Blood sugar testing - What every diabetic should know – When and How often to test your blood sugar levels at home

The next step is to know when and how often you need to test your blood sugar levels.
This depends on various factors and your doctor is the best person to tell you how often you need to test your sugar levels.
Newly diagnosed diabetics and diabetics who are not under control may have to test
*Fasting for at least 8 hours(Before Breakfast)
*1-2 Hours After Breakfast
*Before Lunch
*1-2 Hours After Lunch
*Before Dinner
*1-2 Hours After Dinner
*Bedtime
*3 A.M. (in some conditions)
I have just mentioned the maximum that a person whom I would treat might have to test in one day. In such cases I usually ask them to get admitted and have a lovely nurse do the testing.
But on average my patients are asked to test three to four times a day till their sugar levels are in control then I ask them to test once a day.
But there are some conditions where you should test more often than normal.
Situations where your doctor might want you to check your blood sugar levels more frequently:
*If your diabetes medicine changes
*If you begin taking other kinds of medicines
*If you change your diet
*If your exercise routine or activity level changes
*If your level of stress increases
*If you are sick. When you are sick, even without eating, your sugar levels may run high, so testing is important.
Continue testing more often until you have maintained your blood sugar levels for at least 1 week, or until your doctor advises you that more frequent testing is no longer necessary.

Blood sugar testing - What every diabetic should know – The importance of an HbA1C test

In my last article I talked about how to learn the correct way to test your blood sugar levels at home. After reading that you now know how to check your sugar levels correctly.

Let me tell you about the HbA1c blood test.

How often should this test be done?
This test is usually done once in 3 months for diabetics

What is the use of doing this test?
It tells your doctor and you the average blood sugar level during the past three months.

One of my patients had asked me this question. “Why should I do this test? I check my blood sugar every week.”
This was my answer: it is not enough to know the fasting blood sugar and post Prandial blood sugar levels because what I have seen among my patients is that just before the blood test for few days they eat correctly and when the test comes the level is almost normal. But when I do this test for them it shows a high value. This means that most of the “other” time my patient has high blood sugar levels.
Similarly your doctor and you need to know if this is what happens in your case and your treatment needs to change depending on such a result, or tomorrow a diabetes complication could occur and both your doctor and you will wonder why this happened to you.

Blood sugar testing - What every diabetic should know

Blood sugar testing - What every diabetic should know - How to learn the correct way to test your blood sugar levels at home

Merry Christmas and wish you all a very Happy Healthy New Year!!!

During the holiday season especially during festivals diabetic people wonder what their blood sugar levels are and what they can do to keep it in control.

Lots of people have doubts about their blood sugar levels.

Some of the questions that people have asked me are:

· What should my blood sugar level be most of the time?

· How often should I test my blood sugar levels?

· What is the HbA1C blood sugar test and how often should I test that?

· Is there any particular time of the day that I should test my blood sugar levels?

· Is there anything else that I should know about blood sugar testing?

My answer to them is, “Learn to measure your blood sugar levels correctly”

How do you do that?

First buy a glucometer. You can pick one up from anywhere but you can go here to get one that I recommend.

Secondly, after you have a glucometer. You need to learn how to use it correctly. It is a machine and if used wrongly, it will give wrong results. In my experience what you should do is read the booklet that came with the machine. Next take the glucometer along with you for your next appointment and ask your doctor to show you how to use it. After that you show the doctor how you check you blood sugar levels and ask if you are doing it correctly. If you are making any mistakes your doctor can correct you.

Deep vein thrombosis (DVT): Risk factors and Preventive measures along with some Diet advice

Recently I received some questions from our subscribers asking me advice on Deep Vein Thrombosis
I thought it might help other people also If I wrote about it in my blog.

Here is some information regarding Deep vein thrombosis (DVT):

What is DVT?
Deep vein thrombosis is a condition in which a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs.
Deep vein thrombosis is a serious condition because a blood clot that has formed in your vein can break loose and travel to your lungs. This is called a pulmonary (lung) embolism. In severe cases, a pulmonary embolism can cause death. However, many instances of deep vein thrombosis disappear on their own.

Who is likely to get DVT?

