Instead of supplementing our diet with wholesome foods including fruits and vegetables, presently, mankind is busy consuming various supplements to correct nutrient deficiencies. You could be taking these supplements to fulfil recommended daily intake or to rectify certain disorders including diabetes. Whatever is the reason, the world is filled with thousands of supplements to pick and choose, many of them having safety concerns, interaction with certain drugs, and without having concrete evidence for their safety.
 
Diabetes is a gargantuan global health problem that arises when blood sugar levels go out of control. Presence of excess glucose in the bloodstream results in a variety of health-related problems. Controlling glucose levels is the primary way to manage diabetes and be healthy. This is generally done by taking medications, insulin, and above all, bringing about better lifestyle changes that includes healthier food choices and daily physical activity. Hence, we have numerous studies looking into the effectiveness of consuming supplements including vitamins, minerals, omega 3s, and more.
 
Vitamins to Win Diabetes
 
We’ve got abundant proposals enumerating the varied benefits of vitamins, especially vitamin D, whose insufficiency is a contributing factor towards diabetes. Diabetes is a metabolic disorder that has a strong connect with energy metabolism that predominantly includes carbohydrate and fat management—it must also be noted that micronutrients also play a role in this metabolism and impose antioxidant effects. Vitamins with antioxidant effect are critical to disease development and management while vitamins without the antioxidant effect also have a say in diabetes management.
 
Studies Showing a Strong Connect Between Nutrient Intake & Diabetes Effect
 
Every type of vitamin has a different effect on the body and can/cannot be effective against diabetes.
 
Vitamin A: Having a pivotal role in protecting immunity, retinol is an active form of this vitamin having antioxidant effect and offers protection to the human body against stress. Studies show that healthy individuals as well as those with chronic ailments involving fats and carbs must maintain sufficient vitamin A levels.
 
Vitamin B: Riboflavin, folic acid, biotin, cobalamin, and thiamine are the most important B vitamins and most of these have a direct link with type 2 diabetes mellitus (T2DM). B1 or thiamine has been shown to have a strong link in the development of various diabetes-related complications when their numbers become insufficient. We also have studies showing that consumption of various thiamine supplements decreased blood sugar levels in diabetics. There are not sufficient evidences linking vitamin B6 with the development of T2DM but it’s been postulated that deficiency of this vitamin can trigger certain complications.
 
Not much research has been done connecting vitamin b3 or Niacin to diabetes but vitamin B3 supplements can increase HDL cholesterol levels, and decrease LDL cholesterol and triglyceride levels. Basically, this vitamin is used to decrease lipid levels but some studies also show its negative impact—increased risk of T2DM.
 
Though we have contradicting results regarding the effectiveness of vitamin B12 against diabetes, this vitamin surely has an integral part connected to oxidative stress. T2DM is an oxidative stress disorder and hence, insufficient levels of vitamin B12 is considered a risk factor for diabetes-related complications. Metformin is generally prescribed for diabetes and continuous intake of this medication can result in deficiency of B12. Folate or vitamin B9 supplements improve glycemic levels and control insulin resistance.
 
Vitamin C: There are various studies showing that vitamin C doesn’t have any effect nor can control blood sugar levels in individuals with diabetes. But one of the latest studies shows a weak link between vitamin C and better glucose control when consumed for more than a month. Ascorbic acid has antioxidant potential and participates in maintaining immune system functioning. Research shows that vitamin C can reduce anxiety levels but doesn’t impact stress or depression.
 
Vitamin K: Consumption of vitamin K is related to insulin sensitivity and glucose metabolism, and in turn, is said to have an impact on diabetes.
 
Vitamin D: There are numerous controversies surrounding the effect of vitamin D on diabetes. Some studies show that lack of this vitamin is linked to insulin resistance, release of insulin hormone, and increased risk of diabetes. But, on the contrary, consumption of vitamin D doesn’t seem to prevent diabetes or maintain blood sugar levels. But, there are evidences linking vitamin D and obesity, a serious risk factor for diabetes.
 
The Bottomline
 
Vitamins do impact diabetes, playing a role in its complications but there are no conclusive or concrete evidences suggesting the intake of any vitamin for those with diabetes. Only when you truly suffer from any vitamin deficiency it is recommended to consume supplements after consulting a physician. Your body might show certain signs or symptoms of any vitamin deficiency but to know for sure, it is advised to go for a blood routine. But, there are some supplements that can elevate the effect of diabetes medications even causing hypoglycemia or hyperglycemia depending on the supplement consumed.

​These days, seeing a normal wristwatch on an individual’s hand is a rarity as fitness trackers have dominated our lives. Does this mean that we, as a population, have become fitness conscious than ever before? The answer is not a straightforward optimistic reply, but yes, we have indeed witnessed an overall improvement in health-related activities—this is evident with the omnipotent presence of fitness centres and increase in the use of fitness trackers. However, the foremost threat presently is lack of enough physical activity among people. Such insufficient activity levels increase the risk of premature mortality and morbidity and thrives as a major contributor to diseases including type 2 diabetes, heart disease, cancer, stroke, and many others.
 
Shed Away Disease Risk with Brisk Activities
 
To combat physical inactivity and incorporate better lifestyle changes, we need practical and inexpensive interventions that meet our everyday fitness needs. One practical and simple solution to meet the daily exercise requirements could be in the form of a fitness tracker. Technology is available all around us. Gone are the days when we should set reminders for activities as our smartwatches and trackers prompt us when it’s time to get up, drink water, exercise, or go to sleep. The 10000-step goal is still a craze among fitness enthusiasts and while we do check the overall step count, our tracker does this automatically, gives an account of the total calories burned and stairs climbed.
 
All these lead to humongous data accumulation but there is a purpose behind all of this. Instead of assuming the total steps taken or calories burned, outright details about the exact number of steps and calories makes us aware of the level of activity we do individually. Understanding our performance and trying to make changes willingly happen with such trackers tied to our wrists—improved activity levels do become a basic goal for the health-conscious and there are even research evidences showing clearly that wearable activity trackers improve overall exercise levels by a great number.
 
Fitness Trackers Mark Better Health
 
People worldwide are fans of fitness trackers and they strongly trust its functionality in better health. The good news now is that, even researchers have confirmed the reliability of trackers as a tool for motivating individuals to workout more, lose weight, and stay healthy. Published in the Lancet Digital Health, the research was a large-sized study which showed better results in encouraging people to workout regularly, make physical activity a part of their daily habit, and set targets to lose weight effectively.
 
Wearing a tracker helps in losing around 1 kilogram over a 5-month period and this might seem an insignificant weight loss. But, the major catch here is the change in the exercise duration—wearing a tracker motivates individuals to walk for an extra 40 minutes everyday which translates roughly to an additional 1800-2000 steps.
 
Humans need motivation to achieve success and it’s lack of motivation that halts people from accomplishing things. Also, self-motivation is a daunting task to achieve, especially under stress. Using such fitness trackers are indeed motivating as they assist in regulating our daily fitness schedules, enhance personal exercise duration, and make the individual better responsible toward overall health improvement.
 
Get Going, Get Moving
 
Fitness is a continuous journey and it is an activity that has to be done gradually. You can’t walk a few hundred steps today and aim to achieve 10000 steps the very next day. Start small, tweak your daily routines, improve step count gradually, try to become better with each passing day, and look at the positives to keep you motivated to achieve the goal. During this journey, setbacks are inevitable but they should never be a deterrent to exercise performance. Also, some people take their goals too personally which in due course becomes an addiction. For instance, some individuals don’t get to sleep or avoid eating if they have not achieved their daily step count. Such obsessions are absolutely wrong and such people must be extra careful about using trackers for fitness goals.
 
