Archives for November 2016

November 14, 2016 By Dr Ashwin Nanda 2 Comments

DECODING DIABETES

Last month, I had 2 patients on the same day diagnosed with Diabetes- one an overweight 34 year old IT professional and the other a 6-year-old girl. The reason, why this incident comes to my mind today is because they were both diabetics but, had different diabetes and even their course of treatments was different.

But, the first question I was asked in both the cases was whether they will need to be put on insulin injections immediately. Well, this is a common question asked by patients. To understand this condition better, let me try and explain a bit about the different types of diabetes on the basis of which the required treatment is normally recommended.

Diabetes is a group of metabolic disorders in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body’s cells do not respond properly to insulin or both. Common symptoms of either diabetes are unexplained weight loss, excess hunger, and excess thirst and delayed wound healing.

Today, I would like to take you through specifically 3 major types of diabetes namely, Type 1, Type 2 and gestational Diabetes.

Let’s talk about

Type 1 Diabetes: is caused by a loss or malfunction of the insulin-producing cells in the pancreas, called beta cells. Damage to beta cells results in absence or insufficient production of insulin. Most cases of Type 1 Diabetes have an autoimmune basis in which immune system mistakenly attacks and destroys its own beta cells. These cases are detected either in childhood or teenage years. There are many theories about what causes type 1 diabetes like autoimmune disease, viral infection, genetic predisposition and environmental factors may also play a role.

Whatever be the cause, this missing insulin has to be replaced as insulin is necessary to sustain life. It is responsible for entry of glucose into the body cells from where the glucose is further utilized for energy and other activities. This glucose which is not entering the cells is circulating in the blood which gets detected as high blood sugar. The replacement insulin is administered by injection using a syringe or an insulin pump. Thanks to the invention of Insulin clubbed with a healthy lifestyle, a Type 1 diabetic is able to lead a happy good quality life.

Coming to Type 2 diabetes most often than not your tissues will be resistant to insulin, so the insulin is being produced but unfortunately not being utilized properly. It is the most common form of diabetes worldwide and accounts for 90-95% of the cases.

Insulin resistance in type 2 diabetes means the signal insulin gives to a cell is weakened. This results in less glucose uptake by muscle and fat cells and a reduction in insulin mediated activities inside cells.

Risk factors for Type 2 Diabetes include an Unhealthy Lifestyle (being physically inactive or less active, erratic food and sleep habits, stress), being overweight or obese and importantly family history of diabetes in close relatives.

We have ample medicine combinations for type 2 diabetes like tablets which keep the blood sugar under control. But if sufficient sugar control is not achieved in spite of oral medications and a healthy lifestyle, then insulin might be required for further management.

Another type of Diabetes I would like to talk about is Gestational diabetes which basically refers to diabetes diagnosed during pregnancy.

Pregnancy hormones can interfere with the way insulin works in the mother’s body which can lead to elevated blood glucose levels during pregnancy. Women are typically screened for gestational diabetes at 24-28 weeks of pregnancy, however, women who have risk factors may be screened earlier.

Risk factors for developing gestational diabetes include having a family history of diabetes, being overweight, or over 28 years old. Blood glucose control during pregnancy is critical as elevated maternal glucose levels can lead to pregnancy complications and pose risks to the health of the baby. Gestational diabetes is likely to recur during subsequent pregnancies.

Gestational diabetes requires specialized treatment for the rest of the pregnancy. After the pregnancy is over, most women will have normal blood sugars again; however, up to 20-50 % can develop type 2 diabetes within 10 years. Regular screening is recommended.

A study conducted on people at risk of type 2 diabetes, it was seen that those who lost just 7% of their weight and exercised about 30 minutes a day cut their risk of diabetes by nearly 60%. In a nutshell, irrespective of the type of diabetes the best prevention or management strategy is to eat healthy, stay active and keep a check on your weight.

Reference: University of California, San Francisco – Diabetes online Education website.

November 13, 2016 By Niti Nirvan Leave a Comment

Customized Postnatal Health Plan with GOQii

Being a mom in today’s world, involves juggling a job, your chores, errands and ofcourse your family. Squeezing in some “me time” among the hustle and bustle seems close to impossible with all tasks already laid out on your schedule. But as the tale goes, catering to your health and throwing in some exercise goes a long way in assisting you with all that is lined up in your daily to – do list. We can help you build a customized postnatal health plan for shedding weight, which includes a diet and exercise plan. You will be able to interact with a doctor, who will be able to assist you with your postnatal health.

