Type 1 diabetes – 5 Ways to Improve your Child’s Quality of Life

It doesn’t make one happy to see parents visiting a diabetologist after their child has exhibited symptoms of type 1 diabetes. They go through an emotional turmoil with the initial shock, and then the disbelief and fear.

It is the wish of every parent to see their child blossom in life, have a great childhood and a great future. However, as the diagnosis of type 1 diabetes is confirmed, there is a deep void that resonates with unpredictability and insecurity.

It is unfortunate that the child has to dabble with injections while the rest of the children enjoy carefree adolescence. But, this is the reality of type 1 diabetes and that’s not all that bad. Considering the latest research and advances in medical science, there has been a considerable improvement in the quality of life in type 1 diabetes patients.

Type 1 Diabetes and its Onset

Type 1 diabetes is an autoimmune condition in which the patient’s pancreas stops producing insulin. This happens due to the destruction of the insulin-producing cells. The beta cells that store and release insulin are destroyed by the immune system of the body.

This results in the patient having diabetes type 1 symptoms like:

High blood glucose levels.
Sudden weight loss.
Excessive urination; increased thirst.
Sudden changes in vision.
Fatigue/Lethargy.

Life with Type 1 Diabetes

Though type 1 diabetes can be a life threatening condition, recent advances in medical science has made it possible for patients to enjoy a much better quality of life than before.

Still, life with type 1 diabetes can be peculiar with regular finger sticks to monitor blood sugar levels, going for insulin injections or pumps, maintaining a strict diet regimen, and having measured physical activity.

All this not only needs a lot of discipline, it needs a decent degree of mental strength and morale along with a bulldog spirit.

Thankfully, along with medical advances, it has been understood that it is very important to understand the psychological implications of the disease condition. This has resulted in numerous support groups that offer solace and encourage patients to fight.

Quality of Life and Type 1 Diabetes

However, the cornerstone to improve the quality of life and increase the lifespan of a patient with type 1 diabetes is to insure compliance with treatment and get periodical evaluations for eliminating the risks of complications.

Here are 5 essential things to do to improve the quality of life of a patient with type 1 diabetes

Since most early deaths in patients with type 1 diabetes occur due to strokes and heart diseases, it is vital to consult a cardiologist periodically and keep the heart parameters in control.
Yes, type 1 diabetes is a demanding disease, but one can get good rewards if the children are taught to be aware of the condition – when did they eat last? How do they feel? When to take their insulin shots? This reduces the risks of hypoglycemia, hyperglycemia, and ketoacidosis.
When it comes to general health, mental health, and vitality, good glycemic control with multiple doses of insulin certainly elevates functional abilities. So, the takeaway is maintain normal HbA1c for better life.
It is all about support. It has been found in various researches that diabetic children have better mental and physical health, functional abilities, and better psychosocial abilities when they have generous support from family, friends, and other groups.
For a better life expectancy, it is very important that children with type 1 diabetes be taught the importance of medication compliance as metabolic and physical factors can vastly influence future complications including heart, kidney, nerve, and eye damage. This can lead to hospitalization and the way out is outstanding glycemic control.

As such childhood and adolescence are turbulent times. Add diabetes to that, and it can be an unusually demanding task. So, for a good quality of life for the diabetic children, it is important that they have awareness regarding the symptoms of type 1 diabetes. Apart from that, support and encouragement from the family helps them manage diabetes and live long.

Is gestational diabetes permanent?

Is gestational diabetes permanent?

Ridhima was inconsolable. She got pregnant for the first at the age of 32 after years of trying. But, something was not right. During her 27th week of pregnancy, she started experiencing the symptoms of gestational diabetes. Upon further investigation, she tested positive.

Thanks to the support of her mother and husband, Ridhima could deliver a normal child, but she still couldn’t accept the fact that gestational diabetes was temporary!

Gestational Diabetes & Advanced maternal age

In a recent study done, it was found out that women who attempt pregnancy at a later age are more prone to have gestational diabetes along with women who are obese and who smoke.

This is certainly a cause of concern as more working women prefer pregnancy at a later age and an advanced maternal age is linked to gestational diabetes.

Gestational diabetes increases the risk of macrosomia (high birth weight), stillbirths, respiratory distress syndrome, and the risk of the child getting diabetes later in life.  

Treatment of Gestational Diabetes

Gestational diabetes is generally managed with diet and exercise and only in some cases needs oral medications or insulin.

Myths of Gestational diabetes

For many pregnant women, gestational diabetes mellitus (GDM) is still an enigma that cannot be understood. That’s why people have so many misconceptions regarding GDM.

  • GDM is rare: Gestational diabetes is becoming an increasingly common condition among Indians.
  • GDM can be managed completely with diet and exercise:  Though many GDM cases can be managed with diet and exercise, it needs the supervision of a diabetologist. In some cases, medications are needed.
  • Having GDM is a sign of ill health: A woman can have GDM if she has a family history of diabetes, if she is obese, and above 30 years.
  • With GDM, the risk of a birth defect is imminent: This is not necessary as proper management reduces the risks considerably.
  • GDM comes with clear symptoms: For most women, GDM is confirmed only after testing and they might not experience any symptoms.

To top all these myths, many women believe that gestational diabetes is permanent! This is incorrect.

Yes. Gestational diabetes certainly increases the risk of having type 2 diabetes later in life. But after delivery, the blood glucose levels of women with gestational diabetes comes back to the normal ranges.  

Finally, if you are planning pregnancy at an advanced maternal age, it is advisable that you don’t wait for the symptoms of gestational diabetes. Make it a point to talk to your doctor and get yourself tested.