Some risk factors for developing deep vein thrombosis include:

• Sitting for long
  periods of time, such as when driving or flying.
• Prolonged bed rest, such as during a long hospital stay, or paralysis.
• Injury or surgery.
• A history of deep vein thrombosis or pulmonary embolism. If you've had DVT before, you're more likely to have DVT in the future.
• Being overweight or obese. Being overweight increases the pressure in the veins in your pelvis and legs.
• Smoking. Smoking affects blood clotting and circulation.

If you have any of these conditions/problems consult your doctor on what steps you can take to manage your problem.
In case you want to lose weight we recommend Diet Care Regular or Diet Care Value packages to help you reduce weight
Click on the link below to chat with our dieticians.
http://www.yoscare.in/dietcare

Your goal should be preventing deep vein thrombosis from occurring.

What steps should you take to prevent DVT?

To prevent deep vein thrombosis:

• Take any prescribed medicines as directed.
• Visit your doctor regularly to see if your medication or treatments need to be modified.
• If you take blood thinners (anticoagulants), avoid foods rich in Vitamin K, which can affect how drugs like warfarin work. Foods high in vitamin K include green leafy vegetables such as spinach, Amaranth, green cabbage, brocolli and cauliflower also avoid soybean oils.
• Exercise your lower calf muscles if you'll be sitting a long time. Whenever possible, get up and walk around.
• Move around. If you've been on bed rest, because of surgery or other factors, the sooner you get
  moving, the less likely blood clots will develop.
• Make lifestyle changes. Lose weight, quit smoking and control your blood pressure. Obesity, smoking and
  high blood pressure all increase your risk of deep vein thrombosis.
• Wear compression stockings to help prevent blood clots in the legs if your doctor recommends them.
• Be careful that you do not have excessive bleeding, which can be a side effect of taking medications such as blood thinners.

Please let me know if you have any further questions or comments regarding Deep Vein Thrombosis by writing a comment to this blog or mail me

YosCare is no longer Beta

Winter Tips for Diabetics

Winter is just around the corner so I thought I'll put up an excerpt
from a conversation that I had which would be helpful to diabetics
during winter time.

Q. Does climate in any way, direct or indirect, affect diabetes?

A. Warm and Cold temperatures have no direct effect on diabetes control
but can affect it indirectly. While your blood sugar doesn't go up or
down in response to hot or cold outdoor temperatures, it does have an
impact on eating and exercise habits, which is a key factor in
controlling your blood sugar levels. In warm temperatures, the body can
be stressed due to heat and high humidity. And this can throw the blood
sugar levels out of control.
For those who are on insulin, storing it becomes a problem in warm
climates as improper temperatures can destroy insulin and it won't work
effectively if it is not stored correctly.
Winter season according to some studies is a cause for depression and
anxiety, which is a stressful state for the body and stress can in
turn, affect blood-sugar levels.

Q. Generally people tend to eat more during winter. They also snack
more. In such circumstances should diabetics take special precautions?

A. Only disciplined and responsible eating can help a diabetic control
their blood sugar levels. There is no real harm with snacking when you
are hungry but the key is to snack on healthy alternatives that only a
good dietician can guide you on.

Q. During winter, it is sometimes difficult to exercise because of the
cold. Diabetics are supposed to regularly exercise. What do they do?

A. For those who find it difficult to exercise in the cold they can try
other options such as:
• Heated pools: Swimming in a heated pool is a great way to stay active
in cold weather. Swimming is an ideal full body exercise for those who
have a lot of weight as they can exercise without risking damage to
their joints. • Working out at a Gym: Gyms offer many ways to keep
moving indoors, from aerobics classes to weight machine circuits.
Winter might also be a good time to test a trial membership. Studies
have shown that weight training in diabetics helps tone muscles and
keeps bones strong and healthy.
• Exercising at home: It's easy to be active even without leaving home.
o Housework: Routine house work can be exercise, and you will end up
with a neat and tidy house in the bargain. Playing fast-paced music may
also help.
o Exercise videos: Videos can help people stay focused, teach new moves
and provide good warm-up and cool-down periods. Exercise videos made
especially for people with diabetes are available. Online videos are
available which people can easily download and use.
All people who exercise need to remember to drink clean water or
electrolyte replenishing fluids and avoid sugary drinks.

