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In as much as the diabetic has to take care in adding calorie contents in his meals, a diabetic should seek the assistance of a dietitian to come up with a diabetic meal plan that will suit his medical condition. A diabetic meal plan is more of a guide on the right foods to include in a diabetic meal. Others are prone to think that a diabetic meal plan is a set of menus that make up each daily meal.
However, diabetes is categorized as type 1 and type 2. In type 1 diabetes, the patient does not produce enough insulin hence, the failure in glucose absorption. In type 2 diabetes, the patient may be capable of insulin production but his body cells are insulin resistant, thus, there is still failure in glucose absorption. Hence, despite the ability to produce insulin, he still has to adhere to a diabetic meal plan to lessen his glucose intake.
The type 2 diabetes often occurs in overweight or obese individuals and it is said that the insulin resistance is affected by the presence of too much body fat. Hence, in the treatment of diabetes for both types, a diabetic meal plan should also be supported by a proper exercise regimen especially if the patient is suffering from type 2 diabetes.
Once a person is diagnosed with diabetes, his diabetic meal plan will play an important role in keeping his numeric health indicators at a managed level. He will be required to monitor his blood pressure and glucose levels and at the same time take down notes which food may have caused a significant increase in his blood pressure and blood sugar levels.
There are a lot of food guides available which can be used in planning a diabetic meal. A doctor or a dietitian can help you interpret the significance of the color codes, a list or the counting process that will serve as your guide. You will find out that a diabetic meal plan need not be boring or unappealing but can have a wide array of choices to make each meal as regular as any balanced diet.
Basically, your main concern in your diabetic meal plan are foods that have low sugar content, low in fat and low in salt or sodium. This is actually the same diet recommended even to non-diabetics in order to keep the body supplied with proper nutrition. Hence, a diabetic meal plan can also be beneficial not only for the diabetic patient but even for the whole family. It will curtail the possibilities of the same disorder occurring to family members who may also be susceptible to low or insufficient insulin production.
Usually your diabetic meal plan should be about a third of fruits and vegetables, another third should come from breads, potatoes and cereals and the remaining third should come from meat, dairy products or dish. The remaining minimum portion can contain fats and sugar at a controlled level.
In addition, good health is promoted not only by a well laid out diabetic meal plan but also by a regular exercise program to burn the stored calories, causing overweight and health disorder.
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Article by Pankaj Nagpal
Diabetic Retinopathy Treatment in India at Mumbai and Delhi At low Cost
Q. What is Diabetic Retinopathy ?
it is a complication of diabetes that is caused by changes in the blood vessels of the retina. When blood vessels in the retina are damaged, they may leak blood and grow fragile, brush-like branches and scar tissue. This can blur or distort the vision images that the retina sends to the brain.
Diabetic retinopathy is a condition occurring in persons with diabetes, which causes progressive damage to the retina, the light sensitive lining at the back of the eye. It is a serious sight-threatening complication of diabetes.
Diabetes is a disease that interferes with the body’s ability to use and store sugar, which can cause many health problems. Too much sugar in the blood can cause damage throughout the body, including the eyes. Over time, diabetes affects the circulatory system of the retina.
Apart from the basic eye examination, a thorough fundus examination after dilatation of pupil by indirect ophthalmoscopy is necessary to diagnose diabetic retinopathy. If all the required information cannot be obtained by clinical examination, an investigation called F.F.A (Fundus Fluorescein Angiography) is advised in diabetic patients In the early stages of diabetic retinopathy, Argon Laser Photocoagulation is used to control the disease and maintain the existing vision. Depending upon the severity of the disease each eye may be given One to Four sittings of Laser treatment. Diabetic retinopathy is classified into two types : -
1. Non-proliferative diabetic retinopathy (NPDR) is the early state of the disease in which symptoms will be mild or non-existent. In NPDR, the blood vessels in the retina are weakened causing tiny bulges called microanuerysms to protrude from their walls. The microanuerysms may leak fluid into the retina, which may lead to swelling of the macula.
2. Proliferative diabetic retinopathy (PDR) is the more advanced form of the disease. At this stage, circulation problems cause the retina to become oxygen deprived.
As a result new fragile blood vessels can begin to grow in the retina and into the vitreous, the gel-like fluid that fills the back of the eye. The new blood vessel may leak blood into the vitreous, clouding vision. Other complications of PDR include detachment of the retina due to scar tissue formation and the development of glaucoma. Glaucoma is an eye disease defined as progressive damage to the optic nerve. In cases of proliferative diabetic retinopathy, the cause of this nerve damage is due to extremely high pressure in the eye. If left untreated, proliferative diabetic retinopathy can cause severe vision loss and even blindness.
