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DIABETES – A CLOSER LOOK

Diabetes mellitus (simply called Diabetes) is a metabolic disease where the blood sugar levels are higher than the normal range. Diabetes mellitus is a metabolic condition that prevents your body from properly using the energy from the food you eat because you can’t make insulin or because you can’t use it correctly, resulting in high blood glucose levels (Hyperglycemia) that can lead to health Chronic hyperglycemia is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.

Type FPG (mg/d L) PPG(mg/d L) A1c (%)
Normal < 100 < 140 5.7
Prediabetes > 100 – < 126 > 140 – < 200 > 5.7 – < 6.5
Diabetes > 126 > 200 > 6.5

To check your blood glucose a doctor may ask you to do various tests like fasting plasma glucose (FPG) should be done when you are fasting more than 8 hours and FPG less than 110 mg/dL will be considered as normal; a fasting blood sugar ranges between 100 to 125 mg/dL is considered as prediabetes or borderline to develop diabetes and is your FPG range is above 126 mg/dL then you will be considered as diabetic.

Your doctor may ask you to one more test called postprandial plasma glucose (PPG) this test should be done 2 hours after the meal and if your blood glucose will more than 200 mg/dL then you are considered as diabetic.

Also, your doctor may deploy a sensor of Continuous Glucose Monitoring System (CGMS) for 6- 14 days. The CGMS is modern technology for diabetes monitoring in this technique CGM works through a tiny sensor inserted under your skin, usually on your belly or arm. The sensor measures your interstitial glucose level, which is the glucose found in the fluid between the cells the sensor will be applied on your body (five fingers away from your belly button or back side of your shoulder). This sensor will record your blood glucose every 5 minutes interval and record 288 blood glucose reading per day. After 6-14 days the sensor will be removed and the report will be generated and accordingly, the doctor will prescribe you lifestyle modification or medications.

The amount of glucose in your bloodstream is tightly regulated by the hormone insulin. Insulin is always being released in small amounts by the pancreas. When the amount of glucose in your blood rises to a certain level, the pancreas will release more insulin to push more glucose into the cells. This causes the glucose levels in your blood to drop. Insulin also helps to store glucose in fat cells (Adipose tissue) and liver (for further use when you are not eating) and it increases the usage of glucose from your peripheral muscles.

Diabetes is caused if your body cannot produce insulin or your body cannot utilize insulin properly (Insulin resistance).

Type of diabetes

Gestational diabetes: Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy

Diabetes Complications

High blood glucose for a prolonged period may damage your micro-blood vessels of the eye (retinopathy), kidney (nephropathy), and nerves (neuropathy) and macro-blood vessels of the heart (coronary heart disease), brain (stroke) and lower extremities (peripheral vascular disease).

Prevention and management

Lifestyle changes such as losing weight, eating healthy and engaging in regular, moderate physical activity may reduce the progression of Type 2 diabetes. The key to eating with diabetes is to eat a variety of healthy foods from all food groups, in the amounts your meal plan outlines.

The food groups are

    • Vegetables
      • nonstarchy: includes broccoli, carrots, greens, peppers, and tomatoes
      • starchy: includes potatoes, corn, and green peas
    • Fruits—includes oranges, melon, berries, apples, bananas, and grapes
    • Grains—at least half of your grains for the day should be whole grains
      • includes wheat, rice, oats, cornmeal, barley, and quinoa
      • examples: bread, pasta, cereal, and tortilla
  • Protein
    • lean meat
    • chicken or turkey without the skin
    • fish
    • eggs
    • nuts and peanuts
    • dried beans and certain peas, such as chickpeas and split peas
    • meat substitutes, such as tofu
  • Dairy—nonfat or low fat
    • milk or lactose-free milk if you have lactose intolerance
    • yogurt
    • cheese
You should follow advice
  • Eat Regular meal

 

  •  Eat a variety of foods

 

  • Eat less salt
  • Eat less fat

 

  • Eat less sugar

 

  • Avoid or consume less alcohol
  • Eat fruits having a low glycemic index

 

  • Eat food having low glycemic index

 

  • Quiet smoking

Exercise

When you have type 2 diabetes, physical activity is an important component of your treatment plan.  It’s also important to have a healthy meal plan and maintain your blood glucose level through medications or insulin, if necessary.

If you stay fit and active throughout your life, you’ll be able to better control your diabetes and keep your blood glucose level in the correct range. Controlling your blood glucose level is essential to preventing long-term complications, such as nerve pain and kidney disease.

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Neurology

Neurology is the branch of medical science that deals with structure, functions and diseases of the nervous system. It involves the central nervous system (brain and spinal cord) and the peripheral nervous system (organs, nerves, limbs, muscles, skin and other sensory receptors).

