diabetes pedia

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Location: Mumbai, Maharashtra, India

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Wednesday, January 31, 2007

Middle East Conflicts, Depleted Uranium, and Diabetes

The world must prepare for a dramatic rise in diabetes incidence amongst the people of Iraq, Lebanon, and Palestine, and amongst ground forces of invading armies as well, because the United States, the United Kingdom, and Israel, are leaders in stockpiling depleted uranium, and using it in their ammunition and missiles.

Depleted uranium is terrific for spreading death and fear within enemy ranks, because not only can it penetrate armor made of lead, but it catches fire easily as well. Fortunately, its use in war is not prohibited, so if you have the stuff, then you are free to use it. Best of all, it is not just cheap, but no more than a waste product of all forms of enriched uranium use. It costs a pile to store it, so firing it in to hostile territory makes great environmental sense!

No one is sure about the health risks of depleted uranium once it enters the human body. It is thought to cause things like cancer and diabetes, but published clinical trials are lacking. After all, who in their right minds would pay good money to find out what this nasty stuff can do?

However, I worry that charges against depleted uranium with respect to cancer and diabetes could be true. Civilians in Basra already show unusual spikes in incurable illnesses. U.S. soldiers, who were part of the first invasion force in Iraq, are also known to suffer.

Better watch out if you have a loved one in the invaded and bombed areas of the Middle East, or a member of the family who has fought there on the ground.

Let me know if you would like links to information from a Basra Hospital on serious illnesses before and after the invasion.

Oh by the way, old civilian aircraft also have depeleted uranium as trimmings-so try and stay out of the way if, God forbid, one crashes!

Tuesday, January 30, 2007

Why Whole Fruit Beats Juice in a Diabetes Diet

Sugar addition in packaged juice is an obvious no-no for people with diabetes, but even the new brands without added sugar, are not as good as whole fruits, as components of diets for people with diabetes.

The main reason lies in polyphenols. The latter are chemicals naturally produced by most plants, which retard ageing when consumed by humans. Polyphenols act as anti-oxidant. Tea is rich in this group of beneficial and natural chemicals, as our some dry wines as well. However, polyphenols may also lurk in the skin of fruit. Apple skin is a typical example of a rich plant source of polyphenols. Clarified and processed juice tends to exclude pulp and skin, and some of the polyphenols are lost as a result.

Most branded juices are packed in layered materials which tend to bend and get distorted by handling on retail shelves. It is difficult to distinguish such handling distortions from bulging due to deadly bacterial growth. Fresh and whole fruit, which can be decontaminated simply by washing in potable water, is therefore microbiologically safer than buying branded juice in tetra packs.

A fruit juice is a good choice of beverage to nurse at a social event, but prefer fresh and whole fruits with low sugar, such as apples, melons, pomegranates, and oranges, for your regular meal table.

Sunday, January 28, 2007

Look Your Best to Manage Diabetes Better

Diabetes and having to shop for plus size clothing often go hand-in-hand, though slim people may also suffer from the disease. Unexplained weight loss is a possible sign of untreated diabetes, and one of the first signs that blood glucose is back on track, is that people begin to gain weight. Now that is easy for a diabetes educator to fix, but sustained diabetes management is also feeling confident about your appearance, and looking your best.

A manicure, pedicure, new hair style, massage, and a whole new wardrobe, are some of the wonderful things you can, without having to ask your physician first, which can do a world of good to your resolve to turn the tables on diabetes, and have a whale of a time in life (without cheating on diet and exercise rules though!)

Fashion and beauty parlors are not, as many tend to believe, for women and for the young alone. Older people of both sexes, and men of all ages, also deserve to look their best, and a fashion consultant can do as much for how you look, as your doctor does for your state of health. Now, that may be a bit of an exaggeration, but go out and blow up a whole lot of money on your appearance, and notice how much easier diabetes management seems (do not tell the spouse I told you so, however!)

Saturday, January 27, 2007

Cosmetic Lower Limb Care in Diabetes

Excessively dry skin below the knees, all the way to the toes, is a common issue for people whose diabetes has been discovered late, or who are careless with their prescriptions. Minor skin infections in the area can also flare up, given the effects of spells of high blood glucose on immunity and blood supply just below the skin surface.