Stages of Diabetic Retinopathy
Diabetic retinopathy has four stages : -
1. Mild Nonproliferative Retinopathy At this earliest stage, microaneurysms occur. They are small areas of balloon-like swelling in the retina’s tiny blood vessels. 2. Moderate Nonproliferative Retinopathy As the disease progresses, 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 vessels 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, severe vision loss and even blindness can result.
Diabetic retinopathy can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on evaluation of the retina and macula, may include : -
• Patient history to determine vision difficulties experienced by the patient, presence of diabetes, and other general health concerns that may be affecting vision• Visual acuity measurements to determine the extent to which central vision has been affected• Refraction to determine the need for changes in an eyeglass prescription• Evaluation of the ocular structures, including the evaluation of the retina through a dilated pupil• Measurement of the pressure within the eye
Supplemental testing may include : -
• Retinal photography or tomography to document current status of the retina• Fluorescein angiography to evaluate abnormal blood vessel growth
Symptoms diabetic retinopathy
Often there are no symptoms in the early stages of the disease, nor is there any pain. Don’t wait for symptoms. Be sure to have a comprehensive dilated eye exam at least once a year.
Blurred vision may occur when the macula-the part of the retina that provides sharp central vision-swells from leaking fluid. This condition is called macular edema. If new blood vessels grow on the surface of the retina, they can bleed into the eye and block vision.
In patients with diabetes, prolonged periods of high blood sugar can lead to the accumulation of fluid in the lens inside the eye that controls eye focusing. This changes the curvature of the lens and results in the development of symptoms of blurred vision. The blurring of distance vision as a result of lens swelling will subside once the blood sugar levels are brought under control. Better control of blood sugar levels in patients with diabetes also slows the onset and progression of diabetic retinopathy. Often there are no visual symptoms in the early stages of diabetic retinopathy. That is why the American Optometric Association recommends that everyone with diabetes have a comprehensive dilated eye examination once a year. Early detection and treatment can limit the potential for significant vision loss from diabetic retinopathy.
Treatment of diabetic retinopathy varies depending on the extent of the disease. It may require laser surgery to seal leaking blood vessels or to discourage new leaky blood vessels from forming. Injections of medications into the eye may be needed to decrease inflammation or stop the formation of new blood vessels. In more advanced cases, a surgical procedure to remove and replace the gel-like fluid in the back of the eye, called the vitreous, may be needed. A retinal detachment, defined as a separation of the light-receiving lining in the back of the eye, resulting from diabetic retinopathy, may also require surgical repair.
If you are a diabetic, you can help prevent or slow the development of diabetic retinopathy by taking your prescribed medication, sticking to your diet, exercising regularly, controlling high blood pressure and avoiding alcohol and smoking.
Causes of diabetic Retinopathy
Diabetic retinopathy is the result of damage to the tiny blood vessels that nourish the retina. They leak blood and other fluids that cause swelling of retinal tissue and clouding of vision. The condition usually affects both eyes. The longer a person has diabetes, the more likely they will develop diabetic retinopathy. If left untreated, diabetic retinopathy can cause blindness.
Q. What does diabetic Retinopathy causes ?
Blood vessels damaged from diabetic retinopathy can cause vision loss:
Fluid can leak into the macula, the area of the retina which is responsible for clear central vision. Although small, the macula is the part of the retina that allows us to see colors and fine detail. The fluid causes the macula to swell, resulting in blurred vision.
In an attempt to improve blood circulation in the retina, new blood vessels may form on its surface. These fragile, abnormal blood vessels can leak blood into the back of the eye and block vision Risk factors for diabetic retinopathy include : -
• Diabetes : – people with Type 1 or Type 2 diabetes are at risk for the development of diabetic retinopathy. The longer a person has diabetes, the more likely they are to develop diabetic retinopathy, particularly if the diabetes is poorly controlled.
• Race: – Hispanic and African Americans are at greater risk for developing diabetic retinopathy.
• Medical conditions : – persons with other medical conditions such as high blood pressure and high cholesterol are at greater risk.
• Pregnancy : – pregnant women face a higher risk for developing diabetes and diabetic retinopathy. If gestational diabetes develops, the patient is at much higher risk of developing diabetes as they age.
If remains untreated it may lead to severe diseases such as Glaucoma and Ratinal Detachment.
