Trace Elements and Insulin Resistance in Diabetes

Fear of insulin resistance drives many people with pre-diabetes to resort to crash diets. The obese also often start dieting by themselves in bids to keep diabetes away. However, diets which are not planned by specialists may lack balance. Trace elements such as chromium are the first casualties of diets which are not drawn up in systematic manner.

Trace elements such as chromium have not been studied completely. We do not have firm RDAs (Recommended Daily Allowances) for such substances and their roles in metabolism are known as yet only in part. However, this does not mean that they are any less than essential. Chromium for example, is known to help with insulin resistance.

A balanced diet, with plenty of fresh fruits and vegetables, with meat and dairy products in moderation, should provide all the trace elements we need. Certain foods such as broccoli are known to be rich in chromium, though there could be unknown losses in food processing and in digestion as well. Some nutrition experts prefer to use supplements to guard against any shortage of trace elements in normal diet.

It is true that weight loss is the best way to deal with the insulin resistance factor in diabetes. However, recommended exercise, and a planned diet, which ensures nutritional balance, are the right ways to deal with insulin resistance, rather than any ad-hoc approach which could aggravate diabetes by denying the body vital trace elements such as chromium.

Cigarettes, Chewing Tobacco, and Diabetes

Nothing can match the frustration of a health care professional than the spectacle of a person with diabetes, or even at risk of diabetes because of genetic factors or bad eating and drinking habits, and who smokes cigarettes or chews tobacco. Mainstream communities can hardly escape public health awareness efforts to prevent both diabetes and cancer, but ethnic minorities and the illiterate tend to escape such warnings. Unfortunately, neither nicotine nor diabetes is willing to make any concessions when it comes to finding prey, so people addicted to any form of tobacco are at gravely higher risk to life if susceptible to diabetes, or suffering from high blood glucose already.

Tobacco-related habits make people vulnerable to respiratory and oral infections, and to sores in the mucosa as well. These seemingly minor ailments push blood glucose up, and may bridge whatever gap exists between pre-diabetes and full blown type 2 diabetes. However, the more noxious connection between diabetes and tobacco relates to blood vessels. The latter harden and narrow with linings of cholesterol, and oxygen supply to heart and other tissues decreases. High blood sugar weakens muscles and threatens the heart on its own. The combination of diabetes and tobacco intake in any form is a terrible threat, because the possibilities of life-threatening heart and circulatory system problems stack up with chances of cancers. Tobacco and diabetes also combine together in deadly fashion to threaten nerves, the kidneys, and joints as well. Men who smoke, and those with diabetes, are both vulnerable to impotence: those with both the habit and the disease are almost certain to suffer from erectile dysfunction.

Quitting tobacco is much harder than living with prescriptions for diabetes, but longevity is unlikely to improve through blood glucose control bereft of complete abstinence from tobacco in any form. Psychiatry and modern medicines can help everyone quit tobacco, whether they have diabetes or not, but the need is far greater and more pressing when both conditions exist together in an individual.

Psychotherapy for Better Diabetes Management

Why does diabetes take so many lives years after doctors have found ways to manage the condition so well?

A part of the answer, for poor and illiterate communities, is that diabetes is simply not detected in time. However, this does not apply to people with access to modern health care. Medicine has also made great strides in helping people live with some of the complications of diabetes.

We have therefore to dig deeper to find out why people continue to jeopardize longevity through poorly controlled diabetes, even though they are aware of the dangers: the solution to this tragic problem can be found in a single word.

Medicine no longer accepts the term ‘addiction’ for any psychiatric condition. However, the craving that a person with diabetes tends to develop for sweets, fat-laden food, sodas, and alcohol, makes me wonder if such conditions should not be termed as substance abuse.

Words apart, everyone with diabetes need psychological help, both to cope with the news that the disease has set in, as well as to accept its permanent nature. Physicians are trained in primary psychiatric methods, but often lack time for sustained psychotherapy.

5 key steps can help a person with diabetes live well with the disease:

1. Explanations of the meaning: what is the nature of diabetes, and what are the implications of the complications which can result from neglect, or by giving in to temptations to over-eat, or to skip exercise sessions.

2. Helpful support: there is no useful purpose in recriminating about preventive steps which should have been taken in the past. It does not help to confuse patients with premature information about cures or new medicines either. It is important to provide people who have diabetes with plans which they can use, and with information which they may not have already.