Compliance to Diabetes Treatment

Importance of  Compliance in Diabetes Treatment

The term ‘compliance’ refers to how much a person’s behavior or habits are aligned with the medical advice prescribed or suggested. It covers everything from eating right, exercising for X hours per week, getting your lab tests often, and testing your sugar frequently. For successful diabetes management, it is essential that you not merely comply with drug management but also to lifestyle interventions such as diet and exercise, and timely evaluation for diabetes related complications.

Being compliant does generally result in lower chances of diabetic complications, but unfortunately, studies have shown that close to 80% diabetics are non-compliant!

There are several things that enable a diabetic person’s compliance with his therapy. That includes the patient’s interaction with the diabetes doctor, their own level of awareness, ability to follow diet and exercise regimens, ease of access to clinic or healthcare provider and recording and keeping track of follow-up appointments.

Availability of a diabetes educator at the clinic can address some of the above factors, and enhance the compliance levels of the patients, consequently leading to a significant reduction in the chances of a diabetic developing the various complications.

Apollo Sugar’s unique patient engagement model has proven better compliance and lead to proven results in reducing the HbA1c levels in diabetes patients by 15% to bring it under control.

 

Treatment of Diabetes

Care & Treatment for Diabetes – Management of your Diabetes

Even though there are different types of diabetes, the primary focus of any diabetes treatment is to bring the blood sugar level close to the normal range using a combination of interventions addressing:

  • Lifestyle – diet and exercise
  • Medication
  • Self-monitoring of glucose

Diabetes TreatmentOverall, achieving and maintaining a normal sugar level will help a diabetic not only prevent short term undesirable symptoms of diabetes but also reduce the risk for chronic complications of the eye, kidney, nerve and foot.

Type 1 Diabetes Treatment

As the type 1 diabetic condition occurs due to stopped insulin production, externally supplementing required amounts of insulin is the key treatment strategy.

diabetes treatment in hyderabad

Insulin is a protein that gets degraded due to the enzymes in our stomach if given by mouth, therefore, injection needs to be injected subcutaneously. An image of specific locations of the body where insulin can be injected is given side:

There are different kinds of insulin depending on their speed of action such as rapid acting, moderate-acting, and slow-acting insulin or their type of delivery device such syringes, pens, insulin pumps etc. Diabetes Specialists will suggest the appropriate type and dose of insulin to inject that is determined by multiple factors.

The other important treatment factors for type 1 diabetes are:

  • Ensuring regular monitoring of glucose levels throughout the day, at least four or more times, as suggested by the doctor
  • Having a balanced diet spreading the carbohydrate intake throughout the day
  • Regular physical activity with an eye on how the blood sugars respond to exercise, to avoid hypo or hyper glycaemia
  • Getting examined for the complications of eye, kidney and, heart, nerve diseases and dental problems as suggested by your doctor
  • Avoid smoking and drinking alcohol

Type 2 Diabetes Treatment

When a person is newly diagnosed with type 2 diabetes, a slow progressing disease, the treatment aims to address two issues-

  • Bringing the blood sugar to normal and
  • Promptly evaluating and managing the complications of the kidney, eye, nerve and heart, which may already be present in some people

Initial step for type 2 diabetes management is to modify the lifestyle changes

  • Diet – keep it healthy and balanced
  • Losing excess weight
  • Regular physical activity

When the lifestyle measures are unable to control the blood sugar levels, diabetes medication may be advised by the doctor, including any of the following options:

  • Lifestyle modification + anti-diabetic pill
  • Lifestyle modification + more than one of same anti-diabetic pill
  • Lifestyle modification + two or more types of anti-diabetic pills
  • Lifestyle modification + anti-diabetic pills + insulin injection

Other chief components for type 2 diabetes treatment are:

  • Checking the glucose and HbA1c levels every two to six months until the blood glucose level become stable on unchanging therapy, or at least twice a year
  • Getting examined for abnormal blood pressure at every visit; eye, kidney, heart, nerve and foot disease at least once a year; and going through dental cleaning and check-ups at least twice a year
  • Keeping cholesterol and blood pressure levels within normal range
  • Avoid smoking as it increases risk for other complications
  • Being regular and consistent with the medicines and lifestyle recommendations suggested for any other health problems
  • Taking appropriate care of foot and skin, as advised by the healthcare team

Gestational Diabetes Treatment

Gestational diabetes in a majority of cases could be successfully managed by regular physical activity and following the nutritional recommendations as suggested by the doctor. Some women may require medication management for effective blood sugar control.

Diabetes Complications: A stitch in time saves nine

“Reactive people are often affected by their physical environment. If the weather is good, they feel good. If it isn’t, it affects their attitude and their performance. Proactive people can carry their own weather with them.” -Stephen Covey

Apply this to Diabetes Management, and you already have the winning formula. Knowing how diabetes can affect you over the years and proactively managing it can help prevent the need to troubleshoot when complications crop up.

When you don’t do what is required to keep possible health problems at bay, it can have a taxing effect on health and break the bank!

So, let’s start off with a little insight on the flurry of complications that you can expect in diabetes and know how to tackle them:

Foot Trouble

Nerve damage and diabetic neuropathy can develop gradually over the years causing pain and a tingling sensation that keeps your feet from feeling anything. In this condition, the chances of developing infections from the most minor injuries are high. You may not realize until it has progressed to a more serious level.

In addition, it can also lower blood flow that severely hinders healing allowing the infection to continue unabated and warrant amputation. Charcot Foot and foot ulcers are other complications that can wreak havoc to your feet.

Caring for your feet is thus incredibly important and can spare you from some rather difficult times.

  • Keep a check on your feet from time to time.
  • Wash them and be gentle when you’re smoothening calluses or corns.
  • Keep your soft and comfy socks close.
  • Rotate your ankles and wiggle your toes to keep the blood flowing.
  • Make it a habit to see your Podiatrist and your diabetes doctor , even if you don’t see foot problems.

