THE DIABEE BLOG

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October 23, 2018 Diabetes Care0

One of the very few times we love to hear the number ‘Zero’ is when it comes to calories, isn’t it…

Manufacturers love to position zero-calorie sweetened foods and drinks as better because they create a ‘guilt- free effect’ and therefore more likely to get picked off the shelf. The moment we read zero calorie or low calorie food, it straight away makes a place in our grocery basket without a second thought. Who are we trying to cheat?

There are two types of sweeteners: nutritive and non-nutritive

  • Nutritive or reduced calorie sweeteners approved by the FDA include sugar alcohols (polyols) such as erythritol, isomalt, lactitol, maltitol, mannitol, sorbitol, xylitol, tagatose, and hydrogenated starch Sugar alcohols contain, on average, about 2 calories/g (one-half the calories of other sweeteners such as sucrose (table sugar). The use of sugar alcohols appears to be safe; however, they may have some side effects such as diarrhea in children.

 

  • FDA has approved five non-nutritive sweeteners for use: acesulfame potassium, aspartame, neotame, saccharin and sucralose. FDA has also set an Acceptable Daily Intake (ADI) for these artificial sweeteners. Another sweetener inching toward the safe zone in this category is Stevia. It is a leaf, so would be best if one can get their hands on stevia leaves in its original form.

Have you ever wondered things like – how come the products with these artificial sweeteners taste so sweet? And these chemicals do not get digested in our body (hence no caloric load), then what happens to them once they’re past our tongues?

These sweeteners are mostly manufactured (the word ‘artificial’ is a giveaway right…) chemicals that are 1000 times sweeter in taste than naturally occurring regular sugar (or sucrose) that our bodies cannot digest or absorb. This puts a load on our organs to push them out. For years researchers have been puzzling over the fact that non-caloric artificial sweeteners do not seem to assist in weight loss, and some studies have suggested they may even have an opposite effect. Wondering how? Read on.

It’s that guilt free effect again – since the sweetener is supposed to be sugar-free, most of us tend to get a little trigger happy with the portions of sweetened food. What we need to understand is that a calorie from any source still counts and higher quantities of food will up the intake.

Artificial sweeteners rewire your brain chemistry and metabolism confusing the body into thinking it is consuming real sugar. Your body reacts and gets ready to receive the sugar by revving up production of the fat-storage hormones. Your metabolism slows down, you become hungry more quickly, you’re prone to eat way more food (especially carbs), and increased belly fat is the inevitable result.

I regularly see patients who complain about not being able to kick their diet-soda habit. It isn’t just their imagination: Artificial sweeteners can quickly become addictive just like smoking. Research shows that non nutritive sweeteners and nicotine produce similar effects in the brain i.e., a craving for more of the same.

It is imperative for people with diabetes to reduce stress on their organs by controlling blood sugar levels. And here we are, doing just the opposite by consuming highly processed food products laden with artificial sweeteners.

Don’t get carried away with what the big-name cola companies want us to believe in their glitzy ad campaigns highlighting their efforts to fight diabetes and obesity. Soda companies proudly promote the fact that their diet drinks have low or no calories and that they have cut sales of sugary drinks in schools by 90 percent. Is that a good thing? I don’t think so. Just cut these sodas out of your lives altogether and you’ll be healthier and happier for it. And if you have a desire for something sweet just have a little sugar and make sure you walk or jog it off.

So my health Mantra still remains the same, eat natural, stay super!

 

From the Expert Desk

Ms. Pariksha Rao

She is an accomplished clinical nutritionist, diabetes and behavioural expert, nutrition and wellness consultant, eminent speaker and a passionate writer. She has over 13 years of professional experience and trained over 2000 paramedics and patient counsellors. She specializes in therapeutic nutrition, diabetes, mindfulness, health and wellness.