Conclusion
 
A fitness tracker might be the right tool for individuals who seek to facilitate lifestyle modifications to lose weight and become healthy. As these trackers keep providing regular updates about the progress made, they thrive as a motivation for individuals to promote daily exercising. But, there are also instances when some people indulge in overeating as they feel that they have burned more calories than expected and sometimes, tracking fitness activities and achieving health-related goals becomes an obsession.
 
Before being victimized by any of these negative aspects, it is always advisable to look out for any disturbing trait that might become a habit. Also, to avoid getting stressed over such issues, practising mindfulness meditation or yoga calms the mind and body.
 
All individuals don’t have a unanimous goal, every person’s health history is different, work culture varies, and some accomplish the daily 10,000 steps due to their work requirements. Such steps cannot be translated into activity results and one must be careful about this. Wearing a tracker is not the end of the efforts taken for weight loss or health. We must consciously work harder, exercise more, and eat in a thoughtful way to achieve lifestyle modifications, weight loss goals, and stay healthy.

Beverages like tea and coffee taste good with sugar but nowadays, there are many individuals moving onto other form of sweeteners including honey or palm sugar to make it healthier. But, the fundamental question is whether honey is recommended for those with diabetes? The answer is a simple yes, but there are many ifs and buts behind this answer which we would be seeing in detail below. Basically, it’s highly beneficial for all to have control over their sugar intake and in the case of diabetics, it’s mandatory to restrict their sugar and carbohydrates intake to keep blood glucose levels under control. But, it’s not necessary to cut down sugar intake totally.
 
Sugar is sugar, whatever form it might take and honey is a sweetener just like many other sweeteners available in the market. If you have the practice of looking at the food label, it falls under the category of ‘added sugars,’ meaning that the food isn’t sweet naturally but we add it to foods to make it sweet.
 
Adopting Healthier Natural Products
 
Food adulteration is reaching new peaks, even fruits and vegetables don’t add nutrition like previously due to overuse of pesticides, and as a result of this, people are inclining toward organic products and natural foods, herbs, and even honey for diabetes management. Diabetes, once termed a non-reversible illness is now seen in a new light—diabetes remission is possible with active lifestyle changes, daily exercise routines and consumption of healthy foods. Combining these with traditional medications including honey elevates the possibility of diabetes management and improves overall health.
 
While honey is not something new to the world, especially India where it has been used since long, until recent times, their advantages were known only from observations without proper research evidence. But, in the last decade or so, scientists and researchers have made significant research concerning honey’s effects—its potential to act as an antioxidant, antibacterial, anti-inflammatory, and a cardioprotective agent.
 
Owing to honey’s high carbohydrate content, there have always been controversies surrounding its effect on diabetes patients. Let’s get reading to understand how exactly honey has an effect on diabetes and whether or not it’s advisable for people with diabetes.
 
Composition of Honey
 
There are more than 200 different components in honey and the dominant components include fructose, glucose, and water. Fructose can be anywhere between 21 and 40% in honey and being the most sweetest natural sweetener, it has a glycemic index of 19, a number very much lesser when compared to glucose or sucrose which have a number of 100 and 60 respectively.
 
 
Comparing Honey with Sugar
 
Honey is comprised of 80% carbohydrates and 20% water and on a comparative basis, its carbohydrate and calorie content per tablespoon are slightly higher than white sugar. For instance, in one tablespoon of honey, there are around 60 calories and 17 grams of carbohydrates in accordance with the United States Department of Agriculture. In contrast, one tablespoon of sugar contains around 80 calories.
 
In terms of nutrients, sugar has zero nutrients while honey consists of nutrients such as sodium, phosphorous, zinc, vitamin C, potassium and calcium. There are also research evidences supporting the fact that honey might contain prebiotics that benefit the gut bacteria but we need better conclusive evidence to support this.
 
Also, honey has a low glycemic index (GI) of 58 in comparison to sugar which has a GI value of 60. Such numbers clearly prove that honey does raise blood sugar levels just like many other sweeteners but not as rapidly as sugar.
 
Effect of Honey on Blood Sugar Levels & Diabetes
 
The cornerstone of diabetes management is reduction of carbohydrate intake and increment of whole grains consumption. Honey predominantly comprises of carbs, has a GI value almost close to processed sugar, and does increase blood sugar levels. Though anti-inflammatory and anti-oxidant properties are some of the benefits of honey, we have plenty other foods that provide the same advantages minus the sugar consumption.
 
Research studies also provide varying results and most of them are on animals. Some studies do show that honey reduces plasma glucose levels, blood lipid levels, and aids in weight loss but there are research results showing that honey raises HbA1c levels and blood glucose levels in the body. We need long-term and large-scale studies that clearly establish the effect of honey on diabetes. Until then, it is recommended to consume this ingredient in moderation or avoid its consumption as much as possible in the case of individuals with diabetes.
 
In case diabetes is under control, seek the advise of your healthcare professional and choose any natural, raw honey as this does not have added sugars. Due to honey’s anti-oxidant and anti-inflammatory properties, reduction of diabetes-related complications and improvement in insulin levels, thereby leading to control of blood glucose levels is possible.
 
Conclusion
 
Honey as a standalone product comes with different benefits for the human body. But, when considering it for consumption for people with diabetes, moderation is always the key and confirming its safe of use is still a question mark. Honey isn’t the solution for sugar substitution. Consult a doctor, get the help of a dietitian/nutritionist to plan a meal that includes honey if you crave for it, and ensure that the total carbohydrates intake stays within recommended levels for diabetics.

​Diabetes, in general, has the taunting ability to disrupt the quality of life of the affected individual. Inappropriate blood glucose levels result in diabetes and these bring additional consequences to health. In due course, diabetes starts affecting various other parts of the body including the heart, kidneys, nerves, foot, and even skin. Besides these, there are also very high chances for gastrointestinal complications including gastroparesis, non-alcoholic fatty liver disease, and intestinal enteropathy (which manifests with side effects including constipation, fecal incontinence, and diarrhoea).
 
What is Gastroparesis?
 
Gastroparesis is a condition which has a debilitating impact on the way food is digested and diabetes exists as the most common cause of this problem. Almost 5-12% of the diabetic population exhibits symptoms that favor the existence of the disease. In people with gastroparesis, muscles in the stomach wall fail to do their function properly or stop functioning altogether thereby putting off or slowing down the rate at which the food consumed moves from the stomach to the intestine. Popularly known as ‘delayed gastric emptying,’ this complication arises only because of the ineffective functioning of the muscle but not because of any blockage obstructing the movement of food.
 
As the condition impacts the food absorption, there are problems with insulin doses against food quantities. There are also higher risks for malnutrition as nutrients might not be absorbed as desired, but this is a worrisome issue only if we leave it untreated. Generally, gastroparesis affects people with type 1 diabetes but individuals with type 2 diabetes can also become victims sometimes. In most cases, this becomes a problem in those suffering from diabetes for more than 10 years or so.
 
Link between the Disease & Diabetes
 
Gastroparesis and diabetes have a direct link between each other. Variations in blood glucose levels deter stomach emptying and the reverse is also true. There are various studies showing that increase in blood glucose levels increase the risk of gastroparesis. At the same time, we also have research data supporting the fact that individuals suffering from the condition find it very tough to manage blood glucose levels.
 
