Nine Months That Are Worth A Lifetime

                            

                              

Pregnant women who have diabetes prior to their pregnancy have special health concerns. In addition to the new demands that pregnancy puts on the body, women with diabetes must also monitor and control their blood sugar levels and manage their diabetes medications. Your health  directly affects your baby’s health.

If you are planning a baby, a meeting with your healthcare practitioner is important to ensure a healthy pregnancy. Your healthcare practitioner can ensure that your diabetes is well-controlled for you to stop birth control measures. A blood test called the glycosylated haemoglobin test can help evaluate how well your diabetes has been controlled over the previous 8-12 weeks. Other medical tests before you become pregnant can also help monitor your health and prevent the development of diabetic complications during pregnancy. Pre-conception counselling can educate women so they can be physically and emotionally prepared for pregnancy.

Importance of blood sugar control

Good blood sugar control is important before becoming pregnant because many women do not even know they are pregnant until the baby has been growing for two to four weeks. High blood sugar levels early in pregnancy (before 13 weeks) can cause birth defects. They can also increase risk of miscarriage and diabetes-related complications.

Blood sugar control means keeping blood glucose levels within the ideal range as well as balanced meals, exercise and diabetes medications taken religiously.
Those urges for sweets must be kept in check.

How diabetes may affect Baby

Pregnant women with diabetes may have babies who are considerably larger than normal. This is because they receive too much sugar via the placenta because their mothers have high blood sugar levels. The pancreas senses this and produces more insulin in an attempt to use up all the extra sugar. That extra sugar is converted to fat. The doctor may have to plan for the safest mode of delivery. If the baby is too large to be delivered vaginally, a caesarean may become necessary.

If you have high blood sugar levels consistently during pregnancy (specially in the 24 hours before pregnancy), your baby may develop dangerously low blood sugar levels right after delivery. This is because the baby has high levels of insulin to use up the extra sugar and when that source of sugar is suddenly taken away its  blood sugar level drops quickly. Babies of mothers with diabetes may need to be monitored for low blood sugar levels and given glucose intravenously. Your baby may also have imbalances in calcium and magnesium levels, which will need to be replaced with medication.

Pregnancy is a special time. You are bringing a new human being into the world. This is a time when pregnant women, especially women with diabetes, need to take health issues seriously and be particular about following the doctor’s advice on diet and exercise. Your baby’s health and well-being not only inside the womb but after he or she is born, depend  on your health. Those nine months are worth a lifetime.

                                   

Lifestyle Changes In Managing Diabetes

Type 2 diabetes is becoming more and more common primarily because of increase in the prevalence of a sedentary lifestyle as well as obesity.

Lifestyle factors associated with obesity, eating behavior and physical activity, play a major role in the prevention and management of type 2 diabetes. In recent years, there has been significant progress in the development of behavioral strategies to modify these lifestyle behaviors, however, further research is clearly needed warranted.

Healthy eating habits and physical activity may help prevent or delay diabetes and its complications. Tailoring goals and targets to the patient’s preferences and progress, building the patient’s confidence in small steps and monitoring progress is important. A counseling program may be used to encourage positive choices, develop self-sufficiency and assist the patient in identifying and overcoming barriers.

The treatment goals for a diabetic are:

- Achieve near-normal blood glucose levels.
People with type 1 diabetes must coordinate caloric intake with medication or insulin administration, exercise and other variables to control blood glucose levels. New forms of insulin today allow for more flexibility in timing meals.

- Protect the heart and aim for healthy lipids (cholesterol and triglyceride) levels and control blood pressure.

- Achieve healthy weight
A healthy weight is usually defined as a weight that is achievable and sustainable rather than one that is culturally defined or desirable or ideal. 
Children, pregnant women and people recovering from illness should be sure to maintain adequate calories for health.

- Manage or prevent complications of diabetes
People with diabetes, whether type 1 or 2, are at risk for a number of medical complications including heart and kidney disease. Dietary requirements for diabetes must take these disorders into account.

Overall guidelines
There is no such thing as a single diabetes diet. Patients should meet with a professional dietician to plan an individual diet within the general guidelines that take into consideration their own health needs.

Weight management is the no:1 risk factor for type 2 diabetes. Even modest weight loss can prevent type 2 diabetes from developing. It can also help control or stop progression of type 2 diabetes in people with the condition and reduce risk factors for heart disease. People should lose weight if their body mass index (BMI) is 25-29 (overweight) or higher (obese).
Aim for small but consistent weight loss. Most patients should follow a diet that supplies 1000 – 1200 kcal/day for women and 1200-1600 kcal/day for men.

