TIPS TO CONTROL DIABETIC

1]Bitter gourd (Karela) Juice with seeds or cooked vegetable. Should be consumed daily on empty stomach or in between meals. The high insulin dose of this plant helps to reduce blood and urinary sugar levels.

2]Amla A tablespoon of amla juice with a cup of karela juice is helpful. Daily. Try at least for 2 months for effective results. This mixture helps to reduce the blood sugar in diabetics because of its low glycemic index.

3]Fenugreek (methi) Fenugreek leaves and seeds. In case of seeds soak one teaspoon of seeds overnight. Half a cup of leaves should be consumed daily. Alternatively one teaspoon of seeds twice a day with milk are also helpful. This is considered to be an effective supportive therapy for the management of diabetes.

4]Spirulina Leaves or dried powder Half a cup of leaves should be consumed daily. As these leaves are not easily available, half teaspoon of dried powder can be taken every day. The soluble fibre in it stabilizes the blood sugar and cholesterol levels.

5]Neem and Basil leaves Leaves or dried powder A few neem and basil leaves everyday. In case you can't find fresh leaves half teaspoon of dried powder can be taken every day. Lowers blood sugar levels.

6]Onion Raw Daily Has diuretic and digestive property and also helps to maintain blood sugar levels.

7]Garlic Fresh (crushed) Daily Helps to control blood sugar levels

8]Black Jamun Fruit or seed powder. An equal quantity of jamun powder, amla powder and karela powder is useful. Consume 3 to 4 pieces of jamun fruits or a teaspoonful of mixture once or twice a day. Contains jamboline which helps to control the blood sugar levels.

9]Soyabean Whole beans or sprouts or soya milk or soya flour. Half cup of beans or a quarter cup of sprouts or half cup of flour. Rich in choline which is effective in controlling diabetes and also helps in preventing neurological complications of diabetes.

10]Chana Dal Whole or extract of sprouted dal Half a cup daily Utilizes glucose in the body and reduces the intake of insulin.

11]Low fat curds and buttermilk --- One to two cups daily Lactic acid present in these fermented products stimulates the pancreas to produce insulin and hence helps to control blood sugar levels.

nutrients ,VITAMINS AND HELP FULL TIPS FOR DIABETIC

Effective management of diabetes depends on a delicate balance between medication and diet control. The main goals in looking after diabetes are:

1. To achieve or to maintain ideal body weight: Being overweight or underweight are equally harmful for a diabetic. Hence if you fall in either of the categories, do ensure that you take the necessary precautions to stay at your ideal body weight. You may now wonder what ideal body weight is and how we can determine our ideal body weight.
Here is a formula of Broca's Index to help you determine what weight is appropriate for your height.
For men: Height (cm) - 100 = Ideal body weight (kgs).
"100" mentioned in the formula is the standard figure for men to determine their ideal body weight according to their height.
For women: Height (cm) - 105 = Ideal body weight (kgs).
"105" mentioned in the formula is the standard figure for women to determine their ideal body weight according to their height.

2. To maintain blood sugar levels close to the normal levels...

3. To improve over all physical and mental health by following a balanced routine for exercise, diet and also minimizing stress levels as that also can aggravate the situation.

4. To maintain the blood cholesterol and triglyceride levels , as most diabetic patients are prone to heart disease. Avoid eating sweets and fried foods and also include plenty of fibre in your diet to cut down on any accumulated bad cholesterol.

5. To prevent or to delay any further health ailment associated with diabetes by early detection and prompt treatment.

A diabetic diet should consist of a good combination of nutrients i.e. carbohydrates, protein, fat, vitamins and minerals to stay fit and fine and to keep the blood sugar levels in check.

Every adult requires approximately 2000 kilocalories (or calories as we regularly say) every day to maintain optimum health. However, if the person is either obese or underweight then we need to cut down or add on to these calories as recommended by a doctor or nutritionist.

Plan your daily energy requirements, eating patterns and physical activities with your doctor or nutritionist to bring your weight close to your ideal body weight.

Here are the nutrients you need to know about, along with their distribution you need in your daily diet.
1.

Carbohydrates
Carbohydrates should fulfil approximately 60 to 65% of your daily energy intake (calories).
A common misconception is that most carbohydrates are regarded as sugars, as a result of which they are completely avoided in the diabetic diet whereas actually one should choose carbohydrates carefully.
Carbohydrates are divided into two groups, viz. simple carbohydrates and complex carbohydrates. Simple carbohydrates like sugar, honey, jaggery etc do not need to be metabolized and hence will raise the blood sugar levels immediately. These should be avoided. Refined cereals like maida, pasta, semolina etc. should also be avoided as the process of refining breaks down these complex carbohydrates into simple carbohydrates that raise the blood sugar levels rapidly.

On the other hand, consumption of complex carbohydrates such as whole wheat, jowar, bajra, oats, brown rice instead of white rice etc. should be given more emphasis. These complex carbohydrates are preferred as they take longer to digest and thus give rise to a gradual increase blood sugar levels is gradual, making it easier for a diabetic person to adjust to the changes in blood sugar levels.

The important thing for diabetics is not to completely restrict their consumption of carbohydrates, but need to alter the type of carbohydrates consumed. For example, it is better to have unpolished or brown rice instead of polished white rice.
A simple way to find out how quickly foods raise your blood sugar levels is by means of the glycemic index. Foods with a high glycemic index are those that raise the blood sugar levels very rapidly.
It is a misconception that only table sugar shoots up the blood sugar levels. The glycemic index shows that certain foods like potato, yam etc. also show a rapid increase in blood sugar levels and are hence termed as high glycemic index foods.

It is advisable for diabetics to consume foods with a low glycemic index (as they bring about a gradual rise in the blood sugar levels) such as guava, plums, cluster beans, broccoli, cauliflower etc. and to mix foods with medium glycemic index such as pineapple, muskmelon, pastas etc. with low glycemic index foods.


2]Protein
This nutrient is required for the regular maintenance of our body and wear and tear of our tissues. Protein should form approximately 12 to 20% of our daily caloric (energy) intake.

It is essential to include protein in our diet, but only just enough to meet our daily requirements as excess protein puts a lot of burden on our kidneys to excrete its by-products.

