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Friday, August 27, 2010

WHAT IMPORTANT PART DOES DIET HAVE IN DIABETES

Most items of food contain carbohydrate, protein and fat. Cereals are rich in carbohydrate. Lentils, lean meat, chicken and fish are rich in protein. Oils, nuts and milk cream are rich in fats. Fats are rich in calorie. 1g of fat provides 9 calorie, while 1g of carbohydrate and 1 g of protein provide 4 calorie. Carbohydrate is easily digestible among the three. The rise in blood glucose after a meal is due to absorption of glucose from a carbohydrate  digestion and increase in production of glucose by liver. Sucrose[cane sugar],sweets and syrups cause a rapid rise in blood glucose than whole cereals.

In people with no diabetes, the rise in blood glucose after a meal, comes down to pre-meal level within 2 hours. In diabetes, the rise in blood glucose is not only higher but the fall to Concentration of blood glucosepre-meal level is slower. It takes about 3-4 hours. Therefore snacks in between meals or frequent meals at short intervals tend to cause progressive increase of blood glucose in people with diabetes.
Glucose is constantly needed to provide ready energy for th function of the brain, heart, kidney and liver blood cells. When glucose is not available from ingested food, our liver produces from its store of carbohydrates[glycogen] and from fat and protein stored by the body. The liver produce about 3 gm of glucose/kg body weight in a day. so the liver of a man or woman weighing 70 kg produces over 200 gm of glucose in a day. This production of glucose by the liver is kept in check by small amounts of insulin secreted by pancreas.
GENERAL GUIDLINES ON DIET ARE:-food  
1] In a typical day's meals and snacks, you should have 1500 to 1800 calories. In this there should be 60% contribution by carbohydrates, 20% from fat and remaining 20% by protein. You may need extra calories for your physical work or less calories if you are on weight reduction. If on the other hand, you are on calorie-restricted diet, make sure that you take 50-60% of calorie as complex carbohydrate[Whole cereals] to prevent any feeling of weakness.
2]You should eat a variety of items of food every day. Do not skip a meal. Eat at roughly the same time each day. Eat several[5-6] small meals in a day rather than a large three meals a day. Do not go more than three or four hours without eating. Avoid snacks, unless you are advised so[as like during insulin treatment]. do not over eat.
3]Eat fruits and vegetables. Use less oil in cooking. Eat less, or avoid fFruits and vegetablesried foods, milk cream or food cooked in fat rich medium.
4]Avoid ready to eat food preparations and, sweets and sugary drinks[canned beverages] that provide empty calorie [no vitamins or essential minerals].
5]Eat fewer foods high in sugar, like fruit juices, fruit-flavoured drinks, sodas[colas], tea/coffee with sugar.
6]Keep a regular check on your weight and maintain this within the estimated limit.
7]Restrict protein consumption after you are informed about your kidney damage.
8]Limit use of caffeine through tea/coffee/diet colas and also alcohol.

9]Drink eight glass of water[including intake of other beverages] each day to avoid dehydration which is particularly dangerous in people with diabetes.
10]Check your hemoglobin and protein in blood samples at 6 months or a year's interval. You may have to take suitable correction in diet or supplementation.
11]Despite a good control of blood glucose, if your blood lipids are high, you will need lipid lowering drugs regularly.
a]Total cholesterol should be below 180 mg/dl
b]LDL cholesterol should be below 70-100 mg/dl
c]HDL cholesterol should be above 40 mg/dl in men and above 50 mg/dl in women.
d]Triglyceride less than 150 mg/dl.
Sometimes, these lipid lowering drugs may be advised from the beginning of your diabetes treatment, by your doctor.
12]Match your mealtime to the type of insulin and insulin injection schedule, as adviced by your doctor.
13]Increase the amount of dietary fibers in your diet with whole cereals, lentils.
14]Eat fewer foods that are high in salt, like canned and packaged soups, pickles and processed meat.


SIMPLE THINGS FROM YOUR HOME KITCHEN.
A few dietary supplements that you can take and see better sugar control and fewer complications too.
a]Soy isoflavons contain genestein that improve natural insulin secreation. They also help reduce abdominal fat. Both have a salutary effect in diabetes.
b]Allicin, an extract from garlic, has been researched extensively. Its lipid and blood sugar lowering effects make it a good supplement for diabetes. Other benefits are its antimicrobial action and anticancer action.
c]Green tea is also another wonderful supplement. Epicatechin from green tea and other sources can hGreen Teaelp prevent or delay kidney complications in diabetes. They also reduce stroke and cardiac risk, correct LDL-HDL ratio, reduce abdominal fat by increasing levels of adiponectin. A further bonus is a reduced risk of poor memory-related problems. When combined with theaflavins, again from green tea, these effects are more marked.
d]Anti-oxidants are another group of supplements, found in fruits and vegetables that prevent oxidative damage, which can otherwise cause retinal problems, atherosclerosis etc.,
e]Omega-3 fatty acids are also helpful in lowering blood fat, preventing ischemic heart problems and strokes besides improving bone, joint and skin health and boosting immunity.
RaghuNatrajan.

