 There are Ample Contradictions Surrounding Vitamins & their Effect on Diabetes 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.
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 Fitness Trackers Promote Marked Improvements In Physical Activity Durations 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.  Honey Has High-Carb Content That Isn't Recommended for Diabetics 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.  Gastroparesis can Be a Cause & Effect of Diabetes 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:
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.  Insufficient Insulin & Obesity Risks Could Pave Way for New Treatment Approaches 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.  Discuss with your Physician Regarding the Optimal Glucose Levels for Your Body 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:
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:
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.  Common Risk Factors Increase the Occurrence of Diabetes & Cancer Together 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.  Candies & Baked Goods Contain Sugar Alcohols 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:
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.  Make Changes to Treatment Procedures using Info from the Receiver 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.  Artificial Sweeteners are 500 Times Sweeter than Normal Sugar 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:
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.  Higher Glucose Levels Increase the Chances of Bacterial Growth 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.  Insulin Stacking Could Result in Hypoglycemia We love to keep everything under control, be it our life or even what happens around us. When that’s the case, it comes as no surprise when individuals with diabetes do all that’s within their potential to keep blood glucose levels under control. Diabetes is a metabolic condition where the body is incapable of producing insulin or using it correctly. To correct this, many diabetics need to administer insulin which in turn helps in regulating blood glucose levels. Only when our body has sufficient levels of the insulin hormone, the cells can absorb enough glucose from the blood preventing raises in blood sugar levels.
Hence, when insulin is injected into the body, it helps in decreasing blood glucose levels and keeps them within the desired limits. But, the same hormone, when injected repeatedly at close intervals of time can cause an individual’s blood sugar levels to dip way beyond imagination. The phenomenon here is defined as ‘insulin stacking.’ Insulin Stacking Insulin is of different types namely rapid-acting, intermediate-acting, short-acting, ultra-long acting, and long-acting insulin. Inhaled insulin also comes under the category of rapid-acting insulin. Such intake of rapid-acting (or short-acting) insulin occurs before any meal to avoid skyrocketing of blood sugar levels. There are instances where people might using this rapid-acting insulin (commonly called as bolus insulin) to lower their blood sugar levels. Such an insulin acts fast on the body and starts working only after 15 minutes of injecting it and starts to peak after an hour of administration. The effects last up to 4 hours. But, if a person gives another shot of insulin well under the 4-hour period, the shot administered must be decreased to compensate for the lingering insulin inside the body that’s active from the previous shot. Any person with diabetes who suffers from high blood sugar levels or predicts high levels after any meal must accurately calculate the required dose of rapid-acting insulin to control blood sugar levels. But, there are many instances where such individuals might end up miscalculating the required dose of insulin and get themselves more shots than required. Such actions might result in hypoglycemia. Insulin Stacking: A backup for Insulin Levels? Hyperglycemia Dread: There are instances when the individual is well aware of the fact that bolusing emotionally might lead to low glucose levels. But, these people would rather be ok with low levels than higher ones. They can’t bear to see higher numbers but it’s always necessity to keep control over glucose levels preventing occurrence of both, hyperglycemia and hypoglycemia. Numbers Don’t Match: Many times, people have definite numbers in mind and expect the glucose levels to match them. For instance, some feel that the glucose should drop down 30-40 points in an hour or so, and so on. In reality, there is no determined formula for such numbers nor are there stringent rules to adhere by them. Improper Guidance: There are many cases when the individual involved doesn’t fully understand the impact of the rapid-acting insulin. Hence, they overdo the dosages injecting a second dose even before the impact of the first dose wears off. Tackling Insulin Stacking First and foremost, never blame yourself for the glucose numbers if they don’t come down immediately after administration. Even rapid-acting insulin takes time to act on the body. You might be emotionally inclined to give another dose when the sugar levels go up, but experts suggest waiting for at least 3 hours before giving the next dose. Be calm and cool as there might be times when the sugar levels go high depending on various factors. Hence, the best thing here is to stay tight and check the levels later. Put on the detective cap and check for situations where the blood sugar levels goes high or falls low. Maybe, the levels go low after doing some physical activity or after a second corrective dose. When you understand the pattern, finding a corrective solution becomes an easier task. Technology is both a boon and a bane to mankind. More and more people are using continuous glucose monitors (CGM) to keep a tab on their blood sugar levels. While CGM might be of tremendous help to some people, many individuals making use of this technology become victims to over-blousing. It’s mainly because these devices give a reading every five minutes and waiting simply after seeing the numbers seem impossible for these individuals. Hazards of Insulin Stacking Very high levels of blood glucose levels might result in hyperglycemia which increases the risk of ketoacidosis, a life-threatening condition occurring due to the accumulation of waste products. To avoid this, many people succumb to insulin stacking to correct their blood sugar levels. But, too much of stacking can result in hypoglycemia (very low blood sugar levels). Ways to Administer Insulin There are various ways to administer insulin and the choice depends on the individual’s lifestyle, preferences, and insurance. The most traditional method is to use a needle with syringe which sends insulin into the fat layer beneath the skin. A pen injector shaped like a pen is very easy to use compared to the needle and syringe. These pens also send reminders, help in keeping track of insulin doses, and also send reports. Another useful device that comes with a bolus calculator which tells individuals if they set doses at very close intervals is the insulin pump—these machines can either send insulin continuously or send as short bursts. The Bottomline There are various latest-technology devices that keep track of the time and quantity of every dose, gives reminders when it’s time for the next dose, comes with correct dosage depending on the present blood sugar levels, food choices, and also give alerts when the insulin is way above the recommended temperature range. To correct your food choices, get in touch with a dietitian/nutritionist. Use of such technology helps in avoiding insulin stacking as we are provided with valuable data for maintaining blood sugar levels in a constant state. According to the American Diabetes Association, rapid-acting insulin lasts between 2 and 4 hours after injection. It is always suggested to talk with the physician regarding any doubts about insulin. Also, it is always advisable to wait until for at least 3-4 hours after the first dose before taking more insulin. Insulin stacking has the potential to cause debilitating consequences including very low blood sugar levels. Making use of insulin appropriately, keeping a journal on the daily intake, and leading a healthy lifestyle can help in avoiding bizarre changes in blood glucose levels.  Rise Up With the Morning Sun to Avoid Diabetes Risk The world is not getting any better on the diabetes front as more and more people are succumbing to consuming processed foods, following an unhealthy lifestyle, refraining from exercising regularly, and not sleeping well. We have much awareness regarding the importance of a healthy diet and its role in controlling diabetes risk and there are a greater number of individuals who have started including physical activity as a part of their everyday schedule. What remains undermined is the need for sufficient sleep and its impact on diabetes.
