I get tired very easily, long standing diabetes

These days feeling tired or exhausted seems to be norm for a majority of people. Most people say it’s due to stress, hectic schedules or lack of a good work life balance. However, this sort of constant low energy or fatigue can be due to long standing diabetes.

• Cause for tiredness in diabetes

The feeling of lethargy or fatigue generally arises when blood sugar levels are either higher or lower than normal. This could be due to the body not being able to process insulin correctly (Type 2), inadequate production of insulin (Type 1) or an incorrect diet. When insulin in the body is low, it isn’t regulated enough to supply the cells with energy, making us feel tired.

This is why it is so important for people with diabetes to constantly strive to keep their blood sugar levels normal. Not only does it helps keep you active but also prevent any other diabetic complications such as heart problems or hypertension.

• Reasons for being so tired -

1. Low blood sugar (Hypoglycaemia)

Sometimes diabetics get too focussed on lowering their blood sugar levels without realising that it could fall below normal levels. Low levels of glucose in the body mean there is less conversion into energy making you feel tired. This could be due to a high dosage of medication, skipping meals, eating less carbohydrates or even taking insulin incorrectly. Be sure to eat healthy meals and take your medication as advised by the doctor. In case you are feeling tired even after following the doctor’s prescription, be sure to go in for a follow up consultation, as it may require changes to your medicine dosage or diet plan.

2. High blood sugar after eating

Many people with diabetes complain about feeling tired soon after their meals. This may be because of the meal consumed in itself. Eating carbohydrates made from processed flour get converted in to energy very quickly leading to a sudden spike in glucose levels followed by a quick crash. To avoid such a situation always eat high fiber carbs like whole grains, oats etc. also, if your meal has a higher portion of carbohydrates, it could cause an elevation in blood sugar levels making you tired. Apart from dietary reasons, high blood sugar can also be caused due to insufficient medication. In case, you find yourself feeling more tired be sure to get your levels checked and consult your doctor. He may change your medicine dosage. Keep in mind, weight gain or obesity is the leading cause for high blood sugar levels. So if you are overweight, make sure to eat a healthy diet and exercise to first bring your weight down to normal. This will require a diet of high fiber carbohydrate and a regular workout regime.

3. Abnormal sugar levels during the night

People who wake up tired generally have fluctuating sugar levels during the night. This could be high or low sugar levels. In such a case, it is advised to monitor you sugar levels before sleeping and as soon as you wake up in the morning (fasting blood test). Based on these values the doctor may even recommend you to test these levels during the night. To combat this tiredness dietary and medicinal change may be suggested by the doctor.

Thus we see constant lethargy or tiredness is reflective of abnormal sugar levels. To counter this feeling of exhaustion and be active, ensure that you are following a healthy meal plan and exercise regime. Also, be sure to take your medicine only as advised by the doctor! Monitor your levels regularly and consult your doctor in case you see any fluctuations.

For Full Care of Diabetes,

Visit www.lifespanindia.com

Call 1800 3000 1893

Important tips for Diabetics while travelling

Yes, it’s travel time! No more office for the next few days or worrying about household chores. It’s finally time for you to let your hair down and relax. And to ensure that your holiday stays as fun and relaxed as you hoped, there are certain factors that people with diabetes should consider beforehand. And don’t worry, these aren’t tough. Just like you plan your travel itinerary this is a plan for your health when you travel.

What to do before you travel?

1. Go for a thorough medical check-up before a month or so before you travel. Inform your health care team of your travel plans such as days of travel, destination and mode of travel so they can check for any possible complications.
2. In case you are crossing time zones, be sure to confirm when to take your medicines and meals to avoid fluctuations in blood sugar.
3. When travelling to a new destination, be sure to get the required vaccines or immunizations a month in advance. Any infection or illness could seriously disrupt blood glucose levels and cause you problems in your vacation.
4. Ask for a letter and prescription of your medication. This is extremely important. These will allow you to carry supplies such as glucometer with pricker, insulin syringes and pumps in the flight without objection. Also, a detailed letter about your treatment method can be beneficial for doctors in other places in case you need a consultation. They can be sure to continue with the treatment followed at home and avoid any significant changes.
5. Keep a log of your medicines dosage and timings with you at all times. This can also help doctors in your travel place to judge your response better.
6. Talk to your doctor about possible treatments in case of an infection or illness. Certain medicines can affect sugar levels and interfere with insulin. It’s best to ask for general medicines that could be taken.