Making You A Part Of Your Day

Formulating a good exercise regime is vital to attain fitness goals. It is always good to get in your daily routine first thing in the morning. While a day is full with meetings, and other household tasks, there is a very good chance you may neglect a workout or find an excuse to skip it. Working out in the morning, not only gets your daily exercise out of the way, also sets up your tone for the rest of the day. It boosts metabolism and also the endorphin released helps to spike up your mood and increase energy levels.

Another important fact to keep in mind is that a nutritious diet assists in reaching your fitness goals. Finding time to prepare meals to attain a balanced nutrition is sometimes difficult. You should incorporate essential nutrients in every meal that you take. After delivery it is often paramount to lose the additional pounds you have packed on during pregnancy. In the first few months post delivery, the weight sheds off quite effectively, couple in breastfeeding, and moms note a constant reduction in their weight. However, with time a plateau is attained, and pushing forward to lose more weight is where new moms struggle the most.

A diet conducive to weight loss consists of minimally processed carbohydrates and fat, and a diet rich in fibre, protein and high energy carbohydrates. While the former provides almost zero nutrition, the latter is packed with energy boosting components. This usually includes food like fruits, fresh green vegetables, high fibre carbohydrates in the form of brown rice, pasta and bread and protein sources include eggs, lean chicken, fish and legumes.

While all these are essential, putting plans into action is where the real conflict lies. A few tips include:

Setting a plan in writing: This makes you accountable and more likely to complete it. Noting it down as a task rather than a lingering thought will help you accomplish it daily.
Enlisting assistance: It is never a shameful thing to admit that you need help. Ask your spouse, friends and family, to help you with household chores and looking after your little one. Making time for yourself is crucial in order to look after your family.
Set realistic goals: While we all wish we looked a certain way, having a clear idea of what is achievable goes a long way. Start with a kilogram a week, and in no time you will find that you are able to achieve more than you set out to in the first place.
Choose what works for you: Be it a fitness regime or a diet, use what works for you. There are a plethora of options out there, when it comes to food as well as exercise regimes. Feel free to experiment and mix it up. Ultimately you will find something that suits you.

GOQii is teaming up with Babygogo

We are giving 10 lucky moms a chance to win GOQii 3 Month subscription with free fitness tracker band. To become a contender, starting from the 14th of November; you will have to be the mom with the best answer of the day on the Babygogo app. Answering the queries with the most informative answer automatically puts you in the running to become the mom with the best answer for the day. So go ahead and send in your answers to the queries on the Babygogo app, and stand a chance to win this exciting opportunity towards a healthy and happy you.

November 10, 2016 By Farida Gohil 1 Comment

Whole Grains slash Pre-Diabetes Risk!

Whole grains are packed with nutrients, including protein, fiber, B vitamins, anti-oxidants, and trace minerals (iron, zinc, copper, and magnesium). A diet rich in whole grains has been shown to reduce the risk of heart disease, type 2 diabetes, obesity, and some forms of cancer.

The addition of more whole grains into a healthy diet is associated with a decreased risk of deteriorating glucose tolerance, including progression from normal glucose tolerance to pre-diabetes, according to a new study published in the American Journal of Clinical Nutrition.

According to a research paper titled Food Product Design, dated Dec 26, 2012 published in Health and Nutrition, researchers at Karolinska Institute and Karolinska University Hospital investigated whether a higher intake of whole grains protects against the development of pre-diabetes and type 2 diabetes and tested for modulation by polymorphisms of the TCF7L2 gene. Participants included 5,477 Stockholm residents aged 35 to 56 years who were not diagnosed with diabetes and who kept food journals of how much whole and refined grains they consumed. Researchers measured blood glucose in study participants and followed up 10 years later.

Participants who ate 59 grams of whole grains a day had a 34% lower risk to deteriorate in glucose tolerance compared to those who ate 30 grams of whole grains a day. Risk reduction was significant in men, but not in women. Participants who consumed 59 grams of whole grains a day also had a 27% reduced risk of becoming pre-diabetic.

Whole grains are rich in fibre. Fibre in the diet does not allow the blood glucose levels to rise thereby controls the rise in sugar levels in the body. Fibre also helps in lowering cholesterol as it helps in decreasing the low density lipoprotein whch is bad cholesterol and increases high density lipoprotein which is good cholesterol.

