diabetes pedia

Anything at all that you would like to know about diabetes care, diabetes diets, the causes and types of diabetes, diabetes prevention and related matters. Free information & quick responses to your questions. Search here with keywords related to any aspect of diabetes management. Email or leave a post here if you do not find the information you need: an answer is guaranteed within 24 hours. NO SPONSORED POSTS HERE!

Location: Mumbai, Maharashtra, India

Your contributions are invaluable. Please visit this web site often and post regularly.

Thursday, November 30, 2006

Cord Blood and Diabetes

Find a way to store cord blood if your spouse or partner and you have planned to have a baby. 
It is almost a certainty that a way to generate new insulin producing tissue from stem cells will be available during the life times of individuals born now. This amounts to a cure for diabetes.
Work is also in progress to implant pancreatic tissue from other people and even from animals such as pigs in to the bodies of people with diabetes, but the chance of success is much better if stem cells could be used.
The umbilical cord which nourishes the fetus in the womb, and which is cut at birth is rich in stem cells. It is normally thrown away, which is a shame, since the stem cells could lead to a cure by the time today’s babies become adults.
Stem cells can be stored indefinitely in special freezers. The technology is similar to the storage of semen. Unfortunately, it is not a widespread facility as yet. Your gynecologist may know of a storage facility near your place of residence, or you could write to me, and I will try to find the nearest one.

Wednesday, November 29, 2006

Vaccination and Diabetes

Though some countries report an increase in the incidence of diabetes amongst vaccinated individuals, all available scientific studies fail to establish any definite link between the two.

The benefits of vaccination outweigh any unproven risks by far. Therefore, children and adults with diabetes should follow the same immunization schedule as for others with normal glucose metabolism.

Vaccination can result in transient illness, especially an episode of fever. This is an expected reaction of the body’s natural immunity to vaccination. Blood glucose can rise during this time, so your physician needs to know when vaccination is administered. The person who gives the vaccine should also know beforehand if you have diabetes.

Please write to me if you would like additional information about vaccination and diabetes.

Tuesday, November 28, 2006

Precautions When Starting on a Walking Regimen with Diabetes

A habit of taking long brisk walks can be a pleasure in itself, quite apart from being a part of a prescription for diabetes management. This is especially true if you are fortunate to live in or near some scenic surroundings.

Some people, whether they have diabetes or not, start walking on their own, or because of peer pressure. However, a prior medical check up is a must. Some cardiac and renal diseases make a sudden regimen of exercise dangerous. Please do not start a habit of walking for exercise without asking your physician first.

A dose of 4 kilometers covered in about 45 minutes at least thrice a week, is about right for most adults with normal glucose metabolism, or with diabetes under control. However, it can take a few months to reach such a duration and intensity of exercise. You could start with just one kilometer covered in about 13 minutes, and gain about 100 meters and lop off 30 seconds a kilometer every week, until you reach the peak level. Discontinue exercise immediately, and see your doctor, if you experience breathlessness or pain when you walk.

Monday, November 27, 2006

Planning Delicious and Filling Entrees for Folks with Diabetes

Cooking or even ordering food separately for guests with diabetes can be a vexed issue. You have to serve something attractive for people in normal health, without making a person with diabetes stick out like a sore thumb at the meal table!

The first and last courses are relatively easy, because you can choose from a wide range of salads, high-grain breads, and fruits. Coffee obviously is not a problem!

That leaves you with a single but major problem of the entrée!

Rice with skewered meats and vegetables is a great answer. You can play around with oily dressings for guests who can afford the calories, and just boil and grill everything for the person with diabetes. Everyone’s plates will look great, and only the guest with diabetes and you may know of the special arrangements!

Keep in mind that you can deviate from plain rice to a pilaf, using a tomato puree, condiments, and a variety of beans, to make servings look and taste really special. Add pimentos of every color you can find on store shelves, and even an artist will envy your palette of ingredients-all this with little or no oil!

Fix your plating with small amounts of rice, so that you do not exceed the carbohydrate limit of a person with diabetes. You can always have a large bowl for your other guests ready at hand for refills. That goes for the vegetables and meats you skewer or otherwise arrange on first plates.

Try this the next time you entertain, and let me know if it does not work!

Saturday, November 25, 2006

Happy Snacking with Diabetes

High fiber biscuits are the best snacks for people with diabetes. It does not help if you eat loads of them in addition to your prescribed diet, but you can ask the health care provider who prepares your menu, to build in some of these kinds of snacks for times of the day when you feel a bit puckish.

