Many of you are aware regarding diabetes very well.My target audience is general community so there may be oversimplifications.
We know that glucose is an important fuel for our body.Without glucose we cannot survive for long.Excess of anything is bad.
Diabetes is excess glucose in your blood.
How to suspect that you may have diabetes?
1.Remember three P
-Polydipsia-excessive thirst and you drink excessive water
-Polyphagia-excessive hunger and you take more food
2.You have frequent infections in urinary tract
3.You have frequent chest infections
4.Your wound healing takes longer time
How to make sure yourself that you have diabetes?
After your dinner before 10 P.M.don’t take anything except water and in the morning go to your nearest clinical lab and give your blood sample for Fasting Blood Sugar.In your report if its value is greater than or equal to 126 mg/dl you should repeat it one more day,if it is still more than or equal to 126 mg/dl,you have diabetes.Here one thing everyone should know.When we give our sample to lab generally our sample is tested by GOD POD method which takes sometime in reporting.Apart from this some lab for convenience do this test by ready made strips with glucometer.When you get your report,you should check with lab that whether your blood sugar has been checked with GOD POD method or by glucometer strips.Here one thing I want to make clear that there is a chance for false high blood sugar result by strip method and you may be falsely labeled as diabetic.
Further your blood sugar checked by fasting blood sugar or random blood sugar only give you a snapshot value of your blood sugar at that time.There may be many causes of your temporary rise in blood sugar about which we would discuss later.
What you should do if you get two consecutive Fasting Blood Sugar equal to or greater than 126 mg/dl in your lab report?
If it is done by GOD POD method and your value is above 126 mg/dl you should get your blood tested to confirm that you had average blood sugar level was high for the last three month.For this ask your lab to test your HbA1C.If in that report your value is greater than 6.5,your can say that your average blood sugar was high in the last 3 months.One very important point,if you are taking corticosteroids for allergy,asthma,arthritis etc.for long time,your blood sugar as well as blood pressure would be high and it may return to normal if you stop those medicine.Such medicine should not be stopped abruptly,rather such medicine should we gradually tailed off(slowly reducing the dose to lower level over a period of 5 to 7 days then stop).
It is not necessary that the corticosteroids can be found in allopathic medicines only.Beware of ads which claim to cure your asthma or long chronic pains by herbal or Ayurveda preparations particularly in the developing countries where drug control is very poor,because such preparation may contain steroids or be careful of ads relating muscle building formulas because they may contain anabolic steroids.In my opinion you should take the advice of a qualified medical practitioner before going to opt for such preparations.Even if you should take such treatment under doctor’s supervision only.
If you are confirmed that you have diabetes by your blood sugar test and HbA1c test and you have excluded that you are not getting any form of steroids in any form of medication,what should be your next step…..
If you can consult a diabetologist..so much so good!
If you cannot afford to go to doctor by any reason you should know,what else you can do!
1.Increase your glucose consumption by doing exercise,walking,cycling,swimming,gardening,washing your clothes manually,sweeping your house,mopping your house etc.These actions would keep you healthy and off course wealthy.Send all your servants to their native places forever and do all your household work on your own.I am amazed why people go to gym and pay money for their workouts.They burn candles from both sides.You can have plenty of works in your home in which you can cover all your exercise and at the end of exercise your all the work would be done,their all the things would be in place.It is only you who can do your work in the best possible way.Believe me after following my advice you would shed pounds and you would save pounds.So the first principle to keep control on your sugar is burning your glucose by manual activities.
2.Second principle is to spread your food intake evenly in a day.In other words just break your three major meals into six small snacks.Suppose you take usually four chapatis in your breakfast at 8 A.M.,four chapatis in your lunch at 1.P.M. and four chapatis in dinner at 9 P.M.
In that case you should take early morning snack at 7A.M.,second morning snack at 10 A.M.,third snack at 1 P.M.,Fourth snack at 4. P.M.,fifth snack at 7 P.M. and sixth snack at 10 P.M.two chapatis in every snack.
This spreading your daily total calorie intake from three major meals to six small snacks would maintain your caloric requirement of body and would avoid episodes of high blood sugar.
The gist is don’t eat too much at once rather eat small quantities more frequently.
3.Selection of food is also important.You should avoid direct sugar,glucose because they would be very quickly go to your blood within five minutes of your intake and your blood sugar would rise very fastly.Mind it,you have to take those things which would increase your blood sugar slowly.It is a better idea to incorporate sprouts of gram,wheat germs,salads in your snacks because these contains complex carbohydrates and increase your sugar level slowly,apart from this these are rich in dietary fiber which relieves many ailments.
4.You can choose some well known plant products with little or no risk of side effects.
Mostly diabetes occurs in two types.One in which there a chemical called insulin (which is made in your body in an organ called pancreas) is deficient.