Tips for packing

1. Always keep double the medicines and supplies you need when you travel. Also, don’t pack them all in one place. Make sure to keep half the supplies in a bag that will be with you at all times, irrespective of mode of travel.
2. Carry a copy of your doctor’s letter and prescription in your carry bag.
3. Carry some snacks like khakra, biscuits, dates ladoo with you to avoid episode of low blood sugar. Ask your doctor what are the best food options.
4. Pack your insulin in the temperature controlled case to avoid exposure to extreme temperatures.

During travel

1. Whether you are travelling by flight or train, be sure to speak the attendants about your condition and ask them for low fat snacks. Also, if service timings interfere with your medicine time, request them to serve you later. In any case, always carry some light food with you.
2. Be sure to stretch and walk in between. Sitting or sleeping for long periods can affect blood circulation. Whether you are travelling by flight or car, be sure to stretch a bit every hour and take a walk in between.
3. Wear comfortable shoes. Do not travel barefoot even for a short period of time. Wear sneaker or comfortable shoes when travelling and even while sightseeing at your destination.
4. Be sure to test your blood glucose levels regularly. This will help you monitor and adjust for any changes instantly. Also, maintain a log about your levels and medicines at all times.
5. A little care taken before you travel can help you enjoy your vacation to the fullest without harming your health. After all there is nothing worse than going to a new adventurous or scenic place and being left unwell in your room all day!

For Full Care of Diabetes,

Visit www.lifespanindia.com

Call 1800 3000 1893

Tips to lower your HbA1c levels

Regularly monitoring blood sugar levels is the number one rule for diabetics. This may mean testing blood in the day, in the evening or after a meal. However, there are many factors that influence blood sugar levels which may cause slightly inaccurate readings. This is why doctors ask for a HbA1c test to gauge changes in glucose levels and effects of treatment.

So what is HbA1c?

The HbA1c blood test is a check for the average blood sugar level over a three month period. This is a great way to judge the effectiveness of diabetic treatment and is a better indicator of a person’s risk for chronic illness. The higher the value the, higher is the blood sugar level and risk of ailments.

The ideal HbA1c value is below 6.4%. For diabetics though the number is generally higher than 6.5% but should not exceed 7%. Lowering HbA1c test levels is one of the most important factors in diabetes treatment.

How can I lower my HbA1c number?

1. Follow a healthy meal plan: Include lots of fresh vegetables and fruits in your diet. These are high in nutrition and low in calories. Also, natural fiber got from these fruits and vegetables help keep blood glucose levels normal. Add vegetables like carrot, beans, tomatoes and broccoli to your diet. Fruits such as apples, grapefruit and watermelon are also good for glucose levels. Nuts and seeds are also loaded with anti-oxidants and omega-3 which keep your immunity and overall health good. However, always consume nuts in moderation as they are high in fat.

Note: Certain fruits and vegetables may interfere with diabetes medication. Always talk to your doctor or nutritionist before adding anything new to your diet.

2. Eliminate junk food: Junk and processed food like fried foods, desserts and store-bought foods all raise blood sugar and should be avoided. These foods generally consist of high sugar levels, processed flour and Trans fat, all of which impact glucose levels. Eliminate these from your diet as much as possible. When you do eat these foods, limit yourself to a small portion instead of consuming an entire packet.

3. Monitor portion sizes: Even with a healthy diet, portion size is important. Eating larger size meals can elevate blood sugar levels. Instead, opt for smaller quantities at more frequent intervals. This will help regulate blood sugar levels.

4. Lose weight: Obesity is a leading cause for diabetes. In case you are overweight, be sure to get your weight down to a normal range. Even though it may seem tough at first, don’t panic. Set smaller goals and focus on them. For example, if in total you have to lose 15 kgs, make target groups of 5 kgs at a time. Set a realistic time limit for them so you don’t get discouraged. Also, every time you meet your goals reward yourself a little to stay motivated. Talk to you doctor about advice and tips for healthy weight loss.

