THE DIABEE BLOG

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April 7, 2018 Diabetes Care0

Physical activity is one of the most important things you can do to live well with your diabetes. However, being active is not just about losing weight or running a marathon or spending hours in a gym in fact it’s an excellent way to stay fit and is an integral part of living a healthy lifestyle. Exercise, or physical activity, includes anything that gets you moving such as walking, swimming, dancing or gardening.

Regular Activity is important for everyone but is a key factor of managing diabetes and lower the risk of its complications along with proper meal planning, taking medications as prescribed, and stress management.

Health Benefits of Regular Physical Activity

When you are physically active, your muscles use up glucose as a source of energy and your cells become more sensitive to insulin so it can work more efficiently. This helps glucose from building up in your blood. So, exercising consistently can lower blood glucose and improve your A1C and reduce the need of your diabetes pills or insulin. Physical activity is also important for your wellbeing, and can help with many other health conditions like:

  • Lowers your risk for pre-diabetes, type 2 diabetes, heart disease, and stroke
  • Burns calories and help you to lose or maintain weight
  • Strengthens your heart and lowers blood pressure and cholesterol
  • Improves your blood circulation especially in peripheral areas like arms and feet
  • Strengthens and tone your muscles and reduce aches and pains
  • Helps to preserve bone mass and keeps your joints flexible
  • Improves your posture and a balance to prevent falls
  • Helps to improve quality of sleep and energy levels
  • Reduces stress and improves overall quality of life

However, getting Started and staying motivated to exercise program can seem challenging, especially when you are getting back into a workout routine or starting exercise for the first time. Everyone’s physical abilities and schedules are different; choose the best ways to fit physical activity into your daily life—whether it’s walking to work, doing chair exercises or working out at the gym.

Once you get that momentum going, you’ll feel better, have more energy, and more likely to stick with it and can reap tons of health benefits.


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April 3, 2018 Diabetes Care0

We all know that for effectively managing diabetes the first step is to limit your sugar intake. But, only controlling sugar does not help in controlling its progress in our body. Eating healthy and doing exercise is just not enough if one has diabetes. One needs to adopt a holistic approach in counteracting this disease.

Firstly, one needs to get their ABCs right, which imply managing your ‘A’ for HbA1c, ‘B’ for Blood Pressure, ‘C’ for Cholesterol, and ‘s’ for stopping the habit of smoking. Strive for the following (recommended by American Diabetes Association guidelines, 2017)

Type of measure Reading
Hb1Ac HB1Ac: Under 7.0

% Glucose levels of 70-130 mg/dl before meals and <180 mb/dl after meals

Blood pressure (BP) Systolic BP- 140 mmHg; Diastolic BP – 90 mmHg
Cholesterol HDL level < 35 mg/dL (0.90 mmol/L)

Triglyceride level >250 mg/dL (2.82 mmol/L)

Stop Smoking Studies indicate that diabetic smokers were at ~1.5 times more risk of clogged arteries, heart failure, & reduced blood flow to limbs, to non-smoker diabetics

(Consult your healthcare provider to find out what applies to your specific condition)

Many a times, your doctor may advise a few medications to keep all the above under check. Remember, it is foremost important for you to take those medicines as prescribed without any fail, as these are designed to ensure that your diabetes and linked diseases do not go out of control.

Once, ABCs are in line, focus on other aspects of your life, with a few of them as mentioned under:

  • Limit your alcohol intake: Drinking too much alcohol can lead to dangerously low blood glucose levels as well as side effects when mixed with diabetes medication. It’s always better to entirely give it up. even in situations where you can’t avoid it moderation is a must.

    This implies not more than one drink a day for women or two drinks a day for men. One drink refers to 350 ml beer or 240 ml malt liquor or 150 ml wine or 44ml of a hard liquor (vodka, gin, whiskey).

  • Manage your stress levels: Under stress, one’s body tends to release extra glucose to cope up with the cause of stress, which worsens your diabetic control. Various studies indicate that diabetics are less able to bring their blood pressure, heart rate and cholesterol levels back to normal after a stressful test, compared to otherwise healthy comparable adult.

    Hence, it important to de-stress yourself by either meditation, or picking up a hobby or joining a support group.

  • Ensure a good night’s sleep: Often, lack of good sleep can prove damaging for your diabetes as enough sleep helps body to de-stress, heal and repair itself. Additionally, sleep deprivation is linked with raised levels of Cortisol hormone which triggers insulin resistance.

    In case you are facing difficulty in sleeping try to relax yourself before going to bed. Don’t watch loud or disturbing TV or movies in the evening or in bed. Make sure your room is a comfortable temperature and is protected from light and noises as much as possible. Further, you can talk to your healthcare provider to find a solution for your sleep trouble.