A salad with a yoghurt dressing is another delicious and filling snack, though you may be more accustomed to eating one as part of a main meal.

Small and planned quantities of roasted nuts are fine as well, though your heart and kidneys will be grateful for staying away from the salt!

Social events can be deadly in terms of exceeding your calorie limits, especially if there are long bouts of drinking apart from regular meals. Look for low calorie, high fiber, and tasty snacks at such occasions. Remember to provide them as well if you are a host. Your guests with diabetes will love your thoughtfulness!

Please contribute to this web log with your suggestions for snacks that suit people with diabetes!


Beverage Habits in Diabetes

Thank God for diet sodas! I do not know how I would manage without one at a social event, or after a long and brisk walk on a hot day.

Tea and coffee without cream and sugar are great inventions as well. What else can you have in plenty, besides water, if you have diabetes?

My treat for special occasions is a small serving of orange juice without added sugar. Pile up the glass with ice for extra pleasure, and to make up some volume as well!

A drink now and then does not hurt either provided you start with a high fiber snack-alcohol depresses blood sugar. You have to keep a count of the calories though, because alcohol can supply quite a bit of your blood glucose needs.

Another great drink to nurse with friends is lemon juice with sparkling water and sucralose. It looks as fashionable as a gin and tonic, and has a passable taste to boot.

So you see that there are quite a few things to drink when you have diabetes: you never go thirsty, and can hold a glass as you chat, without harming your diet plan!

Fruits and Vegetables to Avoid and to Enjoy in Diabetes

Avoid fruits? You must be crazy!

Doctors and nutrition specialists never tire of telling everyone, especially people with diabetes, and the obese at risk of developing diabetes, to cut back on red meats, fats, dairy products, and everything else that tastes so good! However, we are encouraged to eat fruits and vegetables, so what is all this about avoiding some of them?

There are three kinds of fruits and vegetables, which we should avoid or consume only in moderation, whether or not we have diabetes:

a. Ones high in sugar: mangoes and tables grapes are prime culprits!

b. Anything with heavy metal, microbial, or chemical pesticide contamination. Washing anything consumed thoroughly with clean water and hands should take care of surface microbes, but sourcing fruits and vegetables from professionally managed farms, is the only way to avoid metals and pesticide residues.

c. Fruits and vegetables with large numbers of small seeds can block the route from each kidney to the bladder, if you eat them in large numbers, though purees and seedless varieties are fine.

Melons and citrus fruits which you can peel and eat are the only ingredients of common diets for diabetes prevention and management, which are safe in terms of all the 3 parameters mentioned above. It is not common to use systemic pesticides in large quantities of them, and deposits of contact fungicides used close to harvest can always be washed off with water. Metals are unlikely to reach pulp even if plants are grown in contaminated soil.

Most vegetables are gown under intensive pesticide covers, and tubers could have metal traces. Most pesticides are heat labile, so boiling makes sense, even if you lose some nutrients in the process. Farms far away from industrial zones are unlikely to have metal contaminants in soil.

It would be wonderful if food processors would offer fruits and vegetables labeled with guarantees against harmful residues, but we are a long way from that utopia as yet, so we have to be health literate and fend for ourselves!

Friday, November 24, 2006

Facts and Claims about Fish Oil and Diabetes

It is true that fish is better than red meats. Non-vegetarians with diabetes are likely to have more fish than the flesh of other animals built in to their prescribed diets.

There are claims that the omega fatty acids in fish have benefits for health, but these matters remain to be researched adequately. The principal issue of cholesterol reduction is better and more surely corrected by modern prescription medicines, in any case.

There is therefore no case for people with diabetes to consume large quantities of fish, or to find ways on their own, for omega fatty acids intake.

It is true that poorly managed diabetes can damage the blood vessels which serve the heart, and that cardiac muscles can weaken. However, it is unlikely that your doctor will use omega fatty acids to correct such serious matters, or that you should try and tinker with the condition on your own.

Fried fish, and catch from polluted coastal waters, are unsuitable for people with diabetes. Crustaceans are high in saturated fats, and should be consumed sparingly, if at all. Mollusks may carry bacterial pathogens, when consumed raw.

You could, if you have diabetes, and if you are fond of sea food, ask for your diet prescription to include small and occasional portions of boiled or grilled fish. It is also a good choice of entrée when dining out, though heavy sauces and marine livers are best avoided. Prefer reputed brands from hygienic farms when you buy fish-exotic imports and the fresh stuff at a stall could be polluted and harmful.

