MV Hospital

Welcome to M.V Hospital for Diabetes, established by late Prof. M.Viswanathan, Doyen of Diabetology in India in 1954 as a general hospital. In 1971 it became a hospital exclusively for Diabetes care. It has, at present,100 beds for the treatment of diabetes and its complications.

Wednesday, February 25, 2015

Hypoglycaemia Unawareness

(Not being able to recognize the symptoms of the onset of hypoglycaemia)











Hypoglycaemia is the most common side effect of insulin treatment and usually presents itself with symptoms such as sweating, palpitation and hunger. These symptoms alert the person with diabetes to the condition of their glucose level so that they can take the necessary action. Some people, however, lose the ability to recognize these symptoms. This condition is not just an issue for the person with Type 1 Diabetes Mellitus, it also affects the whole family…their peace of mind and the quality of their lives.

Hypoglycaemia Unawareness is often accompanied by confusion, changed emotions and anger.
The patient might stubbornly refuse to test blood when asked to do so, be aggressive, quarrelsome, or unreasonable when offered help. In extreme cases they can get verbally or physically abusive.

Caregivers become afraid of their relative /partner after violent reactions. They tend to stay awake at nights   or get disturbed sleep because of worries in case of coma. They tend to get up regularly to check if the patient is all right. They are unwilling to leave them alone because they are worried and concerned as well as because the patient is so reliant on them. Some even give up their hobbies or do not go out at all.

From a study that explored the impact of Hypoglycaemia Unawareness on the whole family it was found that …









A person with diabetes and Hypoglycaemia Unawareness:
  • Relies on the family members to help detect and manage Hypoglycaemia Unawareness
  • Does not like this reliance
  • Does not respond positively to help
  • Worries that they have become a burden to others
  • Loses confidence and in some extreme cases has to cope with an unhappy marriage.









A relative or partner who has to care for a patient with Hypoglycaemia Unawareness:
  • Is angry about how Hypoglycaemia Unawareness has affected his/her life
  • Is sometimes frightened of the patient
  • Feels tired, alone and unsupported
So people who have Hypoglycaemia Unawareness should be taught to recognize symptoms and appreciate that the condition can be serious.

Wednesday, February 18, 2015

Hyperglycaemia - A Short term Complication of Diabetes Mellitus

There are various reasons for this and knowing the cause and the treatment can help.

When does a person with diabetes get hyperglycaemia? – 
When blood glucose levels are > 130 mg/dl fasting OR >180mg//dl after meals.

Symptoms of hyperglycaemia:   















Increased thirst, the need to urinate more often, feeling tired, blurred vision, headaches, hunger and muscle cramps.

These are temporary symptoms that disappear when blood glucose level comes back to normal levels. 

There are many reasons why a person with diabetes can have hyperglycaemia.

It can happen accidentally because of
  • Forgotten or miscalculated medication or insulin dose 
  • An unusually high  amount of carbs in a meal, 
  • Over treating a hypo, or 
  • Getting less physical activity than normal.
It can last for longer periods of time because of
  • Illness or infection 
  • Hormonal changes 
  • Stress 
  • Weight gain or
  • It may be time to make corrections to medication or insulin doses 
Hyperglycaemia can also be a side effect of non-diabetes medication.

Treatment for Hyperglycaemia…

Treatment depends on cause of the hyperglycaemia and the current diabetes treatment.
  • If it is insulin related, the dose has to be corrected.
  • If the hyperglycaemia does not come down by changing medication dosage or if there is no illness, then check urine and blood for ketones and be aware of diabetic ketoacidosis and hyper osmolar hyperglycaemic state that requires emergency treatment.
  • If you are treating your diabetes by diet or by using non- insulin medications, drink plenty of liquids that do not contain sugar and if possible, do some light activity such as walking.
  • Keeping blood glucose levels on target is a difficult task. If the episodes of hyperglycaemia are happening very often or if they are increasing in duration or happening at a particular time of the day, go to your doctor as you may have to change your medication or require other treatment.
Keeping HbA1C levels as close to target as possible is the best way to reduce risk of complications.

Here are some tips for remembering to take medications-
  • Make it a habit …












It is easier to remember to take your medications if you always take it before or after a particular routine task.
  • Sort it:








Put the day’s requirement into a pill box to keep track of whether you have taken it or the time you have to take a medication.
  • Stick a note












A note about your medication will act as a reminder. Carry an extra dose, keep an up-to-date list of medications with the dosage and how and when to take it.










  • Make a note in your diary so that you can restock you medication early enough.









  • Keep an alarm or reminder on your phone or computer to help you remember to take your medications. 

Monday, February 2, 2015

It is very important to pick up any kidney problems at an early stage…










Look for these signs…
  • Swelling in the feet, ankles or hands due to water retention 
As the stages of nephropathy develop, in addition to water retention, symptoms include…
  • Weight loss and poor appetite
  • Shortness of breath
  • Passing more or less urine than normal
  • Itchy skin
  • Muscle cramps
  • Erectile dysfunction in men
Many of the symptoms   mentioned above can be avoided if kidney disease is diagnosed and treated at the early stages. 

Diabetes balance Nov-Dec , 2014

Thursday, January 29, 2015

Be GI Smart

If you have diabetes, choosing foods with low GI can help you to evenly balance blood glucose levels and reduce spikes after eating.