Eye Issues

Uncontrolled blood sugar levels can cause diabetic retinopathy, the eye complication of high glucose induced damage. It negatively impacts blood vessels in the retina. Left untreated, it can potentially lead to poor eyesight or even blindness.

If this has managed to awaken a sense of responsibility, take heart. Small steps go a long way in keeping your vision intact.

  • Lash out on high blood pressure as it can cloud the lens of your eye.
  • Have your blood lipids monitored regularly.
  • It’s not just your body that needs exercise. Your eyes do too. Talk to your diabetes doctor about which ones you can work with.
  • Put on those UV protection equipped shades when you walk out into the sun.
  • A dilated eye check-up annually, goes without saying, is extremely crucial.

Kidney Complications

Kidneys are technically waste filters that constitute small blood vessel networks aiding the process of disposing out the unnecessary. Diabetes can impair this system and put strain on the kidneys. As the strain increases, the chances of irreversible end-stage kidney disease or kidney failure are almost inevitable, leading to the need for dialysis or a kidney transplant.

Screening to check on issues related to kidney function is imperative. Testing for micro albumin in the urine annually, and monitoring diabetes by visiting a diabetes doctor. can help course correct and take action before disaster strikes.

Other Snags

The above were only a few of the many microvascular complications that arise out of poor diabetes management . Macrovascular complications manifest in the brain, heart, and blood vessels. Stroke, heart attack, and coronary artery disease are some of the long-term problems that come with bad diabetes management.

Making heart-healthy choices by staying away from smoking, keeping a tab on cholesterol, following an exercise regimen and the doctor’s instructions reduces risk significantly.

If you can reverse and arrest complications that are born out of diabetes, #WhyWait? Grab the reins of diabetes management ! Don’t let complications reduce your quality of life.

Choose to make small changes. Exchange cheese-loaded pizzas, oily paratha’s, and sugary drinks for fresh greens, fruits, vegetables, and nuts. Put in that little extra effort to walk around for a bit. Vigilantly track and keep blood glucose levels in control with timely medication.

WARNING! By reading this you might know how to improve your blood sugar levels!

diabetes control

(This is a three-part series with insights to live free with diabetes)

Part – I

Shockingly Simple Ways to Control Your Blood Sugar Levels

Diabetes control in a nut shell:

1. Eat more whole grains, legumes, and low-fat dairy.
2. Eat fiber-rich foods.
3. Eat avocados, almonds, walnuts, and olives.
4. Eat foods rich in chromium and magnesium.
5. Drink apple cider vinegar.
6. Use cinnamon in cooking.
7. Restrict sodium intake to 1500 mg per day.
8. Reduce Weight.
9. Quit Smoking.
10. Maintain Blood Pressure at 130/80.
11. Never miss out on medications.
12. Get more than 150 minutes of walking per week.
13. Maintain your cholesterol levels at the target levels.
14. Get periodical medical checkups.
15. Wear diabetic footwear.

*Extra: See below for 20 foods that help you with diabetes control!

For a person newly diagnosed with diabetes, life revolves around three diagnostic tests – fasting blood sugar test, postprandial blood sugar test, and HbA1c. But more than anything else, the disbelief of being diagnosed with diabetes is all consuming. It jolts a person and might take some time to accept the fact.

You never know how strong you are!

It is at this time that you really need the support of your family and friends. Grief, sadness, fear of death, confusion, stress, frustration, and questions like “Why me?” tend to overwhelm most people. You are not alone.

Though it is easier said than done, ruminating, getting depressed, or browsing the internet and getting alarmed does not help!

Talk to your doctor, talk to your family and take some time to digest the fact. Diabetes can be managed with diet, exercise, and medication. Of course, it does need a good bit of mental strength!

Diabetes Management Guidelines

Diabetes caregivers including endocrinologists, diabetes educators, and clinical nutritionists provide diabetes care that emphasizes on the following principles:

• Education of the disease condition, its symptoms, its complications and treatment.
• Periodical medical evaluation including complication screening.This includes evaluating and avoiding risk of cardiovascular diseases, kidney diseases, retinopathy, neuropathy, and foot damage.
• Lifestyle management including cessation of smoking, weight control, dietary control, exercise, adherence to treatment plan, and self-monitoring of blood glucose levels.
• Reaching target glycemic levels (fasting blood sugar level, postprandial level, & HbA1c level).
• Coping up with emergencies like hypoglycemia, illnesses, stress, and surgeries.

What you need to do

After having understood the fact that you have diabetes, the first step is to consult a competent diabetologist, and get a robust treatment plan. But in the case of diabetes, this treatment would work only with your active participation. You need to do certain things for optimum diabetes control and to lead an active life.

• Frequent self-monitoring of blood glucose levels (as per doctor’s advice). It is important for type 1 diabetes patients to check their blood sugar levels at 3: 00 AM.
• Maintain your diabetes diet chart. Ensure that your meal consists of complex carbohydrates (55- 65%), vegetables, and protein (not more than 15%). The diet should also contain a balance of mono and polysaturated fats.
• Restrict your sodium (salt)intake to 1500 milligrams per day.
• Exercise for at least 30 minutes per day. Physical activity is very important to maintain diabetes control. Get more than 150 minutes per week of moderate intensity aerobic activity. Get cardiac assessment before physical activity.
• Stick to your medications. Never miss out even on a single dose of medication.
• Quit smoking. Smoking has devastating consequences along with diabetes.
• Manage your cholesterol levels.
• Keep your blood pressure under control.
• Target fasting blood sugar level: 80 to 130 mg/dL (the exact target shall be determined by your diabetes doctor).
• Target postprandial blood sugar level: Less than 180 mg/dL (the exact target shall be determined by your diabetes doctor).
• Target HbA1c level: Less than 7% (the exact target shall be determined by your diabetes doctor).