Unfortunately, not only is weight loss difficult to sustain but many of the oral medications in use in type 2 diabetes can cause weight gain as a side effect.

Exercise
Sedentary habits, specially watching TV, are associated with significantly higher risks for obesity and type 2 diabetes. Regular exercise even of moderate intensity (i.e., brisk walking) improves insulin sensitivity and may play a significant role in type 2 diabetes.
Because people with diabetes are at higher than average risk of heart disease, they should always check with their doctors before undertaking vigorous exercise.

Improving sleep
Not getting enough sleep may impair insulin use and increase the risk of obesity. It is always wise to improve sleep habits.

Medical science is continually advancing which means more hope for diabetics to live normal and healthy lives. Changes in lifestyle – weight management, exercise and better sleeping habits – go a long way in managing diabetes. It can be done!

How To Relieve Computer Eye Strain

We can’t live without computers these days. But the flip-side is eye strain. It is one of the leading work-related health complaints. Computer vision syndrome (CVS) causes fatigue, decreased productivity and more work errors.

People with diabetes have to be even more careful about eye strain. They are at risk of

developing retinopathy which damages blood vessels inside the retina causing vision loss and risk of blindness.

Here are some ways to relieve computer eye strain:

• Get a computer eye exam (especially important if you are diabetic). Let your doctor know about the extent of computer usage at office and at home.

• Ensure proper lighting. Eye strain is often caused by excessively bright ambient lighting – either from sunlight streaming in from the window or from harsh interior lighting. It is advisable to use fewer fluorescent bulbs in overhead lighting fixtures or use lower intensity bulbs. Position the monitor so that windows are to the side of it instead of in front or back. Adjust window blinds to reduce the amount of sunlight on the work station.

• Minimize glare. Glares on walls and finished surfaces as well as reflections on the computer screen can also cause computer eye strain. Install an anti-glare screen on your monitor, if possible.

• Upgrade your display. If you have not already done so, replace your old tube-style monitor (called a cathode ray tube or CRT) with a flat panel liquid crystal display (LCD), like those on laptop computers.
  LCD screens are easier on the eye and usually leave an anti-reflective surface. Old-fashioned CRT screens can cause a flicker on the screen. Even if this flicker is imperceptible, it can still contribute to eye strain and fatigue while working on the computer.

• Adjust display settings. Ensure that the brightness of the screen is about the same as in your work environment.

• Blink more often. Blinking re-wets the eyes to keep them comfortable and clean. Try to blink every 20 minutes or so while at the computer.

• Exercise your eyes. Research has shown that it is harder for our eyes to maintain focus on computer-generated images than on printed images. Look away from the monitor every 20 minutes and gaze at a distant object. This relaxes the focusing muscles under the eyes, reducing fatigue.

• Take frequent breaks. Stand up, walk away from the work station, stretch arms, back, neck and shoulder. It is interesting to note that work output does not decrease because of these breaks. On the contrary, your efficiency increases.

• Modify your work station. Place reference material on a copy stand adjacent to the screen or monitor. If possible, use a desk lamp to illuminate the print material but make sure it does not shine into your eyes or on the computer screen. Improper posture also contributes to computer vision syndrome. Adjust your work table and chair to a comfortable height, so your feet are flat on the floor in front of you. The screen should be 20-24 inches away from your eyes and slightly below eye level.

• Consider computer eye wear. Your ophthalmologist can prescribe specially designed computer eye wear. Caution: this should not be worn while driving.

While computers have changed the very way we work, we should ensure that we protect against eye strain by taking these simple, but necessary, measures.

Put “I-care” into diabetes eyecare

What people with diabetes need is eyecare – and that really means “I care”. You can do a lot when it comes to early detection of eye problems and getting the right treatment.

Diabetes is a condition that can harm the eyes. It can damage the small blood vessels in the retina. This is called diabetic retinopathy. Diabetes can also increase risk of glaucoma, cataracts and other eye problems.

Regular eye examination

You may not realize the damage to your eyes until the problem is very bad. Regular eye examination can catch the problem early and enable timely medication. Eye examinations should be undertaken at least once a year. Choose an eye doctor who also takes care of people with diabetes.

What the eye examination involves:

* Dilating the eyes to allow a good view of the entire retina. This can only be done by an eye doctor.

* Specific photographs of the back of the eye – which may sometimes be required.

Preventing eye problems

Diabetics can largely prevent eye problems if you follow these few simple steps.

Control blood sugar levels.  High blood sugar increases the risk of eye problems.