3. Empathy: an aspect related to meaningful and relevant support can be its source. Patients may not respond well to hectoring by care givers who have never experienced diabetes themselves. People who have lived successfully with diabetes can best inspire others who are new to the disease.

4. Alternatives: people with diabetes will gain confidence about their abilities to cope with the disease, when they are offered choices in terms of food, drink, exercise regimens, and even the ways in which they can take medicines such as insulin.

5. Relaxation techniques: life with diabetes can be full of stress, tension, worries, and missing forbidden or restricted foods and beverages. However, it need not be so: patients can learn and use a variety of mental relaxation techniques to build the mental strength and equanimity needed to lead productive and happy lives with diabetes, and to keep complications at bay.

The benefits of psychotherapy are often missing in clinics which deal with diabetes. This may account for some of the gaps which exist between the present state of diabetes management, and the rising incidence of cardiac, renal, eye, and nerve damages to people ostensibly under treatment for the condition.

Fatal & Mutual Attractions of Liver Disease and Diabetes

Uncontrolled diabetes can damage your liver. Steroids are sometimes used to treat liver diseases, and can elevate blood sugar levels. There is therefore a noxious connection between liver diseases and diabetes. Prescription medicines to control the complications of one of these two conditions can cause the other.

Your primary care physician is the best person to prevent diabetes from affecting your liver, and to prevent a liver condition raising your blood sugar above the normal range. Remember to ask about such risks if you are prescribed medicines to reduce cholesterol, (which is common as part of diabetes management), or if you are asked to take steroids by mouth or as injections, to treat a liver condition. However, it is not medicine alone which is to blame, because long-standing diabetes and obesity can also combine to destroy the liver.

The Easiest Complication of Diabetes

The name is fearsome, but the condition is innocuous. Xerostomia is a scary word for a simple malfunction of the salivary glands. A dry mouth is not just a nuisance, but can help bacteria build up in the gums, since a normal mouth needs plenty of fluids to wash the critters away.

Xerostomia is a complication of diabetes, though it can also occur for other reasons in people with normal blood sugar metabolism. However, regardless of the reason, xerostomia is easy to fix; just drink plenty of water, and chew on sugar-free gum! Dentists can also prescribe artificial saliva to keep the insides of your mouth moist.

Though a dry mouth is no big deal, it is worth seeing your physician if you experience it, to try and figure out if undetected diabetes could have anything to do it. Episodes of xerostomia are normal when you are under extreme stress, but you have to take corrective action when it persists, or becomes a regular phenomenon.

Employers, Jobs, and Diabetes

Professionally managed corporations are careful to screen potentially new recruits for serious diseases, before making long term commitments to salaries, job responsibilities, and to benefits. One would expect that people with diabetes would get screened out as a result, but this may not be the case always. A person with carefully managed diabetes, which has been detected at the outset, may escape detection by using hypoglycemic drugs and insulin. A new employee could continue to hide a condition of diabetes indefinitely, by taking medicines in private, and by avoiding indulgent eating at business events.

Gestational diabetes, pre-diabetes, and even type 2 diabetes may occur well after a person has been employed, and there would be no deception in such cases. However, all 3 conditions impose significant financial liabilities on employers in terms of reimbursements and insurance costs. Moreover, even the best managed case of diabetes may have occasional spells of hypo or hyperglycemia. Certainly, all employees known to have diabetes will require a range of special concessions with respect to work conditions: they must be allowed space and breaks to test blood sugar, to eat and drink exactly on time and in emergencies as well. Employees with diabetes also need relatively fixed hours of work, and should not have to travel frequently, especially between time zones.

Since diabetes is such a severe limitation of employment, organizations need to make special efforts to promote healthy eating and active lifestyles amongst their employees. Legal contracts of employments should also be reviewed in the light of country-specific laws related to the fair treatment of both recruits and staff with diabetes.

Why Drinking and Playing Do Not Mix in Diabetes

Beer tastes great after a round of golf on a hot day. It is entirely normal to feel thirsty after any game, and drinking with friends after sports is great fun.

Unfortunately, sports and alcohol do not mix well in diabetes, because both depress blood sugar. Drinking alcohol after physical exercise is likely to lead to hypoglycemia.

A diet soda, a small portion of fruit juice without added sugar, or just water, are all suitable for people with diabetes, to quench thirst, after sports and games.