Just imagine a building which is made up of bricks,similarly our body is made up of cells.To survive every cell need energy.For energy every cell require glucose as fuel.When we eat carbohydrates like cereals food,it gets digested in our intestines and converted into glucose.From intestine the glucose enters in our blood circulation which is maintained by a pump called heart.Blood functions as distributor of nutrients to all the cells of our body.So the glucose is distributed to every cell of our body.But glucose entry inside the cell is done by insulin.So without insulin the glucose can not enter the cell and it remains in blood and blood glucose level rises.So one type of diabetes which is due to less insulin production is called Type 1 diabetes or Insulin Dependent Diabetes Melitus IDDM.
Another type of diabetes in which insulin is not deficient,but the glucose entry inside the cell is not occurring because cell are not responding to insulin.This is called Type 2 diabetes or Non IDDM.
Imagine a scenario, blood is a carrier which is carrying glucose and an agent insulin which lifts the glucose and knocks the door of the cell.Cell opens the door and takes up the glucose.If the agent is less or absent it will not knock the door of the cell and the cell will not open the door and take up the glucose,so the glucose level will rise in the blood.This happens in type1 diabetes or IDDM.The agent Insulin is less.
Similar scenario in which the insulin or agent is adequate and it is knocking the door of the cells but cell is not opening the door so not taking up glucose.this is type-2 diabetes.
In pregnant ladies body is getting ready to nurse the developing baby in the mothers womb,there is a chemical called prolactin which helps in milk secretion.If this chemical is formed in the mother,this may also give rise to diabetes.(gestational diabetes)
If you are heavy drinker and your pancreas gets damaged by over alcohol intake,you may get diabetes.
If your own steroid production in a glands( which are attached above your kidneys called adrenal gland)is excessive,you may get diabetes.
If you have lung cancer or any other tumor in the body which produces steroids,you may have diabetes.
If your thyroid gland is excessively releasing its hormone,you may get diabetes.
So the ultimate treatment of diabetes is dependent on causes but in many cases no cause is identified.
So for self care my outlined approach,let me repeat…..
1.Increase your physical activity
2.Break your Three major meals to six minor snacks.
3.Avoid simple sugar,glucose to avoid fast rise in your blood sugar
4.You can take artificial sweetener(be careful about that,some sweetener may prove dangerous in long term use.
5.safe plant products like raw bitter gourd juice,blackberry/Jamun seeds powder,methi,ghormar leaves etc.My advice is that,try to arrange any of these things on your own,don’t rely on the ready made products.
6.One important point to note that,many of you believe that taking tea without sugar would not increase your blood sugar,here I want to clarify you that tea,coffee and cocoa all can alone increase your blood sugar by decreasing phosphodiestrase and increasing cyclic AMP and finally increasing blood sugar(you don’t need to remember the names)bad news for all guys who believe that taking tea without sugar will not increase their sugar level in blood their belief is not right.
7.If your blood sugar is not controlled with diet,exercise and herbs,you can go for Oral hypoglycemic agents OHA this is sophisticated name of oral use tablets to control blood sugar.Here a lot of options you have(acarbose,glimeperide,metformin,glibenclamide,gliclazide,pioglitazone,rosiglitazone,rapeglenide etc.) but you are advised to take OHA on your Doctor’s advice only.When you have taken any of these OHA you are advised to take some sweet lozenges or glucose with you so that you can take those when your blood sugar falls.In my opinion most person with diabetes die due to low sugar caused by excessive medication and over control of sugar intake.REMEMBER ONE THING HIGH SUGAR IS NOT SO DANGEROUS FOR YOU BUT LESS SUGAR MAY TAKE YOUR LIFE WITHIN MINUTES,SO THE GOLDEN RULE IS KEEP THE BLOOD SUGAR HIGHER RATHER THAN DANGEROUSLY LOW.
How can any one know that his blood sugar is getting down and he should take some sugar
3.cold hands or feet
4.giddiness or altered consciousness
Apart from OHA, insulin of many types e.g. Regular,50:50,30:70,glagrine can be used only under your doctor’s advice.
DONT EVER TRY OHA OR INSULIN YOURSELF,THESE MAY KILL YOU!MIND IT!
If in your area there is no lab in your neighboring place,you can do self monitoring of your blood sugar with your glucometer,but Its reading is frequently 10-20mg/dl over GOD POD method.you should calibrate your glucometer by giving one time your blood sample to a standard pathos-lab to test your blood sugar by GOD POD and from the same sample you test with your glucometer,compare the results and keep the correction factor of your glucometer in your mind.whenever you test your blood sugar by your that glucometer in your home,correct your figure by correction factor you got in calibration to assess your actual blood sugar level.