Q. In places like Delhi, Chandigarh, Jammu temperatures dip to near
zero and in south in Hyderabad and Bangalore, the temperature goes
below 10 degrees C. What are the precautions that diabetics should take
in terms of skin care, diet, sleep, protection etc.

A. Winter brings special challenges to people with diabetes.
• Keep yourself warm. Wear layers of clothes. Staying warm requires
that you trap warm, dry air next to the body.
• Watch your weight. Winter can mean an extra 2-5 kilos for many
people. This is risky as weight gain increases your risk of heart
disease.
• Diabetes-related circulation and nerve problems can mean icy cold
feet. Don't use hot-water bottles, but rather just wear layers of socks
to keep your toes warm.
• Drink lots of water as people who are dehydrated will send their
sugar levels up
• Stay relaxed as stress leads to high sugar levels. For those whom
stress is a routine occurrence, they should learn and practice
relaxation exercises to combat stress.
• Don't ever guess your sugar levels. Sometimes we all feel lazy and
guess our sugar levels instead of testing it on the glucometer. This is
not the recommended option. Always test your blood sugar levels and
then take your medicines. Every once a year show your doctor how you
test your blood sugar and confirm that you are doing it correctly.
• When the weather gets cold, old aged individuals who have a decreased
ability to control body temperature and a less body fat have more
chance to face a drop in body temperature. Such people and their care
takers should take more care to prevent this from happening.

Q. Are diabetics more vulnerable to extreme cold conditions?

A .There is not much difference in terms of vulnerability to cold for a
normal diabetic compared to a normal person. But those diabetics who
have begun to lose sensation in their hands and feet need to be very
careful as the cold can cause damage to the hands or feet areas and the
person won't even feel the damage at the time.

Q. This is also a season when people tend to consume alcohol more to
ward off cold. Is alcohol harmful to diabetics even in limited
quantity? Is there any threshold limit?

A. Contrary to popular belief alcohol does not keep you warm. It
actually makes you lose more heat than usual. This is because it
dilates blood vessels and in winter dilated blood vessels allow more
heat to escape from the body compared to normal. Another thing for
diabetics to remember is that alcohol reduces your blood sugar levels
quite quickly so always eat some healthy snacks along with your drinks.
The safe threshold limit is one drink for a woman and two drinks for a
man per day. Anything more will have cancel out any beneficial effects
of alcohol on the body.

Q. In case people eat more and also occasionally drink, how often should they go for check ups?

A. Normally the doctor who is supervising your diabetes treatment will
decide who often you have to visit him. In addition to those normal
visits that can be once in a week to once in a month or even once in 3
months, you have to visit other specialist doctors one in a year or in
case you have any problems more often.

Q. What about juvenile diabetics and winter? Any special care or precautions to be taken?

A. Juvenile diabetic is an older term for Type 1 diabetic. There are
clinical studies that have found that environmental triggers contribute
to the onset of diabetes in people. More people are diagnosed with type
1 diabetes during winter months as well as in colder climates in
general, so cold weather is a suspected environmental trigger for
developing type 1 diabetes. Therefore to sum it up Type 1 diabetics
should follow all recommendations for the control of blood sugar levels
that all diabetics should follow.

Q. Any other comments, suggestions for our readers?

A. You have to visit other
specialist doctors once a year or more often in case you have any other problems.

Metformin in Diabtes treatment

One of the drugs commonly used in the medical treatment of Diabetes is Metformin. I am writing this article as I wanted to help diabetics better understand this medicine.

Metformin can be used alone or in combination with other medicines to treat Type 2 Diabetes mellitus. It is not used to treat type 1 diabetes.

First of all what does this medicine do in the human body. Metformin helps to control the amount of glucose (sugar) in your blood. It does this in three main ways:

1. It decreases the amount of glucose you absorb from the food you eat and
2. It decreases the amount of glucose made by your liver.
3. Metformin also helps your body to respond better to insulin natural or injected.

Only your doctor can tell you how much Metformin and how many times a day you need to take. Do not take more or less of it than what your doctor has prescribed. Metformin controls diabetes but does not cure it. Continue to take metformin even if you feel well. Do not stop taking metformin without talking to your doctor.