Simple Relief from Neuralgia in Diabetes

Topical creams based on Capsaicin do not require prescriptions: you can buy them on your own from pharmacies.

You can try one of these creams for relief from nerve pain in your toes because of poor diabetes control.

Try a small portion first to make sure that you are not allergic to capsaicin; do not try it at all if you know that you are allergic to the substance or to any extract or form of hot peppers.

Ask your doctor if it is safe for you to try such a cream, if you are expecting a baby, or are nursing.

Capsaicin stings and is not suitable for children.

Doctors have a range of prescription medicines to manage neuralgia in case a capsaicin cream does not help, or if it is not safe for you to use such a product.

Please send me a mail or leave a post here if you are unsure whether it is safe for you to use a capsaicin cream, or if you would like to know more about neuralgia.

Arthritis and Diabetes Links

Diabetes can have the same effect on joints as arthritis. This is because diabetes, if poorly controlled, or detected late, affects nerves, and restricts blood supply to the extremities.

Medicines for arthritis affect those for diabetes. Hence, a primary care physician should be in charge of both medical conditions, when they co-exist, or a specialist in one field has to know about all other medications taken by a patient, before preparing a prescription.

Type 1 diabetes and arthritis are both disorders of the immune system, though people with one fortunately need not have the other-however, auto-immune disorders of the thyroid do seem to be correlated with type 1 diabetes within families.

Food Exchange Fun in Diabetes

You know what they say about variety in life, so make your food exchange lists as long as possible if you have diabetes!

Remember that food exchanges work only within nutrition groups. You can have pasta instead of bread, and even add some salad without dressing from the ‘free’ list, but no cheating by adding red meats or fats in place of greens or grains!

Seriously, portion control is integral to playing with and enjoying food exchanges. Spoonfuls refer to level scoops, not ‘mile-high’ ones. Remember that low energy-density foods such as leafy vegetables shrink in volume on heating or processing, because they contain large amounts of water.

Add as much as you can to your exchange lists. Entries for ethnic foods come in handy when dining out. Your known brands may not be available even when you travel small distances from home. So, make your care giver work harder, by asking for as many additions to your food exchanges as possible.

Write to me, or leave a post here, if you are interested in food exchanges in Indian cuisine. I can suggest some grills and beans that will leave you more than satiated within your calorie limits and nutrition requirements.

Botox and Diabetes

Though nerve degeneration leading to errors of involuntary muscle contractions are not yet approved indications for use of specified botulism toxins, investigators have begun clinical trials to help patients with foot ulcers, and difficulties in swallowing food.

You could ask your physician to find, or even to initiate trials, if your diabetes can led to a complication which threatens your feet. There could be risks in participating in such trials, not all of which are known as yet. However, you may wish to take a voluntary and considered chance if your diabetes has been discovered so late, or if it has been so poorly managed in the past, that an amputation appears probable. You should consider this option only if approved medical and surgical measures to treat nerve and muscle complications of diabetes have been exhausted.

Please also tell any poor and health illiterate people you know about this possibility, if they suffer from advanced nerve and muscle disorders as a result of long standing and poorly managed diabetes. They could get free treatment in return for participating in a trial.

Please always bear in mind that the corrective action of a specific botulism toxin on nerve junctions with small muscles, is limited in time. Injections have to be repeated on recurrence of symptoms. The injection is made from a purified extract of a bacterial colony: a gross or a mixture of toxins can kill rather than help! You will have access to an approved source of the medicine if you participate in an official trial.

Hunger, Appetite, Satiety and Diabetes

Bad eating habits, a sedentary life style, obesity, metabolic syndrome, pre-diabetes, or full blow type 2 diabetes, the entire range of potential and actual forms of impaired glucose metabolism, have the deadly triad of hunger, appetite, and satiety as principal threats to management.

A new diet, the pressures of living with reduced volumes of intake, and craving for favorite foods and beverages of the recent past, can all play havoc with one’s resolve, and threaten wellness and longevity.

Every diet or meal plan requires expertise to put together, because balancing energy limits and multiple nutrition requirements, requires knowledge, skills, and experience. Nevertheless, people who suffer from diabetes, and those who need to take dietary steps to prevent this condition, should help their care givers prepare enjoyable diets, by providing inputs on the things they like to eat, and when they tend to feel hungry.