Q. How does diabetes affect the retina ?
Patients with diabetes are more likely to develop eye problems such as cataracts and glaucoma, but the disease’s affect on the retina is the main threat to vision. Most patients develop diabetic changes in the retina after approximately 20 years. The effect of diabetes on the eye is called diabetic retinopathy.
Over time, diabetes affects the circulatory system of the retina. The earliest phase of the disease is known as background diabetic retinopathy. In this phase, the arteries in the retina become weakened and leak, forming small, dot-like hemorrhages. These leaking vessels often lead to swelling or edema in the retina and decreased vision.
The next stage is known as proliferative diabetic retinopathy. In this stage, circulation problems cause areas of the retina to become oxygen-deprived or ischemic. New, fragile, vessels develop as the circulatory system attempts to maintain adequate oxygen levels within the retina. This is called neovascularization. Unfortunately, these delicate vessels hemorrhage easily. Blood may leak into the retina and vitreous, causing spots or floaters, along with decreased vision.
In the later phases of the disease, continued abnormal vessel growth and scar tissue may cause serious problems such as retinal detachment and glaucoma.
Q. How is diabetic retinopathy treated ?
Treatment for diabetic retinopathy depends on the stage of the disease and is directed at trying to slow or stop the progression of the disease.
scatter laser treatment may still be possible, depending on the amount of bleeding. During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol.
In the early stages of diabetic retinopathy, Argon Laser Photocoagulation is used to control the disease and maintain the existing vision. Depending upon the severity of the disease each eye may be given One to Four sittings of Laser treatment. In the early stages of Non-proliferative Diabetic Retinopathy, treatment other than regular monitoring may not be required. Following your doctor’s advice for diet and exercise and keeping blood sugar levels well-controlled can help control the progression of the disease.
If the disease advances, leakage of fluid from blood vessels can lead to macular edema. Laser treatment (photocoagulation) is used to stop the leakage of blood and fluid into the retina. A laser beam of light can be used to create small burns in areas of the retina with abnormal blood vessels to try to seal the leaks.
Proliferative retinopathy is treated with laser surgery. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels. Your doctor places 1,000 to 2,000 laser burns in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Because a high number of laser burns are necessary, two or more sessions usually are required to complete treatment.
Although you may notice some loss of your side vision, scatter laser treatment can save the rest of your sight. Scatter laser treatment may slightly reduce your color vision and night vision. Scatter laser treatment works better before the fragile, new blood vessels have started to bleed. That is why it is important to have regular, comprehensive dilated eye exams. Even if bleeding has started, If the bleeding is severe, you may need a surgical procedure called a vitrectomy. During a vitrectomy, blood is removed from the center of your eye.
Persons with diabetic retinopathy can suffer significant vision loss. Special low vision devices such as telescopic and microscopic lenses, hand and stand magnifiers, and video magnification systems can be prescribed to make the most of remaining vision.
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The vast majority of us buy socks for functional, formal or sporting purposes without giving much thought to what the socks are doing to our feet. Its different for a diabetic person though. Those living with diabetes have poor blood circulation and this can lead to painful foot sores. Therefore, promoting healthy feet is important and Diabetic Socks have been designed with this purpose in mind. Pairs of Diabetic Socks look for all intents and purposes look like normal socks, but they provide extra support for the feet when they are worn. Made from premium materials, Diabetic Socks benefit from a number of features that care for feet that might be at risk from a variety of infections. Top quality Diabetic Socks and Silver Socks provide comfort and care for people that live with diabetes on a daily basis.
What makes them special?
As well as the quality materials that go into making Diabetic Socks, the design of the footwear also has a great deal to say in the comfort factor. If a sock fits comfortably it reduces the risk of infection, and Diabetic Socks have been developed bearing this concept in mind. Each pair of Diabetic Socks is blessed with a soft cuff, you wont find uncomfortable binding elastic in the design of Silver Socks. They have a hand-linked toe area, and unlike standard types of foot accessories, Diabetic Socks are free from creases, they wont leave problematic pressure marks. Its essential for diabetics to look after their feet and Diabetic Socks provide comfort and support in a caring manner.
Something smells funny here
One of the main causes for concern in relation to foot care is the build up of bacteria caused by moisture. Not only does this result in unpleasant foot odour, it can prove harmful to the at risk foot. A decent pair of Diabetic Socks will help and in particular, Silver Socks are extremely effective at alleviating this problem. The silver fibres within the Diabetic Socks offer antibacterial and antimicrobial qualities, helping to keep the skin dry whilst eliminating foot odour at the sock time. You could wear the Diabetic Socks all day long, theyll keep your feet comfortable and supported and you wont feel embarrassed when you take your shoes off in the evening.
