If you or your family member has been diagnosed with diabetes by doctor, we at wockhardt take this opportunity to educate you on diabetes.
Diabetes is a condition in which there is excess of glucose (sugar) in blood. On people with diabetes, the body either doesn't make, or properly use insulin from pancreas gland. This causes the sugar to build up in your blood stream, instead of going into the cells of the body. This means that your body cannot make the energy it needs from the food you eat.
- Type 1 diabetes mellitus: In this type of diabetes, the pancreas produces little or no insulin. This type of diabetes generally develops at young age, has symptoms and, blood glucose is very high. These patients need insulin treatment lifelong.
- Type 2 diabetes mellitus: In this type of diabetes, the pancreas produces less insulin than required to maintain normal blood glucose. It generally develops after 40-45 years of age and progresses slowly. All patients need diet control, tablets or insulin to keep their diabetes under control.
- Secondary diabetes mellitus: This includes diabetes due to genetic defects in insulin secretion and in association with endocrine disorders. Most of them require insulin for diabetes control.
- Gestational diabetes mellitus: This includes diagnosis of diabetes made for the ﬁrst time during pregnancy. In most cases blood glucose becomes normal after delivery.
You are likely to develop diabetes if you
- Are over weight
- Are physically inactive
- Are a woman with a waist measurement at your belly button over 35inches or a man with a waist measure over 40 inches.
- Have a parent, brother or sister with Type 2 diabetes
- Have a polycystic ovarian syndrome
- Have a history of diabetes during pregnancy
- Are over age 45years
- Have high BP over 140 / 90 mm hg
- Have low HDL cholesterol levels (35mg/dl or lower)
- Have high levels of fat called triglyceride in the blood (250mg / dl or higher) All these risk factors put you at risk for heart disease as well.
If you are experiencing
- Delayed wound healing
- Visual symptoms
- Increased hunger
- Rapid weight loss
- Frequent urination
- Frequent infections
It some times leads to major problems such as
- Heart disease
- Eye problems
But the good news is that keeping blood glucose ,blood pressure and cholesterol on target can help to delay or prevent problems.
Diabetes leads to atherosclerosis, or hardening of the arteries in the heart. Heat disease strikes people with diabetes twice as often as people without diabetes. In people with poorly controlled diabetes, cardiovascular complications occur at an earlier age and often result in premature death.
When our bodies digest the protein we eat, the process creates waste products. In the kidneys, millions of tiny blood vessel (capillaries) with even tinier holes in them acts as filters.As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes. These waste products become part of the urine. Useful substances, such as protein and red blood cells, are too big to pass through the holes in the filter and stay in the blood.Diabetes can damage this system. High levels of blood sugar make the kidneys filter too much blood.All this extra work is hard on the filters. After many years, they start to leak . Useful protein is lost in the urine.Not everyone with diabetes develops kidney disease. Factors that can influence kidney disease development include genetics, blood sugar control, and blood pressure.
Loss of vision in diabetes occurs through blood vessel damages in the eye. This may result in glaucoma, early cataracts and retinopathy.
When should you meet your eye specialist? See your eye specialistl if:
- Your vision becomes blurry
- You have trouble in reading signs or books
- You see double
- One or both of your eyes hurt
- Your eyes get red and stay that way
- You feel pressure in your eye
- You see spots or floaters
- Straight lines do not look straight
- You can't see things at the side as you used to
Diabetes will lead to thickening of the walls of the blood vessels on your feet which receive less blood and also changes in the nerves; your feet will have less sensation. You may therefore not feel that your feet are close to a fireplace, that a hot water blood is too hot, that you have an injury sustained, has been infected.
The general guidelines for foot care are
- Clean your feet daily with a mild soap and warm water then dry them thoroughly with a soft cotton towel. Take special care for cleaning between the toes.
- Wear properly fitting shoes with clean socks; do not go bare foot outside the house.
- Examine your feet properly once a week. Use a hand mirror to examine the undersur face and sides.
- Get your toenails clipped regularly.If it hurts see a podiatrist.