Wednesday, November 22, 2006

The Atkins Diet and Diabetes

Public opinion may be divided over the Atkins Diet, but you will not meet real people who can stay with it for long periods. This ‘crash’ approach has no role in diabetes, because it is a life-long solution which you require. The Atkins Diet works by tricking the body’s metabolism in to burning sugar; this kind of tinkering can harm you if you are deficient in insulin, or resistant to it.

It is important to restrict carbohydrate intake in diabetes, and this is a focus area for the Atkins Diet as well. However, diabetes needs regulation and balance. You must get an expert to write a diet which keeps you satiated and adequately nourished. A short-term fad will do more harm than good-you need a plan which takes good care of your diet needs on an on going basis.

Write to me if you disagree or if you have a question.

Tuesday, November 21, 2006

Drive Safe with Diabetes

Unfortunately, driving and diabetes do not generally mix very well. Licensing rules anywhere are generally lax in keeping people with diabetes from driving, and this puts all road users, including pedestrians at risk. Driving with undetected or poorly managed diabetes can be as risky as the effects of alcohol.

The first signs are almost funny. People who have diabetes, but who are unaware of it, need to use rest rooms frequently, and a long drive, whether as driver or passenger, can be most uncomfortable, and even embarrassing!

High blood glucose makes people drowsy, which is fine as long as you are secure in a back seat! However, dozing off at the wheel, or making a driver sleepy by snoozing in the front passenger seat, is clearly dangerous.

It takes some time for a person newly diagnosed with diabetes to adjust diet, exercise, and medication. Hypoglycemia is possible, and the dizzy feeling it evokes, is a sure recipe for an accident. Later, patients learn to recognize the signs, and can pull over and have a fibrous snack, or a drink with a simple sugar. However, until such experience and practice set in, a person new to diabetes is vulnerable to accidents.

Uncontrolled diabetes eventually affects the eyes, heart, kidneys, and feet. Hopefully, victims of such later stages of diabetes will give up driving on their own, but most traffic and motor vehicle departments have poor regulations to stop them legally in time.

Even a person well versed in diabetes management may suffer dire consequences if involved in an accident which causes loss of consciousness. The course of emergency treatment should include blood glucose control, something para-medics and doctors will not know until blood test results become available, if the person does not carry easily accessible information on the body about suffering from diabetes.

You can drive safely with diabetes, if:

- your blood glucose is under control

- you can recognize signs of hyper and hypo glycemia

- you have snacks and medicines to deal with emergencies

- you carry information on your person which emergency workers can use to know about your condition, in the event you lose consciousness

I have no confidence that everyone who drives with diabetes is ready with all these conditions! However, each of us can set personal examples to improve the situation.

Diabetes on Your Nerves!

The damage that diabetes can do to your nerves is worse, in some ways, than the harm to kidneys, and the heart. This is because a doctor can detect even slight kidney or heart damage, and take corrective steps. We have a spare kidney because we can live with just one-this gives some margin for error. Similarly, we can live well even if a part of a heart is damaged. Nerves do not regenerate, no part of the peripheral system is redundant, and doctors do not have precise measures for the early signs of damage. Therefore, patients with diabetes have to be sanguine about nerve damage in their own interests

Nerve damage is known in medicine as a neuropathy, and every part of the body is susceptible in diabetes. Doctors measure blood glucose at fixed times, or at best, the average over a 60-day period. There could be intervals of high or low blood glucose which a doctor cannot detect, though a patient may know about it, because he or she has deviated from a prescription for a day or more in-between clinic visits. Every spell of glucose going between the normal ranges in blood does harm to parts of the nervous system. The tests which are available for finding out whether a nerve has been damaged are site specific. We can, for example, find out if a nerve which serves a foot has been damaged, but the test will not tell us about the rest of the nervous system. It is not practical to test every corner of the nervous system, and hence a lot of damage has occurred already, before a doctor gets the first clue.

The chances of high or low blood glucose episodes increase as one spends increasing time in diabetes. This means that people in who diabetes has been detected relatively late, those who encounter diabetes early in life, and those who tend to lapse in observing their prescriptions, are all vulnerable to some degrees of nerve damage.

The best way to contain nerve damage to diabetes is to take a form of insulin which acts very closely to a normal pancreas. This kind of approach is able to adjust, at least in some measure, to changes in diet and exercise routines, as well as to instances of injuries and infections. Medicine is on the threshold of such systems, and the ones which are available are relatively expensive. It is worth asking your doctor about the possibility of switching over to such a system, to reduce the chances of nerve damage due to diabetes.

