THE DIABEE BLOG

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June 10, 2018 Diabetes Care0

Type 2 diabetes can come on slowly without any notice. The signs may not be obvious, or there may be no signs at all. Therefore, many people with type 2 diabetes are not aware they have the disease and may already have developed various health complications. That’s why it’s very important to know the common symptoms and risk factors of diabetes to find out the risk, so you can do something about it on time.

The common symptoms you need to know:

Increased thirst and frequent urination: due to high blood sugars, body make more urine to remove excess glucose out of the system. As a result, you may drink — and urinate — more than usual.

Increased hunger and fatigue: If the body has insulin that is not enough, it becomes difficult for glucose to enter the cells. This involves a lot of energy expenditure that leads to intense hunger. One may even feel tired and irritable.

Blurred vision: High blood sugars often decrease ability to focus and may lead to blurred vision.

Weight loss: Despite eating more, you may lose weight. It is because there is not enough insulin for the body, so it uses alternative fuel for energy. Excess glucose is passed in the urine, without being utilised, this leads to weight loss.

Slow-healing of wounds and frequent infections: Bacteria can thrive when your blood sugar levels are high. This will hinder the ability of the body to heal. This makes you prone towards harmful infections.

Dry mouth and itchy skin: In diabetes the body utilises fluids to get rid of extra glucose, this leads to dehydration. This cause dryness of mouth, itchy dry skin etc.

Areas of darkened skin: Patches of dark, velvety skin developed in the area where skin folds like armpits and neck. This condition is known as acanthosis nigricans, it is usually due to insulin resistance.

Now, let’s understand some of the common risk factors associated with diabetes:

Your age and origin – Your risk of developing type 2 diabetes increases with age. Generally, people over the age of 40 have an increased risk of developing the condition. However, people of certain origin including Asian Indians have an increased risk of developing type 2 diabetes at a much earlier age. During recent years, type 2 diabetes is increasing dramatically among younger age group.

Family history. Genetics is one of the strong risk factor of diabetes. You’re two to six times more likely to get type 2 diabetes, if you have a parent or sibling with diabetes. The closer the relative, the greater the risk.

Weight. Being overweight will increase your risk of many diseases including diabetes. The more fat you have, especially around your belly, the more resistant your cells become to insulin, thus making you prone to diabetes. However, good news is reducing your body weight by about 5-7% could decrease the risk of getting diabetes by more than 50%.

Physical Inactivity. The less active you are, the greater is your risk. It has been suggested in a variety of observational and experimental epidemiologic studies that physical activity may play a significant role in the prevention of type 2 diabetes mellitus. Physical activity helps you control your weight, it uses up glucose to generate energy and makes the cells use insulin effectively.

High blood pressure and cholesterol levels. Having blood pressure over 140/90 mm Hg is linked to an increased risk of type 2 diabetes. Deranged cholesterol levels are associated with diabetes. If you have low levels of high-density lipoprotein (HDL), or good cholesterol, and high level of triglycerides and low-density lipoprotein (LDL) or bad cholesterol, your risk of type 2 diabetes is higher.

Gestational diabetes. If you have history of gestational diabetes in pregnancy, your risk of developing prediabetes and type 2 diabetes is even more. If you gave birth to a baby weighing more than 9 pounds or 4 kg, you’re are at high risk of type 2 diabetes.

Polycystic ovary syndrome. For women, having polycystic ovary syndrome — a common condition characterized by hormonal imbalance, irregular menstrual periods, excess facial hair growth and obesity — also increases the risk of diabetes.

Some other risk factors to consider:

  • You have ever had a heart attack or a stroke
  • If diagnosed with psychiatric disorders: schizophrenia, depression, bipolar disorder
  • Having been diagnosed with obstructive sleep apnea
  • Or been prescribed any steroid medication by a doctor

It is recommended that anyone over the age of 40 should be tested for diabetes every 3 years. And, anyone who is overweight and has one or more risk factors should be tested more frequently at younger age.

The earlier you are diagnosed, the sooner you can take action to stay well – now and in the future. You can take steps to prevent or delay type 2 diabetes by losing weight if you are overweight, cutting down extra calories, and being more physically active. Talk with your health care provider about your individual risk factor that may require medical treatment. Managing these health problems may help reduce your chances of developing type 2 diabetes.

