World Health Day: Beat Diabetes (Care Giving of Diabetes)

We have in the past 6 days have covered almost every aspect of diabetes. Armed with knowledge of the disease we are better equipped to handle the disease. Today in the final step let us have a look at the Care Giving part of Diabetes. How to care for someone who has DM(Diabetes Mellitus).

We have seen that regardless of the type of DM(Diabetes Mellitus), Diet and Exercise are valuable. This goes right from very young patients to older ones. Living with diabetes is tough for the patient and can be equally challenging for the family but having said that dealing with it together is better for everyone.

Create a plan:
Having spoken to the doctor you know what’s to be done so you need to put things in place now. Create diet charts and activity schedule, also share responsibilities with others around you. Like if the patient has been prescribed Insulin, there would be discipline needed in terms of time and what to eat.

Do it together:
The way DM (Diabetes Mellitus) changes life for everyone can be beneficial. Eating low carbohydrates, low fat diet is good for the whole family, so is exercising. Remember people who do not have DM (Diabetes Mellitus) now can develop later owing to poor food and exercising habits. So get on with this together.

Take it Easy:
DM (Diabetes Mellitus) is not a life threatening disease nor is it contagious so relax. If glucose levels in blood are kept right through wise planning complications related to DM (Diabetes Mellitus) can be delayed by a big stretch. Staying happy will keep you motivated

Handling young patients:
This is where the challenge is the highest. Young patients have their distractions and high activity levels. Especially if your child is Insulin dependent managing insulin shots based on activity levels is an uphill task. If the child is very young make the diet and activity balance a part of lifestyle. As they grow explain the situation without sounding tragic. A lot of children often take their condition as a disability and peer pressure can be depressing for the child. Speak with close friends of the child and seek their support, this can be very helpful. Keep telling the child that a good control on DM (Diabetes Mellitus) will give him a life like anyone else. Remember your efforts will fail many times and that’s OK.

Caring for the care giver:
Its natural to feel tired playing your role. Give yourself small breaks and share responsibility with others in the family. Grow your ability of render care gradually so that you can cope well. Set your targets right and don’t be scared of not achieving them sometimes. Taking small steps and keeping it light will help everyone.

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We have so far seen how DM (Diabetes Mellitus) can be identified in adults and ways to manage it. We would focus on DM (Diabetes Mellitus) in children. Diabetes in Children was earlier found as Type 1 mostly, but trends have shown many children under 20 years age picking up Type 2 DM (Diabetes Mellitus). Let us discuss each separately:

Type 1 DM (Diabetes Mellitus): 
This condition is baffling as many children who have it generally do not have hereditary link to it. Reasons are clearly not known but are considered to be partly genetic and environment triggered. There is a major increase in number of children suffering from DM (Diabetes Mellitus) who are under 5 years old. Asian children tend to suffer less from this type of DM(Diabetes Mellitus). Disease is very common in Europe and Scandinavia. Of Symptoms remain the same as adults:

1. Frequent Urination
2. Increased Urge for Water
3. Increased Appetite
4. Behavioral changes, tiredness
5. Weight loss.

You should consult a doctor whenever you see these signs and don’t see them going away. Doctor would do a few tests and try to ascertain if it actually is Type 1 DM (Diabetes Mellitus). Once the diagnosis has been set an insulin schedule is prepared along with the diet and activity charts. Body’s insulin level greatly changes along with the activity level. If you think the child is going to have a long and strenuous day make sure there is a supply to carbohydrates around. It is difficult for parents but the situation can be managed with knowledge and discipline. Talk to the child when you think it is appropriate to do so. A lot of children take it as a disability and support from family and regular education is important.

Although it is a Type 1 diabetes but diet and exercise will play an important role in the quality of life the child leads. Regular activity levels and weight control will be defining for the life of the child and the complication that may turn up later in life.

Type 2 DM (Diabetes Mellitus):
Presentation and reason are similar to adult DM (Diabetes Mellitus). Body cells in these children develop resistance to Insulin and thus transport of glucose to inside the cell from the blood gets hampered (it is like having a lot of stuff in your warehouse but customers suddenly refusing to accept shipments). Some kids are more susceptible than other like:

• Girls are more prone
• Overweight
• Have a family history of diabetes
• American Indian, African-American, Asian, or Hispanic/Latino

Unhealthy eating and sedentary lifestyle is a common reason for weight gain which in turns precipitates DM (Diabetes Mellitus).