Understanding and Managing Hypoglycemia:

Hypoglycemia is a condition when the blood sugar levels are low. Hypoglycemia can be mild and severe. It occurs due to a miscalculation of an insulin dosage, reduced food intake, skipping a meal, increased physical activity, alcohol consumption, or by adopting a low carbohydrate diet.

Mild low blood sugar symptoms

• Sudden hunger.
• Trembling.
• Rapid heartbeat.
• Pale skin.
• Poor coordination.
• Numbness in mouth or lips.
• Confusion or irritability.
• Blurred vision.

Hypoglycemia requires immediate and prompt treatment. The rule of “15” is a good bet to treat low blood sugar levels. If your sugar levels are below 70 mg/dL, consume 15 grams of carbohydrates and wait for 15 minutes. Measure your blood glucose levels again. If they are still below 70 mg/dL, consume 15 grams of carbohydrates again and wait for 15 minutes. Measure blood glucose levels again.

If your blood glucose levels are still lower than 70 mg/dL, repeat the steps and this time measure after one hour. If the symptoms do not subside, consult your nearest doctor.

Severe low blood sugar symptoms

• Confusion.
• Becoming argumentative.
• Extreme tiredness.
• Seizures or convulsions.
• Unconsciousness.

In cases of severe hypoglycemia, if the person is conscious, the person should be given 20 grams of glucose tablets or 4 teaspoons of sugar (honey or syrup). In case the patient is unconscious, he/she should be given 1 mg of glucagon and should be transported to a hospital for emergency medical care.

20 Foods that help you with diabetes control

1. Garlic.
2. Spinach.
3. Chia Seeds.
4. Almonds and nuts.
5. Bitter Melon.
6. Bitter gourd.
7. Green Beans.
8. Carrots.
9. Snake gourd.
10. Sweet potato.
11. Dark leafy green vegetables.
12. Fish.
13. Kala Jamun (black plum).
14. Onions.
15. Guava
16. Pomegranate.
17. Papaya.
18. Apples.
19. Flaxseed.
20. Oats.

Now, just because these foods are good for people with diabetes it does not mean that you can consume them at will. The magic formula for diabetes control is control over portion sizes. Always eat foods in moderation!

Stay tuned for Part II: Sugar Hangover and Two Major Mistakes People with Diabetes Make

Comfortably Numb! Silent Heart Attacks in People with Type 2 Diabetes

Did you know? About 50% of heart attacks are mistaken for acidity or other less serious problems

SNEAK PEEK:

1. Diabetes & heart diseases are the biggest killers in India.
2. People with diabetes are more prone to heart diseases.
3. People who have diabetes have high blood sugar levels, high triglycerides, and low HDL levels, which makes them prone to atherosclerosis.
4. People with diabetes are prone to silent heart attacks.
5. Silent heart attacks are heart attacks that are equally lethal.
6. Silent heart attacks come with less intense symptoms,but have same amount of heart muscle damage.
7. To prevent heart and cardiovascular diseases, diabetics have to reduce their triglyceride and low-density cholesterol levels, and increase their high-density cholesterol levels.
8. Maintain healthy diet.
9. Get regular exercise (more than 150 minutes per week).
10. Maintain blood pressure as advised by doctor.
11. Restrict sodium intake.
12. Manage stress.
13. Maintain blood glucose levels.
14. Get periodical medical examinations.
15. Stick to medical advice.

Special Heart healthy tips for diabetics

The World Heart Day is on September 29th and it is time to bare our heart! Though as a nation India is young at heart, we are faced with a huge burden of heart and cardiovascular diseases. It is estimated that India has witnessed an increase of around 59% in mortality from cardiovascular diseases and there is bad news for people with diabetes if they do not take precautionary measures. The mantra for people with diabetes is strict diabetes control!

Heart Diseases and India

There seems to be an affinity between heart diseases and India. And, it might be a shocker to many when we reveal the fact that more and more young Indians are falling prey to heart diseases in their prime. It is a fact that 50% of all heart attacks and cardiovascular diseases are occurring in people younger than 50 years of age!

Some of the reasons that leading cardiologists state are:

• Sedentary lifestyles without exercise.
• Poor dietary choices with junk food.
• Obesity.
• Smoking.
• Alcohol.
• Diabetes.

Unknown Heart Facts:As against popular belief, sneezing does not stop your heart. In fact, in a lifetime, the heart beats for more than 2.5 billion times!

Apparently, almost all these risk factors are avoidable! Yet, one of the most significant factors for cardiovascular diseases is diabetes. In fact, diabetes is guilty of causing another life-threatening but oft missed condition, the silent heart attack!

Eleven tips to keep heart disease at bay

1. Quit Smoking.
2. Maintain Blood Pressure.
3. Maintain Cholesterol levels.
4. Get more than 150 minutes of physical activity every week with some aerobic activity.
5. Manage Stress.
6. Manage Weight. Maintain healthy weight.
7. Control your blood sugar levels.
8. If you snore, check yourself for sleep apnea.
9. Get a healthy diet with plenty of fiber, vegetables, whole grains, fruits, and fats with omega-3 fatty acids.
10. Assess yourself for peripheral artery disease (PAD) periodically.
11. Know about the warning signs of heart attack and get immediate medical help.

Diabetes, the Stealthy Killer

Diabetes Mellitus, we all know that this condition causes the glucose levels to rise in the blood and makes us sick. Well, that is the level of awareness most people have. But, some of you might be aware that there are certain complications of diabetes like diabetic nephropathy, diabetic neuropathy, and diabetic retinopathy. You might also be aware that diabetes can affect your kidneys due to excess blood glucose levels and damage your kidneys, but did you ever wonder that diabetes can cause heart diseases?