That is why a cream for the legs can help in diabetes. You could always ask your physician for a prescription, but look for moisturizing and anti-infective properties on labels, if you decide to shop for a cosmetic product on your own. Any reputed brand which can keep the skin moist and take care of visiting bacteria and fungi should do the job. Normal skin pH for the lower limbs varies with age, sex, and ethnicity, so it is best to choose a cream which interferes as little as possible with nature in this respect.

Keep yourself from scratching dry skin around your calves and feet, and stay free of infections in the area by choosing a skin cream which works best for you.

Let me know if you would like specific brand suggestions.

Friday, January 26, 2007

The Diabetes Educator Model Can Work for Other Diseases As Well

I love diabetes education. It reduces time pressures on busy physicians, and helps patients avoid complications of diabetes, if not roll back from pre-diabetes, and by-pass the disease altogether. Anyone can train and qualify to become a diabetes educator, and the public benefits are especially worthwhile in poor communities, and amongst people with low health literacy.

Cancer is another disease in which patient education yields major benefits, both in terms of prevention, as well in coping with the terrifying challenges of managing the condition.

Obesity, high blood pressure, many auto-immune disorders, most mental illnesses, and sexual illnesses can also benefit from professional educators.

Patient education is never for amateurs because partial knowledge of diseases can do more harm than good.

Support professional diabetes education by getting a certification of your own, or by using the services of a diabetes educator.

Write to me if you would like to know more.

Tuesday, January 23, 2007

A Marker of Hope in Diabetes

Your C-peptide level could tell whether your pancreas still produces insulin.

C-peptide is formed when your body makes insulin naturally, even in small amounts. This is different from insulin being injected or inhaled in the form of medicine. A C-peptide test therefore distinguishes between insulin which your body produces and that injected or inhaled. It therefore tells the physician more than what the usual blood glucose tests do.

Perhaps you have diabetes because you are obese, and can make do with whatever insulin your body is able to produce, just by losing weight. That should be additional incentive to stay with your prescribed diet and exercise program!

The role of C-peptide is not fully known, but it has been shown to halt the progress of neuropathy in the feet of people with diabetes. Perhaps we will have a medicine made one day made of C-peptide. However, keeping tabs on how much of this mysterious substance is in your blood could tell you whether you can hope to rely on your pancreas, and perhaps cut back or cut out medication prescriptions, simply by losing weight.

How much C-peptide do you have?

Monday, January 22, 2007

Ask Your Doctor about Gymnema sylvestre for Diabetes Management

Clinical studies confirm ancient knowledge of indigenous people and explorers that the leaves of this herb take away craving for sweet things.

Gymnema sylvestre leaf extracts in water can reduce blood glucose and fat content as well. You should not take such herbal medicine without asking your doctor, because it is likely to require dose reductions of your regular prescriptions over time; you might be allergic to the extract or to the leaves, and safety in pregnancy is unknown as well. Nevertheless, your physician may agree to let you try this herb extract.

Finding a reliable source of supply, and monitoring your blood glucose and lipids periodically, are keys to using Gymnema sylvestre safely over time.

Let me know if your physician and you would like more information about this herb.

Sunday, January 21, 2007

The Silent Role of the Sun in Fighting Diabetes

There is more to the expression ‘a sunny disposition’ than meets the eye. Sunlight helps us stay cheerful and positive, which matters when it comes to fighting morale-busting diseases such as diabetes, on a daily basis.

Those of us who live near the equator have so much of the sun all year around, that we take its effects for granted. However, a continuous spell of even a few days in a harsh winter, suffices to remind us of how dependant we are on the sun.

What does this have to do with diabetes?

Short daylight hours can affect the production of serotonin, a natural substance which the brain uses for communication with the rest of the body. Shortage of serotonin causes a temporary affliction called Seasonal Affective Disorder (appropriately, SAD for short!)

SAD is a kind of depression, which increases the cravings for sweet and starchy food. Now do you see the connection between sunlight hours and fighting diabetes?

A severe winter puts every resolve to fight diabetes to a heightened test. 2 things can help: first, use bright artificial lights to keep your serotonin levels up, and secondly, keep plenty of fresh fruits, vegetables, and nuts at hand, to deal with cravings for all the things you cannot have in diabetes.

Doctors can prescribe short courses of supplements to boost serotonin, provided that the cardiac system is normal, and the person who prepares your diabetes diet can make adjustments to deal with low daylight hours as well. However, awareness goes a long way in fighting SAD, and most people can hold on until spring by themselves. Everyone with diabetes, or at risk of developing it, needs to take special precautions to keep away from increased fat, sugar, and simple carbohydrate foods with high glycemic indices, during the long dark nights of winter.

