Diabetes Health Tips Archives - Page 8 of 16 - Dr. Nikhil Prabhu's Blog

Diabetes and Respiratory tract infections

November 30, 2020 by Haut Diabetes Care

Respiratory infections are very common infections in kids as well as adults. We know that respiratory tract infections are usually due to lower immunity response. Type 1 diabetes increases the tendency for both chronic and acute infections by weakening the immune mechanisms. The risk is specifically increased for respiratory tract infections, along with other infections have also been associated with diabetes. Study was conducted where investigation was carried out whether viral respiratory tract infections in children with type 1 diabetes might impose an additional burden on the arterial endothelial function or not.

As per the study, Upper-respiratory infections in early childhood and especially in the first year of life is associated with an increased risk for type 1 Diabetes Mellitus.

Epidemiology:

The incidence of diabetes mellitus is increasing rapidly in India as well as abroad. In addition to well-known other complications, diabetes increases the risk for hospitalization and death from severe acute respiratory infection (SARI) and influenza, pneumonia and tuberculosis. Male are more affected than females. Older groups are more prone to respiratory tract infections than younger groups.

Pathophysiology:

Diabetes increases the susceptibility to get different kinds of respiratory infections, which is usually identified as an solo risk factor for developing lower respiratory tract infections. Pulmonary infections caused by staphylococcus aureus, Mycobacterium tuberculosis, gram-negative bacteria and fungi may occur with an increased frequency, whereas infections due to influenza virus or Streptococcus pneumonia may be associated with increased mortality and morbidity.

During lung infection, there are changes in the ciliary epithelial lining. Increased susceptibility to pneumococcal infection by individuals with diabetes is due to reduced defense capability of antibodies to protein antigens. The incidence of tuberculosis in diabetic individuals is 5-6 times greater than among the non-diabetic population. It is observed that the malfunction of monocytes in patients with diabetes may contribute to the increased susceptibility to tuberculosis with a worse prognosis. Hospitalization of patients with diabetes due to influenza virus or flu-like infections is up to 7 times more likely to occur compared to healthy individuals, also diabetic patients are more likely to be hospitalized due to infection complications.

Signs and Symptoms:

Breathlessness
Wet Cough and cold, running nose in case of upper respiratory infections.
Fever
Loss of weight
Weakness
Bodyache, headache
Itching of the body
Thirst for sips of water

Investigation and Diagnosis:

CBC
ESR
X ray chest PA view
Blood sugar levels both fasting and Post pariandal
CT scan chest for extent of pneumonia
Chest pain
Sputum examination for bacteria
Mantoux test to rule out tuberculosis.

Management:

Immunization with influenza and anti-pneumococcal vaccines is the usual mode of treatment recommended to reduce hospitalizations, medical expenses and deaths. Also Diabetes should be monitored on regular basis. Antibiotics should be administered along with antitussives for upper respiratory tract infections like cold and cough with throat infections. Home remedies should be advised like warm water with lemon, steam inhalation for boosting immunity. Plate diet should be advised for Diabetes. Also one should consult a diabetologist for regular monitoring of blood sugar levels. Breathing exercises like yoga are very beneficial for healthy lifestyle.

Haut Diabetes Care

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Carbohydrate counting and Diabetes

November 29, 2020November 29, 2020 by Haut Diabetes Care

Do you know why do we count carbohydrate in Diabetes? Carbohydrate counting is the amount of carbohydrate intake in our body in units which provides energy to the body and also increases the blood sugar levels. It is usually counted to monitor the diet, meal intake to regulate the sugar control.

If you take insulin, carbohydrates counting can help you know how much insulin is needed. Not all people suffering from diabetes need to count carbohydrates. Carbohydrate counting is usually counted in grams. Let us first understand which foods are rich in carbohydrates. Some of the carbohydrate rich foods include milk and milk products, rice, starchy substances, sugars, sweets, fruits, processed foods and juices, refined grains, carbonated aerated drinks. One must avoid such substances or keep control over eating habits of carbohydrates.

