Diabetologist in mumbai - Dr Nikhil Prabhu

How to Take Care of Your Feet in Diabetes ?

November 11, 2015September 8, 2015 by Dr. Nikhil Prabhu ( Diabetes Specialist )

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.

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.

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.

Dr. Nikhil Prabhu ( Diabetes Specialist )

Dr Nikhil Prabhu is a consultant Diabetologist from mumbai. he has been practicing for more than 10 years and currently over 7000 patients are under his treatment for diabetes and thyroid disorder from mumbai and navi mumbai area. | you can book his appointment for tele-consultation on 9082523295 | follow us on YouTube for more diabetes & health related tips

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Eat Fruits Before Meals – Diabetes Health Tips

November 11, 2015August 31, 2015 by Dr. Nikhil Prabhu ( Diabetes Specialist )

Many fruits are rich in micronutrients, essential vitamins , fibre content and antioxidants along with that fruits occupy more space and less in calories so makes your tummy full and gives you feeling of satiety or fullness.

Most of the fruits have high fibre content , it comes in soluble or insoluble form. both forms are indigestible. They forms a bulk & increase water content of stool making it softer and easily movable in Gastrointestinal tract. Thus prevents constipation. High fibre diet reduces cardiovascular morbidity & mortality.

Diabetic person should avoid eating fruits with high glycemic index i.e. those fruits which readily digest in stomach and raises your blood sugars more than others like Mango, Chickoo, Banana (Green), Grapes, Custard Apple, etc.

Also one should avoid drinking fruit juices as condensation process increases sugar content of juice as well as a glass of juice is roughly equivalent to eating 2-3 fruits at a time. It is always better to eat a fresh fruit instead of drinking a fruit juice added with or without preservatives.

Managing blood sugars by diabetic person is all about balancing food intake. For example suppose Person (A) who is diabetic had four bread slices at breakfast at 9.00AM and his blood suagrs measured at 11.00AM found out to be 300 mg/dl. If the same person (A) divides those breakfast into 2 halves and take 2 bread slices at 8.00AM and 2 bread slices at 10.00 AM then his blood sugar roughly remains around 130 mg/dl . In this example the food intake is not decreased but instead it is divided into small quantity and consumed frequently.

Normally we consume most of the meal in the first 20 mins of starting a meal so eating a fruit before meal delays food intake and gives feeling of fullness or satiety earlier. That eventually leads to consumption of less food at meal so less calorie intake and helps to loose weight.

Many colorful fruits like berries are rich in antioxidants ( Lycopene, Beta-carotene, etc.) . In diabetes high bloood sugar values causes damage to nerves, retina, blood vessels and other systems via specific pathways. One of them is through generating free oxygen radical species, these anti-oxidants reacts with such harmful oxygen radicals and scavenger them thus minimizes the tissue damage in diabetes.

What fruits to eat in diabetes ?

Blueberries, blackberries, strawberries etc. all berries are rich in antioxidants, vitamins and low in carbohydrates.
Peaches are rich in vitamin A & C , Potassium and fibre.
Apple a day keeps doctor away. Apples are rich in fibre, vitamin C & low in carb. don’t peel the skin as it contains antioxidants.
Oranges are great in vitamin C, low in carb, contains potassium and folate, other citrus fruits like grapefruits are also equally good to eat.
Pears good in potassium and fibre.
Other fruits like apricot , guava are also rich vitamin A and good to eat .

Eating Fruits before meals helps you to loose weight & control your blood sugars. Making a habit of it helps a lot to obese individuals and known diabetic people.

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

Awareness is Prevention.

Dr. Nikhil Prabhu ( Diabetes Specialist )

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Home Remedies To Stop Type 2 Diabetes

November 11, 2015August 22, 2015 by Dr. Nikhil Prabhu ( Diabetes Specialist )

Approximately 95% people suffer from type 2 diabetes, which is primarily obesity & lifestyle related diabetes and can be prevented by diet modification & exercise. We normally diagnose diabetes when fasting blood sugar is more than 125 mg/dl, which is primarily affected by hours of fasting and quantity & quality of carbohydrate meal consumed at dinner last night. Also, 2 hours post prandial blood sugar depends on what we consume at breakfast or lunch. More than 200 mg/dl is diagnosed as diabetes. Majority of obese people, who are in the range of fasting sugars 100-125 mg/dl and/or post lunch sugars in range of 140-200 mg/dl, are about to develop diabetes in succeeding years are termed as Prediabetic. Diabetes can be reversed at Prediabetes stage with lifestyle modification (diet & exercise).

Home remedies can help you a lot to control blood sugars at Prediabetes stage to prevent its progress to Diabetes.