Yes, you heard that right! Diabetes is one of the leading risk factors for heart diseases and it causes a heart attack which you might not even be aware of!

Unknown Heart Facts: Your feet might give you signals of a future heart attack! If your shoe size steps up a notch, your body might be retaining water. This is a cardiovascular redflag!

The Metabolic Dual Effect – Cholesterol and Blood Glucose

Sometimes trouble comes in pairs
This is very true in the case of people with diabetes. As a variable metabolic disorder, diabetes mellitus does more to the body apart from increasing blood glucose levels. Glucose and lipid metabolism are closely linked to each other and diabetes leads to a condition called diabetic dyslipidemia. This condition is characterized by a marked increase in the levels of triglycerides, which is a high risk for heart disease.

The heart of the matter is that when a person develops insulin resistance, the method in which cholesterol is synthesized changes. This is in fact irrespective of the factwhether the person is overweight or not!

There is a strange relationship between fasting blood sugar levels, postprandial levels, triglycerides, and high-density cholesterol in people with diabetes. The general pattern is that all these levels are elevated except for high-density cholesterol levels, which tends to be very low.

This happens as a result of a barrage of free fatty acids that are released from the peripheral tissues. When these free fatty acids flood the liver, there is an increased production of triglyceride-rich lipoprotein, which results in hypertriglyceridemia.

This is not the end! Hypertriglyceridemia in turn leads to many chain reactions leading tolow levels high-density cholesterol. Increased triglycerides and low-density cholesterols lead to atherosclerosis and numerous cardiovascular diseases like peripheral artery diseases and can lead to heart attacks.

Insulin resistance and its mechanismsnot only increase the production of very low-density lipoproteins (VLDL) from the liver, it also assists the production and storage of triglycerides in the adipocytes (fat cells present in the adipose tissue).

Apart from the lipids that flow into the body from the liver, the stomach also contributes its might to the buildup of cholesterol in people with diabetes leading to the increased risk of heart diseases.

Diabetes and Atherosclerosis :

Atherosclerosis: It is a disease in which oxygen carrying arteries have a buildup of plaque. Plaque consists of cholesterol, fat and calcium. Atherosclerosis leads to heart attack, and stroke.

We all know that hypertension, obesity, and smoking as leading causes for heart diseases, but we do not know that diabetes is a cause for heart diseases. We have just seen the link between high triglyceride levels and diabetes and now let us see the connection between diabetes and atherosclerosis.

It is with a heavy heart that one has to say that the relation between high blood sugar levels, high triglyceride levels, and low HDL levels has a big say in the incidence of heart diseases. And, not only is high triglyceride level a risk factor, low HDL level is also high risk factor for the development of heart diseases.

This unholy triad of high blood sugar levels, high triglyceride levels, and low HDL levels are responsible for a host of conditions like pancreatitis, and atherosclerosis. The take home point for people with diabetes is to maintain a strict diabetes control, one that focuses on fasting sugar levels, postprandial levels, and HbA1c levels.
Of note, it is very important to maintain the postprandial triglyceride and blood sugar levels as abnormal lipid metabolism post meals is known to cause increased production of very low-density lipoproteins (VLDL) from the liver.
Unknown Heart Facts:The pressure a heart generates is so strong that it is enough to squirt blood thirty feet across.

The Silent Heart Attack

We are all aware of the classic symptoms of heart attack – The perspiration, the squeezing pain on the left side, and pressure sensation. Now, brace yourself to have your heart in your mouth! For people with diabetes, heart attack occurs and you would not even know about it!

Known as silent myocardial infarctions, these occur with symptoms less intense than regular heart attacks and can be fatal! These can happen when one is feeling fatigue, physical discomfort, or throat pain and is often confused as gastric problem or reflux disease.

This might alarm you as it is normal to have discomfort or heartburn due to indigestion, but it is vital to note the difference for a person with diabetes. As such, a person with diabetes suffers a lot of diabetes complications involving the blood vessels and added to it the unholy triad mentioned above increases the risk of a silent heart attack in people with diabetes further.

Added to all these risk factors, nerve damage that occurs in people with diabetes can aggravate the situation. Known as diabetic neuropathy, this condition can diminish the sensation of pain felt during a heart attack making a person feel like he/she is having a bout of indigestion rather than a heart attack.

Who is at risk of a silent heart attack?

• Smokers.
• People with high cholesterol.
• People with high blood pressure.
• Diabetics.
• People with overweight.
• Age.
• Physically Inactive.

Here are a few symptoms you need to watch out for in case of a silent heart attack:

• Discomfort in chest (center) for several minutes.
• Discomfort in the upper body (arms, back, neck, jaw, stomach).
• Shortness of breath during discomfort.
• Sweating.
• Lightheadedness.

These silent heart attacks, if not fatal, damage the heart muscles. In fact, they can be so mild that they can be brushed off as indigestion or heartburn. So, if you are in doubt, get an ECG or ask your doctor for a blood test (troponin T, a molecular footprint that is released after heart muscle damage).
If you have diabetes, there is no need to be heartbroken with these risk factors. There are ways you can protect your heart and it starts with good blood sugar control. Here are other tips you can follow to give you a heart of gold!

• Reduce abdominal fat.
• Maintain your blood pressure.
• Maintain your blood glucose levels.
• Maintain fasting, postprandial, and HbA1cat target levels.
• Reduce stress.
• Consume antioxidant-rich diet.
• Eat foods with soluble fiber.
• Eat fish instead of poultry and red meat.
• Make sure you laugh daily.
• Do yoga.
• Reduce intake of salt.
• Stay physically active.
• Eat dark chocolate (only occasionally).
• Eat nuts for snacks.
• Reduce caffeine-containing products and opt for green tea.
• Improve your sexual life.