5. Get active: Exercise is essential in keeping diabetes under control. Even working out for a total of 2 hours in the week can greatly help manage blood glucose levels. Apart from exercise, do simple things that keep you active. Go for a run in the park with your pet or walk to your grocery store. Stand up and walk around while you are on the phone. Every simple activity plays a part in keeping sugar levels healthy.

6. Stick to a routine: Consistency is the name of the game! Try to be regular with your meal and medicine timings on a daily basis. Sticking to a routine by waking up at the same time every morning, and consuming your meals and medicines at relatively the same time daily can greatly help keep blood glucose levels in check.

7. Monitor blood sugar levels regularly: Regular monitoring of blood sugar levels can alert you to any changes instantly. This may be due to certain foods, an exercise routine or something else. Regularly monitoring these levels will help you make adjustments that keep you in the normal range, over time reducing you HbA1c level as well.

8. Maintain a diabetic log: Maintain a log with all your blood test readings, your meal plans, the time you eat, exercise and all such information. Overtime this will help you identify the meal plans that were working for you and at what times your blood sugar is high. This log will also help the doctor to monitor and adjust your medication in the right way to keep HbA1c levels low.

The treatment for diabetes has to be customized to each person. So be sure to listen to your doctor and follow the treatment suggested. Also, a healthy lifestyle with timely medication is the best way to keep blood glucose levels normal and be healthy.

For Full Care of Diabetes,

Visit www.lifespanindia.com

Call 1800 3000 1893

Do you know your diabetes targets?

Dealing with diabetes can get overwhelming at times. You have to keep your blood sugar within a certain range, maintain a particular weight, monitor blood pressure levels, cholesterol levels and a lot more. Yet most of us aren’t even aware of the targets that we must be at. We keep striving to reach a goal without even knowing what the accurate goal is. Knowing the range we must be at for all these is essential for effectively treating diabetes. Also, diabetics need to constantly monitor certain levels on a daily basis. Since the doctor is not available daily, it is imperative to know what targets we must be at for good health.

Keep in mind that diabetes is a condition which requires a customised treatment per case. So even though you may be aware of a normal range of levels, the doctor may want you to maintain a more specific target. There are several factors that can influence blood sugar levels and thus need to be monitored regularly. Thus, knowing the specific targets that keep your blood glucose levels in the normal range is crucial for good diabetic control.

Factors that influence blood sugar and recommended targets

There are several factors that can impact blood sugar levels and need to be monitored carefully. The levels included here are the normal range that is considered healthy. However, you should talk to your doctor for advice on more specific targets that should be maintained.

• Blood sugar levels

This is the number one focus for all diabetics! Keeping blood sugar levels within the normal range at all times is crucial for good health.

1. Fasting levels: Taken early morning before a meal, the fasting blood test reveal the effectiveness of medicines in controlling sugar at night. The healthy range is 80-110 mg/dl while a level between 111-125 mg/dl is considered borderline. However, anything over 125 is not healthy and needs correction.
2. Post meal:This test is done 2 hours after eating to judge how blood sugar levels react to the food being consumed. A target between 120-140 mg/dl is considered healthy with levels below 200 considered fair in some cases. Anything over 200 is a cause for concern and may require changes in the diet plan or medication.
3. HbA1c test: This is the most trusted vale for diabetics. Also known as Glycated haemoglobin, this level indicates the blood sugar levels over a span of three months. It is considered to be most reliable as it accounts for unexpected fluctuations in glucose levels. In healthy people, HbA1c level is less than 6%. Studies suggest that complication can be prevented or delayed if Hb1c levels are maintained below 7 %. HbA1c level of 8 % or above indicates that better control of blood sugar level is required.

• Blood pressure

Blood pressure levels should ideally be 130/80 mm/Hg. Elevated levels at 140/90 is considered borderline high, with anything higher than that requiring food and lifestyle changes.

• Lipid Profile

Measuring the levels of good and bad cholesterol levels for diabetes is essential as they not only impact blood sugar levels but can also warn of serious illnesses. Heart problems, hypertension, liver damage etc. can be diagnosed early by monitoring these levels. The ideal values should be:

1. HDL-cholesterol (Good cholesterol): This number should be higher than 60mg/dl for healthy heart function and not lower than 40 mg/dl at any time.
2. LDL-cholesterol (Bad cholesterol): Ideally, LDL levels should not exceed 100 mg/dl. However, in otherwise healthy adults a value up to 129 is also accepted. A value of 130 or more outs one at increased risk for chronic ailments.
3. Total cholesterol: A good judge of overall cholesterol health, total cholesterol values should of under 200mg/dl is considered ideal.
4. Triglycerides: This level should be maintained at under 150mg/dl while some doctors may accept a value up to 200, anything higher than that is a concern.