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Article by Diabetic Supplies
The computer is a powerful tool. But, what can be done at home besides sending emails to the grand kids? There is software that can be added to your current computer at home and it will help you keep track of your glucose levels. This will be invaluable to your health. It will make you life much much easier. It will eliminate your recorded diary of glucose levels. It can even make your care plan much easier. The software will keep track of your glucose levels. It will then show you all sorts of manipulations on it.
It will show you the average glucose level you had. It will show you the peaks and valleys of your sugar levels. It can even isolate a certain time of the day and give you a readout of only those levels to help you better understand what is happening at a certain time of the day, say after you eat. You can program it easily to your care plan that your physician created for your lifestyle. It will help you maintain yourself on that course. It will help you gain control over your food and nutritional levels. It will overall help your life and make your diabetes much easier to cope with. The software program can even be accounted for to understand if you are in gestational diabetes and not with it for your whole life. It will help make sure that the babies and mothers lives are healthy and within the normal ranges at all times and without any confusion. The software will help any parent with following and maintaining a course with children. It will show some direct correlations on certain foods that the child eats and their direct sugars.
The little patients will be able to be easily taught how to plan for special meals or treats that they used to have all the time. The software must of course be coupled with an accurate diabetes glucose monitor to be effective. Having a system like this is important if you want to have a healthy life with diabetes. When you do a little research online you can find all sorts of meal plans which will really help you on your diabetes path. The key to sticking with the plan is to find a variety of foods that you like and that are good parts of the plans. You can find some of these meal plans at the physicians or clinics you frequent, just be sure to ask for them.
The pamphlets you get from the clinics can be small, but they will have a great starting points as they will all have an online site which has user submitted items and reviews. This is where the gold is. This is only the best stuff which users from around the world with different tastes all like. If you struggle with your meal options and with taking control over your daily monitoring of your diabetes then you will have a difficult time. You must find methods that work and allow you to gain control over your life again.
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This chapter only concentrates on diet for type 1 and type 2 diabetics. Refer to Gestational Diabetes Diet for information on diet modification in gestational (pregnancy) diabetes. Diabetes diet is equally important for both types of diabetes: type 1 and type 2.
Type 1 diabetes diet is more specific in timing of meals, because it closely interrelates with the timing of administering insulin injection to prevent hyperglycaemia or hypoglycaemia. The time when to inject insulin depends on the type of insulin and its acting time: short-acting, long-acting or biphasic.
Type 2 diabetes diet is one single measure how to control type-2 diabetes. Eating the right food, in the right amounts and at the right time prevents peaks in blood glucose levels and optimizes glucose control.
There is no one single special diet for people with diabetes.
It is generally advised to eat a healthy balanced diet low in fat, sugar and salt, and high in fibre, fruit and vegetables.
It is recommended:
? To eat regular smaller meals and snacks rather than few big meals a day, or skipping a meals, for example breakfast.
? To reduce intake of unhealthy fat, especially unhealthy saturated fat such as oils found in fried foods, fast foods, cakes, pastries and pies.
? To choose low-fat dairy products.
? To replace intake of sugars with high glycaemic index (chocolate, chocolate bars, sweets, biscuits) for sugars with low glycaemic index such as starchy sugars – starchy carbohydrates (pulses, beans, lentils, pasta).
? To add dissolvable fibre found in cereal meals, wholemeal.
? To avoid adding extra salt to meals.
? To add fruit and vegetables to your meals, 5-a-day recommendation.
? To drink plenty of fluids in small amounts throughout the day.
? To check your intake of alcohol units per day/week and avoid binge drinking (alcohol increases levels of fats)
An animated video from the International Diabetes Federation (IDF) that brings four headline messages to the world from the global diabetes community: Diabetes is a major threat to human security; the global failure to invest in diabetes has led to the current crisis; the news is bad but we have the solutions; diabetes affects everyone and requires a collective response. Learn more at www.idf.org.
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Gestational diabetes is a temporary phase. In this type of diabetes a pregnant woman has the levels of blood sugar that are higher than normal. Till so far the exact cause of this type of diabetes is still unknown. However many doctors are of the belief that these disturbed blood sugar levels are because of an increased stress on the body of the woman. Most women do not experience any obvious symptoms of gestational diabetes. The disease remains undetected unless they go for a routine screening of diabetes during the second trimester of pregnancy.
