Professional Documents
Culture Documents
By Sumedha Sharma
Diabetes
abetes is not a newly born disease, it has been with human race from long
back but, we came to knew about it in 1552 B.C.
Since this period, many of Greek as well French
physicians had worked on it and made us aware of
the nature of disease,
e, organs responsible for it etc. In
1870s, a French physician had discovered a link
between Diabetes and diet intake, and an idea to
formulate individual diet plan came into picture.
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Diabetes was recognized with complete details and its types (Type 1and Type 2
diabetes - that is insulin dependent and non insulin dependent) in the year, 1959.
As we know this is one of the old diseases, existing
ting in many individuals and still
on rising charts. Hence, scientists are continuously working to relieve us from it,
by discovering the relevant drugs and making new researches.
Symptoms of Diabetes
In both types of diabetes, signs and symptoms are more likely to be similar as
the blood sugar is high, either due to less or no production of insulin, or insulin
resistance.. In any case, if there is inadequate glucose in the cells, it is identifiable
through certain signs and symptoms. These symptoms are quickly relieved once
the Diabetes is treated and also reduce the chances of developing serious health
problems.
Diabetes Type 1:
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Diabetes Type 2:
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hunger. In order to cope up with high sugar levels in blood, body produces
insulin which leads to increased hunger.
Weight flactuation : Factors like loss of water (polyuria), glucosuria ,
metabolism of body fat and protein may lead to weight loss. Few cases
may show weight gain due to increased appetite.
Blurry vision : Hyperosmolar hyperglycemia nonketotic syndrome is the
condition when body fluid is pulled out of tissues including lenses of the
eye, which affects its ability to focus, resulting blurry vision.
Irritability : It is a sign of high blood sugar because of the inefficient
glucose supply to the brain and other body organs, which makes us feel
tired and uneasy.
Infections : The body gives few signals whenever there is fluctuation in
blood sugar (due to suppression of immune system) by frequent skin
infections like fungal or bacterial or UTI (urinary tract infection).
Poor wound healing : High blood sugar resists the flourishing of WBC,
(white blood cell) which are responsible for body immune system. When
these cells do not function accordingly, wound healing is not at good pace.
Secondly, long standing diabetes leads to thickening of blood vessels
which affect proper circulation of blood in different body parts.
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Type 1 diabetes
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Type 2 diabetes
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previous case and if both the parents are diabetic, the child has much
greater risk for diabetes.
Age : Increased age is a factor which gives more possibility than in
younger age. This disease may occur at any age, but 80% of cases occur
after 50 year, incidences increase with the age factor.
Poor Diet (Malnutrition Related Diabetes) : Improper nutrition, low
protein and fiber intake, high intake of refined products are the expected
reasons for developing diabetes.
Obesity and Fat Distribution : Being overweight means increased insulin
resistance, that is if body fat is more than 30%, BMI 25+, waist grith 35
inches in women or 40 inches in males.
Sedentary Lifestyle : People with sedentary lifestyle are more prone to
diabetes, when compared to those who exercise thrice a week, are at
low risk of falling prey to diabetes.
Stress : Either physical injury or emotional disturbance is frequently
blamed as the initial cause of the disease. Any disturbance in
Cortiosteroid or ACTH therapy may lead to clinical signs of the disease.
Drug Induced: Clozapine (Clozaril), olanzapine (Zyprexa), risperidone
(Risperdal), quetiapine (Seroquel) and ziprasidone (Geodon) are known
to induce this lethal disease.
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Infection : Some of the strephylococci is suppose to be responsible factor
for infection in pancreas.
Sex : Diabetes is commonly seen in elderly especially males but, strongly
in women and those females with multiple pregnancy or suffering from
(PCOS) Polycystic Ovarian Syndrome.
Hypertension : It had been reported in many studies that there is direct
relation between high systolic pressure and diabetes.
Serum lipids and lipoproteins : High triglyceride and cholesterol level in
the blood is related to high blood sugars, in some cases it has been
studied that risk is involved even with low HDL levels in circulating blood.
Diabetes Diet
Diet plays a significant role in controlling the diabetes. The diabetic diet may be
used alone or else in combination with insulin doses or with oral hypoglycemic
drugs. Main objective of diabetic diet is to maintain ideal body weight, by
providing adequate nutrition along with normal blood sugar levels in blood. The
diet plan for a diabetic is based on height, weight, age, sex, physical activity and
nature of diabetes. While planning diet, the dietician has to consider
complications such as high blood pressure, high cholesterol levels.
With respect to the above factors, a dietician will assess calories to be given, like
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Diabetics always need to take care of their diet and also about the food they eat.
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Care has to be taken because all foods contain not only carbohydrate, but also
some energy value. Protein and fat available in the food are converted to glucose
in the body. This glucose has some effect on the blood sugar level, which has to
be taken care of. Furthermore, you neednt have to eat only the bland boring
diet. Instead, you can eat more fruits, vegetables and whole grains. All it means
is that you need to select foods that are high in nutrition and low in calories.
1. Diet Management
Management During Diabetes
2. Diabetes Care
Most of the food items contain carbohydrate, protein and fat. Cereals are rich in
carbohydrate, lentils, lean meat, chicken and fish are rich in protein while oils,
nuts and milk creams are rich in fat. Fat foods are high in calories; 1g of it
provides 9 calories, while 1g carbohydrate or 1g protein gives only 4 calories.
Carbohydrate is easily digested than fat and protein. The rise in blood glucose
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In people with no diabetes, the rise in blood glucose after a meal comes down to
the pre-meal level with in 2 hrs. In diabetes, the rise in blood glucose after a
meal is not only higher but the fall to pre-meal level is slower (3-4 hrs).