We need not drastically reduce the protein in our diet, but should consume it in moderation. Try and include only one source of protein in each meal. For example, either eggs or milk for breakfast, either curds or dal for lunch or dinner etc. Avoid having dal, paneer and curds in the same meal, as that becomes a very heavy dose of protein.


3]Fat

Fat is a concentrated source of energy and it makes us feel satiated. It is also necessary for our body in small quantities as apart from calories (1 gm. of oil or fat = 9 calories), it contains essential fatty acids, which are required to perform certain vital functions in our body. Since These fatty acids cannot be produced naturally by our body, if we do not consume the recommended amount of fat per day, our body becomes deficient in these fatty acids causing visible symptoms like fatigue, weakness, mood swings, dry skin and dry hair.

Oil also helps in the absorption of fat-soluble vitamins like A, D, E and K. Vitamin A and E are important in our daily diet, as they are antioxidants which means they help us to build up our immune system to fight against the odds of infection. Vitamin D helps in strengthening our bones and teeth, whereas vitamin K helps in clotting our blood during injuries.

Care should be taken in choosing the right type of fat, to prevent another common consequence of diabetes viz.. heart disease. Oil, butter, vanaspati or ghee - which of these is better? We often wonder.... Well, here are the answers to that.

Oil is a healthier cooking option, although you can include small amounts of ghee and butter, using it sparingly. It is advisable for healthy individuals to consume no more than 6 teaspoons of fat (30 grams) per day and for diabetics not more than 3 teaspoons of fat per day , to avoid any health complications. Another way of keeping count is to measure out ½ litre (approx. ½ kg) per person per month.
This recommendation is for diabetics with normal blood cholesterol and triglyceride levels. In case the levels are higher, check with your physician as to whether to cut down on fat or change the type of fat you are using.
Excessive fat on the other hand, apart from making us put on weight can also disturb the absorption of important nutrients like calcium in our body.


4]Fibre

Fibre is a complex carbohydrate present in foods and although it is not really a 'nutrient', it is nevertheless an important component of our diet. It cleans up our system, prevents constipation and reduces blood cholesterol and triglyceride levels thus helping to prevent heart disease.
Our diet should include approximately 15 to 25 grams of fibre daily.

Fibre is extremely essential for diabetics, as it satiates us for longer periods and due to its low glycemic index causes slow release of sugar in the blood stream, thus helping to control diabetes. This also improves the efficiency of insulin in the cells and hence may decrease the need for external insulin if the person is insulin dependent.

Fibre is found only in foods derived from plants and how much depends on whether it has been processed. For example, unpolished rice contains much more fibre than processed/polished rice.

Here are some easy ways to include fibre in your diet.
Start the day with a high fibre dish like Muesli, Green Pea Pancakes etc.

Have plenty of vegetables, especially raw vegetables in the form of salads and raitas. Do not peel vegetables and fruits like cucumber, carrot and apples as their peels are edible. Do remember to wash them thoroughly, or scrape the peels slightly before eating.

Eat high fibre foods like dried peas, beans and lentils.

Choose brown bread or rotis made with whole wheat flour instead of instead of white bread or pasta made from refined flour.

Try to use the bran of cereals like wheat, oats and rice in your regular meals. For example, adding 1 tablespoon of bran in the chapati dough or in the vegetable dishes will provide plenty of fibre. Bran is also a good thickening agent that can add low calorie bulk to soups, gravies etc. Bran is easily available at most health food stores and larger grocery stores.


5]Vitamins and Minerals

Vitamins and minerals are needed for the regular maintenance of our body. Iron (for blood), Calcium (bones and teeth), Folic Acid (cell maintenance), vitamin A (for clear vision and skin), vitamin D (for the absorption of calcium), vitamin E (for healthy skin), vitamin K (helps in clotting blood), vitamin B (for metabolism of protein, carbohydrates and fat) and vitamin C (helps in immunity).
Fresh leafy vegetables like spinach, chawli leaves etc. and other vegetables like cabbage, cauliflower etc. are an excellent source of these vitamins and minerals. Fresh fruits like orange, sweet lime, apple etc. also contribute substantially by providing vitamins and minerals to our diet.

Along with the above nutrients one very important part of our diet is fluids . They are required to flush all the wastes out and to maintain the fluid (water) balance in our body.
Diabetics need to have plenty of fluids as they help to keep the urine diluted, so that the kidneys can flush it out without being taxed.

Water is not the only source of fluid that one can have. Vegetable soups and fruits and their juices are beneficial. Avoid carbonated beverages as far as possible as these provide no real nutrients, but only empty calories, which means they only help in

Nutrients that Help Control Diabetes

Diabetes

Nutrients that Help Control Diabetes

Fibre binds glucose, thus slowing its absorption and preventing a quick rise in blood glucose levels. It also helps to reduce blood cholesterol levels and avoid diabetes related complications like heart disease.

Sources: Whole cereals, fresh fruits and vegetables, sprouts.

Vitamin C is a potent antioxidant that protects our body against damage from free radicals, thus reducing the risk of developing degenerative diseases and diabetes-related complications. It also improves the action of insulin and helps to lower blood glucose levels. A sign of severe vitamin C deficiency, common to diabetics, is delay in wound healing.

Sources: Citrus fruits like orange, sweet lime, and pineapple, and vegetables like cabbage, lettuce, capsicum, etc.
Potassium improves insulin sensitivity and fosters optimum glucose utilisation. A potassium-rich diet also reduces the risk of heart disease and atherosclerosis.

Sources: Leafy vegetables like spinach, fenugreek. Fruits like figs, citrus fruits and cereals like wheat, bajra, ragi etc.
Magnesium plays a pivotal role in the secretion and function of insulin. Magnesium deficiency is common among diabetics and can lead to complications like heart disease, eye damage, high blood pressure, and obesity. Adequate magnesium intake improves the action of insulin, betters glucose tolerance and reduces the stickiness of red blood cell membranes.
Sources: Milk, cereals, soya bean, green vegetables, and dry fruits.
B-complex vitamins- Deficiency of B vitamins can lead to nerve damage in the hands and feet leading to numbness and tingling. Vitamin B6 deficiency has been linked to glucose intolerance, which is an abnormally high rise in blood glucose levels after eating. People with Type I diabetes develop antibodies that attack and destroy the insulin-producing cells in the pancreas; Niacin (vitamin B3) seems to help protect such cells from attack.

