Prevention is Better than Cure

Alanraj Judewin, Jr. Counsellor,
Department of Primary Prevention

Knowing how to prevent diabetes is very important since there is, at present, no known cure for it. The best way to avoid it is by making some lifestyle changes which are quite easy to follow.

Here are some tips to prevent diabetes


1) Exercise is extremely important for preventing diabetes


Obesity is the highest risk factor for Type 2 diabetes. Every 20% increase in weight over desirable levels doubles the risk of diabetes. If you lose even 5% of extra weight, it will help you prevent diabetes. A sedentary lifestyle increases your chances of developing diabetes. You need at least ½ hour of exercise per day. Vigorous walking increases your heart rate. One hour a day is even better. Clinical trials have shown that when participants walked vigorously for 30 minutes a day, 5 days a week, they lost about 5-7% of their total body weight, and cut their risk of developing diabetes by 50%. Exercise not only helps reduces the risk of developing diabetes, but also enhances your immune system by getting your lymph system moving, it builds muscle and bones, improves heart and lung efficiency, reduces stress, burns fat, raises your metabolism and generally keeps your body young.



A Finnish study found that people who exercised for about 35 minutes a day had 80% less risk of developing diabetes when compared to those who did not. Experts believe that exercise helps increase the number of insulin receptors in cells so that they can use insulin more efficiently and help blood glucose move into them. The Nurses’ Health Study found that women who exercised more than once a week reduced the risk of becoming diabetic by 30%. Studies have revealed that exercise also lowers blood sugar and keeps it down for several hours after the exercise, and this also contributes to the prevention of diabetes.

2) Lose Weight:


Weight loss is also extremely important in preventing diabetes. About 80% of diabetics are overweight and excess weight has been shown to increase the risk of diabetes. In fact just losing weight and exercising can often completely control all symptoms of diabetes.









3) Eat healthy:


Be wary of fast foods. Most contain refined carbs, salt, sugar and trans- fats. In a study conducted in Minnesota, 3000 people of normal weight, aged between 18 and 30, were observed closely. Those who ate fast foods more than twice a week developed twice the rate of insulin resistance and gained around 4.5 kg more weight than those who ate fast food less than once a week.

Keep an emergency pack of nuts or fruits instead of picking up fast foods when you feel hungry


Choose unrefined cereals over refined ones. Avoid trans- fats (hydrogenated vegetable oils) of any kind. They have been shown to contribute to heart disease and may also contribute to Type 2 diabetes.

Processed and fried foods are particularly unhealthy and the fats and carbohydrates found in them undermine your health.

Choose foods with low glycemic index such as whole grains, oats, bran, brown rice.

Eat food with high fiber content such as raw fruits and vegetables, beans, whole grains, oatmeal, brown rice, and barley. Fiber helps to buffer high amounts of sugar or carbohydrates in your diet, keeping your blood sugar even, rather than having it fluctuate wildly.




Try to avoid red meats and processed meats. The cholesterol content can put you at risk for diabetes. A study conducted at Brigham and Women’s Hospital found that women who ate red meat daily, had a 29% higher risk of developing diabetes when compared to those who ate less than once a week. Also, eating processed foods like ham and hot dogs raised the risk by 43%.



4) Don't smoke: Smoking is not only associated with the development of diabetes but it also contributes to heart disease and causes lung cancer.



5) Don't drink alcohol: Alcoholic beverages contain quickly absorbed carbohydrates which can raise blood sugar quickly to unhealthy levels.


6) Find company: friends or relatives or a group can help support you in your effort to change over to your healthy, new lifestyle.


7) Manage stress: Stress increases blood glucose levels. Try to relax throughout the day by learning techniques of stress management and Yoga.

Slim and Fit Programme

Diabetes

Chennai Slim and Fit Programme

By,
Mr.Manikandan BCom.,M.S.W
Project Officer
WDF/DRC


Overweight and obesity are vital links in the web of causation in most non-communicable diseases such as cardiovascular diseases, diabetes Cancer etc. Due to industrialization and urbanization there has been a considerable increase in the proportion of population which is obese. These changes have trickled down to child population too. Successive studies conducted by the M.V.Hospital for Diabetes and Diabetes Research Centre have proved that there is a growing trend in the prevalence of obesity in urban children, particularly in Chennai.

