keralaayurvedashram

AYURVEDIC TREATMENT


Post 50 diabetes cuts 8 yrs of life

You lose about eight years from your expected with diabetes after 50 years of age.

In a study that quantifies the exact loss in years of a diabetic, researcher from the University medical centre, Rotterdam (the Netherlands) and Unilever Corporate Research, Sharnbrook (England), have found that diabetic men who are 50 and above live an average of 7.5 years less compared to their counterparts without diabetes, For women, the loss of years is 8.2.

India is home to an estimated 46 milliondiabetics (the highest in the world as per the WHO) of which 60% are above 50 years of age. The number is expected to climb to 80 million by 2030.

Oscar H Franco, the lead author of the Framingham Heart Study, the results of which have been announced in the June 11 issue of the ‘Archives of Internal Medicine’, collected data on more than 5,200 American men and women (aged 28 to 62 years recruited between 1948 and 1951 and followed for more than 46 years) and followed them until they developed heart disease or died. The researchers also noted whether they were diabetic

The results showed that diabetic women had more than twice the risk of developingheart disease than non-diabetic women. Diabetic women who already had heart disease were also more than twice as likely to die when compared to non-diabetic women.

Among men, the researchers found that those with diabetes also had twice and faced 1.7 times higher risk of dying after developing heart trouble as against their non-diabetic peers.

Dr. Anoop Mishra from Fortis Hospitals said, “This study is unique. It pinpoints the number of years lost by a person diagnosed with diabetes, which makes it highly interesting.”

DIABETES MATHS

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Reduces lifespan

  • Men lose 7.5 years, women 8.2 years

 

X

Multiplies risks

  • Women twice at risk of contracting heart diseases
  • Existing heart6 patients twice as likely to die
  • Men twice at risk, 1.7 times more likely to die

+

Adds up

  • India has about 46 million diabetics; 60% are above 50
  • By 2030, that number will touch 80 million


Safety First

Make sure you have a first aid kit with the following essentials:

  • *Scissors
  • *Thermometer (oral and rectal)
  • *Tweezers
  • *Adhesive tape
  • *Butterfly bandages
  • *Elastic bandages
  • *Hypoallergenic tape
  • *Sterile cotton balls
  • *Sterile eye patches
  • *Sterile gauze pads
  • *Stretchable gauze roll
  • *Waterproof tape
  • *Antacid
  • *Antidiarrheal medication
  • *Antihistamine
  • *Aspirin
  • *Antiseptic ointment
  • *Calamine lotion
  • *Decongestant
  • *Ibuprofen
  • *Sugar or glucose solution
  • *Syrup of ipecac
  • *Acetaminophen
  • *Alcohol (rubbing 70 per cent)
  • *Alcohol wipes
  • *Ice bag
  • *Cotton swabs
  • *Disposable latex gloves
  • *Flashlight
  • *Hydrogen peroxide
  • *Insert repellent
  • *Matches
  • *Safety pins
Chromotherapy: Treatment with Colors Chromotherapy, also colled color therapy, is an alternative medical approch in which therapists use color and light to treat heath problems.
Indian Ayurvedic medicine associates colors with the seven main chakras, spiritual centers in the body located along the spine:


Seventh chakra: VOILET

Treast lymphatic system, spleen; soothes organs, relaxes muscles, calms nervous system

Sixth chakra: INDIGO

Treatment for eyes, ears, nose, mental problems; sedative, calming effects

Fifth chakra: BLUE

Relieves headaches,migraines, pains of stomach, muscle cramps, liver disorders; positive effect on all kinds of pain conditions

Forth chakra: GREEN

Treatment of bronchitis, inflammation of joints, swelling, cysts, eye diseases and stimulates general detoxification

Third chakra: YELLOW

Combats glandular diseases, diseases of the lymphatic system, strengthens nervous, assists metabolism and glandular activity

Second chakra: ORANGE

Treats mental illness, depression, discontent and pessimism; arteriosclerosis, loss of appetite, anemia, anorexia and digestive system discomforts

First chakra: RED

May increase pulse rate, raises blood pressure, rate of breathing; calimed to combat anemia, asthama, diseases of the larynx, certain skin diseases and chronic coughs.

History

  • *Roots: Ancient India ROme, Greece, Egypt,China
  • *1810: J.W. Goethe ("Theory of colors")
  • *1878: Edwin D. Babitt ("The principles of light and color")
  • *1912: Oskar Ganser ("Chromotherapie")
  • *1950s: Luscher test
  • *1979: Heinz Schiegl ("colortherapie")
  • *Today: Modern color therapy with different light spots, also focusing on body's acupuncture points, meridians

Light and Body

Light releases harmones in the body, influences reactions in the brain

As diabetes emerges as a major epidemic in India,Diabetic Retinopathy, loss of vision due to diabetes is in sharper focus. The world sight Day 2008 (the second Thursday of October) highlights the flight against vision impairment in later life.

How do you see our problems of sight as another World Sight Day goes by?

The problem of blindness is enormous in India because of the enormity of the population. India accounts of a quarter of the world's blind population of 80 million. the alarming fact is that 75 percent of blindness it is avoidable.

There is a growing concern about Diabetic Retiopathy in the world. Does India face the threat on a simillar scale?

Diabetic Retinopathy (DR) is the major cause of irreversible blindness in old age, and all diabwetics are prone to it. It is one of the most devastating complications of diabetes. A diabetic is 25 times more likely to go blind than a person in the general population.

With Diabetes emerging as a major epidemic, India is likely to emerge as the diabetic capital of the world by 2025.The diabetic polution in India has crossed 30 million, and is expected to touch 75 million by 2025. This means 20 percent of these patients will develop DR in the eye.

How common is DR?

More common then we think. About two million of the 20 million blind population has DR in India, whic could multiply at least four-fold by 2020. Today a third of people with diabetes don't know that they have diabetes. Just two-third seek medical attation. Only a miniscule percentage go through regular eye checkups.

Who is at risk?

All diabetics risk diabetic Retinopathy. It may worsen during pregnancy. the longer the history of diabetes, the greater the risk of diabetic retinopathy. About half the number of diabetics will develop some degree of diabetic retinopathy during their lifetime.

Are there any contributory factors to DR?

Hypertension, renal disease, obesity, Smoking, Anamia...all have an adverse impact on DR pregnancy in women can be associated with worsening of the retinopathy. High levels of serum cholesterol and/or triglycerides are significant risk factors for retinopathy.

How does diabetes affect the eye?

The pathological changes in diabetes lead to lack of blood supply (ischemai) to the retina, resulting in indequate oxigen to the retinal tissues (hypoxia), Long-standing hypoxia leads to formation of new vessels.These arefragile, and readily bleed. Excessive bleeding in the eye leads to lack of vision.

In some areas,there is a swelling of the vessel wall and the fluid leaks leading to retional oedema.If the macula, the central part of the ratina is affected, there will be a severe drop in the vision. DR can be corrected in stage one and stage two by laser treatment. Stage three and stage four are advanced. There is formation of scar tissue, which pulls the retina to cause retinal detachment, resulting in permenent loss of vision.

How do you manage DR?

Laser photocoagulation is the mainstay in managing DR. Advanced cases with vitreous haemorrhage and tractional rential detachment, requir surgery (vitrectomy) and laser treatment. patients with hypertension, renal disease or pregnancy should have a regular ophthalmic check up every six months.those who have undergone laser should have check ups every three months.

Are there any precautions to prevent DR?

An annual eye check up is mandatory for all diabetics. There must be control over diabetes by regular medication, diet and exercise. Control of associated disorders such as hypertension, renal disease and hyperlipidemic status management is a must.

How is vision 2020 strengthening the flight against blindness?
Vision 2020 is a globel initiative to eliminate avoidable blindness. Launched jointly by the World Health Organization (WHO) and the international Agency for the prevention of Blindness (IAPB), vision 2020 envisions a world without avoidable blindness.

http://www.v2020.org

How can India tackle the problem?

According to a recent survey in Chennai city, only 15 per cent of the urben population is aware of the link between diabetes and eyesight. if this is the lavel of awareness of the urban population,

what will be the state of rural areas?

India is now focusing only on curative healthcare due tothe enormity of its population, and has not been able to do much in the direction of preventive healthcare. We have to shift the emphasis to preventive healthcare. If we can prevent loss of vision due to various problems. We can save all the resources which are now being spent on curative healthcare.

A major step would be extensive screening of diabetics for DR. Though resource-intensive , it will yield results if it covers 80 per cent of known diabetics. The screening process should be effective.

The keyword seems to be awareness. How does one create awareness on the scale needed in the Indian context, given the socioeconomic barriers?

The need of the hour is to ensure that awareness percolates down to all members of the community. For instance, many spectacle users get their eyes checked by an optometrist who sees only the front of the eye, and changes their glasses.

The optometrist does not look at the back of the eye, where early indications of DR, or problems with the retina are avaliable. If undetected, the symptoms do not surface until advanced stages.They need to go to an ophthalmologist to get their eyes checked to avoid preventable eye problems.

Elimination of DR calls for a determined effort by the goverment, NGOs, healthcare and eye care organisations to heighten awareness of Diabetes and its complications, extensive screening of the population, especially in rural areas, and provision of free eye care.

In India, the goverment cannot be expected to tackle the problem of blindness single-handedly due to the sheer size of the blind population. We have an excellent example of public-private partners where NGOs and eye care hospitals join hands with the government to conduct awerness camps to educate people on various aspects of blindness.

Ayurveda for diabetics

Dr N K Ikbal explains how Ayurveda can provide a holistic treatment for those suffering from diabetes.

Quality healthcare solutions to the diabetic population across the globe is getting increasingly complex and less patient-compliant in recent days. Reasons:cost, progressive nature of the disease,predictable complication. According to an estimate, India ranks highest for the number of diabetics at 34 million. With convention medicine focused on maintaining only blood suger level,wellness is still a dream for diabetic people. Most patients therefore live in the grayzone of health. And livingwith diabetes poses a formidable challenge for the patients.

bur Ayurveda, the most tested of the Indian systems of medicine, is clearly emerging and superior alternative in managing diabetes with the technically perfected protocol 'Ayurvedic holism'. The invaluable findings are now conclusively processed in the backdrop of Ayurvedic holism by a team of doctors in India and scientists in Europe. They have come up with a promising regimen to suit the present day diabetic.

Diabetes is primarily suspected when a person suffers from increased urination and thirst and indulges in excessive eating. Once these symptoms are detected, the standard prescription is to put the patient on lifelong medication, with special diet and excercise as supporting factors.

While the symptoms could will be under check and laboratory tests may show normal blood level.In Ayurveda, diabetes is considered to be a disease in which Kaphadosha and Medodosha factors get into disorder. Self-care, healthy diet and natural herbal medicines will reverse this imbalance thereby maintaining positive health. There is no single standard medicine which would be effective with all patients. The prakrut (constitution) of each patient is the prime consideration.

Ayurvedic formulations are made to suit these individual traits. Adequate sleep, exercise, positive attitude and creating a healthy home and work environment will be the supporting tools. Ayurveda treats the patient and the disease at the same time, improving the quality of life.

Diabetes Mellitus is recognised as madhumeha in Ayurveda and has been identified as a specific clinical condition in the oldest classics like Charaka Samhitha and Susrutha Samhitha.

It has been well documented that this illness was managed purely by herbal preparations and the diabetic individual could lead a healthy life.

Diabetes Mellitus is a metabolic-cum-vascular disorder primarily characterised by elevated blood sugar levels. It is also a progressive disease with specific complications creeping through various organs and disablling them in the process and gradully wrecking the body.

The new regimen of Ayurvedic management of Diabetes Mellitus is essentially holistic. It takes into consideration several factors like diet and lifestyle.

Diabetes affects the heart too!

With estimated 35 millon person with diabetes, India is the undoubted diabetes of the world. Indians develop diabetes about a decads earlier then people from Europe, America, or China. The incidence of heart disease is also greater among Indians as compared to person of the same age else-where. Several reasons have been advanced for these observations including genetic predilection and environmental factors.

The most common cause of death in diabetes is due to a heart attack. more than 60 per cent of persons with diabetes will die of heart disease. So strong is this association between diabetes and heart disease even in the absence of any demonstrable heart problem.

One amjor reason for this clubbing of diabetes as a 'heart-disease equivalent' is the fact that unlike normal persons who feel pain whenever a heart attack is impending, persons with diabetes often do not feel any pain, and exhibit what is called 'silent heart attack'.This is because the nerves which carry sensation from the heart are damaged due to the high blood glucose concentrations in diabetes.Prevention of death due to anunexpected heart attack is the top priority for doctors who treat diabetes as well as their patients.

What is it about diabetes that makes it so dangerous for the heart?

To understand that we should understand the disease and how it affects the body.

Diabetes is caused by a deficiency and defective action of a harmone called insulin which is produced by the pancreas, and which regulates the supply of the primary fules viz. glucose and free fatty acidsto various parts of the body.

Insulin deficiency leads to an increase in blood glucose and free fatty acid concentrations and these lead to cascade of further abnormalities. These include a tendency for blood vessels to dilate in accordance with the needs of the parts, which need nourishment, and removal to toxic wastes. The build up oaf toxic molecules within cells, as we as outside the cells, called’ gluco-lipotoxicity’ is known to accelerate the process of atherosclerosis. Thus in diabetes there is a premature ageing of blood vessels and a consequent increase in the risk of heart attack due to blockage of the arteries, which supply blood to the heart.

High blood glucose also results in deposition of the reaction products of glucose proteins among muscle fibers. The heart muscle is affected by these deposits, which renders it ineffective for optimal pumping action. The person with diabetes is therefore of arteries supplying blood to the heart, as well as having an inefficiently functioning heart.

So what can be done to protect the heart?

Several lines of investigation have revealed that a multipronged strategy which addresses the primary defects in diabetes, as well as the secondary abnormalities consequent to uncontrolled diabetes yield best results. Good blood glucose control, especially post meal blood glucose control; good blood pressure control; measures to reduce clotting of blood, viz. regular physical exercise, avoidance of calorie dense and fatty ular physical exercise, avoidance of calorie dense and fatty, foods and aspirin; cessation of Smoking ; stress avoidance by behavioral modification, yoga meditation, and relaxaction exercise; and regular treatment and monitoring for diabetes control form the basis of protecting the heart against a surprise attack.

Traditionally diabetes managed by a combination of education, diet, exercise, and drug therapy. Drug treatment is usually initiated with oral tablets. As diabetes is progressive disease, drug treatment has to be stepped up in order to keep the abnormalities of glucose and fats under control. within six years of the diagnosis of diabetes, almost 60per cent of the patients require the ultimate treatment viz. insulin, in order to retain control over the disease and its consequences.

Insulin replacement remains the primary means of reversing all metabolic abnormalities in diabetes, along with insulin sensitizers. Newer insulin preparations produce better control of diabetes at lower risk of side effects and have the potential to delay the possibility of occurrence of significant coronary artery disease. Insulin must be given in a dose sufficient to overcome he deficiency, and it must control blood glucose at the required levels recommended on the basis of long-term studies viz. fasting blood glucose below 100 mg/dl; 2hour post –meal blood glucose below 140 mg/dl, and long term blood glucose control as estimated by glycated hemoglobin should be below seven percent. Persons with additional lipid disorders such as high cholesterol and triglyceride levels may need additional lipid lowering medication.

Dr. Stephen Clement is a well-known global authority on diabetes. He is the acting chief, Division of Endocrinology,Georgetown University Hospital and Director of the Georgetown Diabetes Center.

Ayurvedic control for diabetes

Salaia Oblonga (SaptaRangi) is an ayurvedic herb found in the Indian subcontinent, whih has been trationally used in treating type 2 diabetes patients. Ayurvedic practitioners in India and Sri Lanka have been effectively using this herb for hundreds of years to keep diabetes under control. Salacia Oblonga herb contains a Glucosidase inhibitors-Salacinol and Kotalanol 9. These two inhibitors help in controlling glucose levels in the body. A new study at Ohio State University reports that researchers gave extracts of the herb to 39 healthy adults, and the results were promising. The largest dose of the herb extract-1,000 milligrams-decreased insulin and blood glucose levels by 29 and 23 per cent respectively.

"These kinds of reductions are smiliar to what we might see with prescription oral medications for people with diabetes," said Steve Hertzler, a study coauthor and an assistant professor of nutrition at Ohio State University.

Slacia Oblonga, which is native to regions of India and Sri lanka, binds to intestinal enzymes that breek down carbohydrates in the body. There enzymes, called alpha-glucosidases, turn carbohydrates into glucose, the sugar that circulates throughout the body. If the enzyme binds to the herbal extract rather than to a carbogydrate, then less glucose gets into the blood stream, resulting in lowered blood glucose and insulin levels."Lowering blood glucose levels lowers the risk of diseaserelated complications in people with diabetes," Hertzler said. "Also, poor compliance with diabetes medications often hinders the effectiveness of these drugs."

A water-extract of the same herb has been taken and formulated into easy-to-use capsules. The cost per day is Rs.25.