Adopting such simple measures would not only help you manage your diabetes better but would also help you to lead a healthier and longer life. Remember, eating a proper diet and regular exercising would be more effective for controlling your diabetic condition only when all the above are also observed.


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March 31, 2018 Diabetes Care0

Diabetes is one of the most talked about diseases across the world and especially in India. With the country having the highest number of diabetic population in the world, the sweet disease is posing an enormous health problem to our country today. Often known as the diabetes capital of the world, India has been witnessing an alarming rise in incidence of diabetes. According to WHO fact sheet and International Diabetes Federation (IDF) Atlas 2015 on diabetes, India had 69.2 million people living with diabetes (8.7%) which are expected to rise to 123.5 million by 2040 unless urgent preventive steps are taken.

If we put simply, diabetes is a condition that affect how your body uses blood sugar (glucose). Anyone who has diabetes, no matter what type, means blood glucose levels are above normal, although the causes may differ. Normally, the food we eat is turned into glucose, or sugar, which is vital to your health because it’s an important source of energy for your body and brain.  The pancreas, an organ that lies near the stomach, makes a hormone called insulin that helps glucose get into the cells of our bodies, where it can be used for energy.

When someone has diabetes, the body either doesn’t make enough insulin or can’t utilize its own insulin as effectively as possible. This causes sugar to build up in the blood which may further lead to serious health problems.

Let’s understand the different types of diabetes

Pre-diabetes – According to some recent stats from Centres for Disease Control and Prevention (CDC) over 1 in 3 adults have prediabetes and shockingly 90% don’t even know it. You can have prediabetes for years but have no clear symptoms, so it often goes undetected until serious health problems show up. Pre-diabetes is a transition between normality and diabetes. It means that it is a condition in which blood glucose levels are higher than normal but not high enough to be diagnosed as type 2 diabetes. People with pre-diabetes are at high risk of progressing to type 2 diabetes, although this is not inevitable. However, it’s real and common. But the good news is that it is reversible, by making lifestyle changes (like exercising daily, losing weight and eating balanced meals) many people with pre-diabetes delay or even prevent developing diabetes. Most importantly, without intervention, 15-30 % of people with prediabetes will develop Type 2 diabetes within the next five years.

Type 1 diabetes – Type 1 diabetes account for about 5% of all cases of diabetes. It is an auto-immune condition occurs when insulin-making cells in pancreas are destroyed by the body. So, in people with type 1 diabetes, the body does not produce insulin that’s why the body requires lifelong insulin injections for life. People with type 1 diabetes are usually thin and are in normal weight range. It typically develops in children and young adults, although cases are also seen in later years of life.

Type 2 diabetes – Type 2 diabetes is the most common kind of diabetes, accounting for 90% to 95% of total diabetic population. It occurs when the body does not make enough insulin or cannot effectively use the insulin it has produced. It usually develops in adults over the age of 45 years but is increasingly occurring in younger age groups also. It’s believed that genetic and lifestyle factors like obesity, unhealthy eating habits and physical inactivity etc. play a role in the development of type 2 diabetes. It is initially treated with lifestyle changes like healthy diet and increased physical activity but medication and/or insulin are often required.

Gestational Diabetes – According to analysis by the CDC about 9.2% of pregnant women develops gestation diabetes. It refers to high blood sugar levels during pregnancy. A diagnosis of gestational diabetes doesn’t mean that you had diabetes before you conceived, or that you will have diabetes after giving birth. It’s a temporary condition and usually goes away after the birth of the baby. However, women with gestational diabetes are 7 times higher risk of developing type 2 diabetes 5 to 10 years after delivery. Gestational diabetes is often managed with a specific meal plan, lifestyle changes and may also require insulin.

Other types of Diabetes – One of uncommon type of diabetes called Latent Autoimmune Diabetes in Adults (LADA) which is referred as type 1.5 diabetes. This is not an official term but it does illustrate the fact that LADA is a form of type 1 diabetes that develops later into adulthood and shares some characteristics with type 2 diabetes. As a form of type 1 diabetes, LADA is an autoimmune disease in which the body’s immune system attacks and kills off insulin producing cells.

LADA can often be mistaken for type 2 diabetes as it develops usually in adults over a period of years whereas type 1 diabetes tends to develop quickly in days or months, usually seen in children or younger adults. About 15% to 20% of people diagnosed with type 2 diabetes in fact have LADA.

Genetic defects of insulin producing B-cell function or insulin processing or action may also cause some rare hereditary form of diabetes. In some cases, defects or diseases related to pancreas like inflammation, infection, stones, cyst or tumour in pancreas can also trigger to secondary form of diabetes. At times, in specific cases certain viral infections, chemicals or drugs may also lead to diabetes.

