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Diabetologist in Navi Mumbai

Diabetologist in Navi Mumbai   

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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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DIABETES AND DEPRESSION – A CRY FOR HELP

“The mind is its own place, and in itself, can make heaven of hell, and a hell of heaven”.

“Let’s talk”, launched on April 7th, 2017, with a spotlight on depression, seems to be a fitting theme on World Health Day. According to WHO statistics, nearly 350 million people suffer from depression worldwide and it is also the leading cause of disability. Those suffering from any chronic illnesses such as kidney and heart disease, lupus, HIV/AIDS, and, of course, diabetes, are more prone to depression.

Depression is twice as common in people with diabetes. The problem is bifacial; those with diabetes are at increased risk of developing depression, due to its chronic nature and subsequent complications, while those who are depressed are at risk of getting diabetes. The predominance of poor lifestyle decisions, unhealthy food habits, smoking and alcohol, less physical activity, and weight gain when one is depressed, are all risk factors for diabetes.

The rise in incidences of depression could be due to the pressures of modern living, materialism, a competitive environment, occupational and family demands. Physical and mental health are closely interlinked which is why diabetes and depression can be a double whammy. Depression can be attributed to many factors, such as genetic, brain biochemistry, stressful life events, trauma, and strained interpersonal relationships, apart from chronic stress.

Diabetes and depression can be likened to two sides of a coin, wherein there is a biological and behavioural link. On the one hand, the over-activation of stress hormones, such as cortisol and ACTH can aggravate sugar levels. On the other side of the coin, lack of self-care, which is invariable when one is depressed, can lead to poor health outcomes. Some individuals may get overwhelmed with the challenges of managing diabetes on a daily basis, which can lead to depression.

What is depression and what are the risk factors?

It is normal to feel grief at the loss of a loved one, or show emotional reactivity to some distressing situation, but when it takes longer than usual to return to normal, look out for warning signs. If it has been at least 2 months since a major life event has occurred, or if there has not been any such major life event but one is experiencing several of these symptoms, it may be DEPRESSION:-

Feeling sad or empty most of the time for at least two weeks. Diminished interest or pleasure in the usual activities. Crying spells without reason. Low self-esteem or feelings of guilt. Difficulty in sleeping or excessive sleepiness throughout the day. Poor appetite or eating excessively. Unusual fatigue and loss of energy. Difficulty concentrating on normal activities. Feeling agitated, lethargic or slow. Weight gain or weight loss, without any effort. Recurrent thoughts of death or suicidal ideas. If these symptoms are generally making one feel dysfunctional by coming in the way of social and personal relationships and hindering one’s responsibilities at work, one could be depressed.

Risk factors for depression include: Family history of depression Abuse, either physical, sexual or emotional Death or loss of a loved one Conflict due to interpersonal relationships, outside or within the family Major life events such as marriage, losing one’s job, divorce, relocating, etc. Certain medications taken for other conditions may trigger depression. Apart from these, studies have shown that women and older people are more vulnerable and likely to get depressed. Those with diabetes should be screened for depression regularly, as it can largely go undetected. Hence, appropriate detection and early intervention will help resolve complex health problems. In the larger picture, self-management and good control of diabetes could decrease the risk of depressive symptoms and complications.Diabetologist in Navi Mumbai . Despite so much progress and awareness regarding treatment of depression, prognosis continues to be poor, perhaps due to the following reasons:

Stigma regarding ‘mental illnesses’ Feelings of worthlessness and failure that prevents one from acknowledging that one is depressed. Financial constraints that act as a barrier to effective treatment. Negative perceptions about side effects of anti-depressants. Management of depression: Management of depression and diabetes should be a collaborative effort which involves the following aspects: Professional help. A combination of cognitive behavior therapy and medication has been found to be effective in combating depression. Social support from family, friends and support groups help in lessening feelings of isolation. Proper adherence to the diabetes regimen in the form of healthy diet, regular medication and physical exercise. Regular assessments by the concerned physician as well as mental health professionals have the twin benefits of alleviating feelings of depression as well as controlling sugars.