But before concluding anything, it is always advisable that the physician enquires about different symptoms of the problem which are given below. Surprisingly, though almost 50% of diabetics have this problem, most of them don’t have any of the digestive symptoms. There are some patients who are diagnosed with the condition even in the absence of any symptoms as they remain unable to manage blood glucose levels even after sincere efforts. In such cases, the physician might consider stomach emptying as a reason for such problems with diabetes management.
 
Symptoms
 
Some of the common symptoms of the disease include:
 

• Throwing up regularly, even everyday in some cases when the condition becomes severe and because of this, risk of malnutrition goes up multifold times
• Nausea
• Abdominal Bloating and pain
• Loss of appetite combined with weight loss
• Fullness (early satiety) even when eating very small portions
• Heartburn or reflux
• Bad control of blood glucose levels
• Lack of ability to finish a meal completely

 
Diagnosis
 
Though symptoms help in finding the presence of some disease, these alone aren’t sufficient to come to any conclusions. Physicians might do a physical examination, ask you to do a blood sugar test, and also prescribe for some other tests such as:
 
Barium beefsteak meal: As the name suggests, the patient is given a meal with barium and with the help of an X-ray, the time taken to digest the food is calculated. With this, the time taken for stomach emptying is also calculated.
 
Gastric manometry: A thin tube is inserted from the mouth into the stomach to measure how fast food can be digested.
 
Electrogastrography: Electrodes in the skin are placed to measure the electrical activity in the stomach.
 
Barium X-ray: Liquid barium is given for drinking and this forms a coating on the esophagus, stomach, and small intestine which is clearly visible in an X-ray.
 
Radioisotope gastric-emptying scan: After consuming food with some radioactive substance, the patient is made to lie under a scanner. Presence of more than 50% of the meal in the stomach even after 1.5 hours is a clear indication of gastroparesis.
 
Other tests that help diagnosing the disease include performing an upper endoscopy, biopsy of the small intestine/stomach, ultrasound, and wireless motility capsule to analyse the rate of stomach emptying—slowly, normally, or rapidly—and to confirm that there is nothing blocking the movement of food.
 
Treatment
 
The most predominant treatment approach for handling gastroparesis includes making diet-related changes, achieving glycemic control, and monitoring fluid intake. Diet changes includes limiting fat consumption to not more than 25-30% of the total calories consumed, keeping fiber intake to well under 15 grams for 1,000 calories of food taken, and eating small meals frequently. It’s better to get the help of a nutritionist/dietitian to plan a well-balanced meal plan as spicy, fatty, and acidic foods must be avoided, and choosing foods can be a challenging task. The dietitian might also recommend  patients to avoid consuming legumes, beans, and whole grains as these are rich in fiber.
 
Sometimes, supplements might be necessary to manage malnutrition and correct vitamin and other nutrient deficiencies.
 
Drink plenty of fluids, restrict alcohol consumption, don’t drink carbonated beverages, and avoid smoking altogether. Engage in physical activity for at least 150 minutes daily. Moreover, getting a good glycemic control is mandatory but remains a challenging task as absorption of food is not constant affecting insulin secretion and administration quantities. The healthcare professional might make changes to insulin dosages and medications taken.
 
Conclusion
 
Symptoms of nausea, vomiting, and inability to eat meals might affect the peace of mind of patients and induce stress. There are even times when doctors prescribe medications to control vomiting and nausea, but this happens in extreme situations. As the patients consume less quantities of food, there are higher chances of malnutrition which affects the quality of life of the individual. Gastroparesis is one of the biggest complications of diabetes that might have co-morbidities and increase mortality rates. Though nutritional changes should provide relief, in the case of some individuals, the need for medications and surgical therapy becomes indispensable.

Human health is stealthily degrading though the average lifespan of an individual is increasing. Our quality of living is not great as health has taken a backseat and even young individuals suffer from knee pain or heart attacks. Our distasteful lifestyle practices and choice of foods, obesity/overweight, abstinence from regular physical activity, and sleep crunch are strong enough to cause debilitating consequences including diabetes, chronic health problems, and more. But, the connection works the other way around too! The presence of type 2 diabetes in an individual can be a risk factor for obesity in diabetic.
 
Diabetes Mellitus & Obesity
 
Diabetes mellitus has the potential to trigger changes to the carbohydrate, fat, and protein metabolism primarily due to insufficient secretion of insulin. Type 2 Diabetes Mellitus (T2DM) occurs predominantly due to decreased secretion of the insulin hormone or insulin resistance.
 
Obesity/overweight is the accumulation of adipose tissue that impairs the physical as well as psychological well-being of an individual. Obesity is currently one of the gravest diseases present across nations, developing or developed. In fact, there are a greater number of overweight people than underweight individuals. The common factor connecting obesity and type 2 diabetes is insulin resistance. A greater number of individuals falling under the obesity belt don’t suffer from hyperglycemia. But for the combination of insulin resistance and obesity to result in type 2 diabetes, the beta cells of the pancreas must be unable to compensate for lower insulin sensitivity.
 
In obese individuals, there exists the risk of the release of nonesterified fatty acids (NEFAs) from adipose tissues and this might be the reason behind the close association between insulin resistance and the dysfunctionality of beta cells.
 
Insulin Resistance & Obesity
 
Throughout the lifecycle of every individual, there’s a potential for fluctuations in insulin sensitivity which is highly possible during times of increased carbohydrates intake, vigorous performance of strenuous physical activity, and other lifestyle changes. Puberty, ageing, and pregnancy are some periods during which insulin resistance becomes a very common affair.
 
The insulin-responsive glucose transporter (GLUT4) is downregulated in the adipocytes in obese individuals. The region where the body fat is present is quite a serious determinant of insulin sensitivity. For instance, central deposits of body fat (on the abdomen) poses higher risks of insulin resistance and type 2 diabetes compared to subcutaneous fat deposits.
 
Understanding the Vice-versa
 
We have a team of researchers from the University of Basel who have now found that insufficient production of insulin in the human body can contribute toward increased risk of overweight/obesity.
Different hormones take up different functionalities working in harmony to keep our body healthy and fit. Feelings of hunger and fullness can also be attributed to various hormones and enzymes. Improper functioning of the enzyme protease PC1/3, halts the conversion of inactive hormone precursors into active ones. When the enzyme doesn’t perform its function, there is a greater risk for endocrine disorders which in turn increases the risks of overwhelming feelings of hunger and obesity.
 
The research team blocked the PC1/3 enzyme in the beta cells of the pancreas of mice that produce the insulin hormone. The mice consumed more calories resulting in overweight. We have distinct proof showing that the PC1/3 enzyme’s gene expression is correlated with an individual’s body weight—when there is enough production of the enzyme, the body weight also stays in a healthy range.
 
Insulin & Weight Gain
 
The insulin hormone not only regulates glucose levels in the blood but also helps the cells to absorb it. It does it by stimulating the cells of the fat, muscles, and liver to absorb glucose which is either used for energy or converted into fat for long-term storage. A person with type 1 diabetes suffers from insufficient insulin production and an individual with T2DM suffers from ineffective use of the produced insulin. As a response to both of these, the pancreas starts producing more and more insulin resulting in insulin resistance. When glucose is not removed effectively due to insulin resistance, this glucose is converted to fat and gets stored in the body, which, in turn, leads to weight gain.
 
There are several studies showing hyperinsulinaemia and insulin resistance as important risk factors for weight gain during later stages of life—this is even more true in the case of obese children and postmenopausal women.
 