Not everyone who takes metformin is a Type 2 diabetic. Metformin may be prescribed for other uses; ask your doctor for more information regarding this.

Once you start eating metformin you cannot start eating whatever food you like and stop doing any exercise. Diabetes treatment can only work when the person who has diabetes eats the medicines on time and also eats the correct amount of the correct food at the correct time and exercises at least 30 min a day 5-7 days a week.

In case you forget to take a dose take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Metformin may rarely cause a serious, life-threatening condition called lactic acidosis.

Drinking alcohol increases your risk of developing lactic acidosis or may cause a decrease in blood sugar. Ask your doctor how much alcohol is safe to drink while you are taking metformin.

Side effects from metformin include a change in taste, loss of appetite, nausea or vomiting, abdominal bloating or gas, diarrhea, or skin rash. These may occur during the first few weeks of taking the medication but are seldom long-lasting. Taking the medication with food and starting out with a low dose help reduce side effects. The dosage can be gradually increased as side effects diminish.

Metformin may rarely cause low blood sugar levels or hypoglycemia.

Your doctor will tell you what you should do if you develop hypoglycemia. He or she may tell you to check your blood sugar, eat or drink a food or beverage that contains sugar, such as hard candy or fruit juice, or get medical care. Follow these directions carefully.

The following are symptoms of hypoglycemia:

• shakiness
• dizziness or lightheadedness
• sweating
• nervousness or irritability
• sudden changes in behavior or mood
• headache
• numbness or tingling around the mouth
• weakness
• pale skin
• hunger
• clumsy or jerky movements

If hypoglycemia is not treated, severe symptoms may develop. Be sure that your family, friends, and other people who spend time with you know that if you have any of the following symptoms, they should get medical treatment for you immediately:

• confusion
• seizures
• loss of consciousness

Therefore who should not use metformin? In a nut shell, it should not be used by those who use more than two ounces or two drinks of alcohol everyday day, who have congestive heart failure, or who have significant kidney, liver, or lung disease.

The advantages of metformin are that it has a much short action time and has a much lower risk for severe side effects and is quite safe for use by anyone who is otherwise healthy. In fact, in the major UKPDS study, it was the only drug that reduced diabetes-related death rates, heart attacks, and strokes.

Metformin lowers fasting blood glucose levels by an average of 25%, postprandial blood glucose up to 44.5%, and the HbA1c by an average of 1.5%. Metformin reduces raised plasma insulin levels in cases of metabolic syndrome by as much as 30% and reduces the need for injected insulin in Type 2s by 15 to 32%.

Metformin possesses some distinct advantages in treating diabetes. Excess glucose produced by the liver is the major source of high blood sugars in Type 2 diabetes and is typically the reason for high blood sugars on waking in the morning. Metformin reduces this overproduction of glucose. It helps in lowering the blood sugar, especially after eating, with no risk of hypoglycemia when used alone. Modest improvements in cholesterol levels are also seen. The 10 year UKPDS Study of over 3,000 people with Type 2 diabetes found that those who were placed on metformin had a 36% decrease in overall mortality and a 39% decrease in heart attacks.

Because metformin shuts off the liver’s excess production of glucose, it reduces the amount of injected insulin needed to control the blood sugar in both Type 1 and Type 2 diabetes. People with Type 2 diabetes who are on insulin usually are advised to lower their insulin doses prior to starting metformin. The full improvement in glycemic control and cholesterol levels may not be seen until 4 to 6 weeks of use have passed.

The truth about Diabetes

Like all complicated matters there are certain misunderstandings regarding Diabetes.
Today I want to dispel some myths regarding diabetes.

Here is a list of the questions that I will be discussing:

• Can get diabetes from someone else?
• Eating too much sugar causes diabetes
• Type 2 diabetes is mild diabetes
• People with diabetes eventually go blind
• It's not safe to drive if you have diabetes
• People with diabetes can't play sport
• People with diabetes are more likely to get colds and other illnesses
• People with diabetes can't eat sweets or chocolate
• People with diabetes shouldn’t eat bananas or grapes
• People with diabetes should eat special diabetic foods

Now for some serious myth bashing...

