Bone and joint issues related with diabetes

On the off chance that you have diabetes, you're at expanded danger of different bone and joint issue. Certain elements, for example, nerve harm (diabetic neuropathy), blood vessel infection and corpulence, may add to these issues — yet regularly the reason isn't clear.

Become familiar with different bone and joint issue, including indications and treatment choices.

Charcot joint 

What's going on here? 

Charcot (shahr-KOH) joint, additionally called neuropathic arthropathy, happens when a joint falls apart in view of nerve harm — a typical confusion of diabetes. Charcot joint basically influences the feet.

What are the manifestations? 

You may have deadness and shivering or loss of sensation in the influenced joints. They may turn out to be warm, red and swollen and become insecure or twisted. The included joint may not be extremely excruciating in spite of its appearance.

How is it treated? 

Whenever recognized early, movement of the infection can be eased back. Constraining weight-bearing exercises and utilization of orthotic supports to the influenced joint and encompassing structures can help.

Diabetic hand disorder

What's going on here? 

Diabetic hand disorder, additionally called diabetic cheiroarthropathy, is a confusion wherein the skin on the hands gets waxy and thickened. In the end finger development is restricted. What causes diabetic hand disorder isn't known. It's generally basic in individuals who've had diabetes for quite a while.

What are the indications? 

You might be not able to completely broaden your fingers or press your palms together level.

How is it treated? 

Better administration of blood glucose levels and exercise based recuperation can slow the advancement of this condition, yet the restricted versatility may not be reversible.

Osteoporosis

What's going on here? 

Osteoporosis is a confusion that makes bones become feeble and inclined to break. Individuals who have type 1 diabetes have an expanded danger of osteoporosis.

What are the manifestations? 

Osteoporosis once in a while causes side effects in the beginning periods. In the long run, when the sickness is further developed, you may encounter loss of stature, stooped stance or bone breaks.

How is it treated? 

A solid way of life, including weight-bearing activity, for example, strolling, and eating a fair eating regimen plentiful in calcium and nutrient D — including supplements if necessary — are the most ideal approaches to address this condition. In certain patients with increasingly extreme or propelled illness, meds to forestall further bone misfortune or increment bone mass might be required.

Osteoarthritis

What's going on here? 

Osteoarthritis is a joint issue described by the breakdown of joint ligament. It might influence any joint in your body. Individuals who have type 2 diabetes have an expanded danger of osteoarthritis, likely because of stoutness — a hazard factor for type 2 diabetes — instead of to the diabetes itself.

What are the side effects? 

Osteoarthritis may cause joint agony, expanding and solidness, just as loss of joint adaptability or development.

How is it treated? 

Treatment includes practicing and keeping up a solid weight, thinking about and resting the influenced joint, exercise based recuperation, prescriptions for agony, and medical procedure, for example, knee or hip substitution (joint arthroplasty). Correlative medicines —, for example, needle therapy and back rub — likewise might be useful for overseeing torment.

DISH

What's going on here? 

Diffuse idiopathic skeletal hyperostosis (DISH), likewise called Forestier illness, is a solidifying of ligaments and tendons that normally influences the spine. DISH might be related with type 2 diabetes, maybe because of insulin or insulin-like development factors that advance new bone development.

What are the indications? 

You may encounter agony, firmness or diminished scope of movement in any influenced piece of your body. On the off chance that DISH influences your spine, you may encounter firmness in your back or neck.

How is it treated? 

Treatment includes overseeing side effects, generally with torment relievers (Tylenol, others), and in uncommon cases may expect medical procedure to expel bone that has become because of the condition.

Dupuytren's contracture

What's going on here? 

Dupuytren's contracture is a deformation wherein at least one fingers are bowed toward the palm. It's brought about by thickening and scarring of connective tissue in the palm of the hand and in the fingers. Dupuytren's contracture is basic in individuals who've had diabetes for quite a while, maybe because of the metabolic changes identified with diabetes.

What are the indications? 

You may see thickening of the skin on the palm of your hand. In the end, you will be unable to completely fix at least one fingers.

How is it treated? 

On the off chance that you have torment, a steroid infusion may help by decreasing irritation. Medical procedure, collagenase compound infusion and an insignificantly intrusive strategy called aponeurotomy to break separated the thick tissue are different choices if the condition keeps you from having the option to get a handle on objects.

Solidified shoulder

What's going on here? 

Solidified shoulder is a condition portrayed by shoulder torment and constrained scope of movement. It normally influences just one shoulder. Despite the fact that the reason is frequently obscure, diabetes is a typical hazard factor.

What are the indications? 

Solidified shoulder causes torment or delicacy with shoulder development, firmness of the joint, and diminished scope of movement.

How is it treated? 

Whenever began early, forceful exercise based recuperation can help safeguard development and scope of movement in the joint.

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. 

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.

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.

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.

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.

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.