Perplexing and Unexplained Blood Sugar Level Fluctuations

Attaining normal glucose levels is like a pilgrimage for every person with diabetes. But like the stock market or a rollercoaster ride, blood sugar levels never remain the same and have an uncanny knack of fluctuating throughout the day.

Fasting sugar levels are different from postprandial levels and added to that, people with diabetes tend to have unexplained blood sugar level fluctuations leading to unnecessary low sugar levels (hypoglycemia) and high sugar levels (hyperglycemia).

For many diabetics, this is perplexing and disappointing.Despite all the efforts, their sugar levels never seem to stay put at a single level!

Why do blood sugar levels fluctuate?

It is a fact that even in non-diabetic people, blood sugar levels fluctuate throughout the day. Factors affecting the fluctuation of blood sugar levels include diet (what you eat, how much you eat,&time since last meal),your activity levels, stress, diseases, illness, infection, changing seasons, and a variety of reasons can cause fluctuations in blood sugar levels.

Normal Blood Sugar Fluctuation Range

In non-diabetic people, the fluctuations of blood sugar levels are narrow despite long hours of fasting or after feasting. This is because of their metabolic hemostasis that allows them to maintain balance and equilibrium.

In experiments where a 24-hour continuous measurement of glucose concentration of healthy subjects was conducted, it was found that there were indeed fluctuations. The blood sugar levels were high after meals at around 118 after lunch and dinner, and after breakfast it was highest around 132.4. The values in the rest of the day and the nighttime were around 93 and 81.8.

Unexplained Fluctuations in Blood Sugar Levels

The most disturbing aspect a person with diabetes can have is unexplained fluctuation of blood sugar levels.Though glucose level in blood is not constant,it might be baffling for a diabetic to have blood sugar fluctuations despite taking medications and following dietary guidelines.

However, if you are having such a rollercoaster of extreme blood sugar levels with lows and highs, it might cause diabetes complications. So, in order to avoid unnecessary complications, it is essential to first unravel the mystery of unexplained fluctuations in the blood sugar levels.

Unusual fluctuations in blood sugar levels might occur due to a variety of reasons as blood sugar levels depend on numerous factors. So, you may be feeling irritated, have uncontrollable temper, feel lack of focus, foggy, depressed, and lack energy along with a host of symptoms when your blood sugar levels vary.

So, here are a few surprising reasons that cause blood sugar level fluctuations:
• Artificial Sweeteners.
• Dehydration.
• Household chores.
• Infections like cold and flu.
• Antidepressants, corticosteroids, diuretics,& nasal decongestants.
• Lack of sleep and irregular sleep patterns.
• Travel in different time zones.
• Coffee, tea, energy drinks,& sodas.
• Menopause (hormonal fluctuations).
• Periods (hormonal fluctuations).
• Stress and tension.
• Probiotics like yogurt.
• Excessive workouts.
• Consumptions of alcohol.
• Contraceptives.
• Seasonal changes.

How to control unexplained fluctuations of blood sugar levels

Apart from the reasons mentioned above, most people suffer from unexplained spikes and falls in blood sugar levels as they do not understand how much carbohydrates they have to consume. Excessive carbohydrate consumption leads to high blood sugar level and improper intake of it with respect to the medication might cause low blood sugar symptoms.

Do the Math! Count those carbs!

These are times when we are busy even to cook a square meal. And, we never miss out on an opportunity to eat out. When asked how you like your eggs, we would most likely answer “in a cake!” In short, we indulge.

And, high intake of unhealthy carbohydrates is one of the main culprits for uncontrolled blood sugar levels in people with diabetes.

In people with types of diabetes (both type 1 and type 2), the mechanism of the pancreas is impaired and their metabolism is different. Any miscalculation of carbohydrate intake can lead to large swings in the blood sugar values.

Carbohydrates are one of the sources of nutrients apart from proteins and fats.They are macronutrients and are made of simple carbohydrates and complex carbohydrates.

Simple Carbohydrates

Simple carbohydrates contain sugars like fructose, galactose, sucrose, and lactose. These are found in fruits and milk products and give immediate energy bursts.

Avoid:

Simple carbohydrates are also contained in sodas, fast foods, and candy. These are made from processed and refined sugars. These have no minerals or vitamins and are mere empty calories that lead to high blood sugars.

Complex Carbohydrates

Complex carbohydrates contain more than one sugar. They are found in foods like beans, whole grains, peas, and vegetables. They contain vitamins, minerals, and fiber, which is good for digestion.

What Carbohydrates to Consume?

It is very important for people with diabetes to follow a diet plan for diabetes.For a large extent, this constitutes carbohydrate counting. People with diabetes should consumehealthy carbohydrates such as whole grains, vegetables, fruits, and dietary fiber.
Carbohydrate counting can be effectively done with the help of a Diabetes Educator or a Clinical Nutritionist.

Other techniques to manage blood sugar level variations:

• Reduce weight.
• Get stress management.
• Talk to your doctor about other medications you are using.
• Get adequate sleep.
• Reduce the intake of caffeine and substitute it with lemonade or something else.
Consult your doctor before traveling overseas or before a season change.
People might have high blood sugar in certain unusual circumstances. Insulin-dependent patients, in some cases suffer from scarring and fat formation. This happens if a patient injects insulin repeatedly at a single site. Due to this, there might be delayed absorption of insulin leading to high sugar levels.Later on, after the insulin is absorbed, the blood sugar level might go low. These patients have to change the site of the insulin injection.

Some diabetics have high sugar levels due to kidney diseases, and thyroid and adrenal disorders. Others might have increased sugar levels due to an issue with their injections, and insulin pumps.

It is to be noted that people who have persistent and unexplained hypoglycemia (low blood sugar levels) should consult an Endocrinologist for further evaluation. A thorough lab work is warranted along with a relook at the medications prescribed. Pituitary and adrenal evaluation might be required.