Can get diabetes from someone else?
Although we don’t know exactly why some people get diabetes, we know that diabetes is not contagious – You cannot get it from others. There is a chance that a person whose parents or brothers and sisters have diabetes might get diabetes, particularly Type 2 diabetes. But lifestyle factors also play a part.

Eating too much sugar causes diabetes
Eating sugar does not cause diabetes. Diabetes is caused by a combination of inherited and lifestyle factors. However, eating a diet high in fat and sugar can cause you to become overweight. Being overweight increases your risk of developing Type 2 diabetes, so if you have a history of diabetes in your family, a healthy diet and regular exercise are recommended to control your weight.

Type 2 diabetes is mild diabetes
There is no such thing as mild or borderline diabetes. All diabetes is equally serious, and if not properly controlled can lead to serious complications.

People with diabetes eventually go blind
Although diabetes is the leading cause of blindness in people of working age, research has proved you can reduce your chances of developing diabetes complications – such as damage to your eyes – if you:
• Control your blood pressure and glucose levels
• Keep active
• Maintain your ideal body weight
• Give up smoking

It's not safe to drive if you have diabetes
Providing you are responsible and have good control of your diabetes, research shows that people with diabetes are no less safe on the roads than anyone else. Nevertheless, the myth that people with diabetes are not safe persists

People with diabetes can't play sport
Pakistan's famous all-rounder Wasim Akram has diabetes; many other people with diabetes take part in active sports. People with diabetes are encouraged to exercise as part of a healthy lifestyle. Keeping active can help avoid complications associated with diabetes, such as heart disease. There may be some considerations to take into account with your diabetes before taking up a new exercise regime – talk to your doctor for more information.

People with diabetes are more likely to get colds and other illnesses
No. You are no more likely to get a cold or another illness if you’ve got diabetes. However, people with diabetes are advised to get flu vaccinations. This is because any infection interferes with your blood glucose control, putting you at risk of high blood glucose levels and, for those with Type 1 diabetes, an increased risk of ketoacidosis.

People with diabetes can't eat sweets or chocolate
Sweets and chocolate can be eaten by people with diabetes just like the rest of us, if eaten as part of a healthy diet. Remember that confectionery foods tend to be higher in fat and calories too so for this reason they should be limited especially if you’re trying to lose weight.

People with diabetes shouldn’t eat bananas or grapes
All fruit and vegetables are extremely good for you. Eating more can reduce the risk of coronary heart disease, some cancers and some gut problems. You should aim to eat at least five portions of fruit and vegetables a day. This also helps to improve the overall balance of the diet. Eating a variety of different fruit and vegetables ensure you get the maximum benefit.

People with diabetes should eat special diabetic foods
Diabetic versions of foods offer no special benefit. They still raise blood glucose levels, contain just as much fat and calories, are usually more expensive and can also have a laxative effect. The healthy diet for people with diabetes is the same as that recommended for everyone – low in fat, salt and sugar, with meals including starchy foods like bread and pasta and plenty of fruit and vegetables.

Medicines and side effects

Recently we have added a new tool on our website which helps you know more about any medicine that is available in India.

There was a lot of information on side effects of the medicine in the tool so I wanted to write about this topic

Unwanted side effects can be seen for many medicines. Out of hundred people taking a medicine only one or two people may have an unwanted side-effect. Now what more do you need to know about medicines and their side effects:

· Prescription medicines can cause side effects

All medicines can cause unwanted side effects. For example, antibiotics such as penicillin cause allergic reactions in around five per cent of the population. Skin rashes are a common reaction. However, it may be the illness or the medicines that are to blame for the reaction, and telling the difference is tricky. A further complication is the interaction of any other medicines, including complementary medicines, which the person may be taking.

· Herbal medicines also cause side effects

Many people believe that Herbal preparations, such as herbal remedies, are safer because they are derived from natural sources. This isn’t always true. Some herbs can act on the body as powerfully as any allopathic medicine, and unwanted side effects can occur.

· Alcohol used with medicines can cause side effects

Consuming alcohol with some medicines can also cause unwanted and sometimes dangerous side effects. These effects include drowsiness with antihistamines or antidepressant medicines. Drivers and pilots should be very careful in this regard.