Here is a list of most common signs that parents should watch out for and seek medical assistance:

1. Over eating
2. Excessive thirst
3. Fatigue
4. Dry Mouth
5. Blurred vision

If you see anything like this happening, see your Doctor. The Doctor would assess if the child is overweight and if insulin is required. If Insulin is avoidable then diet and weight control will be instrumental in managing the condition, although depending on sugar levels medication may be recommended. You should have a conversation with the child and explain it in a way that it is not taken as a disability. Change in eating and exercise habits will benefit the whole family and will make it look normal rather than just concentrating on the child.

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World Health Day: Manage/Control Diabetes

We started this campaign on this 1st April. Considering the World Health Day on 7th April we discussed Diabetes which is this years theme for World Health Day. We have already discussed What is Diabetes?, Facts, Prevention and Healthy Pregnancy with Pre-Existing Diabetes.
Today we would be discussing on How to manage and control Diabetes?
Having touched various aspects of DM (Diabetes Mellitus) 1 and 2 we are now moving to understand how the disease can be managed. Let us looks at each type separately:

Diabetes Mellitus Type 1 (Insulin Dependent): The name in itself suggests that Insulin is vital in management of the disease. We learnt earlier that due to defects in the Insulin factory of the body (called Pancreas, a fist size gland under the stomach) not enough insulin is released or a defective or of insulin is supplied. Body is unable to utilize this Insulin and amount of glucose mounts up. So the first line of therapy is to provide body with Insulin through an injection called Insulin Pen. The amount of Insulin that this injection can deliver depends on the deficiency in the body. The physician will start with a dosage that suits your condition and will ask you to check the sugar levels multiple times in a day like before meals and 1-2 hrs after meal. Dosage can be adjust as advised by the physician. You should not use insulin as a counter to sugar eating habits, a lot of patients simply increase the quantity of Insulin injected post meals if they had something too sweet. This in practice must be avoided and insulin levels maintained at a certain level with a matching diet. A small variation typically does not need management. It is important to remember that your target glucose levels can be different from physiological levels depending on other medical conditions that you may have.

Balanced diet based on activity level will keep sugar levels at the right place and will also not cause any weight gain. Excessive intake of sugars that can cause a spur in levels is not recommended. Exercising in itself is a great way as it makes the cells more sensitive to Insulin but any training beyond 30 mins must be managed as it can cause hypoglycemia. A snack bar is a good option to keep levels at a good place.

Diabetes Type 2 (Non-Insulin Dependent): As discussed earlier this type is more about cells becoming resistant to insulin. There are three ways of managing this condition. Doctors may put the patient into a weight reduction and calories cut-down plan straight away or may choose to add a few medicines to bring the levels down immediately. Depending on how high the values are and other conditions you may be put on a medication like metformin, glimepiride etc. When either of these do not work enough the patient might be put on Insulin. In an case diet control and exercise have a profound effect not just on diabetic control but also cardiovascular health

Complication associated with Diabetes: IF sugar levels are allowed to stay out of range for a long period of time these levels affect the brain, eyes, skin, peripheral blood circulation, Kidneys, Liver etc. It almost affects every organ of the body. Keeping a proper dietary control and staying fit in itself is a great way of managing your condition. In case you are on and Insulin plan, you may not want to compromises on the quality of life but actually include external insulin as a way to achieve all that you would have any ways done.

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World Health Day- Beat Diabetes

We have covered in the last three days things that would concern most patients with diabetes. We would today like to talk about how diabetes affects women who are pregnant.

It is imperative to plan pregnancy well in advance and avoid surprise pregnancies if being treated for DM. Elevated glucose levels and chemicals associated with DM like ketones can reach the foetus and affect cell growth and function. Patients diagnosed with Type 1 diabetes should be more careful as diet and Insulin should be regulated closely. Also Type 1 patients must get their Thyroid levels checked regularly. Fasting glucose should range between 60 and 119 mg/dl and post meal after 1 hr should be between 100- 149 mg/dl.

The effects of uncontrolled diabetes can be serious both for the foetus and mother. A few of them are:

For the baby:
Respiratory Distress
Prolonged Jaundice
Over-sized baby
Congenital defects on organ development

For the mother:
Miscarriage
Worsening of other diabetic conditions affecting various organs like eye, brain etc.