Childhood obesity is very troubling because the extra kilos lead to many health problems such as diabetes, high blood pressure, high cholesterol, respiratory problems, sleep and eating disorders. Obese children are at a much higher risk of growing into obese adults. They may experience fatigue and emotional problems such as low self esteem and lack of confidence. The important fact is that each child requires proper nutritious food and physical activity to become physically and mentally strong. It is good to involve the whole family in healthy habits. Children are good learners and they often follow what they see. Hence parents must be involved in the process of making their children healthy.

What is obesity ?

Obesity is the presence of excess fat in the body.

* Factors influencing childhood obesity



* BMI-FOR-AGE Percentile (5 – 20years)

* Less than percentile - Under weight

* 5th per to less than 85th Percentile - Healthy weight

* 85th per to less than 95th Percentile - Risk of weight

* 95th percentile or greater - Overweight

* BENEFITS OF NORMAL BMI

* Prevents diabetes.
* Prevents high blood pressure.
* Prevents heart disease.
* Prevents stroke.
* Prevents certain types of cancer.
* Prevents osteoarthritis (joint pains).
* Normalizes cholesterol levels and deranged blood fat levels (lipid profile).
* Increases life expectancy.
* Makes you look younger.

* HOW TO PREVENT OBESITY

* Exercise regularly for at least 30 minutes every day.
* Avoid high calorie fried snacks .Eat plenty of fruits instead.
* When thirsty, avoid drinking aerated bottled drinks. Drink more water.
* Play plenty of outdoor games and keep physically active.
* Reduce TV watching to a minimum. Help your parents in household work such as gardening and cleaning.
* Avoid frequent eat outs at restaurants.
* Do not skip main meals. This will help avoid unnecessary snacking.
* Keep to regular meal and sleep timings.
* Parental supervision is needed at most meal times.

* Healthy Tips
Eat Healthy

It’s important that your food choices are nutritionally adequate and low in calories.

* Include cereals, fruits and vegetables with a little fat.
* Avoid sugars, sweets, junk food and deep fried food.
* Eat smaller portions when you feel hungry.
* Drink water with your meals.
* Don’t skip meals to reduce weight.

* Make the Right Choice

* Be conscious of what you eat.
* Avoid munching while watching television or doing other activities.
* Eat slowly.
* Exercise daily and increase your physical activity.
* Check your weight once a week.

Anemia & Diabetes

Aruna.V
Jr. Dietitian
Diet Department

What is anemia?
Anemia is a condition where the level of hemoglobin is below normal. Hemoglobin is the protein in red blood cells that carries oxygen to all parts of the body.



Anemia can be a temporary condition, a consequence of other health conditions, or it can be a chronic problem. People with mild anemia may not have any symptoms or may have only mild symptoms. People with severe anemia may have problems carrying out routine activities and feel tired or experience shortness of breath with activity.

Normal Hemoglobin value:

Male = 13-18gm%
Female = 11-16gm%

What causes anemia in people with diabetes?

Anemia is one complication of uncontrolled Type 2 diabetes, due to a condition called diabetic nephropathy. Nephropathy is a disease of the kidneys, common in diabetics. When the kidneys are healthy they produce a hormone called erythropoietin. Erythropoietin acts on the bone marrow to stimulate it to make new red blood cells and helps to stabilize red blood cells. In nephropathy, erythropoietin levels are low and so the bone marrow does not make enough red blood cells to carry the required amount of oxygen to all parts of the body. When the number of red blood cells is low or when the amount of hemoglobin is abnormally low, it results in a state of anemia.