 

 


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October 15, 2018 Diabetes Care0

 

The season for renewing one’s faith through penance and fasting is upon us and this usually is the time when people with diabetes struggle, rather unsuccessfully, to be true to their faith whilst trying to make the best choices in managing their disease. Diabetes patients in India have one of the lowest levels of psychological well-being on the World Health Organization-5 (WHO-5) Well-being Index. Patients also showed a significantly higher perception of the burden of social and personal distress associated with diabetes. This not only impacts the patient’s ability to adhere to therapy but also their psychosocial well-being.

What most people fail to understand and internalise is that one can still participate in and enjoy the festivities and respect one’s beliefs by making smart choices and sticking to a plan rather than going with the flow.

Fasting is an integral part of the Indian culture and tradition. It basically connotes willing abstinence from eating certain or any kind of food, drink or both. The period of fasting also varies i.e. it could be partial or prolong for 24 hours. Some people of certain faiths are known to keep a fast for weeks or months at a stretch. Another type of fasting is ‘Phalahar’ or fruit meals, when, as the names suggests, one consumes only fruits and avoids all cereals, pulses etc. An old tradition, which is also gaining popularity largely with millennials, is fasting purely to improve health by detoxifying the body for a period of 24 to 72 hrs. Though people may keep a fast for varied reasons, the most prevalent are still for religious and spiritual reasons.

So, would you like to make sure you enjoy this season with no adverse after effects?

To begin with, make an appointment to undergo a medical assessment with your healthcare professional and follow through on it. This is especially important if you are planning to fast for more than 3 days at a stretch.

The assessment will check your general well-being, measure your control of your blood sugar and discuss your medication requirements during this period.

Certain diabetes drugs may increase your risk of low blood sugar (hypoglycaemia) while fasting. Therefore, your treatment regimen may need to be modified during this period.

More frequent monitoring of blood sugar levels is essential to know how your body is responding to the absence or major reduction in essential nutrient intake.

The ground rules during fasting are basically the same at during regular eating days:

  • Eat small and frequent meals (when breaking fast); avoid fatty fried food items; fruits and nuts make a healthy snack.
  • Opt for low fat milk based sweets like kheer etc instead of deep fried and fat laden ones like halwas / puddings etc.
  • Even if you are fasting, stay away from juices and fizzy drinks and limit tea and coffee intake to no more than 2-3 cups/day.
  • Keep yourself well hydrated if your fast allows you or make sure to rehydrate your body well as soon as you break.

Try to maintain your usual physical activities when fasting. Light-to-moderate exercise is safe to undertake; however, it is best to avoid rigorous exercise. So stick to your routine.

Whilst fasting, end it and seek immediate medical help, if you experience the following:

  • If you experience any symptom of low or high blood sugars e.g. sweating, headache, dizziness or any other unusual symptom
  • If it is low blood sugar (hypoglycaemia) – blood sugar less than 70 mg/dl during the fasting
  • High blood sugar (hyperglycaemia) – blood sugar higher than 300 mg/dl at any point of time

Keep your family, friends and colleagues in the loop and inform them that you are fasting.

Take charge of your health and help yourself respect your beliefs.

Wish You a Very Happy and Healthy Festive Season.

 

From the Expert Desk

Ms. Pariksha Rao

She is an accomplished clinical nutritionist, diabetes and behavioural expert, nutrition and wellness consultant, eminent speaker and a passionate writer. She has over 13 years of professional experience and trained over 2000 paramedics and patient counsellors. She specializes in therapeutic nutrition, diabetes, mindfulness, health and wellness.


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October 8, 2018 Diabetes Care0

Whether you have diabetes or not, eye health is something important for us all. However, people with diabetes need to pay special attention to their eyes. Why? As they are at more risk of developing diabetic eye disease, especially diabetic retinopathy, which is one of the top cause of blindness. The longer a person has diabetes, the greater is the risk. Once vision is lost, it is often difficult for the person to see normally again. That’s why you need to take special care in protecting your vision from diabetic eye disease.

