Monthly Archives: October 2015

  • 3

Top 10 Myths & Facts About Diabetes

Diabetes is a global disease and it is predicted that it will be affecting over 80 million individuals by 2025 in India and over 300 millions around the world. Compared to the disease progression, its awareness is very low among Indian population. Even though diabetes is common, many people don’t know much about it – this includes people who are at greatest risk.

Here are 10 myths and facts about diabetes.

diabetes myths and facts

Myth 1 : Diabetes is caused by eating too much of sugar

Fact 1 – Diabetes is not caused by eating too much of sugar. There are 2 types of diabetes i.e Type 1 diabetes and Type 2 diabetes. In Type 1 diabetes (Juvenile Diabetes), body doesn’t produce hormone, called insulin, which manages blood sugar levels. The exact cause of Type 1 diabetes is unknown. But it is believed that autoimmunity, genetics and environmental factors like certain viral infections plays an important role in its etiology.

In Type 2 diabetes body produces insulin hormone, but either it is less in quantity or its action is impaired (insulin resistance) and not able to maintain blood sugar level at normal levels. Abdominal obesity (tummy fat) is believed to be culprit for insulin resistance, in Indian population.

Other causes of diabetes includes excessive alcohol consumption which lead to repeated pancreatitis and ultimately beta cell destruction of pancreas leading to insulin shortage and diabetes. Certain pancreatic surgeries like surgery for cancer of pancreas involving tail part or removing entire pancreas lead to insulin deprivation and diabetes.

Myth 2 : Diabetic person should not eat chocolates, sweets, etc

Fact 2 –  Diabetic people can eat chocolates, sweets etc BUT they have to limit the quantity at each serving. Diabetes management is an art of balancing blood sugar level. Foods with low glycemic index raises blood sugar level but to a lower extent whereas those with high glycemic index raises blood sugar level rapidly. Mild to moderate exercise like walking, cycling etc helps to lower blood sugar level. No food is absolutely forbidden if you can maintain the consumption of proper portion size.

Myth 3 : If you are overweight or obese then you will get diabetes for sure.

Fact 3 – Every overweight or obese individual may not get diabetes. There are several other factors such as family history, etc. which are also contributory. But ofcourse, obesity (especially abdominal obesity) is an important risk factor for insulin resistance and diabetes. You can see all other risk factors for diabetes in my previous article.

Myth 4 : Once insulin started it will remain life long.

Fact 4 –  No, not always. Insulin can be of best choice in certain conditions like prior to operation or surgeries, in acute infections or stress, certain conditions where oral intake of food is limited etc. Insulin can be given temporary in these conditions as insulin helps in wound healing. It has very less chance of interaction with other medicines.

Diabetes is progressive disease. Almost 50% of beta cells are dead when diabetes detected for first time. Over the years beta cells keep on decreasing with use of sulfonylurea drugs. Eventually a stage comes, after around 7-10 years, when there is very less beta cell reserve to produce insulin. At this stage patient requires external insulin injections. Around 25% of Type 2 diabetes patients reach beta cell exhaustion stage & require insulin.

Myth 5 : Diabetes is curable.

Fact 5 –  No. There is no cure for diabetes till now. Diabetes can be well controlled with diet, exercise and timely proper medications.

In case of pre-diabetic stage, diabetes can be reversed or delayed. This can achieved by maintaining proper diet, and exercise to induce weight loss. Certain insulin sensitizers like metformin can also be used. But once you have established diabetes, it is not curable.

Myth 6 : Herbal supplements can reverse or cure diabetes.

Fact 6 – Once diabetes is confirmed, it is not curable with any herbal supplements and medicines. HbA1c (Glycated Hemoglobin) is most reliable blood test to confirm diabetes.

Myth 7 – Diabetes is contagious

Fact 7 – Diabetes is not contagious and not transmitted from person to person.

Myth 8 : Insulin injections are very painful

Fact 8 – No, insulin injections are not painful as the needle is very small and very thin compared to normal blood collection needles. Nowadays insulin flex pens are available for insulin injections, they are designed in such a way that patient can himself take insulin shot without any pain.

Myth 9 : Type 2 diabetes is only seen in adults

Fact 9 –  Nowadays, Type 2 diabetes has also been observed in children as well. Type 2 diabetes has been detected in a 5 year old child. Faulty lifestyle, poor food habits and childhood obesity are the culprits for this.

Myth 10 :  People with diabetes can’t live active healthy life

Fact 10 –  No. Exercise, in the form of brisk walking or even cycling, lead to increase glucose uptake by muscles. Exercise also increases insulin sensitivity. Thus an active life along with exercise is very helpful for diabetes patient. Diabetic patients on insulin or certain drugs which increase insulin production from pancreas need to take special precautions like having a carbohydrate rich snack before exercise to prevent hypoglycemia.

Those were the top 10 myths and facts about diabetes. If you like my article please share it with your friends and family.

Awareness is prevention !


  • 0

How To Treat Hypoglycemia at Home?

Hypoglycemia or low blood sugar levels can be commonly encountered by type 1 & type 2 diabetes patients who are on insulin treatment or those type 2 diabetes patients who are on certain oral anti-diabetic medication which increases insulin secretion from pancreas like sulphonylureas (Glimeperide, Gliclazide, Glibenclamide or Glyburide & Glipizide) or megitinides (repaglinide, nateglinide).