• Body Mass Index

Obesity is a leading cause for diabetes. Maintaining a healthy weight can help one keep their sugar levels in control. While a weighing scale gives you an idea if you are overweight, Body mass Index (BMI) is preferred as it accounts for total body fat. A BMI value of 20-23 is considered best though up to 25 is accepted, higher than 25 puts one at an increased risk for chronic ailments such as heart disease, hypertension etc.

• Waist Hip Ratio

Did you know that your body shape can also have a bearing on diabetes? People with higher fat concentrated around their waist (apple shaped bodies) are said to be more at risk for diabetes and other chronic ailments as compared to people with more fat concentrated around their hips (pear shaped).

So we see there are several factors that can have an impact in keeping diabetes under control. Talk to your doctor and find out what your targets are so that you can focus on achieving them.

For Full Care of Diabetes,

Visit www.lifespanindia.com

Call 1800 3000 1893

How should Diabetics take care of their health in monsoon

The arrival of monsoon has the entire nation breathing a sigh of relief. After months of scorching heat, the cool breeze and cloud cover are a welcome change. However, this season also brings with it several complications such as infections and water borne diseases which pose a serious health threat especially for diabetics. While overall healthcare in monsoon is essential for everyone, it is crucial for people with diabetes to avoid changes in blood sugar levels and potential problems.

Here are some important care tips for diabetics to protect their health while enjoying the season to its fullest:

Be wary of foot infections: Puddles in the ground due to potholes or blocked drainage is a common sight for most of us. And chances are even though you’ve tried your best to escape them, you’ve stepped in a few. Since this water is bound to be contaminated, it is advisable to wash your feet with soap as soon as you reach home and wear clean slippers. Place your shoes in the open, preferably in the sun, to dry out and eliminate bacterial growth. Also, be sure to change your socks daily.

If your feet get dry and itchy, apply some moisturiser to them as dry skin tends to increase chances of cuts which can lead to infections. However, be sure to avoid the region between your toes as with sweat or moisture it can aid bacterial infection. Also, do not walk around bare feet at all, even in the house. Germs and infections are very high this season and walking bare feet is sure to get you infected.

Be sure to monitor your feet very carefully in this season. Simple things like boils, corn, rashes or cuts could get infected and lead to serious complications. Alert your doctor instantly if you notice any changes.

No stopping at the chaatwala: Even though standing in the rain and snacking on your favourite chaat may sound like a fun idea, it is a big no! Water borne diseases are at the peak this season and eating out should be avoided at this time. Not only will such an illness affect blood sugar levels, but it can also cause severe problems. The most common symptoms of these diseases are diarrhoea, nausea and vomiting, often resulting in dehydration. For diabetics, this is more problematic as low hydration levels stress the kidney even further, increasing chances of kidney damage. Also, if food consumption is reduced due to nausea while maintaining regular diabetic dosage it could cause hypoglycaemia (low blood sugar).

Avoid getting wet in the rain: Getting drenched in the rain can cause respiratory infections and high fever. While they may not seem so problematic by themselves, they can have a negative impact on blood sugar levels. Also, the immune system may be compromised increasing recovery time. So in case you do get caught in the rain, be sure to take a warm shower as soon as you get home and change into clean, dry clothes.

Stop giving excuses: While it may seem easy to skip your exercise routine if it is raining, but it is not the most prudent thing to do. Move out when the rain stops or there is a light drizzle. If the rain is heavy, climb the stairs of your apartment or walk around the house or walk in the basement area. Monsoon will stay, but you need to plan out the easiest way to keep up to your exercise schedule.

Monitor blood sugar levels regularly: People with abnormal blood sugar levels will be more susceptible to infections. Also, a change in these levels can signify the onset of an illness. So be sure to stick to your meal plan and exercise routine, and monitor sugar levels routinely. In case you observe any changes in your results, be sure to inform your doctor immediately.