Control blood pressure. Blood pressure less than 130/180 is a good goal for people with diabetes. Check your blood pressure often, usually at the same time of day. Make sure you take any prescribed drugs to control blood pressure.

Quit smoking  Smoking is particularly dangerous  if you have diabetes. Quit now. Get help quitting if you can’t do it on your own.

Check before exercising  It’s best to find out if you should avoid some exercises that could strain blood vessels. These might include weight lifting and high impact sports.

Eye-care at home   

* If you cannot read the labels on medicine bottles easily, use a felt-tip pen to label bottles.

* Use rubber bands/clips to tell medicines apart.

* Ask someone else to give you your medicines.

* Read labels with a magnifying glass.

* Use a pill box with compartments for days of the week and times of day.

* Get large-font printouts of instructions and diet plans for diabetic meals.

Call your doctor when …

• You cannot see well in dim light

• You have blind spots

• You have double vision (see two things when there’s only one)

• Vision is hazy or blurry and you can’t focus

• You have frequent headaches

• You see spots floating in your eyes

• You cannot see things on the side of your field of vision

• You see shadows

Your eyes are precious and delicate. The right care at the right time is essential to avoid eye problems specially if you are diabetic.

Monsoon care for eyes

The monsoons bring with them a host of infections, specially those that affect the eyes and cause pain and discomfort.

The main problems that can be aggravated in the monsoons are:

• Conjunctivitis

• Eye Styes

• Dry Eyes

• Corneal ulcers

Let's look at each of these conditions.

  

Conjunctivitis The conjunctiva is the mucous membrane that lines the eyelid and the eye surface. Conjunctivitis is the inflammation of the conjunctiva and is characterized by swelling and redness. Conjunctivitis can be treated by medicine. Wearing dark glasses keeps your eyes cool and prevents immediate contact of the hands and eyes, which can spread the contagious infection faster.

Dry eyes Eyes need a constant flow of tears for moisturizing and lubrication to sustain vision. An imbalance in tear flow can cause dry eyes, lead to irritation, pain and blurring of vision. Treatment ranges from artificial tear drops to punctual occlusion and sometimes even surgery.

Eye styes Styes cause a painful lump along the eyelid. They are caused by bacterial infection and are rampant during the monsoons. They can be treated at home with wet and warm compresses and in case of increased irritation, medication.

Corneal ulcers The cornea is the thin clear structure overlying the iris. Severe infection of the cornea, characterized by open sores, is corneal ulcer. Its  symptoms are pus dischange, severe pain and blurring of vision. It could be caused by viral, bacterial or fungal infection . It could even be caused by tears resulting from trauma. Consulting an ophthalmologist immediately is advised.

How to prevent infections during the monsoons

• It is important to wash your hands frequently after touching   the eyes and face.

• Keep an anti-bacterial lotion handy while outdoors.

• Discontinue use of contact lenses when you have infection. Make sure you clean the lens thoroughly before  putting them back on.

• Do not share contact lens solution or container.

• Do not share eye medication.

• Do not share towels and handkerchiefs as they can transfer infection.

• Do not use eye make-up when you have an eye infection. Replace old make-up products.

• Use eye protection when exposed to direct wind, heat or cold.

• Wear gloves when administering eye medication to someone else.

• Use safety glasses when working with chemicals.

Get an umbrella of protection for your eyes specially during the monsoons.

Diabetes can affect your eyesight

Imagine a door shutting slowly till there is just a sliver of light between you and darkness. It can happen to people with diabetes. Not many people realize that diabetes can affect their vision, their ability to read and write, appreciate the colours of the rainbow and the beauty of the flowers around them. Slowly their world can turn from light to darkness.

Diabetes causes problems in the retina, the delicate tissue that is sensitive to light. It is the retina that converts light into electrical signals that travel along the optic nerve to your brain. The brain then interprets these signs to ‘see’ the world around you. The retina is supplied with blood by a delicate network of blood vessels. This is where diabetes comes in. It damages these blood vessels thereby affecting your eyesight.

Diabetes causes problems in the retina with what are collectively called microvascular abnormalities. The small blood vessels develop microaneurysms and leak blood. New blood vessel growth occurs. However,  these blood vessels are weak and also leak. These leaks – haemorrhages – can cause irreversible damage to the retina and result in vision loss.

The unusual changes in blood sugar levels resulting from diabetes can affect the lens inside the eye. The result is retinopathy – damage to the retina which occurs when there is damage to the small blood vessels that nourish tissue and nerve cells in the retina.

