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To know if you are diabetic, simply check your blood sugar (Fasting and 2 Hours post-meal) & HbA1C

Diabetes is diagnosed when

• HbA1C of greater than or equal to 6.5%
• Fasting blood glucose of greater than or equal to 126 mg/dl
• 2-hour blood glucose or random blood sugar of greater than or equal to 200 mg/dl

The same tests are used to both screens for and diagnose diabetes.

There are 2 main types of Diabetes.

In type 1 diabetes, the body’s own immune system which normally fights harmful bacteria and viruses mistakenly destroy the insulin-producing cells in the pancreas. Genetics may play a role in this process, and exposure to certain environmental factors, such as viruses, may trigger the disease. In this situation, insulin injection must be taken lifelong.

Type 2 Diabetes is a disease of fat overload i.e. when the body becomes resistant to insulin due to excess fat, chokes the insulin receptors leading to overwork to the pancreas and at last, the pancreas stops producing enough insulin and diabetes begins. Lifestyle, obesity, stress, genetics and age are major reason for the disease.

Thyroid medicines are to take on an empty stomach, first thing in the morning and a gap of minimum 30mins to be maintained between food and the medications.

E.g. 6.30 am: Thyroid Tablet

7.00 am: Breakfast

If you have to take other tablets before breakfast, then have them at 7.00 am followed by breakfast at 7.30 am.

Years before the insulin needle for taking insulin injection were long and thick. Today the needles are super thin and Short. If the insulin injecting technique is properly followed, insulin injection needles are virtually painless. They hurt mentally and not physically.

With continuous lifestyle modification and correct dosage of insulin if the following results are achieved and maintained forever, then insulin can be stopped in Type 2 Diabetes forever.

However, in type 1 Diabetes mellitus, insulin injections are for life long

Waist :
Male less than 90 cms
Female less than 80 cms

Weight :
Male : Height in cms – 100 =_____ kg
Female : Height in cms – 105 =_____  kg

Blood Pressure :
< 140 / 80 mmHg

Blood Sugar:
HbA1c : <7 %
Fasting Blood sugar: < 120mg/dl
Post Lunch Blood sugar: <  160 mg/dl
Post Dinner Blood sugar:  <<160 mg/dl

Cholesterol: <200mg/dl
Triglycerides:  <150mg/dl
LDL : < 100mg/dl
HDL: > 45mg/dl

Rice- Wheat-Jowar-Bajra-Nachni all are more or less the same as far as carbohydrates are concerned. In every meal amount of intake of nutrients have to be considered. You can replace a chapati/ bhakri / paratha (30gms) with 1 cup of rice and relish it daily with each meal. Preferably high fibre rice i.e. brown rice or red rice to be considered along with thick dal and a bowl full of raw vegetable salad. This reduced the carb content of the total meal.

Diabetes shouldn’t stop you from doing the things you want to do. If you want to travel, and you have diabetes, you must plan ahead carefully. Although you can’t avoid the odd surprise, preparing before you leave can help avoid undue stress.

Before a long trip, have a medical check-up to make sure your diabetes is in good control and get your insulin dosages adjusted to your blood sugar levels. Plan your diet as per availability of food or carry healthy food. Insulin becomes ineffective when exposed to extreme temperature (low or high) hence carry insulin in your hand luggage and not in checked luggage which is stored in extreme cold temperature, sometimes freezing temperatures. Carry insulin injection in coolant pouch and keep injection in butter compartment once you reach your hotel.

Commercially insulin coolant pouches are available which can keep the insulin cool up to 48 hours or more depending upon the make. You can even invest in a quality insulated wide-neck thermos bottle with at least a one-litre capacity and 18 to 24-hour cooling/heating duration.

If you inject insulin while in flight, be careful not to inject air into the insulin bottle. In the pressurized cabin, pressure differences can cause the plunger to “fight you.” This can make it hard to measure insulin accurately.

Keep a proper medical prescription and travelling certificate with you during your travel.

When you’re sick, you’re under stress. To deal with this stress, your body releases hormones that help it fight disease. These hormones raise blood glucose levels and interfere with the blood-glucose-lowering effects of insulin. As a result, when you are sick, it is harder to keep your blood glucose in your target range and you must take extra food, keep monitoring and take extra insulin as per blood sugar level.

When you have a cold or flu, or if you have a fever for a day or two, your body needs extra sugar for energy to help fight the illness. If you’re feeling too sick to eat, your body will get its energy by releasing blood sugar from stored supplies in the liver, making your blood sugar level rise. That’s why you need to keep taking your insulin or diabetes medication when you’re sick to control your blood glucose levels even though you may not be eating or maybe eating less than normal.