Saturday, January 20, 2007

A Simple Way to Fight Alzheimer’s in Diabetes

The very mention of the word Alzheimer’s spreads terror, regardless of whether one has diabetes. Recent research linking diabetes with the dreaded loss of mental faculties spurs me to write today’s post in favor of exercising the brain everyday to keep it in top shape.

Nature endows us with brains of such enormous capacities that even a genius can use no more than a small fraction of the potential of this wonderful organ.

It is true that blood with too much fat and glucose does no good for the brain, and may even starve some portions of it served by narrow and small blood vessels, to the point of death. It is easier to perceive tingling in the toes than insidious loss of memory and cognition, but loss of mind is a complication of diabetes which is neither fully known nor adequately appreciated.

Conscious attempts to remember lines of poetry or even telephone numbers, a habit of preferring mental math to a digital calculator when doing mundane things such as shopping, thinking logically about public issues, and planning activities and budgeting expenses, are examples of easy but meaningful daily exercises for the brain, which will help keep it in good shape, even if one has diabetes. That is not to say we can ignore abnormal blood sugar levels, but mental calisthenics are just as important as prescriptions for diabetes management from our physicians.

Primary medical care often ignores psychiatry, so the dangers of gradual losses of mental faculties in routine diabetes management, are real and present in many cases. Regular tests of concrete and emotional intelligence levels help to keep tabs on mental health, though they are not substitutes for a professional psychiatric assessment of the Global Assessment of Functioning. Building exercises for the mind in to daily routines is the best way of ensuring that they get done, but special measures to develop intelligence are also available.

Let me know if you would like details, but do resolve to start daily mental exercises for remembering and thinking: now how is that for a late (but not too late) 2007 resolution?

Friday, January 19, 2007

Diabetes Association Benefits

You are not on your own-that is the main benefit of being active in a local diabetes association. Stories of how others like you have fought the disease and lead productive lives will give you confidence, and spur you to do more about following your prescriptions more carefully. There are many complications of diabetes which are difficult to visualize when you read about them, or when your doctor speaks about them, but you come face-to-face with reality when you meet a person with a limb, sight, or other disability which has arisen because of negligence of diabetes.

It is not just about you. Others can benefit from your experiences with diabetes. You will feel a new sense of fulfillment as you help people who are new to diabetes adjust to the disease. Explaining the nature of the disease, forming groups with others with who you can exercise, and sharing ideas for food exchanges, are other inspiring benefits of joining a diabetes association.

Let me know if you would like a link to a diabetes association which you can join on the web. Your physician will also know about a diabetes association in your neighborhood. Finally, you can always form a new diabetes association with other patients in your locality.

Join or form a diabetes association and start reaping and sharing the benefits!

Thursday, January 18, 2007

The Sopas of Puerto Rico and Diabetes

Do not be put off if you know that ‘sopas’ is no more than soup in the Hispanic world, because this hot but humble meal starter is rather special in the U.S. territory of the Caribbean.

Hispanics and the indigenous tribes of Puerto Rico may be no less susceptible to diabetes than any of the rest of us, but the magic which they weave in to bowls of steaming sopas is sure to give you a whole new optic on a great way to satiate hunger with a dish that is more water than anything else!

It may be the infectious rhythms and free laughter that accompany most meals in Puerto Rico, but you do not really know your soup until you have experienced the start of a banquet on the tropical paradise.

Sea-food, vegetables, and even fruit make their way in to Puerto Rican sopas, and the variations are as broad as the many races which live in harmony in this U.S. territory. Learning to make sopas will help you with meal plans, and give you the opportunity to teach a thing or two to your nutrition care-giver for a change!

You do not need diabetes to enjoy a sopas every day, but the travails of the disease will seem lighter if you have a new recipe to which you can look forward every day.

Let me know if you would like links and ideas for creative, healthy, and satisfying sofas, which go well with every diet for top diabetes management.

Wednesday, January 17, 2007

The Unholy Alliance between Stress and Diabetes

Stress is an integral part of human physiology, but it can develop in to a disorder through excess as well. People with diabetes just do not have the insulin to spare to move glucose in to cells, which is a primary requirement of the need to deal with stress.