Are We Heaping Over Insufficient Daily Sleep Levels? Sleep has been our utmost priority during early years of growth with teenagers and young adults trying to squeeze in as many sleeping hours as possible during weekends and holidays. But, the advent of the social media and Internet has stirred up utmost distress among all including kids and adults. Most of us spend most of our time hooked up to smartphones or iPads losing out on hours of overnight sleep. The concept of night owls and early birds has become very popular during recent times with night owls including people who prefer to stay active during the latter part of the day up to late into the night. Early birds are those individuals who wake up early in the morning. Whatever category you belong to, it’s been observed that most individuals lack enough sleeping hours accumulating them and compensating for such hours during weekends. But, our body needs sufficient rest to think clearly and perform our tasks with excellence and preciseness. Such lack of sleep not only affects our quality of life but when we sleep is integral to determining the risk of diabetes and heart disease. An Early Bird Not Only Catches its Prey But… There’s the popular saying “The Early Bird Catches Its Prey.” But, in our case, early risers benefit even better. They not only get to see the sunrise and wake up to breathing fresh air but are also better guarded from diabetes risk. That’s primarily because early birds are more dependent on fat as their primary source of energy for performing various activities and stay more active through the day with better aerobic fitness levels. Whereas, night owls utilize less fat for energy while resting or exercising. That’s the effective conclusion of a recent study done by researchers at the University of Rutgers who also found yet another useful information—early birds are more insulin sensitive than night owls who are, in fact, insulin resistant. Hence, night owls require greater insulin levels to lower blood glucose levels and their body chose carbohydrates instead of fats as their energy source. Such a response by the night owls is harmful for their body as it increases their risk of diabetes to a greater extent. One explanation given for this includes how the body’s circadian rhythm could have a solid impact on the body’s efficiency rate in utilizing insulin. For example, a night owl might sleep late but their responsibilities might force them to get up early thereby ruining their circadian rhythm out of proportion to a great extent. The result clearly shows that deviating from the body’s natural sleep-wake cycle magnifies health risks multi-fold times. The Bottomline The best possible solution for night owls to avoid increasing their risk of diabetes includes going to bed earlier than their usual timing. It is also recommended that individuals must avoid performing strenuous physical activity during late evenings to prepare their body for some peaceful sleep during the night. Some others don’t include staying away from carb- and fat-rich foods and avoiding using smartphones before going to bed. The light from the electronic gadgets can affect sleep quality as well as keep you from sleeping. It’s impossible to do this all at once but incorporate small changes every day to bring bigger positive results. Try going to bed 10-15 minutes earlier than usual and getting up 15 minutes earlier than your regular timing. Start loving the sunrise, make small tweaks to enhance energy and mood levels, and above all, stay well-rested—this helps you spring out of bed with better energy than you could imagine.  Untreated Diabetes Causes Polyuria Having the urge to pee always? It’s normal in the case of individuals with diabetes but some individuals excrete excessively large quantities of urine than what’s normally observed in the case of diabetes. We have a scientific name for this problem—polyuria, a condition where the human body passes too much urine too frequently every time during urination. The average daily urine output in any individual is not beyond 1-2 litres/day but in those with polyuria, the urine output goes anywhere from 3 litres to as high as 15 litres a day. Such immoderate excretion is a typical sign of diabetes. In general, people with diabetes feel the need to urinate frequently but the problem discussed here is different from the need for frequent urination.
For instance, people with diabetes generally pass urine frequently during the daytime but with polyuria, individuals get up too often during the night to urinate. When their sleep routine is disturbed and they fail to sleep well due to such interruptions, people start noticing the presence of polyuria, one of the common symptoms of diabetes. Common Causes of Polyuria There are multiple conditions that can cause polyuria, a condition where excessively high quantities of water are filtered by the kidneys. The presence of elements such as glucose in the urine might pull out too much water. These include:
There are some other conditions such as urinary tract disorder, enlarged prostate, and overactive bladder which induce the urge to pee at all times irrespective of whether or not the bladder is full. On the contrary, polyuria makes an individual pee frequently. Symptoms of Polyuria The predominant symptom of this problem is excessive production of urine throughout the day and night. If you feel there are any deviations from the normal amounts urinated, it is recommended that it’s better to note down the quantity of water consumed, frequency of urine passed, and the quantity of urine excreted every time during urination. Another major symptom of polyuria is feeling thirsty continuously. As there is too much fluid lost from the body, the individual feels thirsty to compensate for this loss. Frequent wake up calls disturbing sleep routines are another emergency call to check your body. Even when sleeping, the urge to urinate doesn’t stop in the presence of this condition. Treatment The required course of action depends on the underlying cause of the problem. If diabetes is the root cause of the disease, it is mandatory to ensure control of blood sugar levels by bringing lifestyle changes and treatment-related modifications. A reputed dietitian nutritionist might help in correcting the haphazard blood sugar levels by incorporating healthy eating habits, forming a well-balanced meal plan, and recommending simple but effective exercise routines. Individuals who drink caffeine and alcohol in excess would be suggested to cut down on the intake of those beverages. Sometimes, the medications taken could be the cause of the problem and hence, discussing with the physician to change the medication or alter the dosage is necessary. Getting in touch with a healthcare provider after observing the urination routines for a couple of days is mandatory if there are any abnormalities noticed including excessive urination that remains unexplained. The doctor might prescribe a couple of tests including blood sugar tests, creatinine, urine osmolality test, electrolytes, and urinalysis.  Pick the Choicest Healthy Foods to Reduce Gestational Diabetes Risk Pregnancy is a beautiful period which is cherished for a lifetime in every woman’s life. Every couple look forward to receiving their little bundle of joy with utmost joy and affection into this world. The most critical aspect during this period is none other than good health of both, the expecting mom and the baby. During earlier times, pregnancy was a cakewalk and complications arose only very rarely. But now, many women face tough times during this period, there are a lot more scans and tests involved than before, and some of them become victims to additional health problems such as thyroid, diabetes, blood pressure, and more.