Because pregnancy makes mothers body partially resistant to Insulin, need to supplement body’s internal production is the treatment of choice. Moreover medication for lowering glucose in blood are not recommended during pregnancy therefore physicians will put the expecting mother on Insulin pumps straight away. Diet and weight control are definitely helpful always

Many expecting mothers who had no history of DM develop the condition around the 24th week. Placenta affects the mothers body by making her cells Insulin resistant. In response her pancreas produce excessive Insulin to rein in her sugar level but sometimes cannot cope up. This Insulin cannot pass the placental barrier but the glucose can, putting a lot of stress on the child’s pancreas. Children born under such conditions can be overweight and may have a higher chance of being diabetic in future. Respiratory distress is also common. Regular testing and control can manage the situation well for both the mother and child. Treatment can include Insulin or diet and exercise. Safe levels of glucose during pregnancy have been recommended as:

Before a meal (pre-prandial): 95 mg/dl
2-hours after a meal (postprandial): 120 mg/dl or less

Although the condition resolves soon after birth but there is a high chance that the patient may develop DM again in the next pregnancy. Many women develop DM later in life, therefore diet and weight should be controlled.

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World Health Day- Beat Diabetes (Prevention)

In the last two days we have covered the basics of Diabetes like what is diabetes, what causes it and how to identify the signs. We will today try to cover on ways to prevent diabetes.

Many of us would believe that DM is hereditary and almost sure to happen should parents suffer from it. We have discussed that the possibility of the child to have diabetes purely for hereditary reasons is merely 10%. Understanding why genes express themselves will help avoid the disease in the long run. Here are the factors that make the genes express themselves and how these factors may be managed:

1.Environment: Pesticides and chemical pollutants present in food are exceedingly seen as reason that trigger DM1 and 2. Long term exposure accumulates these chemicals in cells all over the body and finally changes the ways genes are expressed. Choosing organic food is a good way to avoid direct exposure to the pollutants. Consumers opting for this diet should check how source of water used in irrigation is purified to rule out presence of pollutants. Non-vegetarians opting for an organic diet should check with suppliers if animals are fed with organic diet.

2. Diet: High Carb and fat diet is repeatedly proven to cause Diabetes specially DM 2. In fact DM 2 can totally be controlled by reducing weight and controlling intake of carbs and fat. People already affected by the disease should immediate help from dietitian to control intake of calories even after target weight has been achieved. If parents or siblings have DM and you still don’t have it make sure you follow diet control and check on the source of food as mentioned in point 1

3. Exercising: Exercising helps in ways you may not imagine. When you exercise body goes into an alert and finds ways to absorb glucose from blood even if insulin is not enough. Also exercising improves sensitivity of cells to insulin so the amount of insulin required to transport glucose into cell goes down

4. Regular Check-up: It is always good to know in advance. Type 2 diabetes specially expresses slowly so make sure you check your levels regularly. How often you need to do this is something you can discuss with your physician who will assess your other conditions before offering a schedule. Regular check-ups also make sure that there are no other disease affecting you that can cause diabetes to express itself.

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World Health Day

In the last discussion here we tried to understand various kinds of diabetes and why they happen. Today we would be looking at the Important facts along with signs and symptoms of Diabetes.

IMPORTANT FACTS (ACCORDING TO THE WHO REPORTS)

1-About 347 million people worldwide have diabetes-
Diabetes has become an emerging global epidemic disease. The number of people affected by diabetes has increased from 153 million to 347 million from 1980 to 2016. It is expected to increase more in the near future.

2-Diabetes is predicted to become the 7th leading cause of death in the world by the year 2030-
In 2012 Diabetes was the direct cause of 1.5 million death and it is expected to get double in number by 2030. Obesity is the prominent risk factor of diabetes.

3-There are two major forms of diabetes-
There are two types of diabetes. In TYPE 1 DIABETES, the body’s immune system destroys the cells that release insulin.In TYPE 2 DIABETES, the body is not able to us insulin the right way. 

4-Type 2 diabetes is much more common than type 1 diabetes-
According to International Diabetes federation,more then 371 million people across the globe have diabetes,90%are living with type 2 diabetes.

5-80% of diabetes deaths occur in low and middle income countries- As per the data collected by WHO In developed countries most people with diabetes are above the age of retirement, whereas in developing countries those most frequently affected are aged between 35 and 64.

6-Diabetes is a leading cause of blindness, amputation and kidney failure- 
Reason behind these catastropic health issues is the lack of awareness about the disease , health services required and correct medication.

7-Type 2 diabetes can be prevented-
Type 2 diabetes can occur because of heavy weight, lack of physical activity, family history,etc. It can be prevented with a healthy diet,regular physical activity, oral medication under the supervision of Diabetologist, home based glucose monitoring etc.

HOW TO SPOT SIGNS OF DIABETES?
It is difficult to not notice signs of diabetes if you know what they are. There are ways to identify which diabetes may be affecting you but you will have to go through lab tests to find out exactly which one.

