#BestDiabetologistinNaviMumbai

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Diabetic Foot Care: Taking the Right Steps

Consult diabetic foot doctor in Navi Mumbai as diabetic people are at a high risk of foot ulcers and infections. They are also prone to nerve damage, mostly in the legs.

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In this Infographic, we have given you information about the types of diabetes. Here we have said that each type will be understood briefly.

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Diwali and Diabetes..! (Sweet Clinics)

Diwali the festival of lights is here. It’s also the time when food is in abundance especially sweets and offered to all. So with the wealth of rich food available it can be very taxing time for a diabetic to keep his blood sugar in control. A maximum number of diabetics come with haywire blood sugars post Diwali.

So for those of us whom will power does not come easily here are some tips for enjoying sensible eating at Diwali.

Commit yourself to a food plan. It is very easy to get carried away by what is on the table .To reduce this from happening plan how much you intend to eat and what to eat and make a point sticking to the meal plan. Keep to your routine meals as much as possible as it will prevent unnecessary snacking. Avoid feeling hungry for long. When you are hungry you tend to over eat. One way to avoid being ravenous is to break the delay. Protein and non starchy vegetables based premeal snacks are a good choice as they are filling and slowly broken down.

Have a glass of water before eating, it’s a very effective way of reducing your food intake and reduces appetite. Have food in a small plate. It gives a fuller look with less amount of food. Again base your meals with non starchy vegetables .Make sure vegetables account for a good portion of your plate.

Eat gradually and slowly. Eating with family is a nice occasion but if you are a fast eater it can make you tempted for additional helpings and adding to your overall calorie intake.

Don’t feel guilty or shy about turning offers down. Any food you eat is going to end in your blood and so don’t feel shy about turning food down especially the sweet ones.

Go very easy on the sweets. One can be forgiven for indulging every once in a while. So if you cannot resist the sweet, keep the serving small and sensible. Once again apply the rule about eating gradually. If temptation is too much to have a sweet dish, try fresh fruits. Fresh fruit mixed with yoghurt and frozen can be a good replacement for the Rabidi or Jalebi or ice cream. Try using sugar free sweeteners in a limited amount in your sweets but remember every thing has calories and just because you have used artificial sweeteners does not give you the liberty to have unlimited amounts.

After and between meals put food under cover. Food that is exposed grabs the eye tempting to small unwanted indulgency .Apply the rule out of sight is out of mind.top diabetologist in navi mumbai

Try to increase your physical activity as this is a good way of utilizing those extra calories that you may have indulged in. Remember to take your medications .With family and friends around and the excitement of festival should not make you miss your insulin shot or regular medications.

Continue regular checking of your blood sugars to make you aware of your indulgences, . Finally Diwali is not just about sweets, it’s about family and friends. Enjoy your time with family doing things that you love the best.

Have a happy and safe Diwali…………….Sweet Clinics

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Punch Diabetes Before it Punches you!

Troubled with diabetes? Get your problems solved with our best diabetes specialist at Sweet Clinics and punch diabetes before it punches you!

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RISK OF HYPERTENSION FOR DIABETIC PATIENTS - Sweet Clinics

Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.

Hypertension can be asymptomatic. Even without symptoms, damage to blood vessels and heart continues and can be detected.  The risk of hypertension in diabetes is the most common co-morbid condition present. It is a major risk factor for both the microvascular as well as macrovascular complications of diabetes.

Relationship between Hypertension and Diabetes

Hypertension is an important correlate of metabolic syndrome. Hypertension in diabetes increases the risk of developing high blood pressure and other cardiovascular problems, because diabetes adversely affects the arteries, predisposing them to atherosclerosis (narrowing of the arteries). Concomitant hypertension increases the risk of left ventricular hypertrophy, cardiac failure, stroke, peripheral vascular disease, renal dysfunction and retinopathy.

Types of Hypertension

Essential hypertension. This is a most common type of hypertension with no symptoms, some experience of frequent headaches, tiredness, dizziness, or nose bleeds. Although the cause is unknown, the research has shown that obesity, smoking, alcohol, high-calorie diet, and heredity plays an important role in essential hypertension.