Although diabetes has no cure, yet by knowing early symptoms and causes you can assess your risk and take preventive steps to manage your diabetes and stay healthy.


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March 29, 2018 Diabetes Care0

Mr. Dua is a 55 years old employee working in a company. One day while coming to office, suddenly he felt dizzy and disoriented in the parking lot. He was shaking, sweating and was totally confused. He didn’t know what to do and almost passed out on the floor. Fortunately, a colleague from office was passing by and saw in this condition. He approached to him immediately and asked what is happening? All Mr. Dua could able to speak was “juice” by pointing out on his car. The colleague took keys from him, opened the car and gave him a tetra pack of juice instantly. Within a span on 10-15 minutes he started feeling alright.  After gaining his full conscious back, he thanked his colleague for his help. After reaching office first he went to the medical room, where the nurse checked his blood sugars which were in normal range till then. She asked him to eat a snack or meal, so that his blood sugars won’t fall again.

That day Mr. Dua had realised hypoglycaemia could really be dangerous, if appropriate action is not taken on time. Just Imagine, what would happen if this incident happens while driving car or he didn’t know how to treat it? Scary thought, isn’t it…? A lot of people with diabetes could relate to these symptoms or even incident. Sometimes the cause of hypoglycaemia is obvious or known, either it is inappropriate dose of your insulin or certain diabetes medications, inadequate food, delayed or missed meal, extra physical activity, illness, or consumption of alcohol without food. Other times, it seems just creep up for no apparent reason. So, here are some practical tips which will help you to tackle hypoglycaemia better.

Steps to deal with Hypoglycaemia

Know the symptoms: Low blood glucose brings on very uncomfortable feelings. Symptoms of hypoglycaemia may differ from individual to individual. That’s why it’s important that you learn your own signs and symptoms when your blood glucose is low. However, in mild or early stages of hypoglycaemia you may feel all, some or in some cases none of these signs and symptoms e.g. sweating, shaking, fast heart-beat, dizziness, anxiety, hunger, blurred vision, weakness, headache, tingling or numbness.

Look for support: If you are at home then as soon as you feel symptoms, grab attention of the family members. At office also, keep your colleagues informed about your condition and symptoms. Hypoglycaemia if not treated on time, may lead to confusion, mood changes, poor coordination, slurred speech etc. And, if the blood glucose continues to fall, you may pass out or even develop convulsions or fits. Always keep or wear a medical ID which says you are diabetic, have contact number of your healthcare provider and instructions about what to do in case of any emergency.

Confirm by testing: Check your blood sugar level with glucose meter whenever possible. In some cases when blood sugar levels fall suddenly, say from 250 mg/dl to 120 mg/dl, people may still feel some symptoms of low blood sugar reaction, even if blood sugars are not clinically low. By checking blood sugars, you can be sure. A reading less than 70 mg/dl confirms hypoglycaemia. If you do not have glucometer with you or symptoms are severe then treat it just to be safe.

Treat it Immediately: Hypoglycaemia needs to be corrected immediately. You can eat or drink 15 grams of fast acting carbs. Some of the examples include:

  • 3–4 glucose tablets or glucose candy
  • 15-gm or 1 tablespoon of sugar or glucose powder or gel
  • 1/2 cup fruit juice
  • 1/2 cup regular soda

It is important to wait for 15-20 minutes. It takes 15 minutes for the blood sugars to come within normal range. Make sure! You TREAT but don’t OVER-TREAT. Check your blood glucose again after 15 minutes and if your blood glucose level is still low (<70 mg/dl), or if you still have symptoms, treat it again. As blood glucose tends to drop even after treatment. That is why all treatment for hypoglycaemia should be followed by the next meal or snack.

Seek Immediate Medical Attention: If your body doesn’t respond to carbs or you suffer seizure or fits episode or fall unconscious, seek immediate medical attention. Your family member or colleague at workplace should be able to move you to nearest hospital. You might require Intravenous glucose and/or glucagon injection which can be given in emergency or casualty department of tertiary level hospital.

Prevention is always better than cure: If you are getting frequent hypoglycaemic episodes, consult with your diabetes doctor for adjusting medicine or insulin dosage according to your lifestyle. Take precautionary measures to combat further similar episode in future.

Some quick tips to prevent hypoglycaemia are:

  • Always eat on time, don’t delay or skip your meals
  • Take your prescribed medications or insulin as advised
  • Always be prepared for emergencies and keep quick-acting carbs handy
  • If there is change in your usual routine then monitor your sugars more frequently
  • Avoid taking alcohol and if you do then limit your intake. Avoid drinking without food
  • Learn and record what triggers hypoglycaemia in your case and keep your doctor informed.

