Tips for Smart Living

 It’s hard to shop at the super market!

  A trip to the supermarket can be a challenge with eye catching displays and tempting offers especially if one has to keep an eye on one’s weight! We end up buying things we don’t need.Have you noticed that early in the journey through the supermarket you see the shining fresh choices such as fruit, meat, fish while the essentials such as bread, milk, eggs are at the rear and so you have to walk through the whole shop to get them. On the way are the Buy One Get One Free (BOGOF) offers. Also what about those special offers of reduced rates and small items displayed around the cash counter to encourage impulse buying?Are these offers really worth it? They may either end up in the bin or as fat around your waist.
 
 So before you go shopping, plan out what you really need and make a shopping list to help you buy well. Also, do not go shopping when you are hungry.
  
Eat Smart - Manage weight and blood glucose better:

• •     Use smaller plates and bowls to make your portions look large.
  •     Weigh food if you cannot gauge the size of portions.
  •      Be mindful of what you are eating.
  •      It takes 20 minutes for the brain to register what you are eating. So eat slowly.

 A quick guide to portion sizes:

 Half a cooked jacket potato    looks like a computer mouse

Cooked rice                           looks like 2 heaped table spoons

Hard cheese                           looks like Small match box

Cooked lean meat                  looks like a deck of playing cards

Salmon fillet                           looks like a  large smart phone

Butter                                    looks like a  small dice

Erectile Dysfunction in Men with Diabetes

It’s an indicator of underlying damage. Report this to your diabetologist.

Erectile Dysfunction (ED) occurs quite commonly among men with Type 1 diabetes and Type 2 diabetes but most people shy away from reporting it. That is a pity because ED can be treated . However, more important is the fact that it can indicate the possible  risk of other complications. So, if you have diabetes and problems with reproductive organs, not reporting this condition to the diabetologist is putting yourself at a disadvantage.
 

Hyperglycemia can damage the blood vessels  and  the nervous system resulting in poor  blood flow an d loss of sensation in the sex organs. Once blood vessels start to fail, it affects the related nerves  and they also tend to malfunction. Over time,  diabetes, especially if it is  poorly controlled,  damages the nerves, smooth muscles, fibrous tissues and arteries – all of which usually work together in normal reproductive functions. Poor blood glucose control, excess weight and high cholesterol levels also increase the risk of developing some form of nerve damage.

It is estimated that  60 -70 % of people with diabetes have neuropathy. Age and extent of diabetes increase the risk of ED. Apart from this, obesity, smoking, and hypertension are risk factors for ED. Men with diabetes have a three- fold increased risk of developing ED than those who do not have diabetes.

There are three lines of treatment- oral drug therapy, injections and surgery.

What can ED imply?

It is the beginning of further health complications – both physical and psychological. It is one of the earliest signs of other diabetic conditions involving damage to the blood vessels and nerves. Nerve damage can also occur in the digestive tract and circulatory system . The problem is that unlike the hands and feet where nerve damage can be felt through signs such as numbness, internal organs have no way of showing this.

It left untreated, ED can severely damage sexual organs and create psychological issues such as anxiety, frustration, depression, low self- esteem , loss of intimacy and strained marital relationships.

So, take it seriously as a sign pointing to more severe diabetes related complications and talk to your diabetologist about it.

Osteoarthritis Exercise Treatment

Osteoarthritis is a common cause of pain and disability in the aging population.   At one time it was thought that rest was best. However research and evidence-based medicine have shown  many benefits of exercise.

          
                                                       
The most common type of arthritis is called osteoarthritis or degenerative joint disease. It affects us as we age, particularly along the weight bearing joints such as the knees and hips.  Normally, cartilage acts as a cushion to protect joints from wear and tear.  This cartilage can break or become frayed and at times  there are areas where there is little or no cartilage left at all.  When it becomes severe enough, the bones can come into contact with one another.  This process can result in many things including pain, a change in shape of the joint and extra bone formation.   All of these changes can affect normal physical activity.

As shown below, pain results in decreased activity, which leads to muscle weakness and a decrease in the normal motion of the joint, which further results in joint deformity and loss of function.  Exercise, when done properly is an excellent way to break this cycle, or perhaps to prevent or delay this cycle from occurring in the first place. 

 
EXERCISE :

The aim of exercise is to reduce pain, improve function, and prevent disability thereby improving the quality of life.                                                                 Muscle Strengthening:



It has been shown that weak quadriceps muscles are common in people experiencing symptoms of osteoarthritis at the knee. In addition, studies have shown that when these patients strengthen their quadriceps muscles significant improvements in pain and function are seen when compared with those who did not strengthen these muscles.

 

Improving Flexibility and Joint Motion:

When people do not use their muscles, not only do the muscles become weak, but they can also change shape and shorten to the point where they limit normal movement and result in visible joint deformities . Flexibility exercises take the joint through its normal range of motion  and also relieve tightness in muscles/tendons through  stretching. 

                                                          Improve Aerobic Functioning:

 

Limited activities due to pain and restriction of movement can affect cardiovascular fitnessSo people with osteoarthritis  must find ways to maintain cardiovascular fitness through aerobic exercises such as walking or cycling. 

Weight Loss:
 
Proper exercise results in weight loss which helps to decrease symptoms in patients who have osteoarthritis. 

Types of Exercise:
 
          Your doctor and physiotherapist will  recommend   the right combination of aerobic exercise, muscle strengthening and flexibility taking into view your limitations and any medical conditions that may be affected by an increase in physical activity.
                                                                      
                                                                                     Aerobic:

              Aerobic exercise strives to improve cardiovascular function through activities  such as walking, jogging, biking, swimming and rowing, that increase the heart rate   Proper breathing techniques, sufficient hydration and nutrition, and current  cardiovascular status should be taken into consideration.

In general 30 minutes of moderate activity most days of the week with a  warm up, a workout and a cool down is recommended .  People with sedentary lifestyle should minimize time spend less time sitting throughout the day and do simple  activities such as  parking the car a little further away, taking the stairs instead of the elevator or taking many short walks throughout the day. 

Muscle Strengthening:

Here are some examples of exercises specifically for the legs good for those with osteoarthritis of the knee and or hips. 

 
 Flexibility Training:

Static stretching is what most people are familiar with and most often recommended by doctors.  It involves stretching the muscle slowly and holding it in that position for 10 to 30 seconds.  The key is that it should be pain free without any abrupt, jerky, or bouncing movements.
            There are other methods of improving flexibility that involve whole body training and working with breathing exercises.  Activities such as tai chi and yoga are excellent ways to improve your flexibility with the added benefit of a total body workout and relaxation.  Here are a few examples of stretching exercises.