Diabetics

For many people in India, especially those in the older age groups, diabetes is a lifestyle condition that they live with on a daily basis. However, diabetes is becoming more common in younger age groups as well, raising issues of public health. After China, India is the country with the second-highest prevalence of diabetes, with an estimated 77 million individuals - or roughly 1 in 11 Indians - having the disease. Pre-diabetes is a condition or stage that precedes diabetes, where the body's blood sugar levels are elevated but not yet high enough to be classified as type 2 diabetes. The National Urban Diabetes Survey estimates that our nation has a startling 14 per cent prevalence of pre-diabetes, commonly known as borderline diabetes. Due to the absence or minimal visibility of symptoms, many people in their 30s and 40s may be pre-diabetic without even being aware of it. If diabetes runs in your family, you are at an increased risk of developing it yourself. Nevertheless, by making dietary and lifestyle changes, pre-diabetes may still be somewhat reversed and treated. Here are some precautions and tips one can be mindful of to stay healthy as a pre-diabetic: Move About More Sitting is the new smoking. A sedentary lifestyle is known to increase the risk of Type 2 diabetes. Regular exercise and workouts approved by a trainer or doctor help manage pre-diabetes by lowering blood glucose levels. Moreover, being active can improve insulin sensitivity throughout the body. It can also help you manage your weight which is crucial to not slip into diabetes. Try brisk walks, jogs, and runs and gradually move to more aerobic exercises such as dance and biking/bicyling. Weight Management Did you know that being overweight, or having a body mass index over 25, can increase one's risk of developing type 2 diabetes? If you are diagnosed for pre-diabetes, gradually losing 5-10 per cent of your body weight can significantly improve your chances of delaying or reversing diabetes prevalence. Ask a trainer to help you focus on your midsection for belly fat, as a large waist circumference is known to put a person at an increased risk of diabetes. Keep Stress at Bay Stress can make you sick, but it can also make you pre-diabetic, or at least make your condition worse. An imbalance of stress hormones cortisol and adrenaline - known for the fight or flight response - can trigger blood glucose levels to shoot up and remain high. Make time for adequate rejuvenation on your schedule, and make sure to not pressure yourself to work like a machine. Make time for laughter and time with friends and family. Schedule time for walks, gardening or other hobbies that help you decompress. Watch What's on Your Plate Consider the composition of your meals. Is there an adequate balance between protein, carbohydrates, fats and necessary vitamins and minerals? For a healthy portion, pre-diabetics should fill half of their plate with non-starchy vegetables and leafy greens, and the rest with healthy carbohydrates, whole grains and lean protein. Stocking up on fibre will ensure satiety without raising blood sugar. Snack on nuts and fruit, even if they seem to be sugary. One must remember they have natural sugar. Avoid Drinking Your Sugar Added sugars must be avoided at all costs to avoid escalation into diabetes. Sweetened beverages can spike blood sugar levels and provide little nutritional diversity, such as protein. This includes energy drinks, soft drinks and any syrups or liquid desserts. Research says that substituting one daily serving of a sugary drink with low-calorie alternatives such as water, coffee, or tea is linked with a 2-10 per cent lower risk of diabetes. (Dr Vivek Srivastava, Senior Vice President, Zeon Lifesciences)  

One of the country's busiest seasons, Navratri also brings with it a tradition of fasting and feasting. In addition to fasting on nine auspicious nights, many mouthwatering dishes are also cooked, including sabudana khichdi, fruit chaat, and kheer to kuttu ki poori and aloo kadhi. Adults are advised to fast occasionally as it gives their digestive systems a break and aids in the body's detoxification process. However, if necessary precautions are not followed regarding the type of foods consumed, particularly if the person has diabetes, fasting and consuming a restricted diet for 9 to 10 days consistently can endanger one's health. Dr Sunil M Jain, Endocrinologist, TOTALL Diabetes Hormone Insitute, Indoresays, "Diabetes management during Navratri fasting is important owing to the change in food patterns, nature of the fast, and the food items allowed. People with diabetes must eat at regular intervals to maintain optimum blood