Secondary hypertension. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, the risks of hypertension include:

Obstructive sleep apnea Kidney problems Adrenal gland tumors Thyroid problems Certain defects in blood vessels you’re born with (congenital) Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs Illegal drugs, such as cocaine and amphetamines Alcohol abuse or chronic alcohol use Staging of hypertension

SYSTOLIC BP(mmHg) DIASTOLIC BP(mmHg) Normal <120 <80 Prehypertension 120-139 80-89 Stage 1 hypertension 140-159 90-99 Stage 2 hypertension >160 >100 Systolic BP >140 mmHg is a more important risk factor for cardio vascular disease (CVD) than diastolic BP. The risk of CVD doubles with increment of 20/10 mmHg beginning at 115/75mmHg.

Risk factors for hypertension

Age Race Family history Being overweight or obese Not being physically active Using of tobacco Too much salt (sodium) in the diet Stress Drinking too much alcohol Certain chronic conditions such as diabetes, kidney disease, sleep apnea Prevention

Lifestyle changes can help you control and prevent high blood pressure, even if you’re taking blood pressure medication. Here’s what you can do:

Eat healthy foods Decrease the salt in your diet Maintain a healthy weight Increase physical activity Limit alcohol Don’t smoke Manage Monitor your blood pressure at home Practice relaxation or slow, deep breathing Control blood pressure during pregnancy 

top diabetologist in navi mumbai Sticking to lifestyle changes can be difficult, especially when there are no symptoms of high blood pressure. Motivate yourself, by remembering the risks associated with uncontrolled high blood pressure. It would help to enlist the support of family and friends as well.

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BASICS OF DIABETES – WHAT IS DIABETES?

India is known as diabetes capital of the world, simply because India has the maximum number of diabetic patients worldwide. In addition to the huge population of 1.25 billion, India has a very high prevalence of Diabetes. Every 8th Indian above the age of 40 years is diabetic. On this World Diabetes Day, I intend to start a series of articles that would make it easy for you to understand what diabetes is, how to prevent it and how to take care of a patient who has developed diabetes. Starting the series with first one on basics of diabetes.

Diabetes is characterized by high levels of glucose in blood, more than 125 mg/dl in fasting condition and more than 200 mg/dl 2 hours post meal (or post glucose challenge when done for diagnosing diabetes). Diabetes is far more than simply high levels of blood glucose. There are variety of causes, associated conditions and complications associated with diabetes. The worst part about diabetes is that the patient usually doesn’t develop any symptoms till the disease is progressed. Once diabetes is diagnosed the patient has to be treated well for prevention of the deadly complications though he may not have any symptoms.

Types of Diabetes

The most common type of diabetes is Type 2 DM constituting about 95% of diabetic patients. We sill restrict our discussion to type 2 DM in this article. Diabetes seen in very young children who are not at risk of type 2 DM is called type 1 DM. Patients of type 1 DM usually require insulin injections and cannot be treated with oral medicines. Some females develop a temporary type of diabetes during pregnancy and is called as gestational diabetes. There are number of other secondary types of diabetes which are rare and may not be discussed here.

What causes Diabetes?

It would be necessary to understand the concept of Insulin Resistance explained in earlier article to understand this. Type 2 DM is a dual defect. In addition to insulin resistance the patient has insulin deficiency. So the body produces less amount of insulin and the insulin produced is not of good quality. Due to shortage of insulin the cells fail to take up glucose and that leads to high levels of glucose circulating in blood.

How does it harm?

On the one hand the cells of body are starving as they cannot take up insulin while on the other hand the high levels of glucose in blood harm other organs. High levels of glucose for a short period may not harm the body unless the levels are very high but in long term it leads to various complications.

What are symptoms of diabetes?

In early stage of diabetes when the blood glucose levels are not very high, the patient may not at all feel anything. If the glucose levels go further high, it is filtered through kidneys. Glucose is passed out through urine, and with osmotic pressure it pulls water out. This leads to frequent urination. Due to frequent urination body is short of water and patient feels thirsty and drinks more water. Though the glucose levels in blood are high, cells are unable to take it up. The cells are starved and that leads to weakness, fatigue. This also passes on signal to brain and leads to excessive hunger. The glucose generated from food that patient takes is passing out through urine. So in spite of excessive eating the patient may start loosing weight. The patient may also feel abnormal sensation in his feet, he may feel dizzy. Wounds may not heal soon and patient gets more prone to number of infections.

What are the complications?

