasing activity levels. Here are some tweaks that bring positive results.

Healthy Diet

Eating a variety of fresh fruits and vegetables, whole grains, low-fat food items, a high protein diet helps to combat heart problems.

Healthy Weight

Shedding off the excess weight and maintaining a healthy weight helps to keep away the cardiac issues for long. Instead of a tough weight loss plan, sit with your doctor and chalk out a reasonable weight loss strategy.

Quit Smoking

Smoking damages the blood vessels in the body and increases the risk of heart problems. Quit smoking to improve your health.

Get Moving

Exercising for just 30 minutes five times a week brings down the risks of developing heart problems in diabetics. If you cannot exercise in one go, divide the activity into batches of ten minutes. It also helps to control the high glucose levels in the blood.

Stress Management

Learn to meditate and not stress over things in life. Anger, jealousy, spite are negative emotions that affect the body negatively.

Medications

If you already have heart disease, take your medicines on time to prevent more complicated issues.

Control the Parameters

To prevent an early onset of heart problems, keep your blood sugar levels and your blood pressure levels under control. Avoid too many fluctuations to prevent organ damage.

Takeaway

There are several treatment options to keep heart disease and diabetes under control. With proper lifestyle changes, effective weight management and efficient control over blood sugar levels, those who suffer from diabetes can live healthy, quality lives.

A for apple pie, B for burger… D for diabetes..!! – Dr.Vinod Methil (Sweet Clinics Diabetes Clinic)

With school canteens serving a variety of colas and junk food, children are falling prey to lifestyle diseases like diabetes and obesity at an early age. DNA talks to parents and experts to find whether a possible solution exists.

In two years’ time, from kindergarten to Std II, seven-year-old Vignesh Mohile’s association with the alphabet has undergone a drastic change. Even before the chubby little boy has learnt to communicate in English, his vocabulary already consists of words like enchilada, spaghetti, alfredo, tiramisu —- which his parents often fail to pronounce and that sound like Greek to his grandmother.

Vignesh’s mother finds it difficult to convince Vignesh to carry a home-cooked meal of simple chapati-bhaji in his school tiffin. “I’ve tried options like sprouted bhel or sandwiches on alternate days. But the aroma of Italian and Mexican food which his friends bring in their dabbas, coupled with items like pav bhaji and samosas sold in their school canteen appears far more attractive,” says an exasperated Sucheta.

She says that all her efforts to convince Vignesh to eat healthy falls flat the moment the recess bell rings. “Vignesh and his friends sit in a group and have lunch. It’s but natural that he gets tempted to eat what his friends are eating.”
 


A similar yet slightly different case is that of Mohan and Lalita Kumar, parents of 14-year-old Nishita. The Std IX student eats in her canteen everyday, despite carrying two dabbas. Mohan, who works as a manager in a bank in Girgaon, says that Nishita’s school canteen is flooded with every chips and cola brand available in India.

Her mother, Lalita, says that though Nishita takes roti-sabzi in one dabba and fruits or biscuits in the other, she complains that two dabbas are insufficient, and unfailingly ends up eating a burger or a plate of noodles. “She doesn’t want to carry a third dabba as it will increase the weight of her bag. If this eating out was not enough, there is hardly any outdoor activity that she can indulge in, especially now that she will go to class X,” says Lalita, explaining that all Nishita does after coming from school is either study or chat on the computer.

 just 70 to 80 minutes of PT in an entire week is insufficient for growing children. “The result of all this is weight gain. Over the past year and half, she has put on so much weight that we fear it may lead to obesity,” says Lalita.

Like many other mothers, Sucheta and Lalita believe that it’s pure addiction to junk food that is harming their children. Eating fast food once in a while is fine, say the mothers. “But children often don’t have the capacity to limit intake,” says Lalita.

 once children are familiar with the taste of junk, they tend to eat it regularly and slowly get addicted, to the extent that they can’t do without it even for a day. “Addiction is what I’m worried about.”

 several schools in Mumbai give food coupons and serve vadas and samosas. “After eating junk, the child feels hungry very soon and starts feeling restless and distracted.”

Dr.Vinod Methil, consultant diabetologist at Sweet clinics, says that type II diabetes, which was till lately seen in adults, is now increasingly seen in children because of lifestyle factors.Diabetologists in Vashi

“The main cause of type II diabetes is central obesity — big stomach and insulin resistance. This develops from unhealthy eating,” says Dr Methil, explaining that she has seen children as young at 6-7 years developing type II diabetes.

Dr Methil adds, “When a child complains of excessive thirst, tends to eat more, etc. an examination shows that his sugar levels are high. It is shocking to see such young children having diabetes and obesity.”