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How To Treat Hypoglycemia at Home?

October 12, 2015October 8, 2015 by Dr. Nikhil Prabhu ( Diabetes Specialist )

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.

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.

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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Calculate Your Risk of Getting Diabetes ?

November 11, 2015September 10, 2015 by Dr. Nikhil Prabhu ( Diabetes Specialist )

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.

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

Female = 0 Points
Male = 1 Points

2] Your Age ?

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

3] What is your ethnic Background ?

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

4] Do You have a relative with diabetes ?

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

5] What is your waist circumference ?

< 90 cm = 0 points
90-100 cm = 1 points
100-110 cm = 2 Points
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/

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

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

No = 0 Points
Yes = 1 Points

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

Negative history = 0 Points
Positive history = 1 Points

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

No = 0 Points
Yes = 1 Points

10] Frequent Alcohol intake ?

No = 0 Points
Yes = 1 Points

11] Smoking ?

No = 0 Points
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.

Dr. Nikhil Prabhu ( Diabetes Specialist )

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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 )

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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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