The Bottomline
 
Impairs on the insulin-producing cells leads to obesity/overweight and the discovery of this concept opens the door for numerous ways of treatment. Mankind could come up with medications that reduce the formation of insulin precursors and this could not only benefit in fighting against diabetes but also obesity.
 
The concrete link between obesity, insulin resistance, and type 2 diabetes has been established long back. But, the potential effect of insufficient insulin and its effect on human body weight is truly amusing and holds the key to alter the course of diabetes treatment. Going back to the basics of approaching diabetes and obesity with better lifestyle modifications, diet changes with the help of a dietitian/nutritionist, and regular exercise is a sure-shot course to victory. Still, research evidences as discussed above help in bringing better and new approaches to handle obesity and diabetes.

Diabetes is growing to cause havoc on the human population with its debilitating side effects. Once we start recognizing the signs of diabetes, its recommended to consult a doctor. Before concluding the presence of this disease, the doctor suggests a range of tests including fasting sugar, post prandial test, HbA1c levels, and so. Each of these have a definite value that’s considered normal. But, what exactly is the ideal glucose range for a person without diabetes and what can be considered the ideal blood glucose range for someone suffering from the disease?
 
With diabetes, the blood sugar levels stay on the higher side which in due course, can damage the body’s health. Practically, glucose levels can be low, in the normal range, or high. Ample factors affect their numbers but the most critical of them include the type of foods consumed, their quantity,  the physical activity performed, and lifestyle followed.
 
Recommended Blood Glucose Levels
 
The universal recommendations for ideal blood glucose levels stand the same worldwide but these suggestions have a different degree of interpretation depending on the individual—this must be discussed clearly with your physician. The ranges given below are the ones set by the National Institute for Clinical Excellence (NICE) but, again, the range for different individuals must be set and followed only after a thorough conversation with the doctor.
 
Also mentioned below are target blood glucose ranges for people without diabetes:
 

• In the case of normal individuals without diabetes, the ideal glucose range is between 4.0 and 5.9 mmol/L and the post-prandial range must be under 7.8 mmol/L.
• In case of individuals (both adults and kids) with Type 1 diabetes, the glucose range must be between 4 and 7 mmol/L before meals and between 5 and 9 mmol/L during post-prandial test (taken at least 1.30 hours after meals). Immediately after waking up, the glucose range must be 5-7 mmol/L for adults and 4-7 mmol/L for kids with Type 1 diabetes
• In case of individuals with Type 2 diabetes, the pre-prandial (before meals) range must be 4-7 mmol/L and under 8.5 mmol/L during the post-prandial test.

 
These details stay etched in every clinician’s mind, but the normal blood sugar ranges for a major population of healthy individuals include fasting sugar ranges between 4.0 and 5.4 mmol/L and a post-prandial value of 7.8 mmol/L two hours after meals consumption.
 
Blood Sugar Levels That Help Assessing Diabetes Through Various Tests
 
Generally, doctors recommend going for fasting sugar test, post-prandial and HbA1C tests to confirm the presence of diabetes. Some other tests in prevalence include the oral glucose tolerance test and random blood sugar test. Let’s look at the permissible glucose ranges in the common diagnostic tests that are not considered deleterious to life:
 
Fasting blood sugar test: A test taken without consuming anything for at least 8 hours from the previous night, showing ranges below 5.5 mmol/L and 100 mg/dl are generally considered normal. If the individual’s results stand between 5.5-6.9 mmol/l or 100-125 mg/dl, they can be categorized as pre-diabetics. Any value between 7.0 mmol/l or more and 126 mg/dl or more is classified as diabetes.
Post-prandial test (2 hours after meals): Any value below 7.8 mmol/l or below 140 mg/dl is considered an ideal glucose range. Someone falls into the pre-diabetes range if the blood glucose levels are from 7.8-11.0 mmol/l or 140-199 mg/dl. Any value above 11.1 mmol/l and more (or 200 mg/dl or more) is designated as diabetes.
 
HbA1C: This test gives you the average glucose level across a period of three month. A value below 42 mmol/mol (6%) is taken as normal. Someone is suggested to be in the prediabetes range if the numbers stand around 42-47 mmol/mol (6-6.4%) and categorized to suffer from diabetes if they have glucose numbers beyond 48 mmol/mol (6.5% or above).
 
Too High or Too Low Glucose Ranges
 
It is never good for blood glucose ranges to spike up or down drastically. Too high levels are called hyperglycemia and too low levels are called hypoglycemia. Individuals whose fasting glucose ranges go above 100 mg/dl might have hyperglycemia and it is advisable to get the help of your healthcare physician. Leaving too high sugar levels unattended for too long could lead to stroke, erectile dysfunction, heart attack, circulation-related problems, blindness, and immunity-related problems.
 
Hypoglycemia is when the glucose ranges fall below 70 mg/dl—this condition is extremely dangerous as it not only causes anxiety, confusion, sweating, and blurry vision, it could also result in coma, seizures, or death sometimes.
 
The Bottomline
 
Though we clearly differentiate between normal and dangerous glucose levels, we don’t have distinct differentiation regarding how our blood sugar levels stand during a 24-hour period. Individuals with normal glucose ranges might have high and low levels sometimes which might increase the risk of health problems. So, beyond maintaining admissible blood glucose levels, it is also our duty to prevent too many highs and lows concerning glucose numbers. We can do this by ensuring that there are no haphazard increases in post-meal glucose levels, maintain fasting levels as close as possible near the low end of desired ranges, and stabilize blood sugar levels by consuming a well-balanced meal that brings no surprise sugars to the table.
 
Maintain a log of the daily numbers and discuss with your doctor if there are any discrepancies. Take it up with a dietitian/nutritionist to bring concrete but healthy changes to everyday diet plan as food habits have a generous impact on the overall blood glucose levels. Besides this, exercise regularly, don’t indulge in cheat meals or binge eating, and follow an active lifestyle to stay healthy even with diabetes.

Diabetes is a chronic disease where your body doesn’t make enough insulin or doesn’t use insulin effectively. When either of this happens, there is excess sugar in the bloodstream leading to debilitating consequences. So, how do we know whether or not we have diabetes? There are a couple of symptoms which indicate the presence of diabetes:

• Tiredness
• Loss of weight without making any efforts
• Dry skin
• Sores or wounds take time to heal
• Hunger
• Feeling very thirsty
• Urinating frequently

 
Most individuals are aware of the disease, its consequences, symptoms, and risk factors. So, when anyone experiencing any of these symptoms visits the doctor for diagnosis, the very first thing the physician asks for is a blood sugar test to confirm the disease. There are a number of tests prescribed by authentic diabetes institutions and physicians to confirm the presence of diabetes. Those include:
 
HbA1c test: A blood test, this is used to find out the blood glucose levels over a 3-month average. Also known as the haemoglobin test or glycosylated haemoglobin. The results show the amount of blood glucose levels present in the haemoglobin—the higher the blood sugar levels, the greater percentage of haemoglobin that’s present with sugar. Measured as a percent, any number above 6.5% confirms diabetes. A measure below 5.7% is normal and numbers between 5.7% and 6.4% indicates pre-diabetes. You can eat or drink anything before or after taking this test.
 
Fasting blood sugar test: As the name suggests, readings for the fasting plasma glucose (FPG) test are taken in the morning after having fasted for 8 hours at least. Any number below 99 mg/dL is normal, values between 100 and 125 mg/dL suggests prediabetes, and any number above 126 mg/dL confirms diabetes.
 
