Tuesday, November 19, 2019

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.

Friday, November 15, 2019

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.

Sunday, November 3, 2019

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.”

Thursday, October 31, 2019

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.

Friday, October 25, 2019

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,

Wednesday, October 23, 2019

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.

Friday, October 18, 2019

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.