A few simple precautions and care will allow you to enjoy this season to its fullest. After all, the monsoons are known to put a big smile on everyone’s faces! So here’s a positive tip for diabetics, the one monsoon snack you can indulge in – jamuns! These tasty, tiny purple fruits, popular in this season, are great for diabetics as they help control blood sugar while having no calories. A little care this season can go a long way in keeping you fit and healthy the rest of the year!

For Full Care of Diabetes,

Visit www.lifespanindia.com

Call 1800 3000 1893

Can Diabetics ever be off Insulin?

Living in the diabetic capital of the world, we are all aware of the use of insulin in treating diabetes. Be it in the form of injections, a pen or even through a pump, we know that most people with diabetes need to religiously take their required dosage on time to maintain good health. Now a majority of us only consider insulin treatment for Type 1 diabetes, did you know that even people with Type 2 diabetes may be put on insulin? This may come as a shock for many especially as the belief is that once you are on insulin you are permanently dependent on it. Is this true? Or is it possible for people on insulin to go back to oral medication? Let’s take a look:

Understanding insulin

Insulin is basically a hormone released by the pancreas which helps convert the glucose from our food to energy. However, when this hormone is not produced adequately or used in the right way, it can lead to diabetes. This is because the sugar levels in the blood are not converted into energy. In Type 1 diabetes, the body produces little or no insulin requiring insulin to be taken externally. In Type 2 diabetes, though the body is able to produce the insulin but not process it correctly leading to insulin resistance.

Can I ever stop using insulin?

Type 1 Diabetes : In people with Type 1 diabetes, the pancreas generally produces little or no insulin at all. This leads to very high blood sugar levels which can further damage the pancreas. To keep these levels in check, Type 1 diabetics are insulin dependent on a permanent basis. However, a healthy meal plan and exercise regime can help maintain normal sugar levels and keep the requirement of insulin at a low dosage.

Type 2 Diabetes : Good news for all those stressing about insulin for Type 2 diabetes, you can stop it permanently with a healthy lifestyle! There are certain instances which require Type 2 diabetics to take insulin. These include:

• Obesity : Obesity is a major danger sign for people with diabetes. Excess weight gain affects the body’s ability to regulate insulin further worsening blood sugar levels. Obesity also impacts all major organs over time including pancreas further affecting insulin production. In such situations, a person may be put on insulin if oral medication is unable to regulate glucose levels. However, bringing the weight down to a healthy range with regular exercise and a healthy diet can eliminate need for insulin over time.
• Infection or health conditions : Procedures like surgery or illnesses such as infections, high fever, certain medicines etc. can raise glucose levels significantly requiring additional insulin. To control and manage the situation a person may be put on insulin till the underlying condition is treated. However, once the illness is dealt with and sugar levels are stable in the target range, insulin can be stopped.
• Late diagnosis : High glucose levels left untreated can cause severe harm to the pancreas. This worsens its ability to produce insulin further increasing glucose levels. Here the doctor may advise insulin as a temporary solution to bring down glucose levels and then manage it with oral medication. This is also why an early diagnosis via regular testing is essential!
• Gestational diabetes : During pregnancy some women may experience high blood sugar levels. At the time, doctors are likely to suggest insulin to curb these levels and protect the health of mother and child. After completing the pregnancy term, the blood sugar levels should return to normal eliminating the need for insulin.

So we see that as long as our pancreas is able to produce sufficient insulin levels, we don’t need it from external sources on a permanent basis. A healthy diet and lifestyle with a regular exercise regime is a must for healthy insulin levels and to delay or even prevent diabetes. So, if you are on insulin currently talk to your doctor for advice on steps to eliminate it by naturally improving insulin levels.

For Full Care of Diabetes,

Visit www.lifespanindia.com

Call 1800 3000 1893

Dessert recipes for Diabetics

You cannot think of India and not think of food, especially desserts. Almost all of us have grown up in homes where the mother had a sweet dish for every occasion, no matter what – a birthday, an interview or even studying for exams! A bit of sweet for joy and good luck, and the best way to end a meal. What sheer bliss.