Random Blood Sugar Test: Once again, as the name suggests, a blood sample is collected at any time of the day randomly without having to fast. A value of 200 mg/dL and above suggests diabetes.
 
Glucose Tolerance Test (GTT): This is quite a strenuous test as you would have to fast overnight (at least for 8 hours), take a fasting blood sugar sample and then consume a glucose-containing liquid at intervals of one, two, and three hours respectively. After two hours, a blood sugar levels below 140 mg/dL is normal, a reading between 140 and 199 mg/dL is indicative of pre-diabetes and any reading that shows 200 mg/dL or above confirms diabetes.
 
Do We Really Need Comprehensive Testing Procedures?
 
In a clinical setup, performing any of the above tests has been the norm for detecting, confirming, and following up on diabetes since a long time. But now, with the advent of the ‘diabetes reversal’ terminology and numerous websites fighting against each other to lure clients for remission/reversal programs, each of them come with various plans, technologies, and terminologies for treatment.
 
There are some companies that incorporate continuous glucose monitoring (CGM) even for those type 2 diabetes patients who are not on insulin nor have type 1 diabetes. Some companies take a test every quarter as a part of their routine check up and this is normal. But it doesn’t stop with the test and the patients are provided with a personal glucometer,  a number of strips (50, 100 or more), and a lancet to track blood glucose levels often. Above all this, there are a few of them who go one step ahead and do comprehensive testing using 70+ parameter blood and urine check up during the onboarding process for any of their programs.
 
It’s surprising that someone could use numerous parameters and get the same blood sugar test which is possible with a couple of parameters. They boast of having a macro-level understanding by including nuances in their blood measurements. But reputed diabetes associations worldwide have clearly not supported the use of CGM, accu-chek, or micro-measurements when the person does not use insulin for type 2 diabetes, is not a type 1 diabetes, or when the physician hasn’t recommended for CGM. Even research studies aren’t supporting CGM or comprehensive testing use for dealing with diabetes. Even if we keep these things aside, it is obvious that all that we need are fasting blood sugar, PP, GTT, and HbA1C readings for confirming diabetes and following up on the patient regularly.
 
Anything else is simply unnecessary. Mind you, it is a different game altogether for people suffering from type 1 diabetes or having complications with type 2 diabetes. That’s something entirely different to be dealt with. But, if you are a type 2 diabetes or pre diabetes patient whose doctor hasn’t suggested for any add-on monitoring devices to the body or every day blood glucose tests, please stay away from such routines which add nothing but more stress and anxiety to your already stress-struck self. Be calm, stay strong, and get in touch with a registered dietitian nutritionist to plan a healthy diet, monitor your lifestyle regularly, and recommend doable exercises to stay fit. Take tests as recommended by the physician and put diabetes under control.

Entrapped with one disease is dreadful enough, but sometimes there are chances that one disease could be a risk factor for another serious diseases as well. Yes, we can smell double trouble sometimes! For instance, there have been serious discussions and promising results showing a concrete connection between diabetes and cancer since decades, but only recently we’ve been able to uncover the reason for their frequent twinning occurrence.
 
It’s no surprise that both diabetes and cancer have common risk factors but how they are linked has been a big question mark. We also have cases where diabetes treatment medications either increase or decrease the risk of cancer. While cancer remains as the second cause of death worldwide, diabetes is the 12th leading cause of death. The concurrent occurrence of diabetes and cancer together in a patient has been observed for more than 50 years but conclusive evidences on their link remained undiscovered.
 
“From Cancer to Diabetes” OR “From Diabetes to Cancer”
 
Since long, diabetes has been a potential risk factor for conditions such as stroke, heart attack, kidney diseases, and more. But now, it’s been proved to increase the risk of cancer too. In fact, individuals are being diagnosed with both, cancer and diabetes more frequently than what could be called a coincidence. A German physiologist was the pioneer in establishing a connection between cancer and diabetes as early as the 1930s. According to him, glucose was the main source of fuel for cancer cells which metabolized sugar at higher rates comparatively.
 
It was as early as the 1960s when studies associating both these diseases were conducted without affirmative conclusions. But during the recent years, different meta-analytic studies show evident data supporting that some types of cancers more commonly occur in people with diabetes. For instance, those suffering from type 2 diabetes are at an increased risk of colon, breast, bladder, and rectum cancer, some cancers such as that of the lung are not linked to diabetes, while some others show inconclusive results.
 
Such simultaneous occurrence of cancer and diabetes accelerates the death rates in patients but sadly, not much information is known about the underlying relationship between these two diseases.
 
Cancer Treatments Can Cause Diabetes
Also, patients with cancer who undergo treatment for the condition consume steroids, undergo chemotherapy, and take targeted therapy treatments. Hence, all these including stress due to the disease, diet, excess pain, and inflammation could be the cause for secondary diabetes.
 
There are some cancer treatments that can raise blood sugar levels or sometimes lower them. For instance, some forms of chemotherapy lead to rise in blood glucose levels. The steroids consumed for keeping cancer under control or to reduce the pain due to the disease might cause high blood sugar. Some forms of targeted therapies might affect the way in which insulin is used altering blood sugar levels.
 
Cancer treatment sometimes includes hormone therapies which are more commonly given in the case of breast and prostate cancer. The drugs used for this purpose have the potential to enhance blood sugar levels.  Radiation therapy might sometimes destroy the insulin-producing cells while treating the cancer cells.
 
Research Results Don’t Prove Us Wrong
 
One of the biggest studies done by researchers at the John Hopkins University in Baltimore and the University of Oxford in Great Britain reviewed 47 studies from around the world that contained a pool of information from more than 20 million individuals. This study done in 2018 clearly confirmed that women with diabetes are at a 27% increased risk of cancer and diabetic men have a 19% increased risk compared to the normal population.
 
Two predominant factors contribute to such high risks—the insulin hormone enabling control over glucose levels initiates cell growth that might lead to cancer. Also, overweight people develop higher levels of adipokines, a hormone instigating inflammation which in turn might lead to cancer.
 
Also, a 2018 study from the JAMA Oncology suggested that those with cancer are at a 6-times higher risk of diabetes not because of cancer but as a result of the treatment methodologies followed for treating the illness.
 
Another serious concern presented at the European Breast Cancer Conference showed that those with type 2 diabetes who succumb to cancer are diagnosed with the problem only during the disease’s advanced stage if the condition is not tested during regular checkups. Hence, individuals with metabolism disorders must take extra caution to test for other conditions and identify them at an early stage.
 
 Two Ailment But One Common Risk Factor
 
The risk factors that contribute towards cancer and diabetes are very similar and this causes more than 90% diabetes cases, a fact established by the American Diabetes Association (ADA). These factors include ageing, gender (men are at an increased risk for both the conditions), race, overweight/obesity, a sedentary lifestyle, and smoking. Obesity is a grave risk factor not only for diabetes but for the occurrence of numerous types of cancers including kidney, uterine, stomach cancer, and more.
 
The Bottomline
 
Suffering from two different diagnosis simultaneously is absolutely painful. But, on a positive note, diabetes could be controlled in different ways while we don’t have any power over cancer. The main requirement is to not lose hope. Adhering to better lifestyle changes, choosing healthy foods to eat, sleeping well, and performing physical activity regularly definitely helps in keeping diabetes under control. If you suffer from diabetes only, doing these changes automatically reduces your risk of cancer. But, prevention is always better than cure. Trying to stay away from diabetes does benefit doubly—else, increased blood glucose levels have the potential to alter the body’s DNA structure, reduce its repair potential, and the genome becomes unstable providing the perfect platform for the growth of cancer cells.
 