As explained in the article on Insulin Resistance, people with high insulin resistance are prone to atherosclerosis (thickening of arteries supplying blood to various organs).top diabetologist in navi mumbai Due to this the blood supply to various organs is hampered. If small vessels are affected it leads to complications like Neuropathy (abnormal sensation starting with feet usually), retinopathy (which may lead to loss of vision) and Nephropathy (which may lead to kidney failure). If the large vessels are affected it can lead to heart attack, paralysis or gangrene.

How to prevent diabetes?

People with family history of diabetes, obesity, inactivity are at high risk of developing diabetes. Routine check should be done after age of 30 years. A healthy diet with limited carbohydrates (specifically sweets) and high proteins should be consumed. Regular exercise of at least 45 minutes a day is the best for prevention. There are a few drugs that your doctor may prescribe.

How to treat diabetes?

Control high levels of blood glucose is the easiest task that even a pharmacist can do. But treating diabetes is far beyond controlling blood glucose levels. The drugs to be used vary from person the person. An expert in diabetology is the best person to choose drugs for a patient. Wrong choice of drugs may control blood glucose levels in initial stages but may lead to beta cell failure. The most important aspect of treating diabetes is preventing deadly complications that may arise a few years later.

I have tried to summarize everything in a small article. Will now focus of small issues in each new article. Though diabetes is a highly specialized subject I am sure if explained in simple language you would be able to understand good enough of diabetes that is needed to take care of yourselves or your relatives.

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About type 1 diabetes

Diabetes is a lifelong condition that causes a person's blood sugar (glucose) level to become too high.

The hormone insulin – produced by the pancreas – is responsible for controlling the amount of glucose in the blood.

There are two main types of diabetes:

Type 1 – where the pancreas doesn't produce any insulin Type 2 – where the pancreas doesn't produce enough insulin or the body’s cells don't react to insulin.

Type 1 and type 2 diabetes Type 1 diabetes can develop at any age, but usually appears before the age of 40, particularly in childhood. Around 10% of all diabetes is type 1, but it's the most common type of childhood diabetes. This is why it's sometimes called juvenile diabetes or early-onset diabetes.

In type 1 diabetes, the pancreas (a small gland behind the stomach) doesn't produce any insulin – the hormone that regulates blood glucose levels. This is why it's also sometimes called insulin-dependent diabetes.

If the amount of glucose in the blood is too high, it can, over time, seriously damage the body's organs.

In type 2 diabetes, the body either doesn't produce enough insulin to function properly, or the body's cells don't react to insulin. Around 90% of adults with diabetes have type 2, and it tends to develop later in life than type 1.

Diabetes symptoms The symptoms of diabetes occur because the lack of insulin means that glucose stays in the blood and isn’t used as fuel for energy.

Your body tries to reduce blood glucose levels by getting rid of the excess glucose in your urine.

Typical symptoms include:

feeling very thirsty passing urine more often than usual, particularly at night feeling very tired weight loss and loss of muscle bulk The symptoms of type 1 diabetes usually develop very quickly in young people (over a few days or weeks). In adults, the symptoms often take longer to develop (a few months).

Causes of type 1 diabetes Type 1 diabetes occurs as a result of the body being unable to produce insulin, which moves glucose out of the blood and into your cells to be used for energy.

Without insulin, your body will break down its own fat and muscle, resulting in weight loss. This can lead to a serious short-term condition called diabetic ketoacidosis, where the bloodstream becomes acidic and you develop dangerous levels of dehydration.

Type 1 diabetes is an autoimmune condition, where the immune system (the body's natural defence against infection and illness) mistakes the cells in your pancreas as harmful and attacks them.

Treating type 1 diabetes It's important that diabetes is diagnosed as early as possible, so that treatment can be started.

Diabetes can't be cured, but treatment aims to keep your blood glucose levels as normal as possible and control your symptoms, to prevent health problems developing later in life.

If you're diagnosed with diabetes, you'll be referred to a diabetes care team for specialist treatment and monitoring.

As your body can't produce insulin, you'll need regular insulin injections to keep your glucose levels normal. You'll be taught how to do this and how to match the insulin you inject to the food you eat, taking into account your blood glucose level and how much exercise you do.

Insulin injections come in several different forms, with each working slightly differently. Some last up to a whole day (long-acting), some last up to eight hours (short-acting) and some work quickly but don't last very long (rapid-acting). You'll most likely need a combination of different insulin preparations.