No surgery: A 15-min cure for diabetes, obesity A Device Is Put into Small Intestine Through Endoscopy To Prevent Food Being Absorbed into Body.

London: In what could revolutionise healthcare for the rising diabetes population worldwide, scientists claimed to have developed a 15-minute non-surgical treatment that could lead to drastic weight loss and reverse the onset of the disease.

The breakthrough treatment, considered a cheap and safe alternative to surgery, involves a device called EndoBarrier-a plastic sleeve that is inserted into the intestine of a patient to prevent food being absorbed into the body.

The device, developed by a United States-based company, is fed through the mouth using an instrument called an endoscope while the patients is awake, the Daily Express reported.

“Obesity surgery can be risky simply because of the patient’s weight and the fact that you are giving them a general anaesthetic. That’s why it’s so good to have a non-surgical approach,” said Keith Gersin, head of obesity surgery at Carolinas Medical Centre in Charlotte, North Carolina, which has been trialling the Endobarrier sleeve for 18 months.

“It is so quick to fit that you can get lots more patients treated. The patients loved it so much they didn’t want us to remove it at the end of the trial period. We had no significant side effects and it was easily removed.

Extensive tests of EndoBarrier have been carried out in the US and Europe and last week the new device was given a license for use on European patients.

In a 12-week trial in the Netherlands, patients fitted with the EndoBarrier lost an average of 16kg compared with a control group of paitents who dieted and lost just 5Kg.

According to its developers ,the treatment, which costs £2,000, is about half the cost of the cheapest obesity operation.

“The patients who used it have continued to lose weight. It gave them the intensive to diet and eat sensibly,” said Gersin.

The EndoBarrier device is fitted to the first two feet of the small intensive where most food is absorbed. During trials the sleeve was able to reverse Type 2 diabetes within weeks by reducing patients’ blood sugar levels so they no longer needed to take drugs. Nadey Hakim, a leading UK consultant in weight loss surgery, said: “I would love to able to cure a patient’s obesity with a 15-minute procedure. It’s a very clever idea”.

The Endobarreir digestive tract liner won CE Mark approval in December, 2009, clearing the way for sales to begin in the European Union this year.

5.2 lakh women screened for gestational diabetes in TN 7-8 percent prevalence seen in women visiting PHCs

The risk of nearly 83,000 individuals developing diabetes at a later date has been reduced by a simple, low cost intervention by the Tamil Nadu government.

In a first-of-its-kind programme in the country,5.2 lakh pregnant women visiting government-run prenatal clinics were screened for gestational diabetes(GDM) during 2007-08. And 7-8 percent were found to have elevated glucose level.

Several studies have shown that gestational diabetes-the elevation of maternal blood glucose first seen during pregnancy –when unchecked can put both mother and baby at risk of developing the disease at a later stage.

Easy management

The good news is that simple diet that simple diet management-splitting a big meal to many small ones-was sufficient to keep the glucose level under check in 90 percent of the pregnant women diagnosed with gestational diabetes. “ This shows how easy it is to reduce the risk of both mother and child from becoming diabetic after a few years,” said Dr. V. Balaji, consultant, Apollo Hospitals, Chennai.

With about 65 percent of the 11.38 lakh deliveries in the State taking place in government institutions, the decision to screen all pregnant women visiting these institutions will have great benefits.

“In another six months we can get all pregnant women screened for gestational diabetes, “said DR. P. Padmanban, Director of Public Health and Preventive Medicine, Chennai.

Towards this goal, many of the public health centres (PHC) are being equipped to test for diabetes and other disease. ”Already 385 public health centres are equipped with semi auto analysers and we plan to equip another 385 this year, ”said Dr. Padmanaban. There are totally 1421 PHCs in the State.

Apart from testing for fasting or postprandial blood glucose level, about 2 lakh women underwent glucose tolerance test(GTT). GGT is considered a gold standard for diagnosing gestational diabetes. ’We would be able to test [using GTT] 4 lakh pregnant women this year,” he noted.

The decision to use GTT to confirm the disease is not the only highlight of the screening programme. Even during the first year, the screening programme has adopted the correct time to test for elevated glucose levels.

Early testing

While screening for GDM is usually performed around 24-28 weeks of gestation, many studies have shown that testing as early as during the 16th week, can diagnose the disease.

Identifying the disease at an earlier stage will help in early intervention and hence reduce complications.

While it is a general practice to test just once during pregnancy, a study published in the Diabetes Research and Clinical Practices journal last year showed how important it is to test during all trimesters of pregnancy. The screening programme has adopted not just early screening but screening during all trimesters.

The proof

And the results speak or themselves-2-2.5 percent were detected during the 16th week, 2.5-3 percent during the 24th week, and around 3 percent during the 32nd week of gestation.

“Nearly 75 percent of the 2 lakh women [on whom GTT was done] were tested thrice,” Dr. Padmanaban said. He is optimistic that the percentage of women who will undergo testing thrice will increase this year.

The results of the largest screening programme, which shows that gestational diabetes shows up during all trimesters and that early screening is useful in detecting the disease, should be sufficient proof for medical practitioners to follow the testing protocol.

Diabetes doesn’t spare women’s libido either

Ahmedabad: Diabetes is known to adversely affect the libido and sexual performance of men. In a ground-breaking study by sexologist Dr.Ashok Rughnani, it is now revealed that nearly 47% women reported less interest in sex after being detected with diabetes.

Dr. Rughani is a Gujarati doctor who practised as a gynecologist in Kenya for 20 years before leaving to study sexology in the US. Along with his practise, he did his doctoral thesis on; Difficulty in sexual function among female diabetics; The study was conducted on 107 patients of which 55 were diabetic and rest non-diabetic. While the study was conducted on women the study was conducted on women in the US, the issues remain the same with Indian women, says Dr. Rughani.

Dr. Rughani has now come back to India and has started practice as a sexologist at his hospital, Sexual Medicare Centre, in Ahmedabad. He says that while studies report that 50% diabetic men suffer erectile difficulties and low desire levels, the impact of the silent killer on women’ sexuality is largely neglected,” We have had many patients complain that their wives do not have sexual desire and experiences pain and other problems. It is only on detailed investigation that we find the woman is diabetic and her sexual problems stem from the disease that is so rampant,” said Dr Rughani.

The sexologist’s wife and a practicing nurse, Aarti Rughani, said that diabetic women had nearly double incidence of urinary and genital tract infections as compared to non-diabetic women.

“Nearly 63% women were found to have recurrent vaginal fungal and bacterial infections, dryness of vagina, painful sexual intercourse and orgasmic problem. In non-diabetic women, this problem was found to be in 34%” said DR Rughani. DR. Rughani explained that the wonen with diabetes experiences lesser lubrication which leads to dryness. “This causes pain during sexual relations, which eventually leads to loss of desire, ’he said.

“With a large number of people having diabetes in the state, women tend to suffer in silence as their sexual problems remain largely neglected “These problems remain can be easily dealt if the women talk to their doctor openly. They can be treated and can even get back to their normal life,’ said Dr.Rughani.

Studies report that 50% diabetic men suffer erectile difficulties and low desire levels. Research now days that nearly 47%diabetic women, too, report reduced interest in sex.

NEW SENSOR IS SWEET NEWS FOR DIABETICS

Scientists make a sensor that can detect blood sugar levels from the breath of a patient. The sensor can also be modified to detect multiple disease and will cost less than Rs. 10 to make…

Engineers at the university of Florida have designed and tested versions of the sensor for applications ranging from monitoring diabetics’ glucose levels via their breath to detecting possible indicators of breast cancer in saliva. They say early results are promising-particularly considering that it can be mass produced with tech already widely used for making chips in cellphones and other devices.

“ This uses known manufacturing tech that is already out there,” said Fan Ren, a professor of chemical engineering and an engineer collaborating on the project.

The team has published 15 papers on different versions of the sensor, most recently in this month’s IEEE Sensors Journal. In that, members report integrating the sensor in a wireless system that can detect glucose in exhaled breath, then relay the findings to health care workers. That makes the sensor one of several non-invasive devices in development to replace the finder prick kits widely used by diabetics.

Tests with the sensor contradict long-held assumptions that glucose levels in the breath are too small for accurate assessment, Ren said. That’s because the sensor uses a semiconductor that amplifies the minute signals to readable levels, he said.

“Instead of poking your finger to get the blood, you can just breathe into it and measure the glucose in the breath condensate, ”Ren said.

In the paper, they report using the sensor to detect alkalinity or pH levels in the breath, a technique that could help people who suffer from asthma identify and treat attacks-as well as calibrate the sensitivity of the glucose sensor. The engineers have used versions to experiment with picking up indicators of breast cancer in saliva, and pathogens in water and other substances.

As with the finer prick standard, tests for pH, cancer indicators typically already exist, but they are often bulky or time consuming, Ren said. For example, the current technique for measuring PH in a patient’s breath requires the patients to blow into a tube for 20 minutes to collect enough for a measurement.

At 100 microns, or 100 millionths of a metre, this sensor is so small that the moisture from one breath is enough to get a concentrated reading-in under five seconds, Ren said.

Ren said the sensors work by mating difference reactive substances with gallium nitride commonly used in amplifiers in cellphones and other electronic applications.

While the sensor is not as sensitive as those that rely on nanotech, the manufacturing techniques are already widely available, Ren said.

The cost is as little as 20 cents per chip(Rs. 10 approx) but goes up considerably when combined with equipment to wirelessly transmit to PCs or cell phones. The entire package might cost around $40(Rs1,800 approx). he said, costs could be halved with mass production.

DOLPHINS HOLD KEY TO CURING DIABETES


Dolphins can switch diabetes on and off depending on the availability of food. Scientist believe they can use the dolphins’ mechanism to do the same in humans…

Bottlenose dolphins could provide vital clues to help Type 2 diabetes sufferers. Researchers found that the mammals have an amazing ability to switch the condition on and off. If scientists can find out how the dolphins do it, they could help prevent diabetes in people—a disease that affects 50,768,300 in India as of this year, according to the international Diabetes Federation. That’s more than 7 per cent of the population.

Dolphins and humans share the same glucose blood chemistry needed to feed our large brains. Humans have bigger brains relative to their size than dolphins.

But dolphins are able to keep their blood glucose levels high in a diabetic-like state . When they have no food to feed the demand from their brains.

The Us National Marine Mammal Foundation’s Stephanie Venn-Watson said bottlenoses are the first animal model for Type 2 diabetes in humans.

“When dolphins fast overnight they develop diabetes, then when they are fed in the morning they revert back to a non-diabetic state. Effectively they have a switch which can turn diabetes on and off. Discovering how dolphins control this may help humans turn diabetes off”, she added.

Dolphins are thought to have developed their insulin resistance 55 million years ago when they evolved into sea creatures.

“Their large brains need sugar to function like us. We can eat carbohydrates but their diet of fish has no sugar in it. So it works to have a system which keeps Blood sugar high in their bodies. Their liver will go and produce sugar at just the right amount they need,” said Venn-Watson, speaking to the American Association for the Advancement of Science meeting in San Diego, US.

She also said that dolphins wouldn’t be harmed in any research, adding: “There’s no desire to make a dolphin a lab animal. I don’t think it could ever happen because we all love dolphins too much.

By 2030 diabetes will affect more than 9 percent of the Indian population and it can lead to blindness, heart disease and kidney damage.

Is bariatric procedure the solution to diabetes?

There's mounting evidence to suggest it can though doctors advise extreme caution.

As part of the recently concluded three-day conference, Metasurg 2008, bariatic surgery was performed upon nine patients and relayed live to the delegate doctors. The procedure has been known for over 30 years as the most effective and long-lasting treatment for morbid obesity. But, surprisingly, none of these nine patients, weighing in the range of 100 kg to 200 kg, were seeking weight reduction. Instead, they were looking for a cure for diabetes.

"I have been suffering from diabetes and high-blood pressure for the past six years. My body mass indes(BMI) is 45, putting me in the morbidly obese category. No amount of medication, care, and caution seems to bring my diabetes under control," said Arvind Kalekar (name changed) from Aurangabd. "I hope this surgery will cure my diabetes."Kalekar weighed 160kg when he was wheeled in to the operation theatre.

The new-found use for the procedure was at the core of a heated international debate, which was conducted live during the conference. Bariatric surgeons swear by mounting evidence that suggests that the surgery might be the most effective treatment for metabolic diseases and conditions, including Type-2 diabetes, hypertension, high cholesterol, and sleep apnea. Endocrinologists and diabetologists, though, say it is a drastic measure fraught with risks.

Dr. Shanshank Shah, Consultant bariatric surgeon at Wockhardt Hospital, is confident that the procedure will resolve Kalekar's diabetic condition. "He won't have to take any medication for diabetes," said Shah, who claimed to have performed the surgery on 300 patients. Of them, 175 were rid of their diabetic condition.

Over 300 bariatric surgeons from across the world, who attended Metasurg 2008, agreed that surgery for obsity goes way beyond weight loss and can effect a complete remission of Type 2 diabetes and other life threatening diseases in most patients.

With mounting evidence, endocrinologists too are slowly changing their views. Dr. Udaya Phadke, who was among a group of 25 endocrinologists who participated in the debate, said,"So far, diabetes only had medical treatment. But now, evidence of a surgical option is emerging.

"But there is a catch- the surgery is advisable only for people who are grossly obese and whose diabetic condition is uncontrolled despite conventional medication. But if case selection is done properly, the procedure can be very usefull."

Phadke's view was endorsed by leading city diabetologists like Dr Shanshank Joshi and Dr. Manoj Chaddha.

Diabetes under attack

The Amercian Association of clinical Endocrinologists (AACE), in its recently published guidelines, says the surgery can be a valid oiption in therapy for morbidly obese patients(with a BMI over 35).

Professor Nicola Scorpinaro known as the 'father of bariatric surgery' for pioneering it more than 30 years ago, is currently engaged in clinical research to prove that bariatric surgery may also be useful to control severe diabetes in moderately obese and even non-obese patients(with a BMI between 20-35).

As India debates the Nikita Mehta judgment….

Mumbai docs want to try alternative therapy to ensure healthy babies.

EVEN as the HC denied Nikita Mehta permission to abort her 25-week-old foetus, two Mumbai doctors are hoping to use alternative therapy that will ensure healthy babies. This treatment can be used when allopathic medicines fail to provide the desired results.

Dr. H S Palep of integrative medicine and Dr. Geeta Niyogi of obstetrics, head of their respective departments at K J Somaiya Medical college, are in talks with the Boston University of Medicine to rest the success of an ayurvedic drug on 300 pregnant women aged 18-44 for healthy babies. The drug called Sujat (See box) claims to strengthen the placenta that supports the foetus.

The research will follow a ‘double-blind system where a placebo will be given to 150 expectant mothers and Sujat to the rest. The women will then be tracked for the entire term of their pregnancy.

“The average birth weight for an Indian is unable to significantly raise this weight, why, not try alternative medicine,” said palep who proposed the same to Dr. Robert Saper of Boston University last year.

The initial reaction was skeptical. “Alternative medicine is an important part of the course for medical students in USA, while in India it’s virtually ignored,” said Palap. The investigators are now waiting for approval from the Indian Council of medical Research and Us NIH/NICHD health authorities to start research.

What is Sujat? A combination of nine different ayurvedic ingredients designed to strengthen the placenta of an expecting mother and improve general health.

Steam Cell cure on cards for rural diabetes.


The government is contemplating the use of stem cells for treatment of diabetes, especially in rural area. “Stem cells can now be grown and transferred into specialised medical therapies and this can be an answer to diabetes treatment,” Union health minister Ghulam nabi Azad said on Sunday.

Azad, while speaking a t a diabetes conference in Delhi. Said it is important to take care of the rural population and help them to keep a check on the growing menace of the lifestyle disease. “We are formulating a scheme to facilitate mandatory check-up of the rural population above the age of 40 years for diabetes… if diabetes cases could be easily detected awareness created among them about its implications, then a substantial dent can be made to this disease,” he said.

The minster added that health workers in rural areas with be trained and provided with a diagnostic kit to detect diabetes. “Simultaneously a programme for diabetes control can be launched, “ he said,

Azad also said marginal cases of diabetes can be easily tackled through yoga, naturopathy, exercise and correct eating habits. There is also a need to develop diagnostic kits within the country to substantially bring down the cost of diabetes detection and treatment, Azad said.

A bitter-sweet truth

Diabetes can make you feel helpless. But there are ways to manage this condition

Diabetes is a life-long condition which you need to take it seriously. Managing your diabetes well is a balancing act where you have to manage your medication with a healthy diet and physical activity. The management of diabetes most importantly involves self-care.

REGULAR CHECK UPS

Check your blood glucose levels regularly in order to preserve your health. Keeping tabs on your sugar level will help you to prevent complications from your diabetes. Your blood glucose levels should be below 120 mg/dl before meals and 180 mg/dl after meals. This shows that it is under proper control.

TIMELY MEDICATION

Medications are of utmost importance. If your doctor has prescribed medications you need to take them as directed. Take them at the same time each day and try to take them close to your regular meal times. Don’t try and change the dosage all the time.

WATER POWER

Water is essential for the human body under all circumstances. It is important that you drink at least eight litres of plain water every day.