Apart from this you can purchase uristix to know your urinary sugar in home.Roughly glucose comes in urine only when its level is more than 170mg/dl,so if your urine is positive for sugar,it means your blood sugar is roughly above 170mg/dl.If uristix is costly,you can purchase Benedict reagent prepared from science lab shops a test tube and a test tube holder.Just fill 5ml of Benedict reagent in a test tube and to it add 6 to 8 drops of urine and heat it for 5minutes,take care the boiling fluid should not be spilled over your body part keep it away from your face.You will see change in color from blue to green to yellow to orange to red to brick red deposits.If color is no change or green…no sugar,yellow +
Brick red deposits++++
Thats all thank you!
To be continued……you need to refresh this page since revision in progress..
Heart attack is scaring word used in common population.Very few of us has clear understanding about this.I want to provide clear message to all of my friends so that they can make a proper judgement about the condition.To understand this you need to to know few basic things.
1.Our all body parts need energy which comes from the burning of glucose.In our body glucose is made by the breakdown products of carbohydrates in our diet.
2.To burn the glucose in our body oxygen is essential which enters in our body when we do breathing.
3.So for obtaining energy for our body we need two things glucose as a fuel and oxygen as a burning gas.
4.Apart from this the most important thing is the transport service.Transportation of essential substances to all the parts of our body is done by blood which is pumped by heart (situated in our centre of chest) through elastic pipes to our whole bodyparts.So there are many pipelines to supply blood to the different parts of our body.And the pumping action of heart is essential for us to be alive. Heart starts beating when an individual is of one month age in mother’s womb and it continues beating till the life persists.
So we know till now glucose and oxygen is important things to survive and heart pumping blood is essential to transport those things to the whole bodyparts.Even the heart wall also needs in own blood supply through main three pipes 1.LAD(Left Anterior Descending Artery) 2.RCA (Right Coronary Artery)3.LCX(Left Circumflex Artery) you don’t need to remember these names.You can compare this with a water pump house of a city which pumps water supply to entire city but the pump house people also need water so they have three pipelines for their own pump house.Similarly the heart pumps blood to the whole body through pipelines and it has got three main pipelines for heart itself.
What happens in heart attack
one or more pipeline (Arteries)gets complete or incomplete blockage due to fat deposition as well as blood clot.
Guess what would happen if blood supply of any area of our body is blocked….Less or no oxygen supply.For this that area would have problem in burning glucose and produce energy.Without energy that bodypart start dying.Such death of a part of body is called infarct.Heart muscle is also known as myocardium so the condition is also called myocardial infarction or MI.
Let us write in a nutshell when any of the artery giving blood supply to the heart wall gets partial or complete blockage the heart wall gets deprived of oxygen which is coming along with blood,the heart wall starts getting damaged and the person feels chest pain (Angina),the outcome depends on blockage extent and other factors we would discuss later.To be continued!
So,I have discussed so far about heart attack;to summarize 1.Heart is a pump which keeps blood circulation to all body parts through pipelines(blood vessels).2.Heart’s own walls also need blood supply which is done via three main pipes( LAD,LCX,RCA).3.There may be blockage in any of the three pipes by blood clot or fat or both which leads to partial or complete obstruction of the supply.4.Blood supply is important for oxygen and glucose delivery since heart needs energy to survive and work and energy is produced by burning of glucose as a fuel and oxygen gas.5.If there is obstruction in blood flow there is mismatch of energy requirement and oxygen availability to produce energy.So in such mismatch caused by partial or complete obstruction the person complains chest pain which is called angina by medical terminology.
when we are at rest there is less energy requirement of body and heart pumping rate required to meet the energy need of the body is less,so the heart’s own energy requirement is also less.So many times when the obstruction of pipes supplying heart wall is partial;the angina can be relieved by rest.
Many persons gets confused regarding chest pain and they get apprehensive that they may have heart attack.I am providing you some insights about this to improve your understanding and clear your doubts.
1.If the chest pain increases on brisk walking, climbing ,dancing or any form of exertion and gets relieved by rest.This may be angina or pain originating from heart.
2.If you can locate your pain chest by single finger it is not anginal pain in the most cases and may be relieved by simple analgesics sold over the counter.
3.If chest pain increased or decreased by change of posture , folding and unfolding at shoulder or elbow joint,it is not anginal pain.Such pains can be relieved by muscle relaxants and general analgesics.
4.Angina is generally dull pain and poorly localized chest pain which appears during exertion or it may appear during extreme emotional stress.
5.Chest pain may appear in empty stomach due to distension caused by gas,such pain is also dull and can be relieved by food ,antacids,h2 blocker like ranitidine or proton pump inhibitor like omeprazole(not safe for pregnant women or children).Such pain would be worse,if you use analgesics like NSAIDS(Non Steroidal Anti Inflammatory drugs like disprin,ibuprofen,paracetamol,diclofenac sodium etc.