Advent of Gestational Diabetes A type of diabetes, gestational diabetes can occur during the pregnancy period in women who don’t have a history of diabetes. The condition happens when the body is not well-equipped to produce insulin in sufficient amounts. It’s no wonder that the body is busy producing many hormones to tackle all the requirements during and after pregnancy. Besides this, there are many other changes happening in the body including weight gain. Such changes forces the body to make less efficient use of insulin resulting in insulin resistance. It’s generally observed that pregnancy induces insulin resistance in every pregnant woman but there are some of them who suffer from insulin resistance even before the start of their pregnancy. Those women who start off with their pregnancy requiring more insulin are at a higher risk of gestational diabetes. Risk Factors for Developing Gestational Diabetes Some prominent risk factors that enhance the individual’s risk of acquiring gestational diabetes include:
Chances to Lower the Risk of Gestational Diabetes There is no guarantee that gestational diabetes can be avoided completely but we can take a number of steps to minimize the chances of developing it. Enter Pregnancy with a Healthy Weight Range One of the main risk factors for gestational diabetes include being obese or overweight. Research shows that individuals with a BMI score of 25 and above are likelier to succumb to gestational diabetes and those with a BMI of 30 and above are at a three-times increased risk than others. If you have a BMI value of 30 and above, an oral glucose tolerance test will be done at the start of the term before the 16th week of pregnancy. In those with a BMI value of 25 and below, the test is done between the 24th and 28th week of pregnancy. Doing the test is important as exceedingly high glucose levels can lead to transfer of glucose to the body resulting in a condition called as ‘macrosomia.’ It is always advisable to lose any excess weight before getting pregnant. Never try to lose weight during the pregnancy term as it is not recommended. Also, weight gain is a normal part of the journey and even obese/overweight women are expected to gain weight. Research shows that obese/overweight women who change their diet during pregnancy are at a decreased risk of gestational diabetes. Choose the Right Foods for Your Meal Plan While the food choices can contribute towards development of gestational diabetes, diet alone isn’t the sole reason for the problem. The hormones in the placenta sometimes block the body from using or making insulin. To avoid putting yourself in a risky situation and to stay healthy during the pregnancy term, it is recommended that you follow a healthy diet plan that doesn’t raise blood sugar levels. There is no specific meal plan for pregnancy but all that’s required is to draft a well-balanced meal plan with the help of a dietitian/nutritionist. Focus mainly on cutting down processed foods and those containing empty calories, replace sweets with fruits, eat plenty of rainbow-colored vegetables, have smaller portion sizes, and increase the intake of fiber and lean proteins. Obesity exists as one of the top factors contributing toward gestational diabetes and sadly, a majority of the pregnant women are either obese/overweight. A recent study conducted at the University of Turku focused on the link between dietary intake and gestational diabetes onset. Results showed that eating a healthy diet during the early stages of pregnancy reduces the risk of gestational diabetes. Also, eating foods that elevate the inflammatory markers in the body increased the risk of the disease. It’s better to keep these markers under control by adding foods such as whole grains, berries, veggies, and fruits. Exercise Regularly There has always been the myth that high-intensity exercises aren’t advisable during pregnancy. This is not true and even if you don’t wish to pursue strenuous workouts, it is always suggested to perform some physical activity regularly. Go for a walk, do yoga, or even swimming to keep the body active and to control weight gain. Before starting on any exercise routine, consult with your gynaecologist and get the approval. Exercising before and during pregnancy minimizes the risk of gestational diabetes, makes the body more sensitive to insulin, and helps you get out of the sedentary lifestyle mode. Conclusion Preventing gestational diabetes isn’t always possible as there are some risk uncontrollable factors that make it likelier for the pregnant woman to develop the condition. In case of obesity, try losing weight before pregnancy to decrease the risk, stay on a healthy weight range before and after conceiving, eat a well-balanced diet, and perform physical activity for at least 30 minutes a day 4-5 times a week, and sleep well. A disciplined lifestyle and better eating routines improve the body’s energy levels and your personal confidence levels. Gestational diabetes isn’t going to ruin your beautiful journey during pregnancy. Do all that’s possible to avoid getting into this condition by following the measures stated above. Even if you are affected by gestational diabetes, it goes away on its own in most people. But, the risk of being affected by diabetes in the future always exists. To stay healthy and put this risk to rest, follow a healthy lifestyle routine.  Type 2 Diabetes Has a Potent Risk of Cognitive Decline Our body runs on energy and the primary source of this energy is supplied by glucose to every cell in the human body. Every organ functions tirelessly to keep our body running smoothly and it’s the brain that issues commands to different organs in the human body. Being the command center, the brain controls every action including how we emote, remember, and learn new stuff. Our brain encompasses innumerable neurons which increase the energy demand, and hence, a considerable portion of the glucose is directed to the brain. Only then, we achieve full capability to think, act accordingly, and complete chores successfully.
Too Much or Too Little, Both Cause trouble! But, simply because the brain depends on glucose for energy, it doesn’t mean that we perform better when more and more energy is supplied to the brain. Hyperglycemia can cause stress to our brain and this remains unseen immediately as the effects of high blood sugar levels happen in due course. Very high blood sugar levels can impair the blood vessels carrying oxygen-rich blood to the brain thereby resulting in insufficient blood supply which causes brain death. Termed as ‘brain atrophy,’ such a problem can affect cognition and memory capabilities causing vascular dementia. Lack of sufficient sugar levels immediately stops the oxygen supply to the brain and the consequences are seen immediately unlike hyperglycemia which takes time to cause effects on the brain. Low sugar levels in the body cause symptoms such as dizziness, irritability, shakiness, and even trouble with talking and walking. Extremely low blood sugar levels can cause debilitating consequences including passing out, seizures, or even coma. Accelerated Brain Aging & Cognitive Decline Diabetes doesn’t come alone but leaves lasting impressions everywhere on the human body. The condition has the potential to affect the heart, kidneys, foot, eyes, oral health, and without any doubt, the central commanding system of our body—the brain. Almost 7% of the population worldwide suffer from type 2 diabetes mellitus (T2DM) and such patients are at an all-time risk of developing Alzheimer’s disease (AD) and dementia. Presently, there are more than 40 million individuals suffering from dementia and with the numbers expected to increase two-folds every decade, it is soon cross 100 million by 2050. AD is the most commonly seen dementia problem among people followed by vascular dementia. There have been research happening continuously to explore the underlying connection between dementia and diabetes. A very big analysis of 14 studies that included more than 2 million individuals and covering millions of dementia cases across Asia, Africa, and Europe clearly found that diabetes increased the risk of dementia by 60% with a 40% risk associated with non-vascular dementia. A huge cohort of human studies from the UK Biobank show that the T2DM accelerates normal brain aging and induces marked cognitive decline, especially in the executive functioning and the processing speed. Data obtained from the Swedish National Study on Aging and Care-Kungsholmen clearly had concrete evidence showing the impact of prediabetes and type 2 diabetes on cognitive decline. There have also been studies analyzing the link between cognitive disease and type 1 diabetes. Results show that individuals with type 1 diabetes mellitus (T1DM) are at an increased risk of dementia compared to those without diabetes. One study result showed a 93% increased risk of dementia in those with type 1 diabetes. Another study on older adults who were hospitalized for either hyper- or hypo-glycemia were at a higher risk of dementia but those who suffered from both highs and lows were at a 6-times higher risk of dementia later in life. Impaired cognitive flexibility, reduced attention span, and decrease in thinking speed are some of the effects of T1DM. Though both types, Type 1 and Type 2, had higher risks of dementia, T2DM showed 50% more risk for dementia comparatively. Conclusion We have study results showing that type 2 diabetes increases the risk of dementia and cognitive decline but the awareness regarding this link among individuals is extremely poor. Clinical interventions and recommendations for the same are also poorly available. For T2DM, incorporating rigorous lifestyle changes along with dietary modifications with the help of a reputed nutritionist/dietitian benefits the individual. Individuals should focus more on staying on a healthy weight range, reducing blood sugar levels, ensuring that cholesterol levels are below recommended ranges, eating healthy food, exercising regularly, and sleeping well. Clinicians should focus on strictly controlling blood glucose levels to ensure that the patient’s cognitive skills remain intact.  Never Allow Diabetes to Control Your Life Many individuals around us suffer from diabetes and we feel sorry for them. But, most of us haven’t thought about this dreadful condition striking us and when it does, it is a gruesome shock for most. The very first question we tend to ask is ‘Why me?’ Once diabetes strikes, people go through emotional disturbances having feelings of shock, disbelief, anger, self-pity, and more. Sadly, many of these emotions don’t go away quickly but take time to heal. The only bright side here is that, you are not alone here and there are aplenty others who feel the same way. But, for some others, diagnosing the disease makes them heave a big sigh of relief as they now have answers to their previous symptoms and disturbances.