HEALTHY DIET

You must ensure that your diet includes fresh vegetables, carbs, good fats and some lean protein. This diet will help you and will also help decrease your risk of cardiovascular disease.

VITAMIN SUPPLEMENTS

Since your body doesn’t receive much nutrition, it is important you provide it with the required supplements. Take a multivitamin every day.

FOOT CARE

Take good care of your feet. Wear shoes and socks that fir your feet well. While it may seem that this would not be a big problem, it can become one if there are sores on your feet that become infected. Check your feet after you bathe and before you go to sleep. Check the soles of your feet regularly. Don’t use location between your toes. Dry between your toes thoroughly and make sure that you wash your feet carefully.

DENTAL CARE

Gum disease can be prevented with brushing and flossing your teeth. Diabetic patients are at a higher risk of gum disease, so take care to help prevent it.

SLEEP WELL

Have adequate hours of sleep. Sleeping seven to eight hours a night can make a difference in your diabetes and your overall well being. Go to bed and wake up at a regular time every day.

DAILY EXERCISE


Exercise your body. Moving your body helps you relieve stress, reduce blood sugar levels and can generally lift your spirits. Your can do regular walking, or spirits. You can do regular walking, or take up yoga for some light stretching.

UPDATE YOURSELF

Keep yourself updated on diabetes news. Research all the latest treatments and learn to live with diabetes. Who knows, you might just get lucky and find a cure for this condition.

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Diabetes… Some useful Tips

How does Exercise help?

• Lowers blood glucose levels quickly improves the body’s ability to use insulin

• Reduces insulin requirement

• Better control of diabetes

• Reduces the risk of heart diseases

Primary prevention

Maintaining of normal body weight Healthy nutritional Practice Regular Physical Exercise Such as Brisk walking/jogging Avoiding-alcohol & smoking Periodic health check up

Diet and diabetes

• 30% of the disease can be controlled with proper diet

• Proper Diet is vital in the treatment of diabetes

• Diet for the diabetic person need not be completely different from a non-diabetic person.

Foods you should avoid

• Sugar in any form-Sweets, ice creams Chocolates, Candies Etc.

• High carbohydrate foods like Potatoes Sweet potatoes etc. • Fried items like Puri and Chat items

• Fruits high in sugar content like Banana Sp ota, Grapes, Mango etc. Secondary Prevention

It means control of diabetes and its complication It is possible by maintaining Normal blood glucose levels, ideal body weight and blood pressure, Normal blood cholesterol and fats.

All diabetes persons should regularly get their blood glucose estimation, kidney function test eye check up and foot examination done.

Foods you should eat more often

• Take a balanced Diet

• All green and leafy vegetables like Bitterrgoud, Lettuce leaves, Brinjal, ladies finger, cabbage. Cauliflower, carrot, Soya beans, Drumstick is good.

Remember…

• It is not only important what you eat but also how much you eat.

‘UN – SURGARY’ FACTS

• Currently about 26-27 million Indians are known to be suffering from one of the other form of diabetes.

• About 16 per cent of the metro population in India above the age of 20 is diabetic (Type 2) as against an average of 12. 1 percent for urban India.

• Of the rural population comprising 70 per cent of India’s one billion people, about 2-3 per cent suffer from diabetes.

• 14 per cent of urban Indian also suffer from a pre-diabetic condition called the impaired glucose tolerance (IGT), which is a precursor to diabetes.

• Almost 26 per cent, or more than a quarter of India’s adult urban population, have some form of glucose intolerance.

• Epidemiological studies have revealed that Indians are genetically pre-disposed to getting diabetes.

Diabetes successfully treated by ear acupuncture

GOT a sweet tooth, but can’t indulge in it because of diabetes? Dr. Jay Kumar Deeksshit has a cue for you. November 14 was World Diabetes day and Dr. Deeksshit takes the opportunity to tell you how ear acupuncture help cure diabetes.

Auricular therapy

Auricular acupuncture may be used in conjunction with body acupuncture, but it tends to be used on its own. During treatment, a tingling sensation or slight dull ache may be felt, as well as some sensation in the related part of the body.

Ear acupuncture is based on the idea that each part of the ear is a mirror of the body as a whole. There are, for example, kidney meridian points on the ear. As a result, almost any ailment can be treated with ear acupuncture. Sometimes it is used together with body acupuncture, but some practitioners, use ear acupuncture on its won for diagnosis and treatment. There are two points in the ear, by giving acupuncture on one point; the B cell of pancreas gets reactivated. As a result, the resistance of insulin decreases and finally diabetes can be cured.

Dr. Jay Kumar Deeksshit is an eminent acupuncture practitioner since 30 years and his work has been recognised by the Government of India. He is the only acupuncturist to have received this recognition, and after 12 years of research work in diabetics mellitus, he has successfully treated it by ear acupuncture.

Dr. Deeksshit explains that there are mainly two types of diabetes – Type 1 and Type 2 ? Type 1: IDDM (Insulin dependent diabetes mellitus) ? Type 2: NIDDM (non insulin dependent diabetes mellitus) Both type of diabetes is incurable by any type of existing system of medicines like allopathy, ayurveda, homeopathy, etc. Nowadays, the modern lifestyle and stress have become to diabetes cause that leads to diabetes. Another type of diabetes is the one that woman develop during pregnancy. Obesity also one of the common causes that leads to diabetes.

Diabetes is also hereditary.

? Whatever may be the reason, once a person gets detected with diabetes, it cannot be cured by means of any type of medicine or insulin, but it can be successfully treated by ear acupuncture.

? Natural insulin can be produced through ear acupuncture. And when sufficient quantity of insulin gets stored into the pancreas, only then can diabetes be cured.

? The body needs only 20 units of glucose into glycogen, which gets deposited in the liver. This is why the liver is known as the bank of sugar. So taking 30 units of insulin injection cannot control the sugar level because external insulin is not acceptable to our human body. The spleen reacts and produces anti-Insulin and anti-bodies and therefore diabetes is incurable. But with ear acupuncture, diabetes can not only be successfully controlled, but can also be cured completely.

Hold that sugar!

India is diabetes capital of the world. Do you do enough to manage your blood sugar?

Currently, India has about 41 million diabetics and the number is likely to go up to 69.9 million by 2025. Lifestyle modification is what will prevent and control the disease. It’s important to have a healthy diet and complement it with regular exercise and stress management.

EAT RIGHT

Having a healthy diet helps in achieving sugar levels and desirable lipid levels, which in turn help even prevent diabetes.

An ideal intake should be 500 Kcal/day of which,55-60 percent should come from carbohydrate. Proteins should provide 10 to 15 percent of calorie and the rest can come from fat. Saturated fats should provide less than 7 per cent of total daily calories and cholesterol intake should be less than 300 mg per day.

Eat high-fibre food, salads and fruits, though juices should be avoided. Alcohol, if consumed, should be in moderation. However, some foods are a total no – simple sugars (all kinds of sweets process food and red meat.

For pregnant women, artificial sweeteners and tobacco in any form must be avoided

A LITTLE WORKOUT PLAN

Like diets, exercise regimes are also individualized. The best is a stepwise incremental aerobic exercise . A 30-60 minute walk is recommended. Yoga can be useful if done under guidance. However, strenuous exercise must be avoided in patients with heart disease, retinopathy and autonomic neuropathy.

Footwear

Particularly important to diabetics, a patients should not walk bare foot: wear cotton socks and sneakers.

Toe webs should be kept clean and dry. Cracks in the heels are to be avoided. Toe-nails must be trimmed slightly away from the skin. For any minor foot injuries immediate medical attention is a requisite.

www.keralaayurvedashram.com

DIBETIC EYE PROBLEM

DIBETIC RETIONPATHY

Eye is the window of Brain & organ of sight, which is our most precious sense organ and many people fear Blindness more than any other disability. There are Thousands of Diabetic patients who become blind every year because of Diabetic retinopathy. There is no curative treatment for Diabetic Retinopathy in Allopathic system of medicine.

World’s Fastest & safest Ayurvedic O2 Treatment for Diabetic Retinopathy

Indian Ayurveda is a very old medical science which has many treasures hidden in it which cures various diseases. Our treatment is one of them which has opened the doors for patients of the whole World looking for the treatment of Diabetic retinopathy. After continuous research for a long time by Ayurvedic Experts from Sanjeevan Ayurvedic Superspeciality clinic & research centre in association with experienced Ophthalmologists, have developed and achieved surest treatment for Diabetic Retinopathy.

ABOUT US:

We provide Ayurvedic treatment to cure diabetic Retinopathy under the supervision of experienced and well qualified Ophthalmologists.

MEDICOS (Faculties)

Experienced Ayurvedic Doctors, Ophthalmologists & Allopathic physicians. INVESTIGATION FACILITIES

Thorough Ophthalmic checkup by experienced Ophthalmogists with special stress on indirect opthalmoscope and digital funds petrography to detect the exact condition of the disease for actual record of funds. This helps to compare the results on Retinopathy before and after our treatment and also as a permanent record.

RESEARCH

We are also carrying on research for Ayurvedic treatment for diploma (Double Vision),Glaucoma and allied condition for which trails are underway and results are quite encouraging.

DIBETIC RETIONPATHY

Diabetic Retinopathy is a complication of diabetes, which affects the Retina of the eye. In some of the Diabetic patients blood vessels of retina get damaged, due to which the retina does not receive enough amounts of oxygen & glucose. This results in ischemic (deficiency for nourishment. These new blood vessels are weak , fragile and cause recurrent bleeding in Retina and Vitreous ( the clear jelly substance inside the Eyeball). This makes the Vitreous opaque, causing Black-spots or floaters in the vision, blurring of vision or complete loss of vision (blindness).

Diabetic Retinopathy as four stages:

1. Mild Nonproliferative Retinopathy: At this earliest stage, micro aneurysms occurs. They are small areas of balloon—like swelling in the retina’s tiny blood vessels.

2. Moderate Nonproliferative Retinopathy: As the disease progress, some blood vessels that nourish the Retina are blocked.

3. Severe Nonproliferative Retinopathy: Many more blood vessels are blocked depriving several areas of the Retina with their blood supply. These areas of the retina send signals to the body to grow new blood vessles for nourishment.

4. Proliferative retinopathy: At this advanced stage, the signals sent by the Retina for nourishment trigger the growth of new blood vessels. This condition is called Proliferative retinopathy. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, server vision loss and even blindness can result.

TREATMENT


We cure diabetic retinopathy by Ayurvedic treatment.

By our Ayurvedic treatment, the leaked blood (hemorrhage) in retina and vitreous (inside the eyeball) gets cleared (quickly absorbed ) within a period of 2 to 8 weeks working and Retina receives sufficient amount of oxygen and nutrients. Formation of new abnormal blood vessels stops as well as the already present abnormal leaking blood vessels shrink, thus the further bleeding stops. Diabetic retinopathy is not only cured but also maintained by our treatment. This treatment, unlike laser surgery, doesn’t damage the Retina. It not only restores the damaged retina to great extent but also makes it healthier and protects it from further damages due to Diabetes and saves the Eye from permanent damage.

Why our Ayurvedic treatment is best for DIBETIC RETIONPATHY, why not LASER TREATMENT & VITRECTOMY (OPERATION).

The difference between both the treatments:-

Advantages & disadvantages of Ayurvedic treatment:

1. Ayurvedic treatment does not have any disadvantage:

2. Any stage of the disease ( diabetic Retinopathy) can be treated successfully by Ayurvedic Treatment.

3. Restoration of the Vision is faster ( 2 to 8 weeks approx)

4. No additional damage to Retina.

5. No need of admission in hospital 6. There is no need for bed rest; patients can continue their day to day work & activities.

No surgical intervention.

7. Diabetic Retinopathy is not only cured but is also maintained by our treatment in addition it helps in overall well being of the patient.

Advantages & disadvantages of laser treatment & vitrectomy operation:

1. Laser treatment & Vitrectomy operation have many disadvantages.

2. Laser treatment causes permanent damages to retina. The vision in the laser treated part of Retina is permanently lost.

3. There is no treatment in Allopathic system of medicine to cure diabetic Retinopathy, only n the advanced 4th stage of the disease: to avoid further compactions Laser Treatment can be advised.

4. In the advanced stage of Retinopathy patients require 1000-2000 Laser burns on Retina, to just try to preserve the central vision & night vision.

5. Surgical intervention in vitrectomy(operation) requires skilled surgeon.

6. Admission to the hospital is required & rest for at least 6 weeks after surgery is required. And also you will need to wear an eye patch for a few days or weeks to protect your eye.

7. Recurrent bleeding required recurrent Vitrectomy (operations ) and Laser treatments in addition and repeated follow-up visits to the Eye clinic.

8. Complications of Vitrectomy (operations ) like infections, loss of Vision and loss of whole Eye in few percent of cases are unavoidable.

9. Main thing is that Laser treatment and Vitrectomy (operation) do not cure Diabetic Retinopathy. They only cure the symptoms temporarily caused by Diabetic Retinopathy and even they do not guarantee results.

ASSURANCE : complete Money back Guarantee if no improvement I n Diabetic Retinopathy within TWO months

. DIABETIES AND TREATMENT

Increase in blood sugar level is a disease known as diabetes. If it is not controlled in time it damages the blood vessels which lead to Eye & Nerve problems.

We have specialized Ayurvedic Treatment for controlling diabetes. There is no side effect to a patient even if the medicine is taken for a longer period. It also prevents from the future complications like above mentioned. Our treatment not only controls the blood sugar but also improves the blood circulation and supplies sufficient amount of oxygen and nutrients to the organs of the body die to which the life of the patients become more comfortable and they .live healthy for a longer period.

Diabetes at Heart of cardiac trouble

Sion Koliwada resident Shakuntala is to undergo a cardiac bypass surgery next week,. Even though the 56-year-old fisherwoman is scared about the operation, doctors feel it might be her only option.

What Shakuntala doesn't know is that her uncontrolled diabetes is the main reason of her heart problems. For three monts now, Shakuntala complained of a recurrent pain in her body. It was only when she went for a free check-up that she got to know that she had a heart problem.

"Shakuntala has had uncontrolled diabetes for the last six years. And in the past few months, she has started complaining of convulsions with mild exertions, even while sleeping. Her tests showed that three of her vessels are blocked. So the only treatment is a bypass surgery," said Dr.Ameya Udyavar, consultant cardiologist with Hinduja Hospital.

Cardiologists say that those suffering from diabetes are more susceptible to cardiovascular problems as compared to those who don't. Statistics show that 65% patients with diabetes die from cardiovascular disease, 20-35% of patients with heart disease have diabetes and 55-60% patients undergoing bypass surgery are diabetics.

Dr.Hasmukh Ravat, head of cardiology department in Wockhardt Hospital in Muluand, says that one out of the ten people in India suffer from diabetes."Because of the high blood sugar level, the artery becomes thicker and may even lose its elasticity. In such a case, if the fatty materials deposit on the inner walls of the arteries, the blood flow towards the heart will be affected, leading to an attack,"said Dr.Ravat.

Cardiologists also believe that silent attacks are more common with diabetics. "Since the arteries get clogged, it causes pain in the chest. But with diabetic patients, these arteries also cause loss of the nerve function, because of which, the patient might not experience pain while getting an attack," said Dr.Udyavar.

Doctors say that a treatment might not always be possible as the patient might not come to know that there is a heart problem if not for ECG tests. It is thus better for all diabetics to take precautionary measures.

"It might not be possible for a diabetic to prevent an attack. But precautionary measures can ensure decreased succeptibility of heart problems," said Dr.N.Bansal, cardiologist from state government run JJ Hospital in Byculla. "People tend to gain weight in their mid 30s and 40s. If diabetics keep a check on their diet, exercise regularly, avoid gaining weight, keep the sugar levels in control, there is no reason why they cannot live a healthy life," he said.

PLATE FULL OF PROPER FOOD

High blood sugar or glucose level over time can lead to deposits of fatty materials on the insides of blood vessel walls. This may affect blood flow, increase the chance of clogging, or cause arteries to narrow or lose elasticity ( atherosclerosis)

DIETARY GUIDELINES


Carbohydrates

Daily carbohydrate intake should be approximately 50-60% of total calorie intake. Low Glycemic Index carbohydrate foods like oats, unpolished rice, whole pulses, beans and legumes, whole fruits like guava, apple and the like are preferred.

Fats

Fat(both visible in the form of oil, butter, ghee etc and invisible fat from cereals and pulses) should provide not more than 30% of total energy. This could be obtained by 4-5 tsp of oil and cereals and pulses in a 1600 Kcal diet.

Proteins

Protein intake should be as per body weight. A 60-kg man needs 60 gm of protein daily, provided by 9 servings of whole wheat flour, 2 bowls of dal or 2 pieces of lean meat like chicken or fish and 500 ml of double toned milk

Salt

Have less than 5 g of sodium chloride per day

Sugar and Artificial Sweeteners

Free sugars should be less than 19% of total calories. This includes all added sugars and sugars present in honey, syrups and fruit juices. Artificial sweeteners can be used in moderation

Alcohol

Regular excessive intake of alcohol is harmful.