Anemia is one complication of uncontrolled Type 2 diabetes, due to a condition called diabetic nephropathy. Nephropathy is a disease of the kidneys, common in diabetics. When the kidneys are healthy they produce a hormone called erythropoietin. Erythropoietin acts on the bone marrow to stimulate it to make new red blood cells and helps to stabilize red blood cells. In nephropathy, erythropoietin levels are low and so the bone marrow does not make enough red blood cells to carry the required amount of oxygen to all parts of the body. When the number of red blood cells is low or when the amount of hemoglobin is abnormally low, it results in a state of anemia.



Other causes are as follows:

•Deficiency of Vitamin B12: Vitamin B12 deficiency develops when you cannot absorb this vitamin from food.
•When the body destroys cells responsible for absorption of vitamin B12.( pernicious anemia occurs).
•Surgery that alters the surface area of your stomach or the last section of your intestine (ileum)
•Digestive diseases such as Celiac disease and Crohn's disease
•Diabetes drug therapy with metformin. Anemia occurs in nearly 30% of diabetes patients using metformin for at least three years.

Iron deficiency is due to a lack of dietary iron. Nearly 20% of women, 50% of pregnant women, and 3% of men are iron-deficient.
•Women are at higher risk due to menstruation, lactation, or pregnancy – conditions that increase the requirement.
•Growth spurts demand higher iron levels.

What are the symptoms of anemia in diabetes?


People with diabetes who have anemia may feel weak, become tired easily, and have problems carrying out routine activities. Since these symptoms are also symptoms of diabetes, it may be difficult to determine if the symptoms are caused by anemia or by diabetes.

What are the effects of untreated anemia in diabetes?

Studies show that having anemia along with diabetes may increase the likelihood of developing diabetic eye disease, developing heart disease or having a stroke. People who have both diabetes and anemia are more likely to die earlier than those who have diabetes but not anemia. Fortunately, anemia can be treated, and benefits such as increased energy, activity level and improved quality of life can be achieved.

How to prevent anemia

People with diabetes can take steps to decrease their risk of developing anemia.
Cut the risk of developing anemia by controlling both blood glucose and blood pressure. Studies have shown that people with very good blood glucose control and blood pressure control have a lower risk of developing kidney damage.

Cutting the risk of kidney disease cuts the risk of anemia.

What are the treatments available?

Correction of anemia not only leads to less tiredness, more energy, and an improved quality of life but also to a reduction in mortality and admission to the hospital. Studies suggest that treatment of anemia slows the development of some of the complications of diabetes including damage to the nerves, the eyes and the kidneys.
Treatment varies according to the cause of the anemia. Iron or vitamin supplements may be recommended. Anemia that is associated with kidney disease may require treatment with drugs called erythropoiesis-stimulating agents (ESAs) that stimulate red blood cell production.

Another goal is to treat the underlying condition or cause of the anemia.

Dietary Factors:

Low levels of vitamins or iron in the body can cause some types of anemia. These low levels may be due to poor diet or certain diseases or conditions.


Iron

Iron found in foods is either in the form of heme or non-heme iron:

• Heme Iron. Foods containing heme iron are the best sources for increasing or maintaining healthy iron levels. Such foods include (in decreasing order of iron-richness) clams, oysters, organ meats, beef, pork, poultry, and fish.

•Non-Heme Iron. Non-heme iron is less well-absorbed. Eggs, dairy products, and iron-containing vegetables have only the non-heme form. Such vegetable products include dried beans and peas, iron-fortified cereals, bread, and pasta products, dark green leafy vegetables dried fruits, nuts, and seeds.

Vitamin C

Vitamin C helps the body absorb iron. Good sources of vitamin C are vegetables and fruits, especially citrus fruits


Vitamin B12

Low levels of vitamin B 12 can lead to pernicious anemia. The only natural dietary sources of B12 are animal products, such as meats, dairy products, eggs, and fish.


Folic Acid

Folic acid (folate) is a form of vitamin B that's found in foods. Your body needs folic acid to make and maintain new cells. Folic acid also is very important for pregnant women. It helps them avoid anemia and promotes healthy growth of the fetus.


Steps to Help Prevent Anemia
•Control your blood glucose
•Control your blood pressure
•Eat recommended amount of iron
•Include vitamin C rich foods in your diet
•Avoid caffeine which limits iron absorption