Now what should some one do if they experience side effects

Note down exactly what happened and consult your doctor. The dose or type of medicine may need to be adjusted.

If you are sensitive to a particular medicine, your doctor can suggest a substitute. Please don’t ask your pharmacist for a substitute. This is a way to get more side effects. J

Now what should a person do to reduce their chances of side effects

• Take all medicines strictly as prescribed. Taking medication incorrectly can cause side effects.
• Don’t take anyone else’s medicines. Even if the both of you have the same problem.
• Learn about your medication. We have a facility known as "Know your medicine" on our website just click on the link below
  http://personalcare.yoscare.in/know_your_medicines
  This tool helps you to get more information about any medicine that you want to know more about.
• Tell your doctor about all the medicines you take, including prescription, and ayurvedic and homeopathic
• Ask your doctor if improving your lifestyle could reduce your need for medication. Some conditions can be better managed with changes to your diet and regular exercise.
• You need to take the medicines on time and we have a facility that can help you organize your pill taking known as medication reminders for registered users (it’s free). You may be at risk of making mistakes if you take many different medicines at different times.

Varicose veins – in a nutshell

Lots of people are worried that they have/might get varicose veins.
I thought that I should provide some thing short and sweet for anyone who wants to know more about this particular condition.
Obviously this is a problem affecting the veins of the body, most commonly the legs.
Blood vessels that carry blood from the various parts of the body to the heart are known as veins, they have one-way valves that prevent blood from flowing backward. If the valves become weakened, some blood can remain in the vein, causing the vein to enlarge and bulge.
• Smaller congested veins close to the skin are commonly referred to as spider veins.
• Larger congested veins are found mostly in the legs and are commonly called varicose veins.
No one knows the exact cause of congested veins, but heredity, aging, pregnancy, and prolonged sitting and standing may contribute to the problem.

Whether varicose veins need to be treated, is generally up to the individual. Some people request treatment because of the appearance or discomfort of varicose or spider veins.
Congested veins can worsen over time, causing sensations of heaviness, cramping, or burning. The most severe cases may cause swelling in the legs and feet, skin ulcers, or blood clots.

How can this disorder be treated?
Options for treating large varicose veins:
• Elevating your legs as often as possible;
• Wearing elastic support stockings;
• Sclerotherapy;
• Surgery to remove the veins;
• Wait and see.
Options for treating spider veins:
• Sclerotherapy — small needles are used to inject a chemical solution into each varicose vein, causing the vein to close. Blood is rerouted to other veins.
• Laser ablation — sends intense bursts of light onto the veins to seal them off, causing them to dissolve over time.
• Thermal ablation — is similar to sclerotherapy, except the veins are sealed off with an electric current instead of a chemical solution.

Researchers are still evaluating which treatments are most effective for cosmetic and long-lasting results.
Surgery is preferred for severe varicose veins. Sclerotherapy is recommended for recurrent varicose veins after surgery. Most of the procedures can be done in an outpatient setting.

What should you discuss with your doctor?
Talk to your doctor about referrals to specialists who do vein treatment or surgery. You should ask the specialist which treatment might be successful in your case. You should also know congested veins may return after surgery. Most insurance policies do not cover treatment for varicose veins if it is done only to make you look better, but if you have physical symptoms, too, insurance may cover the treatment.

What can I do to prevent it from getting worse?
Doing simple things like elevating your legs, wearing support hose, exercising regularly, keeping your weight down, not crossing your legs when sitting, and eating a high-fiber diet to avoid constipation will help prevent varicose veins and relieve discomfort from the ones you have.

Tea and me

I was basically someone who did not drink tea or coffee unless I had an exam a few days away and I really needed to stay awake and study. One fine day I decided to try something. I decided to make the perfect cup of tea and looked up the Internet for instructions on how to make the perfect cup of black tea. I finally got everything I needed to make the tea, and made it just as they said in the recipe. It was good. But then I had made a little extra so I left it there and sat down to study something. After a while of studies I came back for a snack and saw my tea there again, this time it was cold and I tasted it and thought “Wow!” this is good stuff.