After a month or so, the reality sets in, we start admitting the presence of the disease, and look out for ways to live in peaceful co-existence with it. It does take time to come to this state, adapt to a diabetes-friendly lifestyle, and make everyday modifications to suit your health needs. It is an energy-consuming process that requires complete effort and ample energy. But, if you are consistent in putting efforts, it is possible to live with diabetes without completely shattering life. Talking to your healthcare professional, meeting with a dietitian/nutritionist to plan everyday foods habits, and seeking guidance can help in simplifying things. Let’s see how to go about leading a life with diabetes: Lifestyle Management There is no choice here but to get going with the humongous task of managing diabetes. The biggest challenge here is to accept and adapt to the everyday lifestyle changes that occur as a result of diabetes. It starts from altering your breakfast timings, portions, and meal content to sleeping schedule, and even the exercise duration and types of exercise allowed. Keep a check on the following pointers to make life better comfortable and easy to lead: Control Blood Sugar Levels: Any number beyond 170-180 mg/dL is high blood pressure (hyperglycemia) and we need the right medications, exercise, food portions, and insulin dose to keep it under control. Another condition called hypoglycemia (below 70 mg/dL) or low blood sugar levels are even more dangerous as the organs are at a risk of being compromised due to insufficient sugar levels. It is always advisable to monitor glucose levels multiple times daily to ensure control over glucose levels. Follow a Disciplined Diet & Exercise Schedule: Food plays an integral role in managing diabetes and watching over your intake is the first recommendation given by any healthy physician. For this, reduce carbohydrates intake, increase the intake of fiber and whole grains, and moderate the consumption of dairy and proteins. Watch over the GI value of various foods before consuming them—a low GI number is good for diabetes while foods with high GI values must be avoided as much as possible. Such high GI-value foods include white grains, baked goods, processed foods, and starchy foods. Keep a tab on alcohol consumption and the standard suggestion includes avoiding the intake of alcoholic beverages as much as possible. There are greater chances of hypoglycemia a few hours after alcohol consumption. Hence, monitor blood sugar levels before and after consuming alcohol. Exercising regularly must be an indispensable part of your daily routine as this helps to control glucose levels well. Practise any physical activity that interests you—it might be a sport, hitting the gym, going for a walk, or even swimming. But, before taking up any of them, consult with the healthcare professional and get a green signal for practicing the same as a daily routine. Get Sufficient Sleep Our body needs energy to pull us through the day efficiently. A good night’s sleep is the tonic for overcoming tiredness, staying calm, and being successful at what you do. Create an everyday sleep routine by going to bed and waking up at the same time daily, avoid taking naps during the say, try to limit caffeine consumption after 5 PM, and create the right setting for a peaceful sleep surrounding. Avoid Stress Stress is bad especially for people with diabetes as it brings changes in blood glucose levels. Being informed about the disease is a definite cause of stress but going on with such anxiety and stress is not going to lead you anywhere. Practice mindful exercising techniques such as breathing, meditation, and yoga to keep stress under control. Choose to Be with People Unity is power and never try fighting the disease alone if you have the luxury of including family and friends in this battle against diabetes. Make them understand your situation and how you would like their participation and support in this process. There are some who provide practical ways to control the disease by providing healthy food choices, give a shoulder to lean upon during emotional turmoil, and accompanying you for your everyday exercise routine. Choose the right person and be benefitted in the long run. Plan Meticulously Before doing any of the above, it is indispensable that you make a plan to manage diabetes in a smooth and efficient way. Bring about small changes and combine them to unravel a big change. Make regular appointments with your doctor and never miss out on them. Discuss, raise concerns, and get answers to queries with the physician. Build a relationship upon trust with some family members and friends about your condition and don’t miss to connect with other people with diabetes to relax your mind. Don’t miss out on social activities—having fun is never out of picture even when you are suffering from diabetes. The metabolic disorder is only one part of your life. Don’t ruin your whole life by letting diabetes control and overtake you. The Bottomline Adapting to a diabetes-friendly routine needs implementing mental, behavioral, and emotional changes to lead a normal and peaceful life. Besides taking care of the above, individuals also need to attend to skin, foot, and tooth care routines to avoid long-term complications. Diabetes can also have effect on the organs such as the liver, kidneys, heart, lungs, and feet if not kept under control. To avoid all these, it is necessary to maintain blood glucose levels in the right range and get an eye and foot test once a year. Every person with diabetes is entitled to leading a normal life by making few changes in everyday routine. Make a plan that satisfies both physical and emotional health in order to succeed in your diabetes-friendly lifestyle. While doctors and family members are always there to shoulder support, sometimes they might not always have the time to do so. Hence, joining a peer group is very helpful as it has like-minded people who are undergoing your similar emotional turmoil and physical changes. Hence, they easily relate to your worries and come up with suggestions to overcome them. Peer support helps individuals share their knowledge and skills, experiences, and concerns over living with diabetes.  Glycemic Index is Only a Tool for Planning a Diabetes-friendly Diet Diabetes has been a non-reversible disease until sometime recently, but off late, we have various reputed health organizations and individuals claiming to enable diabetes remission/reversal. Reversal is nothing but helping diabetic individuals to stay within desired blood glucose ranges with the sole help of lifestyle changes. How do they achieve this? By lifestyle changes, it includes bringing changes to the food that we eat, engaging in regular physical activity, sleeping for desired number of hours, minimizing stress, and leading an active lifestyle. Choosing to eat the right foods is inevitable to control glycemic index and for this, it is necessary to pick those foods whose glycemic index (GI) values are in the admissible ranges. To achieve this, we must know the glycemic index of various foods. Glycemic Index Glycemic index is a number that’s assigned to various carbohydrate-containing foods depending on how much each type of foods affects blood sugar levels. Don’t misunderstand this as a diet plan but it is only a tool to accomplish your diet goals. Pure glucose has a GI value of 100 and other carb-containing foods are classified in comparison to glucose. GI values can be distinctly divided into three categories namely:
Lesser the GI value, higher the healthy nature of the food. Eating foods with a high GI value instantly increases postprandial blood glucose values that decreases rapidly while eating low GI value foods leads to low blood sugar concentration which decreases more gradually. Research Studies We have various research results strongly proving that including a low-GI diet is a very good way to keep blood sugar levels under control and reduce the risk of type 2 diabetes in individuals. A long-term US study showed that increased consumption of refined carbs increases the prevalence rate of type 2 diabetes. Several cohort studies show that high GI diets increase the risk of diabetes. Also, obese individuals consuming high GI diets are at a 10-times increased risk of diabetes compared to their leaner counterparts consuming low-Gi diets. Contrarily, we do have some studies showing no clear association between GI and type 2 diabetes. Though not a popular part of the US dietary guidelines, Diabetes UK and the European Association for the Study of Diabetes have used low GI diets containing a major portion of whole grains and high dietary fiber as a part of their diabetes-prevention plan in individuals at a higher risk of diabetes. GI Value of Various Foods To incorporate low GI value foods in the diet and to understand how different foods consumed might affect your blood sugar levels, the table below might be helpful. Vegetables
Fruits
Pulses
High-Carbohydrate Foods
Milk/Milk Products
The Bottomline
Though glycemic index is important, it should not be the only factor to consider while making food choices. The GI value of any foods doesn’t divulge any other nutrition-related information. Though one cup of whole milk has a low GI value of 4, it is not recommended for weight control/loss as it has high fat content. While the numbers here exist to suggest individuals with various food choices, these numbers might change depending on the way of preparation and several other factors. For instance, cooking starches for a longer period increases the GI value, ripened fruits have a higher GI value than raw ones, and the body’s reaction to carb also varies upon the age, how fast digestion happens, and your activeness quotient. So, the presence of various nutrients such as vitamins and minerals, fat content of the food, and the food’s GI value is integral to pick the right foods. It is always recommended to combine high-GI foods with low-GI foods to find the right balance. Get in touch with a reputed dietitian/nutritionist to choose the right mix of foods to find nutrition balance and blood glucose stability. Don’t overthink and restrict yourself too much. Indulge in your favorite meal occasionally but choose smaller portions that satisfy taste buds while not causing erratic sugar spikes. By sticking to smaller portions, you get the privilege of picking high-nutrition content foods to provide a well-balanced diet.  Very Low Sugar Levels Could Result in Seizures Most of us are familiar with the terms hyperglycemia and hypoglycemia, especially in this diabetes-driven world. Hypo or hyper, the primary aim of any individual is refraining from entering into diabetes. Glycemia is the presence of glucose in the bloodstream and the difference set in depending on whether someone is suffering from hyper- or hypoglycemia.