glucose levels and consume foods, which have a low glycemic index, before beginning the fast. It is key to check blood glucose levels a few times during the day. Today, there are continuous glucose monitoring devices that are easily accessible and do not involve any pricks. These devices show real-time glucose results and a directional trend arrow showing where glucose levels are headed, that help make informed dietary decisions by the person." Here are some suggestions for navigating the holidays without jeopardising your health, even if managing diabetes is more difficult when fasting is followed by a feast. Eat The Right Foods Due to the dietary restrictions and altered food patterns, it is possible that blood sugar levels could fluctuate. Therefore, it is important to talk to your doctor about your plan for fasting, which should include the number of fasting days, eating frequency and timings, and foods that can be consumed, as that will help regulate glucose fluctuations and boost overall health. One can opt for foods rich in vitamin C, antioxidants, protein, and fiber, which facilitate in controlling blood glucose levels. Consumption of roasted makhana, nuts, and pumpkin cutlets can make for good snackable satiety during fasting, as they also meet protein requirements. Additionally, vitamin C and fiber-rich fruits such as orange and kiwi are good for consumption as they help manage the insulin fluctuations in the body. Keep Track of Your Counts Knowing when to check your blood glucose levels during fasting is key. Keeping a home glucose monitoring system will help you track your glucose levels from time to time. Today there are sensor-based devices such as Freestyle Libre, that provide actionable trends and patterns that help you make better decisions about your health. It is also important to monitor glucose levels during fasting, to ensure you avoid a hypoglycemia or hyperglycemia attack. Maintain Hydration Dehydration during fasting is troublesome for those with diabetes. Consumption of at least 2 to 3 liters of water is a must while fasting. Buttermilk without salt and low-calorie drinks like nimbu pani, green tea, mint water, cardamom tea, smoothies, and coconut water can help combat dehydration during Navratri. It is better to have fruits like apples in the smoothie instead of bananas. You can also add 2 tsp of flaxseeds and chia seeds to your smoothie as they help reduce the risk of type 2 diabetes and diabetes complications. Exercising People with diabetes can exercise during fasting, however, it needs to be done at a low pace. It is important to not strain yourself during this time. One can go for short walks and include stretching exercises in their routine. You can also ditch the exercises during Navratri and enjoy yourself to the tunes of Garba. Eating an hour before Garba will not make you feel heavy during the dance and will also ensure that you are not low on energy. For people with diabetes, having a combination of proteins and the right carbohydrates keeps you going for a long period. You can opt for a dry fruit milkshake or a buckwheat pancake with some cottage cheese cubes in such cases. Read More► How to Deal With Itchy Eyes?

With a whopping 77 million people in India living with diabetes, a simultaneous and sharp rise has been observed in the prevalence of diabetes-related preventable vision loss, particularly among the young people, say experts. Diabetic retinopathy is a chronic, progressive retinal disease that is a leading cause of vision impairment in today's young adults, working population. It's of major concern among children suffering from juvenile diabetes (Type-1 diabetes) and especially if they have had diabetes for over 10 years. It is estimated that approximately 1.1-crore people are suffering from retinal disorders in India and more alarmingly, about one in every three people living with diabetes have some degree of diabetic retinopathy, a diabetes complication that affects eyes. "With the growing incidence of diabetes, it has been estimated that diabetic retinopathy affects one in three people with diabetes and remains the leading cause of blindness in young working-aged adults," Dr Mahipal Sachdev, Medical Director and Chairman, Centre for Sight Group of Eye Hospital, told IANS. "Approximately 7-10 per cent of young diabetics will go on to develop diabetic retinopathy, of which 2-4 per cent will have vision threatening sequelae if not taken proper treatment." added Dr. Aditya Sudhalkar, M.S. Ophthalmology, Consultant Vitreoretinal Surgeon. The most common form of diabetic retinopathy is Diabetic Macular Edema (DME) which arises when the damaged blood vessels swell and flow into the