Some doctors think that it is the placenta and its working that is the main reason of gestational diabetes. Placenta is the system that supports the growing fetus in the uterus. In the period of pregnancy placenta produces many different types of hormones. Some of these hormones are not in the favor of the efficiency of mother’s hormones.
The result is high-level of sugar in blood. Though the pancreas of the mother’s body is producing three times more insulin to counteract the placental hormones but insulin cannot enter the cells. This condition is termed insulin resistance.
Sometimes pregnant women are able to note the classical symptoms of diabetes. These are
Excessive Urination: This is the result of increased blood flow towards the kidneys so surplus sugar could be expelled through urine.
Excessive Thirst: This is the reaction to the excessive urinary output to avoid dehydration.
Extreme Hunger: The sugar consumed by the body is unable to enter the cells of the body so the cells become starved of energy. These starving cells give signals to the brain that they are hungry.
Unexplained Weight Loss: In spite of the fact that a pregnant woman is eating a lot to feed the starving cells and the growing fetus, there is a continuous decrease in the weight of the body of the mother.
The doctor may be able to see that the weight of the baby is increasing but the weight of the mom is decreasing.
Tiredness: It is very difficult to distinguish between pregnancy fatigue and the exhaustion because of diabetes. The woman may feel completely exhausted even without doing any strenuous activity. The reason again here is the lack of energy as the cells are unable to convert glucose into energy.
Irritability and Mood Swings: Again the woman may confuse this irritable behavior because of pregnancy hormones.
Blurriness in Vision: The vision of the pregnant women starts to get blurred because of an increased blood flow towards the retina of eye.
Diabetes is principally a disease of the middle-aged and elderly; more than one in ten people over 65 suffer from diabetes. Often the elderly do not have access to information about diabetes and this affects their ability and willingness to follow advice about diet, exercise and medicines. Doctors often do not have time to counsel them fully. The following information about diabetes is presented in the question-answer format. If your parents suffer from diabetes, you can ensure they have the knowledge and understanding to deal with diabetes with confidence and success.
Diabetes: What is it?
Diabetes is a condition in which there is increased sugar (glucose) in the bloodstream. This happens because the pancreas does not produce enough insulin or because the body tissues are resistant to the action of insulin.
Insulin is responsible for moving glucose from the blood into the body cells especially after meals. It acts like a key opening a door into the cell for the glucose to enter. So, when there is no insulin or when the body is resistant to its action, glucose cannot enter the cells and accumulates in the blood. Increased blood glucose, over time, leads to progressive damage to blood vessels and nerves.
Symptoms of diabetes and how are they caused?
Many people with diabetes may not have any symptoms.
Fatigue is often the first symptom. Since glucose is unable to enter the cells, the muscles tire easily because they do not have the basic fuel they need for power.
Meanwhile, the glucose that cannot get into the cells of the body builds up in the blood. The kidneys are able to reabsorb all the glucose in the blood until blood glucose level is more than 180 mg/dl. Once the glucose in the blood exceeds 180 mg/dl, it passes through the kidneys into the urine and carries water along with it. So, extra water is lost in the urine resulting in thirst and increased intake of water. So, fatigue, increased urination and increased thirst are all symptoms of glucose not being able to get into your cells.
Also, you may lose weight even though you are eating plenty of food because nutrients are unable to enter your cells.
Normal blood glucose is less than 100 mg/dl after an 8-hour fast and less than 140 mg/dl after a two-hour glucose tolerance test.)
Diagnosis of diabetes is confirmed if:
1. Blood glucose is 126 mg/dl (7.0 mmol/l) or higher after an 8-hour fast
2. Blood glucose is 200 mg/dl (mg/dl) or higher, two hours after a meal
3. Blood glucose is 200 mg/dl two hours after drinking 75 grams of glucose
(glucose tolerance test)
Prediabetes(impaired tolerance of glucose) indicating increased risk of developing diabetes in future is diagnosed if:
1. Blood glucose is between 100 and 126 mg/dl after an 8-hour fast
2. Blood glucose is between 140 to 200 mg/dl two hours after drinking 75 grams of glucose
Diabetes: Different Types
Type 1 diabetesis caused by a lack of insulin and is usually seen in children.
Type 2 diabetesis mainly because of resistance of body tissues to insulin and develops in middle-age. Ninety percent of all diabetics worldwide have type 2 diabetes.