Stress helps us meet challenges, but the tension, if acute and sustained, results in a disorder which has implication for mental health. Acute Stress Disorder is a specific condition in psychiatry, and has to be treated with a combination of medicines and counseling.

The news that you have diabetes, having to forego some of your favorite foods, the pressures to lose weight, the costs of treatment, and the chances of serious complications, all create undue stress. This is a vicious cycle, because anxiety and mental disturbance about the implications of diabetes only pushes blood glucose even higher!

Twitching, body and head aches, hyperventilation, fatigue, perspiration, difficulty swallowing and diarrhea, are some of the common physical symptoms of anxiety disorders such as acute stress. A feeling of dread, difficulty in focusing the mind, insomnia, a loss of sex drive are also possible: all this while the doses of medicines keeps rising!

A psychiatrist is the best person to help a person with diabetes break out of such a vicious alliance between the endocrine disease and the mind. Do consider asking your physician for a reference to a psychiatrist even before you develop symptoms of acute stress, so that you give your diabetes management its best shot.

Remember an understanding of diabetes, confidence in your physician’s ability to manage your condition, enjoying your new diet, test results which show that your blood glucose is under control, and regular exercise, will also keep harmful stress levels at bay!

Do write to me as well, if you would like more information and counsel.

Tuesday, January 16, 2007

A New and Easy Way to Keep Tabs on Foot Ulcers in Diabetes

Infra-red skin temperature measurement can predict the development of ulcers in the feet of people with diabetes. A new device, which needs a prescription, but which people can use at home, offers a precise and reliable way of preventing serious wounds in feet, which is a common and serious complication of diabetes.

Physicians and their assistants normally examine feet of patients with diabetes carefully during each visit to their clinics, but ulcers can develop between visits in people with diabetes of long standing, or those who are careless about following their prescriptions. It always helps if there is someone at home to take close looks at feet everyday, but this is not always easy or practical.

The new infra-red skin thermometer is sensitive enough to record a temperature increase much before an ulcer rises to the surface, warning people with diabetes to take corrective actions through their doctors in time.

Ask your physician about this new device during your next scheduled check-up, and let me know if you would like a link to the manufacturer’s web site.

It is Delicious and you can enjoy it Even if You Have Diabetes!

Here is a tip I always knew about, but needed a trip to the house of a dear friend to recall:


Eat the seeds with the fiber, or just put them in a blender to make a juice: either way, the pomegranate is a marvelous fruit, full of vitamin c, fiber, and minerals such as iron.

My friend served glasses of pomegranate juice for breakfast when I recently called on her family and her. She lovingly separated the skin from the seeds, and added some black salt in the blender. The juice tasted great, and filled me with good spirit. The color is superb, and looks so good at the breakfast table.

You need not suffer from diabetes to enjoy pomegranates, but it is certainly a fruit to put at the top of your meal plan, if you do!

Let me know if you would like a link to detailed information of the nutrition values of pomegranates

Monday, January 15, 2007

A Simple Way to Choose a Glucose Meter for Your Diabetes Management

There is nothing better than asking your physician for a prescription because only doctors have full access to new developments, and the most reliable brands.

However, some doctors prefer to allow patients with diabetes to choose meters by themselves. Others want to buy meters because they fear that diabetes may set in though they do not have the disease as yet.

Choosing a glucose meter on your own can be difficult. Manufacturers make claims which you may find in real life to be highly exaggerated if not outright wrong. I bought a meter based on the international reputation of the manufacturer, and because of endorsement by a cricketer I respect, only to find a useless call center on the telephone, when on opening the package, I found that I had been tricked in to buying a defective unit!

The United States FDA has had occasion in 2006 to order the recall of a batch of test strips which made its way in to the market, though they were defective. Are you sure that the strips you use are calibrated properly? Who will make contact with you to let you know that you should return defective strips?

I am tempted to say that it is best to rely on a trusted diagnostic laboratory, but feel guilty because my family owns one! It would be more appropriate to conclude that your neighborhood pharmacist should choose a brand, if your doctor has not done so, and if you prefer and need your own tests, in addition to ones by professional laboratories. The local pharmacy is where you must return regularly to buy strips, so the brand of the meter, which you buy just once, is secondary. Remember to keep your contacts with the pharmacy in case a batch of strips is found after making its way to market, to be defective.