Note:Person suffering from diabetes may not have anginal pain and they may just feel chest discomfort or shortness of breathe during heart attack.
Risk factors for heart attack:
1.Smoking -Both active and passive smoking increases the risk of heart attack.
Smoking promotes the blood clottings so there is more chance of blockage in pipe supplying blood to the heart wall.
2.If you have truncal obesity you are at increased risk of heart attack.Truncal obesity means your belley is laden with fat.You can pinch your skin fold at the side of your abdomen and the thickness of fold can be can be assessed by your index finger and thumb.
3.If you are heavy alcoholic you are at increased risk.Though many people argues in favor of moderate drinking,but I opine that people seldom go for moderation those who claim to be moderate drinkers too frequently take heavy drinks on occasions.Further drinking also increases the risk for liver cancer ,peptic ulcer,psychosis secondary to vitamin B1 deficiency.
4.If you have uncontrolled diabetes,you are at risk.
5.If your life style is sedentary and you do not do exercise,you are at increased risk.You should do minimum 150 minutes exercise per week.Be careful in exercise.Don’t do heavy exercise at once.You are required to gradually increase the level and duration of exercise and try to maintain your hydration by taking liquids otherwise your exercise may land you in serious trouble.
6.If in your blood,bad cholesterol level is high and/or good cholesterol level is low you are at increased risk.First of all you need to understand good cholesterol and the bad cholesterol.After the dinner at around 9 P.M.do not eat anything except water.Next morning empty stomach go to clinical lab and give your blood sample for Lipid Profile testing.When you get the report, see the parameters tested
-HDL High Density Lipoprotein
-LDL Low density lipo protein
-VLDL Very low density lipoprotein
-Triglyceride additionally you may get IDL Intermediate density lipoprotein
In all those parameters the HDL is good cholesterol for your heart because it cleans your blood pipelines’fat.Rest all are bad for your heart.
Now the question is how we can increase good fat and decrease bad fat in our blood.
All the animal fats are bad except fat from small fish.
Sunflower oil,safflower oil,olive oil and soyabean oil are good fat.
Palm oil and hydrogenated vanaspati are bad for your heart.
One important message I have to give that the mustard oil is also rich in good fat but be careful about this and do not reheat or reuse the mustard oil after one cooking because it is converted on trans fat which is bad for your heart.
You can easily assess your lipid profile yourself by just checking the normal values of the parameter tested and the patient’s actual value.If the patient value in the report is within the given normal range of that parameter then It is O.K.
To be continued….
7.If you have high blood pressure and you have not controlled it with your life style modification or drugs;you are at increased risk of heart attack.High blood pressure in your pipelines causes your heart to work more against increased load,so the energy requirement of your heart increases,so the oxygen requirement is also increased.Apart from this chronic uncontrolled blood pressure also cause enlargement of heart which can not be reversed back if you control your blood pressure after that change.So person with high blood pressure should keep control on that by prescribed medicine or alternative methods.Medicine choice varies from person to person and your doctor would decide which medicine would be suitable to you.Apart from medicine,there are alot of alternative options for controlling blood pressure.Low salt diet is one option.By low salt I mean table salt that is sodium chloride.One should not take more than 5 gram table salt per day.If you are religious person and believe in fasting and fruit and salt free diet,it may be good thing for you to observe such fast to reduce your blood pressure.You may use natural diuretics like tea or coffee which will cause excessive urination and sodium would be reduced from your blood.
8.If you are a Type-A personality,very much ambitious and restless to achieve your hard goal,you are at increased risk of heart attack.You should do meditation and yoga.Further to relax yourself try to write diary to pour out your thoughts on paper which would release your burdens.Try to live your life in present only.Engage yourself with children,pets and optimistic people.
What would you do,if you are sure that the person is having chest pain or discomfort is characteristic of heart attack?
1.Make emergency call for medical assistance on number applicable to your local area.
2.Relieve his emotional stress by giving him assurance that nothing has happened.Since emotional stress would cause his heart to beat faster leading to increased energy and oxygen demand of the heart.And the situation would be worse.
3.Don’t allow the person to walk on his on.The person should be moved to hospital with least effort from his side.Ideally he should be moved on stretcher by other fellows.Any exertion done by the patient would increase the energy and oxygen demand of his heart and would spoil his condition.
4.Person should have fresh air for breathing,if one can avail oxygen cyllinder,it is a good idea to oxygenate the person in the way to hospital.
5.Some coronary dilater-medicine which dilates the pipelines supplying the heart wall like isosorbide dinitrate 5 mg is used below tongue to relieve the anginal pain.
6.Aspirin can be used as first aid measure if you are certain that the person has got heart attack.Since this prevents the clotting of the blood in the pipeline.
warning!the purpose of this article is educational in nature you are advised to act according to your doctors’advice.