Hunger and satiety both involve sending signals to the brain, and there are things we can do to reduce the feeling of deprivation when on a diet. Similarly, easy availability of calorific food, and attractive plating, can whet appetites, so there are social eating situations to avoid, making it easier to adhere to planned meals.

Here are 5 tips to make it easier to satiate hunger, and to keep your appetite from flying off the handle, so that you are better poised to manage diabetes, or to prevent it:

1. Ask the care giver who prepares your diet, to build in snacks for those times between meals, when you crave food most. Peanuts without salt, yoghurt without sugar, apples, and pop corn are some filling favorites.

2. Start each meal with a large serving of broth, followed by an equally large serving of salad, without a heavy dressing. This approach will lull your brain in to thinking that you have eaten plenty, even before you start on a main course!

3. Eat slowly. Your brain needs time to realize that physiological hunger needs have been met, and you will enjoy planned portions more by nursing them for longer.

4. Stay away from buffet tables at social events, especially from the dessert end of things. Remember that you could develop an appetite even after hunger needs have been met with a planned meal, at the sight of cakes, candies, chocolate, and the like.

5. Make sure that you get a good night’s rest. Sleep deprivation can sky rocket your cravings for fat and sugar ridden snacks.

Diabetes prevention and management are life long affairs, so a diet which meets your hunger needs, coupled with precautions to avoid situations in which you develop indulgent appetites, will go a long way in keeping you fit and well.

Salute the Sun for Peak Physical Fitness in Diabetes

Most people with diabetes are prescribed long, brisk walks by their physicians. This is great for keeping insulin resistance at bay, keeps the heart and lungs in good shape, and prevents complications of diabetes as well. However, major muscle groups, such as the ones in the upper arms, chest, and shoulders, are left out, and may waste away, without separate regimens.

Yoga is a great way to keep the entire body, including both muscles and joints, fully exercised, supple, and in top shape. Yoga consists of a series of ‘asanas’, which are actually a series of coordinated moves leading to specific postures. The ‘Surya Namaskar’ or ‘Salute to the Sun’ consists of a set of 12 movements, which is a quick and deliberate way of exercising the entire body.

The ‘Sun Salute’ may be done just once, or even in part only, by a novice, but can be repeated up to 12 times a day at a brisk pace by those in peak physical condition. Most people with diabetes should be able to do the routine 2-4 times at a stretch, if they practice the postures regularly, and build up stamina gradually.

Never try the postures on your own. They look deceptively simple in books or when demonstrated by an expert, but can only be learnt safely from accomplished instructors. Never start without a thorough physical examination by your physician, and take breaks whenever you feel unwell, are injured, or have an infection.

It helps to precede the ‘Surya Namaskar’ with ‘Pavan Mukta Asanas’. These are exercises to make your ankles, knees, wrists, and neck supple and flexible, and can be learnt from your instructor.

Always follow a session of ‘Surya Namaskar’ with ‘Shav Asana’ or the corpse pose, which relaxes the body, and returns the heart beat to the normal rhythm, before you end each Yoga session.

It is best to do these exercises on awakening, in calm and quiet surroundings, without any strong drafts of breeze. It is important, as always, to exercise at least 4 hours after a meal.

Most people can learn the routines in less than a month of daily instruction. It is best to set aside about 30 minutes, preferably at the start of each day, to practice regularly.

So, salute the sun every dawn and stay in enviable physical condition, even if you have diabetes!

Alzheimer’s and Diabetes

There is no established link between Alzheimer’s and diabetes as yet, but that does not mean that the two are not related. We can say that insulin resistance does prevent brain cells from getting essential nutrition, and would therefore damage them. Brain malfunction could therefore result from poorly managed diabetes. Unfortunately, there are no guarantees that even the best blood glucose control can prevent Alzheimer’s altogether.

A certain amount of memory loss is normal at any age: it is also a normal part of the ageing process. Only a doctor can tell if Alzheimer’s can begun to set in, and no spell of forgetfulness can be definitively linked with the disease.

We are left with troubling paradoxes. There is no conclusive proof on the possible relationships between diabetes and Alzheimer’s. We cannot tell on our own whether the dreaded losses of brain functions have begun to develop. What does one do?

1. Keep in mind that delaying or even preventing Alzheimer’s is a possible though unproven benefit of keeping blood glucose within the normal range, diabetes under control, and to shed extra weight.