Diagnosing the Inner Meaning Hypoglycemia is derived from the Greek word ‘hupo’ meaning under or less. Hence logically hypoglycemia means ‘low blood sugar level.’ In contrast, hyperglycemia means ‘high blood sugar levels.’ Whatever might be the meaning, any individual’s primary goal includes being healthy maintaining consistent blood sugar levels. Hypoglycemia happens when your blood glucose levels drop below the healthy range. Speaking in terms of numbers, we term it low blood sugar when the glucose numbers fall below 70 mg/dL. Commonly called as low blood sugar or low blood glucose, hypoglycemia becomes dangerous when the numbers stoop too low, even requiring immediate treatment. Causes There are multiple reasons behind the occurrence of low blood sugar levels and these include:
Hypoglycemia can occur with or without diabetes. In case of people without diabetes, there are chances of occurrence of hypoglycemia when individuals don’t eat for 8 hours or more. In such cases, the body lacks enough glucose to provide energy to the brain and body. Another way in which low blood sugar levels without diabetes might occur is when someone takes medications that lower blood sugars. Such medications include aspirin, steroids, birth control pills, certain antibiotics, and blood pressure tablets. Symptoms There are several symptoms that indicate the presence of hypoglycemia but they vary depending on the people being affected. It might start quickly but also provide clear signs that give sufficient warning that something must be done to curb its devastating effects on the body. Symptoms that commonly show the presence of hypoglycemia include:
Sometimes, symptoms might occur during sleep and those include nightmares, tiredness, weakness, crying out loud, and sweating through nightwear. There are some individuals who stay unaware of the presence of hypoglycemia as they don’t suffer from any of the symptoms. Called as ‘hypoglycemia unawareness,’ this is worse as we can’t detect any signs of the condition at an early stage and treat it. In turn, this increases the risk of several occurrences of low sugar levels which is dangerous for the individual. But, such unawareness might occur if you suffer from diabetes for more than 5 years, have frequent occurrence of low blood sugar levels, or consume some medications such as beta blockers. During such instances, it is advisable to test blood sugar levels frequently to check whether or not the levels are too low. Never indulge in physical activity or drive any vehicle before confirming these and talking with your physician. Types of Low Blood Sugar Some might wonder how there can be types in low blood sugar levels. Yes, we have got different types. One is the night-time low blood sugar where sugar levels become low while sleeping. It might be due to having an active day, consuming too much insulin, drinking alcohol during the night, or doing physical activity before bedtime. Another type of low blood sugar is severe low blood sugar which also has serious symptoms including incidents of seizures, feelings of confusion, acting strange, difficulty with vision, and feeling weak. Anything lower than 54mg/dL can be termed severe low blood sugar and such numbers result in passing out/fainting. To avoid instances of night-time low blood sugar, try to eat a small snack before bedtime, eat your meals regularly and don’t skip any. Treatment Once diagnosed with hypoglycemia and if you suffer from any of the symptoms, it is necessary to take certain steps to treat it. If the blood glucose levels fall below 70mg/dL, do the following to treat the same:
If none of the above treatment protocols work, it is better to get in touch with your healthcare provider who might provide a medication called glucagon—this might be injected or puffed into the nostril. Conclusion For someone experience low blood sugar levels, it is advisable that you have a record of the numbers, activity levels, exercise, insulin, and food habits. Consult a physician, review these data, and understand why the numbers become low. Maybe, the healthcare physician might adjust the insulin timings, exercise and meal timings, and snack routines to stabilize glucose numbers. Also, check your blood glucose numbers regularly to avoid severe consequences, consume meals at proper timings, and bring about small changes in lifestyle and exercise routines to avoid big damages to health and body.  Sugar Substitutes, However Natural They Might Be, Should Be consumed in Limitation Are you one of those having a sweet tooth or craving for sugary indulgences? Even otherwise, it is a mammoth task to cut down sugar intake from your everyday meal plan. Rome was not built in a day, likewise, completely excluding sugar and sugar-based foods from your diet starting tomorrow is an impractical dream. The very first recommendation given when anyone wishes to cut down on dietary sugar intake is to choose sugar substitutes and artificial sweeteners. But, how familiar are we with these substitutes and their impact on our overall health?