If it’s Diabetes Type 1 (Insulin dependent): The onset is sudden, from a few hours to just a few days. As the pancreatic cells fail to produce enough Insulin, glucose levels will suddenly rise in blood and kidneys would begin throwing it out. Presence of too much glucose in urine affect the way kidneys’ filter blood, making them release too much water, this will make you visit the loo far too often. Due to the loss of water, excessive thirst, dehydration and fatigue can also be noticed. Fatigue also creeps in because your cells do not have enough glucose cause most of it is in the blood, unable to enter the cells cause of lack of Insulin. This exact is the reason why most people would feel sugar craving and unusual hunger pangs.

I case of Diabetes Mellitus Type 2 (Non-Insulin Dependent): Symptoms will take many months to show up and in many cases may never do. A lot of people learn that they are diabetic only after regular tests or tests done for other reasons. Symptoms remain the same although they may not vary as much in intensity as they do in case of Type 1. People often attribute fatigue to work load, age etc. and take it normal to have a slightly raised appetite, it is when frequent urination begins to bother is when most people go over to get checked. In principle if you are obese/have a sedentary work life and or a genetic history, you must get yourself checked regularly

Gestational Diabetes: In case you have been diagnosed of DM1/2 earlier and are now pregnant there is a strong chance that your levels will play up more than they usually do. Even if you have been able to manage your Type 2 diabetes without medication, pregnancy may warrant you to take some. In most case this will end with child birth when treated well. You must not attribute increase in appetite, visits to loo and fatigue to pregnancy alone if you have a history of DM, a quick check with your physician is a must. 

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NRI Family Health brings to you Awareness 2016, a knowledge series that discusses the most common diseases in a way that is easy to understand. 

The theme for this ‘’World Health Day’ is ‘’Beat Diabetes’’ .

Diabetes has started showing up in people less than 45 years of age, which is a concern because it can gravely affect the quality of life in older years. Let us have a look at what we shall be discussing over the next 7 days. 

1. What is Diabetes?
2. Important Facts
3. Prevention
4. Diabetes and Pregnancy
5. Control
6. Risks of Diabetes in children
7. Care giving for Diabetics 

WHAT IS DIABETES?

Diabetes is simply elevated amounts of sugar in blood. The amount of sugar in blood is controlled by Insulin and obviously any defect in the life of Insulin will affect the amount of sugar the blood carries. When the amount of Insulin produced in the body is low then we call it: 

DIABETES MELLITUS TYPE 1 OR (INSULIN DEPENDENT DIABETES MELLITUS) : This starts typically in people under 30 years age. Insulin is manufactured in a simple looking factory smaller than your fist. Surprisingly Insulin is not the only hormone produced by it, it also controls your digestion and releases other hormones. So this factory at times goes in an array due to various condition like: 

HEREDITARY: It is not mandatory that children will have it if parents have diabetes. Chances are higher is father has it and highest if both have it and if the age of the mother was less than 25 at the time if birth. People from Scandinavian countries have a higher chance of developing it during their lifetime. Asians and Africans carry a lower chance. Of all the cases Type DM is 10%

MEDICATION: A lot of medications specially anti-cancer can alter Insulin levels. Always share your Diabetic history with the physician. It is also important to understand that medicines should never be consumed without consultation 

ENVIRONMENT: Colder temperatures tend to influence production of Insulin. Chances of Genetic predisposition expressing itself is higher in certain conditions more than others. 

Others: Injury, Cancer and pancreatitis

DIABETES MELLITUS TYPE 2 (NON-INSULIN DEPENDENT DIABETES MELLITUS) : This is what affects 90% of the people you see affected with this disease. It starts at a later stage in life and can finally turn into an Insulin Dependent DM. Some reasons that are linked to this condition are: 

 HEREDITARY: Contrary to popular belief genetic predisposition is only 10% cause of the disease. Other factors can trigger these genes to produce the effect 

 LIFESTYLE: Fat and Carbohydrate rich diet is an important factor. A diet rich in these often leads to weight gain and which in turn can lead to expression of faulty genetics. In fact people who do not carry many faulty genes can also turn diabetic. Little or no exercise, stress are vital factors affecting Type 2 diabetes.   

 OTHER: Many medications given over a period to control blood pressure can precipitate this disease. Disarrayed thyroid levels can produce temporary diabetic conditions

 GESTATIONAL DIABETES: This happens to women who earlier where diagnosed with either of the two forms of diabetes and are now expecting a baby. This condition requires immediate medical attention and if left untreated can severely affect the child birth, child and the mother.

To talk tour Diabetologist or get yourself tested for Diabetes:

Contact us:
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Direct Helpline no. : +91 92-8989-1234
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