Sunday, January 14, 2007

Chocolate Celebrations and Cautions in Diabetes

Chocolate and celebrations are like 2 peas in a pod. Diabetes may keep you away from chocolate at most times, but everyone has occasions when a square of the irresistible brown treat seems in order.

Chocolate made without sugar seems to be manna from heaven for people with diabetes, but it does contain carbohydrates, so it is not as though you can gorge on it to your heart’s content, or have it everyday.

Modern brands of chocolate without sugar are made so well, that people with diabetes need miss nothing, as long as they keep portions and frequencies within reasonable limits. It is important to choose a brand without chemical coloring and flavors, because these could be harmful. Nothing like the natural stuff when it comes to chocolate without sugar for people with diabetes!

Sugar-free chocolate is available not just as ready-to-eat bars, but in the form of chunks that can be used for baking. Ask your nutrition expert to make exchanges for desserts with sugar free chocolate, but remember, moderation is the key!

Saturday, January 13, 2007

Racial Discrimination by Diabetes

It is illegal and unconstitutional, but diabetes could not care less!

Diabetes preys on ethnic minorities. Africans, Asians, and Polynesians are far more likely to suffer from diabetes than white Caucasians.

That does not mean you escape by being part of the mainstream, but diabetes is a much greater threat for the illiterate, poor, and those without access to health care. Such groups are more common amongst ethnic minorities than amongst white Caucasians, though I am not sure of the reasons for such linkages between prosperity and skin colors! There are the wealthy in all communities, but much of the third world lives in Asia, Africa, and isolated islands of the Pacific. They are also in the east sides of U.S. cities, and in neglected parts of the U.K. and Europe as well.

Diabetes screening amongst the poor and the illiterate needs the kind of support that AIDS and some vector borne and other infectious diseases have. The screening has to be by way of comprehensive blood glucose testing, using hygienic and safe phlebotomy. That is quite a demand, but the investments will yield massive public health returns.

Please write to me if you would like detailed guidelines on how to conduct a proper diabetes screening program amongst the ethnic minorities and poor in your neighborhood.

Friday, January 12, 2007

Rediscovering an Old Ally in the Fight against Type 2 Diabetes

It is over 100 years since scientists first discovered that the intestines contain a substance which lowers blood sugar. However, research in to this hormone, called Incretin, has been relatively slow. Incretin is produced by the gastro-intestinal tract. It stimulates insulin production in anticipation of food absorption, and slows the digestion process.

Exenatide is the first medicine to be approved and to be commercially available against prescriptions, which mimics the action of Incretin. It can be used, as a sub-cutaneous injection, alone, with other oral medication, or even with insulin, for the management of type 2 diabetes.

The Incretin approach to diabetes management has the advantage that it helps people to eat less. Hypoglycemia is also not a risk if medicines which use the Incretin approach are used alone.

Exenatide has to be prescribed-you cannot buy it on your own. This medicine will affect doses of other drugs and injections you take for type 2 diabetes. People with digestive and kidney disorders cannot take Exenatide.

Overall, the Incretin approach has advantages for type 2 diabetes management-ask your physician whether it can help in your case.

Wednesday, January 10, 2007

A Hat-Trick of Easy Tips to Fight Craving for Food in Diabetes

I was born for diabetes! My ancestors were devoted to trans-fats even before they were discovered, and I am compelled to follow their haloed footsteps in the quicksand of cholesterol! You are on the button if you think I am on the candy bandwagon as well, and chefs in charge of dessert buffets quake in my presence! Seriously, I am really in to food, and can survive no summer without plenty of sodas. The latter is no longer an issue, thanks to the miracle of aspartame, but I have had to find a path to longevity through the maze of ingrained eating habits. Here are 3 easy tips you can try if you have diabetes, or are on the way there:

1. Make every planned meal a grand event: eating and drinking are rigors of diabetes, for any extra tit-bit or treat out of place comes with a deadly calorie tag-and I do really mean deadly! I like to spend time thinking about my next planned meal, setting it out with great fanfare, making it look more voluminous than it really is, and then consuming it with dedication. No TV, newspaper, doorbell, telephone call, or even conversation is welcome, when I sit down to enjoy whatever it is that my nutrition-expert-wife will let me eat and drink. I recall now that I used to feel much hungrier when I did distracting things at meal times, such as talking, reading, or whatever.