2. An annual mental health evaluation will help a psychiatrist evaluate any worrisome loss of brain faculties, order tests, and plan for early intervention.

3. Mental exercises, just like physical ones for muscles, will help keep the brain in top gear.

There are many fun ways of exercising the mind everyday. Leave a post here or send me an email if you would like suggestions for exercising your memory, and keeping your cognitive abilities as sharp as possible.

Diabetes and the Menstrual Cycle

Hormones interact with each other, and this complicates diabetes management in women when they menstruate.

Estrogen and progesterone levels vary during ovulation. This can make blood glucose rise just before a menstrual period. This rise is transient, and returns to the normal level as soon as monthly bleeding commences.

A woman of reproductive age with diabetes may require adjustments to medication, especially insulin, during various stages of each menstrual cycle. Not all women respond in exactly the same way, so blood glucose levels must be titrated separately for each individual.

Some women, who experience PMS (Pre-Menstrual Syndrome), may develop a craving for certain foods before ovulation. Such desires are best directed towards sugar and fat free things to eat, and preferably with plenty of fiber, but can contribute to pre-menstruation blood glucose elevation if a woman gives in to temptation and indulges in some calorific snacks!

Other women prefer not to exercise during their monthly periods, which can also contribute to blood glucose elevation. Medically, it is best to adhere to an exercise regimen throughout each menstrual cycle.

Do make it a point to check blood glucose frequently during a typical menstrual cycle, if you are a young adult woman with diabetes. Your physician will be able to use records of your tests to suggest how medication doses can be adjusted for even blood glucose control.

Swim Safely with Diabetes

Since the inner ear has fluid, and a tube connecting it with the insides of the mouth, this part of the body is a favorite haunt for fungi and bacteria. Microbes also find it convenient to live in and around the outer ears.

The fluid in the inner ear is acidic to keep pathogens under control, but swimming, getting drenched in the rain, and even a vigorous shower can all add to the fluid volume inside the ears, diluting the acidity, and introducing new colonies of microbes as well.

People with diabetes are more vulnerable than others when it comes to fighting infection, so the inner and outer ears need special protective measures.

Here are 5 tips to protect your ears when swimming, or if exposed to unusual volumes of water for any length of time. These steps can help everyone, but they matter most for people with diabetes:

1. Swim in clean water

2. Use ear plugs

3. Dry outer ears thoroughly as soon as you out of the water

4. Use cotton buds to keep outer ear canals dry and to remove wax-never insert sharp or moist objects in these areas.

5. Ask your physician for drops which you can use to prevent infections after swimming or getting drenched. Products are available to restore natural acidity in and around the ears, and some of these drops do not even require prescriptions.

Snacks to Prevent Emergencies in Diabetes

It is all very well to say that people with diabetes should adhere to routines and prescriptions, but there are occasions when meals can be delayed, or when circumstances cause blood sugar to fall steeply because of stress or sudden physical exertion.

People with diabetes should always carry 2 kinds of snacks with them, wherever they go. One kind, should give a quick bolus of glucose when the level falls suddenly. The other kind should provide a low but steady supply of glucose over an extended period (this is useful when you know beforehand that a normal meal schedule is likely to be disrupted). A snack which gives a quick burst of glucose is said to have a high glycemic index. It follows that food with a low glycemic index will not result in a sudden rise in blood glucose, but will prevent hypoglycemia for a relatively long time.

Here is a list:

High Glycemic Index	Low Glycemic Index
Cornflakes	Apples
Dates	Cherries
Corn chips	Grapefruit
Croissant	Oranges
Salted crackers	Prunes
French fries	Pasta
Mashed potatoes	Tomato soup
White bread	Skimmed milk
Pizza	Soy
Sodas	Plain yoghurt

Please check these lists with your physician or with the care-giver responsible for your prescribed diet.

Let me know if you would like information about other food items which do not appear here. You can leave a post, or send me an email.

Tiny Threats to Hair, Skin, and Nails in Diabetes

Anyone can get a ringworm infection (called Tinea in medicine), but people with diabetes are especially susceptible. The term ringworm is misleading, because Tinea, the causative organism, is a fungus, and not a ‘worm!’

Ringworm attacks the scalp, groin, and toe nails. It can also spread to skin on other parts of the body. Victims spread the infection from one part of their bodies to others, when they scratch infections with finger nails.

Tinea also spreads from one person to another through bed and bath linen.