For better management of blood sugar levels consult our Diabetes Clinics near by or call our toll free number: 18001031010

10 Tips For A Person Newly Diagnosed With Diabetes

Diabetes is not a Devil

It’s common for people to undergo a whirlwind of emotions after being diagnosed with diabetes. The sheer disbelief of being diagnosed, and the ensuing state of confusion and depression is enough to make a devil out of diabetes. However, there is Hope. Type 1 or type 2, people can survive diabetes and lead fulfilling lives!

Even as numerous patients shudder at the fact that they are diabetic, Diabetes Educators at Apollo Sugar Clinics make it a point to create awareness regarding the psychological aspect of diabetes.
Yes. Though diabetes is a variable metabolic syndrome, there is a major psychological aspect to it that cannot be avoided. This is because people with diabetes can lead complete lives, but with some rigors. And, to follow these rigors, one needs constant psychological support.

Managing diabetes needs management of diet, exercise, and medications. A failure of any of these can lead to uncontrolled diabetes, which causes eye, kidney, and nerve diseases.

*See below for exercise tips for people with diabetes

Living with diabetes is challenging. And, the crux of it lies in controlling blood sugar levels. If you control blood sugar and cholesterol levels, you are more or less safe from numerous complications of diabetes and cardiovascular diseases.

Here are 10 tips you need to follow in order to keep your blood sugar levels in control–

1. Self-monitoring of blood glucose levels –

Monitoring of blood glucose levels on a regular basis is the most important aspect of diabetes management. For this, you might have to use a glucometer. By monitoring your blood glucose levels on a regular basis, you would be able to avoid hypoglycaemia (low sugar levels) and hyperglycemia (high sugar levels). Maintaining a log of your sugar levels allows your doctors to assess fluctuations in blood sugar levels and thus alter the diabetes treatment plan.

2. Periodical checkups –

You need to get some diabetes tests done periodically apart from your blood sugar tests and HbA1c, which is done once in three months. Diabetes is known to cause complications like diabetic retinopathy, diabetic nephropathy, diabetic neuropathy (causing diabetic foot) and cardiovascular diseases. So, it is important to get certain diagnostic tests done in order to assess the efficacy of the treatment. This would enable your doctors to adjust medication and diet to compensate the damage done to the organs. Generally, the diagnostic tests include:

a. Dilated fundoscopy to evaluate the retina of the eye.
b. Urine microalbumin to assess the kidneys.
c. Sensory perception test of the feet.
d. Lipid profile test for cholesterol levels.

3. Diet –

Managing diet for a patient with diabetes is another important aspect. Consuming the right amount of carbohydrates, proteins, vitamins, and dietary fibre is vital to maintain blood sugar levels and cholesterol. Eat more fruits, vegetables, nuts, flax seeds, olive oil, avocados, chicken, eggs, high-fibre cereals and whole grains. Avoid trans fats, fast foods, sweets, chips, white bread, white rice, desserts, processed meat, and red meat.

Dietary dos and don’ts for people with diabetes

Dos (Eat) Don’ts (Avoid)
Brown rice White rice
Channa, oats, millets Corn and cornflakes
Whole grain bread White bread
Whole wheat pasta Regular pasta
Sweet potatoes, cauliflower White potatoes
Papaya, apple, guava, pear, orange Fruit juice beverages
High-fibre cookies, Nuts, Seeds, Idli, Upma, Poha, Dhokla, non-sweetened yogurt Deep fried snacks
Fish, skinless chicken, tofu. Red meat, steak, hot dogs, sausages.
Bitter Gourd, Indian Blackberry, Garlic, Onion, Flax seed Dried fruit, canned vegetables with added sodium, frozen vegetables, sweet sauces
Coffee – black or with low-fat milk Flavoured coffee

4. Diabetes bars and shakes as meal replacement –

Bars or shakes made specifically for people with diabetes can help you control blood sugar levels when you are on the go because when these diabetes bars and shakes are used as a meal replacement or snack, they can take the guesswork out of carbohydrate counting. Carry them in your purse, suitcase, or stock your desk drawer so you will always have a suitable choice when you are stuck in traffic or can’t take a proper break for lunch. But if you fall into the habit of eating them in addition to your usual meals or snacks, both your weight and your blood sugar levels may increase. You always have to replace them for other foods or your calorie and carb intake will likely be too high.

5. Cinnamon as a natural flavor booster –

Cinnamon contains a number of compounds that improve insulin sensitivity and insulin action. For people with type 2 diabetes, the consumption of cinnamon leads to lower fasting blood glucose, LDL cholesterol and triglyceride levels as well as a beneficial increase in their HDL cholesterol levels. You can enjoy this fragrant spice to delight your taste buds without extra calories or sodium. Cinnamon brings out the natural sweetness of tomatoes in a sauce and adds an interesting complexity to beef and poultry. Sprinkle it on oatmeal, yogurt, and fruit to boost sweetness without adding sugar. However, cinnamon might not lower blood sugar.

6. Have a cup of green tea –

Replacing sugary beverages with green tea is a great way to cut calories, save carbs, and get a good dose of disease-fighting polyphenols. But don’t always bank on it to lower your blood sugar, though green tea may help prevent type 2 diabetes and improve insulin sensitivity. Green tea extracts in high doses have been associated with several cases of liver toxicity so not more than a cup of green tea is advisable for a diabetic, every day.

7. Stay hydrated & save calories –

It’s a good idea to drink plenty of calorie-free beverages, especially a lot of water every day when your blood sugar levels are elevated. Because high blood sugar can cause excessive urination, drinking plenty of water helps prevent dehydration and saves extra calories you may add up consuming other beverages.