Learn from Mr. Mangal’s story, why protecting eyes from diabetes is so important.

Mr. Mangal who’s 40-year-old banker, lives in Pune with his wife and 2 small kids has already lost his eye sight due to diabetes. Retinopathy was robbing his sight, and he had no clue. He is living with diabetes for more than 5 years but had never been to ophthalmologist for eye check-up. He often experienced eye strain, blurred vision and assumed that glasses would fix everything. Not quite, as it turned out. He got both a new set of specs and an urgent referral to the eye hospital.

He was shocked to know that retinopathy in eyes was already in advanced stages. In eye hospital, a team of ophthalmologist referred him for retinal surgery as there were traces of retinal bleeding. Even after the surgery and despite of the best efforts done by doctors retinal bleeding relapsed. They used injections to stop bleeding and continued with his laser surgery for another more year but eventually due to so much blood loss, eye sight was lost.

Due to all this his daily activities were affected; he couldn’t read, write or drive. For the first time, he was frightened about the future of his family. He couldn’t even imagine what the next weeks and months would bring. His mind was flooded with questions like, what would I do now? How would I get around? How would I work? How would I perform basic household tasks? Would I able to see my children? How would I cope with my sudden loss of independence? He was completely devastated and it was far tougher for his wife and children.

Could this incident and my vision loss be prevented? He asked himself this question again and again. What do you think?

Yes, it could be prevented if Mr. Mangal knew how diabetes can also affect the eyes, if he had an idea about early warning signs to identify eye disease or even if he was aware of the significance of regular screening, his vision could be saved.

So, let’s understand the disease better to prevent retinopathy from stealing one more sight again.

Diabetes is a leading cause of blindness and 95% of severe vision loss from diabetic retinopathy can be prevented by early detection, timely treatment and an appropriate follow-up. So, we’re here to help and make you all well equip to prevent future complications. How? By making sure you fully understand what diabetic retinopathy is; including the causes, potential complications, and ways you can prevent it.

What is diabetes eye disease?

A diabetic eye disease is a group of eye conditions that can affect people with diabetes. It includes Diabetic Retinopathy (DR) which affects tiny blood vessels that nourish the retina. It is the most common cause of vision impairment and blindness among people with diabetes. Other eye problems include cataract or clouding of the eye’s lens that makes the things you look at, seem blurry. And other condition is glaucoma which damage the optic nerve that carries signals to the brain that help you to see.

Who are at risk of developing eye disease?

Everyone with diabetes is at risk of developing diabetic retinopathy. Factors like long duration of diabetes, poor blood sugar control, high blood pressure or cholesterol or both, smoking or kidney disease increase this risk multiple times.

What are the warning signs?

There are usually no symptoms in the early stages of diabetic retinopathy. The symptoms of diabetic retinopathy often don’t appear until major damage occurs inside of the eye. That’s why it’s critical for people with diabetes should have regular comprehensive dilated eye examination. The earlier diabetic retinopathy is detected, the better the chance that it can be effectively treated and further vision loss can be prevented. Symptoms may include sudden increase in eye floaters e.g. dark spots or cobweb-like strands, blurred vision, pain or difficulty in seeing, flashing lights or sudden loss of vision.

How can diabetic eye disease be diagnosed?

Your eye doctor may conduct one or more tests to diagnose diabetic retinopathy. Doctor may check your ability to see at various distances by using standard eye chart. He may also dilate your eyes by using eye drops to check your retina closely to detect early sign of damage. Additional examination may include test to measure pressure inside the eye, test to measure swelling, check leakage or abnormal growth inside the eye. Your eye doctor would be the best person who can guide you regarding which tests needs to be done on what frequency according to your specific condition.

How can diabetes eye disease be prevented?