In fact, replacing sugar with popular sweeteners available in the market has become an unwritten rule for those with diabetes or in pre-diabetes stage. It’s high time we accept the fact that any form of sugar is harmful to health, when consumed in high quantities. But, substituting sucrose with artificial and natural sweeteners is promoted these days as they are low in calories and don’t increase glycemic levels. Artificial sweeteners has been discussed as a standalone topic in the blog section and now, we would be focusing on the natural sugar substitutes available in the market. The Best Natural Sugar Substitutes Fruits: Fruits are one of the healthiest sources of natural sugar. They have no empty calories and the icing on the cake is that fruits come enriched with nutrients including fiber, vitamins, and antioxidants. Add some fresh pieces of berries, bananas, or avocados to your smoothies, top the unsweetened yogurt with your choicest exotic fruits, and sweeten the cereal with some blueberries, apples, or strawberries. In fact, you could enhance the flavor of the dish by adding vanilla extract, almond powder, cocoa powder, or even cinnamons. Once you regularly start substituting sugar/sweeteners with fruits, not only the real taste of the product is revealed but the sugar cravings start to sober down gradually. Honey: Though we constantly read about substituting sugar with honey for the shakes, cereals, and more, the brutal truth is that honey is another form of sugar that is high in calories. On the brighter side, honey is equipped with antioxidants, oligosaccharides, and nutrients such as zinc, calcium, potassium, and vitamins. The bee variety and the plant components that contribute to honey production have weightage on the anti-oxidant and anti-inflammatory benefits provided by this golden liquid. Still, honey has a lower GI value than sugar but should not be consumed beyond 1-2 teaspoons a day. Maple Syrup: The sponge cake soaked in maple syrup or the granola bar coated with maple syrup seem to tickle your taste buds and comfort the mind as maple syrup is yet another natural sweetener. Though this liquid has a lower GI than sugar, it does have higher quantities of sugar comparatively. Some of the commercially sold maple syrup brands are overloaded with high-fructose corn syrup that could lead to accumulation of belly fat, increased triglyceride levels, and belly fat. Containing nutrients such as zinc, potassium, manganese, calcium, and iron, this liquid also has anti-inflammatory and anti-oxidant properties. Though better than sugar, maple syrup does contain sucrose and should be used sparingly in your waffles, pancakes, and breakfast options. Dates: Though dates are calorie-rich and contain sugar content, the good news is that including dates doesn’t affect blood sugar levels in the same way as table sugar—even a study including 100 participants showed that eating dates reduced bad cholesterol levels in the body without bringing any changes to HbA1c levels. The thick, sweet dried fruit of the palm trees come equipped with nutrients such as potassium, fiber, magnesium, manganese, carotenoids, vitamin B6, and antioxidant, thereby making them a good substitute for sugar in making energy bars, smoothies, and cookies. Make a paste of dates and use it sparingly as this is sweeter than sugar. Monk fruit extract: Extracted from a fruit called the monk fruit which is a native of SouthEast Asia, this fruit is now being used to make natural sweeteners that are 300 times sweeter than normal sugar. The extract not only has zero calories but also doesn’t affect blood sugar levels—all these make it a preferred choice as a sugar substitute among weight watchers and those with diabetes. But be aware that there are no human studies that confirm the safety of this sweetener. Also, commercially sold monk fruit extracts always come in combination with other sweeteners. Hence, it is advised that you check the ingredient list before picking this natural sweetener from the grocery shelf Agave nectar: Though popularly suggested as a natural sugar substitute, it is advisable to stay away from agave nectar as this sweetener is calorie-rich and has high fructose levels (even higher than corn syrup) increasing the risk of weight gain and obesity. Also, having better nutrients than normal sugar, still the nutritional content is lesser than honey. Tasting similar to honey, not leaving you with a bitter aftertaste, and having a long shelf life, we can use agave nectar for any sort of cooking purpose, but execute caution while adding this sweetener as it is flavor-rich and adding a small quantity brings about the desired taste to the dish. The Bottomline No sugar substitute, natural or artificial, is good for health, especially when consumed in excess. Instead of hunting for the so-called healthy and sugar-free sugar substitute find creative ways to reduce sugar intake and replace them with healthier fructose from fruits. It’s no sin to indulge in a small piece of sponge cake or the delicious mithai occasionally but never form a habit of consuming desserts and sweets regularly just because the ingredient list contains artificial or natural sweeteners. Even in daily food preparations, enhance the flavor of foods using spices and add variety to the meal plan to keep it healthy and interesting. Get in touch with a reputed dietitian/nutritionist to make small tweaks to your everyday recipes to add nutrition and good health to diet plans without disturbing sugar levels.  Stevia Has Zero Carbohydrates & minimal Calories The colorful chrysanthemums, yellow sunflowers, and the beautiful daisies are a pretty sight to behold. Can you believe that Stevia, a sugar substitute made from the stevia plant belongs to the same family (Asteraceae) as these beauties? Stevia rebaudiana is another unique member of the chrysanthemum family that offers trememndous difference in taste when grown at our home in contrast to the ones bought at the store. A native of South America, stevia is a small shrub that has been used for hundreds of years as a natural sweetener without any calories.
Produced from the leaves of the stevia plant, this sugar substitute is 100-300 times sweeter than table sugar but without the added worries about calories, carbohydrates, or other ingredients as it contains none of these. Doesn’t it sound inviting to immediately switch over to this magic potion? For some, it might be. But the hard truth is that not all individuals might like the taste of stevia as they find it bitter. Even more, some find it tasting similar to menthol. If you would like to understand whether or not you like the taste of stevia, it is better to use a small portion of it in your beverage or cereal before filling your kitchen cabinets with this sugar substitute. Composition of Stevia There are eight glycosides extracted from the plant namely Dulcoside A, Steviolbioside, Rebaudioside A, C, D, E, and F, and Stevioside. While commercial products are made from all of these, Rebaudioside A (Reb-A) is potentially the main ingredient in a majority of those manufactured. The Food and Drug Administration (FDA) recognizes Reb-A as safe for use in foods and beverages and it is 200-300 times sweeter than sucrose. At the same time, whole leaf or crude stevia hasn’t been approved by the FDA for use in food products as their safety and authenticity hasn’t been proved until now. There are even concerns regarding their effect on kidney, cardiovascular, and reproductive health besides posing concerns on blood sugar control. Research Data on Stevia & It’s Effect on Health There have been numerous research done on stevia providing us with various results and conclusions. One study clearly proved that including stevia in beverages could be a good alternative for normal sugar in those with diabetes as it has no effect on blood sugar levels, lipid, HbA1c, and insulin levels. Studies have shown that diabetic people recommended to follow a strict diet can use stevia as an alternative sweetening agent to normal sugar. It’s also been seen that stevia leaves could be used as a sweetener in beverages and food products for those who have a sweet tooth. The plant is not only useful for controlling glycemic levels but also shows positive effects on treating skin diseases and has anti-inflammatory, anti-bacterial, diuretic, and antiseptic property. In recent times, we’ve also had results positively backing up the use of stevia