There is research happening continuously on the medication front too and the good news is that metformin, a commonly-used drug for diabetes can repair DNA, reduce blood glucose levels, and might have anti-cancer properties. Hence, do what’s in your control to minimize the risk of diabetes and cancer. Meet with a registered dietitian nutritionist to plan a healthy lifestyle and include wholesome foods in your everyday meal plan. Doing this will surely make you feel better emotionally and physically.

​Neither sugars nor alcohols, sugar alcohols are not only found naturally in fruits and vegetables but can also be manufactured. Though not calorie-free, only a small part of these sugar substitutes is absorbed by the body and don’t cause erroneous spikes in blood sugar levels. Most processed foods containing the label ‘sugar free’ or ‘no added sugar’ surely contain sugar alcohol as one of their ingredients. Any health-conscious person or those wanting to restrict calorie intake surely looks at the nutrition label at the grocery store while picking any product. Hence, it is even better when we understand the most popular and commonly used sugar alcohols in our favorite foods. This way, it becomes easier for us to choose a healthy product that contains the right quantities of various nutrients in moderate amounts.
 
Most Popular Sugar Alcohols
 
There are eight sugar alcohols that have been currently approved as safe to use in edible foods and these include:
 

• Mannitol
• Isomalt
• Xylitol
• Erythritol
• Hydrogenated starch hydrolysates
• Lactitol
• Maltitol
• Sorbitol

 
Let’s look into them in detail below.
 
Mannitol: Is pineapple your favorite fruit? If so, you have been consuming a little of sugar alcohols even without your knowledge. Mannitol naturally occurs in fruits and veggies such as pineapples, carrots, sweet potatoes, olives, and asparagus. Besides being available naturally, sugar alcohols are also artificially manufactured, and one of the common ingredients used in this is seaweed. Unlike artificial sweeteners that leave you with an intense sweetness, mannitol has only 50-70% of sweetness compared to sugar. Hence, one must use increased quantities of this sweetener to bring the required sweetness levels. Mannitol has a glycemic index of 2 and a relative sweetness score of 0.5 in comparison to sugar. Belonging to the FODMAP group, consuming mannitol in excess could result in diarrhoea and bloating.
 
Sorbitol: Available in fruits such as apples, peaches, plums, berries, and pears, sorbitol is almost 50% sweet as sugar having a glycemic index of 4 and a relative sweetness score of 0.58. The sweetener is used more commonly in making candies, jelly spreads, and packaged foods. Manufactured commercially from corn syrup, sorbitol is a common occurrence in many sugar-free beverages and foods. As this sweetener has little effect on your blood sugar levels, it results in minimal digestive symptoms when consumed.
 
Maltitol: This tastes similar to sugar and is almost 75% as sweet as sugar with a relative sweetness score of 0.87 and glycemic index of 35. As this sweetener adds a creamy nature to foods, it is added to baked foods, ice creams, chewing gums, chocolate-flavored desserts, and sugar-free hard candies.  The main advantage here is that maltitol tastes similar to sugar but only has 50% of calories and is poorly absorbed in the bloodstream thereby posing no threat to rapid rise in blood sugar levels.
 
Xylitol: Once again, this is one of the most-commonly used sugar alcohols as it tastes very similar to sugar. Called as ‘wood sugar,’ xylitol is present in fruits, cereals, vegetables, mushrooms, and certain cereals. Commercially made from corncobs, it is found in chewing gums, toothpaste, mints, and oral care products. It has a relative sweetness score of 0.97 and a glycemic index of 12.
 
Erythritol: One of the sugar alcohols having excellent taste, erythritol is almost 70% as sweet as sugar and contains only as low as 5% of the calories. While it naturally occurs in products such as watermelon, soy sauce, and pear, commercially this sweetener is made by fermenting corn. Erythritol has a relative sweetness score of 0.63 and a glycemic index of 1.
 
Hydrogenated Starch Hydrolysates (HSH): These are produced by the partial hydrolysis of corn and are 40-90% as sweet as sugar. Commercially, HSH is prepared from mixing different sugar alcohols and is used widely in making confectionary, baked goods, and mouthwashes as it does not crystallize easily.
 
Isomalt: Having a sweet taste equivalent to 45-65% as that of sugar, isomalt has the unique tendency to protect its sweetness without breaking down during heating. We can find its use more commonly in hard candies, cough drops, toffee, and lollipops. Having a relative sweetness score of 0.54 and a glycemic index of 2, isomalt is extracted from beet sugar.
 
Lactitol: Have you every read the nutrition label of any sugar-free ice creams that you purchased recently? If so, you would have definitely read the name lactitol as this is an integral ingredient not only in sugar-free ice creams but also in baked goods, sugar-reduced preserves, chewing gums, chocolates, and candies. Having a relative sweetness score of 0.35 and a glycemic index of 3, lactitol is the least sweet of all sugar alcohols and is made from milk, as the name implies.
 
Conclusion
 
Though sugar alcohols do have a certain role in affecting blood sugar levels, if you compare their GI values, all of them have definitely lower values than normal sugar. Hence, replacing normal sugar with sugar alcohols definitely provides advantages for controlling blood sugar levels and helps in better diabetes management. There are some sugar alcohols such as erythritol and xylitol that have been scientifically proved to bestow better dental health. Sugar alcohols might be considered safe and even beneficial sometimes, but it is always better to cut back on sugar consumption and switch over to naturally sweet foods such as fruits and grains.
 
But if you are cautious about consuming sugar alcohols in limited quantities, they might help in reducing carbs intake. Get in touch with a dietitian/nutritionist if you are looking for a diabetes- or weight loss diet plan where such sugar substitutes might play a strong role in building a diet plan. Nevertheless, a diet plan rich in fresh fruits and veggies, whole grains, dairy, proteins, and nuts remains the best on any given day.

​Diabetes is a metabolic disease that affects 1 in 3 people worldwide. It is a terminology used for a group of conditions where the blood sugar levels are either above or below recommended normal glucose levels. Higher than normal glucose levels is called as hyperglycemia while lower than normal levels are called as hypoglycemia. Both, hyper- and hypoglycemia fall under the umbrella term type 2 diabetes. Type 1 diabetes (earlier known as juvenile diabetes) is a condition where the pancreas cannot make insulin or makes very little insulin owing to which sugar can’t enter the cells and hence, builds up in the bloodstream. This type of diabetes generally occurs in teenagers, kids, and young adults mostly. But, it is type 2 diabetes that’s commonly present in 80-85% of the population. It’s only the rest who succumb to type 1 diabetes, which becomes quite dangerous without without holding over a good glycemic control. Till today, we don’t have a specific treatment protocol for overcoming type 1 diabetes but abiding by some rules can help keep it under control—this includes pursuing a healthy lifestyle, consulting the physician for regular health checkups, and managing blood sugar levels. It also helps to understand self-management plans and execute them to avoid compromising on the individual’s quality of life.
 
Type 1 Diabetes: History
 
Insulin is a magic pill for diabetics, especially those with type 1 diabetes as the life expectancy was not more than a couple of months in those with this condition before insulin was discovered. Use of insulin has changed the management plan required for the disease but at the same time, widened the understanding of the common man that the disease leads to long-term complications and shortened life tenure.
 