More details of oral anti diabetic drugs causing hypoglycemia & Hypoglycemic symptoms are already mentioned in my previous article.

hypo

credits: Medscape.com

Steps to tackle Hypoglycemia or Low Blood Sugar level :

  • Identify the symptoms :  Symptoms of hypoglycemia differ from individual to individual. I have already mentioned symptoms of hypoglycemia in my previous article. Early Hypoglycemia symptoms includes Sweating, Palpitations, dizziness, slurred speech, confusion, weakness, anger, etc
  • Grab Attention : If you are at home seek immediate attention of your family member or colleague at office because hypoglycemia can lead to confusion, slurred speech or even unconsciousness & explain them about your symptoms. If you are driving a car then stop and pull over. If you are walking or climbing steps, stop & sit down. Make yourself and others safe.
  • Confirm by testing : Check your capillary blood sugar level by finger pricking with Glucometer, A reading less than 70 mg/dl confirms hypoglycemia. If you do not have glucometer with you or symptoms are severe then proceed to step 4 directly.
  • Grab Sugar or Fast acting carbs : Hypoglycemia needs to be corrected immediately so fast acting carbs like simple sugars can be consumed. I normally advice my patients to take 2-3 tablespoons of Glucon D powder ( Green Packet ) sublingually (below tongue) this causes immediate rise in blood sugar level. In India, glucose tablets are not freely available so keeping a small packet of 15 -20 gms of simple sugar or glucon D with them is quite useful atleast for diabetic patients on insulin or sulfonyureas. Other fast acting home remedies includes :
    • Half cup of fruit juice
    • 1 cup of milk
    • 1-2  tablespoons of honey
    • half cup of soda or non diet soft drink
    • 2 tablespoons of Manuka (raisins/dried grapes)
    • 5-6 hard candies
    • or 3-4 chocolates (dairy milk eclairs)
  • Re-check : Don’t go on eating too much otherwise sugars will raise much higher. Wait for 15-20 minutes and re-check your blood sugars again. If it is still less than 70 mg/dl eat another 15-20 gms of sugar or glucon D, repeat this till sugar level goes more than 70 mg/dl. After hypoglycemic episode try to eat meal within 1 hour or eat some high carbohydrate food if meal time is more than 1 hour away.
  • Seek Immediate Medical Attention : If your body doesn’t respond to carbs or you suffer seizure 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 :  If you are getting repeated mild hypoglycemic episodes or even one severe episode, consult with your diabetologist for adjusting your medicine or insulin dosage according to your lifestyle. Take precautionary measures to combat further similar episode in future.

If you found this article useful, please share it with your friends & family. I appreciate the feedback and encouragement.

Awareness is Prevention.


  • 5

Which Anti-Diabetes Medicines can Cause Low Blood Sugars or Hypoglycemia?

What is Hypoglycemia ?

When blood glucose level falls below 70mg/dl, person feels dizziness, headaches, sweating, confusion, anxiety symptoms, which relieve immediately after restoring blood glucose level to normal is known as Hypoglycemia.

Hypoglycemia

Credits: Oliveviewim.org

Common Symptoms of Hypoglycemia includes :

  1. Adrenergic Symptoms :
    • Hunger
    • Faintness
    • Weakness
    • Sweating
    • Palpitations
    • Tremors
    • Tingling
    • Nervousness
    • Numbness around mouth

     

  2. Neuro-glycopenic Symptoms : may require help or assistance from another person.
    • Headache
    • Double Vision
    • Lack of co-ordination
    • Inappropriate behavior
    • Confusion
    • seizures
    • Coma
    • Permanent Brain Damage & Death

Which Anti-Diabetes Medicines can cause Low blood Sugars or Hypoglycemia?

Most common is Insulin. Any type of insulin or its analogues can cause hypoglycemia.

Most commonly used insulin includes Premixes like Mixtard 30/70, Huminsulin 30/70, Novomix 3o, Humalog 25/75, regular insulin like Human Actrapid, Huminsulin R. etc or Fast acting analogues like Novorapid, Apidra, Humalog etc

Long & intermediate acting insulin & analogues like Glargine (Lantus), Detemir ( Levemir) Degludec (Tresiba), NPH, Huminsulin N etc.

In case of oral medication, those oral anti-diabetes tablets which increases insulin secretion (insulin secretagogues) from pancreas can cause hypoglycemia.

Most commonly used Insulin secretagogues includes:

  1. Sulphonyureas:

    • Glibenclamide – Daonil, Glucored, Semi daonil, etc.
    • Glimeperide – Amaryl, Zoryl, Glimestar, Glimy, Azulix, Euglim, Glimiprex, Glucoryl, etc.
    • Gliclazide – Reclide, meclazide, diamicron, Glizid, Diabend, Dianorm, Glycinorm, etc.
    • Glipizide – Glynase, Semi-glynase, Lipi, etc.
  2. Glinides:

  • Repaglinide – Eurepa, Novonorm, Repa, Regan, etc.
  • Nateglinide – Glinate, Natiz, etc.

Other anti diabetic medicines like metformin (Glyciphage, Cetapin, Metsmall, etc.), Pioglitazone (Pioz, piopar, etc.), Alfa – glucosidase inhibitors like voglibose ( PPG, Volibo, Advog, Prandial,Volix, etc.), Acarbose (Glucobay, etc.), & DPP4 inhibitors including sitagliptin ( Zita, Istavel, Januvia, etc), Viladgliptin ( Galvus, Zomelis, etc) , Saxagliptin ( Onglyza), Linagliptin ( Trajenta) DO NOT Cause Hypoglycemia when given alone or in monotherapy but can cause hypoglycemia when given in combination with insulin secretagogues or with insulin.

If you found this article useful, please share it with your friends & family. I appreciate the feedback and encouragement.

Awareness is Prevention.

Related Posts Plugin for WordPress, Blogger...

Register For Blog Updates

Follow Us on Social Media


Dr Nikhil Prabhu


Book Appointment