A physician will look for ringworm infection during physical examination, and can treat it effectively through a range of anti-fungal prescription medicines. However, everyone can take a few simples steps to keep Tinea at bay, and these will suffice for people with diabetes as well.

Here are some steps to prevent ringworm infections:

1. Enjoy frequent pedicures, keeping toenails short and clean.

2. Avoid sharing bed and bath linen with unknown people who may be infected.

3. Keep skin dry-all fungi thrive in moist conditions.

4. Avoid contact with pets, because Tinea affects them as well.

5. See your physician promptly if your scalp, groin, or skin over other parts of the body itches unduly, or if toe nails change color.

6. Keep scalps clean, using shampoo at least every week.

7. Observe strict genital hygiene, keeping the groin dry, and changing innerwear frequently.

8. Do not walk with bare feet over wet and unclean surfaces, especially in public places.

9. Do not use footwear which belongs to unknown people who may be infected.

10. Isolate any area affected by ringworm, making sure that infection does not spread from an affected region to other parts of your body through your finger nails, or to other people who may share linen with you. Your doctor can show you how to recognize ringworm, because it derives its name from the characteristic circular patches it causes on skin.

Though Tinea is easy to recognize, and to treat as well, it can keep coming back periodically, if you have diabetes, and are exposed to fresh infections.

Exuberant About Diabetes!

A new form of insulin, made by Pfizer, and called Exubera, is available in the United States. It comes with its own inhaler, and you just breathe it in, so that it enters your blood from your lungs.

This new form of insulin, which you inhale rather than inject, is not for people with diabetes who smoke, or you have lung infections or diseases. Your doctor will ask you to take a lung function test called spirometry, before you can get a prescription for it.

The dose of this form of insulin is different from all conventional injectable forms. You will have to learn to take care of the inhaler as well.

Your doctor may want to continue oral pills for your diabetes with the new form of insulin which is inhaled.

You need to inhale the insulin 10 minutes before each meal.

Ask your doctor about the new form of insulin which is inhaled-perhaps you can use it to reduce if not substitute completely, the chore of daily injections.

Fasting Safely with Diabetes

Religion motivates most fasts, though it has also been used as a form of political action by Mahatma Gandhi, and is still used in this manner by followers of his ideology.

Fasting with fluids is also medically safer than one in which not even water is allowed. Such extreme fasts disturb vital fluid balances of the body, and can threaten life if persisted with for more than about 12 hours at a stretch. People on extended fasts over many days regular continuous medical monitoring, and may relapse in to a state of emergency at any time.

Diabetes complicates fasting, and needs special precautions. An obvious first step is to cut back on medication, and only a doctor can do this safely for a patient. You should tell your physician well in advance if you plan daily fasts as during Ramadan, so that he or she can adjust your prescription.

The natural tendency to over-eat on breaking a fast needs to be curbed if you have diabetes. Allowing blood glucose to rise rapidly after a fast is not healthy. A small meal, rich in fruits without high sugar content, vegetables, and whole grains, eaten slowly, is the best way for a person with diabetes to break a fast. Candies and red meats in rich gravies, in which many communities indulge after a fast, are not suitable for people with diabetes. A large meal before embarking on a fast is similarly unhealthy for people with diabetes.

Walking Tips for People with Diabetes

Walking is the most fun part of diabetes management. It quickly becomes a habit, and something to which we van look forward. Here are some tips to make most of your walking regimen:

1. It is worth driving to a scenic spot-walking in a built up area, or round and round a small strip can be boring

2. Look for grass or sand, because walking on concrete can strain joints even if you have the best brand of walking shoes

3. Change in to loosely fitting cotton clothes because walking in formal clothes can be less than enjoyable. Remember to dress warm when necessary and to prevent chills.

4. Keep emergency snacks or a beverage handy, because hypoglycemia is possible if it is hot or if you have not eaten normally on a particular day.

5. Walk alone to clear your mind, and pace your speed and duration to suit your level of fitness

Never start without medical evaluation-walking suddenly can harm the heart and kidneys.

Walking and diabetes are made for each other!

Inspiring Company in Diabetes

Important celebrities from the entertainment world and professional sports people have diabetes. This proves that the disease need not prevent any of us from achieving excellence in our chosen fields.