Thursday, August 26, 2010

What are the effects of diabetes on kidneys?

Kidneys are remarkable organs. Inside them there are millions of tiny vessels that act as filters. Their job is to
remove waste products from the blood. 10-21% of all people with diabetes have nephropathy. Approximately 43% of new cases of ESRD[end stage renal disease] are attributed to diabetes.
Why diabetes can cause kidney damage.

When our bodies digest the protein we eat, the process creates waste products. In the kidneys millions of tiny blood vessels[capillaries] with even tiny holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes. The waste products become part of the urine. Useful substances, such as protein and red blood cells, are too big to pass through the holes in the filter and stay in the blood. Diabetes can damage this system. High levels of blood sugar make the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak. useful protein is lost through this leak and leaves the body through urine. Having small amounts of protein in the urine is called microalbyminuria. When kidney disease is diagnosed early[during microalbuminuria] several treatments may keep kidney disease from getting worse. Having large amounts of protein in urine is called macroalbuminuria. When kidney disease is found later[during macroalbuminuria] end stage renal disease, or ESRD occurs.ESRD is very serious. A person with ESRD needs to have a kidney transplant or to have the blood filtered by machine[dialysis].Not everyone with diabetes develops kidney disease. Factors that can influence kidney disease development include genetct scanics, blood sugar control,and blood pressure. The better a person keeps diabetes and blood pressure under control, the lower are the chances of getting kidney disease. Your kidney function should be checked at least once a year or earlier if advised by your doctor.
Important treatments for kidney disease are tight control of blood glucose and blood pressure. Blood pressure has a dramatic effect on the rate at which the disease progresses. Even a mild rise in blood pressure can quickly make kidney disease worsen.


Four ways to lower the blood pressure are
a]Losing weight
b]Eating less salt
c]Avoiding alcohol and tobacco
d]Regular exercise.


If kidney disease sets in, eat low protein diet. If this method fails, certain medication may help to lower blood pressure. ACE inhibitors are necessary for most people with diabetes, high blood pressure and kidney disease. Once kidney fails, dialysis is must. The person than is left to choose whether to continue with dialysis or to go for a kidney transplant.
Raghu Natrajan

Wednesday, August 25, 2010

What role does stress play to diabetes?

Stress can cause or worsen many diseases- diabetes is one of them.[ JJSYPEKAEBBT] Stress raises blood sugar in diabetic patients.
STRESS AND BLOOD SUGAR LEVELS:
Two main grStressoups of hormones control blood sugar levels. Insulin, only member  of one group, reduces blood sugar. The other group, such as cortisol and adrenaline, glycogen and growth hormones, called counter- regulatory hormones, opposes the action of insulin  and as such raises blood sugar. Stress plays a role in increasing  the second set of Growth Hormonehormones, particulary cortisol  and adrenaline. If these remain on higher side for a long time, are responsible for development of diabetes in predisposed individual and worsens the ailment in a  diabetic patient and should be kept in controlled levels. Reduction of stress often leads to dramatic improvement in diabetic condition. Often individuals do not realize that they are under stress, even if they do, they try to deny it. The main approach to deal with stress is to adopt a change in the individuals mindset. One should Insulin releaseaccept a stressful situation as a challenge and not a threat. In fact a mild degree of stress will be impetus to a higher level of performance, but at the same time one should be also careful and alert to the sign and symptoms of it.
When one is under higher stress levels, he should not be satisfied with just treating it with medicine, but analyze the root cause of it. To this, use of stress management techniques like diet, exercise, meditation, yoga will be of great help. By this the root cause can be identified and corrected, by consulting a qualified clinical psychologist.
Stress nowadays has become unavoidable in these modern lifestyle.Following a healthy lifestyle with adequate exercise, correct diet and regular sleeping hours keeps one physically and mentally fit to face any stressful situation. A healthy social life is vital in reducing stress levels, which in turn reduces the risk of developing diabetes. All the more important is for a diabetic patient to learn to keep the stress under control, since it can play havoc with the management of diabetes, and at the Monitoring devicessame time take control of their condition.

 symptoms_of_diabetes
Raghu Natrajan
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Tuesday, August 24, 2010

Gestational Diabetes Mellitus in pregnant women.