What foods are in the grains group?

Any food made from wheat, rice, oats, cornmeal, barley or another cereal grain is a grain product. Bread, pasta, oatmeal, breakfast cereals, tortillas, and grits are examples of grain products.

It is advised that at least half the grains in your diet should be whole grains. Whole-grain versions of rice, bread, cereal, flour and pasta can be found at most grocery stores. Many whole-grain foods come ready to eat. These include a variety of breads, pastas and cereals.

Examples of whole grains include:

Barley
Brown rice
Buckwheat
Bulgur (cracked wheat)
Millet
Oatmeal
Popcorn
Whole-wheat bread, pasta or crackers
Wild rice

It’s not always easy to tell what kind of grains a product has, especially bread. For instance, a brown bread isn’t necessarily whole wheat — the colour may come from added colouring. If you’re not sure something has whole grains, check the product label or the Nutrition Facts panel. Look for the word “whole” on the package, and make sure whole grains appear among the first items in the ingredient list.

November 3, 2016 By Dr Darshana Salve 1 Comment

BE – AWARE: CERVICAL CANCER

Recently, I received a call from a friend whose aunt complained of post-menopausal bleeding. My first thought was could it be ‘cervical cancer’ but, I did not voice my concern, instead asked her to take her aunt for a PAP SMEAR Test.

Unfortunately, the results indeed matched my concern. She was diagnosed to have Cervical cancer. This was not the first time that I had come across a case of Cervical Cancer as the numbers have been on the rise for the last decade.

According to a study titled Epidemiology of cervical cancer with special focus on India, every year in India 1,22,844 women are diagnosed with cervical cancer and 67,477 die from the disease. India has a population of 432.2 million women aged 15 years and older who are at risk of developing cancer. It is the 2nd most common cancer in women aged 15–44 years.

(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404964)

As per world statistics, India’s contribution to cervical cancer cases is 25.4%. Majority of the Indian women diagnosed with cervical cancer have never been screened for the disease and around 70% of these cases present in advance stages due to absence of any organized cervical cancer screening program. The most important risk factor for development of cervical cancer is persistent infection by a high-risk subset of Human Papilloma Virus (HPV). Cervical cancer being the third most common cancer in the world, very little is known about it among the masses.

What is cervical cancer?

Cervical cancer is a disease that develops very slowly and begins with the precancerous condition known as dysplasia. Dysplasia is easily detected in a routine pap smear and is treatable.

High risk
1)Sexual history- has had multiple sexual partners OR established sexual relations before the age of 18 OR has a partner who has had sexual contact with a woman with HPV infection.
2) Smoking
3) Weakened Immunity
4) Giving birth at very young age
5) Long-term use of contraceptive pills
6) Family history

You need to look out for these signs

1) Bleeding that occurs between regular menstrual periods.
2) Bleeding after sexual intercourse, douching, or pelvic exam.
3) Menstrual periods that lasts longer and are heavier than before.
4) Bleeding after completingMenopause.
5) Increased vaginal discharge.
6) Pelvic pain

If you have noticed any of these symptoms, kindly consult your Doctor at the earliest.

Prevention:

As we know Prevention is better than Cure especially for any cancer, creating awareness becomes the first step towards that milestone.

Lifestyle plays an important role in the prevention of cervical cancer. Foods that are rich in Flavonoids (apples, black beans, broccoli, cabbage, garlic, onion, soy, and spinach), Folate (Avocados, strawberries, oranges, lentils) and Carotenoids (Carrots, sweet potatoes, pumpkin) are seen to reduce the chances of cervical cancer.

Other than diet make sure you follow the below habits to keep Cervical cancer at bay;

Regular Screening (PAP SMEAR) post the age of 30
HPV vaccine (most effective when administered before start of sexual intercourse)
Practising Safe sex
Avoid Multiple sexual partners
Delaying first sexual intercourse
NoSmoking

There is an HPV Vaccination that is certified by the Indian Academy of Pediatrics (IAP). 2 doses of either of the two HPV vaccines for adolescent/pre-adolescent girls aged 9-14 years is recommended. However, this vaccination is optional. One should consult a Gynaecologist to know more about the vaccine and how it helps.

It is always better to be safe than sorry and as we have now seen. Being safe is the best way to prevent Cervical cancer.