Category Archives: Prevention

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Top 5 Tips To Prevent Diabetes

As you are already aware of increasing diabetes prevalence among indian population, it is very important to control and start preventive measures to control diabetes among us. To control diabetes it is important to control risk factors which predispose individual for getting diabetes.

Diabetes risk factors are either modifiable or non modifiable. certain risk factors like age, ethnicity, family hereditary etc are non modifiable or can not be changed but modifiable risk factors can be changed so that we can prevent or delay the disease.

based on modifiable risk factors following measures can prevent or delay the diabetes.

diabetes prevention

Image Credits : diabeteshelpsa.com

Tips to Prevent Diabetes :

  1. Staying Lean : Weight loss by means of diet and exercise helps to prevent or delay the disease. According to broca’s index Ideal weight (in Kgs) = Height (in cms) – 100         for example if a person’s height is 172 cms then his ideal weight is roughly 72 kgs.  If you are not able to loose weight even after 3 months of diet and exercise then certain weight loss medication like metformin, orlistat etc can be started but it is necessary to consult a diabetologist or weight loss specialist before starting such medication.
  2. Control Hypertension : restrictive salt intake and regular physical exercise helps to control your blood pressure. If your blood pressure is more than 140/90 mm of Hg even after regular exercise and diet restriction consult your physician to start anti-hypertensive medication.
  3. Control Stress : Majority of people working in corporate surrounding in metro cities like mumbai suffer from work stress and tension.  In physical or mental stress situations body releases stress hormones (cortisol, epinephrine etc) which increases blood pressure and have action opposite to insulin (raises sugars). peaceful sleep of atleast 8 hours at night & other stress relieving remedies like music, yoga, meditation etc helps to control stress.
  4. Avoid Excess Alcohol intake : Alcohol abuse with or without carbonated drinks (fizz) gives you empty calories leading to weight gain. also may lead to hypertension and dislipidemia. Limit your alcohol intake to not more than 2 standard drinks for men and single drink for women at a time.
  5. Quit Smoking : Smoking is not only a risk factor for diabetes but also a risk factor for cardiovascular morbidities. Smokers have 2 times more risk of getting diabetes than  non smokers.

As you get older chances of getting diabetes increases so it is advisable to check your blood sugar levels every year when you are above 40 years of age.

You can also read my previous article on Calculating the risk of diabetes for better understanding.

If you found this article helpful, please share it with your friends & family.

Awareness is Prevention.


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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.


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Calculate Your Risk of Getting Diabetes ?

In India, Diabetes prevalence is increasing day by day, 90-95% of diabetes belongs to type 2. Attributable risk factors include sedentary lifestyle, inappropriate meal pattern, lack of physical activity, lack of sleep , stress, alcohol abuse, smoking, etc which can be modified. Other risk factors like age, ethnicity, family history etc are inevitable to us.

Diabetes-Risk-Factors

Based on these risk factors following questionnaire will calculate your approximate risk of developing diabetes in the next 10 years. Those who are in Moderate to High risk should start appropriate interventions to prevent diabetes.

1] Your Gender

  1. Female = 0 Points
  2. Male     = 1 Points

2] Your Age ?

  1. <45 Years = 0 Points
  2. 45- 55 Years = 1 Points
  3. 55- 65 year = 2 Points
  4. 65+ = 3 Points

3] What is your ethnic Background ?

  1. Only White European  = 0 Points
  2.  Asian/Indians/Others = 1 Points

4] Do You have a relative with diabetes ?

  1. None                                    = 0 points
  2. 1 Parent or/and 1 sibling = 2 points
  3. Both parents                      = 3 points

5] What is your waist circumference ?

  1. < 90 cm = 0 points
  2. 90-100 cm = 1 points
  3. 100-110 cm = 2 Points
  4. 110+ cm = 3 Points

6] Body Mass Index (BMI) = Weight in Kg / Height in (Meter)2

For example a person with weight of 60 kg and height 155 cm will have BMI = 60/1.55 x 1.55 = 24.97

or Simply calculate it here – http://bmicalculator.cc/

  1. BMI < 23 = 0 Points
  2. BMI 23-27 = 1 Points
  3. BMI 27-35 = 2 Points
  4. BMI 35+ = 3 Points

7] Are you taking medication for Hypertension or High Blood Pressure ?

  1. No = 0 Points
  2. Yes = 1 Points

8] Do you have previous history of Gestational ( Pregnancy ) Diabetes ?

  1. Negative history = 0 Points
  2. Positive history = 1 Points

9] Do you suffer from Polycystic Ovarian Syndrome ( PCOS ) ?

  1. No  = 0 Points
  2. Yes = 1 Points

10] Frequent Alcohol intake ?

  1. No = 0 Points
  2. Yes = 1 Points

11] Smoking ?

