Know Your Diabetes - Part 2
Know Your Diabetes (Part 2 of 2)
-Dr. Shantanu P Sheshgir
In the first part of this article, we discussed the exact nature of Diabetes, what sets it apart from the common infectious diseases and its causes. We also talked about the signs and symptoms that might help you in suspecting it and thus enable you to seek timely help from a physician.
We have already established that lifestyle plays a major role in the development of this disease. We also know its human cost and that in the coming years as India’s standard of living rises, the issue will progressively worsen. Thus it is necessary that everyone should know at least the basics of Diabetes or D.M. as it is called in doc-speak (Diabetes Mellitus), the tests involved in its diagnosis and treatment options.
Diagnosing the “Silent Killer”:
Since Diabetes is essentially a malfunction in the process by which our body utilizes sugar (glucose) and its amount in the blood, the most obvious way of testing is by checking the blood glucose levels. These are the common diagnostics for the disease:
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Blood Sugar Level (Fasting and Post-Prandial): Here, a blood sample is collected after a minimum of 12 hrs of fasting, a small meal is given, and the next sample is taken 2 hrs later. (Levels above 126mg/dL in two fasting samples are diagnostic for Diabetes)
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Urine Examination: Here the patient is given a solution of glucose in standard concentration and the urine sample is taken and examined two hours later. A patient with a positive result is taken to be diabetic unless proved otherwise by a blood test. (We do not excrete glucose via urine under normal conditions)
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Ultrasonography: To detect anomalies in the Pancreatic anatomy (structure) itself.
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C.T. Scan/MRI: To check for tumors, other abnormalities
These are the most common tests; even here, the last two are rarely done.
Complications:
Diabetes is more dangerous because of the high incidence of certain complications. These are listed below as Acute and Chronic:
Acute:
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Diabetic Ketoacidosis: This is the most serious complication and a medical emergency. Blood pH drops drastically and life is endangered.(Normal Blood pH is around 7.3)
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Hyperglycemia: This is an umbrella condition. Blood glucose levels spiral out of control (Normal- 80-140mg/dl). When they breach the 300mg/dl mark, a variety of conditions arise. Hyperosmolarity (blood gets thickened), unconsciousness, brain damage, stroke, even death
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Hypoglycemia: Blood glucose levels drop drastically, leading to confusion, dizziness, loss of consciousness, stroke, even a comatose state or death. Usually brought on by excessive exercise, prolonged fasting or an excessive dose of insulin.
Major Chronic Complications:
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Diabetic vascular disease: Most common complication. The blood vessels of the body react to elevated blood glucose levels by getting thick walls. This leads to a rise in blood pressure and a drop in the amount of blood delivered to the organs per systole.
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Diabetic Retinopathy: Progressive loss of field of vision
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Diabetic Nephropathy: Loss of kidney function due to changes in the renal blood vessels. Can cause chronic renal failure, a disabling condition, needing frequent dialysis.
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Diabetic Neuropathy: Loss of sensation in peripheries (fingers, toes, etc) due to sensory nerve damage.
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Diabetic Ulcer: An ugly non-healing ulcer which starts as a simple wound but progressively deepens, gets infected an at times reaches the bone. Healing doesn’t occur until glucose levels normalize.
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Gangrene: Advanced stage of the above condition.
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Diabetic foot: Combination of Neuropathy and diabetic vascular disease. A non-healing ulcer on the foot. Very common condition as the diabetic is prone to non-healing wounds on the leg, which they don’t pay attention to, due to sensory loss.
Treatment:
Conventional: There’s no “magic pill” that can “cure” diabetes, however, certain treatments like stem cell therapy, that are under development look promising in some cases. However, the mainstay of conventional treatment is Insulin injection, whether synthetic or genetically engineered (Humulin, other brand names). Antibiotics help in Diabetic foot, or ulcers. Fluid resuscitation helps in Diabetic Ketoacidosis or Hyperglycemia/Hyperosmolarity.
Lifestyle changes: As we have already mentioned, this is a lifestyle disease. A few alterations in the way we live can go a long way in defeating it. They are:
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Regular exercise: Obesity is a big factor. Reducing body fat through exercise is a great way to fight diabetes and can reduce the dosage of insulin required, esp. in type-2.
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Diet: A low-fat and balanced diet, divided into frequent small meals with high fiber content helps achieve weight loss besides maintaining blood glucose levels.
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Fight stress to win against the killer: Stress does not simply mean work stress or pressure, personal or professional. It can be due to irregular lifestyle, surgery, trauma, environmental factors, etc. Meditation and stress busting techniques like Yoga or Tai-chi help a lot.
Homoeopathic Medicines:
Homoeopathy can play a vital role in the control of diabetes, by taking care of the mental as well as physical disturbances which either bring out the disease or result from it. The following medicines have been used for decades by doctors to achieve control and are well supported by doctors’ and patients’ testimonies.
Syzygium Jambolanum: Particularly effective in treating glycosuria (glucose in urine).
Natrum Phos.6X: Effective in cases with persistently elevated BSL counts.
Phosphoric Acid: Diabetics with frequent and copious urination, especially at night with marked anxiety.
Other remedies are Arsenicum Album, Cephalandra Indicia (Diabetics with frequent itchy boils), Argentum Metallicm, etc.
Note: Homoeopathic medicines are given in dilutions, called “potencies” after all aspects of a case are taken into consideration. The person as a whole is taken into account, rather than symptom specific medication. Thus consulting a Homoeopath and then beginning treatment will help you fix the potency correctly for effective relief.
Surgery:
Surgical intervention is useful only when there is an organic cause for the problem like a tumor or any other obstructive condition. However gastric bypass surgery helps in the pathologically obese (around 80% cases respond favorably). Other than this, surgery is used to cure some of the complications like Diabetic ulcers, Retinopathy, Vascular conditions, etc.
In conclusion, we all know, prevention is better than cure. So eat well, a low fat, high protein balanced diet in moderation with adequate exercise, esp. if you have a family history. Skip colas and fries and step back when you get stressed to smell the flowers and relax. Enjoy life…
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