2. Start with fiber and water: grainy bread, pasta without a thick sauce, cereal with loads of soy milk and sucralose, and melons, are my favorite meal starters. They are all good filling values for calories, and trick the brain in to thinking that hunger has gone away. Start with something fried and tasty, and it will only whet your appetite for more. Strange meal habits will not make you a popular guest, unless you are amongst the bold and beautiful, but it will help keep you diabetes free of complications.

3. Savor your favorite foods: the first taste matters most, as with a great wine. I used to rush through my meat and gulp my shakes, but it would only leave me longing for more! I have discovered that if I linger with the first bite or sip, I am satisfied even before that tip-of-the-food-pyramid portion is over.

Do try this bag of tricks and let me know if it works to help you stay with planned meals for diabetes.

Thursday, January 04, 2007

How Diabetes Management Suffers Because of Patents

New medicines to deal with diabetes and its complications are a dime a dozen. Certainly no year has passed in this century without new discoveries and devices to make life with diabetes better.

So what is my crib?

Complementary and Alternative medicine, herbs, and other natural substances, which were used before the days of modern medicine, are ignored. Most of these are way cheaper than proprietary medicines, and are therefore especially meaningful for the unemployed, and for those without health insurance.

Complementary and Alternative medicine has not been tested for safety and efficacy to the standards of modern science. That is because clinical trials cost millions of dollars. Society depends largely on private capital for new medical discoveries, and investors will not back stakes without prospects of financial returns.

We have become so dependent on patented medicines that large numbers in our ranks can afford them only after they become generics. Many potential natural substances remain incompletely tested and standardized in the meantime.

Long term solutions lies in shortening patent durations, in organizations which work not-for-profit taking leads in health care research, and in finding alternate ways to compensate pharmaceutical companies for their R&D efforts.

You and I cannot effect such path-breaking changes in a day, but it is worth being conscious of the vile effects of the capitalist system of patents on diabetes management, and on other diseases which plague society as well.

Burns and Diabetes

Everyone with diabetes needs to take extra precautions to avoid burns. Even minor scalds, especially of the legs, which tend to have damaged nerves after years of diabetes, can take long periods to heal. Blood sugar is certain to shoot up after a burn. Medical treatment, especially surgical intervention, to help in recovery from burns, is complicated by diabetes.

Serious burns can lead to loss of consciousness. A person with extensive burns may be unable to speak coherently due to shock. Emergency care givers should know if a person with burns has diabetes. Normal dosages of oral medication and insulin will need changes in the period of treatment of and recovery from burns, so doctors in emergency rooms must have details of pre-existing prescriptions, and should be able to make immediate contacts with primary care physicians. Therefore, people with diabetes should carry information related to their condition, details of their prescriptions, and emergency contacts of their physicians, on their persons at all times.

Senior citizens with diabetes are especially vulnerable to complications if they suffer burns. Every effort to prevent such accidents is especially worthwhile in their cases.

Wednesday, January 03, 2007

Limits to Insulin Use in Diabetes

New forms of insulin, and the development of pumps which can be attached to or put inside our bodies, have certainly made diabetes management very close to having a normal pancreas. Indeed, there is even light at the end of the tunnel in terms of generating entirely new and healthy cells capable of producing insulin.

However, insulin dosing is always tricky business, and it is not as though taking unlimited amounts of it can return people with diabetes to the days of indulging in sweets and fats. Indeed, weight gain is common after starting insulin therapy, as the body begins to recover from the decaying effects of too much glucose circulating in blood.

Insulin is only available through prescriptions, so people with diabetes who use it know from their doctors about hypoglycemia, how to recognize it signs, and how to deal with it. Nevertheless, dangerous fluctuations in blood glucose levels are still possible when one is asleep, falls unconscious after an accident, or is even mildly unwell.

The delicate balancing act, to which one is subject with insulin, is not its only limitation. It is possible to have a surfeit of insulin circulating in blood, without glucose moving in to the cells where it is needed. A shortage of cell receptors may prevent insulin from acting. We know that losing weight is the best way to deal with insulin resistance, but excessive dosing may also reduce the receptor numbers over time.

Exercising regularly, moderation in eating carbohydrates, restricting fat and diary product intakes severely, and avoiding sugar altogether are the best ways of keeping insulin doses as low as possible, while keeping body cells full of receptors. These are things which depend on patient compliance, and there is little a doctor can do to correct matters if a patient becomes less and less responsive to insulin dose increases over time.