Another more conventional approach is to exercise special vigilance. The toes and feet should be the first target, because peripheral nerves at extremities are often the first to show signs of damage. You can run a feather or a brush very lightly over your toes to check whether you can feel the sensations. A tingling feeling or episodes of pain in the feet could also signal nerve damage. People with diabetes have to be fastidious about pedicures, avoid naked exposure of their feet, and have someone check them every day for sores, blisters, and minor injuries. Nerve damage in diabetes can prevent us from knowing in time if a foot has an infection or has been damaged.

Muscular weakness, digestive upsets, dizzy spells with drastic blood pressure changes when standing up or lying down, unplanned weight loss, and depression, are other signs of possible nerve damage, which you must discuss with your doctor.

Homeopathy has a number of herbal and inorganic agents which are said to protect nerves from damage. These preparations will not reverse diabetes, but they can serve a useful role in diabetes management. The benefits claimed are anecdotal and not validated with the same rigor as applied to modern medicine. Nevertheless, it is in order to ask you doctor for approval to use this kind of Complementary Medicine. I will be happy to make suggestions provided that you do not take such medicine on your own.

Have you had your feet checked today?

Sunday, November 19, 2006

Diabetes and Dentists

Every breath you exhale through your mouth brings bacteria from your respiratory tract in to your mouth. Microbes from the outside world can enter your mouth every time you open your mouth. Close proximity with a person who has a cough or a cold puts you in special danger! 
Many of the microscopic bugs which transit through your mouth prefer to travel in to your digestive and respiratory systems, or in to blood, and the other parts of your upper body, but many of the ones which enter along with food and drink prefer to live between your teeth and off your gums. Quite a few enjoy the corridor between your mouth and inner ears, and travel back and forth as though shopping in a mall!
A healthy human body has a pretty tough job of policing the insides of your mouth, making sure that any pathogens in transit are at least chased away, if not killed outright. Flossing and brushing help a great deal, because they dislodge pieces of food in which bacteria love to hide.
Dentists always look for signs of diseased gums because they can cause you much harm and distress. Diabetes reduces your immunity, and an infection pushes your blood glucose up. Therefore, a person with diabetes is more vulnerable to periodontal diseases than others with normal glucose metabolism.
A dentist will check your blood glucose status before any major invasive work, but it helps to be pro-active with more frequent visit to the dentist if you have diabetes. So reduce your handicap with respect to dental health as a result of diabetes, with additional dental vigilance, and fastidious oral hygiene. Visit your dentist today for reassurance that diabetes has not affected your gums, and for more information on what you can do for the stereo benefits of healthy gums and top blood glucose control.

Mental Health in Diabetes

Diabetes can cause depression, anxiety, and stress, and some of these conditions can exacerbate diabetes as well. There is a kind of vicious cycle relationship between diabetes and mental health.

News that you or your child has diabetes can be traumatic. Many people have incomplete knowledge about how well diabetes can be managed. Even those who are well informed, baulk at the prospects of having to forego their favorite sweets and fried foods. There is no cure as yet for diabetes, so it is natural to feel depressed on knowing that you or someone you have has the condition.

The complications of diabetes for the heart, kidney, eyes, and feet can cause anxiety. Indeed, there is good reason to worry if you cheat on your prescribed diet, do not set aside time for exercise routines, or forget to take medicines.

Prescriptions for diabetes management are detailed, and it can be quite a chore to follow them as part of routine life. Stress pushes your blood glucose up, and there could be aspects of your life unrelated to diabetes, which build up stress inside you.

Some people feel depressed, anxious, or stressed out at the financial implications of diabetes. Children and their immediate families, often also need help to cope with a chronic illness so early in life.

A cheerful and normal state of mind is a part of managing diabetes.

Your physician can counsel you on how to manage depression, anxiety, and stress. He or she can also refer you to a psychiatrist for more focused treatment of your mental condition.

Please leave a post here or send me an email if you would like information related to the links between diabetes and mental wellness.

Saturday, November 18, 2006

Sex and Diabetes

The good news first-you can enjoy great sex as long as diabetes is detected in time, and you follow your prescription without any lapse. However, undetected or poorly managed diabetes will affect libido. Diabetes has 3 effects which rob you of sexual pleasure:

- it weakens your muscles

- it damages your nerves

- it makes you prone to infection

A flaccid penis or clitoris is the most dramatic outcome of neglected diabetes. The ability of the vagina to expand and contract will also be affected, making coitus painful for the woman and less satisfying for the man. The female reproductive tract harbors beneficial natural microbes, and this population will be vulnerable to displacement by nasty pathogens, inflaming the area, and resulting in smelly discharges.