Water

Drink 1.5-2 litres (8-10 glasses) of water everyday.

Eating Out

Have healthy snacks. Avoid aerated and high calorie drinks, have buttermilk, coconut water or fresh lime water instead.

Regular Breakfast

Have a healthy breakfast daily, according to guidelines

Cooking Methods

Boiled/steamed/roasted/grilled/sauted/poached/broiled/pan-broiled/stewed food is recommended over frying as it reduces the fat content in the food

Meal Portions and Times

Eat small, frequent meals at regular intervals, keeping 3-4 hours gap between 2 meals.

Diabetes In S.Asia

Prevalence(%)

7.0

8.4

Number of people with diabetes(m)

58.7

101.0

Diabetes in India

Prevalence(%)

7.1

9

Number of people with diabetes(m)

50.8

87

Year 2010  2030

Half of India is too undernourished, the other half is eating the wrong food leading to a spurt in diseases like diabetes. We have to guide them on the right diet.

'Diabetes, hypertension deal twin blows to citizens'

Mumbai: India is not only the diabetes capital of the world, a new survey also shows that Mumbaikars have something to worry about the galloping twin epidemics of diabetes and hypertension.

The study- Screening India's Twin Epidemic (SITE)-conducted for the first time on the two diseases at general physicians' clinics across the state revealed that almost a third of the surveyed patients had both the ailments, "About 25% of those who walked into the clinics had undiagnosed hypertension, while an other 5% had undiagnosed diabetes. Worse, almost 30% of those surveyed suffered from both diabetes and hypertension," saidendocrionalogist Shashank Joshi, principal investigator for the study on the epidemic of the twin diseases, which is being conducted by pharmaceutical giant Sanofi Aventis. SITE, which convered 1,842 people in Mumbai, Pune and Nagpur, will study 20,000 patients in the next one year."For two days, we screened the first 10 patients walking into the clinics of 100 GPs," said a company official.

India is infamous as the diabetes capital of the world, with 50.8 million people suffering from the disorder."But the real problem before India is the masked population that is unaware about the disease. This ignorance leads to the onset of co-morbidities, such as heart and kidney ailments,"Joshi said.

The SITE study's Maharashtras section also showed that 73% of diabetic patients did not have their counts in control, while the figure stood at around 64% with those suffering from hypertension."As a result of the uncontrolled disease, 32% of these patients have kidney problems, 18% altered lipid levels and 72% are overweight," stated the study.

However, Dr.S.Sadikot of Jaslok Hospital does not find the findings of the survey surprising at all. "Nine years ago, we realised that India had relatively high incidence of both diabetes and hypertension. This is all due to lifestyle changes. We no longer follow the old diet, and to top it all, we have become too sedentary for our own good. People use the lift when it comes to climbing up even two flights of stairs," he said.

DOUBLE TROUBLE

WHAT IS DIABETES?

Diabetes is the inability of the human body to produce insulin. It is believed that 7% of the general population suffers from diabetes, but a Chennai study pegs it at 19%

WHAT IS HYPERTENSTION?

In this condition, blood pressure remains abnormally high ( a reading of 140/90 mm Hg or greater). Around 25% of Indians suffer from this ailment.

SALIENT POINTS OF THE STUDY OF 1,842 PATIENTS

* 39.8% of the patients visiting clinics are diabetic and 54.6% hypertensive.

*29% has both diabetes and hyptension

*5% has undiagnosed diabetes and 25% hypertension

*32% hypertensive patients has kidney problems

*20% has altered lipids, indicating heart problems

*72% are overweight or obese and 82.8% has central obesity

KNOW WHAT COUNTS

Wait Circumference:Less than 80 cm (31 inches) for women Less than 90 cm (36 inches) for men

Body Mass Index: Less than 23 kg/m2 for women and men

Blood Pressure: Less than 130/85 mm Hg Less than 120/80mm Hg for diabetes/ heart failure

Total Cholesterol:Less than 160 mg/dl

Retinal Diseases

Normal Vision:

The Retina is the nerve cell layer of the eye and acts much like film in a Camera. When light enters the eye it passes through the Cornea an dLens and is focused onto the Retina. The Retina transforms the light energy into vision and sends the information back to the brain through the optic nerve. The macula is the sensitive, central part of the retina and is responsible for sharp, detailed vision.

DIABETIC RETINOPATHY

diabetic Retinopathy results from the effects of the diabetes on blood vessels that nourish the Retina tissue, which is the innermost layer of the eye wall. It is mainly associated with diabetes and is caused by the blockage of tiny blood vessels in the retina, causing hemorrhages on or in the retina. Diabetes causes retinal blood vessels to leak an dgrow abnormally. Untreated diabetes or poor disease maintenance greatly increases the risk of diabetic retinopathy. Depending on the severity of the disease, sight can remain near normal or may be lost entirely. Remaining vision may be blurred or distorted or the hemorrhage may cause a deep reddish veil to form over the field of vision.

Types of diabetic Retinopathy:

There are two main types of Diabetic Retinopathy:

A.Non-Proliferative

B.Proferative

In Non-Prolifeative or Background Diabetic Retinopathy , patients may have normal vision. The damaged retinal vessels leak fluid. Fat and protein particules may leak from these vessels and become deposited in the retina in patches know and Retinal Exudates.The retinal blood vessels may bleed into the retina and result in tiny hemorrhages. If any of the leaking fluid accumulates in the central part of the retina (called the macula), the vision is affected. This condition is called Macular Edema.

In Prolierative Diabetic Retinopathy, new abnormal blood vessels grow, which extend over the surface of the retina. These vessels occasionally invade the gelationus contents of the eye, the vitreous.The proliferating blood vessels frequently break, causing vitreous bleeding that may significantly decrease vision. Fibrous tissue may grow over the new blood vessels and distort vision. Occassionally, the tissue may contract and pull the retina off the inner surface of the eye, causing a tractional retinal detachment.

Symptoms

There are no symptoms in the early stages of diabetic retinopathy. Vision may not change untile the disease is advanced or the Macula is affected. The earliest sign may be an abrupt change in eyglass prescription. The blood sugar affected. The earliest sign may be an abrupt change in eyeglass prescription. The blood sugar effects the water content of the lens of the eye and, therefore, spectacle prescription changes. Sudden increase in blood sugar will cause an increase in myopia. This often occurs before the detection of the disease. Diabetic Retinopathy may begin in eyes without one noticing any change in vison. Unfortunately, there may be extensive and sever changes before vision is affected. Thus it is very important to have the eyes examined regularly at six-month or yearly intervals depending on duration and/or severity of the diabetes.

Detection of Diabetic Retionapthy:

Diabetic retinopathy is detected during an examination of the back of the eye Fundoscopy through dilated (enlarged) pupils and by testing your vison. Dilatation is the method through which, after putting some eyedrops, we can see what is inside, to properly evaluate the Retina. We look for evidence of Diabetic Retinopathy. Based on the findings a Fluorescein Angiogram may be advised.

Fundus FluoresceinAngiography(FFA)

Fluorescein Angiography is a dye test often used to assess the damage to the retina and its blood vessels. A dye is injected into a vein of one arm. Photographs are taken of the retina as the dye passes through the blood vessels. Since there is a risk of allergic reaction, a history of allergy is important. There may be mild nausea during the procedure. The skin and urine may turn yellow for 24 to 48 hours. The Angiograms show areas of leakage, areas of oxygen-starved retinas, and weak, fragile new vessels. Based on the results a LASER may be advised.

Treatment:

Laser:

The most important treatment for diabetes and its complications including diabetic retinopathy is control of the diabetes. Tight control of blood sugar, weight an dblood pressure are important in preventing the ocular complications of diabetes and thus slowing the progression of the disease.

Once retinopathy is diagnosed, Laser therapy is the current modality of treatment . Most patients tolerate the procedure extremely well with little discomfort.Laser surgery is used to treat both diabetic macular edema and proliferative diabetic retinopathy. Laser treatment for diabetic macular edema stabilizes vision by stopping blood vessels from leaking fluid into the retina. Either focal treatment for small discrete areas of leakage, or a grid pattern is used when the leakage is diffuse in nature. After treatment, the patient may notice small spots of decreased visual sensitivity in the field of vision. Usually these spots become less noticeable with time. It is possible that the vision may get a little worse after laser. However, the laser helps prevent futher reduction in vision. Studies have shown that most patients who receive laser for macular edema will have better vision in the future than if they hadn't received the treatment. After instilling an anaeshetic drop in the eye, the retina is treated with LASER using suitable Laser delivery system.

Frequently Asked Question(FAQS):

1.Who is at risk of developing Diabetic Retinopathy?

Every person with diabetes is at risk of developing diabetic retinopathy. The longer a person has diabetes the more likely the person is to deveop diabetic retinopathy. Eye examination at the time of diagnosis of Diabetes and then as advised by the Doctor, would reduce the risk of vision loss and blindness. Strick control of Diabetes can delay the development of Retinopathy.

2. Once diagnosed what is to be done?

After the diagnosis of Retinopathy is done, it is categorized according to its severity. Fundus Fluoresceine Angiography is performed to exactly know the site of blockage and amount of leakage. And accordingly the laser treatment is advised. But sometimes if Retinopathy is with vitreous hemorrhage or Tractional Retinal detachment, then surgery may be required.

3. Will My Vision Improve After Laser Treatment?

Laser therapy can only stop the progression of the retinopathy. It cannot reverse the damage already done.

4. What Happens if the Laser Doesn't Work?

While panretinal photocoagulation is usually successful in halting the proliferative process, some patients progress despite laser treatment. Other patiens may have bleeding into the vitreous of the eye. These eys may require vitreous surgery (vitrectomy). The main indications for vitrectomy are persistent vitreous hemorrhage and tractional retinal detachment. Virtrectomy surgery is a major eye operation. It involves removal of the vitreous from the eye. Frequently, the retina has to be reattached by surgically separating the scar tissue from the surface of the retina. Laser treatment is often applied at the time of vitrectomy. In some cases, a gas bubble is left in the eye following surgery to keep the retina flat against the back of the eye.

5.Will Glasses Help?

The glasses that the patient was using earlier can be continued. Many times special vision aids need to be prescribed. Magnifiers and other devices can help.

6. Can vision loss from diabetic retinopathy be prevented?

Yes, Severe visual loss can be prevented if diabetic retinopathy is deteced early and treated properly. By keeping blood glucose levels with in the normal range, one can minimize the risk of visual loss. Take action before you notice any eye-problems.

RETINAL DETACHMENT

In Retinal detachment, the retina separates from the outer layers of the eye thus losing its function. If not treated early, retinal detachment may lead to impirment or complete loss of vision.

Causes:

More retinal detachments are preceded by one of more tears or holes in the retina. Fluid passes through these opening and separates the retina from the adjacent layers of the eye. Near-sighted individuals are more commonly affected due to thinning of the retina. Holes or tears can then develop in the thinned retina. The vitreous (gel fluid in the eye) also plays a significant role by causing tugging on the retina especially when shirnkage occurs. Cataract surgery can also be a precipitating cause. A positve family history of retinal detachment is another risk factor. A combination of factors is usually responsible for retinal detachment. Retinal detachment can also be caused by other diseases in the eye such as tumours, severe inflammations, or complications of diabetes.

Symptoms

Middle aged and older persons PREVENTION AND MANAGEMENT OF DIABETES GUIDELINES:

Detailed diest guidelines are given below:

1. Omit all cooking oils in use at present namely: Safflower, Sunflower, Corn, Til, or Groundnut oil or Vanaspathi.

2. Instead use a small quantity (3-4 teaspoonful per person per day or half kg per month per person) of any one (or combined) from ghee, coconut oil. In India we have used them for centuries without any harm.

3. Avoid use of non-vegetarian items(Eggs,Chicken, Lamb, Port, Beef or Cheese etc.) It is advisable to take fish regularly (2-3 helpings/week) but avoid taking fried fish. Vegetarians can take flax seed, methi seeds or green leafy vegetables. Encourage us of urad dal and rajmah instead of besan and bengal gram(Channa).

4. Unlike other foods of animal orgin, it is necessary for Indians to take some milk/curds/yoghurt (about 1/2 litre per day). Our diet is mainly vegetarian. We need many important nutrients like calcium, phosphorus, vitamin A, D and proteins present in Milk.

5. Avoid refined processed foods or those containing preservatives; this means that biscuits, cakes, bakery products or other maida preparations like pizza, Roomali Roti or white bread must be avoided. Avoid fried foods.

6. Avoid Alcohol, Tobacco in any form.

7. Avoid taking desserts, sweet dishes. Instead take fresh fruits. Diabetics also need to take 2-3 fruits daily. One of these must be an orange or seetlime. It is better to take whole fruit rather than fruit juice. All fruits including mango or banana can be taken by subjects with diabetes.

8. Patients with high blood pressure or swelling on feet or congestive heart failure should avoid taking excessive salt or salty preparations (Pickles, Chutney, Papad etc.), bakery products, preserved food in tins and cans.

9. You are advised to take vitamins and fish oil supplements as prescribed. These help to prevent diabetes and heart disease.

10. Caution be exercised while using the use of seetening agents marketed under various trade names. There are some reports suggesting Aspartame may increase chances for some cancers.

11. Rice, potatoes and other root vegetables can easily be consumed by a diabetic, keeping count of their calories.

GUIDELINESS FOR PREVENTION OF EYE DISEASE

Diabetes is a majore cause of preventable blindess due to Diabetic Retinopathy & Glaucoma.

In order to prevent blindness, certain guidelines must be followed.

I. INITIAL EXAMINATION AND PERIODIC FOLLOW UP ESSENTIAL

*for detailed fundus examination

*for regular check of intra-ocular pressure

A. Initial Examination

*Type-I diabetics(IDDM): 5 Yrs. after detection of diabetes in childhood or at puberty.

*Type-II diabetics(NIDDM): as soon as NIDDM is diagnosed.

B.Follow-Up Examinations

*No Diabetic Retinopathy detected on initial Examination: Yearly follow-up, even if there are no eye symptoms.

*Diabetic Retinopathy detected on initial Examination: Follow-up according to discretion of Ophthalmologist.

C. In Pregnancy

*Ophthalmic examination of diabetics before planning pregnancy.

*During pregnancy: according to discretion of Ophthalmologist.

II URGENT OPHTHALMIC REFERENCE-IF:

*c/o. seeing-

- floaters (cobwebs/blackspots/fly or mosquito like structures)

- transient shower of red/black/brown dots in field of vision

-flashes of light like lightning esp.in twilight/darkness

*c/o. sudden blurring/decrease/loss of vision

*c/o. pain/redness of the eye.

III.GOOD GLYCEMIC CONTROL & CONTROL OF ALL RISK FACTORS

*Maintain good glycemic control

*Control of risk factors like hypertension, IHD, Dyslipidemias, Nephropathy.

*Avoid Betel nuts& Tobacco in any form (including pan masalas & gutkas)

*Avoid alcohol in any form.

IV.CORRECT DIET

*Avoid pro-oxidants in the diet (Fast,Fried, Processed, Preserved & Junk food)

*Correct Omega 6: Omega3 imbalance : for this, follow the 'Suggestions for Diet'.

The studies at the All India Institute of Diabetes show that: (a) Use of refined oil & (b) deficiency of Omega 3 fatty acids (fish/fishoi; flax seeds & methi are sources of Omega 3) are important risk factors for the developemnt of Diabetes Mellitus & diabetic Eye Disease. These are also risk factors for other diabetes related complications. Please correct this faulty fat intake as per guidelines given for the diet.

GUIDELINESS FOR PREVENTION OF KIDNEY DISEASE

1. Detection at Initial Diagnosis.

All newly detected cases must have

a) BP

b)Urine Routine

c)Blood Urea

d)SA.Creatinine estimation

2. All newly deteced cases found to have "Macro" albuminuria in Routine urine analysis need not be checked for micro albuminuria.

3.Yearly check up of

a) BP

b)Routine urine

c)Micro albuminuria if urine routine shows no macroalbuminuria.

d)If microalbuminuria is present repeat 3 times at monthly interval after correcting extraneous causes like urinary infection.

4. If "macro" albuminuria present, do 24 hours urine albumin excretion, blood urea, S. Creatinine and S.Protein estimation. If any abnormality is detected, refer to a kidney clinic.

5. If BP is elevated at yearly or other check up, or microalbuminuria present then do doppler, USG of kidney and then start ACE-Inhibitors.

6.Target BP 125/75 in sitting position.(or mean arterial Pressure less than 92)

7. If ACE-I contraindicated due to cough-then AT2 blocker

If ACE-I & AT2 blocker contraindicated for reason of Double Renal Artery steosis, other anti hypertensives with same Target BP.

8. If micor albumiuria persistently +ve. then protein restriction diet to 0.8 gm/kg body wt per day.

GUIDELINES FOR FOOT CARE

Diabetic Foot Problem is a serious complication of diabetes requiring hospitalisation which invariably results in a loss of toe or limb. It causes tremendous hardships to individuals with diabetes and his family. It handicaps them physically, socially and economically.