Sources: Cereals, vegetables, milk, pulses, yeast, egg, sprouts, etc.
Folic acid is required to produce red blood cells and helps convert homocysteine (a harmful amino acid that causes heart diseases) into methionine, which protect the heart and reduces the risk of developing heart disorders, a long-term complication of diabetes.

Sources: Green leafy vegetables like spinach, pulses, tomatoes, carrots, etc.
Zinc- Diabetics usually have low zinc levels since it is lost in urine and hence it is advisable to eat zinc rich foods necessary for maintaining the insulin producing cells.

Sources: Cereals, pulses and legumes, dry fruits, etc.
Iron does not have a direct relation with the disease, but plays an important role in the production of red blood cells and maintaining normal blood flow. This avoids accumulation of glucose in one part of the body, which would otherwise lead to complications like cataract, and kidney disorders. Maintaining normal blood circulation also ensures availability of nutrients and oxygen to each part of the body, especially the heart.

Sources : Cereals like wheat, ragi/nachni, pulses, soya bean, leafy vegetables like spinach, methi, and colcocasia.

ONLINE DIET CONSULTANT

This is a banglore website and this site moniter your health ,check and remind you your medicine on time.

http://www.yoscare.in/

Consult a diabetic doctor online.

CLICK THIS LINK YOU CAN GET YOUR ANSWER.

http://www.madhavdiabetescentre.com/

EXERCISE IN DIABETIC

Regular exercise is especially important for a person with diabetes. It helps with blood sugar control, weight loss, and high blood pressure. People with diabetes who exercise are less likely to experience a heart attack or stroke than diabetics who not exercise regularly. Exercise, generally helps control blood glucose levels because exercising muscle cells use more sugar and oxygen than those at rest. Exercise also helps insulin to work better.

There are two main types of exercise i.e. Aerobic and Anaerobic.

Aerobic Exercise: It is steady exercise over a period of time that causes our body to use more oxygen. It makes our heart and lungs stronger, lowers blood lipids, lowers blood pressure, and used up blood sugar. Aerobic exercises includes walking briskly, cycling, dancing, swimming, Jogging, cross-country skiing, some team sports etc.

Anaerobic Exercise : It consists of short bursts of energy that work one part of the body at a time, such as weight lifting. It builds muscles but does not strengthen the heart and lungs. It uses small amounts of blood sugar, but not enough to have much effect on overall blood sugar levels.

Both types of exercises are beneficial. While aerobic exercise works to lower blood sugar better, the benefits of anaerobic activities such as weight training are important too. For maximum benefit, aerobic exercise should be done 3 to 5 minutes a week, for 20-30 minutes each time. If a person is taking insulin them it is easier to balance his blood glucose levels if he exercise at the same time of day.
How Regular Exercise Controls Blood Sugar :

Regular Exercise is of great value in patients suffering from both Type-1 and Type-2 diabetes.

Sometimes, it may seem easier to pop a pill or even take a shot than to put on your walking shoes and hit the trail. But the truth is that exercise, in combination with a healthy diet, is one of the best things; the person can do to take care of himself, if he/she is suffering from diabetes. Due to exercise, the glucose is metabolised in the body and thus normal blood sugar level is maintained. Exercise increases the body efficiency, because it increases the tissue sensitivity to Insulin in patients suffering from Type-2 Diabetes. Here more amount of glucose is forced out of the blood stream and into the cells where it is utilized for the production of energy. Hence, this condition reduces the level of glucose in the blood. It has been known that, exercise also increases the demand of muscles for glucose. If the muscles are exercising or in the working order then require more glucose the muscles those are not in working order. Hence, this condition also lowers the blood sugar level.

In addition, to all this, the exercise burns calories which therefore helps in lose weight or maintain a healthy weight. And it is said that in a healthy weight individual, the blood sugar level remains in normal range, particularly in Type-2 diabetes.

Exercise can improve circulation, especially in the arms and legs, where people with diabetes can have problems. Exercise can possibly reduce the amount of medication we need to treat diabetes or even eliminate the need for medication. Exercise also provides us relief from stress, which is the major contributing factor in raising blood sugar levels.

Moreover, exercises reduce weight in case of the obese person. If there is extra body weight then unnecessary strain is put on beta cells, they needed to overwork, and hence the function of Beta cells is impaired for whole life. In some people, exercise combined with a meal plan, can control Type-2 Diabetes without the need for medications.

EXERCISE, HYPERTENSION AND DIABETES

Exercise, helps in reducing the high blood pressure. A high blood pressure can lead to a heart attack or stroke. So, an exercise helps in lowering the risk for heart diseases. With all these good things going for it, it’s mind boggling that only a few people get enough exercise or leisure-time physical activity to benefit.

Hypertension is more commonly prevalent in a diabetic than in a non-diabetic. It is present in more than 50% of patient with Non insulin dependent diabetes mellitus and may or may not be accompanied by renal damage. Hypertension is a major risk factor for the development of macro/micro vascular disease in diabetics. Although increased cardiovascular risk has been demonstrated in adult diabetic subject with pressure slightly greater than 130/80 mm Hg. The decision to treat mildly elevated levels of blood pressure must rest on clinical grounds in each individual. Isolated systolic hypertension is more common in a diabetic than a non-diabetic and is a risk factor for micro vascular disease, but treatment should be individualised. In diabetics, the high blood pressure may be due to secondary causes, which must be carefully considered and ruled out.

Primary Measures for management of hypertension in diabetics include, Regular Exercise, weight optimization, Cessation of smoking and dietary salt restriction. The drugs to be given to diabetics for hypertension must be carefully thought about because many anti hypertensive drugs shows side effects in diabetic individuals.

EXERCISE, CHOLESTEROL AND DIABETES

Exercise can help reduce the cholesterol of diabetics. Hence, by lowering the cholesterol level in diabetics, the risk for heart disease like heart attack or stroke is also reduced in them. Exercise lowers the elevated blood cholesterol by increasing the amount of high-density lipoproteins (HDLs), which are mainly responsible for removing cholesterol from the blood stream. Exercise also reduces the triglycerides and bad type of low-density lipoproteins in the blood and thus lowers the blood pressure, which in turn minimizes or decreases the risk of heat attacks in diabetics. Atherosclerosis is also prevented by Exercise in Diabetic people. No hardening of arteries occurs, if a diabetic person performs regular exercise.