Some medicines used to manage high blood pressure and diabetes may also decrease your sex drive.

Uncontrolled diabetes can affect homosexual relationships just as with men and women partners.

A drop in sexual performance leads to anxiety and depression, which takes sex life in a vicious and downward spiral.

Many patients and their partners suffer in silence. This is sad and unnecessary, because doctors can help.

So return to your sexual pleasure peak by discussing your problems and developments with your physician. You can also leave a post here or send me an email in guaranteed confidence. I will not suggest prescription medicines, but will suggest how to approach your doctor, and some non-prescription approaches as well.

Friday, November 17, 2006

Health Literacy for Diabetes Prevention and Management

Is it not strange that diabetes incidence should rise even though we know so much about prevention now?

Why must so many people lose their limbs and eyesight, or damage their hearts and kidneys, when it is so easy for doctors to avoid such complications?

Timely and widespread diabetes detection and patient compliance with prescriptions hold golden answers to questions about how diabetes continues to make headway, and to cause grievous losses in this day and age.

Health literacy is the answer. Everyone needs to know the following basics:

- An RBS (Random Blood Sugar) reading can mislead

- A blood glucose test older than a year may not be relevant

- Diabetes may rear its head during pregnancy and harm the fetus, even though a woman may have normal glucose metabolism before and after pregnancy.

- Carbohydrates affect blood glucose, so it is not enough to stay away from sugar alone

- Most processed foods contain sugar and trans fats, which may not be labeled

This kind of information is most important for:

- children

- the elderly and uneducated amongst poor ethnic communities

- people who travel frequently, and who find it hard to lead orderly lives

Please do what you can to

- Promote regular GTT (Glucose Tolerance Test) and HbA1c (glycosylated hemoglobin) testing

- Make people aware of the terrible complications of untreated diabetes for eyes, feet, heart, and kidneys

Please leave a post here, or send me an email if you would like to know more

Wednesday, November 15, 2006

Are You Sure You Do Not Have Diabetes?


Your relief on being told by your physician or by a technician, that you do not have diabetes, is good news, but it could be premature to write off the future risk, especially if you are overweight for your height and sex, or if you have a family history of the disease.

Ask specifically if you could have pre-diabetes. Many people spend years in this state, and fail to stall full scale type 2 diabetes from developing. Pre-diabetes can be diagnosed from a combination of fasting and post prandial blood sugar readings, from the results of a glucose tolerance test, or from a test of glycosylated hemoglobin, which is also called HbA1c.

Your doctor can suggest diet and exercise changes which will bring your blood glucose below the pre-diabetes level, and delay type 2 diabetes if not prevent it outright.

Adults should check their diabetes, pre-diabetes, or normal glucose metabolism status, every 6 months. An annual check may suffice in some cases, and a doctor can decide if such a reduction in testing frequency is safe for your individual case. A reading which is more than a year old may no longer be relevant, and could place you at risk of a complication.

You can cheat on a diabetes test by skipping a meal or eating a very light one the evening before, or for lunch, but you will be the loser! A glucose tolerance test or an HbA1c could be more reliable if you suspect that someone may try and dodge the truth on a diabetes test!

Diabetes, detected in time, is one of the easiest jobs your doctor could have, for modern medicine can manage few other illnesses as well. However, no doctor can watch your medication, food and exercise, everyday, so your compliance with a prescription on a daily and sustained basis counts for everything in diabetes management!

Tuesday, November 14, 2006

How to Make Halloween Fun for Children with Diabetes

It is not just Halloween.

There are birthdays and other occasions on which you wonder if a child with diabetes could not have a small treat. Regulators have approved the use of sucralose, a substitute for sugar. It can be used in cooking, so perhaps a parent could ask a doctor for a diet and insulin adjustment on special occasions.

Carbohydrates affect blood glucose levels, and even a candy or a dessert made with sucralose would have calories. Therefore a treat without a doctor’s prior approval could harm a child. Certainly, no one with diabetes can ever gorge on sweets even if they are made from sucralose. Some doctors may not approve of the use of sucralose, though it has been cleared by the authorities.

So perhaps you will have to settle for a toy or something else to make a child’s day on a special occasion, but there is no harm in asking the doctor if a small portion of something made from sucralose could be built in to diet for a day.

The Needless Horrors of Coma in Diabetes

The sight of an unconscious person is sure to raise alarm amongst others around. It can also place a doctor in a quandary. A person who is known to have diabetes, may lapse in to a coma, because of an overdose of medication, or a failure to eat as planned in time, or because of unusual physical activity, results in dangerously low blood glucose.