I drank up and went back and hit the books again. At the end of the day while lying in bed at night I realized that I had completed all the topics I had set for myself for that day and was not as drained out as usual. I went over the events of the day and realized that it was an ordinary day with the only exception being that I had two cups of tea. The next day I decided that there must be something about tea that I had not known until now and decided to do some research. What I found, amazed me, and now I’m a firm believer in the beneficial effects of tea.

Here were some of the problems that used to worry me:
• My dad has diabetes and I was afraid I would also end up diabetic.
• I wanted to lose a few kilos.
• I had to study hard for my post grad exam which was around the corner and I kept forgetting stuff that I had read a month back.
Here are some of the things that I found:
• Black tea increases your metabolic rate. Clinical trials conducted by the University of Geneva and the University of Birmingham indicate that green tea raises metabolic rates. In addition to caffeine, green tea contains catechin polyphenols that raise thermogenesis (the rate at which calories are burned), and hence increases energy expenditure.
• It also apparently increases endurance in exercise by improving fat metabolism.
• Tea speeds up fat oxidation and improves insulin sensitivity and glucose tolerance, this is really good news for diabetics (I did not say you can start adding sugar in the tea though)
• John Foxe, Ph.D., professor of neuroscience, biology and psychology at City College of the City University of New York, found that theanine is absorbed by the small intestine and crosses the blood-brain barrier, where it affects the brain's neurotransmitters and increases alpha brain-wave activity. The result is a calmer, yet more alert, state of mind. (Exams, here I come!!)
• In 2003 the Brigham and Women's Hospital released details of a research project which indicated that theanine may help the body's immune system response when fighting infection, by boosting the disease-fighting capacity of gamma delta T cells. The study included a four-week trial with 11 coffee drinkers and 10 tea drinkers, who consumed 600ml of coffee or black tea daily. Blood sample analysis found that the production of anti-bacterial proteins was up to five times higher in the tea-drinkers, an indicator of a stronger immune response.
• According to a study by UCL researchers, drinking black tea lowers stress hormone levels. Just 50 minutes after a high stress event, tea drinkers, who had been drinking 4 cups of black tea daily for a month, had a 20% greater drop in cortisol than the placebo group. Blood platelet activation, which is linked to blood clotting and the risk of heart attacks, was also lower for tea drinkers.

And that is not all, the list goes on. But it was enough to convince me.

But for us Indians there is one more piece of news that we need to keep in mind.

All of this information refers to studies where the tea did not have any milk in it!!
A study at the Charité Hospital of the Berlin Universities showed that adding milk to tea will block the beneficial effects that tea has in protecting against cardiovascular disease. This occurs because casein from the milk binds to the molecules in tea that cause the arteries to relax. Tea protects against cancer but one you add milk this benefit is lost again. So the take home message is drink tea, leave out the milk (and sugar for diabetics) and stay happy.

Hypoglycemia and hyperglycemia. What you should do if you get it.

Many people with diabetes don't really know what to do when they have an very low or very high sugar level readings.

Here I explain some easy, practical things to keep in mind.
If the sugar levels in your blood are very low (Hypoglycemia) you might feel some of these symptoms:

• Shakiness, jerky movements, dizziness, seizure, sweating, hunger, headache, perspiration, difficulty speaking, difficulty paying attention, pale skin color, tingling sensations around the mouth, feeling anxious or weak

In such a case, this is what you should immediately do:
Drink a soft drink like Pepsi, 7up, Sprite, etc. In case only sugar is available then take one or two tablespoons of sugar and mix it in some water and drink it.
Once you feel better eat a healthy, long-acting carbohydrate to maintain blood sugars in the appropriate range. Half a sandwich is a reasonable option.
If the hypoglycemic episode has progressed to the point where you cannot or will not take anything by mouth, you need to make sure someone around you knows how to give you a glucagon injection. A response is usually seen in minutes and lasts for about 90 minutes. Again, a long-acting source of glucose should thereafter be consumed to maintain blood sugar levels in the safe range.

I recommend that you sign up for a YosCare account so that you can take a print out of an emergency card and keep it with you always. It’s free, takes 5 mins and in an emergency it could save your life some day. Just click on the title to go to the YosCare login page.

If the sugar level in your blood goes up very much (Hyperglycemia) you might feel the following symptoms

• Early signs: Increased thirst, Headaches, Difficulty concentrating, Blurred vision, Frequent urination, Fatigue (weak, tired feeling), Weight loss, Blood glucose more than 180 mg/dL,
• Prolonged hyperglycemia in diabetes may result in: Vaginal and skin infections, Slow-healing cuts and sores, Decreased vision, Nerve damage causing painful cold or insensitive feet, loss of hair on the lower extremities, and/or erectile dysfunction, Stomach and intestinal problems such as chronic constipation or diarrhea,

Here are some measures that you can take if you know (after a blood test) that you have hyperglycemia:
• Drink more water. Water helps remove the excess glucose from your urine and helps you avoid dehydration.
• Exercise more. Exercise will help to lower your blood glucose.
Caution:
If you have type 1 diabetes and your blood glucose is over 240 mg/dL, you need to check your urine for ketones. When you have ketones, do NOT exercise.
If you have type 2 diabetes and your blood glucose is over 300 mg/dL, even without ketones, do NOT exercise.
• Change your eating habits. You may need to meet with the dietitian to change the amount and types of foods you are eating.
• Change your medications. Do not make adjustments in your diabetes medications without first talking with your health care provider.

When one has hyperglycemia for a prolonged duration, the body starts breaking down fats for energy. When fats are broken down a substance called ketones are released into the blood which if not managed early can lead to a dangerous condition called Ketoacidosis.
Symptoms include:
• shortness of breath
• breath that smells fruity
• nausea and vomiting
• a very dry mouth
In such cases rush to the emergency department to see a doctor.

Diabetics their fears and some solutions

All Diabetics will remember the day they were told they had diabetes. Different people react to the news in different ways.

Questions foremost in the mind of a new diabetic’s mind are:

• ‘Is it serious?’
• ‘Am I going to die?’
• ‘Will I get better?’
• ‘Am I going to lose my legs like that lady in the waiting room?’
• ‘Will I go blind?’
• ‘Will I lose my job?’
• ‘Am I going to lose my driving license?’
• ‘Will I lose my boyfriend?’
• ‘What are you going to do to me now?’
• ‘Will I need to have injections?’
• ‘Will it hurt?’

In the near past there have been many advances in the management of diabetes; but the sad reality that stares society in the face whenever we look at the mirror with respect to diabetes and the way it is presently managed is that of the sad diabetic who wants to do whatever his doctor tell him to do but is unable to due to various reasons.

Let’s round up the usual suspects:

• 58% of people diagnosed with diabetes do not know what the diagnosis means
• More than 1/3rd do not know what questions to ask their doctor.
• 60% of patients with diabetes do not understand what different medicines are available,
• The few to whom the doctor explains the situation, many of them do not understand what their doctor is telling them
• Some people who get some printed material from the doctor are unable to understand the material as it is written.

All if this leads to a feeling of frustration, depression and helplessness.

A solution to the problem lies in providing personalized information that focus on individual circumstances and locally available services.This is what YosCare is aiming to address. We can provide the personalized information at the right time from among the locally available sources.

We seek to achieve this through encouraging more people:


• To understand what questions they need answered
• To prepare for their consultations by maintaining one single health record
• We also provide them with a set of tools that help them meet their doctor’s prescription.
• Thus helping them become an active partner in their treatment plan and thereby building their confidence to understand their condition and its treatment better.

Everyone recognizes that the first step to dealing with a problem is to learn as much as necessary about that problem. Hence the need for educating a diabetic about their condition needs no further discussion.
Then other issues that need to be addressed are then, why do they need a single health record, and why do they need a set of tools.

• The doctor will be able to efficiently tailor the personalized treatment plan if he has all the information that he requires while examining the patient. Therefore to ensure that the patient receives the best quality of care, it is imperative that his health record needs to be up-to-date and available at the time of the consultation.
• The set of tools are a convenient way by which the patient is able to systematically record and maintain his records, while being alerted to the treatment plan that his doctor has developed for him and other guidelines that must be followed for better clinical and quality of life outcomes.

We believe that such an interconnected system which addresses the special needs of a diabetic will go a long way in improving diabetes care in the present day scenario.