Prevention:

Following subjects may be at high risk for developing foot lesions:

1.Diabetes uncontrolled for a long time.

2.Older age.

3. Presence of neuropathy

4.Presence of ischemia

5. History of previous ulceration

6. Amputation of toe

7. Presence of retinopathy and neuropathy

8. Uneducated patients.

Prevention Programme

Daily inspection of feet is necessary. Because of loss of sensation a diabetic may not notice an ulcer. Pressure point areas like ball of the big toe, heel, outer aspects of the feet need to be inspected every day. Due to poor vision it may be difficult to inspect the foot properly. Use of a mirror placed on the ground is helpful. Family members should also take active interest in inspecting the foot whenever possible. Family physician should make it a point ot examine the foot of the patients on each visit.

Overcome Dryness:

Autonomic neuropathy affects sweating mechanism leaving the foot very dry. Dry skin is vulnerable to cracks and fissures as it loses its suppleness. This can be best overcome by application of petroleum jelly, coconut oil or cold cream to the sole of the foot including inter digital area. We have noticed consumption of vegetable oils increases the dryness of the foot resulting in cracks and fissures. Consumption of fish oil and correcting nutrition reverses the dryness. Details of nutrition are given in the nutritional guidelines.

Careful pedicure:Diabetics tend to injure their toes in the process of cutting their nails because of impaired sensation and poor vision. Great care needs to be taken while cutting the nails and they may need the help of someone else to cut their nails.

Avoid home surgery: It is a common practice in India to shave corns or callus on the sole of the foot with the help of a shaving blade. This is dangerous in a diabetic because of impaired sensation. Unknowingly he might cut deeper leaving a raw area and a possibility of infection creeping in. This job should be left to the doctor concerned or podiatrist.

Avoid walking bare foot: Walking bare foot is harmful because of loss of sensation and inability to feel hot or cold. Soft slippers is recommended.

Shoes should be comfortable and well padded. Socks should always be worn. New shoes should be gradually broken in over a few days.

If a foot problem does occur it should be detected early. Foot problems should be treated with great caution by bed rest, appropriate dressing, correct footware and antibiotics as suggested by the doctor.

Symptoms

Middle-aged and older persons may see floating black spots called floaters and flashes of light. In most cases, these symptoms do not indicate serious problems. In some eye, the sudden appearance of spots or flashes of light may herald the onset of retinal detachment. A through examination of the retina by an Ophthalmologist after dilatation of the pupil is necessary to determine the cause of the symptoms. Some retinal detachments can proceed unnoticed until a large section of the retina is detached. In these instances, patients may notice the appearance of a dark shadow in some parts of their vision. Further development of the retina detachment will blur central vision and create significant sight loss in the affected eye. A few detachments may occur suddenly and the patient will experience a total loss of vision in that eye. Similar rapid loss of vision may also be caused by bleeding into the vitreous which may happen when the retina is torn.

Treatment

If the retina is torn but detachment has not yet occurred, prompt treatment may prevent the occurrence of a complete detachment. Once the retina becomes detached, it must be repaired surgically.

*Laser Photocoagulation:

When new small retinal tears are found with little or no nearby retinal detachment, the tears are sometimes sealed with a laser light. The laser places small burns around the edge of the tear. These produce scars small burns around the edge of the tear. These produce scars the edges of the tear.These produce scars that seal the edges of the tear and prevent fluid from passing through and collecting under the retina.

*Freezing or Cryopexy:

Freezing through the sclera (white of the eye) behind a retinal tear will also stimulate scar formation and sealdown the edges.

*Surgical Repairs:

Successful reattachment of the retina consists of sealing the retinal tear with a silicone material, which is sutured to the Sclera (white of the eye) to indent the eyeball inwards. Freezing applications are then used to bind the retina to the underlying layers.

Newer procedures have been developed to achieve the same result using the injection of a gas into the eye in suitable cases.

The surgery may be performed under local or general anesthesia depending on the procedure, age an dgeneral health of the patient. In more complex retinal detachments, it may be necessary to use a technique called vitrectomy. This operation removes the vitreous body from the eye. In some cases, when the detached retina itself is severely shrunken or scarred, air of gas may have to be used to fill the vitreous cavity temporarily.

Prognosis:

Over 90% of all retinal detachments can be reattached by modern surgical techniques. Occassionally, more than one operation may be required.

The degree of vision, which finally returns about six months after successful surgery, depends upon a number of factors. In general, there is less visual return when the retina has been detached for a long time or if there is fibrous growth on the surface of the retina.

Approximately 40% of successfully treated retinal detachments achieve excellent vision. The remainder attains varying amounts of reading vision.

Due to continuous shrinkage of the vitreous and the development of fibrous growths on the retina. not all retinas can be attached. If the retina cannot be reattached, the eye will continue to lose sight and ultimately become blind.

Surgery removes bitter taste of medicine from life of diabetic

The procedure will help reduce patient's dependence on pills and insulin

For the first rime in 10 years, Vrajendra Singh, 52, was able to relish a cup of tea with sugar and savour the famous pedas from his hometown Mathura, thanks to a surgery for diabetes conducted on him at Bombay Hospital.

Singh, a type-II diabetes patient, is the first to undergo a successful surgery for diabetes at Bombay Hospital. The operation, called Ileal Interposition Surgery, was performed at Bombay Hospital, which is the first centre in Asia, to get permission from the Indian Council of Medical Research to conduct this kind of a surgery.

Vrajendra works as an LPG delivery man in Matyhura. He is suffering from diabetes for the last 10 years. He was spending over Rs. 2000 every month. The disease has taken a toll on his kidneys and eyes and he experiences breathlessness after walking just half a kilometre. Doctors at Bombay Hospital are confident that the surgery, being hearlded as a breakthrough in medical field, will help Singh control his sugar without medicines.

Singh underwent surgery on October 4 and had to spend 15 days in hospital. The surgery cost ranges between Rs.2 lakh to Rs 3 lakh, but since Singh was the first patient, he was offered a huge concession.

So far, doctors have tried to control sugar through gastric bypass and sleeve gastrectomy on diabetes patients. But the latest technique is likely to yield better results.

"I was tensed before the surgery, but the doctors encouraged me. My sugar levels got much better within six days of surgery. The doctors say that I need not take a single pill for the next three months. My eyes and kidneys are functioning better. I have recommended this surgery to my brother and sister as well since they suffer from sever diabetes," said Singh.

"There are only four such centres in the world that perform such surgeries. We don't claim this is the ultimate cure for diabetes, but we are hoepful that it will reduce the patient's dependence on pills and insulin after three months. In Singh's case results have been positive," said Dr.Raman Goel, metabolic surgeon at Bombay Hospital.

"We are targeting those who have to inject insulin or consume diabetes pills to control their sugar level," added Dr.Goel.

More than three crore Indians suffer from diabetes. So far, apart from the obesity surgery, there was no other operation that could help type-II diabetes patients.

How it works?

The stomach comprises of the duodenum (the C-shaped first part), the jejunum(the coiled mid-section) and the ileum, which is the final section that leads into the large intestine.

In the latest metabolic surgery, doctors perform what is being called the neuro-endocrine brake or the ilegal transposition. A part of the ileum is transported to dueodenum. What the tranported ileum does is to provide stimulus for production of Glucagonlike peptide-1 (GLP-1), a hormone that is secreted in response to food. This, in turn, provides the stimulus for insulin secretion. The transposition also helps the beta cells in the pancreas to recover (patients who have undergone the operation record lower insulin secretion than in other diabetic patients, indicating that the pancreas is not overworking itself).

How can I control my diabetes?

You can help control your blood sugar( also called blood glucose) and diabetes when you eat healthy, get enough exercise, and stay at a healthy weight.

A healthy weight also helps you control your blood fats and lower your blood pressure.

Many people with diabetes also need to take medicine to help control their blood sugar.

How can I eat healthy?

Using the food pyamid helps you eat a variety of healthuy foods. when you eat different foods, you get the vitamins and minerals you need.

Points to remember

To follow a healthy eating plan

*Choose foods from all six food groups each day.

*Eat a wide variety of foods from each group to get all your vitamins and minerals.

*Eat enough starches, vegetables, fruits, and low-fat milk and yogurt.

*Eat fewer fats,oils and sugary foods.

It often becomes difficult to maintain the right nutritional balance in diabetes. On one hand it is necessary to get enough nutrients to meet the body's requirements, but at the same time one should avoid any item that tends to increase the blood sugar levels.

What is the Glycemic Index?

The glycemic index ranks foods on how they affect our blood sugar increases in the two or three hours after eating.

A lot of people still think that it is only plain table sugar that people with diabetes need to avoid. The experts used to say that, but the Glycemic Index shows that even complex carbohydrates, can cause blood sugar levels to rise significantly.

Glycemic Indes varies significantly depending on the food. For instance, bread has a glycemic index of 72, whereas apple juice has a glycemic index of 41. This means that a meal of bread would cause a higher rise in blood sugar compared to a glass of apple juice.

When you make use of the Glycemic Index to prepare healthy meals, it helps to keep your blood sugar levels under control. This is especially important for people with diabetes.

Diabetes damage: India Inc loses $6 billion


Mumbai: A 25-year-old executive slumped on his computer after suffering a heart attack. While such an incident would have raised an eyebrow a few years ago, It’s no longer an anomaly, said Union health minister Anbumani Ramadoss on Saturday, urging corporate to help make India the “diabetes prevention capital of the world” instead of being the “diabetes capital”

Ramadoss was addressing a meet organized by the CII in Mumbai to deal with the growing threat of diabesity—lethal combination of diabetes and obesity.

Ramadoss said India lost revenue worth $6 billion in 2005 due to the productivity loss caused by diabetes. “Diabetes is affecting Indians earlier in life, with an estimated 54.1% of patients getting the disease below 50 years. These are scary statistics given that it’s our productive age group and we need to be prepared,” said the health minister. Obesity, too, has seen a rise from 11% in 1999 to 15.17% in 2004-05.

Industry representative A vaidheesh said the cost burden of diebsity was cause for concern especially because and India bore most of the brunt.

Builder Niranjan Hiranandani the session, agreed that corporate had to be proactive.”Another problem is that our hospitals are seen as a centres of sickness. Our healthcare centres of sickness. Our healthcare centres need to lay more emphasis on preventive strategies to ensure the well-being of people.

The minister said,” Corporate leadership could do a lot more to adopt parks and create cycling tracks or walking paths so that our youngsters can lead a healthy life”.

Ramadoss said the “big three” killer disease---HIV/AIDS, malaria and tuberculosis ---were slowly being overtaken by the “big five”---diabetes, cardio-vascular problems, cancer mental health and stroke.

India currently has an estimated 40 million diabetics.

AFTER SRK, ITS SAIF

Union health minister A Ramadoss, who had till now trained his guns on the likes of actor Shah Rukh Khan and West Bengal CM Buddhadeb Bhattacharjee over smoking, on Saturday shifted his focus to “junk food”. It’s a kind request to celebrate ties to desists from endorsing junk food,” he said “There is one actor who endorsees chips. I am told that he recently landed in hospital with a heart attack,” he added, alluding to the hospitalization of Saif Ali Khan following chest pain.

BOOST TO URBAN HEALTH

Drawing attention to his pet project, the national Rural health Mission (NHRM), health minister A Ramadoss assured that the urban poor too were a priority.”We will launch the national Urban Health Mission in four to five months,” said the minister, explaining that the scheme would cover 429 cities and towns with a population of more than 1 lakh. “We will have a health insurance scheme where the community itself will create a corpus, just like a self-help group, “ he said. The cities will get USH As (urban social health activists) or a health worker for every 2,000 people

Census to track no.of diabetics across India


Mumbai: Years after India had already earned the dubious distinction of being the diates capital of the world, the Centre seems to have finally woken up to one the most serious health hazards. On Friday, Union health Minister Ghulam Nabi Azad announced that the government would initiate a diabetes census across the country to gauge the enormity of the epidemic.

By the end of this year or early next year, the census probably the first of its kind in the world is likely to start. Azad is also presenting the idea of the census at the five-day EHO's Health Assembly commencing in Geneva, Switzerland from May 17.

"We intend to start mandatory testing for diabetes in the age-group of 25-70 years across the country in the next two years," Azad said.

"The idea is to figure out the actual number of people who are suffering from diabetes, or are likely to suffer," said Azad, on the sidelines of the inauguration of a mega health camp at Malad.

Azad added that soon, the Centre will ask for help from all state governments to pull off the mamoth initiative. "We will study all three categories of diabetes and decide on the next course of action accordingly," he said. "For those who will be on the borderline, state governments will help to bring about behavioural changes, like changes in food habits and exercise," he said.

It is believed that Asian countries carry about 60% of the global diabetes burden. The diabetes census will start from cities and will trickle down to villages. "In certain villages, where ambulances cannot reach, we will take the help of Glucometers (device for determining glucose in blood)," said Azad.

" Glucometers will cost the government an additional Rs.100 cror as per patient, the cost will come up to Rs.100. This includes the cost of involving a doctor and sending him to villages," Azad explained.

The Union minister said that defeating diabetes would mean defeating the plethora of ailments that come with it. "And, that includes the economic burden on families and the state," he said.

City doctors feel there could not have been a better time to come up with the census as diabetes has already become a serious health problem in the country. Founder and president of diabetic foot Association of India Dr.Arun Bal said there was no proper epidemiological data to establish the enormity of diabetes in India so far. "The data available is mostly from small centres, so data from across the country will be of great significance,"he said.

Bal added that it was all the more important as India has about 40 million people who have Impaired Glucose Tolerance, meaning they are on the verge of becoming full-blown diabetics."If we can detect it early and help people prevent it, several social and economic problems can be tackled," he said.

KEEP THE EXCESS WEIGHT AWAY

The number of diabetics is increasing at an alarming level all of the globe. And one of the topmost reasons for this increase in numbers is the lifestyle that people have adopted in recent years. Obesity and Bariatric surgeon, Dr.Mufazzal Lakdawala says that Diabetes can be described as a disease in which the body either does not produce enough insulin or does not utilise the produced insulin properly leading to a high blood glucose level.

"There are two types of diabetes-Type I diabetes, in which there is no generation of insulin in the body and Type 2 diabetes, in which the cells in the body become resistant to insulin. Diabetes tends to run in families and it is possible to inherit a tendency for the disease. Hereditary causes of diabetes constitute a very small percentage. Most of the times factors that lead to diabetes are a sedentary lifestyle, lack of exercise, obesity, consumption of high calorie foods and stress," says Dr. Lakdawala.

Type 1 diabetes usually tends to affect children and people below the age of 40. Type 2 diabetes tends to affect people above the age of 40 years. In the recent times a change in this trend has been observed. Type 2 diabetes is now often seen to affect a lot of children and youngsters as well. "This is very worrying because the younger, one becomes diabetic, the longer they suffer and more are the chances of developing complications like high blood pressure, heart attacks and kidney failure,"says Endocrinologist Dr. Shehla Sheikth.

Sypmtoms

"Diabetes usually presents with the classic triad of Polydipsia (excessive thirst), Poluphagia (excessive appetite) and Polyuria (excessive urination).Nausea, vomiting, weight loss, irritability, repeated infections and delayed wound healing can be other symptoms. Long standing, uncontrolled diabetes can affect almost every part of the body and cause damage to the nerves, blood vessels, heart, eyes, kidneys and can also lead to gangrene in some cases.

Prevention

Prevention of diabetes mainly requires lifestyle modification. Moderate degree of exercise and keeping the excess weight away can keep the disease at bay. Regular consumption of very high calorie foods must be avoided. Children must be detracted from having too much unhealthy junk food.

Treatment

Healthy eating and exercise form the mainstay of therapy. Type 1 diabetes is the insulindependent diabetes and hence patients need to be on insulin life-long. Type 2 diabetes is usually treated with a combination of diet modification, oral medication and insulin.

Cure

Conventionally, the text book treatment says that diabetes can only be controlled and cannot be cured. Weight loss surgery is now a proven cure for obese diabetics. Even the newer sleeve gastrectomy has been seen to give very good results in diabetics. Whether the surgery will work in not so obese people is yet to be seen," says Dr. Lakdawala.

According to consultant laparoscopic and obesity surgeon, Dr shashank shah, diabetes is not only a disease of the overweight. One must learn to recognise, prevent and cure the disease that is known to affect almost 171 million people worldwide. "The most dangerous fact about it is that it's painless and hence is hard detect. Even a slight increase in fat content can cause insulin resistance. One should be checked by a physician and a glucose tolerance test is a must. It checks the response of the body to 100 grams of glucose, studied at a gap of every 30 minutes. Insulin levels should be checked against the blood sugar levels. If the insulin levels are more, it means the body has to produce more insulin to turn glucose into energy," he says.