  1. No = 0 Points
  2. Yes = 1 Points

Interpretation:

Min Score = 0
Max Score = 18

Low Risk = Score between (0 – 6) = 1 in 20 people with this score will get diabetes in the next 10 years
Moderate Risk = Score between (7 – 12) – 1 in 10 people with this score will get diabetes in the next 10 years
High Risk = Score between (13 – 18) – 1 in 3 people with this score will get diabetes in the next 10 years

If you are in Moderate to High risk score table then it is advisable to consult a sugar specialist doctor immediately.

Explanation:

  • Men are at higher risk for developing diabetes than women with same BMI.
  • Chances of getting diabetes increases with age. Nowadays we can see even adolescents and younger adults developing type 2 diabetes.
  • Blacks, Hispanics, American Indians and Asian Americans are at higher risk than whites for developing type 2 diabetes.
  • If 1 parent or 1 sibling is diabetic then your chance of getting diabetes is 1 in 5 to 1 in 3. If both parents are diabetic then there is almost 80-90% chances of you getting diabetes.
  • Abdominal Obesity is the main culprit to cause diabetes especially in Indian population. Waist circumference (Females>80 cm, Males >90 cm) , waist to hip ratio( Females > 0.85, Males > 0.90) and BMI (>23 kg/m2) are good indicators to measure metabolic syndrome & obesity.
  • High blood pressure causes damage to heart,kidney,eyes and increases chances of getting stroke and diabetes.
  • History of hyperglycemia during pregnancy increases chances of getting diabetes in future life.
  • PCOS has background features of insulin resistance and metabolic syndrome.
  • Alcohol abuse can lead to Pancreatitits and pancreatic damage.
  • Smoking cause decrease in HDL (good cholesterol) and increase in LDL (bad cholesterol) further leading to increased atherosclerosis.

If you found this article useful, please share it with your friends & family.

Awareness is Prevention.

what's-your-score


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How to Take Care of Your Feet in Diabetes ?

In India, Diabetes is the leading cause of minor and major foot amputations. Prevalence of Diabetes is increasing day by day in India, becoming World’s capital of Diabetes by 2025 with over 80 million affected population as per Diabetes Foundation India.

Diabetes Foot Care

There are four main reasons which increase the chances of foot ulcer & amputation:

  • Decreased blood flow to feet – Diabetic individuals have more accelerated & diffuse atherosclerosis throughout all major & minor blood vessels which leads to narrowing of blood vessels and poor circulation in feet.
  • Neuropathy – Majority of long standing diabetic individuals suffer from sensory motor & autonomic neuropathy i.e. nerve damage. Loss of pain sensation exposes foot to repeated trauma & injury. Autonomic neuropathy causes lack of sweating in foot area making it dry & prone to cracks and infection.
  • Loss of Arc – Long standing diabetes patients has lost the normal foot arc. Majority has clawed toes or Hammer toes, forward displacement of fat cushion below 1st metatarsal head, some have rocker bottom deformity,  all this leading to abnormal weight bearing pressure points in foot (corns & callosities) and change of shape of foot. This abnormal shape foot doesn’t fit properly in normal footwares, causing further injuries.
  • Slowed Delayed healing – In diabetes Neutrophil functions is impaired. Further more inter connected foot compartments easily pass infection from one area to other. Poor blood supply again delays healing.

To avoid all this complications, it is necessary to take care of your foot from the start.

Diabetes Foot Care

DiabeticFootCare

Following Diabetes Foot Care Tips will help you to keep your feet healthy :

  • Keep Your Blood Sugar in Target Range – HbA1c < 7
  • Do not walk bare foot even at home – Keep two separate pairs of footware for home & outdoors.
  • Inspect your feet everyday for blisters, cuts, redness, swelling, dryness, ingrown toenails, corns & callosities- use mirror to see bottom of foot.
  • Use special diabetes footware. Prefer using Ketto type sandels & shoes instead of slippers.
  • Wash your feet daily with warm water & mild soaps – check & confirm temperature of water with elbow before inserting feet into it. After washing, dry them thoroughly , even inter digit space.
  • Apply moisturizers on feet & lower leg to avoid dryness of skin – don’t apply between toes.
  • Cut toe nails carefully after bath when they are soft – avoid cutting cuticle & digging under toenails with sharp objects.
  • Use cotton or wool socks – change them daily, avoid too tight socks.
  • Wear properly fitting shoes with ample of cushioning. It is preferable to use leather shoes than synthetic material.
  • Always inspect your shoes or footwear for objects like metal pins, coins etc before wearing it.
  • Be physically more active – it increases blood supply to feet.
  • Do not cross legs for longer period while sitting, In spare free time move your feet up & down and rotate at ankle joint.
  • Quit smoking.

If you see cuts, corns, callosities, redness, blackening or delayed healing in minor cuts seek medical attention or consult your diabetes doctor immediately. Routine foot care & prompt attention to injuries can prevent foot problems from threatening your life and amputations.

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

Awareness is Prevention.

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