While retinopathy is not always preventable, one of the best things you can do is regular follow-ups with your diabetes care team including eye specialist and get your eyes screened periodically. Catching eye problems early is crucial to mitigate future complications. Other things you can do to prevent the onset or worsening of eye problems are:

  • Maintaining good control of your diabetes helps to prevent eye problems. One can achieve target blood sugar levels by eating a healthy diet, frequently monitoring your blood sugar levels, getting regular physical exercise, and taking insulin or medicines as prescribed.
  • Keep your blood pressure and cholesterol under control by following a healthy lifestyle, losing extra body weight and taking medications if needed will not only help your eyes but your overall health.
  • Quit smoking and avoid alcohol as both increase risk of many diabetes complications including eye disease. By quitting smoking and cutting down on your alcohol intake will help to reduce your risk.

The only thing worse than being blind is knowing it could be prevented.

Our mission is your healthy vision. Get your eyes screened today…!

 

From the Expert Desk

Ms. Bhawana Rani

She is a proficient diabetes expert and a passionate medical writer. She has over 9 years of experience in the field of diabetes and nutrition. She specializes in educating and developing teaching and training tools for patients and healthcare professionals on different aspects of diabetes education and management. Apart from diabetes, her special interest is writing on various other subjects like health, lifestyle, wellness, nutrition and research.


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September 26, 2018 Diabetes Care0

Living with diabetes is not an easy job. At times it creates mess, and dealing with it sometimes becomes a challenge. Following diet, exercise or taking medications is not the only thing you have to do. You also need to check blood sugars, inject insulin and change lancets, needles and syringes from time-to-time. Have you ever wondered, what to do with these sharp things?

You shouldn’t throw them in the household trash for sure. Or, never place loose needles and other sharps in the public trash cans or recycling bins, and never flush them down the toilet. This puts trash and sewage workers, housekeepers, household members, and children at risk of being harmed.

Sharps is a medical term for devices with sharp points or edges that can puncture or cut skin. And, every year millions and million sharp are used by people with diabetes. Just imagine, if they are not disposed of properly, they can injure people and pets. They can even spread infections such as HIV, hepatitis B or hepatitis C, if not disposed safely. That’s why safe sharps disposal is important whether you are at home, at work, at school, traveling, or in other public place.

Where should I dispose my sharps?

All used sharps should be immediately discarded into a specified sharps container. FDA-approved sharps containers are generally available through pharmacies, medical supply companies, health care providers and online. These containers are made of puncture-resistant plastic with leak-resistant sides and bottom. They also have a tight fitting, puncture-resistant lid.

However, you can make your own version of sharp container at home. A solid, hard, non-see-through plastic container, the one which can’t break or crack like an old laundry detergent or fabric softener bottle can be used as a dedicated sharps container.

While disposing sharps, don’t try to recap or clip a needle that has been used by another person. This can lead to accidental needle sticks, which may cause serious infections. Don’t attempt to remove the needle without the safe-clipper device because the needles could fall, fly off, or get lost and injure someone.

After disposal, you should store your sharp bin in a safe place inside your home and keep all sharps out of reach of children or pets at all times. To ensure the bin is not dangerous to others, you should not remove the lid once it contains waste. Once you have placed a sharp object into your sharps bin, you should not try and take it out again as it can cause an injury. Sharps should be placed into the bin one at a time, and in one piece. They should not be bent, broken or dismantled before being put in.

What to do when the sharp container is full?

When your sharps bin is almost two thirds full you should seal the lid securely with durable tape and label the container with something like “Contains Sharps” so it’s clear as to what’s inside! You should not fill your sharps bin above the full line, nor force sharps into a full bin by trying to push them down further and risk hurting yourself.

As sharps are classed as clinical waste, special arrangements need to be made for their disposal, which can vary from area to area. Check with your trash pickup company about their policy on sharps disposal. You can also dispose sharps to your pharmacy or doctor’s clinic and check if they offer a sharps collection service. Local disposal regulations vary, so call your local health department for more information.

