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Diabetes

Diabetes

Diabetes is a heterogeneous group of disorders which result in impaired regulations of carbohydrates and nutrients.

This means that Diabetes and its symptoms are - not just one disease but different diseases which give the same symptoms, like high blood glucose, Cholesterol and Triglyceride levels etc and cause long term complications. The basic underlying mechanism is decreased action of Insulin-either due to its deficit ( Diabetes type 1) or due to its lower effectiveness ( Diabetes type 2).




Symptoms of Diabetes PDF Print E-mail
Diabetes
Written by Dr Rajesh Kesari MD   
Thursday, 07 January 2010 07:12

Diabetes Symptoms

Diabetes Type 1

Diabetes type 1 develops at an early age ( from a small child to young age)  and symptoms may be noticed like:

Excessive urination

Excessive thirst

Failure to put on body weight or weight-loss despite good appetite

Dry skin

A typical fruity odour from breath may be the result of high ketones in blood

Type 1 Diabetes patients are frequently diagnosed only when they have suffered from Diabetic Ketoacidosis .

 

Diabetes Type 2

In 95% of Diabetes type 2 patients no diabetes symptoms may be seen, so symptoms themselves cannot be the guiding arrow for testing Blood Glucose , Diabetes in such patients may frequently be detected because of symptoms of complications of Diabetes like High Blood Pressure, Angina,  eye complications etc..Such patients may also be suffering from other conditions such as thyroid which may mask the symptoms of Diabetes.

But if blood sugar levels are quite high some symptoms may be present like:

Excessive thirst, urination

Weight Loss

Weakness

Pain or burning in legs

Breathlessness

 

Who should test blood glucose regularly

Last Updated on Thursday, 07 January 2010 08:15

 

What is Diabetes? PDF Print E-mail
Diabetes
Written by Dr Rajesh Kesari MD   
Wednesday, 30 December 2009 06:20

Diabetes-Simplified

Diabetes is a condition of body in which levels of Glucose in Blood are above normal simply put- the whole body is drenched in a 'bloody syrup'

Normal Blood Glucose

It is normal and necessary to have some glucose in the blood! but not higher than the tolerable levels... Normal Glucose levels are considered to be:

Fasting ( without having any food for 8 hrs) less than 100mg/dl

Source of Blood Glucose

Glucose in the Blood is derived from the food we eat. Different foods contain different amounts of glucose, even if they contain the same amount of glucose the way it is absorbed in the blood may be different, as is determined by the Glycemic index of the food. Carbohydrates are most easily converted to glucose in the body by the process of Digestion. The Glucose present in foods is quickly absorbed in the stomach and intestines and from there on into blood.

Glucose Powerhouse

Glucose is the most important, and readily usable source of energy in our body- like electricity in the house or petrol/fuel in car... We simply cannot function without it. Most of the organs do have some stores of energy like fatty acids, glycogen etc. but the most  vital organ -brain does not have any stores of its own - it needs glucose derived from blood for its energy each and every minute (remember, brain is an energy guzzling organ- it uses more energy by weight than any other organ in the body) and we need the brain to be working inorder to survive just as well. So our body stores glucose in various organs like Liver, Muscles or in form of some fats like Triglycerides and clears it from the blood.

When we have not eaten for some time and already utilized the glucose present in the blood after meals or snacks or any food for that matter, glucose is released from the stores of the body...

Insulin the 'Conductor'

Insulin is the Hormone which plays the role of Conductor here- it tells the various organs and cells either to store Glucose or release it into Blood Stream. When Insulin levels are high in the Blood Stream Glucose is stored in the cells...When its levels fall Glucose is released from its stores (Primarily Liver).

If Insulin looses its effectiveness- Blood Glucose is not mobilized properly 'into' the cells ( stored)- High Glucose after meals; or may 'gate crash' into blood stream from its 'stores, without proper Insulin 'invitation' as happens when Fasting Blood Glucose is High. The high levels of glucose in the blood are responsible for all the complications of Diabetes Like CAD & CVD ( Diseases of Blood vessels leading to Heart Attack & Stroke),  Retinopathy ( Blindness), Nephropathy ( Kidney Failure), Diabetic Foot, Neuropathy ( Disease of Nerves) etc...

Last Updated on Wednesday, 30 December 2009 09:35

 

Insulin PDF Print E-mail
Diabetes
Written by Dr Rajesh Kesari MD   
Tuesday, 08 December 2009 14:07

Insulin is a hormone secreted by the endocrine part of the organ pancreas.Pancreas in our body

Pancreas is located just below the Diaphragm near stomach. It has two main parts- the exocrine and the endocrine parts.

Exocrine Pancreas-Enzymes & juices

The exocrine pancreas secretes enzymes like amylase, lipase etc. into the intestines through a duct ( or pipe), these enzymes (chemicals substances) help in the breakdown of proteins and their subsequent digestion.

Endocrine Pancreas-Hormones

Insulin factoryThe other important part of the pancreas is the endocrine part- it consists of the islets of Langerhans ( named after Paul Langerhans who first described them in 1869) these are groups of cells which produce and secretes hormones directly into the blood circulation. About one million of these islets are scattered all over the pancreas of a healthy adult. By weight this part of pancreas constitutes 1-1.5 gms (hardly 1-2%) of the whole organ, but its functional importance is of tremendous value.