Nowadays, cholesterol has become the number one public health issue nationwide. The US National Institute of Health has described high cholesterol as an epidemic. This really no surprise because it has been observed that heart disease kills many people every year and the elevated cholesterol level is the main causative factor in them. In order, to prevent this the National Institute of Health has given certain Cholesterol treatment guidelines. By following the preventive programs the preventive programs or getting proper treatment, the patients cholesterol level decreases considerably and thereby reducing the occurrence of more serious diseases. Statins are the family of drugs most commonly used to treat high cholesterol. But there are certain controversies in using them. Such as Statins and their herbal source and red rice yeast may cause muscle damage and in some cases it may be fatal even.
SELECTING YOUR EXERCISE

It is people is out of shape or have been recently diagnosed as having diabetes, and then he/she should see his doctor before starting an exercise program. Doctor can best guide about the type of exercises that are good for him depending on how well the diabetes is controlled. Moreover, doctor can choose an enjoyable physical activity that is perfect for his current fitness level.

Before making choice of an exercise program for the patient doctor should check the sensation in patient’s feet. He should check patient’s feet for any cut; sores, bruises, blisters, or any provide tips to the patient that is about the best care of his feet. Doctor should advise to the patient, the use of special shoes, if required.

While choosing an exercise, person should keep in mind that it should put undue stress on his feet. Hence, exercises like walking, swimming or bicycling must be the appropriate choices. Person should try to avoid activities like running or jumping that could injure his feet. Patient should remember to warm up and cool down before and after exercising and he/she should always wear comfortable footwear. During walking or jogging, person should be very sure that his shoes fit well and are designed for the activity, which the person is performing. Person should be alert for blisters. Person should wear and shoes for a bit of each day until they are comfortable and are not as likely to cause blisters. Person should always remember to wear soaks. Diabetics should choose light exercises. They should not choose strenuous exercise as it may elevate blood pressure in them. If a patient has foot problem, then he should choose swimming or biking rather than jogging because it is easier on the foot. After making final choice of the exercise, the person should begin the exercising activity, slowly with a low impact. Such as if a person has to do walking then he should start with five minutes and add a bit of time each day.

Exercises like diving, parachuting and mountain climbing are not recommended for people with diabetes. Because, during performing these exercises, hypoglycaemia can occur which can lead to serious complications.
WHY WALKING WINS

Diabetics can cut down their risk of dying prematurely by just getting up and walking. These have been found by several researchers. Their study found that the diabetic people who walked at least two hours a week had nearly a 40 percent reduction in death from all causes. Many studies have shown the health benefits of regular physical exercises including a decrease in the risk of developing diabetes. But little research has been done on the effect of exercise on people who already have the disease. In this study investigators from the Centers for Diseases Central and Prevention looked at nearly 3,000 adults with diabetes. All were questioned about their exercise habits through surveys administered in the community. Participants were followed for eight years. When compared with individuals who did not exercise, those who reported at least two hours a week of walking had a 39 percent lower death rate overall and a 34 percent lower death from cardio vascular causes. Even better results were seen for those who walked three to four hours a week. Therefore, these findings support the current recommendations that brisk walking on a regular basis is key health behaviour for persons suffering from Type-2 Diabetes mellitus. This regular daily walk will prevent the deposition of fat and maintain normal blood circulation particularly in the extremities
.
HOW OFTEN SHOULD A PERSON EXERCISE

Person should try to exercise at the same time every day and for the same duration. This will help him controlling his blood sugar. It is mainly recommended to exercise at least three times a week for about 30 to 45 minutes. But if a person does not have at least 30 minutes to exercise then they should break their routine into shorter intervals. They could perform exercise for 10-15 minutes in the morning before going for job. Then they should take a 10-15 minutes walk at lunch time. Then again they can perform exercise for 10-15 minutes in the evening.

HOW MUCH EXERCISE

It has been noted that a sedentary life style increases the chances of becoming overweight and developing a large number of chronic diseases. Exercise or regular physical activity helps many of the body’s systems function better and keeps a host of diseases at bay. The physical exercises improve the chances of living longer and living healthier. It also prevents developing heart diseases or developing certain cancers like that of colon and breast cancer. It also prevents and helps in controlling Type-2 diabetes. Despite of all such beneficial effects, the person should fix up the time for exercise. He should not overexert himself. Hence, Regularity, intensity and duration of exercise are very important. It is recommended half an hour of continuous aerobic exercise. During this exercise, the heart goes up for a few minutes and a drop of sweat appear. This is all what is generally required. Person should stop exercising at once, if he feels any sort of discomforts like pain in the chest, neck or any other body part.
PRECAUTIONS

No doubt, exercises are very good for people suffering with diabetes but certain precautions should be taken during performing them. Straining or overexertion during exercising should be avoided. If after stopping the exercise, the breathing and pulse rate do not come to normal then it proves that the person has got overstrained and this may lead to a condition known as hypoglycaemia that is reduction in blood sugar level.

During exercising, person should not wear tight clothes. He should wear loose, comfortable clothes and the types of clothes he wear should suit the weather. In summers, generally lightweight and light coloured clothes are preferred. If a person is exercising then care should be taken that he is having his regular meals, that is sufficient quantity of carbohydrates are provided in his diet. Otherwise, hypoglycaemia may occur.

Patient should not keep on exercising continuously, in a condition if he finds blisters or cuts in his feet. Exercise should be immediately stopped until the healing of feet occurs.

LISTEN TO YOUR BODY: WHEN NOT TO EXERCISE

If the person’s blood sugar level is above 300 mg/dl, then he/she should not exercise. Due to exercise the blood glucose level may be raised. It is because when the person performs exercise, then he liver releases the glucose, which has been stored in it in the form of glycogen.

If a person is ill or suffering from any infection, then also exercising should be stopped, till the person gets well. It is because during sick condition, the blood sugar levels are already very difficult to control and further exercises may worsen the condition.