macula of the retina causing visibility issues in the normal vision. According to Dr. Chaitra Jayadev, senior vitreo-retinal consultant, Narayana Nethralaya Eye Institute Karnataka, studies have shown that the prevalence of DME and diabetic retinopathy is higher and more severe in young diabetics with a longer duration of diabetes. "Diabetes in the younger is a distinct pathological entity characterised by a more aggressive presentation and manifestation. An earlier onset of diabetes leads to a longer exposure to insulin resistance and hyperglycemia. This gives rise to a greater propensity for developing long-term microvascular and macrovascular complications," Dr. Jayadev said. Thus, screening for diabetes is of utmost importance, even if one is "young" and has no symptoms. It becomes more crucial if one has risk factors such as family history, obesity, sedentary lifestyle, or on long term steroid medications. Dr. Sudhalkar said that in India, there is a general reluctance towards attending clinics and nearly 25 per cent of young patients with DME come late for diagnosis. "It's important to know, only 11 per cent of diabetic retinopathy patients can actually reverse vision threatening sequelae once they set in. The rest continue to progress even with strict glycemic control," he noted. "Retinopathy, unfortunately, is the most neglected complication of diabetes. We see so many patients come to OPD where eyes have not been checked for. So the screening, also known as Funduscopy, should be done at the time of diagnosis of Type-2 diabetes, in adults, and in children, five years after the onset of diabetes, and thereafter annually," Dr Dheeraj Kapoor, HOD, Endocrinology at Artemis, Gurugram, told IANS. If diabetes occurs near puberty, then funduscopy should be checked for potential retinopathy. "It is important because the condition poses no symptoms in the initial days. And once symptoms set in, such as bleeding in the eye, red vision, sudden loss of vision, it's too late," Kapoor said. The doctors advised to adhere to the treatment and maintain a healthy lifestyle to effectively manage diabetes and to prevent the onset or progression of eye diseases. Read More► People Inhale Up to 7,000 Microplastic Particles Daily: Study

London- While people with diabetes are no more likely to contract Covid-19 than others, they are more likely to become severely ill if they do catch it. Research presented at the annual meeting of the European Association for the Study of Diabetes (EASD) has shown that certain characteristics put some people with diabetes at higher risk of serious illness and death than others. An analysis of over 1,000 patients by researchers from the NHS Foundation Trust, England, showed that those with Type 2 diabetes were 2.5 times as likely to die within seven days of admission as those with other types of diabetes. This may be because Type 2 diabetes usually occurs in older people and can be accompanied by other long-standing health conditions, putting them at higher risk of poorer outcomes, the team explained. Further, those who had insulin infusions were, half as likely to die as those who didn't need IV insulin, showing that better blood sugar control can improve outcomes in patients with severe Covid and diabetes. The study included 1,004 patients with an average age of 74.1. About 7.5 per cent were admitted to intensive care and 24 per cent died within seven days of admission to the hospital. The risk of death was also 2.74 times higher among under-70s with chronic kidney disease than those without. "According to several studies, patients with diabetic kidney disease have a chronic pro-inflammatory state and immune dysregulation, making it difficult to 'fight off' the virus compared to someone who has a properly working immune system," said Llanera, who has recently moved to Imperial College London. "In addition, ACE2 receptors are upregulated in the kidneys of patients with diabetic kidney disease. These are molecules that facilitate the entry of SARS-COV-2 into the cells. This may lead to a direct attack of the kidneys by the virus, possibly leading to worse overall outcomes, he noted. The combination of older age and high CRP (a marker of inflammation) was linked to a more than three-fold (3.44) higher risk of death by Day 7. The higher CRP correlates with a high degree of inflammation, which can eventually lead to organ failure, the researchers said. The data has been used to create a model, which, if applied to a patient with similar demographic characteristics, can predict a higher risk of death in seven days using only age and CRP as variables. Read More► Risk of Stroke Increases With Insulin Resistance: Study