Every diabetic needs foot exam

diabetic foot ulcer.pngIn individuals with diabetes, the average risk of foot ulcer development is 15%. Several factors such as walking barefoot at home/outside, inadequate education and care by healthcare providers and poor affordability are main causes for increased risk of foot ulcers. Unfortunately, cases are identified only in advanced stages when amputation becomes necessary leading to Read More »

Take charge of your diabetes with frequent self- checks

blood glucose monitoring.pngIf you have been diagnosed with diabetes, you ought to be prepared to test blood sugars at home using a suitable glucometer. Checking blood sugars at home also called as self monitoring of blood glucose (SMBG) is not only a convenience but a necessity . Especially in the initial stages, having a glucometer at home helps the new patient to check blood sugars whenever they are feeling slightly low or down. At the same time, recording blood sugar levels after a hearty meal at a wedding or party can serve as a deterrent to future indulgence.

Benefits of SMBG

SMBG can aid in diabetes control by:

  • Individualized blood sugar management program can be created by dietician based on the blood glucose chart (see image).
  • Day-to-day planning of meals and physical activity can be facilitated by this chart
  • It can help catch early signs of hyper or hypoglycemia
  • Empowers patient to understand blood sugar patterns and modify diet and medication (in consultation with physician) accordingly

Blood glucose monitoring chart.pngFrequency of monitoring

Insulin treated patients / type 1 diabetics  must check blood sugar levels at least 4 times in a day – fasting, before lunch, before dinner and at bedtime. This way they can adjust insulin dose to be taken before the meal.  However, recording post meal sugars are also effective in  understanding correlations between insulin and meal carbohydrate dose.

Individuals with type 2 diabetes who use insulin should perform SMBG at least four times per week, including at least two fasting and two postprandial values. Additional measurements at bedtime and before meals can also be obtained

Research has shown that frequent blood sugar checks  can help improve HbA1c values, especially in type 1 diabetics and overall glycemic control in type 2 diabetes thereby emphasizing the need for performing these tests regularly to prevent long term complications of diabetes.

Reference:

http://clinical.diabetesjournals.org/content/20/1/45

http://www.formsbirds.com/free-daily-self-monitoring-blood-glucose-chart

Microalbuminuria : critical marker of kidney disease

Microalbuminuria.pngIn a study on North Indian population,  more than 20% of the diabetics (duration less than one year also) were found to have microalbuminuria.  Microalbuminuria (defined as urinary albumin excretion of 30-300 mg/day, or 20-200 µg/min) is an earlier sign of vascular damage and being an Asian puts us at higher risk.

In individuals with long – standing diabetes,  microalbuminuria is the first clinical sign of impaired kidney function. Basically the main function of the kidney is to filter waste products from the body. A well- functioning kidney only eliminates the toxic and unwanted substances and those that are essential for the body are absorbed back into the blood stream.  But, in case of some damage to the kidneys, proteins, especially albumin may be spill out into urine and this albumin is detected in the microalbuminuria test.

Signs and symptoms of kidney damage are slow and gradual thereby leading to detection in very late stages when much damage has set in.

The microalbuminuria test is a very significant marker and monitoring tool not only for kidney disease but also for cardiovascular diseases. Hence, therapies that prevent or delay the development of microalbuminuria and all measures that reduce it, may help to prevent or delay end organ damage.

References:

http://care.diabetesjournals.org/content/31/Supplement_2/S194

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658722/

https://www.ncbi.nlm.nih.gov/pubmed/20105047

Quit sugar for a day!

sugar-affects-moodCan you try it?! Yes, avoid added sugar for a day?..It is very challenging, but if you are able to do it, it will be like a revolution! I know that you are thinking that you actually do not consume much sugar daily, but we can tell you that there is sugar hidden in almost all the ready-to-eat foods , even those that do not taste sweet!

For e.g. if you start your day with tea/coffee/ horlicks or a canned juice with some crackers -all of these contain sugar. If you eat bread, muffin or your so-called healthy muesli or cornflakes; these contain sugar for sure. Sugar is also present in abundance in our ketchups, sauces, snacks/ farsaans (chips, chivda, etc) , beverages, chocolates and of course the desserts /sweets. Added sugars are present in many foods and we do not even realize it , read the labels and you will be shocked

Why sugar is bad?

Impaired memory : Research has shown that sugar can compromise cognitive abilities such as learning and memory. The high sugar diet damages communication between brain cells that fuel learning and memory formation.

Increase anxiety: High sugar intake may not cause but worsen anxiety symptoms and impair the body’s ability to cope with stress. Sugar can cause blurry vision, difficulty thinking and fatigue, all of which may be interpreted as signs of a panic attack, thereby increasing worry and fear

Is addictive: Sugar causes release of chemicals that imitate the action of addictive compounds such as cocaine. They stimulate the same reward centers in the brain leading to addiction to sugar.

Increases risk of depression : Although we seek sugary foods when we are feeling low, sugar provides only a temporary high.  Rather, sugar further suppresses activity of hormone (BDNF) that is low in individuals with depression and schizophrenia aggravating their symptoms.

On your sugarless day, you can eat naturally sweet foods such as fruits, vegetables, and dried fruits (https://blog.ekincare.com/2015/10/27/some-naturally-sweet-food/) but we can still guarantee that these will only partially serve to satisfy the craving.

Sugar is comforting because it floods the brain with the feel-good chemical dopamine and that is why we seek the sweetness. However, even the apparently non-sweet tasting foods such as bread, chips and salted crackers also contain sugar and thus provide satisfaction.

Abstaining from sugar even for a day can be make you feel very irritable and confused as your brain is addicted to that kick. But, if you can train your brain to work without it then you are a WINNER!

References:

https://www.psychologytoday.com/blog/where-science-meets-the-steps/201309/4-ways-sugar-could-be-harming-your-mental-health

http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-blog/sugar-challenge/bgp-20056270/?utm_source=newsletter&utm_medium=email&utm_campaign=housecall