There are alternatives to insulin injections, but they're only suitable for a small number of patients. They are:

insulin pump therapy – where a small device constantly pumps insulin (at a rate you control) into your bloodstream through a needle that's inserted under the skin famous diabetologist in navi mumbai islet cell transplantation – where healthy insulin-producing cells from the pancreas of a deceased donor are implanted into the pancreas of someone with type 1 diabetes (read about the criteria for having an islet transplant) a complete pancreas transplant

Complications If diabetes is left untreated, it can cause a number of different health problems. Large amounts of glucose can damage blood vessels, nerves and organs.

Even a mildly raised glucose level that doesn't cause any symptoms can have damaging effects in the long term.

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Gestational diabetes - Sweet clinics(Diabetologist in Navi Mumbai)

Gestational diabetes is a temporary condition that affects some women during pregnancy.

Effects of gestational diabetes

Gestational diabetes often resolves after delivery, but a person who experiences it may have a higher risk of developing type 2 diabetes later in life.

Other problems that can arise include:

gestational diabetes Some women experience gestational diabetes during pregnancy. labor difficulties the need for a cesarian delivery a risk of tearing in the vagina or between the anus and the vagina heavy bleeding after delivery

The baby may be born with:

breathing problems low blood sugar jaundice There may be no symptoms during pregnancy, so testing is important, especially for those who may be at risk.

If getational diabetes is present, it is important to follow the doctor's instuctions about diet, exercise, and tracking blood sugar levels.

Risk factors

Gestational diabetes is more likely if a person:

is overweight before becoming pregnant has prediabetes, when blood sugar levels are high but not high enough for a diagnosis of diabetes has a family history of diabetes has previously had gestational diabetes has delivered an infant larger than 9 pounds in the past has PCOS has an African American, Asian American, Hispanic, Native American, or Pacific Island background After pregnancy

When a person has had gestational diabetes during pregnancy, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recommend the following steps after delivery:

screening for type 2 diabetes 6–12 weeks after delivery and every 3 years after that getting back to a healthy weight through regular exercise and a healthful diet breastfeeding the baby, if posssible, to give them the right balance of nutrients and to help you burn calories check with a physician about using metformin, a medication, to help prevent type 2 diabetes What are the early signs of type 2 diabetes? Click here to find out more.

Pregnancy and the menopause Diabetes can impact on two major aspects of female sexual and reproductive health.

Pregnancy Women who have diabetes before pregnancy need to take certain steps to ensure a safe pregnancy.

Blood sugar levels: If possible, keeping blood sugar levels under control before pregnancy is vital. High blood sugar levels can harm the fetus and may result in congenital anomalies.

This is especially true early in pregnancy, when a person might not yet know they are pregnant.

Medication: The person may need to change their use of medication during pregnancy.

Diet and lifestyle factors: Diabetes can increase the risk of complications during pregnancy, so a person should work closely with their healthcare team to establish:

a safe diet an exercise plan a schedule for testing blood sugar at home the need for other tests and monitoring Menopause woman exercising Menopause can worsen diabetes symptoms, but exercise and a healthful diet will help. Menopause and the years leading up to it involve a variety of changes that can trigger diabetes or make it worse.Diabetologist in Navi Mumbai

Hormonal changes alter how cells respond to insulin. Blood sugar levels might become less predictable and require more frequent monitoring.

Menopause leads to a drop in estrogen levels as the ovaries stop producing eggs. A person may be more prone to UTIs and vaginal infections at this time if they have diabetes.

Many women experience weight gain during menopause. Women with diabetes may need to change their insulin doses or oral diabetes medications to adapt to these changes.

A study published in 2018 concluded that women with type 2 diabetes who experience hot flashes and other symptoms of menopause may benefit from hormone therapy.

However, the authors note that treatment will depend on the individual.

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Type -1 Diabetes - Sweet clinics

hba1c calculator.Diabetes Definition type 1 diabetes.diabetes diet Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy.