The presence of ketone, in the urine, also indicates that one should not perform exercise. It is because when we exercise, we usually burn glucose and fat. So when fats are burned in order to provide energy, they release certain by products like ketones. Enough insulin in our blood means that little quantity of ketone can be used as fuel. But when there is less amount of insulin, then ketones get deposited up and they are excreted into urine. Hence, presence of ketone in urine indicates that our body does not have sufficient quantity of insulin maintain the blood sugar level under normal range.

If the person, experiences, tingling or pain or numbness in his legs then also he should stop exercising.

During certain, climatic changes like in extreme, hot or cold weather, there is increased chance of diabetics for developing hypoglycemia and moreover, due to cold weather in diabetics skin cracks may occur due to impaired circulation and neuropathy. If the patient feels dizziness, nausea or short of breath then he should not exercise. Moreover if he/she suffers from the problem of blurred vision then also they should stop exercising.

WHAT IS INSULIN?

Insulin is a hormone, synthesized and secreted by Pancreas, which is and elongated structure about 15 cm in length, 100 gm is weight and is situated behind the stomach. The pancreas consists of two parts-the Exocrine and Endocrine. The Exocrine part constituents about 80 to 85% of the total gland. The total weight of endocrine pancreas in the adult however does not exceed 1-1.5 gm. The exocrine part secretes various enzymes which are needed for digestion. The endocrine, part consists of “ Islets of Langerhans” which are made up of several types of cells. They are alpha cells (also called A cells) which secrete glucagons; the beta cells (also called B Cells) which secrete insulin; delta cells (also called D cells) which secret somatostatin.

Insulin was first discovered in 1922 by Banting and Best. Its chemical structure was worked out in 1956 by Sanger. Steiner discovered by Proinsulin in 1967.

Because of the Insulin secretion, blood sugar remains within the normal limits.
FUNCTIONS OF INSULIN IN OUR BODY

* Our body needs glucose to produce energy, in order to carry out body’s various vital functions. Glucose is obtained from the carbohydrates mainly Cereals and starch such as wheat, Rice Fruit, etc. Insulin helps the entry of glucose into all cells of the body. However, glucose entry in liver, brain, R.B.C.’s is largely, independent of insulin. Hence, insulin while present within the cells of the body, converts the glucose into energy, which is required to perform major body functions. But when Insulin is insufficient or lacking, then the glucose is not transported to the cells and no energy is produced.
* Along with entry of glucose into the cells, insulin also helps in Glycogen sis, i.e. synthesis of glycogen from glucose, in liver and muscle cells. This stored glycogen will act as a source of reserve energy. In between the meals, when the cells need energy, the stored glycogen is transformed back into glucose and is utilized by the cells.
* Insulin inhibits the synthesis of glucose from sources other than Carbohydrates (known as Neoglucogenesis). This decreases the blood glucose level.
* Insulin also helps in the entry of amino acids into cells and their synthesis into protein.
* Insulin promote lipogenesis (i.e., synthesis of triglyceride) and thus facilitates entry of fatty acids within the cells.

Therefore, in the absence of Insulin maintenance of blood sugar level is hampered, leading to hyperglycaemia, and severe consequences.

DIAGNOSIS

In general testing is done to determine the cause of an illness or to determine what disease is present. The correct treatment is possible only if correct diagnosis is mode.

Doctor must decide how frequently a person must be tested for diabetes. It may depend upon patient’s age and number of risk factors present in him. As if the patient is 45 years old or more than that, then he/she must be tested for diabetes every three years. But if the person in younger than 45 but have one or more risk factors, then he should be also regularly tested.

Normally a urine analysis may be used to look for glucose and ketones produced by the break down of fat and muscle. But a urine test alone does not diagnose diabetes because there are certain other things also which can cause sugar to appear in urine.

The following blood glucose tests are used to diagnose diabetes:
1. THE FASTING BLOOD GLUCOSE (SUGAR) TEST:

It is the best way to diagnose diabetes. It is very comfortable and easy to perform. The person is asked to fast overnight (at least 8 hours), then a sample of blood is drawn and is sent to laboratory for analysis. It the fasting blood glucose level comes out to be less than 100 milligrams per deciliter (mg/dl) then the person is believed to be normal. If the fasting blood glucose level lies between 100 and 126 milligrams per deciliter (mg/dl) then they are referred to as Impaired Fasting Glucose or Pre-diabetes. This level is considered to be risk factor for Type 2 Diabetes and its complications. Every year 1.5 of people who shows Impaired Fasting Glucose, infect develop diabetes in coming days. But if patient exercise and loose weight then impaired fasting glucose levels return to normal.

If the overnight fasting blood glucose level is more than 126 mg/dl on two different tests on different days, them the person is said to be suffering from diabetes.
2. RANDON (NON-FASTING) BLOOD GLUCOSE TEST:

It is also a better way to diagnose diabetes. When classic symptoms like increased thirst, urination and fatigue are present, them random blood samples (taken shortly after eating or drinking) are used to test for diabetes. If the blood glucose level is higher than 200 mg/dl, then the patient is said to be diabetic, but it must be reconfirmed by fasting blood glucose test on the another day or by an oral Glucose Tolerance Test.
3. ORAL GLUCOSE TOLERANCE TEST (OGTT):

It is not used routinely nowadays, but still it serves as a gold standard for diagnosing diabetes. This test measures the rate at which sugar is removed from the blood. It is more commonly used for diagnosing Gestational Diabetes.

Instructions given to the patients before Oral Glucose Tolerance Test are as follow:-

* The person undergoing Glucose Tolerance Test must be in good health. He must not be having any other problem, not even a cold.
* Person should be normally active, means he should not be ridden.
* He/She should not be taking any medicine that may other the blood glucose.
* For three days before the test patient must eat on unrestricted diet, high in carbohydrates.
* He should avoid alcoholic beverages.
* The morning the test is to be performed; the person should not smoke or drink coffee.

TEST PROCEDURE

First of all fasting blood glucose is tested. Then the person is given 75 gm of glucose but the pregnant woman is given 100 gms of glucose. Normally, the glucose is a sweet tasting liquid that the person drinks. The blood samples are taken at particular intervals to measure the blood glucose. In general, the blood glucose level is measured five times over a period of 3 hours. Person who does not suffer from diabetes, shows rise in the blood glucose levels, which fall down quickly but in person suffering from diabetes the blood glucose level rise higher than normal but does not come down quickly.