The beautiful star Halle Berry, the versatile actor Marcello Mastroianni, the award-winning George C. Scott, the beloved Spencer Tracy, the sensual Mae West, and the incredibly gifted Ella Fitzgerald, are a few of the people who have entertained us so splendidly for years, though each of them has lived with diabetes.

Kris Freeman, who has been one of the world’s top performers in the extreme sport of cross-country skiing, the professional golfer, Scott Verplank, and the celebrated Pakistani cricketer Wasim Akram, all suffer from diabetes, but have excelled in their respective fields.

Diabetes need make no difference to our abilities to do well at our vocations, and to lead highly productive lives. It is just a matter of understanding the nature of the disease, and of cooperating with our physicians in management of the condition, by following prescriptions for diets, exercise routines, and medicines, without fail.

Candid Discrimination against Women with Diabetes!

The name is impressive enough, though the behavior of this fungus is quite blatantly chauvinistic! Candida albicans discriminates against women, because the female genital tract is its favorite haunt. It is versatile though, and does not fight shy of attacking the mouth as well. All women are vulnerable to fungal infections, and those with diabetes have to be especially careful.

The skin is highly sensitive to the states of the fine blood vessels and nerves. Uncontrolled diabetes can lead to changes in skin texture and appearance, apart from threats of microbial infections. Fortunately, most of the skin complications of poorly managed diabetes can be uncovered during physical examination by a doctor, and treated in time. However, delayed detection and treatment of diabetes because a person is denied or avoids medical care, can lead to serious skin disorders. Keeping blood sugar within the normal range at all times is critical for keeping skin supple and free of blemishes.

Sex and Bladder Problems in Diabetes

Sexual drive decreases naturally with age, and the elderly experience incontinence and other disturbances of the urinary system.

Poorly managed diabetes brings the onset of sex and urological problems forward, embarrassing adults who are not yet senior citizens.

Hypertension and high cholesterol levels in blood aggravate the complications of diabetes on sexual and urological health.

Sexual health and normal bladder functions are major incentives for people of all ages to try and prevent diabetes, to detect it in time, and to manage it well from onset.

However, this does not mean that you have to live with a poor sex life and with incontinence if your diabetes has been detected late, or if you have been careless with its management.

Doctors can use surgery and prescribe medicines to help with penile erections, normal vaginal moisture, complete and timely bladder emptying, and to treat bladder infections.

Embarrassment can keep patients from discussing these problems with doctors frankly, and they suffer needlessly in silence as a result.

Turn a new page today, and discuss any sex and bladder problems you experience with your physician today. There is little you can do on your own, other than to keep blood sugar, cholesterol, and weight always within the normal ranges, but your doctor can order tests, and decide on a course of action, if you have been lax in the past, and want to stay fit and healthy.

Diabetes and Depression

There is a vicious cycle relationship between diabetes and depression. Each can cause the other, and it is not uncommon for people to have both.

Depression, unlike diabetes, does not have a numerical diagnostic test. Therefore, only a psychiatrist can make a subjective diagnosis of this condition.

It is certain that a psychiatrist treating a patient for depression will monitor glucose metabolism. However, a physician managing a case of diabetes may fail to spot signs of possible depression. Hence, everyone with diabetes should ask his or her doctor for a reference to a psychiatrist to rule out depression, and other mental disorders as well.

Insomnia, a feeling of hopelessness, excessive stress, and tiredness may make many people with diabetes guess that they some degree of depression. However, self-management of this condition can aggravate it, or may not work at all. Psychiatrists use counseling and medication to manage diabetes, and their professional approach is always in the best interests of patients.

Diabetes prevention and management steps work well to prevent depression. These steps include adherence to a prescribed diet, regular exercise, and adequate sleep. Health literacy about diabetes, the ability to lead a meaningful life with the condition, and adequate insurance or money to pay for treatment, play key roles in keeping depression and diabetes apart.

Everyone can benefit from an annual psychiatric evaluation, but this is especially the case with people who have diabetes.

Why not ask for a reference to a psychiatrist today?

Nerve Protection in Diabetes

Diabetes affects all body tissues, and the nerves are amongst the worst affected. Even short durations of hypo or hyperglycemia can hurt

We do not realize it in the beginning, or when young, because the nervous system, especially the brain has so much redundancy built in to it.