If a woman has poor control of her diabetes during pregnancy, which means that her blood sugar levels are often above normal, this increases the chances for problems for her baby like,

• Still birth or miscarriage
• Birth Defects
• Very high or very low birth weight
• Injury during birth if the baby is very large
• Low blood sugar after birth
• Yellow skin and eyes (jaundice) during the first 28 days of life
• Potential metabolic disorders (problems converting food into energy; i.e., diabetes) later in life.

A woman can work to keep her blood sugar in control before and during pregnancy.

• Plan your pregnancy (if possible)
• Work to achieve and maintain a healthy body weight before pregnancy
• Eat healthy foods
• Be physically active 150 minutes per week (10 minutes at a time is fine, such as a brisk walk)
• Talk with your doctor about whether your current medications will be appropriate if you become pregnant
• Monitor your blood sugar often
• Controland treat low blood sugar right away (e.g., eating a glucose tablet or 15gms powdered sugar or table sugar)
• Limit excess weight gain during pregnancy
• Follow up with your doctor regularly

As your child grows, things like eating a healthy diet, maintaining a healthy weight, and getting regular, moderate physical activity may help to reduce this risk.

If you have missed thyroid tablet in morning, do not eat for 4 hours, after breakfast take thyroid tablet and have lunch after 30 mins.

E.g. 8.00 am breakfast,

8.30 am to 12.30 pm empty stomach.

12.30 pm take tablet and

1.00 pm lunch.

If you have missed diabetes medicine before meals take it after meals. If you are on metformin, pioglitazone, glipizide you can take it 2-4 hours after food also. If you are taking glimepiride, gliclazide take immediately after food or with next meal but do check blood sugar 2 hours after meal.

If you are on a long-acting medication that you take once a day, take your medication if you are within 12 hours of the missed dose. Otherwise, wait until the next scheduled time to resume taking your medication.

You may want to try a simple memory tool such as a weekly pill box. These boxes come with once-a-day, twice-a-day, or three-times-a-day containers where you can place a day’s worth of pills. Also there are some great smartphone apps that allow you to set up notifications or text messages to help you remember your medication. Set up an alarm. If you don’t have or use a mobile phone, you could use a portable alarm clock or set an alarm on your watch.

Thyroid tablets are not medicines; they are hormone supplements. it fulfils the deficit created in the body due to the absence of thyroid hormone, for a condition called hypothyroidism. Take it in optimal amount (not more not less) has no side effect, if taken in a lower amount than required or not taken or stopped in between (without doctor’s advice) then it causes irreversible damage to heart, kidney brain and other organs. If taken excess, it can lead to weight loss, palpitations and tremors. Regular monitoring of TSH is required for dose adjustment of thyroid supplement.

• Worldwide all emergencies are handled on basis of glucometer reading.

• The method used in the lab and in the glucometer is different and hence the variation is bound to occur. Changes in food, exercise, stress, medications also show the effect on sugar level.

• To check the accuracy of your glucometer, carry your meter to the lab when you go for the blood test. When the technician collects a blood sample for the test, ask him/her to put a drop of the same blood sample on your meter and note the reading.

• The ISO guidelines recommend that the accuracy criteria for values <100 mg/dl to ±10 mg/dl and ±20% for values ≥100 mg/dl. However, the ADA recommends a ±5% variation for all values. Glucometer fulfilling these criteria are 100% reliable.

• For simple understanding fasting blood sugar level between 80 and 120, post-meal blood sugar level between 140 and 160 are to be considered normal. Any reading which is not in this range needs to be worked on.

Always keep 15-20 minutes of gap after taking an insulin shot or medication then have your food.

Yes! you can eat all fruits keeping in mind the right portion size. Try to eat more seasonal fruits and keep variation every day.

Around 1 Katori or cup size(100-150g) as a mid-meal snack.

Preferably carry home-made high protein snack from home eg. Masala Roti, Date chana roll, roasted chana, roasted makhana, nuts, roasted khakhra, etc.

No, you can have a normal healthy diet like your family members, few points should be considered such as avoiding refined sugars and simple carbohydrates such as honey, jaggery, sweets etc all maida products like bread, toast, biscuits, Khari and all junk foods. Increase fibre and proteins in the diet by including more fruits, vegetables, sprouts, dal and pulses.

Whenever going for any physical activity always check your blood glucose levels if the levels are above 200mg/dl avoid going for any activity and if below that you can do the activity. While doing vigorous exercise stress hormone like adrenaline, cortisol, epinephrine is at the peak which raises blood glucose levels hence always keep yourself hydrated and always carry small snacks with you. After doing the activity again check blood glucose levels.

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