Therefore, snacks in between meals or frequent meals at short intervals tend to
cause progressive increase in blood glucose in people with diabetes.
Glucose is constantly needed to provide ready energy for the proper functioning
of brain, heart, kidneys, liver and blood cells. When glucose is not available
from ingested food, our liver produces from its store of carbohydrate (glycocen)
and body stores of fats and proteins. The liver produces about 0.1058 oz of
glucose/lbs body weight in a day. For example the liver of a man or woman
weighing 154 lbs produces 7.0547 oz of glucose in a day. The production of
glucose by the liver is kept in a check by small amounts of insulin secreted by
the pancreas.
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These considerations and the modality of your treatment (tablets/insulin) are
taken into account for formulating your diet management during diabetes and
meal timings. The dietician would give your information on your diet.
In a typical days meals and snacks, you should have 1500-1800 calories with
60% contribution from the carbohydrate, 20% from fat and 20% from proteins.
You may need extra weight reduction. If you are on calorie-restricted diet, make
sure to take 50-60% of calories as complex carbohydrate (whole cereals) to
prevent any feeling of weakness.
You should eat a variety of food items everyday. Do not skip meals. Avoid
snacks, unless you are advised to (example during insulin treatment).
Dont over eat.
Eat fruits and vegetables. Use less oil in cooking. Avoid fried foods, milk
cream or food items cooked in coconut milk.
Avoid ready to eat food preparations, sweets and sugary drinks (canned
beverages) that provide empty calories (no vitamin or essential
minerals).
Keep a regular check on your weight maintain it within the estimated
limit.
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Diabetes Care
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Eat about the same amounts of
food each day
Eat your meals and snacks at about the same times each day
Make sure the gaps between your meals are short
Do not eat fast; masticate and munch your food well before you
swallow
Drink a lot of water that will help flush the toxins off your system
Avoid fried foods and sweetmeats
Include fresh vegetable salad in every meal
Include sprouts in the diet
Take your medicines at the same times each day
Exercise at about the same times each day
Avoid smoking. Smoking leads to heart disease and poor
circulation
Check your feet for cuts, blisters, and swelling which are likely to
result from diabetes-related nerve damage
Take good sleep daily
Check your blood sugar level regularly
Try to stick up to the plan made up for sugar control
Check the other tests such as kidney function, liver function, heart
function, ketone level etc
Check your weight periodically and maintain ideal body weight
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Increase fiber intake in the form of raw fruits, vegetables, whole
cereals etc
Intake of cinnamon, garlic, onion, bitter melon, guar gum is known
to considerably reduce blood glucose level
Don't fry foods instead bake, boil, poach or saut in a nonstick pan.
Steam or microwave vegetables. Buy tuna packed in water, not oil
Eat less high-fat red meat and more low-fat turkey and fish. Avoid
organ meats
Limit the use of condiments such as ketchup, mustard and salad
dress ion--they're high in salt and can be high in sugar, too
Rinse processed foods in water and, wherever possible, choose
fresh foods over canned
Limit your salt (sodium content)
Read labels carefully. Soy sauce, brine and MSG, for example,
contain a lot of sodium
Don't select ready to eat and junk foods items available to you
Don't smoke and stop alcohol consumption
Don't skip meals and medicine times
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Diabetes Complications
Diabetic retinopathy shows symptoms of pain in the eyes and may even
result in loss of vision.
Renal (kidney) disease shows symptoms of swelling (edema) in the feet
and legs. It then passes over total body and as the disease progresses,
blood pressure also increases.
Tingling, burning, numbness, tightness, shooting or stabbing pain in the
hands, feet or other parts of your body, especially at night. Digestive
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problems also occur if, the nerves controlling internal organs get
damaged (autonomic neuropathy).
You may have scanty or profuse sweating, difficulty of sensing when your
bladder is full, when there is a low blood sugar, increased sexual
problems, weakness, dizziness, and fainting.
Chest pain (angina) or shortness of breath dizziness or light headache,
shoulder or stomach pain, fast heartbeat. You might not show any
symptoms until having a heart attack or stroke.
When alarming symptoms given by the body are ignored and the same status is
maintained, it starts damaging body organs, such as heart, kidney, eye, feet, and
skin. The physiology for each and every affected organ is explained one by one.
Diabetes Control
Whether your treatment consists of diet alone, diet and tablets or diet and
insulin, you need regular blood tests to keep a check on your blood sugar. Urine
sugar test is not a reliable indicator of diabetes control.
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When blood glucose remains higher than 200mg/dl for 8-10 8 weeks, the
concentration of glycosylated hemoglobin (HbA1c) arises. A (HbA1c)
measurement therefore reflects the blood glucose control over a preceding 2-3 2
months period, while the estimates of blood glucose indicate the glucose value at
the time of blood test. HbA1c values between 6-7%
6 7% indicate very good control
on diabetes. You should
aim at keeping your blood
glucose in the normal range
i.e. between 90-130 mg/dl
while fasting and less than
180 mg/dl after meals
and HbA1c around 7%.
Frequent tests for blood
glucose are necessary
when starting treatment with
insulin.
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Urine test for sugar is not reliable indicator of diabetes control. Although
spillage of sugar in urine occurs when the blood glucose exceeds 180 mg/dl in
the majority of healthy persons, this is not always so in a patient with diabetes.
Most patients with diabetes of many years acquire an increase in the renal
threshold for glucose (capacity to prevent spillage of glucose into urine). Hence
urine test for glucose is not helpful for assessing control of diabetes.
diabetes In the
presence of urinary infections, the bacteria eats up the sugar present in urine,
thereby making urine test for sugar unreliable.
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