Travelling with sharps

When you travel with diabetes, carry a “travel letter” from your physician stating you have diabetes and giving you permission to carry all your sharps and a portable container to dispose. Check the guidelines about sharps disposal in foreign countries which should be available from the national diabetes body wherever you are visiting.

What to do if you are accidently stuck by a used needle or other sharp

If you are accidently stuck by another person’s used needle or other sharp:

  • Wash the exposed area right away with water and soap or use a skin disinfectant (antiseptic) such as rubbing alcohol or hand sanitizer.
  • Seek immediate medical attention by calling your physician or local hospital.

Take care and stay safe.

From the Expert Desk

Ms. Bhawana Rani

She is a proficient diabetes expert and a passionate medical writer. She has over 9 years of experience in the field of diabetes and nutrition. She specializes in educating and developing teaching and training tools for patients and healthcare professionals on different aspects of diabetes education and management. Apart from diabetes, her special interest is writing on various other subjects like health, lifestyle, wellness, nutrition and research.

 

 

 


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September 15, 2018 Diabetes Care0

 

Rakesh, a 42 years old marketer who has type 2 diabetes, never made it to the diner to till 10 pm, as he worked in Manesar, Haryana and lived with his family in Delhi.

He daily had to commute at least 60 km one side to reach the organization he worked for. Since years he was driving 3-4 hours on a daily basis. One day, as he drove through Gurgaon, he experienced sudden anxiety, restlessness, dizziness and was feeling extremely exhausted to drive home.

He pulled his car to the side near Delhi cantt, where some traffic police were present. Somehow, he asked a pedestrian for help and with his help they contacted the police.

Initially, police were suspecting that he may be drunk, but in faint voice Rakesh muttered that he is diabetic. He told that I have diabetes since last year but I have not experienced such symptoms. The police contacted the ambulance. And then the attendants in the emergency vehicles managed his case.

This may be a case of Rakesh who is living with diabetes in the past 1 years but I am sure there may be a lot of people with diabetes who have to go through all this.

Let’s understand what might have happened:

People with diabetes experience sudden dips in blood sugars, also known as hypoglycemia. This may sometimes have confusions, loss of consciousness, vision disturbances, delayed responses etc. On the contrary, people with diabetes may experience eye problems, neuropathy in feet, that may affect ability to feel the clutch and brake. This may impact driving and may lead to dangerous consequences also.

According to a study, people with diabetes who drive have 12-19% higher risk for motor vehicle accidents. It is generally seen that most accidents related to diabetes complications happen to a small group of people with type 1 diabetes, who need to take insulin and also people with type 2 diabetes who are at high risk.

Most of the people who drive on daily don’t even check their blood sugars before driving. They are totally unaware of the dangers that driving can bring in, if one has diabetes. Sometimes, if one experience symptoms of hypos, he or she can avoid driving on that day, but milder symptoms sometimes get ignored.

The problem here is people don’t know about the relation of driving with diabetes.

The responsibility of a person who is driving is not only his life, he has to ensure that there is no collateral damage also. This means safety of other people on the road should be a priority.

Following are simple tips that people with diabetes should follow while driving:

  • Check blood glucose before going for drive
  • Avoid delaying or missing meals on the day of driving
  • Always keep healthy snacks and sugar sachet or glucose tablet handy
  • Take short breaks on long drives

If you feel any warning signs of hypoglycemia like sweating, diziness or blurred vision then stop the car at an appropriate place. People with diabetes should know how to recognize physical signs of low blood sugar and treat it. If you are not able to manage it then talk to your health care provider immediately, ask for help or call an ambulance.

 

From the Expert Desk

Dr. Himanshu Arora

He is an accomplished physician and consultant with over 6 years of experience. He is an ingenious writer, speaker, thinker and leader who specialises in areas of health and wellness. For his unique achievements and contributions in the field of medicine, he has been honoured with various prestigious awards. He has been relentlessly working towards awareness of preventive diseases.


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