Now, we have a more reliable test called HbA1c ( Glycated Hemoglobin), which shows an average of blood sugars over last 3 preceding months which is not affected by hours of fasting and quality of food consumed. Normal person has a HbA1c value of 5.7% or less. Prediabetic person ranges between 5.7 -6.4 % of HbA1c , 6.5 % & above is diagnosed as Diabetes.

(HbA1c value is also affected by certain rare conditions like blood loss, hemoglobinopathies, adminstration of certain drugs like aspirin, Vitamin C, etc.)

Type 2 Diabetes is a progressive disease. When diabetes develops approximately 60% of pancreatic beta cells are dead and eventually over the time beta cells keep on diminishing and finally a stage arrives when exogenous insulin is necessary to control blood sugar.

Natural home remedies are fruits and vegetables which helps to lower sugar by reducing carbohydrate absorption from gut, delaying gastric emptying or preserving and promoting beta cell function.

In prediabetic stage these home remedies can help a lot to prevent its progress to diabetes. Also, in case of already developed diabetes these home remedies along with medication, can help to keep sugar under control. In diagnosed diabetes patients it is not an alternative to medication but adjunct to medication.

Commonly used home remedies includes :

Fenugreek (Methi): Methi seeds can be soaked in water overnight and can be consumed in morning along with water or powdered methi seeds can be consumed along with milk or water. Normally two tablespoon is an appropriate quantity.
Bitter gourd (Karela): Drinking karela juice daily on an empty stomach helps to lower sugar
Cinnamon (Dalacini): Adding dalacini to beverages and food helps to lower blood sugar to some extent.
Indian Goosebery (Amla): Amla is a rich source of Vitamin C. Drinking small quantity of amla juice daily helps to lower sugars.
Black Plum (Jamun): Powdered dried seeds of Jambul can be consumed along with water on empty stomach daily or jambul fruits can be consumed directly.
Other home remedies includes consumption of guava , powder of mango leaves with water , black coffee without sugar, green tea , okra , aloe vera , cloves, peas etc

All these home remedies are effective only if they are consumed daily for atleast 2-3 months. In known diabetes patients already on insulin or certain medication, occasional or sudden use may induce Hypoglycemia. In such a case, it is advisable to consult your diabetologist before starting such home remedies.

Other Home remedies includes :

Lifestyle modification with diet & exercise.
Daily high quality sleep to minimize stress.
Avoid smoking & tobacco.
Avoid excessive consumption of alcohol.
Staying lean with healthy diet & regular exercise is key to prevent diabetes.

If you like this article , Please share it with your friends & family.

Awareness is Prevention!

Dr. Nikhil Prabhu ( Diabetes Specialist )

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Darkening behind neck – Sign of Diabetes?

November 8, 2015August 15, 2015 by Dr. Nikhil Prabhu ( Diabetes Specialist )

Many overweight & obese people have darkening behind neck , darkening in armpits and other parts of body with creases and folds like elbows, knees, knuckles, etc. which is commonly mistaken as smudge of dirt or uncleanliness or lack of hygiene . Some people think that it is due to repeated friction caused by necklace or chains etc. In fact it is a sign of Diabetes which is already developed or going to develop.

This darkening is due to excessive cell growth & differentiation of fibroblasts caused by excess of insulin in the body especially in obese individuals and type 2 diabetes patients.

In Obese individuals and Type 2 diabetes patients excess amount of fat especially abdominal fat ( Tummy fat ) causes resistance to action of insulin secreted by pancreas and hamper its action. in return body produces more and more insulin from pancreas to keep blood sugar under control. This excess amount of insulin secreted by body promotes this skin cell growth and which leads to acanthosis nigricans.

After producing excess amount of insulin pancreas start exhausting and which leads to developing diabetes.

At this stage diabetes can be prevented by simple lifestyle modification & moderate weight loss.

Other commonly experienced warning signs & symptoms already mentioned in my previous article.

Keeping in mind that complications caused by diabetes on damaging retina, kidney, nerves , heart , vascular system etc and money burden caused by treatment, it is important to STOP DIABETES here.

Lifestyle Modification includes:

Replacing refined carbohydrates with whole grains foods.
Increase intake of fresh fruits , vegetables and other foods high in fibre content.
Decrease saturated fat intake like avoiding chips,biscuits,pastries, Samosas, Vada pav etc.
Increase intake of grilled & steammed food instead of frying and roasting.
Reducing Amount of meal at a time ( Portion size ) cuts down calorie intake.
Atleast daily 30 min moderate exercise including brisk walking, cycling etc.
Gradual Weight loss to keep BMI in range of 18- 23 ( for Indians )
Stress management with yoga, meditation etc

If you show this sign, Get your blood sugar test done and consult diabetologist immediately.

Feel free to share this article with your friends & family.

Awareness is Prevention.

Dr. Nikhil Prabhu ( Diabetes Specialist )

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