Individuals with fasting value of plasma glucose higher than 140mg/dl and 2 hours value after 75 gm oral glucose higher than 200 mg/dl are labeled as diabetics. But the individuals with fasting and 2 hours plasma glucose value between 140 and 200mg/dl are considered to have impaired fasting glucose. These patients are kept under observation for repeating the test later. However, during pregnancy, a case of impaired fasting glucose is treated as Diabetic. The patient on whom OGTT is performed may complain of nausea, vomiting etc.
4 . OTHER TESTS:
i) Glycosylated haemoglobin Test:

During this test, the glycosylated haemoglobin (a minor haemoglobin component present in normal persons) is measured. This is because the non-enzymatic glycosylation of haemoglobin takes place over 120 days, life span of red blood cells. Therefore, this test gives and estimates of diabetes control for the coming 6-10 weeks.
ii) Intravenous GTT:

This test is performed in persons who have intestinal malabsorption.
iii) Extended GTT:

In this the oral Glucose Tolerance Test is extended to 3-4 hours for appearance of symptoms of hyperglycaemia

FACTORS FOR CAUSE OF DIABETIC

Factors Related to Diet

Diet is one of the most important factors triggering diabetes mellitus. Indeed, diabetes mellitus is a condition in which the blood sugar level increases and so, any diet that contains carbohydrates (or more specifically, sugars) in it, are directly responsible for increasing the overall blood sugar level.

Diabetes mellitus is not an easy disease to control. Proper monitoring of the blood sugar level must be done at all times, so that it is not allowed to go up. This is indeed one of the most frustrating aspects of the disease. The following foods are directly responsible for the development and aggravation of diabetes mellitus, and they should be strictly avoided:-

* All foods containing sugar or jaggery, such as jam, jelly, marmalade, chocolates, desserts, ice cream, candy, etc.
* Honey in all forms
* Cokes, cola drinks and all such artificially sweetened cold drinks
* Milk and milk products, including cheese, butter and condensed milk
* Fruits with high sugar content and their juices
* Oily foods
* Alcoholic beverages, including wines

Factors Related to Lifestyle

Diabetes mellitus is a lifestyle disease. It has been observed that this disease is more rampant in the upper classes, since they tend to binge more on unhealthy foods. For this reason, diabetes mellitus is termed as a rich man’s disease. Expostulating on this trend, it can be said that diabetes mellitus is more of an urban disease than a rural disease. People who migrate to advanced countries stand a higher risk of contracting diabetes mellitus.

It has been observed that people who lead a sedentary lifestyle are more vulnerable to non-insulin dependent diabetes, or diabetes mellitus type 2. Such people have unexercised muscles and tissues, which can affect the overall action of insulin and reduce its capacity in the utilization of glucose.

Stress is another very important cause of diabetes mellitus. In some high-risk people, stress can cause malfunctioning of the pancreas, and hence, secretion of insulin. Several reasons can bring on stress and trauma. The following is a list of the most common of the stress-causing factors:-

* Injury
* Surgery
* Infections
* Pregnancy
* Different kinds of mental tensions and worries

Environmental and External Factors

In many instances, diabetes mellitus can be originated from outside the body rather than from within. The following are some of the more obvious of these extrinsic factors:-

* People who take steroids and other drugs that alter the hormonal balance are very susceptible to diabetes mellitus, as the amount of insulin can be reduced.
* Some people can develop diabetes due to the chemicals contained in certain vegetables such as beans.
* Infections can also cause diabetes mellitus. Some microorganisms can infect the pancreas and reduce its functioning. The insulin dependent diabetes mellitus or the diabetes mellitus type 1 is believed to be caused, among other causes, due to the infection of the Coxsackie virus on the pancreas.


HEREDITARY FACTORS

diabetes mellitus shows a very strong hereditary connection. People who have the human leukocyte antigen (HLA) in their blood, which is obtained from the parents, they have a strong propensity towards developing diabetes mellitus type 1. Though it is believed that diabetes mellitus type 1 is not hereditary, it is seen that the disease is more common in people who have a relative suffering from other forms of diabetes. Diabetes mellitus type 2 is definitely hereditary, but it is compounded in future generations due to other problems such as obesity, hypertension and high blood pressure. People can also get a defective mechanism from their preceding generations due to which the beta cells of the islets of Langerhans can be impaired in their functions.

Factors Related to Age

Though diabetes mellitus can occur in any age, there are a few points to be considered. Diabetes mellitus type 2 mostly occurs in the adulthood. It can begin in youth, but its repercussions on the overall health are found in the later stages of life, when the person reaches middle age. On the other hand, diabetes mellitus type 2 was once called juvenile diabetes because it was found to be prevalent in children and adolescents predominantly. However, it has been found out now that this type of diabetes too can occur in later stages of life.

In this manner, there are several factors that are strongly indicated to be responsible for diabetes mellitus. For this reason, the prevention and control of the disease becomes exceedingly difficult. Proper knowledge is needed for the treatment of the disease.

INDIAN FOOD DIET

Foods you must avoid!Salt

i. Salt

Salt is the greatest culprit for diabetics. You get enough salt from vegetables in inorganic form, so reduce the intake of inorganic salt.

ii. Sugar

Sucrose, a table sugar, provides nothing but calories and carbohydrates.

Also, you need calcium to digest sucrose. Insufficient sucrose intake might lead to calcium being leached off the bones.

Substitute sucrose with natural sugar, like honey, jaggery (gur), etc.

iii. Fat

Excessive fat intake is definitely not a good habit.

Try and exclude fried items from your diet totally.

But, remember, you must have a small quantity of oil to absorb fat-soluble vitamins, especially vitamin E.Red meat

iv. For non-vegetarians

Try and stop the intake of red meat completely.

Try to go in for a vegetarian diet. If you cannot, decrease the consumption of eggs and poultry.

You can, however, eat lean fish two to three times a week.

v. Whole milk and productsMilk

Try to switch to low fat milk and its products like yogurt (curd).

Replace high fat cheese with low fat cottage cheese.

vi. Tea and coffee

Do not have than two cups of the conventional tea or decaffeinated coffee every day.

Try to switch to herbal teas.

vii. White flour and its products

Replace these with whole grains, wholewheat or soya breads and unpolished rice.

viii. Foods with a high glycemic index

Avoid white rice, potatoes, carrots, breads and banana -- they increase the blood-sugar levels.