for reduced energy and sugar intake thereby preventing rise in obesity. We have studies showing the impact of stevia on gut microbiota as well. Some studies show that stevia is harmful for gut microbiota health while there are some that portray the benefits of adding stevia. But, we need more studies and research to understand the long-term outcomes of stevia on human health. Advantages of Stevia The name Stevia is instantly associated with zero calories. But besides this, there are many other benefits of this category of sugar substitute called the novel sweetener. Stevia has been used for decades in South America and Asia as a sweetening agent in beverages such as teas and coffees. Commercial products including flavored water and beverages contain stevia. There are some studies that show their benefits in patients with diabetes helping them control their blood sugar levels. Also, as it has antioxidant properties, it has been proposed to reduce the risk of cancer. Another major advantage associated with stevia is its contribution to effective weight loss. As it has no sugar and very few calories, stevia has been a personal favorite not only for those with glycemic instability but also for many health-conscious individuals who want to reduce/maintain their weight. One study showed that consuming stevia increased the HDL cholesterol levels while lowering LDL and triglyceride levels. Side Effects of Stevia The FDA has approved only the use of stevioside (the purified form of stevia). So, if you find any products in the grocery shelf labeled with whole-leaf stevia or crude stevia extract, it is better to avoid them altogether. That’s mainly because there are concerns regarding raw stevia’s effect on the kidneys, cardiovascular system, and reproductive system. It might even react with medications for blood pressure or lead to low blood pressure levels. Also, some individuals complain of dizziness, bloating, numbness, and muscle pain after using Stevia. Sometimes, stevia is used in combination with sugar alcohols and this might cause digestive problems such as bloating and diarrhea in some individuals. Above all, not all are fans of this bitter-tasting sweetener. Coming with a very mild bitter taste, this non-nutritive sweetener’s addition doesn’t give pleasure to all those who use it in beverages and dishes. So, before choosing to go with stevia, try tasting some beverages and decide whether or not this sweetener should be your choice. Presently, stevia is widely used in the preparation of smoothies, cereals, hot beverages, yogurt, and baked goods. But baking using this sweetener might be tricky as it does not leave you with the desired texture. Hence, it’s been recommended that you either add 50% of stevia choosing an alternative sweetening agent instead. This way, it is easier to come up with the desired texture and taste. The Bottomline Regardless of the research results, millions of people worldwide have been using stevia as a sweetening agent for years together. Though a non-nutritive sweetener that’s low in calories, there are no serious evaluations or concrete long-term research results giving a go ahead sign to use stevia regularly. Moreover, it is always better to minimize sugar intake and consume sweet delicacies in moderation to stay healthy and control glycemic levels. It is better to get in touch with a dietitian/nutritionist who might be able to guide you in planning a well-balanced diet for diabetes and also recommend whether or not sugar substitutes should find a place in your daily diet.  Keep Monitoring Bood Sugar Levels to Avoid Life-threatening Consequences Having diabetes or not, small fluctuations in blood sugar levels are a common occurrence in individuals due to the different foods consumed. Any number between 60 and 140 mg/dL is considered to be a normal range but those having anything beyond 140 mg/dL is termed as hyperglycemic.
Hyperglycemia Derived from a Greek word, hyperglycemia means high (hyper) sugar (glykys) blood (haima). If we look into the details, a fasting blood sugar number beyond 125 mg/dL and a 2-hour postprandial level beyond 180 mg/dL is termed as hyperglycemia. A person is said to be in the prediabetes range (known as impaired glucose tolerance) if the blood sugar readings are between 100 mg/dL and 125 mg/dL. Factors Contributing Toward Hyperglycemia There are a number of reasons that result in hyperglycemia and those include:
Hyperglycemia could happen with/without the presence of diabetes. In the presence of diabetes, hyperglycemia occurs when the pancreas doesn’t produce sufficient levels of insulin to stabilize blood sugar levels. In the absence of diabetes, hyperglycemia could be the result of medical conditions such as Cushing’s syndrome, PCOD, some infections that release excess stress hormones which cause hindrance to the working ability of insulin, and also due to excess weight or decreased physical activity. Risk Factors of Hyperglycemia
In recent times, the incidence rate of hyperglycemia has increased multifold times due to decrease in physical activity, increase in sedentary lifestyle, overweight/obesity, and increase in ageing population. In fact, its occurrence is predominantly seen in middle- to lower-income countries such as India, Brazil, and China. Symptoms There are various symptoms that denote the onset of hyperglycemia:
Treating Hyperglycemia First and foremost, the best way to treat hyperglycemia is to rectify the symptoms related to it. Besides this, exercising regularly helps in maintaining normal blood sugar levels. Try to workout for at least 30 minutes 5 times a week. A word of caution here, having blood sugar levels above 240 mg/dL increases the risk of ketones in the urine. In the presence of ketones, it is always recommended to refrain from exercising as doing so might lead to further increase in blood sugar levels in the body. The next best treatment for hyperglycemia includes following a well-balanced diet plan that includes healthy portions of various foods. For planning your meal, it is recommended that you get in touch with a registered dietitian nutritionist. Also, stay hydrated. Your doctor might also bring in changes to your medical routines to adjust blood glucose levels and normalize it. But prevention is always better than cure, and hence, try avoiding hyperglycemia in the first place by adhering to certain guidelines. Take your insulin medications as prescribed by the physician, adhere to a healthy lifestyle by consuming a healthy diet, avoid consumption of sugary beverages, exercise regularly, avoid stress, and never fail to meet your doctor as per the appointment schedule. Conclusion Hyperglycemia is a serious problem, when left untreated. Any failure in acknowledging the disease and correcting it might lead to a condition called as ketoacidosis (diabetic coma) where the individual loses consciousness and remains unaware of anything happening around him/her. But, according to the American Diabetes Association (ADA), ketoacidosis primarily affects people with type 1 diabetes and rarely impacts those with type 2 diabetes. Understand when hyperglycemia is an emergency with warning signs such as nausea, shortness of breath, coma, and fruity-smelling breath, and take action immediately by calling emergency. Learning to recognise the symptoms during normal times and during times of emergency, knowing the right treatment methods, and taking timely actions help avoiding life-threatening consequences of the problem. Monitor blood sugar levels regularly and keep them controlled to avoid debilitating consequences of hyperglycemia including eye, nerve and kidney damage, stroke, prolonged healing time for infections, and heart attack. In short, eat healthy, exercise daily, sleep well, avoid stress, and be hydrated to minimize the risk of altered blood glucose levels.  Choose Any Monitoring Option Only After Careful Deliberation A number of tests help us diagnose diabetes and confirm its presence. Once an individual becomes a diabetic, the need for such testing doesn’t stop but becomes a continuous process. Only then we can be sure of controlled blood glucose levels in our body and avoid any hazardous consequences. Glucose monitoring is suggested for individuals suffering from diabetes to help them manage their health. Making use of monitoring devices is a good way to understand whether the sugar levels in the body are too low or high as neither of them are good for health.