Diabetes mellitus in pregnant women poses problems for the mother, fetus and child.[ JJSYPEKAEBBT]
Wpregnant ladyomen with established diabetes may have menstrual problem and difficulties in
pregnancy. Pregnancy by itself worsens diabetic control and may cause certain diabetic complications to progress in women. Maternal diabetes is also hazardous for the fetus and carries increased risk for fetal loss and major congenital malformations.
However nowadays most women of childbearing age can realistically expect to become mothers of healthy children with intensive glycemic control. Improvements have
ranged from technological advances in fetal surveillance, [ultrasound scanning] home glucose monitoring and intensive insulin regimens and have enabled even women
with multiple diabetic complications to have successful pregnancies. Blood glucose monitor
Diabetes mellitus in pregnancy is divided  into pre-gestational and gestational diabetes.If diabetes is found for the first time in a pregnant women,where it was not there before, is called gestational diabetes.Approximately 7% of all pregnancies are complicated by GDM[gestational diabetes mellitus]. Normal pregnancy reduces
insulin sensitivity because of diabetogenic effects of placental hormones. Gestational diabetes resolves after delivery, but may recur in subsequent pregnancies and a lifetime risk for developing type 2 diabetes is 30%.
INDICATIONS FOR DETECTION OF DIABETES IN PREGNANT WOMEN.
1]Family history of diabetes.
2]Glucose in urine sample.
3]History of unexplained prenatal loss.
4]History of large baby.3d image @20 weeks
5]History of congenitally malformation infant.
6]Maternal obesity.
7]Maternal age more than 25 years.
8]Members of ethical/racial group with high prevalence of diabetes mellitus.
[such as African American, American Indian,Asian American, Hispanic/Latino, or pacific Islander.]
To prevent excess spontaneous abortion and congenial malformation in infants of diabetic mothers, diabetes care and education must begin before conception.There are no contraceptive methods that are specifically contraindicated in women with diabetes. The selection of a method should focus on methods with proven high degree of effectiveness. Once patient achieved stable sugar control than conception can be
discontinued and plan for pregnancy.
Management during pregnancy.
1]Quiet smoking/alcohol.
2]Home blood glucose monitoring.
3]Diet control/foliate supplementation.
4]Regular exercise.
5]Fetal monitoring by ultrasound scan.
6]Accurate insulin regimen.
7]Management of complications.


Diabetes is associated with a significant increase in the risk complications during
pregnancy and delivery.Appropriate management, including medical education, therapy
accurate insulin regiment and cautious obstetric management achieves a successful
pregnancy outcome for the mother and child.
Up date on 03/09/2010.
Gestational diabetes Cause
When you are pregnant your body gains weight and some hormone changes take place. But these changes are hard on your body to keep up with its need for a hormone called insulin. This condition negates the body from its energy needs.
Gestational diabetes diagnosis
Your health care team will check your blood glucose level. Depending on your risk and your test results, you may have one or more of the following tests.
1.Fasting blood glucose or random blood glucose test.
Here you are asked to fast before taking the test.You have go without food for at least 8 hours before the test.This test is known as fasting glucose test.
In random blood glucose test, your blood glucose may be checked at any time of the day.
With these tests its is possible to find gestational diabetes in some women, at the time other tests are also needed so as to not miss the prevalence of gestational diabetes.
2.Screening glucose challenge test.
In this, you are given a sugary beverage 1 hour before taking the blood glucose test. If the result is above normal, further tests are needed.
3.Oral Glucose Tolerance Test.
Here, from 3 days before the test, you have to have normal food. On the test day you have to fast for 8 hours before the test. On the test day your blood glucose levels will be checked. You will be given a sugary beverage to drink and blood glucose levels at intervals of 1 hour, 2 hours and 3 hours after the drink will be taken. If the levels are above normal twice during the test, you have gestational diabetes.
Above-normal results for the oral glucose tolerance test*
Fasting   95 or higher
At 1 hour 180 or higher
At 2 hour 155 or higher
At 3 hour 140 or higher
Note: Some labs use other numbers for this test.
*These numbers are for a test using a drink with 100 grams of glucose.
GESTATIONAL DIABETES TREATMENT?
Treatment is aimed at keeping the blood glucose levels at a target during pregnancy by
1] diet
2]exercise
3]insulin
1] DIET- A dietitian will give you a meal plan which you are to follow.This plan is aimed to keep your glucose level within the target.The broad guidelines will consist, among others, the following;
a]To Eat three small meals and one to three snacks every day.
b]To be careful in the amount of carbohydrate rich food you take and when to take it.
c]To include fiber in your food.
2]EXERCISE
Your health care team will guide you through the physical activity that you will undergo, after having a discussion and knowing you normal activity schedule.
3]INSULIN
Some women may require insulin in addition to the above to be within their blood glucose target.