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A Diabetics guide to fasting – by A Diabetologist & Dietician..! Sweet clinics Diabetologist in Navi Mumbai/Vashi

For Diabetics, managing diet in normal day-to-day life is no child’s play; add to that the twist of fasting is an even very risky affair. Diabetics in general are advised not to do fasting. However, if you still want to venture into fasting there are some important precautions & guideline which diabetics need to follow. As we have highlight in this article. First, we talk about who absolutely cannot do fasting & who can. Followed by the right way to plan fasting with the help of your diabetologist and finally what a diabetic should eat and when. So, let’s get started

Diabetics who should absolutely and Definitely NOT do Fasting Diabetic people who are on insulin treatment should not even think about fasting as they need constant monitoring and any drop or increase in blood sugar can prove fatal. Type 1 diabetics who are inherently dependent on insulin should not fast, sorry but its for your own good. Diabetics who have other medical conditions like cardiac, renal problems need to avoid fasting aswell. Diabetics who are at a risk or prone to both hypo & hyper glycemia should not do fasting. Senior Citizens who are diabetic are advised not to. Diabetics who can do fasting under the observation of a diabetologist: Diabetics who fall in the following category of patients can think of fasting but only if their diabetologist clears them to do so:

Diabetics who have good control on their blood sugar and are not on any high dose of medication can opt for fasting. Diabetics who do not have much fluctuations in their sugar levels can think of fasting. Diabetics who are not at a high risk of hypo-glycemia can fast.

How to go about fasting if you are diabetic: Consult your Diabetologist & get your medications in order: As there will be a change in the food intake there will be a significant change in the blood sugar levels compared to your normal routine. Hence, the dosage of diabetes medications needs to change according. For example, your main medication needs to be shifted according to the time when you will have the proper fasting meal of the day (details below). This change can only be prescribed by your treating diabetologist. Monitor your Blood Sugar Religiously; Diabetics should check their blood sugar at-least 3 times a day or whenever they feel symptoms of hypoglycaemia. Signs of hypoglycaemia include feeling weak and giddy, having palpitations. If they find that the blood sugar is below 80 you need to break your fast and have something to eat ASAP! Like a fresh fruit juice!

Managing Diet when fasting if you are diabetic: The critical challenge for diabetics when fasting is to make sure they don’t go into hypoglycaemia nor should they suffer from hyperglycaemia. For example, Some fasting foods like sabudana (Tapioca) which has a higher glycaemic index if taken in excess can trigger hyperglycaemia While not eating anything for more than 2-3 hours can cause hypoglycaemia. Hence, as suggested earlier its critical to check your blood sugars actively when fasting.

So What should a typical fasting diet include during Navratri; Diabetics cannot do the fasting where no food or water is allowed during day, please don’t. Fortunately fasting in Navratri allows most of us to have fruits and some sattvic foods during the course of the day. it is important to select foods which have a lower glycaemic index for the reason stated above. Nonetheless you can have other foods with higher glycaemic index in moderation aswell so lets dig in Diabetologist in  Vashi

Foreword: Diabetics must make sure that they have something every 2 hours to keep their sugar level maintained. Having Mid-meals like Fresh fruit, Milkshake, Chaas, Shikanji, kheer, Shakarkandi ki chaat or Sabudana wada with dahi can be a good option. Keep the portions balanced depending on your physical activity. Stay Hydrated: Diabetics should have atleast 3 litres of water in a day.

Avoid Caffeine – Tea Cofee – Tea can often cause acidity leading to vomiting and other complications. Just after waking up– Early morning are critical as the blood sugars in general are low so diabetics need to make up for it else can go into hypoglycaemia. Start the day by having either of these. Any Fresh fruit that you like or may have Handful of nuts Overnight soaked almonds with kesar Breakfast– This meal should ideally help your regain your blood sugar levels and also keep you going for the day hence something like Singhare ke pakode Sabudana khichdi Sweet potato with dahi Alu Ki kheer Chana poori and halwa (Yes but on last day! With some moderation) Lunch – For lunch you can have. Rajgira or kuttu or singhare atta ki roti with Alu or arbi sabzi Makhane ki sabzi Kuttu ki kadhi with samo chawal upasacha thalipeeth Dinner – For fasting diabetics, skipping dinner is not an option. Dinner needs to keep your sugars up all night so you the diabetic can stills stand in the morning. A proper fasting meal would be ideal or you could try Samo chawal with dahi Jhangora kheer Paneer ki sabzi with kuttu or singhare or rajgira or banana flour ki roti So have a happy & safe fasting! and remember If you are unsure of how to go about this you can contact your treating diabetologist or contact us 9167444888 on and our inhouse diabetologist & Diet consultant will guide you.

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Lifelong care for diabetes..!! Sweet clinics

WHAT DOES DIABETES MEAN?

Diabetes mellitus is a chronic disease in which blood sugar level of a person goes abnormally high due to decreased insulin production or due to insulin resistance or both. The common symptoms of diabetes mellitus include increased frequency of urination, increased thirst, hunger, and tiredness. Diabetes cannot be cured. It can only be controlled or managed.