You can fight diabetes

Research shows that Salacia Oblonga (Sapta Rangi), an ayurvedic herb found in the Indian subcontinent, can help in battling the condition of diabetes. This natural herb is considered safe and more potent than some other traditional synthesized drugs. This herb has earlier been used in traditional Indian and Sri Lankan medicinal system to fight Type 2 diabetes. But its inherent power was recognized in mainstream medicine only recently. Anti-diabetic and dieting agent –Here’s how it works: Salacia Oblonga contains alpha-glucosidase inhibitors, Salacinol an dKotalanol 9. Salacia Oblonga binds to intestinal enzymes that break down carbohydrates in the body. These enzymes, the alpha-glucosidases, turn carbohydrates into glucose, the sugar that circulates throughout the body. If the enzyme blinds to the herbal extract rather than to a carbohydrate, then less glucose get into the blood steam, resulting in lowered blood glucose and insulin levels. Salacia Oblonga also helps prevent eye an dnerve damage closely associated to diabetes, like peripheral neuropathy, retinopathy and cataracts.

It is primarily an anti-diabetic drug, but Salacia Oblonga has another positive side effect – It is a dieting agent, too. High insulin levels prevent the use of body fat for energy and create weight problems. Salacia Oblonga inhibits the absorption of monosaccharides (which have the ability to turn into fat) and works to prevent blood sugar levels from rising. Study supports claim that a new study conducted at Ohio State University and reported by the Journal of the American Dietetic Association supports these claims. The experiment, which involved 39 adults drinking test beverage of Salacia Oblonga in different doses, yielded this result: The beverage that contained the highest concentration of the herbal extract (1,000 milligrams) provided the most dramatic reduction in insulin and blood glucose levels-by up to 29 percent. Steve Hertzler, study co-author and assistant professor of nutrition at Ohio State University, points out that these kinds of reductions are similar to what we might see with prescription oral medications for people with diabetes.

Sugar Control

With India having the world’s largest number of diabetic patients, diabetes care and lifestyle management takes a front seat.

The annual report of the International Diabetic Federation (IDF), released at their 20 th annual World Diabetes Congress on Octobor 2009, shows that at present, India has the highest number of diabetics in the world at 50.8 million, followed by 43.2 million in China and 26.8 million in the USA. An alarming prediction of the report was that due to increasing life expectancy an das a result of repid urbanization, over 8.4 per cent of the Indian adult population will suffer from the disease by 2030!

What exactly is diabetes and how is it caused? To put it simply diabetes is excess of glucose in blood-when glucose builds up in the blood, instead of going into the cells. A metabolic disorder, the disease is caused when either the body does not produce insulin or when it does not use the insulin produced properly. There are two types of diabetes-Type1, where the person needs to take insulin everyday and Type2, which is controlled with diet plans, exercising and medication.

When glucose builds up in the blood, it can cause two problems- your cells become starved for energy and /or you develop diabetic complications like kidney failure, blurred vision, heart problems etc. This makes it extremely important for patients to take proper care in following their treatment plan.

Diabetes Care

A change in lifestyle is often part of diabetes care. Diabetes care includes diet, exercising, monitoring and medication.

Diet: A balanced diet is the key to controlling sugar levels in the body-it is not about eating less, but about eating healthy. You should opt for foods with low carbs and more vitamins, minerals and fibres. Your diet will depend on your age, sex height, weight, level of physical activity and type of diabetes.

Exercising: Maintaining a good fitness level is especially important for diabetics as it helps in reducing blood glucose levels. Even simple things, like taking the stairs instead of the elevator and taking a stroll after dinner, make a difference. The benefits of physical activity include low blood sugar, better insulin absorption, healthy heart, muscles and bones, low cholesterol and blood pressure, improved blood circulation, stress management and a reduced risk of heart disease and stroke, among others. It is best to consult your doctor before starting a new/different exercise regime.

Monitoring: An important part of diabetes management is getting your blood glucose level checked regularly. You need to develop and follow a regular test routine to keep a tab on your sugar levels. Regular tests help you determine how meals, exercise and/or medication impact your blood sugar levels.

Glycosylated haemoglobin, also called HBA, GHB and HbAlc, measures the long-term blood glucose control of the patient. It finds out the average plasma glucose concentration over a period of three months, thus avoiding momentary highs an dlows. Based on the direct relationship between HbAlc, and diabetic complications, recent guidelines for the management of diabetes, stress the importance of monitoring HbAlc. Medication: Your medication depends on the type of diabetes you have and the level of the blood glucose. Oral medication works by either helping the pancreas produce more insulin or by making the cells more sensitive to the body’s insulin. Whether you need insulin or pills, make sure you have the medications in proper dosage, on time , as discussed with your healthcare professional.

Soon, a simple breath test can tell if you are diabetic

Washington: A nanotechonogy-based sensor could soon tell whether someone has Type 1 diabetes-just by analyzing their breath.

The sensor, which has been successfully tested by Swiss researchers, could also be used by emergency room doctors to determine whether a patient has developed diabetic ketoacidosis, a potentially serious complication that happens when diabetics do not take enough insulin.

Even diabetics could use the technology in their homes, to determine whether they need more insulin. Sotiris Pratsinis and colleagues at ETH Zurich in Switzerland explain that everyone has a little bit of acetone in their breath.

But people with Type 1 diabetes release un usually high levels of the chemical when they exhale. If they have diabetic ketoacidosis, a dangerous buildup of acetone in the blood, they exhale even-larger amounts of acetone.

They built a sensitive acetone detector by directly depositing from a flame plume a thin film of semiconducting, mixed ceramic nano particles between a set of gold electrodes.

Diabetic? You may need to inject insulin once a week.

Mumbai: Long-suffering patients of diabetes can find daily jabs painful and cumbersome, so a new, once a week insulin shot may soon revolutionise treatment for thousands inflicted with the disease that causes sugar imbalance.

Researches found that a long-acting medication, Exenatide, if injected once a week, improved blood sugar control and induced weight loss in type 2 diabetics. The study, which was conducted at VU University Medical Centre Amsterdam, has been reported in the lasted issue of medical journal ‘Lancet’, and will be discussed at the ongoing American Diabetes Association’s session in Orlando.

A cross-section of doctors whom TOI spoke to pointed out that newer treatments are constantly need for curing diabetes as first line drugs fail to have the desired impact over a period of time, or may have serious side-effects. What is needed is drugs that are convenient, provide effective glycaemic control, and do not cause weight gain.

The weekly Exenatide shot is good news for patients who have uncontrolled sugar despite maximum doses of conventional anti-diabetic drugs. Those who are obese or prone to recurrent low sugars(hypoglycemia) may particularly benefit from it, doctors pointed out. The study says that the new formulation of Exenatide may be better for patients than once-daily insulin shot (Glargine), as the latter leads to weight gain.

In this 26-week randomised study, the authors of the ‘Lancet’ article, Dr. Anoop Misra, Fortis Hospital, New Delhi , and Dr. Shashank Joshi, Lilavati, and Bhatia Hospitals Mumbai, compared once-weekly Exenatide and insulin Glargine in adults with type-2 diabetes who had inadequate blood sugar control despite use of first-line anti-diabetic drugs for three months or longer. In the study, Professor Michaela Diamant and colleagues has tested the new formulation of Exenatide on 456 patients (233 once-weekly Exenatide, 223 insulin Glargine).

The doctors say that once weekly Exenatide for type 2 diabetes is more convenient and induces better blood sugar control, and more weight loss than second-line treatment of daily insulin Glargine. Glargine, which has to be injected daily, led to weight gain of 1.4 kg per patient.

Diabetologist Dr. A. Ramachandran says, The quality of life (of a patient) improves drastically with once a week insulin shot, but it may work in certain patients only.

’DIABETES DRUG CAN DAMAGE HEART’:

Medical exports have urged a ban on Avandia, a drug taken by diabetics, because it increases risk of heart attack. The Commission on Human Medicines said the “risk of rosiglitazone (Avandia) out weights benefits” and called for prompt action. Yoon Loke of the University of East Anglia estimated that the drug causes around 1,000 extra heart attacks a year in Britain.

DIABETES ALERT 10 YRS BEFORE ONSET

blood Test To Detect Genetic Molecules That Pinpoints Those At Higher Risk

London: British scientists claim to have developed a blood test that could predict those at risk of getting diabetes 10 years earlier than available diagnosis.

A team at King’s College London has claimed the test can identify around half of people who will and will not go on to develop some of the complication of the blood sugar condition, such as heart attack, stroke and poor circulation.

The test works by detecting levels of a genetic molecule in their blood; the same molecule, called a microRNA (MiR), could help pinpoint suffers at high risk of heart and artery disease, the Daily Telegraph reported.

Lead scientist Manuel Mayr said he expected the MiR test to be used in conjunction with conventional methods. Its biggest advantage was that it directly assessed the damage diabetes was causing to blood vessels.

“It’s very important for doctors to define those diabetic patients that are at the highest risk of developing cardiovascular complications. We hope that this new class of blood makers may give additional insight that we’ve currently not getting from other clinical tests,” Mayr said.

For their research, the scientists studied 822, adults aged between 40 and 79 living in northern Italy. Jeremy Person of the British Heart Foundation said, “This is important because right now there is no quick and simple way to monitor blood vessel health.

This yr, diabetes to bleed India of $32b

Most Patients Dip Into Savings, Take Loan: Study

New Delhi: A study on the financial burden of diabetes on the common man in the country has found that 60% of diabetes-irrespective of their socio-economic status-pay for treatment and management of the disease from their personal savings.

The study, The Socio-Economics of Diabetes from a Developing Country: A Population-based Cost of Illness Study, by the MV Hospital for diabetes and Diabetes Research Center in Chennai, says the next common method of payment was by dipping into their savings.

Among those with a monthly income between Rs.10, 000 and Rs.30, 000, 72% pay from their savings, and 11.7% take loans.

Published in the Diabetes Research and Clinical Practice, the official journal of the Internal Diabetes Federation (IDF), the study reveals that 81% of the higher income groups pay medical bills from personal savings.

Health insurance coverage was observed only among the high income group and figure stood at only 2 %.

With a sample size of 4.677-of which 1,050 had diabetes (718 participated in the survey) - the study makes an in-depth finding into the financial burden.

On an average, a diabetic in India spends Rs.25, 931 annually on diagnosis and treatment of the ailment. It includes costs for routine lag investigations, physicians’ ambulances, medication and transport.

The patient also spends nearly Rs.5, 000 as indirect cost annually in the form of lost man days while making round of hospitals.

Extrapolating the figures, the study claims that the nations will spend a whopping $31.9 billion this year on diabetes care. “Keeping the diabetes explosion in the future in mind, this heavy economic burden highlights the urgent need for the decision makers to allocate resources for planning and implementing strategies in prevention and strategies in prevention and management of diabetes,” the finding says.

According to IDE, an estimated 50.8 million will be hit by diabetes in 2010 in India. Global projections for 2025 have estimated a 170% rise in patients and India figures prominently on the map.

LONG-TERM WEIGHT LOSS MAY BE HARMFUL TO HEALTH

Long-term weight loss may release into the blood industrial pollutants linked to illnesses like diabetes, hypertension and rheumatoid arthritis, researchers said. These compounds are normally stored in fatty tissues, but when fat breaks down during weight loss, they get into the blood stream, said lead researcher Duk-Hee Lee at the kyungpook National University in Daegu in South Korea. “We are living under the strong dogma that weight loss is always harmful…but we think that increased (pollutant) levels (in the blood) due to weight loss can affect human health in a variety of ways,” she said.

Diabetes is on the rise, yet most cases are preventable with healthy lifestyle changes. Some can even be reversed. Taking steps to prevent and control diabetes doesn’t mean living in deprivation. While eating right is important, you don’t have to give up sweets entirely or resign yourself to a lifetime of bland “health food”. With these tips, you can still enjoy your favorite foods and take pleasure from your meals without feeling hungry or deprived

Taking control of diabetes

Have you recently been diagnosed with diabetes or prediabetes? Or has your doctor warned you that you're at risk? It can be scary to hear that your health's on the line, especially if you feel helpless to do anything about it.

Here's a scenario that may sound familiar: your doctor's telling you how important it is to lose weight and transform your eating habits, but you’re already discouraged. After all, you've tried dieting in the past without success. And counting calories, measuring portion sizes, and following complicated food charts sounds like way too much work.

Small changes equal big results

Whether you're trying to prevent or control diabetes, there is some good news. You can make a big difference with healthy lifestyle changes. The most important thing you can do for your health is to lose weight—and you don’t have to lose all your extra pounds to reap the benefits. Experts say that losing just 5% to 10% of your total weight can help you lower your blood sugar considerably, as well as lower your blood pressure and cholesterol levels. It’s not too late to make a positive change, even if you’ve already developed diabetes. The bottom line is that you have more control over your health than you think.

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Myths and facts about diabetes and diet
You must avoid sugar at all costs.

Fact: The good news is that you can enjoy your favorite treats as long as you plan properly. Dessert doesn’t have to be off limits, as long as it’s a part of a healthy meal plan or combined with exercise.

A high-protein diet is best.

Fact: Studies have shown that eating too much protein, especially animal protein, may actually cause insulin resistance, a key factor in diabetes. A healthy diet includes protein, carbohydrates, and fats. Our bodies need all three to function properly. The key is a balanced diet.

You have to cut way down on carbs.

Fact: Again, the key is to eat a balanced diet. The serving size and the type of carbohydrates you eat are especially important. Focus on whole grain carbs since they are a good source of fiber and they are digested slowly, keeping blood sugar levels more even.

You’ll no longer be able to eat normally. You need special diabetic meals.

Fact: The principles of healthy eating are the same—whether or not you’re trying to prevent or control diabetes. Expensive diabetic foods generally offer no special benefit. You can easily eat with your family and friends if you eat in moderation.

Diabetes and diet tip 1: Choose high-fiber, slow-release carbs

Carbohydrates have a big impact on your blood sugar levels—more so than fats and proteins—but you don’t have to avoid them. You just need to be smart about what types of carbs you eat.

In general, it’s best to limit highly refined carbohydrates like white bread, pasta, and rice, as well as soda, candy, and snack foods. Focus instead on high-fiber complex carbohydrates—also known as slow-release carbs. Slow-release carbs help keep blood sugar levels even because they are digested more slowly, thus preventing your body from producing too much insulin. They also provide lasting energy and help you stay full longer.

8 principles of low-glycemic eating

1. Eat a lot of non-starchy vegetables, beans, and fruits such as apples, pears, peaches, and berries. Even tropical fruits like bananas, mangoes, and papayas tend to have a lower glycemic index than typical desserts.

2. Eat grains in the least-processed state possible: “unbroken,” such as whole-kernel bread, brown rice, and whole barley, millet, and wheat berries; or traditionally processed, such as stone-ground bread, steel-cut oats, and natural granola or muesli breakfast cereals.

3. Limit white potatoes and refined grain products such as white breads and white pasta to small side dishes.

4. Limit concentrated sweets—including high-calorie foods with a low glycemic index, such as ice cream— to occasional treats. Reduce fruit juice to no more than one cup a day. Completely eliminate sugar-sweetened drinks. 5. Eat a healthful type of protein at most meals, such as beans, fish, or skinless chicken.

6. Choose foods with healthful fats, such as olive oil, nuts (almonds, walnuts, pecans), and avocados. Limit saturated fats from dairy and other animal products. Completely eliminate partially hydrogenated fats (trans fats), which are in fast food and many packaged foods.

7. Have three meals and one or two snacks each day, and don’t skip breakfast.

8. Eat slowly and stop when full.

Diabetes and diet tip 2: Be smart about sweets

Eating for diabetes doesn’t mean eliminating sugar. If you have diabetes, you can still enjoy a small serving of your favorite dessert now and then. The key is moderation.

But maybe you have a sweet tooth and the thought of cutting back on sweets sounds almost as bad as cutting them out altogether. The good news is that cravings do go away and preferences change. As your eating habits become healthier, foods that you used to love may seem too rich or too sweet, and you may find yourself craving healthier options.

How to include sweets in a diabetes-friendly diet

Hold the bread (or rice or pasta) if you want dessert. Eating sweets at a meal adds extra carbohydrates. Because of this it is best to cut back on the other carb-containing foods at the same meal.

Add some healthy fat to your dessert. It may seem counterintuitive to pass over the low-fat or fat-free desserts in favor of their higher-fat counterparts. But fat slows down the digestive process, meaning blood sugar levels don’t spike as quickly. That doesn’t mean, however, that you should reach for the donuts. Think healthy fats, such as peanut butter, ricotta cheese, yogurt, or some nuts.

Eat sweets with a meal, rather than as a stand-alone snack. When eaten on their own, sweets and desserts cause your blood sugar to spike. But if you eat them along with other healthy foods as part of your meal, your blood sugar won’t rise as rapidly.

When you eat dessert, truly savor each bite. How many times have you mindlessly eaten your way through a bag of cookies or a huge piece of cake. Can you really say that you enjoyed each bite? Make your indulgence count by eating slowly and paying attention to the flavors and textures. You’ll enjoy it more, plus you’re less likely to overeat. Tricks for cutting down on sugar

Reduce how much soft drinks, soda and juice you drink. A recent study found that for each 12 oz. serving of a sugar-sweetened beverage you drink a day, your risk for diabetes increases by about 15 percent. If you miss your carbonation kick, try sparkling water with a twist of lemon or lime or a splash of fruit juice. Reduce the amount of creamers and sweeteners you add to tea and coffee drinks.