You can also check your risk of having diabetes in future by clicking the link below.

https://diabee.hcah.in/diabetes-risk/


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June 7, 2018 Diabetes Care0

Every diabetic is aware that healthy eating is a must for managing their diabetes well. But, in order to ensure that your meals are healthy, you have to adopt healthy shopping habits as well.

The foremost step is to make a list. Understand what all you need to buy from the grocery store and jot them down in your list. This step becomes easier if you have a set menu in front of you. Plan all of your meals for the week beforehand by balancing your food intake for all food groups. This helps in writing down all essential food items in your shopping list. Remember to stick to this list and not get tempted by the products displayed on shelves. The list also helps to put a stop on impulse buying.

Once your list is prepared, you are all set to step out and shop. But never shop on an empty stomach as it can lead to binge eating in the market, breaking your diet plans. This will also prevent low blood sugar episodes because of staying hungry for long time in the market. It is usually seen that hunger weakens your ability to shop and eat healthy, as it makes you impulsive to have foods that you normally don’t consume as very tempting.

When you are presented with a choice over two similar looking food items, and it becomes difficult for you to choose then read their ‘Food Labels’. The food having more nutritious values should always take a precedence. Also pay attention to the amount of fat per serving. Read beyond just the total fats as foods with high saturated and trans fat that can raise bad cholesterol and increase heart disease risk.

Prefer to buy fresh produce and in-season produce as much as possible. Opt for whole grains instead of processed ones. Avoid deep freeze products as much as possible. In case you must buy frozen or canned foods, prefer ones which do not have a sauce base. Such sauces generally have high amount of fat as well as salts added to them. Remember to check expiry dates for all packed foods.

Go dark for fresh produce by picking up darker-hued foods. choose spinach over iceberg lettuce, sweet potatoes over white potatoes, brown rice over white rice, and hearty whole-grain breads over white. Vibrant veggies generally have more nutrients than paler ones. And whole-grain breads, brown rice, and whole wheat pastas contain more fiber than white kinds

If you can’t resist a favorite food, treat yourself to a small portion or buy a single 100-calorie pack, usually available near the checkout lines. Always remember these calories consumed and try to balance the rest of your meals, so that the daily calorie intake as per your requirement remains the same.

For actionable tips and strategies on healthy lifestyle, talk to a Diabee health coach today.

References:

  1. http://www.diabeticlivingonline.com/food-to-eat/nutrition/quick-guide-to-grocery-shopping-diabetes?page=13
  2. https://www.diabetesqld.org.au/healthy-shopping/modules/1-getting-started.aspx

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June 4, 2018 Diabetes Care0

When you are sick, either having cold, cough or fever, vomiting or diarrhoea, diabetes is probably the last thing you want to worry about. However, everyday illnesses or infection can affect your blood glucose levels, so you need to be extra careful with managing your diabetes on the sick days.

What happens to the body during sickness, if one has diabetes?

When you have diabetes, even a minor illness can make it harder to keep your blood glucose in the target range. Illness puts the body in a state of stress. To deal with this stress, the body releases hormones that help to fight disease. But downside of these hormones is that they raise blood glucose levels by increasing amount or glucose produced by the liver and make it difficult for insulin to do its job effectively. If not treated quickly, blood sugar levels can go dangerously high and lead to serious complications.

Plan Ahead

The best way to prevent a minor illness from becoming a major and life-threatening complications is to work out a plan of action for sick days ahead of time. So, you can discuss your personalised sick-day plan and keep your management kit ready with help of your diabetes care team. This will allow you to manage your diabetes better and recover from your illness without complications.

Here are some general guidelines to deal with sick-days:

Check your Blood Sugars More Often

Each type of illness can affect a person’s blood glucose differently. Check your blood sugar every 2-4 hours, especially if you have vomiting. Make sure you check your blood glucose levels at least 3-4 times a day. Keep a record of your readings, if your sugars are consistently high then consult diabetes care team immediately.

