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.

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.

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.

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.

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.”

Diabetes Care Center Navi Mumbai - Sweet Clinics

Diabetic Nephropathy

What is Albumin Creatinine Ratio [ACR]

It is ratio of albumin and creatinine in urine excretion.

What is the importance of ACR in management of Diabetes?

Raised ACR is an indicator of Kidney dysfunction in Diabetes. Normally no protein is excreted in urine. Presence of protein in urine without any Urinary Tract Infection is a indicator of Kidney pathology like Diabetic or Hypertensive Nephropathy.

ACR is the most accurate and preferred method of detecting Diabetic Nephropathy

What is the normal level of ACR?

Less than 30mg/g is the normal level

Diabetes Clinic in Navi Mumbai

What is the ideal frequency of doing ACR levels?

Once a year

How can I reduce my ACR levels?

• Controlling blood sugar & blood pressure levels
• Diet control

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