Protect Your Kidneys and Control Diabetes

March 14th, 2010 admin Diabetes 1 Comment

World Kidney day was observed on 11 March in more than 100 countries of the world. The slogan of World Kidney Day this year was “Protect your kidneys, control Diabetes”. World Kidney Days aims to raise awareness about the heavy burden of chronic kidney disease (CKD) on human lives.

The mission of World Kidney Day is to raise awareness of the importance of our kidneys to overall health and to reduce the frequency and impact of kidney diseases and its associated health problems worldwide. The objectives of the World Kidney Day 2010 were the followings:

* Raise awareness about our “amazing kidneys”

* Highlight that diabetes and high blood pressure are key risk factors for chronic kidney disease (CKD)

* Encourage systematic screening of all patients with diabetes and hypertension for CKD

* Encourage preventive behaviours

* Educate medical professionals about their key role in detecting and reducing the risk of CKD, particularly in high risk population

* Stress the important role of local and national health authorities in controlling CKD epidemics. Health authorities worldwide will have to deal with high and escalating costs if no action is taken to treat the growing number of people with CKD. On World Kidney Day all governments are encouraged to take action and invest in further kidney screening

* If detected early, CKD can be treated by reducing other complications and dramatically reduced the growing burden of deaths and cardiovascular disease worldwide

Kidney diseases are silent killers which largely affect the quality of life. There are, however, several easy ways to reduce the risk of developing this kidney disease.

Seven golden rules:
i) Keep fit and active
ii) Keep regular control of your blood sugar level
iii) Monitor your blood pressure
iv) Eat healthy and keep your weight in check
v) Do not smoke
vi) Do not take over the counter pills on regular basis
vii) Check your kidney function if you have one or more of the high risk factors

Diagnosis of CKD with Diabetes:
People with diabetes should be screened regularly for kidney diseases. The two key markers of kidney diseases are eGFR and urine albumin. Kidney diseases are present when eGFR is less than 60 ml/min.

The Americal Diabetic Association (ADA) and National Institute of Health (NIH) recommend that eGFR can be calculated from serum creatinine at least once a year in all people with diabetes.

Urine albumin is measured by comparing amount of albumin to the amount of creatinine in a single urine sample. When the kidneys are healthy, the urine will contain large amount of creatinine but almost no albumin. Even small increase in ratio of albumin to creatinine is a sign of kidney diseases. Kidney diseases is present when urine contain more than 30 mg of albumin per gram of creatinine, with or without decrease eGFR. The ADA and NIH recommend annual assessment of urine albumin excretion to assess kidney damage in all people with type 2 diabetes and people who have type 1 diabetes for 5 years or more.

Good care makes a differencePeople with diabetes should:
* Measure their HbA1C level at least twice a year which should be kept less than 7%

* Regular insulin injection, intake of other medicines, meal planning, physical activity and blood sugar monitoring

* Blood pressure should be checked several times a year which should be kept <130/80 mmHg

* Regular intake ACEI or ARB medicine for controlling high blood pressure

* To measure effective eGFR yearly

* To estimate urine albumin atleast once a year to check kidney damage

* To take reduce amount of protein in the died at to seek health from the dietitian regarding meal planning

In conclusion early detection and treatment of kidney diseases are the best way to prevent CKD in order to reduced substantial burden of health budget.

Smoking and Diabetes

June 5th, 2009 admin Diabetes 1 Comment

The harmful effects of smoking. Studies show that smokers are five times more likely than that of the nonsmokers to have gum disease. For smokers with diabetes, the risk is even greater. If you are a smoker, diabetic and age 45 or order, you are 20 times more likely than a person without these risk factors to get severe gum disease.

Smoking increases your risk of getting type 2 diabetes
Some recent research shows there is a significant relationship between diabetes and smoking. The more you smoke, the more chance you have of getting diabetes. If you smoke 16 to 25 cigarettes a day, your risk for type 2 diabetes is 3 times greater than a non-smoker. When you quite smoking, your risk decreases during the years that follow.

Smoking affects the way insulin works in your body
In type 2 diabetes, the body does not respond to insulin made by the pancreas. Insulin helps blood glucose enter into the cells for fuel. When you smoke, your body is less able to respond to insulin. When your body resists insulin, your glucose level increase in the blood. Resistance does not start to reverse until you do not smoke for 10 to 12 hours.

Smoking makes it harder to control your diabetes
Studies show that smokers have poorer glucose control than non-smokers do. Smokers who quit have the same blood glucose control as non-smokers. When you have type 1 or type 2 diabetes, glucose control is very important. The HbA1c test checks how well you control your glucose level over 3 months. The goal is to keep your A1c at 7 percent or less. When you have diabetes and you smoke, your A1c level increases. If you quit smoking, your A1c level may decrease to the same level as a non-smokers.