Take Your Medications/Insulin as Advised

When sick, do not skip or stop taking your diabetes pills or insulin. As your blood sugar may continue to rise because of your illness. Perhaps you might need some dose adjustments to compensate for high blood glucose levels or to avoid low blood glucose if you can’t eat. Consult with your diabetes care team, to create a sick-day adjustment plan for food and medications.

Check your Ketones

When you are sick and have high blood sugars, the presence of ketones in the urine becomes a matter of concern. To feel safe, when your blood sugar is higher than 240 mg/dL or advised by a doctor, get checked for ketones in urine and report their presence to the doctor. If you are unable to check ketones at home and feeling symptoms like fruity smell breath, vomiting, cramps or confusion call your health care provider immediately or go to the nearest Emergency Care Centre.

Keep Yourself Hydrated and Maintain Your Diet

Try to eat your meals and snack as normal as possible. Drink plenty of fluid to keep yourself hydrated and to replace the fluids that the body loses due to high blood sugars, fever, vomiting or diarrhoea. Options for fluids could be tea, milk, lemon water, chaach (buttermilk), daal (pulse), vegetable or chicken soup or broth. If you are unable to eat normal meal then take something which you can better tolerate like khichri, dalia, oats, upma, mashed potato, noodles, custard, milk and biscuit or bread etc. If you are unable to consume anything or manage your diet, talk to your diabetes care team about customised diet plan and medication adjustment.

When to See a Doctor?

During illness, there are a number of situations that warrant immediate medical attention. If you have fever for couple of days or having problems in breathing. If you have ketones in urine or fruity odour or if feeling drowsy. If you have had at least 3 episodes of vomiting or diarrhoea and/or abdominal pain then, consult your doctor. Of course, if you have any questions or concerns about adjusting your medication or insulin dosage and persistently high sugars then don’t hesitate to call your health care professional.

What all items you need to keep in a sick days kit?

You won’t feel like running out to the store when you are sick.  So always be prepared for Sick Days by having a few supplies in the house including:

  • Written handout with clear instructions: “My Sick Day Plan with Emergency Contact Numbers”
  • Medication or Insulin supplies
  • Ketone testing strips (blood or urine)
  • Blood glucose meter, battery, lancets and strips
  • Thermometer
  • Hand sanitizer
  • 1 pack of sugar-free and sweetened beverages e.g. diet /regular soft-drink, fruit juice, sport drink, vegetable soup or both
  • Glucose tablets or powder to treat low-sugars
  • Over-the-counter medications as advised by your healthcare provider (i.e. fever, cough, cold, pain, diarrhoea or vomiting).

Check your kit every six months to make sure it is till date and restock your kit for items that are consumed.

Some Tips to Stay Healthy and Prevent Sick-days

It’s natural that one can get sick once in a while. But you can keep yourself from getting sick more often than necessary.

  • Take care of personal hygiene. Wash your hands frequently, especially after coming in contact with other sick people
  • Take your flu shot on time. Diabetes, over a time may reduce the ability of the body to fight diseases and puts you at an increased risk for developing common flu.
  • Keep your blood glucose levels within your target range. It will reduce the risk of illness and infections.
  • Do regular follow-ups with your diabetes-care team. It will help you stay on top of your diabetes and prevent chances of getting sick.
  • Eat a healthy and balanced diet. Include fresh, seasonal and colorful veggies and fruits to boost your immunity.
  • Manage your stress and get quality sleep. Regular physical activity and enjoying hobbies you like are great ways to keep your body and mind healthy.
Note: If you have diabetes, don’t ignore any symptom. It is recommended to keep in touch with your health care provider during the sick days.

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May 31, 2018 Diabetes Care0

Over the years we have all witnessed a never-ending debate around which oils are the healthiest. With the increased spending on marketing by different oil manufacturing brands, we end up looking a variety of oils on the shelves of a grocery store. Each brand is claiming to be the healthiest and it becomes really confusing to choose the right option.

When it comes to diabetes, it is very important to keep a check on your diet as the blood sugar levels are directly affected by what you eat. Hence, it is a must to win the battle and choose the correct oils for yourself. To ensure optimal fat quality the use of a combination of vegetable oils is important.

Let’s first start by looking out for what are the basic types of oils available on the market shelves.