WHAT IS DIABETES?

A person’s blood sugar level goes abnormally high It happens due to insulin resistance or decreased insulin production or both Common symptoms: Frequent urination, increased thirst, hunger, tiredness Diabetes cannot be cured. It can only be controlled or managed.

TYPES OF DIABETES

TYPE 1 DIABETES: It is an autoimmune condition in which body’s immune cells destroy the insulin secreting cells of pancreas. There is absolute insulin deficiency and injectable insulin is the only medical way to control it.

TYPE 2 DIABETES: It is the most common type of diabetes and its primary cause is insulin resistance and amount of insulin production is reduced (no absolute insulin deficiency). Obesity, sedentary lifestyle and family history are the risk factors for diabetes. It is managed with lifestyle modification, dietary modification and oral drugs. If not adequately controlled, later on, the patients may need to be switched to injectable insulin.

GESTATIONAL DIABETES: When a pregnant woman develops high blood sugar levels for the first time during pregnancy, it is called gestational diabetes. Pregnancy is a state of insulin resistance and thus triggers diabetes. It generally manifests during second and third trimester of pregnancy. It is managed with injectable insulin.

WHAT CAUSES DIABETES?

GENETIC SUSCEPTIBILITY

Heredity plays an important part in determining who is likely to develop diabetes. Genes are passed down from biological parent to child.

OBESITY AND PHYSICAL INACTIVITY

Physical inactivity and obesity are strongly associated with the development of type 2 diabetes. People who are genetically susceptible to type 2 diabetes are more vulnerable when these risk factors are present.

INSULIN RESISTANCE

Insulin resistance is a common condition in people who are overweight or obese, have excess abdominal fat, and are not physically active. Muscle, fat, and liver cells stop responding properly to insulin, forcing the pancreas to compensate by producing extra insulin. As long as beta cells are able to produce enough insulin, blood glucose levels stay in the normal range. But when insulin production falters because of beta cell dysfunction, glucose levels rise, leading to prediabetes or diabetes.

SOME OTHER CONDITIONS ALSO PLAY A ROLE IN DEVELOPING DIABETES:

Gestational diabetes (in pregnancy) Hyperthyroidism Cushing syndrome Acromegaly Phaeochromocytoma Pancreatitis Cancer in pancreas Haemochromatosis Cystic fibrosis Some drugs, chemicals Infection like German measles, down syndrome, turner syndrome etc. So, the target is: Control blood sugar and avoid cardiometabolic complications

EATING WELL WITH DIABETES

Taking steps to prevent and control diabetes doesn’t mean living in deprivation; it means eating a tasty, healthy and well balanced diet

You don’t have to give up sweets entirely or resign yourself to a lifetime of bland food. With these tips, you can still take pleasure from your meals without feeling hungry or deprived.

Set timely reminder on when to eat! Your body is better able to regulate blood sugar levels—and your weight—when you maintain a regular meal schedule. Aim for moderate and consistent portion sizes for each meal or snack. Don’t skip breakfast. Start your day off with a good breakfast. Eating breakfast every day will help you have energy as well as steady blood sugar levels. Eat regular small meals—up to 6 per day. People tend to eat larger portions when they are overly hungry, so eating regularly will help you keep your portions in check. Keep calorie intake the same. Regulating the amount of calories you eat on a day-to-day basis has an impact on the regularity of your blood sugar levels. Try to eat roughly the same amount of calories every day, rather than overeating one day or at one meal, and then skimping on the next.Top diabetologist in Navi Mumbai

RATE YOUR PLATE

Take a good look at your plates -- the foods you choose and the portions you eat. Rate your plates to see if they measure up.

Try to eat a balance of food groups so as to obtain healthy combination of carbohydrate, protein & fat in your diet as described in the diabetic food plates below.

Diabetic Non-Vegetarian Plate Diabetic Vegetarian Plate Reduce extra-large servings of less-healthful foods and increase servings of foods we're not eating enough of: vegetables, fruits, dairy foods, and whole grains.

Start by reducing your portions of less-healthful foods by 5 to 10 percent. You'll barely notice the trimming, but you'll immediately taper your intake of calories, carbohydrate, fat, and sodium. Over time, this portion slim-down will improve your weight, blood glucose, cholesterol, and blood pressure.