Special food for diabetics

i. Bitter gourd (karela)

This vegetable contains a high dosage of 'plant insulin'. It lowers the blood-sugar levels effectively.

Have the juice of three to four karelas early morning on an empty stomach.

As a vegetable, too, it can be taken on a regular basis.

Powder the seeds of karela (measuring 1 teaspoon), mix with water and drink it.

ii. Fenugreek (methi)

It is the most common food used to control diabetes.

Gulp a teaspoonful of these seeds with a glass of water daily.

Soak the seeds overnight. Have the water in which the seeds were soaked.

You can make a chutney with methi seeds. You can also eat them sprouted, dried and powdered, or mix them in wheat flour to make chapattis.

iii. Indian blackberry (jamun)

This fruit is very effective in preventing and controlling diabetes.

Powder the stone of the fruit and eat it -- it contains glucoside, which prevents the conversion of starch into sugars.

iv. Garlic

This is used to lower blood-sugar levels.

Garlic is rich in potassium and replaces the potassium which gets lost in urine.

It also contains zinc and sulphur, which are components of insulin.

Take about three to four flakes of freshly crushed garlic daily.

v. Onion Onion

Because of its diuretic and digestive properties, onion works against diabetes.

Raw onion is more useful.

vi. Flaxseed

This is the richest source of Omega 3 fatty acids.

It helps control diabetes because it maintains the sensitivity of the cell membrane, facilitates insulin, and thereby the uptake of glucose by the cells.

Applesvii. Fibre

Soluble fibre, found in apples, kidney beans, oatmeal, soyabean, etc, help control diabetes.

These aid slow digestion and absorption of nutrients, resulting in a slow and steady release of glucose.

They soak up excess bile acids found in the intestinal tract, the same acids that are converted to blood cholesterol.

They also help empty the stomach and trigger satiety that can help Type 2 diabetics to achieve weight loss goals.

viii. Cinnamon solution

Water extracts of cinnamon have been found to promote glucose metabolism and reduce cholesterol.

You can boil cinnamon sticks in water and drink this water.

ix. Antioxidants

Diabetes is often associated with conditions like heart disease, diabetic retinopathy, immune deficiency and kidney disease.

Many are caused by free radical damage. Therefore, make sure you include antioxidants, especially vitamin C (lemons), E, selenium, zinc and chromium (Brewer's yeast), in your diet, as they have been shown to control blood sugar levels.

RECIPES FOR DIABETIC


A vegetarian diet is an inherent part of any diabetic recipe. South Indian dishes like idlis and dosa, which have very little fat content, are good for them. Idlis contain a mixture of rice and Bengal gram dal, which is soaked, ground and then allowed to ferment. As idlis are steam cooked, the question of fats do not arise. Idlis or dosas can be taken for breakfast. A little known but very good for diabetics is porridge made from ragi (nachni). The ragi is ground into flour and this flour is mixed with water and cooked for a while. A semi solid paste when mixed with buttermilk or curd is not only filling but also good to control the blood sugar levels.

In India, Khichidis, which are a mixture of rice and toor dal, are filling and acceptable for diabetics. Broken wheat cooked just like rice is another alternative. It can be eaten in the same way as rice is. However, there is nothing like the ubiquitous Indian roti, which is filling and can be prepared in many ways. Wheat flour made into a dough and rolled into rotis which can be prepared on a tava or tandoori rotis which can be made on a tandoor, bhakris and naan are nutritive and at the same time fat free. The good thing about them is that they raise the blood sugar levels very slowly. Dal is a good protein supplement and vegetables like bitter gourd, tomatoes, lettuce and other leafy greens, carrots, onions, garlic, cabbage can be prepared as dry side dishes. Sprouts are filling and are full of nutrition and should be a part of the meal. They can be cooked with salt and masala and eaten directly or mixed with the juice of lime and a pinch of salt. Both the varieties are tasty and healthy alternatives. Methi (fenugreek seeds) turmeric powder, tender mango leaves can be used liberally in diabetic recipes.

Grapefruit, jambul, apple, orange and mosambi can be made into juice. Diabetics should either eat a fruit or drink juice. While making apple juice, add milk instead of water.. Diabetic recipes include vegetable soups and salads. Vegetables like cabbage, tomato, celery, spinach, can either be cooked together or separately. To the broth of the soup add a pinch of salt and a dash of lime. It tastes wonderful. For salads, finely sliced cabbage, cucumber, capsicum, can be mixed with a pinch of salt. To this mixture add thick curd and sauté the mixture with mustard seeds. A sprig of parsley or dhania adds to the flavor.

With a little perseverance, a little patience and with the right attitude diabetics can actually enjoy the food they eat. It is not easy but at the same time it is not very difficult. Exercise, nutrition, and the correct amount of calories can a go a long way to help regulate blood sugar levels. The advantage of a vegetarian recipe for a diabetic is that diabetics can feel that they control the disease and the disease does not control them.

DIABETES

Diabetes can be caused by too little insulin (a hormone produced by the pancreas to control blood sugar), resistance to insulin, or both.

To understand diabetes, it is important to first understand the normal process of food metabolism. Several things happen when food is digested:

* A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body.
* An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.

People with diabetes have high blood sugar. This is because their pancreas does not make enough insulin or their muscle, fat, and liver cells do not respond to insulin normally, or both.

There are three major types of diabetes:

* Type 1 diabetes is usually diagnosed in childhood. The body makes little or no insulin, and daily injections of insulin are needed to sustain life.
* Type 2 diabetes is far more common than type 1 and makes up most of all cases of diabetes. It usually occurs in adulthood. The pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to the insulin. Many people with type 2 diabetes do not know they have it, although it is a serious condition. Type 2 diabetes is becoming more common due to the growing number of older Americans, increasing obesity, and failure to exercise.
* Gestational diabetes is high blood glucose that develops at any time during pregnancy in a woman who does not have diabetes.

Diabetes affects more than 20 million indians About 54 million Americans have prediabetes. There are many risk factors for diabetes, including:

* A parent, brother, or sister with diabetes
* Obesity
* Age greater than 45 years


* High blood pressure
* High blood levels of triglycerides (a type of fat molecule)
* High blood cholesterol level
* Not getting enough exercise

The American Diabetes Association recommends that all adults over age 45 be screened for diabetes at least every 3 years. A person at high risk should be screened more often.
Back to TopSymptoms

High blood levels of glucose can cause several problems, including frequent urination, excessive thirst, hunger, fatigue, weight loss, and blurry vision. However, because type 2 diabetes develops slowly, some people with high blood sugar experience no symptoms at all.