Sweeten foods yourself. Buy unsweetened iced tea, plain yogurt, or unflavored oatmeal, for example, and add sweetener (or fruit) yourself. You’re likely to add far less sugar than the manufacturer would have.

Reduce the amount of sugar in recipes by ¼ to ⅓. If a recipe calls for 1 cup of sugar, for example, use ⅔ or ¾ cup instead. You can also boost sweetness with cinnamon, nutmeg, or vanilla extract.

Find healthy ways to satisfy your sweet tooth. Instead of ice cream, blend up frozen bananas for a creamy, frozen treat. Or enjoy a small chunk of dark chocolate, rather than your usual milk chocolate bar.

Start with half of the dessert you normally eat, and replace the other half with fruit.

Diabetes and your diet tip 3: Choose fats wisely

Fats can be either helpful or harmful in your diet. People with diabetes are at higher risk for heart disease, so it is even more important to be smart about fats. Some fats are unhealthy and others have enormous health benefits. But all fats are high in calories, so you should always watch your portion sizes.

Unhealthy fats :- The two most damaging fats are saturated fats and trans fats. Saturated fats are found mainly in animal products such as red meat, whole milk dairy products, and eggs. Trans fats, also called partially hydrogenated oils, are created by adding hydrogen to liquid vegetable oils to make them more solid and less likely to spoil—which is very good for food manufacturers, and very bad for you.

Healthy fats :- The best fats are unsaturated fats, which come from plant and fish sources and are liquid at room temperature. Primary sources include olive oil, canola oil, nuts, and avocados. Also focus on omega-3 fatty acids, which fight inflammation and support brain and heart health. Good sources include salmon, tuna, and flaxseeds.

Ways to reduce unhealthy fats and add healthy fats:

Cook with olive oil instead of butter or vegetable oil.
Trim any visible fat off of meat before cooking and remove the skin before cooking chicken and turkey.
Instead of chips or crackers, try snacking on nuts or seeds. Add them to your morning cereal or have a little handful for a filling snack. Nut butters are also very satisfying and full of healthy fats.
Instead of frying, choose to grill, broil, bake, or stir-fry.
Serve fish 2 or 3 times week instead of red meat.
Add avocado to your sandwiches instead of cheese. This will keep the creamy texture, but improve the health factor.
When baking, use canola oil or applesauce instead of shortening or butter.
Rather than using heavy cream, make your soups creamy by adding low-fat milk thickened with flour, pureed potatoes, or reduced-fat sour cream.
Diabetes and diet tip 4: Eat regularly and keep a food diary

If you’re overweight, you may be encouraged to note that you only have to lose 7% of your body weight to cut your risk of diabetes in half. And you don’t have to obsessively count calories or starve yourself to do it.

When it comes to successful weight loss, research shows that the two most helpful strategies involve following a regular eating schedule and recording what you eat.

Eat at regularly set times

Your body is better able to regulate blood sugar levels—and your weight—when you maintain a regular meal schedule. Aim for moderate and consistent portion sizes for each meal or snack.

Don’t skip breakfast. Start your day off with a good breakfast. Eating breakfast every day will help you have energy as well as steady blood sugar levels.

Eat regular small meals—up to 6 per day. People tend to eat larger portions when they are overly hungry, so eating regularly will help you keep your portions in check.

Keep calorie intake the same. Regulating the amount of calories you eat on a day-to-day basis has an impact on the regularity of your blood sugar levels. Try to eat roughly the same amount of calories every day, rather than overeating one day or at one meal, and then skimping on the next.

Keep a food diary

Research shows that people who keep a food diary are more likely to lose weight and keep it off. In fact, a recent study found that people who kept a food diary lost twice as much weight as those who didn’t.

Why does writing down what you eat and drink help you drop pounds? For one, it helps you identify problem areas—such as your afternoon snack or your morning latte—where you’re getting a lot more calories than you realized. It also increases your awareness of what, why, and how much you’re eating, which helps you cut back on mindless snacking and emotional eating.

What about exercise?

When it comes to preventing, controlling, or reversing diabetes, you can’t afford to overlook exercise. Exercise can help your weight loss efforts, and is especially important in maintaining weight loss. There is also evidence that regular exercise can improve your insulin sensitivity even if you don’t lose weight.

You don’t have to become a gym rat or adopt a grueling fitness regimen. One of the easiest ways is to start walking for 30 minutes five or more times a week. You can also try swimming, biking, or any other moderate-intensity activities—meaning you work up a light sweat and start to breathe harder. Even house and yard work counts.

Learn how to lose weight and keep it off. If your last diet attempt wasn't a success, or life events have caused you to gain weight, don’t be discouraged. The key is to find a plan that works with your body’s individual needs so that you can avoid common diet pitfalls and instead make lasting lifestyle changes that can help you find long-term, weight loss success. Read: Healthy Weight Loss

Home remedies for diabetes

There is an alarming rise in the prevalence of diabetes in India. Thanks to our eating habits and sedentary lifestyle, even gestational diabetes is not uncommon.

The sad fact is that it could affect the baby too. According to recent statistics, India has more people with Type 2 diabetes than any other nation. Who likes to take medicines everyday? Insulin and dialysis is even worse experience. And mind you, as opposed to the misconception, eating sweets is not the only cause for this disease. Stress and genes too play a major role in this. Although one cannot do much about it if it's genetic, it definitely doesn't harm to prevent it.

There is an alarming rise in the prevalence of diabetes in India. Thanks to our eating habits and sedentary lifestyle, even gestational diabetes is not uncommon.

No, you don't have to pop pills everyday. Just a few changes in your foot habits and you can cut the risks to a great extent. Here are some things that you can do at home to prevent diabetes or reduce it if you already are affected by it.

Nobody likes bitter things. But isn't it better to take a fruit or a vegetable instead of medicines? Having bitter gourd juice on an empty stomach has proved to prevent diabetes. If you are too stubborn or enjoy eating bitter gourd, then you could make stuffed karela (bitter bourd) or fry them like chips and have them as a snack. This will not just bring a change in your menu and give a respite to your taste buds, but also be beneficial to your health.

Soak a few seeds (1/4 tsps) of methi in water overnight. First thing after you brush your teeth in the morning, gulp down the methi along with the water.

Jambul fruit is considered as an effective medicine for diabetes considering its effect on pancreas. The seeds too can be dried, powdered and had with water twice a day.

The guava is among those fruits that are available in most times of the year. With its vitamin C property and high fibre content, this is perhaps one fruit that diabetics can fearlessly have. However, a recent study has shown that having guava with its skin can heighten the blood sugar levels, so make sure you peel off the skin before consumption.

Gooseberry/amla juice too cuts the blood sugar levels.

If you can't do without sugar in your coffee or tea, try and substitute honey.

Studies have shown that black coffee without sugar cuts the risk of Type 2 diabetes

Among other benefits, green tea is also helpful in reducing the blood sugar and insulin levels in the body

Talk to the eldest member in your family and am sure they will come up with a number of home remedies to prevent diabetes. Besides, make regular walk and exercise part of your routine.

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Keep your blood sugar in control naturally with garlic

Looking for a natural method to help control your blood sugar? Garlic might just be what you are looking for. A regular ingredient in a number of dishes, garlic packs much more of a punch than you can see. Touted as an antidote for various ailments and packed with innumerable health benefits, garlic is a boon for your body. Here is how you can use it to keep diabetes in check.

New buzzword: Diabetes remission

Doctors in India have found cases where diabetic patients have been relieved of insulin shots after a surgery. In Pune, 21-year-old Rujuta Durape smilingly talks about being the youngest Asian to have undergone such a surgery. I was 17 years old and 75kg when I underwent a gastric bypass surgery, she says. Her father, a chronic diabetic patient, would often cry for gifting her diabetes. The minute he heard that a surgery could control diabetes, he enrolled me for it, says Rujuta, who now weighs 48kg and works for a call centre.

Last week, results of city surgeon Muffazal Lakdwalas five-year-long study were published in medical journal, Surgery for Obesity and Related Diseases. This is among the longest-running studies in the world. It proves beyond doubt that diabetes can be controlled for five years and more with a gastric bypass surgery (See: What is Type 2 diabetes ) in patients who have a body mass index (BMI) of 30-35, said Dr Lakdawala. However, doctors agree that surgery is not an option for all patients.

Considering that India is home to more than 60 million diabetics, the disease generates a lot of interest. The surgical option, which presents an opportunity for medical devices companies, is also being intensely studied. It is now believed that surgery leads to production of certain enzymes in the digestive system that help balance blood sugar.

Not surprising then that doctors in India believe 2012 is a game-changing year for diabetes when surgery stopped being an experimental option. In March 2012,the New England Journal of Medicine published a study showing that surgery in a certain group of diabetics helped them better than medicines. Previously people would talk about undergoing weight-loss surgery to control diabetes. But now most come in seeking diabetes control, says Dr Lakdawala.

In fact, a new term diabetes remission entered the medical lexicon only recently. A couple of years back, the American Diabetes Association defined diabetes remission for the first time after seeing the results of surgery. It is a phase of more than five years without medication, says Dr Shashank Shah, who operated on Rujuta and 900 other diabetic patients over eight years. He has started a 100-patient clinical trial where he will operate on diabetic patients with a BMI of less than 30.In 2014 when our trial ends, we will be able to talk more authoritatively about this treatment.

His first patient weighed 80kg and was 30 years old when he operated on her. I now weigh 64kg and have had two deliveries. Best of all, I have no medication, she says.

Doctors agree that its too early to embrace surgery as the best option. We cannot say how the patients body will react a decade or two decades after surgery, admits Mumbai surgeon Ramen Goel. But, he says, it earns patients a break from the harmful effects of diabetes. It means their eyes, kidneys, hearts and nervous system have more time without suffering side effects, he says and adds patients may have better options soon.

Delhi endocrinologist Anoop Misra says, At present, we say people with a BMI of up to 30 can undergo surgery. Five years back, it was only offered to those with a BMI of over 35.It is still not the norm, but it is certainly helping some patients.

WHAT IS TYPE 2 DIABETES
It is a condition where the body is unable to metabolize (break down) blood sugar. Although pancreas of Type 2 patients produces insulin, it is either not enough or the body is unable to use it

Treatment

Usually people with diabetes are put on medication or insulin shots. In the past few years, though, surgery has emerged as an option for patients with a BMI (ratio of height and weight) of over 30

THERE ARE 3 TYPES OF PROCEDURES TO TREAT DIABETES

Sleeve gastrectomy in which the surgeon removes a large portion of the stomach. The new, smaller stomach is roughly the size of a banana, thereby limiting your food intake

Gastric bypass surgery is where most of the stomach is bypassed and a small stomach pouch is made. This small part is connected directly to the second part of the small intestine

The ileal transposition surgery in which a segment of the last part of the small intestine (ileum) is interposed between two parts of the small intestine (jejunum) just beyond the stomach. No part of the small intestine is removed or bypassed

Diabetes at heart of cardiac trouble

Sion Koliwada resident Shakuntala is to undergo a cardiac bypass surgery next week. Even though the 56-year-old fisherwoman is scared about the operation, doctors feel it might be her only option.

What Shakuntala doesn't know is that her uncontrolled diabetes is the main reason of her heart problems. For three months now, Shakuntala complained of a recurrent pain in her body. It was only when she went for a free check-up that she got to know that she had a heart problem.

Shakuntala has had uncontrolled diabetes for the last six years. And in the past few months, she has started complaining of convulsions with mild exertions, even while sleeping. Her tests showed that three of her vessels are blocked. So the only treatment is a bypass surgery,'' said Dr Ameya Udyavar, consultant cardiologist with Hinduja Hospital.

Cardiologists say that those suffering from diabetes are more susceptible to cardiovascular problems as compared to those who don't. Statistics show that 65% patients with diabetes die from cardiovascular disease, 20-35% of patients with heart disease have diabetes and 55-60% patients undergoing bypass surgery are diabetics.

Dr Hasmukh Ravat, head of cardiology department in Wockhardt Hospital in Mulund, says that one out of ten people in India suffer from diabetes. "Because of the high blood sugar level, the artery becomes thicker and may even lose its elasticity. In such a case, if the fatty materials deposit on the inner walls of the arteries, the blood flow towards the heart will be affected, leading to an attack,'' said Dr Ravat.

Cardiologists also believe that silent attacks are more common with diabetics. "Since the arteries get clogged, it causes pain in the chest. But with diabetic patients, these arteries also cause loss of the nerve function, because of which, the patient might not experience pain while getting an attack,'' said Dr Udyavar.

Doctors say that a treatment might not always be possible as the patiennt might not come to know that there is a heart problem if not for ECG tests. It is thus better for all diabetics to take precautionary measures.

"It might not be possible for a diabetic to prevent an attack. But precautionary measures can ensure decreased succeptibility of heart problems,'' said Dr N Bansal, cardiologist from state government-run JJ Hospital in Byculla. "People tend to gain weight in their mid 30s and 40s. If diabetics keep a check on their diet, exercise regularly, avoid gaining weight, keep the sugar levels in control, there is no reason why they cannot live a healthy life,'' he said.

Like many of us, 61-year-old Professor Vijay Joshi was focused at work, didn’t have time for exercise and indulged himself with all kinds of food. That is until he was diagnosed with diabetes 11 years ago.

A retired professor in psychometrics for a renowned banking institute, Joshi did not show any symptoms of the disease before that. He had just turned 50 and his family forced him to go for a routine medical check-up. Before this he had no clue that he was ailing with Type 2 diabetes.

"My work was hectic and stressful," he says. "After checking my blood sugar level, the doctor told me that hypertension, low activity levels, an unhealthy diet and excess body weight (especially around the waist) over the years, had led to the disease."

Being diagnosed with a lifestyle disease was shocking for Joshi. “The thought that I won't be able to eat any sweets bore heavily on me," he says. "I was in my pre-diabetic stages.

I had some hope that I could still control the situation with regular exercise and diet changes." Joshi's blood sugar figures were found to be 131 and 204 mg/dl before and after the meals respectively. For a normal person, the sugar levels range between 100 and 140.

He was put on allopathic medicine which helped his cells absorb insulin and kept his blood sugar level in check. "I started exercising regularly and it really helped in bringing down the sugar level in my body. This was the time I thought I had it under control,” he says.

But, his condition got worse a couple of years later, when his cholesterol and triglyceride levels shot up to 240 and 299 mg/dl respectively.

The normal range for cholesterol is 36-165 mg/dl and triglyceride is between 15-250 mg/dl. "I was under the assumption that I would become fine very soon," he says. "So I took it easy and started skipping exercise and medicines."

As a result, his sugar levels shot up again. “Every three months I had to go to the doctor for a check up. I started fearing what the doctor will have to say about my condition now.” He learned of the horrors of diabetes and how it interferes with the functioning of vital organs including, failure of kidneys, damage to heart, eyes and in extreme cases nerve disorders leading to the amputation. Realising this, he never skipped medication again

What changed his life

The doses of medicine kept on increasing as the years passed by. He started with half a tablet of insulin per day and it increased to one and a half tablets by 2009.

"This bothered me a lot as I thought the medicines might start causing side-effects in my body as I age," he says. "I started looking for a solution."

One day he came across an article in Mirror dated December 1, 2009, titled 'Diabetes isn't a One Way Street'.

The article featured an interview with an American physician, researcher and author Dr Neal Barnard. His book titled Dr Neal Barnard’s Program for Reversing Diabetes, depicted ways in which diabetics could get rid of medication simply by switching to a healthy diet.

"It seemed quite logical the way it was written. I did some research on the internet about the book. I came across an organisation called SHARAN which was working on the principles of Dr Barnard in India, teaching people to adapt to a plant-based diet." One day he came across an article in Mirror dated December 1, 2009, titled 'Diabetes isn't a One Way Street'.

The article featured an interview with an American physician, researcher and author Dr Neal Barnard. His book titled Dr Neal Barnard’s Program for Reversing Diabetes, depicted ways in which diabetics could get rid of medication simply by switching to a healthy diet.

"It seemed quite logical the way it was written. I did some research on the internet about the book. I came across an organisation called SHARAN which was working on the principles of Dr Barnard in India, teaching people to adapt to a plant-based diet."

Time to conquer

Joshi got in touch with the organisation and attended a workshop organised in the city at the beginning of 2010. He learned that he has to get refined oil in his diet and have only ‘whole food diet’.

For instance, he switched from white rice to brown rice. Brown rice is full of fibre and not processed, the body takes time to digest it. Therefore, glucose is reduced gradually which makes it easy to be absorbed by the insulin-resistant muscle cells.

Eating fruits and not juice and vegetables such as cucumber without peeling them also helps.

Since he is a vegetarian, he figured that his cholesterol was the result of milk products that he loved to eat, such as cow’s milk, paneer, rasgullas, laddoos and other milk sweets. He went off milk. Secondly, he had to replace the refined oil in his diet with something natural.

His present diet

Joshi has given up milk and its products completely. He doesn't even have biscuits because they contain milk powder. "People fear that when you stop milk, the calcium content in your body may go down drastically,” he says. “But there are lot of other ways to substitute calcium, such as raw apples, pomegranate, soybean and dry fruits."

