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.

Friday, July 24, 2009

Diabetes and Hair loss

Diabetes is a disease which is directly linked with hair loss resulting from hormone imbalance. It is one of the early symptoms of diabetes. The disease requires proper treatment to avoid further complications and side effects.

For the loss of hair, stress is another factor that causes it. When the body cannot metabolize carbohydrates properly, it causes diabetes and leads to several skin ailments. Bruises and wounds take longer time to heal in the body. As a result, the recovery rate becomes slow and obstructs the further growth of hair. This causes visible hair reduction. Diabetics are unable to maintain a normal re growth cycle as they become prone to early infection. Bacterial and fungal infections on the scalp can also cause hair loss. The disease increases anxiety which ultimately promotes hair loss. That is why there is a direct relation between diabetes and hair loss.

Studies show that a healthy person loses around fifty to hundred strands per day. If hair loss increases more than the usual, then you must seek doctor’s help. He can check the problem thoroughly and make his conclusion accordingly. If the diabetes is not treated in time, it can further promote hair loss. Diabetic patients must take proper care of their health to avoid any complications. It is essential to exercise regularly to increase blood circulation in the body. A diabetic person also suffers from autoimmune problem. In such a situation, small bald patches are formed on the scalp. This ailment is known as alopecia area. Medical stress and side effects of different medicines may be another factor for hair loss. It normally depends on the individual’s health to respond to various medications and sometimes they have an adverse effect on his health and hair.

The diabetes may also affect a person’s health by dysfunctional thyroid gland, skin rash vitiligo and pernicious anemia. Type second diabetes is usually caused by hormonal imbalance which leads to polycystic ovary syndrome. This condition is related to insulin resistance which reduces the ability of cells to react on insulin. It is essential to detect diabetes at an early stage so that recovery from hair loss can be possible early. Some of the common symptoms of diabetes are blurred vision, frequent urination, acute hunger, increased thirst, unusual weight loss, fatigue and unnecessary irritation.

To check the diabetes, monitoring the blood sugar level from time to time is essential, failing which the complications lead to damage of blood vessels and nerves, loss of functioning of the kidneys, loss of sensation, heart disease and strokes.

It is better to seek doctor’s advice in severe condition who can guide about the required precautions. The doctor prescribes different lotions and oils to provide relief to the patient. Balanced diet is also very important and the patient must include lots of green vegetables and fruits to make his diet balanced in every form. It is advisable to drink sugar free juices to detoxify the body. Drinking lots of water can also help to keep the system clean.

Tuesday, July 21, 2009

Lantus and Cancer Risk

Some news has come out in the last couple of days about a possible link between Lantus and an increased risk of some types of cancer.
Now, they are telling people not to panic and not to stop taking their Lantus!!!!
Like the last scare with Rosiglitazone, where there was initially some big concerns about increased cardiovascular risks as a result of trials that were not necessarily looking for CV risks, and which from later studies it was found that there was no significant difference in CV risk between Avandia and other common diabetic drugs - I myself stopped taking Avandia because of that scare and really did myself a disservice because the drug was actually really good at keeping my BG under control.
When I first heard the news about Lantus - which I take twice a day - my immediate reaction was, "better make an appointment with the endo and get off this evil stuff!"
But then I remembered my experience with Avandia. Lantus actually works very well for me and less hypos - a much smoother ride than protophane. So this time I've decided I'm not going to panic, and sit back and wait for the outcome of further trials.
I guess there are always risks/benefits that have to be weighed up with any drugs.

Tuesday, July 7, 2009

Diabetes Screening

High risk individuals:

  • Age >45 yrs with minimal physical activity
  • obesity
  • First degree relatives with diabetes
  • Previous h/o diabetes during pregnancy or women who have delivered babies more than 4.5kgs weight
  • Hypertensive
  • Altered lipid profile ( HDL <35>250 )
  • PCOS
  • IGT/IGF on previous testing
How to screen for DM

OGTT to be done every year.
Normal –    FBS<100mg/dl  2hrs <140mg/dl
IFG / IGT –       100-125             140-199
DM -                >126                  >200

If a person is confirmed to be a diabetic he/she should undergo annual checkup which should include screening for diabetes related complications like in eyes, kidney, nerves and heart. Patients should check their blood sugars (FBS /PPBS) regularly(Once in a week) and HbA1c once in 3 months.