If you take insulin during your meal time then one needs to monitor the carbohydrate intake so that it doesn’t increase your sugar levels and also one can judge the amount of insulin required for the body.

Advantages of carbohydrates counting in Diabetes:

It helps in improving the lifestyle.
Improves your activity and prevents sluggishness.
It prevents or delays the complications of Diabetes like Diabetic Nephropathy, Neuropathy, retinopathy, obesity, cardiovascular diseases, hypertension etc.

One carb serving gives 15 grams of carbohydrates. Every body needs different amounts of carbohydrates. If you have 2 baked potatoes, it gives 2 carb servings with total of 30 grams of carbohydrates. Also the amount of carbohydrates needed by the body depends upon various factors like age, weight, activity of the individual etc. A person usually takes 1800 to 1900 calories/day , out of which 900 to 1000 calories consists of carbohydrates as indian’s eat more of carbs. If 4 calories/gram of carb then 225-250 grams of carbs per day. One needs to avoid fried oily fatty foods, starchy substances to control body weight and maintain blood sugar levels. Try to eat same amount of carbohydrates every day to maintain a stable blood sugar level.

Carbohydrate serving 15 grams meal plan:

Starch: 1 slice of bread, 1/4 cup of pasta, 3/4 cup cereals

Milk: one cup of skimmed milk or 3/4 cup curd

Fruit: One small piece of fruit or 1/2 cup of fruit juice

Desert: 2 small buiscuits or 1/2 cup ice cream.

Tools that can be useful to patients as they become familiar with carbohydrate counting include measuring cups and spoons, food package labels, food scales, carbohydrate counting books.

Advanced Carbohydrate Counting:

However the following skills are required for people who have understood basic carbohydrate counting and wish to learn more advanced carbohydrate counting level (e.g., if a patient is planning to use an insulin pump or a bolus insulin regimen).

Ability to count all aspects of basic carbohydrate counting.
Understanding the concept of target blood glucose levels.

Understanding the concept of action of insulin and the basal-bolus insulin.

Willingness and ability to keep complete proper records.
Willingness to do pattern management.

Additionally one needs to know how to calculate a bolus insulin dose using insulin-to-carbohydrate ratios, insulin sensitivity factor for correction or supplementation of insulin doses when glucose levels are either too high or too low before meals, and how to make corrections for such special situations.

There are various ways and methods for determining insulin-to-carbohydrate ratios. For patients with type 1 diabetes, the general rule is that most people need about half of their total daily dose of insulin for basal insulin and half for their bolus doses to cover their meals. In type 2 diabetes, the basal and bolus demands can vary from patient to patient. Bolus insulin doses is calculated from the insulin-to-carbohydrate ratio which is based on the total grams of carbohydrate or the total number of 15gm carbohydrate servings consumed.

How to determine insulin carbohydrate ratio:

First record the total amount of carbohydrate intake during meals and snacks for 3 days. It will vary as per the activity and demand of the person.
Note down the blood glucose levels for 3 days.
Calculate the average intake of carbohydrates of 3 days and average of blood glucose levels. Then one can determine the amount of insulin required for that average blood glucose levels.
Then one can calculate the ratio of insulin carbohydrate ratio by dividing the number of grams of carbohydrate in a meal by number of bolus insulin given in units.

Hope our readers understood the simple way of calculating carbohydrate in your meal and plan your meal accordingly. Also the importance of monitoring carbohydrates in regulating the blood glucose levels and also manage the intake of insulin injections accordingly. One also needs to consult your diabetologist for proper guidance for calculating carbohydrate intake and insulin dose regulation.

Haut Diabetes Care

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Diabetes and fungal infections

November 21, 2020 by Dr. Nikhil Prabhu ( Diabetes Specialist )

Diabetes when uncontrolled, leads to increased chances of fungal infections. About 20 percent of India population suffers from fungal infections of the foot. Both Diabetes and fungal infections are linked with eachother. When the blood sugar levels are increased, there is increased growth of yeast resulting in fungal infections. The most common fungal infection is caused by Candida albicans (Yeast). Diabetes affects each and every part of the body, especially the skin. The first sign or symptom appearing is itching of the skin, especially the vagina in women. The most common skin symptoms include diabetic dermopathy, diabetic blisters, eruptive xanthomatosis and necrobiosis lipoidica diabeticorum.