Raghu Natrajan


What are the reasons,causes and signs of diabetes?

Blood_sugar_regulation.Diabetes is a chronic disease in which there is a excess of glucose [sugar] in blood. In diabetes blood sugar levels go haywire. It is one of the leading major causes of blindness, heart disease, kidney failure, amputations and digestive disorders. The major causes are heredity, immune system dysfunction and viruses. Among the
contributory causes are obesity, lack of exercise and improper nutrition diet. You don't get the proper nutrients needed, if you over consume processed, chemically treated, overcooked, high fat,high glycemic, packaged and nutrient deficient food. glucose_insulin_chart
Normally, sugar and starch in food are absorbed as glucose, produced by liver, into  our blood. insulin, the hormone produced by pancreas, cleans up the glucose from blood by directing it into the cells. In diabetes, the body doesn't make, or properly use insulin. This causes the blood sugar levels to go high and glucose not able to
enter the cells. In this condition, the body cannot make the energy it needs from
Damaged Heartthe food you eat. Eating food high in sugar and starch complicates the condition.
Eating the right food in the right amount at the right time is important to maintain blood sugar levels throughout the day. This will help to feel better and be mentally sharp. You will have better moods, less depression and less fatigue
than those who don't. By being so, it will reduce the risk of complications such as high blood pressure, heart disease and cancer. Pancreas release insulin
Body needs energy. Energy is produced from glucose which in turn is got from the food we eat.If we are not eating properly, we can not produce efficient energy,that body needs. Any time if one of our basic need is out of balance, the body is under stress and cannot function properly.
Insulin Ampule



Types of diabetes:
A: Type 1 diabetes mellitus: In this type of diabetes, the pancreas produces little
or no insulin. This type of diabetes generally develops at young age, has symptoms
abd blood glucose is high. These patients need insulin treatment lifelong.
B: Type 2 diabetes mellitus: In this type of diabetes, the pancreas produces less
insulin than required to maintain normal blood glucose. It generally develops after
40-45 tears of age and progresses slowly. Several years may pass before the the
diagnosis is actually made. All patients need diet control, tablets or insulin to 
keep their diabetes under control.
C: Secondary diabetes mellitus: This includes diabetes due to genetic defects in
insulin secreation and action, drugs [steroids,contraceptive pills, ACTH,etc.,]and diabetes in association with ebdocrine disorders. Most of them require insulin for diabetes control.
D: Gestational diabetes mellitus: This includes dignosis of diabetes made for the first time during pregnancy.The diagnosis is done when fasing blood glucose is in excess  of 95 mg/dl and if it is higher than 180 mg/dl at 1hr,155 mg/dl at 2hr or 140 mg/dl at 3hr after 100g oral glucose intake. These patients need very strict pregnancy control through diet modifications and insulin treatment to prevent pregnancy loss and high birth weight[more than 3.8kgs] of their babies. In most cases blood glucose becomes normal after delivery. A repeat blood glucose test after 6 weeks of delivery is necessary for assessing diabetes.


Reasons for developing diabetes:
Though it can not be answered easely the following causes might answer this.
1]Heredity is considered as an important cause. children of parents with no diabetes are less likely to develop diabetes than children of parents with diabetes.
2]Obesity and sendentary lifestyle are major contributing causes.
3]Alcoholic beverages when taken in excess, damage the pancreas and cause diabetes.
4]Higher consumption of bitter tapioca,maize, sugar,salt and low protein diet during childhood increases the risk.
5]Those with low[1.5kg and lower] high[3.8kg] birth weight, stress, high blood sugar,diabetes during pregnancy are at gigh risk of developing diabetes.
6]Viral gastroenteritis, mumps and chickenpox may precede development of type 1 diabetes. 


SYMPTOMS:-

Diabetes is an isidious disease. In fact, moderately high levels of blood glucose
[180-200 mg/dl] produce no symptoms for many months or even years.

Most patients with type 1 diabetes pass large volumes of urine, experience an 
increase in the frequency of urination, undue thirst and hunger, and rapid weight 
loss. These provide clues for diagnosis of diabetes.

men and women with type 2 diabetes may not have the above symptoms. Some of them 
experience an increase in the frequency of urination and abnormal thirst.They may 
however feel tired, irritable, lack of concentration at work, proneness to 
infection, delay in wound healing, intense itching and need for frequent change of 
eye glasses.



Raghu Natrajan
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