While neurology is a nonsurgical field of medicine, surgical intervention of neurological disorders is known as neurosurgery. A neurologist is a specialist who diagnoses and treats neurological disorders.

Some of the most common and debilitating neurological disorders are epilepsy, dementia, Alzheimer’s, migraine, multiple sclerosis, neuroinfections, traumatic brain injuries, stroke, movement disorders and brain tumors.

Neurological disorders are also associated with improper nutrition and lifestyle, mood swings and depression, environment, genetics and infections (bacterial, viral, fungal and parasitic).

If ignored and left untreated, the consequences of neurological disorders can be serious with long-term disability and even death, as, few of these conditions are reversible. A quick diagnosis and treatment, such as medical care in the first ‘golden hour’ for a stroke patient, can arrest the progression of the disorder.

Although neurological disorders are prevalent in every strata of society and come with a high burden on patients and their families, there is an acute lack of awareness among the general public, especially the poor and the underprivileged.

The acronym STAND (Symptoms, Treatment, Advice and Assessment, Neurology, Determine), can be a thumb rule that can help both patients and their caregivers understand, manage and treat many neurological disorders.

Symptoms

Physical symptoms can be as simple as muscle weakness, numbness and headaches and/or as serious as partial or complete paralysis with loss of sensation. Emotional symptoms are hard to recognize but can include depression and delusions. Consult a medical professional in case of recurring symptoms such as fatigue and migraine, and especially if you experience tingling and numbness, changes in coordination, loss of balance, blurry vision and slurred speech.

Treatment

A number of specialized tests, such as electroencephalogram (EEG), genetic screening and brain scans, enable a neurologist to diagnose the problem and start treatment. With rapid advances in pharmaceutical and medical technology, various drugs and treatment options are now available to treat neurological disorders.

Advice and Assessment

While self-assessment can lead to awareness of a possible disorder, it is crucial that the person seeks immediate medical advice and treatment. Self-medication should be avoided as it can lead to side effects and even prove fatal.

Neurology

Although a neurological disorder can be frightening, a heart-to-heart talk with your doctor will give you a proper understanding of the condition, its symptoms and treatment options. Knowing that the condition can be treated will also put you at ease.

Determine

Determine to lead a healthy and active life, both physically and emotionally, and keep many disorders at bay. In the event of a neurological problem, your determination will help you fight the condition.

Knowledge, awareness and certain behavioral changes can help manage and treat many diseases and disorders.

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Pain Management

Pain is a complex, subjective and confusing phenomenon. Every person reacts differently to pain, depending on his or her awareness and capacity to bear it. Chronic or intense pain can be the result of an underlying condition and can cause acute distress to the sufferer. Some people have a high pain threshold, which means they can tolerate pain better than others. The capacity to endure pain reduces as one grows older; though, with a strong mind, one can overcome the debilitating effects of pain at any age.

The International Association for the Study of Pain defines the condition as

“An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

Pain can be managed and resolved with various treatment options, including medication, surgery, therapy, and mind-body techniques such as yoga and its associated disciplines.

Pain is broadly categorized into acute pain and chronic pain.

While acute pain is usually short term and treated with medication, chronic pain is often resistant to medical treatment. Pain is mostly associated with damage caused to the skin, tissue, muscles, bones, visceral organs, joints, tendons and nerves.

The severity of pain and the complications thereof depend on the injury or another health condition. To a large extent, complications can be avoided with proper understanding, diagnosis and management of pain. Doctors often treat symptoms of pain because they cannot find the cause. This can delay medical treatment and prolong a patient’s suffering.

In most situations, Pain Management is possible by simply being MOBILE:

M: Movement is a must. Doctors and physiatrists recommend movement and advise against sitting still (except in a few cases) to overcome injury-related pain. This improves blood circulation to the affected area, strengthens tissues and muscles, and speeds up the healing process.

O: Avoid self-medication or being your own doctor. Popping painkillers without a prescription will ease the pain temporarily and even lead to drug dependency. Besides, painkillers, when combined with other medicines, can have either a synergic or a contrary effect on the body. This can result in side-effects and even prove fatal.

B: A better understanding of various treatment options helps overcome the injury and pain faster. It is also possible to treat injuries with little or no medication, by relying on physical therapy, psychotherapy and counseling.

I: While interventional treatment options are available in severe cases, one should avoid these unless recommended by the doctor. The first line of treatment should be to let the injury heal itself.

L: Lifestyle modification such as a change in diet and exercise can provide relief from physical pain. Ask a qualified nutritionist for a list of foods that can aggravate pain. Then make a conscious effort to avoid eating blacklisted food, however tasty it may be.

E: Never hesitate to seek expert medical advice. Trust a medical professional enough to deal with the problem.

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