Many bacterial infections of skin include stye (infection of glands of eyelid), carbuncles, furnuncles, folliculitis (infection of hair follicles) etc. The most common bacterial infection is staphylococcus bacteria. Fungal infections like Candida albicans are yeast-like fungus which create itchy rashes of moist, wet, red areas surrounded by tiny small blisters and scales. These infections occur in warm and moist folds of the skin. Most common regions are under the breasts, around the nails, between fingers and toes, in the corners of the mouth, under the foreskin of penis (in uncircumcised men), and under the armpits and groin.

Common fungal infections include ringworm (a ring-shaped itchy patch), jock itch, athlete’s foot and vaginal infection that causes itching.

Severity of these fungal infections varies from asymptomatic-mild mucocutaneous infections to life threatening systemic infections.

Factors contributing to Fungal infections:

The main determining factors of fungal infections are linked to geographical and socio-economic characteristics and increasing number of at-risk populations. Patients susceptible to fungal infections include those with immunosuppressive illnesses such as HIV/AIDS, chronic pulmonary diseases (COPD), tuberculosis, cancer and diabetes. It has been observed that patients with systemic fungal infections are at high risk of developing disseminated fungemia and prolonged stay in hospital. This condition is worsened if the patient has a metabolic disorder due to diabetes mellitus. This is because the diabetic patients are more prone to high blood sugar concentration which weakens the immune system and causes several other health complications.

There is high risk of fungal infections in individuals suffering from Diabetes Mellitus. Also it is difficult to treat fungal infections when the blood sugar levels are high.

Pathophysiology:

Usually there is presence of yeast in skin and mucous membrane. But when the blood sugar levels are high, yeast multiplies and form colonies which stick to the skin and mucous membranes. This leads to fungal infūections. There is itching, pain and inflammation of the skin in moist and wet regions.

In type 1 Diabetes Mellitus, the immune system is weak resulting in highl risk for fungal infections especially of foot. When the blood sugar levels are high, the extra glucose is excreated in mucus, urine and sweat. Once the yeast has formed colonies, it’s easier for the fungal infections to return.

Sites of infection:

In women with high Diabetes, the vagina and folds below breast are the common site where there is itching, with foul odour, vesicles formed.

In men, penis is the common site of infection.

Foot infections are very common for fungal Infections.

Eye infections with discharges, blurring of vision, itching and pain in eyes.

Oral thrush, with white patches in mouth, loss of taste, burning and cottony sensation in tongue.

Management:

Usually the patient is examined for the affected area of the skin and prescribed antifungal topical application and suppositories as well as oral medication like fluconazole, Itraconazole, cotrimazole, Miconazole, luliconazole and in severe infections even variconazole. Also Diabetes is also kept under complete check.

Now a days Many Diabetologists have noticed that the resistance to antifungal drugs is increasing day by day and even after using a combination of 2 or sometimes 3 antifungals not able to control the infection.

Also local hygiene is also maintained of the affected area. Diet is also monitored.

In resistant cases personal hygiene play an very important role. fungal spores are not easily destroyed so merging cloths in boiling water and changing bedsheets every alternate day. not using same cloths again without washing. not sharing cloths. breaking scratch-itch-scratch cycle by anti allergic medication. keeping genital area free of moist and clean plays a pivotal role.

Hope this article clarifies your doubts and queries regarding the Fungal infections in Diabetes.

i will soon write a new article on Ringworm infection and white discharge through PV soon.

if you have any queries drop me a meassage in comments here or on Youtube.

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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Glycemic index- it’s role in Diabetes.

October 29, 2020 by Dr. Nikhil Prabhu ( Diabetes Specialist )

The glycemic index (GI) is a scale in units assigned to a food for carbohydrates, with pure glucose value of 100, which represents the relative increase of carbohydrates in the blood sugar levels 2 hours after consuming that food. Low GI foods increase glucose levels gradually. High GI foods increase glucose levels instantly.