Symptoms of type 1 diabetes:

* Increased thirst
* Increased urination
* Weight loss in spite of increased appetite
* Fatigue
* Nausea
* Vomiting

Patients with type 1 diabetes usually develop symptoms over a short period of time, and the condition is often diagnosed in an emergency setting.

Symptoms of type 2 diabetes:

* Increased thirst
* Increased urination
* Increased appetite
* Fatigue
* Blurred vision
* Slow-healing infections
* Impotence in men

Back to TopSigns and Tests

A urine analysis may be used to look for glucose and ketones from the breakdown of fat. However, a urine test alone does not diagnose diabetes. The following blood glucose tests are used to diagnose diabetes:

* Fasting blood glucose level -- diabetes is diagnosed if higher than 126 mg/dL on two occasions. Levels between 100 and 126 mg/dl are referred to as impaired fasting glucose or pre-diabetes. These levels are considered to be risk factors for type 2 diabetes and its complications.
* Random (non-fasting) blood glucose level -- diabetes is suspected if higher than 200 mg/dL and accompanied by the classic symptoms of increased thirst, urination, and fatigue. (This test must be confirmed with a fasting blood glucose test.)
* Oral glucose tolerance test -- diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours (This test is used more for type 2 diabetes.)

You should also ask your doctor how often to you need your hemoglobin A1c (HbA1c) level checked. The HbA1c is a measure of average blood glucose during the previous 2 to 3 months. It is a very helpful way to determine how well treatment is working.

Ketone testing is another test that is used in type 1 diabetes. Ketones are produced by the breakdown of fat and muscle, and they are harmful at high levels. The ketone test is done using a urine sample. High levels of blood ketones may result in a serious condition called ketoacidosis. Ketone testing is usually done at the following times:

* When the blood sugar is higher than 240 mg/dL
* During acute illness (for example, pneumonia, heart attack, or stroke)
* When nausea or vomiting occur
* During pregnancy

Back to TopTreatment

There is no cure for diabetes. Treatment involves medicines, diet, and exercise to control blood sugar and prevent symptoms and complications.

LEARN THESE SKILLS

Basic diabetes management skills will help prevent the need for emergency care. These skills include:

* How to recognize and treat low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia)
* What to eat and when
* How to take insulin or oral medication
* How to test and record blood glucose
* How to test urine for ketones (type 1 diabetes only)
* How to adjust insulin or food intake when changing exercise and eating habits
* How to handle sick days
* Where to buy diabetes supplies and how to store them

After you learn the basics of diabetes care, learn how the disease can cause long-term health problems and the best ways to prevent these problems. People with diabetes need to review and update their knowledge, because new research and improved ways to treat diabetes are constantly being developed.

SELF-TESTING

If you have diabetes, your doctor may tell you to regularly check your blood sugar levels at home. There are a number of devices available, and they use only a drop of blood. Self-monitoring tells you how well diet, medication, and exercise are working together to control your diabetes and can help your doctor prevent complications.
that premeal blood sugar levels fall in the range of 80 to 120 mg/dL and bedtime blood levels fall in the range of 100 to 140 mg/dL. Your doctor may adjust this depending on your circumstances.

WHAT TO EAT

You should work closely with your health care provider to learn how much fat, protein, and carbohydrates you need in your diet. A registered dietician can be very helpful in planning dietary needs.

People with type 1 diabetes should eat at about the same times each day and try to be consistent with the types of food they choose. This helps to prevent blood sugars from becoming extremely high or low.

Persons with type 2 diabetes should follow a well-balanced and low-fat diet.

HOW TO TAKE MEDICATION

Medications to treat diabetes include insulin and glucose-lowering pills called oral hypoglycemic drugs.

Persons with type 1 diabetes cannot make their own insulin, so daily insulin injections are needed. Insulin does not come in pill form. Injections that are generally needed one to four times per day. Some people use an insulin pump, which is worn at all times and delivers a steady flow of insulin throughout the day. Other people may use a new type of inhaled insulin.

WHY SHOULD WE CONCENTRATE ON DIET IN DIABETIC

A good diet is an essential part of managing diabetes. Meals and snacks play a big role in determining an individual’s glucose (blood sugar) levels. The meal choices patients make are crucial to keeping blood glucose from spiking too high or falling too low.Diabetes mellitus is a disorder in the body's ability to break down blood sugar (glucose).

Patients can work with physicians and dietitians to create a meal plan that is well-balanced and that offers a variety of food choices. The right meal plan can help patients:

*
Prevent hyperglycemia and hypoglycemia
*
Lower blood pressure
*
Control cholesterol
*
Achieve a healthy weight and avoid obesity

People with diabetes who achieve these goals are likely to reduce the odds of suffering health problems related to high blood glucose and diabetes, including:

* High blood pressure, atherosclerosis and heart conditions
*
Diabetic neuropathy
*
Diabetic nephropathy
*
Eye diseases such as diabetic retinopathy and glaucoma
*
Diabetic coma

Diabetic neuropathy is nerve damage that can affect sensation, muscle strength or both. Diabetic nephropathy is kidney damage resulting from diabetes. It can lead to kidney failure.


A diet plan can also help patients to keep an optimal weight, which can increase the body’s ability to use insulin more effectively. Even a modest weight loss of 8 or 10 pounds can pay big dividends when attempting to manage glucose. The American College of Preventative Medicine states that efforts to prevent diabetes can be significantly enhanced by planning a diet adequate in complex carbohydrates (including fiber-rich whole grains, fruits and vegetables), moderate in protein and total fat, and restricted in saturated fat and trans fat.

Patients can greatly enhance the benefits of a well-balanced diet by adding an exercise regimen to their treatment routine, as approved by their physician. In some cases of type 2 diabetes, a combination of diet and exercise alone can allow patients to control their diabetes. In other cases, diet and exercise are an important adjunct to insulin therapy or antidiabetic agents.

DIABETES and FOOD PHYRAMID

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