HEALTHY FOOD CHOICES

Mrs. Sheela Paul, Dietitian
-  MVH

              

               Women in India have always been honoured and respected yet the majority of them go through life in a state of nutritional stress - they are anaemic and malnourished. Girls and women face nutritional discrimination within the family, eating the last and the least. Women work longer hours than men, carry the major share of household and community work, which is unpaid and invisible. Nowadays, more women work to support their families financially.

          So, women must take greater care of their nutrition in order to remain healthy and fit.

  Some surprising facts:

• Women are at an equal or sometimes higher risk for developing pre- diabetes, diabetes and diabetes-related complications than men.

• An increasing number of people with Diabetes belong to the middle and even lower socio- economic strata.

Healthy Tips for the Home maker and the Working Woman…

• Plan an individualized diet according to  dietary habits and nutritional requirements with the help of health professionals.

• Eat small regular meals at frequent intervals rather than heavy meals once or twice a day.

• Avoid fasting and feasting.                 
  
• Enjoy a variety of food.

• Snack on fresh vegetables and fruits.

• Use low- fat milk and milk products.

• Avoid nibbling high calorie food between meals.

• Eat slowly and take more time to chew the food. You can control how much you eat.

• Don’t eat left over foods.

• Leave the table as soon you finish eating.

• Stock your house with healthier food choices.

• Shop for groceries after a full meal. If you are hungry you may buy more than you need!

• Limit the amount of money you take with you when you go shopping.

• Plan meals and snacks. 

Never forget to read the label on the containers. It will be very useful to calculate your calories and other nutrients. 

EXERCISE:   

• The time of exercise varies from person to person and his\her individual preference. Exercise should preferably be done in the morning hours.

• One should avoid going for exercise after heavy meals like lunch and dinner.

• Exercise reduces the triglyceride and cholesterol in the blood.

• Exercise helps decrease excess fat and thereby increases the body’s cell sensitivity to insulin and helps maintain good glycemic control.

• Do exercises like skipping, jumping, jogging at home. Avoid sitting in a place for long continue hours.

LIFESTYLE MODIFICATION:

• Reduce the time spent in watching TV.

• During leisure time instead of watching TV try to do some walking on the terrace.

• Do gardening.

• Walk to the nearby temple or church and close- by places instead of using a vehicle.

• Pick up your children from school.

• Do not sleep during leisure time.

• Climb the stairs instead of using the lift.

• Park at the far end of the shopping centre parking lot and walk to the store. 

 

 

               To improve your body image and the way you feel about yourself, monitor your snacking and do your best to follow a disciplined eating routine. Eat balanced meals, exercise and maintain a positive outlook and you will be on your way to a healthier body, mind and soul.

Eat less, work more. Moderation is the key     
  

                                             

Lipohypertrophy

Dr.Mitalee Barman
Diabetologist , MVH

Lipohypertrophy is a fatty tumour- like growth at or around the injection site. These spongy growths result when insulin has been injected over and over again into a single area. Over time, the skin around the hypertrophied area becomes numb. People with diabetes, who continuously use a single area for injecting insulin, develop lipohypertrophy over a period of time. They then add to the problem by continuing to inject into this area because they do not feel any pain while injecting. However, it is not the same in all cases as some people feel pain at the site.

Treatment:

The treatment consists of systematically rotating injection sites.

It is your choice where you want to inject. You will get the best results if you are consistent because insulin is absorbed at different rates in different body areas and inconsistency could cause your body to respond differently to each injection.
Insulin is absorbed most swiftly when injected into the abdomen, more slowly in the arms, and even slower in the thighs and buttocks.
Other factors that affect insulin absorption are temperature and exercise. The greater the temperature is, the greater the rate of absorption. Exercise or massage may increase absorption leading to large fluctuations in blood glucose levels.
 

Prevention:

Rotation of sites is important to prevent lipohypertrophy.

Instead of randomly using different areas for each injection, some doctors recommend that individuals with IDDM inject in a given area before moving to another. For example, using areas in the abdomen systematically before moving to the deltoid becausean injection in the abdominal area and an injection in the hip have different rates of absorption and it may be difficult to interpret the body’s response to dosage.

Another approach is that if you eat a big breakfast and need a faster response from insulin,
but a slower one from night insulin because you like to go to bed early and want night insulin to last all night, in the morning you can use the abdomen and at night the thighs.

Based on your needs, your diabetologist will be able to suggest a rotation plan, which you must follow.

Typical injection sites
 

The best site is a layer of fat above a muscle tissue. Don’t inject into muscle tissue anywhere in the body.Several areas of the body have enough fat tissue under the skin for insulin injection.
Insulin is absorbed most quickly and at the most consistent speed from one injection to another in the area of the abdomen, except for a 2 inch circle around the navel. The tough tissue around the navel causes inconsistent absorption.
Another suitable area is the top of the outer thighs which is best used in a sitting position. The backs of the upper arm, hips and buttocks also work well.
Keeping these points in mind, divide the body area into injection sites about the size of a coin and try to keep each new injection at that distance from your last shot.

At MVH, we teach our patients to inject on the abdomen and thighs.

Precautions

Avoid the deltoid muscle - the large triangular muscle that covers the shoulder joint.
Avoid injecting too close to moles, scars.
When injecting in the thighs, avoid the inner thighs Use  the top and outward areas. Friction between the legs when moving about may make the inner thigh sore.
Persons who exercise should avoid injecting into subcutaneous tissue adjacent to the muscle to be used as rapid absorption can lead to hypoglycemia.