There is no one perfect food so including a variety of different foods and watching portion sizes is key to a healthy diet.

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Arthroscopic Release of Frozen Shoulder Problems in Diabetics By Sweet Clinics..!!

Diabetics in India have an additional burden of joint problem in addition to their systemic problems of nerves, eyes, blood vessels, kidneys etc. Diabetics are prone to develop a condition of the shoulders called primary frozen shoulder. It can affect both shoulders in a small percentage of people. It usually resolves over a period of time but can leave behind a lasting deficit of certain movements.

Middle aged diabetics also develop tears of the rotator cuff and this can lead to a secondary frozen shoulder. Rotator cuff is group of tendons on top of the shoulder which help to stabilize the joint.

They can develop calcium deposition in the rotator cuff tendons.

They are prone to develop Gouty arthritis in their shoulders like in any other joints since Gout has an association with diabetes. Gout is a condition due to consumption of uric acid which is a by product of the digestion of red meat.

In this article I shall discuss frozen shoulder.

Definition-

Frozen shoulder (Adhesive capsulitis, periathritis) is a condition characterized by a loss all movements at the true shoulder joint. There is pain initially. Pain settles down and there remains stiffness which sets in over a short period of time. Clever people may recall a traumatic incident. In others it may come on slowly. Stiffness may be permanent. The movement that is maximally affected is external rotation (rotating the arm outwards away from the body). This results in inability to reach behind the head with the hand to tie the hair. When both shoulders are affected elderly women are in an embarrassing situation. Overhead activities are also affected as the degree of elevation of the arm is reduced.

Anatomy

The shoulder is the most mobile joint in the body. Its function is to position the arm in space to reach out to objects and deliver them to the mouth for eating and for other actions. The shoulder is a ball and socket joint formed by the upper end of the humerus (arm bone) and the socket formed by the glenoid of the shoulder blade. It is lined by a bag like capsule. The capacity of this joint is about 15- 20 cc. In frozen shoulder the capacity is reduced to 2- 3 cc. The movements at the shoulder joint occur synchronously with that at joint between the shoulder blade and the torso and are compensated to some extent by this.

History of frozen shoulder-

Only in the last few years has the ideal treatment been suggested. It is a relatively rare disorder of the shoulder and in a population of 20 shoulder patients there may be one or two with this condition.

However many doctors and orthopaedic surgeons label any painful condition as a frozen shoulder and advice physiotherapy. This can make the condition worse.

Recent advances

It has been recently discovered that the answer to frozen shoulder lies in the genes. These genes may also be associated with Diabetes mellitus. The alterations in these genes and chromosomes lead to a distorted response to wound healing and scar tissue formation. Exuberant scar tissue forms in response to trauma. The remodeling of scar tissue collagen is less. When more scar tissue forms in the capsule of the shoulder joint, the normally possible movements are grossly reduced. Diabetics also develop nodules in their palms and feet, another evidence of the exaggerated healing process.

Standard treatment-

This is a combination of physiotherapy and steroid injections when the condition is initially painful. Physio can be done at home. The standard Orthopaedic treatment has been a manipulation under anaesthesia. This carries a theoretical risk of fracture but has not been validated in practice.

A manipulation is contraindicated when a x ray reveals that the bone is very osteoporotic. It is also contra indicated in diabetics as more exuberant scar tissue will form in response to the crude method.Top Diabetologist in navi mumbai

Since I have pointed out that sometimes rotator cuff tears can coexist with a frozen shoulder, the ideal management for a frozen shoulder would be an arthroscopic release of the contracted structures within the joint. An arthroscope is an instrument used to look into joints through tiny key hole incisions. The benefits are less pain after surgery and faster rehabilitation. Since scar tissue formation is minimized, chances of recurrence are less and greater are the chance of retaining the full range of movement achieved during the procedure. The range of movement achieved after the release has to be maintained with physiotherapy. In case there is some tear of the rotator cuff, repair can be done at a later stage.

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Diabetes and Heart Disease: What Is The Relationship Between Them...?

A link between Heart Disease and Diabetes

Diabetes is a chronic disease that is marked by high blood glucose levels. Over a period of time, the elevated sugar in the blood leads to arterial damage that causes them to stiffen and harden. This is known as Atherosclerosis. High sugar levels also lead to plaque formation as those with diabetes also have high cholesterol levels. When the arteries get damaged due to plaque, the body sends platelets to try to repair the wall. Due to the narrowing of the arteries, this leads to a blockage which stops the oxygen from reaching the heart and the brain and ultimately results in a heart attack or a stroke. It is interesting to note that high cholesterol levels have already occurred before the elevation of sugar levels. Therefore, heart disease has already manifested before the onset of diabetes.