Apart from all these, involving oneself in pleasurable activities and following a structured lifestyle will be greatly beneficial for those who are going through ‘low’ phases. However, despite one’s best efforts, sometimes it’s easy to be weighed down by lethargy and low energy levels due to diabetes and depression. So do set realistic goals for yourself, take small steps, stay motivated, and do not give up! As Margaret Thatcher put it, “You may have to fight a battle more than once to win it.”

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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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Diabetes Type -2 Overview,Causes,Symptoms

Overview

Type 2 diabetes is a chronic condition that affects the way your body metabolizes sugar (glucose) — an important source of fuel for your body.

With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain normal glucose levels.

Type 2 diabetes used to be known as adult-onset diabetes, but today more children are being diagnosed with the disorder, probably due to the rise in childhood obesity. There's no cure for type 2 diabetes, but losing weight, eating well and exercising can help manage the disease. If diet and exercise aren't enough to manage your blood sugar well, you may also need diabetes medications or insulin therapy.

Symptoms

Signs and symptoms of type 2 diabetes often develop slowly. In fact, you can have type 2 diabetes for years and not know it.Diabetologist in vashi  Look for:

Increased thirst Frequent urination Increased hunger Unintended weight loss Fatigue Blurred vision Slow-healing sores Frequent infections Areas of darkened skin, usually in the armpits and neck

Causes

Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas is unable to produce enough insulin. Exactly why this happens is unknown, although genetics and environmental factors, such as being overweight and inactive, seem to be contributing factors.

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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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Don’t ignore these 5 lesser known signs of pre-diabetes..! - Sweet clinics Diabetologist

Pre-diabetes has become a raging concern in India with an increasing number of cases being diagnosed. 60% of Prediabetics go on to develop Diabetes.

In addition, common symptoms like increased thirst and urination, increased hunger and blurry vision, may have become well known, but it is important to note that these symptoms do not arise overnight, but tend to build up gradually. Further, there are some additional symptoms that may be indicative of high blood sugar, which one would not even think to associate with pre-diabetes.

This could be a major reason why a majority of pre-diabetes cases are still undiagnosed. Here we bring you some of the lesser known symptoms of pre-diabetes that can help you with a timely diagnosis and better management of this condition.

Your vision seems to be changing

You may have heard that blurry vision is a sign of blood sugar levels being higher than normal, but did you know that a sudden improvement in your vision can also indicate abnormal sugar levels? According to research studies, high sugar levels can lead to movement in the bodily fluids including the eyes. This can lead to changes in the vision which may be blurry or more defined. However, the instant you observe any sudden changes in your eyesight, it is advisable to go in for a consultation.

UTI seems to be a frequent occurrence

UTI or Urinary Tract Infection can also be a symptom of elevated sugar levels. Especially if this condition becomes a recurrent concern, doctors advise to instantly check blood glucose levels. When sugar levels in the blood and urine are high, the genitals are more prone to bacterial and yeast infections, upping the risk for UTI.

Skin is constantly itchy

A skin condition is clearly a dermatological issue right, how can it relate to blood sugar? This is a common thought as a large number of people are still unaware of the connection of sugar levels and skin health. High sugar levels can slow down the blood and oxygen circulation in the body, leading to an increase in itchiness especially around the hands, feet and genital areas. If you notice any rashes or experience constant itchiness which doesn’t seem to subside after a couple of days, it may be time to check your sugar levels.

Your TV volume is louder than before

One of the least known symptoms of pre-diabetes is often changes in hearing levels. Without realising you may find yourself talking louder so as to encourage people to talk back at a louder volume. The volume of your music station may be set a little higher than before cause your hearing isn’t as good. In a country as noisy as India, it is easy to attribute this to external sounds.Diabetologists in Vashi However, it may also be a sign of high blood sugar which can damage the nerves of the inner ear, affecting your ability to hear.

Sleep comes with loud snores

Yes, if you find your partner suddenly complaining about your loud snoring (something you swear you don’t do), it may be time to check your sugar levels. A large number of people with higher sugar levels than normal also develop a sleep disorder known as sleep apnea which leads to disturbed sleep, snoring and often tiredness during the day.

So while it is advisable to look out for common pre-diabetes symptoms, it is essential not to ignore any of the above-mentioned signs either as enable timely diagnosis, it is recommended to get a timely diagnosis and treatment from a Diabetologist, as Prediabetes with proper treatment and lifestyle changes can be reversed.

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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.