We feel the effects of nerve damage first by tingling, acute pain, and numbness in the toes-damage is quite advanced by then

Some ways of protecting nerves:

- Try homeopathy with your physician’s permission. Biochemic Tissue salts are not tested to the standards of modern medicine, but they will not harm, and there are anecdotal reports of benefits

- ensure that your diet is balanced for minerals if it has not been made professionally-or ask your doctor for approval to use a vitamin supplement

- Exercise you entire nervous system-use mind expanding and other exercises for the brain, and use your toes regularly

None of this is entirely effective, at least in a substantiated way, but it is a worthwhile course of action if your blood glucose control is not even, or if your diabetes has been discovered late.

Drinking Alcohol and Diabetes

How to handle a social event with plenty of alcohol around, if you have diabetes?

Alcohol with plenty of sugar and calories can push your blood sugar up quickly, but equally, it can give you hypoglycemia as well, if you are on oral drugs or insulin.

There are 3 things you can do to participate in social drinking on a low key, without affecting your diabetes condition:

a.      Have a high-fiber snack or a light meal before you start drinking. This will send the alcohol in to your blood slower than if you drink on an empty stomach.

b.      Nurse your drink. The ‘bottoms-up’ mentality does not work if you have diabetes. Bear in mind that getting drunk makes you feel no different from the symptoms of hypoglycemia. It is difficult to know whether you are happily drunk, or dangerous short of glucose in blood!

c.      A dry wine or a light beer is a top choice of alcoholic beverages for people with diabetes. It is best to keep topping the first drink with water, and to try and avoid a second. More than 2 drinks in one event amount to asking for trouble.

So remember that moderation is your watch word when it comes to drinking and diabetes.

To Your Health!

Vision Protection in Diabetes

Those of us, who have diabetes and have enjoyed the gifts of sight, may find it hard to imagine what blindness can do the quality of life. It takes away independence, and many of the mundane pleasures to which we are so accustomed.

Environmental pollutants, toxic chemicals, and even the stray projectile all threaten physical damage to our eyes, and some parts of these vital organs decay naturally with age. These are not things most of us can control, but poorly controlled diabetes certainly is within reach, affects vision dramatically over time.

High blood sugar damages blood vessels and nerves which serve the eyes, and vision can virtually disappear over time. Loss of sight is amongst the worst complications of diabetes, and there is no way to reverse the loss, even if we do eventually find a cure for diabetes.

A simple dilated eye examination by an ophthalmologist is all that any of us need to make sure that our eyes are healthy. The doctor can look inside and tell if there are any signs of serious damage. It is best to take an eye examination at least once a year, though once every 6 months is safer if one has diabetes.

When was your last eye examination done?

A Great Diabetes Dessert!

There is this wonderful discovery that I cannot wait to share with you!

Dessert is always a trying time, whether you are the one with diabetes at a meal table, or if someone you love has it. You cannot gorge on the sweet stuff while someone else just nurses a black coffee!

Until my discovery of sugar-free jelly that is! You get it in red, orange, lime, and perhaps a few other colors I have not seen as yet, and it is quick and easy to fix. It tastes wonderful, and you can have a steak-sized helping without feeling guilty!

Speak to your diet expert, and make sure that every meal from now on has a ‘free’ helping of sugar-free jelly.

Let me know if you cannot find it at your food store.

Bon apetit!

Packaged Foods and Diabetes

Reputed brands of processed and packaged foods are a blessing for people with diabetes, though you must never shop or prepare a meal without a handy magnifying lens!

The attractive packaging and modern convenience apart, branded foods make it easy to keep tabs on your diabetes diet.

Here are 3 easy-to-follow rules to follow when buying and preparing ready-to-eat meals, food items, and beverages:

1. Ask your doctor for the following daily limits:

a. How many calories you can consume a day.

b. How much of carbohydrates, total fats, saturated fats, and trans-fats you are allowed a day.

2. Look for how much of these ingredients each brand and package contains. Stay away from products which do not have these details on labels. Prefer brands which use up as little as possible of the daily limits your doctor sets. Remember that limiting carbohydrate, total fat, saturated fat, and trans-fat daily intakes, is as important as staying away from sugar.

3. Reflect on the serving size before you help yourself to a snack or a meal, because the label may mention the details you seek in terms of serving sizes smaller than the ones you are tempted to have.

Stick a form on your refrigerator or wherever, which makes it easy to keep tabs on your diet for the day. Let me know if you would like a table with rows and columns, which you can print and copy.

Oh, and the magnifying lens is for reading the fine print on the label.

Enjoy!