 

For more information talk to your health care provider.


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March 26, 2018 Diabetes Care0

Whenever someone is diagnosed with diabetes, they are often asked to check their blood sugars at home with glucose meter. Do you ever wonder why…? Blood glucose checking or often called “Self-Monitoring of Blood Glucose (SMBG)”. It is one of the most important thing you can do to take charge of your own health. It is a tool that not only helps to record and track your blood glucose readings but also plays a vital role in diabetes management but also lower the risk of complications.

Self-Monitoring: How It Helps…?

  • Determine if you have a high, low or in range blood glucose level at a given time;
  • Show how your food, exercise and medication affect your blood glucose levels; and
  • Help you and your diabetes care team to make informed decisions about any change in lifestyle and treatment regimen

If we see today, the days are gone when people had to run to labs for testing blood sugar levels. With the advancement of science and technology, handy glucose meters have come up that can provide accurate blood sugar test result within seconds. These meters are quite convenient, that checking can be done just about anywhere and at any time-point.

Glucose Meter – How to Choose the Right One?

Your healthcare provider will help you to choose the meter which is best for you.  However, some important features to consider while selecting a blood glucose meter are:

  • Cost of supplies and insurance coverage
  • Fast results and small blood sample size
  • Ease of use, display and maintenance
  • Availability of test strips and other supplies
  • Memory to store your readings and easy retrieval
  • Customer support facility

Glucose Meter – Supplies you need

The supplies which are often used with meter for checking blood sugars are given below

  • Blood glucose meter – that reads and display your sugar reading
  • Test strip – it collects blood sample after you insert in the meter
  • Lancet – a small needle fits into a device which use to prick finger to obtain a drop of blood
  • Lancing device – a device which holds a lancet
  • Alcohol wipes or soap and water – to clean the testing site
  • Log-book – a tabulate format to record your readings and comments
  • User Manual – which provides all the information about your meter and supplies
  • Control solution – solution used instead of blood drop to check accuracy of meter
  • Sharp container – hard and puncture proof container with a tight lid to collect used needles

Glucose Meter – Steps of Checking

Checking your blood glucose is a simple process using a lancing device, lancet, test strip and a meter. Your diabetes educator or healthcare provider will teach you how to use it and how to record your results. The following are general instructions for using a blood glucose meter.

  1. Wash your hands with soap and dry them well. In case you use an alcohol swab, let the area dry completely before testing.
  2. Prepare a lancing device by inserting a new needle and load it for pricking.
  3. Take out one test strip and close the container tightly to avoid any contamination of other strips from dirt or moisture.
  4. Prick the side of your fingertip with the lancet and gently squeeze a drop of blood.
  5. Collect a drop of blood on the test strip. Make sure you have an adequate amount to cover the area entirely.
  6. Wait for results on the display and record your reading in log-book with your comments.
  7. Dispose of the strips and lancets properly into a sharp container.

What do the result Mean?

Recording your blood sugar results is very important. When you finish the blood glucose check, write down your results. It will help you and your doctor to review how food, activity, change in routine and stress affect your blood glucose levels. Make sure to take your record or log-book with you on each visit to your doctor or diabetes educator.

Your healthcare provider will work with you to decide the blood glucose goals that are right for you. The following table provides general recommended target blood glucose ranges and shows when you should act to get your blood glucose back on track.

ADA RECOMMENDED TARGETS FOR BLOOD GLUCOSE CONTROL IN ADULTS WITH DIABETES
  Normal Target When to Take Action
Plasma Glucose
Fasting/Pre-meals < 100 80 to 130 If < 80 or >130
2 hours after eating < 140 < 180 If < 110 or > 180
*Reference – Standard of Medical Care in Diabetes; American Diabetes Association (ADA) 2018

Take a close look at your blood glucose record to see if your level is too high or too low several days in a row at about the same time. If your pattern is consistent, it might be time to change your treatment plan. So, you need to work closely with your doctor or diabetes educator to learn what your results mean for you and how to manage them if they are out of range.

Self-monitoring – Things to REMEMBER…!

  • Testing area should be clean and dry. Use different sites each time to prevent soreness.
  • Prick side of fingertip and squeeze gently from base to tip to obtain sufficient blood drop.
  • Change the lancets frequently, reused lancets will be blunt and hurt more.
  • The meter should be clean and coded properly. Calibrate it periodically to check accuracy.
  • The strips should not be outdated, or left open; as it will give false results.
  • Maintain a proper record of your readings with your comments of anything unusual.

Self-monitoring of Blood Glucose (SMBG) is YOUR best friend for better diabetes management. As the power to control is in YOUR hands and you have the right to live a healthy life. After all, you are worth it…!!!


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