A person in a coma, whose blood glucose status is unknown, may become unconscious because of untreated diabetes. A coma is the final outcome of someone who leaves diabetes undetected or untreated.

Unconsciousness is also possible as a result of a head injury in an accident. A person with diabetes needs additional measures in such situations, so a doctor in a casualty department should know if an unconscious person has diabetes. This is why it is important to carry information about this aspect on one’s person at all times.

Doctors can correct a coma due to extremes of blood glucose, by using either insulin or glucagon, and by re-hydrating the body. Blood and urine tests will quickly establish the reason for a coma, and whether the kidneys are functional. Consciousness should return on correcting blood glucose, but a coma may damage parts of the brain. A coma can also be fatal if a patient is not brought to a casualty department of a hospital in time.

A coma due to diabetes is entirely preventable through the simple measures of regular medical check-ups, and unvarying adherence to prescriptions for medication, diet, and exercise.

Monday, November 13, 2006

Trends in Diabetes Care

Medical science continues to make rapid strides in the management of diabetes. A cure is in sight, if we keep the lifetimes of today’s babies in view. However, the trials which are in progress are beyond the reach of average people who are not doctors, so what can patients and their relatives do? Social workers are also seized of the rising incidence of diabetes, and feel impelled to do something meaningful with respect to this dreaded disease.

Here are 5 steps that people who are not doctors can take, to reduce the incidence of diabetes, to improve its management, and to mitigate the severity of its potentially debilitating effects:

1. Use free camps sponsored by pharmaceutical companies and by other organizations, to create awareness about the complications of diabetes. Many people, who prevaricate about testing and prevention, do not know that they can lose their eyes and feet, and damage their hearts and kidneys, due to diabetes.

Be wary of random blood sugar tests offered at such camps. They can mislead, and are not substitutes for fasting and post-prandial readings, glucose tolerance tests, and glycosylated hemoglobin readings. Moreover, hygiene and accidental viral transfers are real threats when the camps draw in large crowds of people eager for free tests.

2. Sugar, oil, and red meat substitutes are now available, and there is no harm in promoting their use even without a doctor’s prior prescription. Patients can always be counseled to ask their doctors about such products, and it would be rare for a doctor to say that a patient should not use them in moderation. Earlier posts in this web log mention specific products, and I can repeat this information by individual emails on request.

3. Campaign against scurrilous Complementary and Alternative Medicines. They harm the public interests by touring untested and possibly unsafe remedies for diabetes.

4. Spread word about the international spread in drug prices. This is not related to diabetes prevention, but relates to the costs of treatment. Internet sites generally offer spurious versions of top brands. However, since diabetes is a chronic condition, it makes sense to procure genuine medicines from the foreign operations of pharmaceutical companies. Reliable quality human insulin, under license of the innovator company, is available for about $3 per 400 units in India.

5. Join and support movements against fast food, and sodas with sugar. Ask popular icons to avoid endorsement of products which make people vulnerable to type 2 diabetes. Similarly, form walking clubs and apply peer pressure on people to exercise regularly, if they have approval to do so from their doctors.

You do not need a medical degree to make a difference to the fight against diabetes!

Saturday, November 11, 2006

Towards a Future without Diabetes

The number of people affected by diabetes climbs every year. Can we get rid of this expensive and inconvenient disease?

The answer for type 2 diabetes is a resounding ‘yes’. Weight gain, obesity, and a sedentary lifestyle are risk factors which are both easy to spot, and possible to correct as well. Type 2 diabetes is preceded by a spell of many years in the pre-diabetes stage. Hence type 2 diabetes can only raise its head with people who do not take annual medical examinations, or with those who do not heed warnings.

We are close to a most workable answer with insulin pumps for type 1 diabetes. Children and adult can lead nearly normal lives with these modern devices, though adherence to food and exercise routines still matter.

Stem cell research and other routes of tissue culture hold out the promise that we could soon have new pancreatic tissue generated in bodies. Scientists are also close to using animal pancreatic tissue for incorporation in human systems. There is light at the end of the tunnel with respect to eliminating both types of diabetes, but it could be a decade before such products and systems are ready for the market.

Even today’s technology makes it possible to live well with diabetes. Modern medicine can manage this disease relatively better than many other conditions. However, much depends of patient compliance, because no one can help if you reach for the candy and skip walks!

Preventing the complications of diabetes is a key social and public health objective. Diabetes can take away eye sight and parts of limbs. It can also disrupt normal heart and kidney functions. However, simple vigilance and observance of prescriptions can keep these terrible outcomes far away.