Risk Factors of Diabetes and Heart Disease

There are several risk factors when it comes to diabetes and the heart. Here are some of them.

Family History

Those who have a family history of diabetes and heart disease are at a very high risk. They should be extra careful about their diet, medicines, and exercise. Those with Type 2 diabetes are at a risk of having a silent heart attack or a heart attack without any symptoms.

High Cholesterol Levels

The LDL levels (bad cholesterol) determine the timeline of the onset of heart disease. LDL has been considered one of the most important factors in determining vulnerability to cardiovascular problems.

Smoking

Smoking causes constriction and tightening of the blood vessels, thereby reducing blood flow to the heart and the brain. Those who smoke and are diabetics, increase their risks of developing heart problems exponentially.

High Blood Pressure

This is another significant risk factor for diabetes and heart disease. Chronically elevated blood pressure levels cause a majority of heart attacks.

Obesity

Obesity is linked to high blood pressure, high cholesterol levels, and diabetes. Even those who appear lean or thin but have a high amount of belly fat are at an increased risk of developing heart disease.

Sedentary Lifestyle

Those who are not active physically and have diabetes tend to develop heart problems at a much earlier age than their counterparts who are diabetics but who exercise.

Age

Those who develop diabetes earlier in life have an increased risk of developing cardiovascular problems. Also, as one gets older, the odds of suffering from heart disease increase.

Unhealthy Diet

A diet rich in fats, processed foods and with fewer quantities of fresh fruits and vegetables is bad for diabetes and for the heart. Following such a unhealthy diet will definitely cause diabetes and heart disease.

Stress

People with diabetes already respond negatively to stress as their sugar levels become high due to anxiety. Stress can indirectly increase the risk of developing heart problems as it makes one overeat or smoke or drink more.

Gender

More men develop heart problems under the age of 55 years. Women suffer more from cardiac issues once they cross 55 years of age.

Symptoms of a Heart Attack

Many people who have diabetes suffer from ‘silent heart attacks’ due to the nerve damage related to their high sugar levels. This is why regular screening is essential for all those who have diabetes. There are some symptoms to watch out for. If you suffer from any of the following, call the ambulance immediately.

Chest pain is one of the most common symptoms of a heart attack. It is also known as Angina. It feels like a pressure or painful squeezing of the chest. One might feel it in the arms, neck, back or the jaws. Nausea and lightheadedness Shortness of breath Sweating Fatigue Indigestion Loss of balance or dizziness Trouble seeing things or having double vision Confusion Sudden severe headache Prevention of Diabetes and Heart Disease

There are a lot of things you can do to manage your diabetes and stop or delay the onset of heart problems. The risks are reduced by introducing lifestyle changes, medicines, and increasing activity levels. Here are some tweaks that bring positive results.

Healthy Diet

Eating a variety of fresh fruits and vegetables, whole grains, low-fat food items, a high protein diet helps to combat heart problems.

Healthy Weight

Shedding off the excess weight and maintaining a healthy weight helps to keep away the cardiac issues for long. Instead of a tough weight loss plan, sit with your doctor and chalk out a reasonable weight loss strategy.

Quit Smoking

Smoking damages the blood vessels in the body and increases the risk of heart problems. Quit smoking to improve your health.

Get Moving

Exercising for just 30 minutes five times a week brings down the risks of developing heart problems in diabetics. If you cannot exercise in one go, divide the activity into batches of ten minutes. It also helps to control the high glucose levels in the blood.

Stress Management

Learn to meditate and not stress over things in life. Anger, jealousy, spite are negative emotions that affect the body negatively.Diabetologist in navi mumbai

Medications

If you already have heart disease, take your medicines on time to prevent more complicated issues.

Control the Parameters

To prevent an early onset of heart problems, keep your blood sugar levels and your blood pressure levels under control. Avoid too many fluctuations to prevent organ damage.

Takeaway

There are several treatment options to keep heart disease and diabetes under control. With proper lifestyle changes, effective weight management and efficient control over blood sugar levels, those who suffer from diabetes can live healthy, quality lives.