For type 1 diabetes, it is necessary that individuals get their glucose levels assessed as per the physician’s recommendations while glycemic levels must be checked every quarter in those who don’t match glycemic goals or whose therapy has changed. There are various ways to monitor blood glucose levels including capillary blood glucose monitoring (BGM), continuous blood glucose monitoring, and more. BGM helps in avoiding hypoglycemia and provides ideal guidance to insulin dosages. Becoming hypoglycemic before certain situations is dangerous and these include—before bedtime, before, during, and after exercise, and before driving. Practically keeping a tab on the blood sugar levels very frequently is a big problem. Knowing the numbers can be irritating and even lead to lesser number of measurements taken in case of diabetic patients. To simplify things and make people’s life easier, getting hold of devices with in-built memory option is helpful in adjusting insulin doses correspondingly and observe variations in insulin levels.
 
Continuous Glucose Monitoring (CGM)
 
By now, most of us would be familiar with continuous glucose monitoring or CGM as it’s commonly called. A tool for individuals with diabetes, CGM is a wearable technology that makes tracking down blood sugar levels extremely simple and easy. It measures intestinal fluid glucose levels and provides semi-continuous information about glucose levels which would otherwise be impossible with conventional self-monitoring. You can measure blood glucose levels 24 hours a day while wearing this device choosing from either of the two CGM systems—retrospective or real-time systems with real time systems giving the actual glucose concentration on a display.
 
Every CGM comes with a sensor and a reader/receiver. The sensor is attached to the arms or tummy helping to measure interstitial fluid while the reader shows the results either on the smartphone or on an insulin pump (some types of CGM do this). There are some CGMs that come with alarm provisioning. The alarm goes off when blood sugar levels are too high or low.
 
Why use CGM?
 
Though we are pretty confident about the list of foods and the activities that increase/decrease blood sugar levels, there are times during which the glycemic levels change due to reasons unknown to us. In such cases, collecting data continuously using CGM helps in understanding these issues and patterns compared to finger-prick technology test. We saw previously that it’s possible for sudden shoot up in glucose levels during sleep or early mornings. Measuring such spikes is possible with CGM. Using continuous glucose monitoring is useful in knowing how exercising and medication impact blood sugar levels in the body.
 
Showing data every few minutes gives a clear idea of our body respond’s to blood sugar levels over time and make changes to eating habits, exercise goals, and lifestyle accordingly. While CGM tells you when the levels go up and down, they don’t answer the ‘why’ part. For this, analysing the data and reviewing them for patterns can help in personalizing diabetes care needs. Another big advantage with CGMs is their ability to send off an alarm in case of haphazard glucose levels. As most devices come built with this ability, the affected patients can make changes quickly before these numbers shoot up beyond control.
 
Also, using CGM reduces the number of fingerstick tests needed everyday to monitor glycemic levels. But, please understand that finger prick checks are needed every now and then as CGM readings lag by a couple of minutes behind blood sugar levels. Such time lags are improving more and more with technological advancements and hence, there is no need for using finger-prick method more than twice daily if the CGM calibrations are good.
 
Above all, we have a significant number of research and well-controlled clinical trials that indicate their advantage in achieving metabolic control and decreasing hypoglycemia risks.
 
Are CGMs Affordable?
 
With so many advantages related to using CGM for type 1 diabetes, why isn’t its use widespread and popular? One of the main reasons is the expensive nature of these monitoring devices. The high cost of CGMs is a big obstacle in purchasing them as it is not a one-time purchase but requires changing the sensor every 7-14 days or a couple of times every year in case of long-term implantable CGM devices.
 
There are a few companies that provide insurance coverage but still, the procurement procedures aren’t simple and various plans have different coverages of CGMs.
 
Can We Cure Diabetes with CGM?
CGM is only a tool that can help maintain blood sugar levels and keep them under control. Using CGM regularly helps in understanding your body’s way of responding to various activities and foods thereby making changes to maintain recommended glucose numbers. Use a CGM only when recommended by your physician and get back to them when numbers don’t match the recommendations. Else, it could result in coma, seizures, and even death.
 
The Bottomline
 
It is not very easy to understand the nuances of using a CGM. It takes time but once you become adept in handling the device, there must be no hiccups thereon. Though not a cure for diabetes, it is very much useful in gaining better knowledge about the disease and monitor the glucose trends closely. Sometimes, seeing the numbers frequently might induce stress but once you realize the importance of continuous monitoring and its advantage in preventing hypoglycemia, CGM becomes a boon for type 1 diabetes patients.
 
Follow a healthy lifestyle, be active physically, keep cholesterol levels under control, and minimize stress to keep glucose numbers in a healthy range with type 1 diabetes. Consulting a dietitian/nutritionist and managing overweight/obesity is a good way to incorporate a healthy lifestyle to control blood sugar levels. The additional use of CGM gives individuals mind peace and helps them go forward with their actions without worrying about extreme variations in blood sugar levels.

Many individuals have a sweet tooth and there are some who crave for sweetened beverages and pastries. Irrespective of whether or not someone has a desire for sweets, it is practically impossible to avoid sugar-based ingredients altogether. Still, individuals are trying to reduce sugar intake as much as possible, even more reduce the intake of refined sugars. Hence, this motivates people to look out for sugar substitutes but another major problem is the availability of numerous sugar substitutes available these days. Only if we get a thorough understanding of each of their benefits and disadvantages, we can make an informed choice regarding the same.
 
Dissecting Sugar
 
Sugar is not naturally bad. In fact, our body thrives on sugar converting the carbohydrates we consume into energy for performing various activities. Humans have misused this ingredient to such an extent that the younger generation are suffering for their grave mistake. In fact, people are staying away from natural sources of sugar and carbohydrates including fruits, grains, and dairy products which is unnecessary. The need of the hour includes picking the right materials that add sweetness to foods in a healthier way.
 
There is a monumental difference between natural and artificial sugar with natural sugars being the healthy choice obviously. Still, most individuals choose to consume more of artificial sugar-based foods that can result in serious health problems such as high blood sugar, insulin resistance, diabetes, dental caries, and obesity. There are some sweeteners such as maple syrup, honey, molasses, and more that come with a couple of benefits including antioxidant benefits and mineral presence such as iron, zinc, and potassium.
 
Understand Sugar Substitutes to Take a Stand For or Against Them
 
Our mind instantly thinks about Stevia or sucralose on the mention of the word sugar substitute, but this terminology might be quite tricky to dissect. A sugar substitute is any sweetener that’s used instead of table sugar to add sweetness to any dish. Having lesser calories than normal sugar, in reality sugar substitutes might be categorized into three namely natural sweeteners, artificial sweeteners, and sugar alcohols. Let’s look into artificial sweeteners in detail.
 
Artificial Sweeteners
 
As the name suggests, artificial sweeteners are created artificially using chemical in a lab. Synthetic sugar substitutes, these might also be derived from naturally occurring ingredients such as herbs. One might be surprised to understand that these sweetening agents might be 200-700 times sweeter than normal sugar. Another interesting point is that they come with zero calories as well as add zero nutritive value to foods.
 
We use artificial sweeteners predominantly in the preparation of processed foods such as candies, jellies, processed foods, puddings, dairy products, baked goods, jams, and sweetened beverages. These days, many of them are used for home-based cooking as well as baking. But, it’s always better to get a taste of each of them as some leave you with an aftertaste. In such cases, combining different sweeteners or using a different one might be more effective.
 
Does Adding Artificial Sweeteners Add Health Benefits?
 