Friday, November 10, 2006

Diabetes Management without Health Insurance

The specter of diabetes without funds for tests and treatment is horrible indeed. The situation goes from bad to worse, as eyesight, limbs, kidneys, and the heart get involved.

Medicare and similar systems are not available for all, especially for ethnic minorities whose citizenship status is not clear. Most of these people are not health literate, and may not even know that they have diabetes, or be able to afford comprehensive diagnostics

Here are steps that poor people with diabetes can take. They are not perfect or even adequate. They merely constitute a compromise of last resort.

1. Eliminate saturated fats and sugar from diet altogether.

2. Eat small portions of roasted cereals and boiled beans and vegetables

3. Add a multi-vitamin tablet or globules of Biochemic Tissue Salts No 28 to daily diet to make up for possible mineral deficiencies (poor people may not be able to afford large portions of fresh fruits).

4. Walk briskly for at least 45 minutes at least thrice a week if found to do so after a free heart and kidney check up camp.

5. Learn to recognize the symptoms of hypoglycemia, and keep glucose biscuits handy for emergencies.

These steps are useless for children with type 1 diabetes. It is essential to provide them with insulin and a nutritious diet.

Type 2 diabetes prevention is a key for economically vulnerable adults.

My wife has developed an affordable nutrition powder based on roasted and sprouted grains. A tablespoon in water is a substitute for a meal, and can make a partial contribution to managing diabetes for the poor. Leave a post here or write to me for a recipe.

Thursday, November 09, 2006

A Threat for Every Child with Diabetes

“Doctor, could my child’s type 1 diabetes cause other illnesses as well?”

We may dread the answer, but the question has to be asked when a doctor declares that a child has type 1 diabetes. The latter is an inherited disorder of the immune system, and therefore other body systems can also get affected. The digestive system is often affected in tandem with type 1 diabetes. The illness is called celiac disease. It may not have symptoms at first, especially if you child has been breast fed for a relatively long time. However, your doctor can order blood tests to find out conclusively whether or not a child with type 1 diabetes also has celiac disease. A biopsy of the small intestines can also be used to confirm the existence of celiac disease.

Celiac disease is treated by complete elimination of gluten from diet. Wheat is the principal source of this substance, though traces are also used in processed foods and in some medicines. A nutrition expert can draw up a diet that is entirely free from gluten. Celiac disease, if left unmanaged, will affect the physical and mental development of a child with type 1 diabetes. There may be other symptoms of malnutrition and digestive disorders as well. Only a doctor can determine whether or not a child with type 1 diabetes has celiac disease as well.

Ask your doctor for the blood tests.

Remember that you should not remove wheat and other gluten containing items from you child’s diet until the blood tests have been done, for you could get a false negative result.

You can leave a post here or send me an email if you want details of the blood tests for celiac disease, and of how to eliminate gluten from diet.

Wednesday, November 08, 2006

Cheers to Diabetes!

The Medical Nutrition arm of Novartis has launched a new drink specifically targeted at people with diabetes. It is available in the U.S. and should come soon to your country if you live somewhere else.

The composition is just right for a person with diabetes, with plenty of protein, and just a touch of carbohydrate, and unsaturated fats. It has 26 vitamins and minerals as well. A taste bonus is that it is available in a variety of the most popular flavors.

Ask your doctor to prescribe the product and build it in to your diet. It is called Boost Glucose Control in the United States.


Tuesday, November 07, 2006

Sports and Diabetes

It is certainly possible to enjoy one’s favorite sports even if one has diabetes. Indeed, an active lifestyle helps enormously to live with this medical condition. People with diabetes play at professional levels, and have represented their countries with honor and medals at various Olympic events.

However, it is not the same as with other people-there are special precautions that you need to take to play sports safely with diabetes. Most people might check their blood glucose only on occasion, but a sportsperson needs to have a meter handy for frequent measurement. It is likely that blood glucose will fall below the normal range, even if you have diabetes, when you step up the duration and intensity of physical exercise.

Recording is as important as measurement, because your doctor can study trends and adjust dosages of your medication. The best meters can record up to 200 readings at a time, and transfer data to your computer as well, but you can also just enter the readings with dates and notes in a small book.

You need rations of high fiber snacks with small amounts of simple sugars, to restore blood sugar quickly and steadily if it does fall below the normal range. Ask your doctor if glucose biscuits or a container of orange juice without added sugar will do. Remember that injuries will alter your glucose metabolism, though this may raise rather than lower your blood glucose.