His tea is milk free and his vegetables are cooked in non-refined til oil or sesame oil which is also rich in calcium. But most of the times he avoids using any sort of cooking oil. As we met him at his residence during the lunch hour, he is cooking cauliflower sabzi with rai, jeera and haldi in plain water.

"I drink the water as soup once the vegetable is cooked," he says, not feeling any regret that it doesn't taste as great as regular food. His evening snacks such as cutlets are made of vegetables such as carrots, sprouts and beans instead of potatoes. And they are not fried but steamed.

He ensures that he takes a brisk walk for 3.5 kilometres every day in the morning for 35-40 minutesafter a short warm-up session. However, he faces a problem with food when he steps out of his house. "This is something I cannot help. If I am in a restaurant with my family I usually order fruits, salads or something non-oily like idlis," he says.

Also organic food which is free from chemical fertilizers is not available at local departmental stores. So he travels to few selected malls in the city which stock the same.

"It takes a lot of courage to refrain from the way you have been used to eating what you eat. But the desire to live long and healthy makes you change your ways," he adds. "I know one of my relatives who are trying the Chinese acupuncture technique to get of the medication for their diabetes."

But I find it funny because unless you modify your intake, nothing is going to happen. Nowadays a lot of people tell me that 'you have lost weight'. I tell them that I have lost weight but I have also lost my diabetes," he laughs.

His present blood sugar level recorded in the month of May 2011 is in the normal range of 89-120 mg/dl before and after meals respectively. Today he is able to enjoy mangoes of the season, which he couldn’t do two years ago. Sharan is conducting a workshop on getting rid of diabetes on June 19 from 9 am to 5.30 pm. The venue is Times Tower, 6th floor, Kamala Mills Compound, Lower Parel, Mumbai

Joshi's recipie for No diabetes

One cup hot water or tulsi tea without milk
Breakfast includes two chapattis and curry
Between lunch and breakfast he has fruits such as banana and mango
For lunch he has brown rice with salads, curry and raw vegetables like beat root, bhindi, and pumpkin. He uses rock salt instead of normal salt
Steamed vegetable cutlets for evening snacks Steamed vegetable cutlets for evening snacks
Brown rice or 1 and a half chapatti with vegetables like karela or beans cooked in Til oil
Do a basic warm-up followed by a walk for 3.5 kilometres every day in the shortest time possible (Because he is off animal food, he has vitamin B12 tablets as supplements additionally.)
Diabetic You may need to inject insulin once a week

Mumbai: Long-suffering patients of diabetes can find daily jabs painful and cumbersome, so a new, once-aweek insulin shot may soon revolutionise treatment for thousands inflicted with the disease that causes sugar imbalance.

Researchers found that a long-acting medication, Exenatide, if injected once a week, improved blood sugar control and induced weight loss in type 2 diabetics. The study, which was conducted at VU University Medical Centre Amsterdam, has been reported in the latest issue of medical journal ‘Lancet’, and will be discussed at the ongoing American Diabetes Association’s session in Orlando.

A cross-section of doctors whom TOI spoke to pointed out that newer treatments are constantly needed for curing diabetes as first-line drugs fail to have the desired impact over a period of time, or may have serious side-effects. What is needed is drugs that are convenient, provide effective glycaemic control, and do not cause weight gain.

The weekly Exenatide shot is good news for patients who have uncontrolled sugar despite maximum doses of conventional anti-diabetic drugs. Those who are obese or prone to recurrent low sugars (hypoglycemia) may particularly benefit from it, doctors pointed out. The study says that the new formulation of Exenatide may be better for patients than once-daily insulin shot (Glargine), as the latter leads to weight gain.

In this 26-week randomised study, the authors of the ‘Lancet’ article, Dr Anoop Misra, Fortis Hospital, New Delhi, and Dr Shashank Joshi, Lilavati, and Bhatia Hospitals, Mumbai, compared once-weekly Exenatide and insulin Glargine in adults with type 2 diabetes who had inadequate blood sugar control despite use of first-line anti-diabetic drugs for three months or longer. In the study, Professor Michaela Diamant and colleagues had tested the new formulation of Exenatide on 456 patients (233 once-weekly Exenatide, 223 insulin Glargine).

The doctors say that once weekly Exenatide for type 2 diabetes is more convenient and induces better blood sugar control, and more weight loss than second-line treatment of daily insulin Glargine. Glargine, which has to be injected daily, led to weight gain of 1.4 kg per patient.

Diabetologist Dr A Ramachandran says, The quality of life (of a patient) improves drastically with once a week insulin shot, but it may work in certain patients only.

Census to track no.of diabetics across India

Mumbai:Years after India had already earned the dubious distinction of being the diabetes capital of the world,the Centre seems to have finally woken up to one the most serious health hazards.On Friday,Union health minister Ghulam Nabi Azad announced that the government would initiate a diabetes census across the country to gauge the enormity of the epidemic.

By the end of this year or early next year,the censusprobably the first of its kind in the worldis likely to start.Azad is also presenting the idea of the census at the five-day WHOs Health Assembly commencing in Geneva,Switzerland from May 17.

We intend to start mandatory testing for diabetes in the age-group of 25-70 years across the country in the next two years, Azad said.

The idea is to figure out the actual number of people who are suffering from diabetes,or are likely to suffer, said Azad, on the sidelines of the inauguration of a mega health camp at Malad.

Azad added that soon,the Centre will ask for help from all state governments to pull off the mammoth initiative.We will study all three categories of diabetes and decide on the next course of action accordingly, he said.For those who will be on the borderline,state governments will help to bring about behavioural changes,like changes in food habits and exercise, he said.

It is believed that Asian countries carry about 60% of the global diabetes burden.The diabetes census will start from cities and will trickle down to villages.In certain villages,where ambulances cannot reach,we will take the help of Glucometers (device for determining glucose in blood), said Azad.

Glucometers will cost the government an additional Rs 100 crore as per patient,the cost will come up to Rs 100.This includes the cost of involving a doctor and sending him to villages, Azad explained.

The Union minister said that defeating diabetes would mean defeating the plethora of ailments that come with it.And,that includes the economic burden on families and the state, he said.

City doctors feel there could not have been a better time to come up with the census as diabetes has already become a serious health problem in the country. Founder and president of Diabetic Foot Association of India Dr Arun Bal said there was no proper epidemiological data to establish the enormity of diabetes in India so far.The data available is mostly from small centres,so data from across the country will be of great significance, he said.

Bal added that it was all the more important as India has about 40 million people who have Impaired Glucose Tolerance, meaning they are on the verge of becoming full-blown diabetics.If we can detect it early and help people prevent it,several social and economic problems can be tackled, he said.

NUMBER CRUNCHING

More than 60% of the total diabetes burden of the world is from Asia It is estimated that India at present has 50.9 million diabetics and this is set to rise to 87 million by 2030 That would mean about 8.4% of the countrys adult population will be diabetic by 2030 About 7.8% of worlds diabetics are believed to be from India According to International Diabetes Federation,about 10 lakh deaths can be attributed to diabetes in India annually Annual health expenditure per person with diabetes is Rs 3,000 on an average About 40 million have Impaired Glucose Tolerance in India

No surgery: A 15-min cure for diabetes, obesity

In what could revolutionise healthcare for the rising diabetes population worldwide, scientists claimed to have developed a 15-minute non-surgical treatment that could lead to drastic weight loss and reverse the onset of the disease.

The breakthrough treatment, considered a cheap and safe alternative to surgery, involves a device called EndoBarrier — a plastic sleeve that is inserted into the intestine of a patient to prevent food being absorbed into the body.

The device, developed by a United States-based company, is fed through the mouth using an instrument called an endoscope while the patient is awake, the Daily Express reported.

"Obesity surgery can be risky simply because of the patient's weight and the fact that you are giving them a general anaesthetic. That's why it's so good to have a non-surgical approach," said Keith Gersin, head of obesity surgery at Carolinas Medical Centre in Charlotte, North Carolina, which has been trialling the EndoBarrier sleeve for 18 months.

"It is so quick to fit that you can get lots more patients treated. The patients loved it so much they didn't want us to remove it at the end of the trial period. We had no significant side effects and it was easily removed."

Extensive tests of EndoBarrier have been carried out in the US and Europe and last week the new device was given a licence for use on European patients.

In a 12-week trial in the Netherlands, patients fitted with the EndoBarrier lost an average of 16kg compared with a control group of patients who dieted and lost just 5kg.

According to its developers, the treatment, which costs £2,000, is about half the cost of the cheapest obesity operation.

"The patients who used it have continued to lose weight. It gave them the incentive to diet and eat sensibly," said Gersin.

The EndoBarrier device is fitted to the first two feet of the small intestine where most food is absorbed.

During trials the sleeve was able to reverse Type 2 diabetes within weeks by reducing patients' blood sugar levels so they no longer needed to take drugs. Nadey Hakim, a leading UK consultant in weight loss surgery, said: "I would love to be able to cure a patient's obesity with a 15-minute procedure. It's a very clever idea".

The Endo Barrier digestive tract liner won CE Mark approval in December, 2009, clearing the way for sales to begin in the European Union this year

This yr,diabetes to bleed India of $32b >

New Delhi: A study on the financial burden of diabetes on the common man in the country has found that 60% of diabetics irrespective of their socio-economic status pay for treatment and management of the disease from their personal savings. The study, The Socio-Economics of Diabetes from a Developing Country: A Population-based Cost of Illness Study, by the MV Hospital for Diabetes and Diabetes Research Centre in Chennai, says the next common method of payment was by selling, mortgaging immovable assets or taking loans with interest rates as high as 39%.The situation is especially grim for those patients whose monthly income is Rs 10,000 or less. Around 60% of them borrow, mortgage or sell their property just to keep their blood sugar level under control. While among the rest ,around 27% have no option but to finance their treatment by dipping into their savings. Among those with a monthly income between Rs 10,000 and Rs 30,000,72% pay from their savings ,and 11.7% take loans. Published in the Diabetes Research and Clinical Practice, the official journal of the Internal Diabetes Federation (IDF),the study reveals that 81% of the higher income group pay medical bills from personal savings. Health insurance coverage was observed only among the high income group and the figure stood at only 2%.With a sample size of 4,677 of which 1,050 had diabetes (718 participated in the survey) the study makes an in-depth finding into the financial burden. On an average, a diabetic in India spends Rs 25,931 annually on diagnosis and treatment of the ailment. It includes costs for routine lab investigations, physicians, ambulances, medication and transport. The patient also spends nearly Rs 5,000 as indirect cost annually in the form of lost mandays while making rounds of hospitals.Extrapolating the figures, the study claims that the nation will spend a whopping $31.9 billion this year on diabetes care. Keeping the diabetes explosion in the future in mind, this heavy economic burden highlights the urgent need for the decision makers to allocate resources for planning and implementing strategies in prevention and management of diabetes, the finding says. According to IDF,an estimated 50.8 million will be hit by diabetes in 2010 in India. Global projections for 2025 have estimated a 170% rise in patients and India India figures prominently on the map.

STEEP COST

On an average,a diabetic spends Rs 25,931 annually on treatment.Rs 5000 is the indirect cost for every patient The study by a Chennai hospital has found that 60% Indians,irrespective of their earnings,pay for treatment from their personal savings 60% of those earning less than Rs 10k/month,have to borrow to foot the bill Health insurance coverage is only 2%,and 81% of those in the higher income group also have to dip into savings

On India's diabetes map, Mumbai comes off as worst

Moreover, studies in the city showed that women are more prone to the disease than men, a reversal of the general trend across the world, and pointed at a trend of early onset of diabetes among the population."In all other cit ies, the glucose abnormality was found to be higher in the age group of above 55 years. In Mumbai, however, the abnormality was found to be the same across all age groups, which shows that there is early onset of diabetes in the city," said the survey done by Metropolis a disgnostic chain.

Diabetes is rising in the country at an alarming rate which prompted us to seek out better and far-reaching ways of spreading awareness among the masses," said Dr.A K Jhingan, Chairperson, Delhi Diabetes Reserch Center on the eve of world diabetes day, in 2011.It was then by lighting up the monuments with blue, commenced India’s biggest awareness drive for diabetes in Delhi and different parts of the country. "I could be the next…" is the thougt that never appears in our mind for any bad situation,be it a fraud, a brutal accident or some silently killing diseases like diabetes.Right diet,which we rarely follow is the basic requirement to avoid diabetes.Sadly we often land up following suit of a trendy lifestyle,making junk food as our diet.The ever increasing crowd near any fast food outlet gives an account of people who are servent of their taste buds.This situation often creats a question in my mind,”Is just being aware of diabetes enough?Or it is the time to move ahead and prevent ourselves against conditions that cause diabetes. The season is starting up in the sunshine state, and we know you want a slice of that sea, sand, sun, and party pie — and eat it too. From A Reverie's (Calangute) new-age sensibility fare served in a dreamy setting, and Siberian pelmeni dumplings at Gato Loco (Candolim) to dainty desserts at Patisserie Delicieux (Ashwem and Mirarmar), every year vacationing foodies enjoy discovering what a veritable foodie paradise Goa is.

55% of 21,000 diabetics in Mumbai are women

Tags:

  • 1) Metropolis Laboratory|
  • 2) Manisha Mhaiskar|
  • 3) lilavati hospital|
  • 4) executive health officer|
  • 5) diabetes|
  • 6) 55% of 21|
  • 7) diabetics in Mumbai are women
MUMBAI: Even as the BMC will attempt to detect more cases of hidden diabetes by randomly checking the blood sugar of more than two lakh Mumbaikars on Wednesday, existing statistics reveal a worrying trend. More women than men-55% of the 21,000 patients are women-seek free treatment at BMC's 55 diabetic clinics.

"We were surprised to find that we had more women than men as patients," said additional municipal commissioner Manisha Mhaiskar on Tuesday. However, city's executive health officer Dr Arun Bamne said that the gender bias could be a reflection of the fact that women were free to attend the civic clinics that function during afternoons.

Diabetes epidemic on the rise in India

Tags:

  • 1) Women
  • 2) Weight loss
  • 3) sugar
  • 4) stress
  • 5) Obesity
  • 6) juvenile
  • 7) heart
  • 8) Gestational diabetes
  • 9) Epidemic
  • 10) diet
  • 11) diabetes
  • 12) Cancer
With World Diabetes Day having gone by on November 14, experts give the low-down on one of the biggest lifestyle diseases and how to deal with it

Have a deskbound job that has you sitting for over six hours at a stretch? Have you been leading a very sedentary lifestyle and done nothing about it so far? Well, sit up and smell the proverbial coffee, or in this case, get out and get that adrenalin going. An inactive life, which involves lack of exercise and poor calorie management, is one of the biggest contributors to the dreaded disease of diabetes, today. "India is facing an epidemic of diabetes. At present, confirmed diabetes patients in India are 67 million, with another 30 million in prediabetes group. By 2030, India will have the largest number of patients in the world. Diabetes is not only a blood sugar problem, but brings along other complications as well," warns Dr Arun Bal, diabetic foot surgeon.

Diabetes and cardio

It's not just the vision, diabetes takes a severe toll on the heart too. "The incidence of heart disease is increasing at a rapid rate. It was 1.09% in the 1950s, increased to 9.7 % in 1990, and 11% by 2000. This rising trend will make India the heart disease capital of the world," warns interventional cardiologist, Dr Suresh Vijan. "Indians face a dual risk of heart disease and diabetes. The risk of death due to myocardial infarction is three times higher in diabetics as compared with non-diabetics. Life expectancy too is reduced by 30% in diabetics as compared to non diabetics; this translates into a loss of eight years of life." The culprit? "Increased consumption of dense-rich foods along with increasing sedentary lifestyle has increased the incidence of diabetes and heart disease," he says.

How it's treated: Adopting a healthy lifestyle with more activity will reduce the incidence of diabetes and heart disease. Try walking each day or do some cardio activity, after consulting your doctor. Diabetic foot ulcers

One of the most dreaded complications of diabetes is foot ulcer and gangrene. Deaths due to foot gangrene are only second to cancer deaths. "People with diabetes are at an increased risk of complications from wound healing. Due to the decreased blood flow, injuries heal slowly than in people who do not have the disease. It occurs in 15% of all patients with diabetes and precedes 84% of all lower leg amputations. Many people with diabetes also have Neuropathy — loss of sensation in their hands or feet," adds Dr Bal. How it's treated: He says 85% of these amputations can be easily prevented by patient education and proper and early wound care. The cornerstone of prevention of diabetes is regular exercise, managing stress and healthy food habits. Gestational diabetes
Gestational diabetes is a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy. "In developing countries Including India, the prevalence is almost 16-17%. Those who are overweight and have a family history of diabetes, are at the risk of developing GDM," says Dr Deepak Chaturvedi, endocrinologist and diabetologist. Is there any way to avoid it? "Control weight through calorie intake for one. Have small, frequent meals during pregnancy (balanced diet), avoid obesity before conception and stay active throughout your pregnancy," he advises.

Causes

Symptoms
Ayurvedic view of Treatment

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