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.

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.”

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.

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.