Diabetes Dr Prasad Honap M D Sushrut 1000

Diabetes Dr Prasad Honap M. D.

Sushrut (1000 B. C. ) Charak ( 100 B. C. )

1000 B. C. • Sushruta described diabetes (madhumeha) as a disease characterized by passage of large amount of urine, sweet in taste, hence the name “madhumeha” — honey like urine. • He goes on to say that diabetes primarily affects obese people who are sedentary and emphasized the role of physical activity in amelioration of diabetes.

Diabetes Epidemic in India • The prevalence of diabetes increased tenfold, from 1. 2% to 12. 1%, between 1971 and 2000 • It is estimated that 61. 3 million people aged 20 -79 years live with diabetes in India (2011 estimates). This number is expected to increase to 101. 2 million by 2030. • 77. 2 million people in India are said to have prediabetes • About 1 million people died from diabetes in India in 2012

The annual cost for India due to diabetes was about $38 2011 billion in $38 billion = 247, 000 Crores One Diabetic patient’s care consumes 25% of Total Family Income

Why is Diabetes rising? 1971 : 1. 2% • Bicycle Commonest Transport • More Physical Activity • Lower Incidence of Obesity • Home Food Consumption • Less Stressful life 2017 : 12% • Two wheeler • • Low Physical Activity Rampant Obesity Fast Food consumption More Stressful life So It’s All about Changing Life Style !!

What is Diabetes • It’s a disease of Metabolism • Sugar can not enter into the cells to provide energy to cells. • So sugar accumulates in Blood but cells remain hungry • Insulin drives sugar from blood into the cells • If Insulin is deficient or inefficient person gets Diabetes

Types of Diabetes • • • Type 1 Diabetes Type 2 Diabetes Gestational Diabetes Stress Diabetes Secondary Diabetes

Pre-Diabetes Higher Blood Sugar Levels but not in the range of Diabetes Higher Risk of Type 2 Diabetes and IHD or Stroke r o d e y a e del Good b n a C !! s w e N d e t n e Prev

How to Prevent or Delay Diabetes? • • • Change the Life style Eat properly Optimum exercise Increase Physical Activity Control the Blood Fats Medication with Doctor’s advice

Diabetes : Symptoms • Being very thirsty or hungry • Feeling tired for no reason • Urinating (going to the bathroom) more than usual • Losing weight for no reason • Having cuts or bruises that are slow to heal • Having trouble seeing (blurry vision) • Losing feeling or having tingling in your hands or feet

A large number of Diabetics DO NOT HAVE ANY SYMPTOMS AT ALL !!

Who Is At the Risk? • • • Are over age 40 Are overweight or obese Have a parent or sibling with diabetes Are African American, Hispanic or Latino, Native American, Alaska Native, Asian American, or Pacific Islander Have had gestational diabetes or given birth to a baby who weighed more than 9 pounds Have polycystic ovary syndrome (when a woman's ovaries produce more male hormones than usual) Have high blood pressure or cholesterol Exercise less than 3 times a week Have pre-diabetes

What is the Danger? • • • Heart Attack Stroke Blindness Kidney failure Risk of amputations

Diagnosis of Diabetes Diagnosis A 1 C (percent) Fasting plasma glucose (FPG) Oral glucose tolerance test Random plasma glucose (OGTT) test (RPG) Normal below 5. 7 99 or below 139 or below Prediabetes 5. 7 to 6. 4 100 to 125 140 to 199 Diabetes 6. 5 or above 126 or above 200 or above

Gestational Diabetes Pregnant women who have never had diabetes before, but have high blood sugar levels during pregnancy are said to have gestational diabetes.

Who is at Risk? • Obesity - with a BMI of 30 or over - losing about 20% of your body weight can reduce your risk • Family history of Type 2 diabetes • If you are an older mom - age 35 or over • If you previously delivered larger babies (between 8 lbs. 5 oz and 9 lbs. 14 oz. ) • If you have high blood pressure • You are Hispanic, African American, Native American, South or East Asian, or of Pacific Island descent. • If you have unhealthy cholesterol • If you smoke • If you do not get enough physical activity • If you are an unhealthy eater

Consequences • Large Babies leading to difficult labour or CS • High Chances of Childhood obesity and Type 2 DM • Increased chances for Mom to get Type 2 DM

How Can You Lower Your Risk? • • Loose Weight Increase Activity and exercise Level Eat Healthy Be under Medical Supervision

After Diabetes What?

Life Style Modification Physical Activity Exercise • Increase Physical Activity • Do Household chores yourself • Avoid Elevators , Climb • Avoid Scooters , walk • Take a break every hour and do stretching • At Least 150 minutes in a week • Aerobic exercise • Muscle strengthening exercises • Stretches • Yoga • Sports

Life Style Modification • Quit Smoking • Control Alcohol Intake • Cut down on Fast Food

Eat Properly MEASURE YOUR WEIGHT AND HEIGHT ESTIMATE YOUR OPTIMAL BODY WEIGHT DECIDE WHAT CHANGES IN YOUR WEIGHT YOU WILL NEED TO MAKE CALCULATE THE CALORY INTAKE NEEDED TO MAINTAIN YOUR PRESENT WEIGHT WITH THE DIET YOU EAT AND YOUR ACTIVITY LEVELS ESTIMATE THE CALORY REQUIREMENTS TO GRADUALLY REACH OPTIMAL WEIGHT

Eat properly If you spend 7700 Calories you will loose 1 Kg of your weight. Food Type Calories Days to Loose 1 Kg 1 Beer 146 52 6 Thin Chapatis 240 32 1 Plate Rice 643 11

Eat properly • • • Eat small Frequent (5 /6) meals Follow the advice of your Dietician Include fibre Restrict Oil/ Ghee/Fat Try to keep the Balance

Trying to Loose weight? • Gradual is wise • No Fancy Diets Please • Remember it’s Diet and Exercise , Not diet alone • Over enthusiasm is dangerous!! • Learn proper Technique

Medication • Medication is only as an adjutant to Life Style Modification • On Medication you need to eat as advised and not to skip meals. • Ask about the side effects of the medications • Do not refill the prescription without doctor’s advice

Self- Monitoring of Blood Glucose • Helps the Doctor to adjust the medication timing and Dosage : Better Control • Allows patient to make day-to-day adjustment to dosage especially Insulin • Avoids sudden lowering of Blood Sugar Level, as well as persistent High levels • Better Patient Education

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