Getting a good understanding of your blood glucose levels is inevitable to know how your lifestyle routines, food habits, exercise activities, and medications impact diabetes. Every time there is a need to check the glucose levels, you cannot rush to the laboratory. These days, many individuals have glucometers at their home—with a small prick, the meter tells the blood glucose readings. But, off late, another new device has made its grand entry into the healthcare industry—none other than continuous monitoring devices or CGMs that have become the latest passion among diabetics. What’s the difference between blood glucose monitoring and continuous glucose monitoring? Which of the two is better for long-term use and practical application? Read further to understand better. But before choosing any monitoring device, it is recommended to talk to your healthcare physician to know whether or not you must check blood glucose levels regularly—this is mainly because such devices and monitoring systems are recommended only for some individuals including pregnant women, individuals taking insulin, having low blood sugar levels, finding difficulty in reaching necessary blood glucose levels, or those whose levels shoot up or drop suddenly without any notice. Blood Glucose Monitoring (BGM) BGM looks out for specific patterns/changes in blood glucose readings as a result of exercise, dietary restrictions, and medications. If you take a blood glucose test at home, it is generally referred to as a capillary blood glucose test (CBG) where a small blood sample is collected with the prick of a finger using a lancet. BGM can be done using a glucometer, a lancet, and test strips. Glucometers these days are sophisticated needing just a teeny tiny drop of blood and have bluetooth compatibility to synchronize data onto smartphones using paired apps. There are some apps that go a step further and help in recording the meals consumed, types of physical activity performed, and the medication doses taken, thereby giving a clear history to the physician to decide upon the next course of treatment. Continuous Glucose Monitoring (CGM) Helping to monitor blood sugar levels 24 hours a day, CGM is used these days by very many people irrespective of understanding whether or not it is essential to use it. Want to check the glucose levels this very minute, simply peep into your CGM readings as the device takes a reading every 5-15 minutes. It works with the help of a tiny sensor that’s placed under the skin of your belly or arms generally. The sensor tracks the intestinal blood sugar readings every couple of minutes and sends the data to the monitor, a standalone device or a part of your insulin pump that must be carried along with you. Besides blood glucose readings, the device also keeps track of diet, medications, and physical activity performed. The user is informed about too high or low blood glucose levels using an alarm sound. There are some models which can send the notification to a second person, maybe a parent in case the user is a child, or in general, a partner or a caretaker. Earlier, only doctors were able to view the readings but now, the data is simply available to the user directly on the smartphone, on a handheld device (like a smartphone), or an insulin pump depending on the type of the device. The sensor must be replaced every 7-14 days depending on the type of the device. There are a couple of long-term CGM devices for which the physician changes the sensor at their clinic a couple of times annually. Difference Between A CGM & BGM
It’s Time to Announce The Winner Alas, there is no winner here as both the monitoring devices serve different purposes. While CGM is suggested for patients requiring insulin therapy and those who have erratic blood glucose levels, many don’t value CGM as an accurate measure as glucose makes its appearance in the blood before reaching the intestinal fluid. Also, CGM’s expensive costing doesn’t make it reachable for all. But, getting data every 5 minutes or so makes it invaluable to individuals who need change in medications regularly as their blood sugar levels keep fluctuating often, have bouts of low glucose levels, and whose healthcare physician recommends using one. Else, it is essential to stick to BGM as its rate of accuracy is better, economical, and keeps you free from the stress of having to check the glucose levels often and getting anxious about the readings. CGM can never be a total replacement for BGM or other monitors but can only coexist with them to reduce drastic effects of changing blood glucose levels. Apart from these, it is essential that individuals with diabetes follow a well-balanced diet, exercise regularly, sleep well, and minimize stress to keep their blood sugar levels under control. Getting in touch with a reputed nutritionist/dietitian can make the diabetic’s job simpler as all that’s left to do is to follow the diet plan and lifestyle modifications suggested by the expert.  Insulin Resistance, to Avoid the Effect, Increased Blood Sugar Levels Diabetes is one of the most-commonly prevalent metabolic diseases worldwide—this might sound like a cliché, but sadly not many are taking steps seriously to overcome this problem. But, on the brighter side, it is also seen that individuals are more focused on lifestyle changes, diet modifications, and physical activities as a good remedy for diabetes control rather than leaning toward clinical solutions.
Enter any clinical setting and the first words any diabetes patient hears is about controlling blood sugar levels. But, it has been clearly proved that rather than modifying blood sugar levels we should primarily focus on sorting problems linked to insulin resistance, the root cause behind diabetes. Providing Assistance to Address Insulin Resistance Though there aren’t very clear research studies and evidences proving the causes behind insulin resistance, researches are almost certain that obesity/overweight and lack of physical activity are some major factors behind the problem. Insulin resistance occurs when the cells in the muscles, fat, and liver don’t respond as they should to the insulin hormone secreted by the pancreas. As a result, the pancreas keeps secreting insulin to help the glucose enter the cells. In course of time, the blood sugar levels spike up resulting in diabetes. The phenomenon explained above proves without doubt that the reason for increase in blood sugar levels is insulin resistance and hence, solving this issue is the first step toward finding a solution for diabetes/pre diabetes. There are a couple of factors that must be dealt with in order to stop insulin resistance:
We cannot decide whether someone has insulin resistance or not simply by looking at them. A blood sugar test is also used for generally confirming the presence of diabetes/pre-diabetes while tests for insulin resistance are more complicated and used mostly for research purposes only. Diet for Insulin Resistance A healthy diet exists as the cornerstone for controlling diabetes. Recent studies show that succumbing to increased intake of animal foods while decreasing the intake of veggies is a sure risk factor for diabetes. Individuals with insulin resistance generally suffer from haphazard insulin levels and planning an optimized diet is the key toward staying healthy. As the American Diabetes Association (ADA) rightly said, there is no ‘magic’ diet for diabetes as each person responds differently to different foods. The bigger picture is to include more fruits, vegetables, and whole grains, decrease the consumption of processed and starchy foods, unhealthy sugars and fats, and to include dairy and proteins in moderation. Cut down on carbs but don’t eliminate them from the diet completely. Make smart choices with carbs picking healthy ones present in veggies, whole grains, and fruits. Choose lean proteins from lentils, chicken without skin, low-fat cheese, etc. Go for low-fat dairy and choose healthy fats instead of saturated/trans-fat foods as these help in lowering insulin resistance. Never go near sweetened beverages, highly processed foods, or those loaded with unhealthy fats as these can shoot up blood glucose levels instantly. Make Everything Count Besides having a good diet plan it’s necessary to focus on the quality and the quantity of foods that we consume. Don’t adopt a monotonous diet but mix different foods and choose those foods rich in vitamins, minerals, and fiber. Never go for some crash diet but adopt a healthy diet with the help of a registered dietitian nutritionist to follow it on a long-term basis. Make lifestyle changes to become sensitive to insulin once again. Some lifestyle changes that are doable and sustainable include:
Conclusion It is always smarter to solve the underlying case of the problem instead of beating around the bush trying to lower some risk factors. With diabetes too, the same holds good. Solve the underlying problem of insulin resistance by adopting a healthier lifestyle, eating foods that keep insulin production in the right levels, and exercising regularly. Take baby steps, be in touch with a support group, and get help from a dietitian/nutritionist to make diet modifications for addressing insulin resistance. |
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Dr. Nafeesa Imteyaz of First Eat Right clinic, is the Best Dietitian Nutritionist in Bangalore. Best Dietitian Nutritionist in Pune. Best Dietitian Nutritionist in Hyderabad. Best Dietitian Nutritionist in Chennai. Best Dietitian Nutritionist in Mumbai. Best Dietitian Nutritionist in Delhi. Best Dietitian Nutritionist in Kolkata.