Smoking Cessation

Tobacco use increases the risk of micro- and macro vascular complication of diabetes and is one of the most preventable causes of death worldwide. Each year, 430,000 deaths are attributable to tobacco use in U.S. alone, more than alcohol abuse, automobile accidents, AIDS, homicide, suicide, heroin and cocaine combined. compared to age – matched non smokers , persons who smoke 1 pack of cigarettes per day are 14 times more likely to die from cancer of the esophagus : twice as likely to suffer an MI or stroke : and twice as likely to die from heart diseases or cancer of the bladder. At any age, the risk of death is doubled in smokers compared with nonsmoking age-matched controls, and the risk associated with smoking is dose dependent. Despite these statistics, many physicians do not routinely ask patients about cigarette smoking or offer counseling about smoking cessation. The increased cardiovascular risk attributable to smoking returns to baseline soon after cessation of tobacco use, emphasizing the importance of intervention. By 12-18 months, most of the increased cardiovascular risk has disappeared, and by 3-5 years, the risk of vascular events is no different than that of a non smoker. As a physician, there is virtually nothing more effective at improving a patient’s long term prognosis than convincing and helping him or her to stop smoking .if a physician discusses this topic even briefly with the smoker and makes a strong statement about the medical necessity of discontinuing this habit, a person’s chances of permanent cessation of smoking is doubled.

Strategies to assist patients willing to quit smoking

Step 1: Strategies for implementation
Help the patient with a quit plan
1. Have patient set quit date, ideally within 2 weeks.
2. Have patient tell family, friends, and coworkers about quitting and request their understanding and support.
3. help patient anticipate withdrawal symptoms and discuss ways to resist urges and cravings (clean the house ;take 5 minutes walk ; do stretching exercise ; put a toothpick , cinnamon gum , or lemon drop in mouth ;take several slow deep breaths; brush teeth ; call a non smoking friend and talk).
4. Have patient remove tobacco products from their environment: throw out ashtrays; clean clothes, car, and carpets.
5. Encourage patients to learn as much about how to quit smoking as possible. Useful sources for reading materials include:

American heart association, 7272 Greenville Avenue, Dallas, TX 75231, (800) 242-8721; www.americanheart.org.
American cancer society ,1599 Clifton road, NE, Atlanta, A 30329,(800) 227-2345;www.cancer.org
National cancer institute ,Bethesda,MD 20894,(202) 4- cancer (422-6237);www.nci.nih.gov
For pregnant women : American college of obstetricians and gynecologists,409 12th street ,SW,Washington , DC 20024,(202) 638-5577; www.acog .org

Step 2:
Provided practical counseling
1. Total abstinence is essential.” not even a single puff after you quit.”
2. Identify what helped and hinders previous quit attempts.
3. Discuss challenges / triggers and how to overcome them.
4. Since alcohol can cause relapse, the patient should consider limiting /obtaining from alcohol while quitting.
5. Patients should encourage housemates to quit with them or not to smoke in there presence.
6. Provide a supportive clinical environment while encouraging the patient to quit:” My staff and I are available for you.

Step 3: Strategies for implementation
Recommend approved drug therapy
1. Recommend the use of first-line drug therapy (varenicline, bupropion,NRT) to all smokers trying to quit, except in special circumstances (e.g., medical contraindications, pregnant/breastfeeding women, adolescent smokers). If drug therapy is used with lighter smokers (10-15 cigarettes/day), consider reducing the dose of NRT; no dosage adjustment is necessary for sustained-release bupropion.
2. Some studies suggest that bupropion may be more effective than NRT for achieving permanent cessation of tobacco use, and that some synergism between the two approaches may exist. There are insufficient data to rank-order these medications, So initial therapy must be guided by factors such as clinician familiarity with the medications, contraindications foe selected patients, patients preference ,previous patient experience with a specific therapy (positive or negative), and patient characteristics (e.g., history of depression, concerns about weight gain). Sustained-release bupropion hydrochloride and NRT, in particular nicotine gum, have been shown to delay but not prevent weight gain. Sustained –release bupropion hydrochloride and nortriptyline hydrochloride are particularly well-suited for patients with a history of depression.
3. There is evidence that combining the nicotine patch with either nicotine gum or nicotine nasal spray increase long-term abstinence rates compared to a single form of NRT, based on a meta-analysis.
4. The nicotine patch in particular is safe in patients with cardiovascular disease. However, the safety of these products has not been established for the immediate post-MI period or in patients with severe or unstable angina.
5. Long-term therapy may be helpful for smokers who report persistent withdrawal symptoms. A minority of individuals who successfully quit smoking use NRT medications (gum, nasal spray, and inhaler) long term. The long-term use of these medications does not present a known health risk, and the FDA has approved the use of sustained-release bupropion hydrochloride for long-term maintenance.
6. Clonidine and nortriptyline may be considered when first-line medications are contraindicated or not helpful.

Friday, July 3, 2009

Diabetes and Erectile Dysfunction

Erectile dysfunction (ED) is when a man has trouble getting or keeping an erection. ED becomes more common as you get older. But male sexual dysfunction is not a natural part of aging.

Some people have trouble speaking with their doctors about sex. But if you have ED, you should tell your doctor. ED can be a sign of health problems. It may mean your blood vessels are clogged. It may mean you have nerve damage from diabetes. If you don't see your doctor, these problems will go untreated.

Your doctor can offer several new treatments for ED. For many men, the answer is as simple as taking a pill. Getting more exercise, losing weight or stopping smoking may also help.

Tip of the Week

Tip of the Week
Choose the right shoe and socks