Gestational diabetesoccurs during pregnancy. Though it disappears after childbirth, it is a sign of insulin resistance and such women are at greater risk of becoming diabetic in future.
If not controlled, the raised blood sugar level can progressively damage the delicate capillaries as well as the larger blood vessels and nerves in all tissues.
The most common complications of diabetes are:
1. Heart disease
2. Kidney failure
3. Stroke (bleeding or blood clot in the brain leading to paralysis)
5. Foot ulcers and eventual amputation
6. Decrease in general immunity leading to increased risk of infection
Principles of Treatment of Diabetes
Diabetes usually cannot be cured or reversed.
The principles of treatment are:
1. Keep blood glucose within normal limits
2. Prevent long-term complications of diabetes with the help of counseling, healthy diet, adequate exercise, and appropriate medication
3. Control associated risk factors such as smoking, obesity, increased blood pressure, high blood cholesterol, and lack of exercise.
4. Avoid prolonged physical inactivity, which is an independent risk factor for heart disease.
1. Blood glucoseshould be checked as frequently as recommended by the doctor. Blood glucose may have to be checked more frequently if diet, medications, exercise routine or health status change.
2. Hemoglobin A1cindicates how well your blood glucose has been controlled in the preceding three months. It is a better indicator of control of diabetes than individual blood glucose levels. Hemoglobin Ac1 values below 6.5 percent cut the risk of complications.
Monitoring Complications of Diabetes
1. Examine feet daily for ulcers
2. Visit your doctor regularly and follow his or her advice
3. Monitor the following:
a. Body weight and waistline
b. Blood pressure
c. Blood cholesterol
d. Kidney function (urine protein and serum creatinine)
e. Heart function (EKG, stress test, echocardiography, coronary angiography)
f. Vision (examination of eyes every 3-4 months)
Treatment of Diabetes
1. Diet is the mainstay of treatment of diabetes. In many diabetics, control of diet and reduction of body weight is the only treatment required. Doctors usually advise a gradual loss of body weight of about one pound every week. To achieve this, doctors recommend a diet rich in nutrients and fiber and low in fats and refined carbohydrates. Diabetics are encouraged to eat more vegetables, fruits, whole grains, and legumes.
2. Exerciseimproves control of diabetes by reducing blood glucose and improving insulin sensitivity. More importantly, exercise is a natural antidepressant and improves mental wellbeing and sleep.
3. Medication:If diabetes is not controlled by diet and exercise, your doctor may have to prescribe anti-diabetic tablets or insulin.
Hypoglycemia: Symptoms and Treatment
Hypoglycemia means low glucose level in the blood (below 70 mg/dl) and is usually seen in diabetics treated with insulin or anti-diabetic tablets such as Glimepiride (Amaryl), Nateglinide (Starlix), Glipizide (Glucotrol), Repaglinide (Prandin), and Glyburide (Glynase).
It is either caused by exercise, delay in meal or increased dose of anti-diabetic medications. Early signs include shaking, sweating, hunger, anxiety, weakness, dizziness, rapid heartbeat, lightheadedness, sleepiness, confusion and difficulty in speaking.
The immediate solution is to take about 2-3 spoonfuls of sugar or 4-6 glucose biscuits. Repeat after 15 minutes if the blood sugar is still low. Inform your doctor who may reduce your anti-diabetic medication.
Hypoglycemia is more common in the elderly and more dangerous so they must take extra precautions to deal with it.
1. Avoid long gaps between meals, especially after exercise or insulin
2. Always carry sugar or glucose biscuits and ingest at the first signs of hypoglycemia
3. Wear an identification bracelet stating you are a diabetic and should be given sugar if you are unconscious or confused and taken to the nearest doctor.
Precautions about Diabetes Medication
The elderly usually have more than one illness and have to take many medications several times a day. It is important to help them by labeling all medications clearly. If they are likely to miss or repeat doses, their medicines must be kept in individual boxes and labeled with the date and time when they are supposed to take them.
Elderly people with diabetes may be handicapped by insufficient knowledge of how to deal with their illness. The best way you can help your diabetic parent is to provide him or her with adequate information about diabetes. This will enable them to gain a better understanding of how to control diabetes and prevent its complications. It will also help them to be more responsible for their own health.
1. Haslett Christopher et al, eds. Davidson’s Principles and Practice of Medicine. 19th ed. Oxford: Churchill Livingstone; 2002
2. Barnard Neal, Dr. Neal Barnard’s Program for Reversing Diabetes. New York: Rodale; 2007
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