The GI scale ranges from 0 to 100. Pure glucose contains highest GI and is given a value of 100.

Having low GI foods can help you attain better control over your blood sugar. Monitoring the GI of foods can be another tool to manage diabetes, along with carbohydrate control and counting. A low-GI diet also helps with weight loss program.

Glycemic Index of Certain Foods discussed below:

Low GI foods (0 to 50):

Barley
Pasta, parboiled (converted) rice
High-fiber bran cereal
Oatmeal
Quinoa
Carrots, non-starchy vegetables, green vegetables
Oranges, grapefruit, apples and many other fruits
Legumes, nuts and beans
Milk, yogurt and milk products.

Moderate GI foods (50 to 65):

Pita bread
Raisins
Rye
Brown rice
Chapatti (whole wheat)

High GI foods (65 and higher):

White bread
Processed cereals and instant oatmeal, including bran flakes
Roasted snack foods
Potatoes(boiled, mashed)
White rice
Honey
Pineapple, watermelon

For glycemic load, below 10 is said to be low, 11 to 20 is said to be medium, and above 20 is considered high.

Several factors are taken into consideration while assigning a food a glycemic rating.

These factors are stated below:

Acidity

Foods that are highly acidic, such as pickles, citric fruits tend to be lower on the GI than foods that are not. Hence the fact proves that breads made with lactic acid, such as sourdough bread, are lower on the GI than white bread.

Cooking Time

The longer a food is cooked, the higher its GI. When a food is cooked, the carbohydrates begin to break down more quickly.

Fiber Content

In general, foods that are high in fiber have lower glycemic index. The fibrous coatings around seeds and beans reveals that the body breaks them down more slowly and gradually.

Process

As a general rule, the more the food is processed, the higher it is on the glycemic scale. For example, fruit juice has a higher GI scale than fresh fruits.

Ripeness

The more the fruit or vegetable is ripe, the higher it tends to be on the GI.

Importance of GI in Diabetes:

The main purpose of GI is it helps us in monitoring the post meal blood glucose levels. This helps the patient to eat the choice of combinations of foods an individual can eat.

Effects of eating low GI foods:

It helps in natural weight loss

Helps keep cholesterol level under control
It increases the body’s sensitivity to insulin
Help refuel carbohydrate stores after intense exercise
Reduces the risk of cardiac diseases

Effects of eating high GI foods:

It can lead to interference with cell function
It can increase the production of insulin
Increases the risk for obesity and type 2 diabetes and it’s complications in uncontrolled Diabetes.
Helps in accumulation of free fatty acid in the body

Hope this clarifies the importance of GI in our day to day life and also it’s role in Diabetes. Thus GI helps an individual especially suffering from Diabetes to chose the food wisely and monitor the blood glucose levels post lunch or dinner.

Glycemic Load : This is the actual value of GI x portion size.

Even if you eat low GI food but the portion size is more then your blood sugar levels will rise. In diabetes portion size per serving plays a very important role. so every diabetic should focus of Glycemic load rather than Glycemic Index only.

You can ask any doubts in comments. i will love to explain them

Have a great day

Dr. Nikhil Prabhu ( Diabetes Specialist )

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Epidemiology:

Pathophysiology:

Signs and Symptoms:

Investigation and Diagnosis:

Management:

Related posts:

Advantages of carbohydrates counting in Diabetes:

Carbohydrate serving 15 grams meal plan:

Advanced Carbohydrate Counting:

How to determine insulin carbohydrate ratio:

Related posts:

Factors contributing to Fungal infections:

Pathophysiology:

Sites of infection:

Management:

Related posts:

Glycemic Index of Certain Foods discussed below:

Low GI foods (0 to 50):

Moderate GI foods (50 to 65):

High GI foods (65 and higher):

Acidity

Cooking Time

Fiber Content

Process

Ripeness

Importance of GI in Diabetes:

Effects of eating low GI foods:

Effects of eating high GI foods:

Glycemic Load : This is the actual value of GI x portion size.

Related posts: