What is Diabetes and Pre-Diabetes?

Diabetes mellitus is a state with ‘increased blood glucose levels’, which can damage your kidney, eye, heart, nerves, etc. Pre-Diabetes means you are at higher risk of developing diabetes mellitus.

Which are the symptoms of diabetes?

Patient with mildly elevated sugars may not have any symptoms. Usual symptoms of diabetes are: frequency of urine, excessive thirst, increased/decreased apatite, weight loss, burning feet & generalized weakness.

How to confirm the diagnosis of Diabetes?

Diagnosis of diabetes is confirmed by fasting/postprandial sugars or HbA1c. Fasting glucose ≥ 126 mg/dl or postprandial glucose ≥ 200 mg/dl or HbA1c > 6.4% is called ‘Diabetes mellitus’. Fasting glucose 100-125 mg/dl or postprandial glucose 140-199 mg/dl or HbA1c 5.6-6.4 % is called ‘Pre-Diabetes’.

What is HbA1c?

HbA1c is a better reflection of sugar control than fasting or postprandial sugars, because it is an average of last 3 months blood glucose levels. Hence, every diabetic patient should do HbA1c testing at least 2-3 times per year.

What are the types of Diabetes?

Type 1 diabetes, type 2 diabetes, diabetes in pregnancy & other types. Majority (90-95 %) of the patients with diabetes have Type 2 diabetes.

What is the difference between Type 1 & Type 2 diabetes?

In Type 2 diabetes, sugars can be controlled with oral drugs for many years & Insulin is required in few patients only. In Type 1 diabetes, Insulin is always required for sugar control and stopping of insulin can lead to death.

Does eating too much of sugar/sweet leads to diabetes?

Not directly. In fact, eating too much calories in form of carbohydrate/fat in presence of sedentary lifestyle (physical inactivity) can lead to obesity. Obesity leads to insulin resistance (inability of insulin to control sugars) and hence diabetes.

Who is at risk of developing diabetes?

Those who are overweight or obese or have family member with diabetes are at risk for diabetes. Females with history of diabetes in pregnancy or PCOS (polycystic ovary syndrome) are also at increased risk of developing diabetes. Diabetes can occur in anyone without any of these risk factors because we Indians are already at high risk of developing diabetes.

Why is it important to control the sugars?

Uncontrolled diabetes can cause damage to eyes, kidney & nerves. It can lead to stroke or heart diseases. It can also increase the risk of infections and diabetic foot problems. Hence, it is very important to control the sugars.

Is it possible to cure the Diabetes by Yoga or any particular food item (such as karela juice) or any home remedies?

No. But, sugars can be controlled with diet & lifestyle modifications without medicines in some patients with type 2 diabetes.

Is it possible to control the sugars without medicines or is there any permanent cure for diabetes?

Sugars can be controlled with diet & lifestyle modifications (with weight loss) in some of the patients with type 2 diabetes. But, majority of the patients require medicines to control sugars.

Can the medicines used to control sugars damage the kidney?

No. Medicines used to treat diabetes don’t damage the kidney. But, uncontrolled diabetes can certainly damage the kidney and many other organs in the body.

What is the importance of diet, exercise & weight loss in type 2 diabetes?

Diet, exercise & weight loss helps in controlling sugars. If you don’t follow diet exercise & weight loss, you will need higher dose of medicines to control sugars.

Role of exercise in controlling sugars?

Physical activity is the most important aspect of management of diabetes. At least 30 minutes of walking/day is advisable. Avoid prolonged (>90 minutes) sitting. Avoid watching TV or using Laptops continuously for a long time. Exercise helps in controlling sugars and reducing weight. It also helps in lowering blood pressure and cholesterol levels and reducing the risk of heart disease or stroke.

What are the diet modifications for sugar control?

Avoid: sugar, sweets, butter, ghee, cheese, honey, bakery products (Khari/toast/buiscuits/bread/pav/pastries/cakes), potato, sweet potato, fried items, fastfood, junkfood, packaged food, fruit juices & oily foods

Limit: rice, roti & wheat.

Prefer: salads (cucumber/tomato/carrot/onion/cabbage/capsicum), green leafy vegetables, pulses, sprouts, citrus fruits & low fat milk.

Which fruits are preferred for diabetes?

Most of the fruits (except mango, banana, chikoo & clustered apple) are advisable in diabetes. At least 2-3 fruits per day are recommended. It is always better to eat whole fruit than fruit juice.

What is ideal sugar control?

Fasting glucose < 130 mg/dl, postprandial glucose < 180 mg/dl and HbA1c <7 %.

How to monitor for complications of Diabetes?

A patients with diabetes needs to be monitored for eye, kidney & foot problems at least once in a year. Blood pressure should be measured at regular intervals. Lipid profile (cholesterol) should be done at least once in a year.