Beta Cells-Insulin factory

The Islets of Langerhans contain five different groups of cells each responsible for secretion of different hormones, namely Insulin, Glucagon, Somatostatin, Pancreatin, and Ghrelin Insulin is secreted by the Beta cells of the islets of Langerhans. It is released directly into the blood circulation by the beta cells. Insulin release is triggered by the rise of glucose levels in the blood flowing past the beta cells.

Insulin

The Beta cells contain huge amount of insulin stored in the storage vesicles inside the cells, but the quantity of insulin which can be immediately released into the blood circulation is limited. Once released into the circulations insulin travels with blood to all the parts of the body. Cells which require insulin have insulin receptors (sort of antenna’s hanging out on their external walls). These are most abundant in Muscles, Liver, Adipose (fat) tissue, Kidneys, Nerve cells etc. Glucose is absorbed by these cells and either utilized immediately for providing energy or stored as glycogen (animal starch) or Fat as energy reserve or store which can be later on converted to glucose and utilized for generating energy. Insulin has many other effects in the body which make it of such a great importance, some of the prominent effects of insulin are: Glucose, energy metabolism Fat metabolism Protein synthesis, Growth stimulation In Type 1 Diabetes these types of cells are destroyed by the immune system of the body and the body is unable to produce any of its own insulin- hence arises the need for insulin injections. Whereas in Type 2 Diabetes, the action of Insulin on various tissues of the body is insufficient, this is also termed as insulin resistance; hence pancreas, more specifically Beta cells release more insulin into circulation to compensate for the inefficient insulin or insufficient action of insulin. Initially the pancreas may be able to compensate and keep the Blood glucose levels under control, but the other effects of insulin deposition of fat, damage to blood vessels, excessive protein synthesis have adverse effects and result in complications of Diabetes.

Last Updated on Thursday, 25 March 2010 07:52

 

Type II Diabetes PDF Print E-mail
Diabetes
Written by Dr Rajesh Kesari MD   
Thursday, 04 June 2009 06:35

Diabetes Mellitus Type II or Type 2 Diabetes

( Earlier called Non Insulin dependent Diabetes Mellitus - NIDDM)

 

Diabetes type II is the largest prevalent type of diabetes in the world, approximately 90-95% of Diabetics in the world are suffering from Type 2 diabetes. 

Causes

Type II Diabetes is caused due to relative deficiency of insulin. This means in simple terms that Insulin is present in the body as against type I Diabetes in which insulin is practically absent, But this insulin is not doing its job well enough, hence more and more of it is required which the pancreas are not in a posistion to supply, They are simply 'exhausted'.

Age of onset

 
This type of Diabetes is recognised in adult age generally after 30 yrs of age - more often after 45-50 yr. The overweight and obese are more affectedwith Type II Diabetes than thin and lean.  

Metabolic Syndrome

 
This type of Diabetes is frequently present together with High Blood Pressure and High Blood Cholesterol- the constellation of these three together is called metabolic syndrome- its virtually there in every type II Diabetic.

Such patients are more prone to heart disease like heart attacks, Angina pain, Stroke and paralysis, Peripheral vascular disease- which give tingling

exercise in diabetes

 sensations and weakness after walking or standing for long time. 

 Treatment 

Persons suffering from this type of Diabetes may may be treated with oral medicines- even though eventually they also may have to take insulin injections.

 

Exercise 

Exercise is very helpful to such patients- exercise improves the effectiveness of Insulin many fold.
Decreasing weight in overweight and obese persons may also increase control of blood sugar and decrease requirement of medications.
 
Ketoacidosis is very rare in Type II Diabetics.
 

Diet

Appropriate diet also plays a very important role in treatment of Type 2 Diabetes, The type and quantity of food have important bearing on the blood glucose and cholesterol levels, more information about

Food in Diabetes,

Diet in Diabetes

Diabetes friendly Recipes 

Last Updated on Wednesday, 30 June 2010 11:40

 

Type 1 Diabetes PDF Print E-mail
Diabetes
Written by Total Control team   
Thursday, 04 June 2009 06:11

Type 1 Diabetes

Cause

Type 1 Diabetes Mellitus is characterized by high fasting and Post meal blood glucose levels. The reason for this is complete absence of insulin in the body. Due to destruction of beta cells in pancreas which produce the insulin- no insulin is formed and secreted at all. Such patients may require lifelong insulin injections.

insulin bottle

Growth & Complications

This disease may be diagnosed even in early childhood which makes it all the more important. Insulin is not only required for controlling Bloo glucose but its essential for the proper growth of the child as well. If a Diabetic child is not given sufficient insulin his or her growth may be inadequate. Complications of Diabetes may manifest at a relatively young age.

 

Ketoacidosis

 

Even small infections may precipitate Diabetic Ketoacidosis in Type 1 Diabetics- hence the 'Sick day rule':-

On days when you fall ill ( due to any illness be it flu, cold cough or tummy problems like loose motions etc..) Even if you are not eating bu you are on insulin you must take atleast small doses of insulin.

Ketones can be easily checked by urine dipstick for ketones, if unrine ketones are positive visit your doctor for further advice.

 

Normal & Successful  life with Diabetes

 

But with proper understanding of Diabetes and its monitoring,  Blood glucose levels can be controlled and complications of Type 1 Diabetes avoided.

An encouraging fact is many of the famous sports personalities are suffering from it, yet they are able to maintain their strenuos regimens and keep Blood Glucose under control as well.

 

Last Updated on Wednesday, 06 January 2010 16:31

 




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