8. A dash of vinegar –

A spoonful of vinegar with every meal helps the blood sugar go down. Consuming about 1-2 tablespoons of vinegar, diluted in a cup of water or consumed as part of a salad before a meal may help slow the post-meal surge in blood glucose by as much as 40%. Vinegar may inhibit starch digestion and hold food in the stomach a little longer which is good for a diabetic. Take advantage of vinegar’s benefits by splashing some on a salad and adding it to cooked vegetables, or make your own vinaigrette with two parts vinegar to one part olive oil. If you use insulin, use vinegar cautiously.

9. Get quality sleep –

Less sleep or poor sleep can disrupt your hormones leading to an increased appetite, higher blood sugar, and a thicker waistline, which you might want to avoid. Stick to a sleeping pattern that works for you. If you have trouble sleeping, talk to your doctor about your sleeping pattern to see if they warrant an assessment for sleep apnea, which is a potentially serious sleep disorder. Studies claim, that a small amount of weight loss can dramatically decrease sleep apnea.

10. Exercise to boost energy & improve sleep –

Inactivity can reduce the quality of sleep, and poor sleep leaves you too lethargic to exercise. Sneak in at least a few minutes of daily exercise by walking during your lunch break and taking the stairs instead of the lift. Always remember that, every single time you exercise, you are improving insulin sensitivity, and a good workout can help you rest well at night.

Exercise tips for people with Diabetes

• Do not start with very high goals.
• Look at the big picture. Maintaining a physically active life would help you manage your diabetes better.
• A brisk walk for 30 minutes a day is a great way to start your exercise regimen.
• For elderly diabetics, yoga or tai chi for about 30 minutes is a better option. This would help avoid nerve damage.
• If you have taken your diabetes medications, be sure that you consume some carbohydrates in order to avoid hypoglycaemia.
• If you are dependent on insulin, it is better to measure your sugar level before exercise. If your sugar level is/below 70 mg/dl, take carbohydrates.
• For high intensity exercises, it is better to consume extra carbohydrates, or carry an energy bar along with you.
• Weight training is highly beneficial and should be done with 10 to 15 repetitions in order to avoid muscle wastage. Muscle wastage leads to poor blood glucose control.
• During physical activity, it is important to wear proper diabetic footwear in order to avoid foot injuries.

What should you do in case you’ve missed insulin shots?

Insulin Shots

Insulin ShotsIs medication the only answer to diabetes? We all think that insulin for diabetes (type 1) is the mainstay therapy and tend to set aside the human factor out of diabetes management. However, despite all the treatments available, what can be done when a patient for some reason does not totally comply with the treatment?  

Role of patient-doctor partnership in diabetes management

Though there are numerous innovations in insulin management like artificial pancreas and improved insulin pumps, a better quality of life can be achieved only with the active participation of the patient and the healthcare provider working together.

Traditionally, the doctor is someone who provides a few diagnostic tests and, based upon those diagnostics, prescribes medication. This approach has its intrinsic deficits. For caregivers, to achieve the goals of treatment, a major impediment is poor control from the side of the patient.

This has nothing to do with the willingness of the patient to have a better quality of life. This is due to the fact that type 1 diabetes is a demanding condition and it asks for constant monitoring, and extreme conditioning.

This is  where the patient needs support and an extended care from the doctor – We need a care that is both In-Clinic and Beyond the Clinic.

Missed an insulin shot

Take for example the case of a juvenile with diabetes. As such, adolescence is turbulent with hormonal changes, the transition to adulthood, and peer pressure. A child in this stage needs much more support in terms of treatment compliance.

For parents of such patients, the horror of a missed insulin shot (intentional/unknowingly) is unimaginable. Reasons stated by children for intentionally skipping insulin shots were that it was an interference in their activities, it was an embarrassment, or rarely had injection-related issues.

When it comes to skipping the shot unknowingly, the reasons commonly stated were oversleeping, forgetting, and not carrying the injection kit along with them.

Is insulin pump an answer for this? Talk to our expert diabetologists to consider this option!

Facts about missing insulin injections.

  1. Most missed shots happen during the meal time.
  2. Most people are not sure if they have missed a shot.  
  3. It has been found that omitted insulin injections contribute to poor glycemic control on the long run. Forgetting insulin injections for 2.1 times in a week leads to an increase in HbA1c levels by 0.4%.
  4. Missed injections of insulin is one of the most important reasons for suboptimal control and increased complications.

Patients often are clueless about the next course of action after missing out on an insulin injection. “Do I have to compensate for the missed injection by taking another shot?” “Do I just take it easy and wait for the nest dosage?”

The answers to these simple questions are not so simple. The answers depend upon the type of insulin you take and the duration it was meant for.     

Missed the Basal Insulin Shot

For basal insulin shots (acting for around 24 hours), it is normally okay to take a shot within two hours of the stipulated time. This might carry an increased risk of hypoglycemia and so one should consult a doctor before doing so.

If the injection has been delayed for more than two hours, then there is a risk of higher blood sugar levels. So, it is important to contact a doctor who might prescribe a fast acting insulin shot.

Missed the Bolus Insulin Shot     

In case a bolus insulin shot (mealtime insulin) is missed, it is normally not risky to inject within two hours of the stipulated time. But, if the time exceeds two hours, it is better to consult a doctor.

It is common for some people to suggest a reduced dosage of insulin after two hours of delay, but it is not advisable as it carries a higher risk of erratic blood glucose levels.

A Better method to manage

Not being able to comply with the rigors of diabetes treatment might happen unknowingly. This should not stop you from having a healthy life. So, wouldn’t it be great to have a trusted ally who not only reminds you to take a shot, but does a lot more.

With a mobile app that reminds you to take your insulin shot to calls from experienced dieticians, explore the technology-based solutions provided by Apollo Sugar Clinics. http://www.apollosugar.com/diabetes-programs/