What is Glycaemic Index?

Glycaemic Index (GI) is a ranking of how quickly each carbohydrate containing food and drink makes blood glucose rise. 

The index was originally developed in 1981 in Toronto by researchers for people with diabetes so that they could manage their blood glucose levels better after mealtimes. Foods that are absorbed slowly have a low rating as compared to those that are absorbed quickly.








The GI index progresses from 0 – 100 and usually uses glucose or white bread as the basic reference point for comparing other foods.  Carbs that are absorbed in the body  slowly to moderately are rated as low to medium GI and include  foods such as wholegrain breads, lentils and many  fruits (papaya,  guava, apple, oranges, sweet lime, etc.) and non-starchy vegetables such as peas,  broccoli,  and cauliflower. 








Carbohydrates that are absorbed quickly have a high GI rating of 70 or more. These include foods such as white bread, rice cakes and cornflakes.











  




Generally speaking whole grain foods have lower GI and the more processed or cooked the higher is the GI. However, other factors also affect the GI of foods.

Cooking methods
Using cooking methods such as frying, boiling and baking can alter the GI level.
The longer pasta is cooked the higher the GI. So al dente (just cooked) is the best way to eat pasta.

Protein and fat content of foods 
Fat and protein slow down the absorption of carbohydrates so high- fat milk and dairy products have a low GI, however people with diabetes should be careful in the use of whole fat dairy products as the fat content may cause obesity and heart related problems.

Ripeness of fruit and vegetables
In general, the riper the fruit and some vegetables are, the higher the GI.

Fibre
Fibre in foods acts as a physical barrier that slows down the absorption of carbohydrates in the body. So, the higher the fibre content of the food, the slower it is absorbed.

MVH advises you to Go Low
  • Instead of using white bread and bagels, include breads made of whole grain or sour dough.








  • Add beans, lentils, and peas to your meals.  







  • Include selected fruit and plenty of green vegetables 
 

  • Choose whole wheat pasta or noodles or complex carbohydrates.

 

Thursday, January 22, 2015

Get the most from a weight loss plan







The current trend of maintaining a healthy lifestyle has brought with it numerous irresistible programmes for losing weight.

However, a word of caution - weigh your options before you take the leap!

It is tempting to think that the ‘one size fits all’ approach will help you shed those extra kilos in a short time. BUT… The best weight loss plan is the one you enjoy and fits in with your everyday life.

You are more likely to succeed in your mission of shedding those extra kilos if the changes you make are small and realistic.

Here are some tips for choosing wisely.









Slow and steady wins the race. Look for a plan that aims for an initial weight loss of 10%. Research shows that this will improve your health – including blood pressure, cholesterol, and your risk for developing any long term health problems. It is also very important for controlling Type 2 diabetes mellitus.









Being more active and reducing the amount of calories is something that all weight loss programmes have in common.

  






However, good programmes recommend eating around 600 Kcal less each day resulting in a slow and steady weight loss of 0.5 kg – 1 kg per week which is the best way to lose weight.

Don’t believe in hype. Be cautious of plans that promise drastic results, offer quick fixes, eliminate entire food groups, or promise too much.








Less & more Eating less and doing more will bring your blood glucose levels down, so consult with your doctor in case you have to make adjustments to your medication.

…and finally










It is easy to give up so keep a diary of your progress so that you can track it.

Monday, January 19, 2015

Diabetes stigma – Another challenge for people with diabetes

In addition to the difficulties of managing blood glucose levels, many people with diabetes face an additional burden – that of diabetes stigma.

For people with Type 2 Diabetes (T2DM) the main form of stigma relates to how it began.  People sometimes associate it with a poor and indisciplined lifestyle - lack of physical activity, eating too much of the wrong food and obesity.

However, although this may be a reason for the onset of T2DM, one has to also take into account other important causes such as age, inherited genes, other reasons for gaining weight, demands of the job and so on.

People with Type 1 diabetes mellitus report stigma for other reasons such as eating the wrong food, not having good control, and being blamed as being irresponsible all the time.

In general, diabetes of any type can arouse feelings of over - protectiveness or pity towards the patient as many people think that having diabetes prevents a person from leading a normal life.

However, diabetes is not a death sentence if managed well and it definitely does not make people sickly, weak or limit their opportunities.

Sometimes managing diabetes also often leads to embarrassment. At times the act of injecting insulin can be mistaken for using recreational drugs and symptoms of severe hypo can be mistaken for rudeness, aggressiveness, or even drunken behaviour!

People around a person with diabetes should be sensitized to these aspects.

Tuesday, January 13, 2015

Diabetes and Dementia








People with Type 2 Diabetes mellitus may have a 1 ½ to 2 ½ times increased risk of developing dementia when compared to those without diabetes.

There are many different types of dementia. The most common is Alzheimer’s disease. Early symptoms include forgetfulness, repetition, short term memory loss, and impaired word finding ability. As it progresses it is marked by disorientation, impaired reasoning and decision- making, and loss of both daily living and social skills.

People with diabetes who have dementia have difficulty in managing diabetes. On the other hand, poorly controlled diabetes can also have an effect on the safety and well- being of people with dementia.

Tip of the Week

Tip of the Week
Choose the right shoe and socks