Now I’m pretty sure that anyone with diabetes reading this is probably thinking of a few choice words to say, considering they need to reduce sugar intake. But that’s just it people. Who said sugar was the only way to make a yummy dessert? In a nation that’s grown up with a sweet tooth, do you think if 60 million were declared to have diabetes, it would mean the end of desserts? Nope. It just means naturally sweet and healthy treats that taste just like our childhood desserts.

In fact these treats are rich in nutrients making them a great option for everyone looking to control sugar intake, not just diabetics. Let’s look at a few simple and yum examples that you could try out!

1) Apple and Date Kheer

Ingredients

• Apple – 1 (chopped)
• Skimmed milk – 5 cups
• Dates - 1/2 cup (chopped)
• Walnuts – Finely chopped for garnish

Preparation

In a non-stick pan add the chopped apples with 5-6 tablespoons of water and cook for about 3 minutes on a medium flame. Be sure to stir this mix continuously and then place it in the fridge. In a separate pan add the milk and dates and cook on low flame for about 10-12 minutes. Be careful to stir this mix constantly to avoid burning. In case you prefer desserts on the sweeter side, add some raisins to this mix. Place this mix in the fridge.

Now simply combine these 2 ingredients lightly at the time of serving and sprinkle some walnuts on top as a garnish.

2) Anjeer Barfi

Ingredients

• Fig (Anjeer) – 100 grams
• Sugar – 2 tablespoon
• Cardamom (elaichi) powder – ½ teaspoon
• Roasted chana dal coarsely ground – ½ cup
• Water – 1 tablespoon

Preparation

Using the figs, make a puree till they are completely soft and breaking apart. Then in a pan, add water and sugar and make a syrup which reaches string consistency. To this pan, add the anjeer puree and cardamom powder. Cook for about 5 minutes while being sure to stir continuously. Add ground chana dal and transfer this mixture to a greased plate and cut in diamond or squares. For those that enjoy some extra crunch, you can even top it with some roasted nuts like almonds.

3) Oat Phirnee

Ingredients

• Skimmed milk - 1 cup
• Oats - 9 tablespoon
• Water – 3-/4 cup
• Rose water – 1.5 teaspoons
• Cardamom (Elaichi) powder – ¾ teaspoon
• A mix of almond and pista powder – 1 teaspoon
• Dates – 3 finely chopped

Preparation

In a non-stick vessel add the oats and water, and cook on sim till the oats turn soft. Then add milk along with the dates and cardamom powder and mix well. Stir the mixture regularly and it will soon start to thicken. At this point add the almond and pista mix and combine well. Once the mixture reaches a nice thick consistency, move it from the flame. Add the rose water and mix well.

A great fact about this dessert is that it can be enjoyed hot or cold depending on your mood!

4) Date Rolls

Ingredients

• Black dates – 1.5 cups (finely chopped)
• Ghee – 1 teaspoon
• Walnuts – 1 tablespoon (chopped)
• Pista - 2 tablespoons (chopped)
• Almonds - 2 tablespoons (chopped)
• Sesame seeds or poppy seeds for garnish

Preparation

In a non-stick pan, add ghee and let it warm. Add the dates and cook on sim till about 5 mins while stirring regularly. The dates should turn soft and mushy. Move the pan from the heat and all the chopped nuts. Mix the ingredients well and divide into 10 portions. Roll each portion to resemble a log and cover lightly with the seeds. Set these rolls in the fridge to set.

5) Carrot Kheer

Ingredients

• Carrots (grated) - 2 cups
• Skimmed milk - 1 cup
• Raisins - 1 teaspoon raisins
• Cardamom powder – 1/2 teaspoon
• Finely chopped almond and pista for garnish

Preparation

Add milk to a non-stick vessel and bring it to a boil. Reduce the flame and add the carrots and stir occasionally. The mixture will start to thicken after 30 minutes or so. Keep stirring regularly and add the cardamom powder. Check the carrots for a soft consistency ideal for kheer. At this time the milk will also have thickened slightly. Off the gas and the dessert is ready. Garnish it with some chopped nuts for a bit of crunchiness.

You do not need to feel sad about not being able to enjoy your sweet treats. You can enjoy your special desserts if you learn to choose carefully, mind portion sizes and manage the frequency of the indulgence.

Note: Before introducing anything new to your diet be sure to discuss it with your healthcare specialist first.

For Full Care of Diabetes,

Visit www.lifespanindia.com

Call 1800 3000 1893