The Right Shoes for Diabetes

Since walking has so much to do with diabetes management, buying the right pair of shoes, matters more than for others with normal glucose metabolism.

Buying shoes of the right size and width are important for everyone, but fashion aspects such as color and style have to take back seats if you have diabetes.

Here are some tips for buying shoes which suit diabetes management:

1. Orthotics: choose a pair with removable braces and multiple soles. This will help you achieve a custom fit to care of parts of your feet which hurt, and will also help you adjust the fit when your feet swell after walking for long periods in warm weather.

2. Overpronator: prefer shoes made from materials and with linings to absorb shocks, and which give your feet as much support as possible. Many people with diabetes may have flat feet or defective arches, and need shoes designed to provide protection against such limitations.

3. Generous toe space: shoes with high and wide tips will prevent chafing of the toes, and suit people with diabetes best.

4. Adjustable closures: hook-and-loop systems in which you can easily adjust a fit, help in diabetes, since as mentioned earlier in this post, feet can swell on walking for a long time in warm weather.

5. Extra protection: you may have to buy shoes slightly larger than a normal size, because a design with plenty of padding will prevent blisters and other minor injuries which are common in diabetes.

Buying shoes deserves special care if you have diabetes. Look for a retailer with a wide selection, specialist knowledge to help you choose, a convenient supply of seamless socks, and a liberal return policy, just in case the feel after a long walk is not quite the same as in the shop!

Do Home Test Kit Errors Interfere With Your Diabetes Management?

The convenience of glucose meters which you can use at home is undeniable, but here are 5 safeguards for you to follow, to ensure that your diabetes management does not suffer on account of inaccuracies and shortcomings to which some brands of these devices may be subject:

1. Range: each meter has a range of blood glucose within which it can work correctly. Your physician is certain to take this in to account when recommending a brand for you to buy. Do not allow a pharmacist to change such a prescription, or be swayed by price and marketing efforts of manufacturers, without consulting your doctor.

2. Temperature: Study all information supplied by reputed glucose meter manufacturers, and observe stipulated conditions strictly. Some meters may have components which need refrigeration. Keeping parts away from moisture is often important. Your meter may give misleading results if you are careless about essential temperature conditions. This is especially important if you live in extremely hot or cold places, without air-conditioning and heating.

3. Quality: Never buy meters or their consumable components from unauthorized sources. You could be lumped with defective or spurious materials, and suffer from diabetes irregularities without knowing. Even official supplies may sometimes suffer from batch defects, and your pharmacist should know how to reach you in the event of a batch recall.

4. Storage: Make a note of expiry dates when you buy parts of your meter system which require regular replacements. Try to avoid products with short shelf lives left at the time of purchase. Check this aspect once again if there is a long gap between successive uses of your meter.

5. Calibration: Ask a trusted laboratory technician to check the calibration of the strips and reagents you buy periodically, to go with your meter. Make contact with the manufacturer, and ask for a replacement, if blood glucose readings from your meter vary from those given by a standard diagnostic laboratory.

Everyone with diabetes needs glucose meters to cope with situations of unusually high or low blood glucose in a new place, or when routines of diet and exercise break down, or when you first start on a new regimen of oral medication, or a new type of insulin. Meters are also useful when you need to know the effects of sudden stress, illness, and infections, on blood glucose. The key is to ensure that your meter works and gives you accurate results.

Meditation and Diabetes

Meditation is a part of Hindu practice, but you can enjoy its fruits even if you belong to another religion, or even if you are an agnostic.

Lord Gautama Buddha meditated to gain the insights which enabled him to expound the principles of the faith, which has inspired generations for eons, and which countless numbers of people all over the world follow to this day.

It is best to learn how to meditate from a spiritual leader (Guru), but anyone can also practice a rudimentary form of this deep introspection on his or her own.

Meditation helps people with diabetes live better with their afflictions. Daily practice calms the mind, fights stress, anxiety, and depression, and helps resist temptations to indulge in unhealthy eating, and lazy habits. Meditation also builds self-confidence, and increases resilience against adversity.

Measurements before and after meditation can prove that the process reduces blood pressure and slow down the heart rate as well, though these benefits are only transient with casual practice. Meditation, in any case is not a substitute for professional medical management of hypertension or of irregular heart beats. However, everyone with diabetes can usefully practice meditation to blend well with their prescriptions for management of the disease.