The longer a person has diabetes,the greater the chances of developing diabetic retinopathy. It is said that almost 80% of  people who have diabetes for 15 years or more suffer some damage to the blood vessels and their retina – and have a greater chance of developing retinopathy. Diabetes can affect any of the cranial nerves that are responsible for the movement of the eye. This can cause peripheral vision, a dangerous condition when reading, writing or driving.

Although individuals with diabetes are more likely to develop cataracts at a younger age and twice as likely to develop glaucoma vs non-diabetics, the primary vision problem caused by diabetes is diabetic retinopathy.

When you have diabetic retinopathy no two days are the same. Your vision changes along with blood sugar levels. People with the condition have noticed that when their sugar drops, they can actually see better.

The unusual changes in blood sugar levels resulting from diabetes can affect the lens inside the eye,  especially when diabetes is uncontrolled. This can result in blurring of vision which comes and goes over the course of the day, depending on the blood sugar level. People with diabetes are more likely to get bacterial infection, including pink eye and an eyelid sty. This is because diabetes affects the auto-response immune system of the body, lowering one’s resistance to infection.

The eye being a sensitive organ, it is important to control diabetes by keeping blood sugar levels as low as possible, practicing good hygiene such as washing your hands frequently and avoiding constant contact such as touching and rubbing your eyes. A yearly visit to an ophthalmologist will help you keep your condition in check and may prevent it from worsening. You can partner with your ophthalmologist towards the maintenance of the health of your eyes. It’s worth the time and effort,to ensure that diabetes does not steal from you one of the greatest gifts of life – sight.

Diabetes: The Silent Killer

Diabetes is often called ‘the silent killer'. You never know when it comes on,it

preys on the body and can take away one’s limbs, affect the eyes and eat away one’s organs.

                                                      

                                                                                    What is diabetes?

Diabetes – or diabetes mellitus in medical terms – is a disorder caused by insufficient or no production of the hormone insulin by the pancreas. Insulin is responsible for the absorption of glucose into cells for their energy needs and into the liver and fat cells for storage.If there is deficiency of insulin, levels of glucose in the blood stream become abnormally high, causing unquenchable thirst and the tendency to urinate frequently.

There are two main types of diabetes. Type 1 diabetes or insulin-dependent diabetes, the more severe form,  usually first appears in people under the age of 35 and most commonly between the ages of 10 and 15. It develops rapidly. The insulin secreting cells in the pancreas are destroyed probably as a result of an immune response after a viral infection, and insulin production ceases almost completely. Without regular injections of insulin,the sufferer can lapse into a coma. Type 1 diabetes is a lifelong illness. Patients with Type 1 diabetes have an increased chance of developing cardio-vascular disease, suffer loss of vision and loss of limbs.

The other type, Type 2 diabetes, also known as non-insulin-dependent diabetes, is usually of gradual onset and develops mainly in people over 40. In many cases it is discovered only during a routine medical examination. Not enough insulin is produced for the body’s needs, specially when the person is over-weight.  Often the body is resistant to the effects of insulin.In most cases insulin replacement injections are not needed.Instead, a combination of dietary measures,weight reduction and oral medicines controls the condition.

Causes

Diabetes tends to run in families. However,of those who inherit the genes responsible for the insulin-dependent form, only a small proportion eventually develops the disease. In these cases, the disorder is thought to be the delayed result of a viral infection that damaged the pancreas several years earlier. In the case of non-insulin-dependent diabetes, a greater proportion of the people who are pre-disposed by heredity actually go on to develop the disease.

Treatment

The aims of the treatment are to prolong life, relieve symptoms and prevent longterm complications. Success depends on keeping the level blood glucose as near normal as possible through maintenance of normal weight, regular physical activity, careful dietary management and, if necessary, injections of insulin.

In people with insulin-dependent diabetes, treatment consists of regular self-injections–between one and four times a day – with insulin. In addition, the person must follow a diet in which carbohydrate intake is regulated and spread out over the day. By this means,marked fluctuations in the glucose levels in the blood can be avoided.

In non-insulin-dependent diabetes, because the pancreas does produce some insulin, the disorder can often be controlled by dietary means (regulating the carbohydrate intake with meals spaced out over the day). This not only lowers the blood glucose level but also reduces weight.If diet fails to lower the glucose level sufficiently,oral tablets that stimulate the pancreas to produce more insulin may be prescribed, although these are ineffective unless dietary restrictions are observed.

All people with diabetes need regular advice from their doctors so that any complications can be detected and treated at any early stage. Diabetics should wear or carry information identifying them as diabetics in case of an emergency.

There is no cure for diabetes but it can be successfully managed with careful medical monitoring which minimizes complications With modern treatment and sensible self-monitoring,diabetics can look forward to a normal,healthy and active life.