Sugar primarily helps in providing energy for daily activities. Besides this, there is no greater benefit. Hence, we are smart enough to understand that there might not be any benefits beyond this and doesn’t the same apply to artificial sweeteners as well? These sweeteners don’t induce tooth decays but also stay beneficial in different ways as mentioned below:
 
Diabetes: Unlike natural sugar that are carbohydrate-rich, artificial sweeteners don’t contain carbohydrates and hence, don’t promote any risk of raising blood glucose levels. Still, get in touch with a healthcare physician to confirm whether or not you can use any sweetener in case you have diabetes.
 
Weight Control: Most of us are well-aware that sugar is full of calories with one teaspoon of sugar having about 16 calories. So, any sweetened beverage normally contains at least 5-10 teaspoons of sugar taking up the calorie count to about 90-160 calories. When sugar substitutes are used, there is no chance for calorie increase as they contain zero calories. It is indeed attractive but we are still trying to figure out the long-term effectiveness of these products with regards to weight loss.
 
Concerns Regarding Artificial Sweeteners
 
There have been numerous arguments and scrutinies regarding the health concerns associated with artificial sweeteners. We have even got arguments that consumption of artificial sweeteners might result in cancer and numerous other health concerns. Long ago, one of the artificial sweeteners called saccharin had a tagline warning people that it might be harmful to health. But the good news is that, not any sweetener has been branded as threatening to human health by the National Cancer Institute. A number of studies have even confirmed that these sweeteners are safe, even in the case of pregnant women.
 
Regulated as food additives by the Food and Drug Administration (FDA), artificial sweeteners have been declared ‘generally recognized as safe (GRAS)’ when they meet any of the below-given criteria:
 

• The substance has met all scientific criteria and authorized personnel have declared the substance safe for use
• The sweetener has been used for so long that they have been declared safe

 
Still, the FDA has set a certain upper limit that’s deemed to be safe to use by any individual.
 
Conclusion
 
It is best to avoid any sweetener and minimize sugar intake as much as possible. Still, if you feel like having sugar, it is always recommended that you eat it in moderation and minimize sugar intake as much as possible. Try eating a piece of fruit, blend dates or raisins into smoothies, or use some sugar substitute in your dish. Using sugar substitutes in a sensible ways helps in lowering calories and minimizing carbohydrate intake. Try using flavors including spices, vanilla, and more to flavor foods, go for unsweetened products, and pick your most-preferred sugar substitute to add in your meal when craving for sweets.
 
Artificial sweeteners are no magic pill and whatever might be their content, they cannot be equated to naturally sweet foods in terms of health.

Urinary tract infection (UTI) affects more than half the women population worldwide sometime in life. The proportion of women affected by UTI is even greater when they suffer from diabetes. The National Center for Biotechnology Information (NCBI) states that individuals with type 2 diabetes are more commonly affected by UTI comparatively and the degree of severity is also worse in such individuals.
 
Diabetes is a metabolic condition that occurs due to lack of enough insulin or the body’s inability to absorb insulin secreted by the pancreas. Usually, this chronic disease can trigger the risk of numerous other diseases including heart attack, stroke, nerve-related problems, vision problems, dental concerns, and skin ailments. Besides all these, individuals with diabetes are greatly liable to developing UTI, an infection of the urinary tract, that has debilitating impact on the kidneys, urinary bladder, urethra, and ureters.
 
The Link Between UTI & Diabetes
 
UTI infections generally occur when some bacteria enters the urinary system. But what is the lurking cause behind diabetes increasing the risk of UTI? The predominant cause could be that alarmingly high blood glucose levels have the potential to disrupt blood flow and cause nerve damages in the bladder. Due to this, the affected individual doesn’t realize the need to urinate and there is accumulation of urine in the bladder which could lead to growth of bacteria. Various studies show that 25-85% of women with diabetes develop UTI due to diabetic neuropathy.
 
Also, greater the glucose concentration in the body, higher is the risk for the growth of UTI-causing microorganisms. Our immune system is critical for maintaining the health of the body and the presence of diabetes could lead to weakening of the immune system. Due to this, there is increased difficulty in responding to an infection. When our primary defence mechanism is disrupted, the guaranteed protection against UTI is lost. Besides all these, such chain of events decreases the levels of psoriasin, a natural antibiotic present in the body.
 
Attacked Psoriasin Rips Off the Barrier Against UTI
 
Continuous analysis of the major cause behind diabetes and UTI link resulted in a concrete discovery by researchers at the Karolinska Institute who focused on whether the raised blood glucose levels in individuals have something to do with psoriasin, an antibiotic that’s an integral part of the human immune system. On analysis, results showed that high blood glucose levels decreased the levels of antimicrobial psoriasin levels but insulin had no say in any of these processes.
 
Psoriasin is a protein that deflects the binding of the bacteria to the epithelial cells and the endothelial cells. When this binding is not successful, there is no breeding ground for these bacteria inside the urinary bladder. But, the presence of diabetes reduces the availability of these antibiotics which in turn nullify the protective barrier and increase bladder infection risk.
 
To address this issue, the researchers recommend the use of estrogen treatment to correct bacterial growth and reduce infection risk. The suggestion is in line with the one that requests post-menopausal women to use estrogen vaginal creams to avoid UTI, an infection to which these women are at an increased risk. Also, this once again proves that estrogen could be a saviour against urinary tract infection. But, execute caution while administering estrogen as oral administration is never recommended and hasn’t proved to be helpful against UTI.
 
Besides all these, we have abundance research data supporting the notion that urinary tract infections are profoundly present in patients with type 2 diabetes. Not only that, but the infection is more severe as it’s due to more resistant pathogens and hence, causes worse results in diabetics compared to those without the chronic condition.
 
Even Higher Risk During Pregnancy & Old Age
 
The chances of UTI during pregnancy is already high due to changes in the urinary tract. When these pregnant women suffer from diabetes or gestational diabetes, the risk of UTI is even more higher. On a comparative basis, if the risk of UTI in pregnant women is between 3 and 10%, the risk of UTI in pregnant women with diabetes can be as high as 28%.
 
Older people with diabetes are also at an increased risk of UTI due to various factors including the greater potential of the bacteria to bind to the urinary tract, prolonged existence of diabetes, inability of the bladder to empty the urine completely, decreased immunity, and higher levels of HbA1C.
 
Addressing the Concern of UTI with Diabetes
 
The treatment procedures for UTI in persons with diabetes are similar to those without the condition. Besides prescribing certain medications, the treatment varies depending on the individual’s gender, age, presence of any health conditions, and the type of bacteria.
 
The best way to prevent keep yourself away from the dangers of UTI include staying hydrated by consuming plenty of water, keeping blood glucose levels under control, staying fit by exercising regularly, sleeping well, eating a well-balanced diet, and maintaining good personal hygiene. Basically, a healthy lifestyle is critical to avoid UTI risk and getting in touch with a dietitian or nutritionist can help in formulating a comfortable way to lead such a life
 
Conclusion
 
UTI generally triggers a burning sensation while urinating, causes rectal or pelvic pain, urges the individual to pass small quantities of urine frequently, and leads to bloody urine. In case any individual experiences any of these symptoms while having diabetes, it is better to get in touch with a healthcare physician immediately. People with diabetes already find it hard to control infections and if UTI is not detected earlier, there’s a higher potential for the infection spreading prolifically and even causing kidney damage.
 
By following basic personal hygiene and keeping the blood sugar levels under control, it’s not so hard to prevent UTI in individuals with diabetes. Keep in touch with your physician and get tips on quickly identifying UTI, the best ways to prevent its occurrence, and the best ways to care for yourself.