Here are simple steps to start meditation on your own, if you do not have access to a Guru or to an accomplished practitioner, to show you the way:

1. Choose a place and a time of day: 45 minutes before dawn is the best time for meditation, though any time and place may do after some years of daily practice. The stillness, calm, and one’s refreshed state of mind just after even a few hours of restful sleep, make the wee hours most suitable for meditation. However, you can also choose to draw the curtains, to close doors, and ask people around to leave you alone for a few minutes, if you prefer to meditate during the day. Some people like to meditate at night, and to lapse in to sleep from this state. There are no restrictions on how many times you can meditate in a 24-hour period, but at least one session at a fixed time, on a 24*7 basis, will give best results.

2. Choose a posture: the classic position in which to meditate is the Lotus pose of Yoga, in which one sits cross-legged on the floor or on a mat. However, this will not suit people with osteoarthritis of the knee joints, and those accustomed to sitting on modern chairs. Many people with diabetes are uncomfortable with the Lotus pose. It is important to sit in a way that you can remain still for some time, because meditation is difficult for the average practitioner, with any form of voluntary movement. You can choose a stool or a straight-backed chair as a substitute for the Lotus pose. It is also possible to meditate in the Shava-Asana pose of Yoga. The latter, for the purpose of meditation, is no more than lying flat on your back.

3. Put your hands at rest: there are two common ways of keeping the upper limbs still while meditating: one is to place your palms, facing downwards, on your knees, with index fingers of each hand touching the respective thumbs, at the tips. The other way is to place any one palm in the other, with both facing upwards. There is no harm in creating your own variations of these poses, as long as you can sit or lie completely still in comfort.

4. Choose what you would like to do with your eyes: most practitioners like to meditate with their eyes closed, but beginners often find it easier to focus on a spot on a wall, or on any inspiring picture or statue. I recommend that you try alternatives, and choose whatever seems to suit you best.

5. Become conscious of your rhythm of breathing: the Yoga technique of Pranayama is the right way to breathe before and after meditating, but it is not safe to attempt this without a Guru, or if you have an arrhythmia. It may be safest to try and breathe in through the nose, drawing air in so as to fill the lungs completely, to hold the breath momentarily, and to finally exhale through the mouth, as slowly as possible. Do not worry if this sound too complicated, because you can meditate as long as your breathing is measured and follows a natural pattern.

You are now ready to meditate.

Folk lore has it that sages could meditate for years at a time, but you will find it hard to practice the method for even a few seconds. 5 minutes a day is a fair compromise for most working people.

Inspiring music, often devotional, and incense are commonly used to provide the right atmospherics for meditation, but neither is essential.

The key part of meditation is its most difficult part. It sounds and looks simple, but can prove annoyingly elusive when you start. This relates to emptying the mind of all thoughts. The principal objective of meditation is to make the mind as still as prescribed for the body in earlier parts of this post. The average human mind has large numbers of fleeting thoughts all the time, and we are not conscious of all of them. All kinds of things will flit across your mind when to sit or lie down to meditate, not least being conscious of what you are trying to do. It is important to be patient during this phase, because it could be weeks, if you attempt meditation alone, before you can truly empty your mind of all activity for even a few seconds at a time. Do not get frustrated if you find your mind wavering off in some direction: just try and get back to the tightrope balancing act of ceasing all thoughts for as long as you can.

The benefits of meditation have not been proven by modern scientific methods, but I have found that it does help people to deal with the stresses of diabetes. I am also certain that it will do no harm as long as you follow the guidelines in this post.

I can provide audio and video support for anyone who would like to try meditation, and who finds this text insufficient as a guide. Just leave a post here or send me an email. I am available, by appointment, on Skype as drsbanerji.

Tuesday, January 02, 2007

Soy and Diabetes

Full of healthy protein, low on saturated fats, and with some important vitamins, soy is a nutritious and healthy diet ingredient, even for people without diabetes. Communities in the Far East have used soy in plenty for generations, and this is something for the rest of the world to follow.

Soy is flexible: you can use the bean as a substitute for meat, or as a cooking medium, and even as a beverage. The Japanese are especially creative in using soy beans as a most common ingredient of their meals. Let me know if you would like a link to a site where you can learn all about the many delicious and healthy ways of putting soy on a meal table. Do speak to your care giver, if you have diabetes, and if you would like to exchange some of the items in your meal plan with substitutes made from soy.