- Do not sit close to heaters or a fireplace.If your feet feel cold, wear warm or stockings. Do not use a hot water bottle
- Clean small cuts and sores with small mild antiseptic. Apply antiseptic creams and sterile dressings.
- Consult your doctor or podiatrist immediately about any throbbing pain or discharge from a corn, underneath or sides of a toe nail.
- Balance your diet Take a reduced calorie diet,which is rich in vegetables and whole grains.Substitute whole milk products with skimmed milk and cook with unsaturated vegetable oil.
- Give your heart a workout Follow a regular programme of aerobic exercises like walking, jogging, running or swimming. Schedule at least five sessions a week of at least 30 minutes.
- Cut Cholesterol Elevated lipids namely cholesterol and triglycerides are best controlled through a regimen of strict diet, which is low on saturated fats such as organ meats, fatty meats and egg yolk.Avoid butter and cheese and say yes to vegetables and fruits lean cuts of meat, chicken with out skin,fish and brown bread.
- Reduce Stress Chronic stress can increase the risk of heart diseases, spend time with yourself and choose to do things that make you happy.Sleep well.
- Control Diabetes If you have diabetes keep it under check, remember - diabetes multiplies your risk of heart diseases. Targets for blood glucose.
- before meals: 90 to 130mg/dl
- 2 hours after meals : less than 180mg/dl
- Quit Smoking Smoking triples chances of heart attack. Quit today and reduce your risk to half in 2yrs.
- Maintain ideal body weight and reduce obesity.
- Preferably restrict rice to one meal a day.
- Have whole grams, green leafy vegetables 2-3 times a week with rice / chapatti. Whole cereals and grams to be preferred over reﬁned ones. Sprouted grams to be included in at least 1 meal a day.
- Fruits with edible skin are preferred to fruit juices.Fruits, washed well to be had with the peel wherever possible.
- Remove cream from milk, curds, buttermilk and skin from chicken.
- Eat small quantities at frequent intervals as suggested. Daily should be well distributed between the 3 meals - breakfast, lunch and dinner, with 2 snacks, a variety of foods that are well balanced in your daily diet.
- Have regular timings for meals and have a light dinner - 2hours prior to sleep
- Reduce consumption of oil and coconut used in cooking.
- Do not add soda or baking powder to any foods (like dosa & idly batter).
- Green leafy vegetables and salads to be included more in the daily diet.
- Foods containing large amounts of carbohydrate must be limited as starch is converted in to sugar in the body and may increase blood sugar levels if taken excessively.
- It is recommended that carbohydrates provide 50 to 60% of the kcal. Approximately 40% to 50% should be from complex carbohydrates. The remaining 10% to 20% of carbohydrates could be from simple sugar.
- Fats should be limited to 20% of total kcal,and proteins should provide 20% to 30% of total kcal.
- Start a walk for 15 mins and gradually increase it to 40mins.Remain active throughout the day.(Consult your doctor before starting).
- Blood pressure: If your BP is not on target,meal planning, physical activity and medications can help.
- Weight: If you need to lose weight,a 10 to 15 pound loss can help you to reach your BP,Blood glucose and cholesterol goals.
- Smoking: If you smoke, ask your doctor about plan to help you quit
- Check atleast every 3 to 6 months A -I- C The A -I- C is the blood glucose check "with a memory".It tells your average blood glucose for the past 2 to 3 months
- Check atleast once a year:
- Cholesterol: Check the amount of fat in your blood
- Micro albumin: Check for small amount of protein in the urine.
- Foot exam: Foot problems can be avoided if detected and treated early.
- Eye exam: Treatment can help slow eye disease if its found early.
- Diabetes education and nutrition counselling
At Wockhardt, we care for your well being.We strongly recommend practicing prevention and securing health.In a world where lifestyle evolves by the day, it is essential to stay in the pink of health.Wishing you and your family good health and happiness always.
The information in the booklet is not intended as a substitute for medical advice but is to be used as an aid in understanding ailment. Always consult your doctor about your medical condition.