The impact of an oil on your health is determined by the type of fat contained in it. Saturated oils like ghee, butter and coconut oil are easily digestible by bodies but they must be consumed in moderation. Whereas oils such as canola, corn, olive, groundnut, rice bran, safflower, soybean, sunflower, etc., are good sources of monosaturated & polysaturated fats, having all essential fatty acids that are good for the heart.

Earlier there was a lot of focus on using refined oils, which could be found in almost every kitchen. But, over the years studies have indicated that refining process removes some of the flavor, color, and nutrients from the oils, thereby reducing their healthiness quotient.

It’s important to keep a check on the daily intake of all oils combined together. Prefer unrefined (Kachi Ghani) or cold pressed oils versus refined oils. Ideally, use a combination of these oils or keep rotating them. A good practice is to buy small packs of oils and change to a new one every time you run out of it.

A few of the healthy oils are as follows:

  1. Canola oil is a plant-based oil derived from the rapeseed plant, rich in alpha-linolenic acid, a type of omega-3 fatty acid. Per a study conducted at University of Toronto, canola oil helps to lower blood glucose levels as well as bad cholesterol. Use it in salad dressings or in cooking.
  2. Olive oil contains an antioxidant, tyrosol, which helps improve insulin resistance. Use it for dressings, dipping, and low-heat cooking. Avoid high heat cooking and frying with olive oil.
    Olive oil can be graded as virgin, refined, pure or blended. Read carefully before buying. Virgin or extra-virgin means the oil has been produced using physical means with no chemical treatment during processing, resulting in a full-flavored oil. Extra-virgin oil is the highest grade. Refined means the oil has been chemically treated to neutralize strong tastes and acids. Pure or simply labeled “olive oil” may be a combination of virgin and refined oil. Unfiltered one contains small particles of olive flesh. Light refers to flavorless or refined olive oil; it is not lower in calories. Blends are mixtures of olive oil and other, often less expensive, oils.
  3. Flaxseed oil contains mucilage, a type of fiber which slows digestion, allowing glucose from foods to be digested and released into the blood slowly. Thereby it prevents sudden spikes in blood glucose levels. It is often used as a dietary supplement rather than a cooking oil.
  4. Rice Bran oil is regarded as one of the healthiest oils for your heart. It is rich in antioxidants and mono & poly unsaturated fatty acids. Because of its high smoke point and suitability for high-temperature cooking methods such as deep-frying and stir-frying.
  5. Sesame oil is rich in vitamin E and other antioxidants. Light sesame oil has a nutty flavor and is good for frying, while dark sesame oil has a strong flavor and is generally added to dishes in small quantities for flavor just before serving. Sesame oil has a high smoke point and is the least prone among oils to turn rancid.
  6. Peanut oil is bland, made from pressed, steam-cooked peanuts. It has a high smoke point making it good for cooking involving high heat, like frying, because it does not absorb flavors.

Remember, as cooking oils are 100% fat and high in calories, use as little as possible. To minimize the amount of oil you use when cooking on the stovetop, try using nonstick pans and measuring spoons to check the volume of oil you add while cooking.

  1. Coconut Oil, known for its strong smell, contains minerals and vitamins that help manage diabetes by lowering the levels of triglycerides, and also helps in stabilizing the blood pressure. However, it contains saturated fats because of which it should be consumed only in moderation.
  2. Ghee is another healthy option. It is better than butter as it helps in digestion, improves the functioning of the brain and helps in weight loss when accompanied by exercise. Remember, it should only be taken in a small dosage s prescribed by your diet plans.
  3. Mustard oil is a great oil substitute for traditional cooking. It acts as a stimulant to help digestion and circulation. Its antibacterial and anti-viral properties, help fight germs, viruses, and keep a check on skin problems.

Once you are able to choose healthier oils, do not go overboard with their use. it is still important to control your daily oil intake. Avoid deep fried foods at all times. Choose pan fried items if you must have some. Also, try to brush your food with oils rather than just pouring it in the meals with a spoon. Use non-stick utensils for cooking which helps to cook without too much of oil.