You should also recognize the symptoms of hypoglycemia. The feeling of light-headed dizziness and unease can set off a panic if you do not spot low glucose before it begins to fall off very rapidly indeed. Your coach and others around you should also know of your condition, and how to help you in emergencies. Do keep your doctor’s emergency contact numbers handy, though with these tips, you should not have occasion to use it!

Sunday, November 05, 2006

Hygiene Precautions in Diabetes

Everyone should take reasonable precautions against infections. People with diabetes have to especially careful because high blood glucose impairs natural immunity. The immune system does not develop fully before the age of about 10 years. Therefore, children with type 1 diabetes are easy prey for all kinds of microbial infections. Similarly, immunity declines in old age. Therefore, senior citizens tend to catch coughs and colds quicker than healthy young adults. The elderly with type II diabetes are even more vulnerable than their peers who enjoy normal blood glucose metabolism.

Why should diabetes make people vulnerable to infections if they follow their prescriptions and keep blood glucose within normal limits?

The answer lies in the fact that blood glucose tends to rise when our bodies are stressed by infection. This implies that a person with pre-diabetes may cross the upper limit for blood glucose when he or she comes down with an infection. It follows that everyone with impaired glucose metabolism needs to be extra careful about preventing infections.

Here are the most common ways in which viruses, bacteria, fungi, and protozoan parasites make their ways in to our bodies:

1. Coughing, sneezing, spitting, and discharging any body fluids within close proximity to another is always bad manners, but not everyone shows due awareness and courtesy! Crowded places, and indoor areas with heating, ventilation, and air-conditioning that we have to share with many unknown people, are especially dangerous from this point of view. People with diabetes should others with obvious signs of any kind of influenza or tuberculosis, in offices, aircraft and trains, malls, and the like.

2. Food and beverages may harbor microbes. Salads, cold cuts, cut fruit, and any beverage left in the open are always suspect. People with diabetes should opt for thoroughly cooked food, bottled water or sugar-free sodas in sealed cans which have not bloated, and stay away from food which is raw, or which has become cold after preparation.

3. Cuts, burns and other wounds invite the entire microbe world to enter a human blood stream. A major injury will call for professional medical attention (the care giver should know that you are diabetic right away). However, small nicks while shaving or when outdoors are the ones we tend to ignore, thus inviting trouble. A person with diabetes has to be fastidious about immediate disinfection of even the slightest break in skin.

4. Most of us know about the dangers of HIV-AIDS and sexually transmitted diseases. What is less widely known is that kissing in the mouth exchanges saliva, and is a route of infection. Intercourse with a condom, or even manual stimulation of the genitalia of another person, brings infected skin around the groin of a partner in to contact, and many infections are able to use this route. Every adult with diabetes has medical reasons to avoid sexual promiscuity.

5. Manually washed linen and towels may harbor fungi. It is best to carry your own or to use paper towels when staying at a place without a mechanized laundry. Toilet seats and taps are safe as long as you wipe them dry before use. Many bacteria are able to survive for long periods on our hands, but cause no harm as long as they do not enter our mouths. Washing hands thoroughly before eating, after petting animals, and keeping children with diabetes away from skin contact with strangers, all help to prevent diabetes from inviting infections.

Saturday, November 04, 2006

Diabetes Secrets of World Travelers

Modern medicine makes it entirely possible for people with diabetes to trot all over the globe, but it is necessary to stay fighting fit, whether you travel for business, pleasure, or to participate in an event.

Here is a check-list of the 5 most important things that need attention well before you leave for the airport:

1. Consult your doctor: packed schedules and the uncertainty of landing in new places can raise blood glucose levels abnormally. Handling changing time zones is also an issue as it could affect sleep; you may feel hungry at odd times, and not have the time and a place for your regular exercise. Your physician will guide you on how to handle these changes in daily routine, and may change prescribed medicine doses as well.

2. Tell the airline of your condition, and ask for a special meal on board. Ask if you could hand in insulin at the time of check-in for the cabin crew to hold for you, as the medicine will not stand the extreme cold and low pressure in a luggage hold at cruising altitude.

3. Carry a copy of your prescription, chemical descriptions of your medicines (brand names can vary by country), emergency snacks on which to munch if flight schedules are disrupted, as well as a stock of your oral medicines (what if you lose your registered luggage?)

4. Request airport security to check any insulin on your person physically, rather than put it through an x-ray. Security concern s should be allayed by a copy of your doctor’s prescription.

5. Keep your doctor’s emergency contacts, as well as those of a reliable medical professional at your destination handy at all times.

You are now well armed to go about your business, vacation, or social agenda! Have a great trip!