References:

  1. https://food.ndtv.com/food-drinks/6-best-cooking-oils-for-people-with-diabetes-1761113
  2. https://www.diabetesselfmanagement.com/nutrition-exercise/meal-planning/cooking-oils/

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May 28, 2018 Diabetes Care0

Regular exercising can do a lot for your physical as well as emotional health, and it’s also an excellent way to keep your diabetes in check. However, before starting a new diabetes exercise program, always consult your diabetes care team for safe options and precautions. Certain activities may or may not be compatible with your health profile. Once you get the go-ahead to start on a diabetes fitness program, you’ll need the appropriate gear and guidance to ensure safe regimen. Here are some safety tips you can follow for safe exercise with diabetes:

  • Wear a diabetes identification bracelet/ID tag/card: to ensure proper treatment and others can help you better in case of any emergency when you’re exercising or you have an injury.
  • Learn your blood glucose response to exercise: Everyone’s blood glucose response to exercise is different. Checking your blood glucose before and after exercise can show you the benefits of activity. You also can use the results of your blood glucose checks to prevent low blood glucose or high blood glucose.
  • Keep water and snack handy during activity: Keep yourself hydrated and have plenty of water before, during, and after activity. If you are at risk for low blood glucose, always carry a source of carbohydrate so you’ll be ready to treat low blood glucose.
  • Beware of Low sugars: If you think you are having hypo, check your blood glucose right away and if it is low (less than 70 mg/dl) treat it immediately with 15 grams of simple carbs like 3 tsp sugar or glucose or 3-4 glucose tablets or biscuits or half glass juice or regular cold-drink. Check again after 15 minutes and if it is still below 100 mg/dl avoid exercising.

Some Quick Points to Prevent Low Blood Sugars

  • Don’t go for exercise empty stomach or if have long gap between the two meals. If you plan than have a small snack before you start like a fruit, nuts, paneer sandwich or buttermilk etc.
  • Longer or more intense exercise can cause your blood glucose to drop more than shorter or easier exercise. You may need to take some carbohydrate or small snack after 20-30 minutes of intense exercise.
  • Blood glucose may continue to drop for several hours after activity and should be monitored and followed by small snack right after (depending on intensity) and meal after 1-2 hour.
  • If you often have trouble with low blood glucose when you are active, eat a snack before exercise and review your glucose numbers with your healthcare provider to understand the effect of exercise on your sugars and how to manage/adjust your meals, medications according to it.

Exercise Alerts……!

  • Postpone your exercise session if you are sick, cold, cough or fever until you feel well
  • Avoid exercise if blood glucose over 250 and ketones
  • Be cautious during exercise; if blood glucose over 300 and no ketones. Check your blood glucose 15 minutes after you start. If it goes up, stop exercising and follow your doctor’s high blood glucose instructions.
  • If you have diabetes complications related with eyes, heart, kidney or feet then follow your doctor’s advice.

Safety tips during exercise

Avoid any Injury

  • Start your activity program gradually, and work up slowly. Exercising too much, too fast, can cause injuries.
  • Use proper equipment’s, clothing and protective accessories for exercise to avoid any injuries like light and comfortable shoes with adequate cushioning or if cycling outdoors wear helmet

Take care of your feet

  • As people with diabetes are more prone to foot related complications due to less sensitivity that’s why they must wear shoes that fit properly.
  • Always inspect your feet after activity for blisters or sores.

Warm up and cool down is important

  • Always warm up first and cool down after exercise to get ready for activity and prevent injuries.
  • Move slowly and stretch for 5 to 10 minutes before and after your exercise session.

If you are not used to exercise

  • Start slowly (5 to 10 minutes) and increase gradually up-to 30-60 minutes or more.
  • Build up to 3 to 5 sessions per week.

Keep yourself hydrated

  • Drink water, especially in hot weather, even if you are not thirsty.
  • Have 15 to 20 ounces of water 30-60 minutes before a workout and then 12-15 ounces every 15 minutes during exercise.

Weather Check

  • In Winters – prefer exercise during warmer part of a day; like late morning or early evening. Wear proper clothing to protect your body and feet from cold.
  • In Summers – prefer activity during cooler and less humid part of the day like early morning or late evening. Wear light, comfortable and breathable clothing. Keep yourself hydrated. Be careful about heat exhaustion or sun-tan.

Note: People with diabetes should always talk to their health care provider before starting any exercise routine.


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