Smoking increases your risk for getting other problems from diabetes
When you have diabetes and smoking habit, your chances are greater for getting other health problems form diabetes — complications. You can get serious eye problems, kidney problems, nerve problems, heart and blood vessel disease and so on.

Even for people who do not have diabetes but smoke, the risk of getting other health problems is greater. The more and the longer you smoke, the more your risk increases. Smoking and diabetes together greatly increase the danger of getting complications. To lower your risk, you must control your glucose levels and quit smoking. Diabetic people will be benefitted in many ways when they quit smoking.

Experts’ views
All smokers need stop smoking in a clear, strong and personalised manner. Ask every tobacco user if s/he is willing to make and attempt to stop smoking at this time (within the next 30 days for example).

Assist all people with smoking cessation. For those unwilling to attempt cessation at this time, stress the 5 R’s.

Relevance: provide individualised information on the hazards of smoking.

Risks: Emphasise the increased risks of heart disease and diabetes complications arising from the combination of smoking and diabetes.

Rewards: Review benefits of smoking cessation.

Roadblocks: Assure people of your willingness to assist in their efforts to stop smoking.

Repetition: Review people’s thoughts about cessation during their following visit.

Key messages
* Review major steps of smoking cessation

* Set a date to stop smoking

* Identify likely relapse triggers and make specific plans for coping with them before stopping smoking

* Assess for nicotine replacement therapy

* Discuss any concerns about weight gain and other concerns related to diabetes

* Make referral for additional smoking cessation support, prescribe nicotine replacement, provide self-help materials, or otherwise assist in a specific plan

* Arrange for ongoing contact

* Schedule follow-up contact either in person or via telephone

* Follow-up contact should occur soon after the date set to stop smoking, preferably within the first week.

Diabetes Nutrition Focuses on Healthy Foods

February 23rd, 2009 admin Diabetes 1 Comment

Diabetes nutrition focuses on healthy foods. But you can eat sweets once in a while without feeling guilty or interfering with your blood sugar control. The key to diabetes nutrition is moderation.

The scoop on sugar

For years, people with diabetes were warned to avoid sweets. But what researchers understand about diabetes nutrition has changed.

* Total carbohydrate is what counts. It was once assumed that honey, candy and other sweets would raise your blood sugar level faster and higher than would fruits, vegetables or “starchy” foods such as potatoes, pasta or whole-grain bread. But this is not true, as long as the sweets are eaten with a meal and balanced with other foods in your meal plan. Although different types of carbohydrates can affect your blood sugar level differently, it is the total amount of carbohydrate that counts the most.

* But don’t overdo empty calories. Of course, it is still best to consider sweets as only a small part of your overall plan for diabetes nutrition. Candy, cookies and other sweets have few vitamins and minerals and are often high in fat and calories. You will get empty calories — calories without the essential nutrients found in healthier foods.

Have your cake and eat it, too
Sweets count as carbohydrates in your meal plan. The trick is substituting small portions of sweets for other carbohydrates — such as bread, tortillas, rice, crackers, cereal, fruit, juice, milk, yogurt or potatoes — in your meals. To allow room for sweets as part of a meal, you have two options:

* Replace some of the carbohydrates in your meal with a sweet.

* Swap a high carb-containing food in your meal for something with fewer carbohydrates and eat the remaining carbohydrates as a sweet.

Let’s say your typical dinner is a grilled chicken breast, a medium potato, a slice of whole-grain bread, a vegetable salad and fresh fruit. If you would like a frosted cupcake after your meal, look for ways to keep the total carbohydrate count in the meal the same. Trade your slice of bread and the fresh fruit for the cupcake. Or replace the potato with a low-carbohydrate vegetable such as broccoli. Adding the cupcake after this meal keeps the total carbohydrate count the same.

To make sure you are making even trades, read food labels carefully. Look for the total carbohydrate in each food, which tells you how much carbohydrate is in one serving of the food.

Consider sugar substitutes
As part of diabetes nutrition, artificial sweeteners can offer the sweetness of sugar without the calories. Artificial sweeteners may help you reduce calories and stick to a healthy meal plan — especially when used instead of sugar in coffee and tea, on cereal or in baked goods. In fact, artificial sweeteners are considered free foods because they contain very few calories and don’t count as a carbohydrate, a fat or any other food in your meal plan.

Examples of artificial sweeteners include:

* Acesulfame potassium

* Aspartame

* Saccharin

* Sucralose

Artificial sweeteners don’t necessarily offer a free pass for sweets.

* Keep an eye out for calories and carbs. Many products made with artificial sweeteners, such as baked goods and artificially sweetened yogurt or pudding, still contain calories and carbohydrates that can affect your blood sugar level.

* Sugar alcohols are not calorie-free. Sugar alcohols, another type of reduced-calorie sweetener, are often used in sugar-free candies, chewing gum and desserts. Check product labels for words such as “isomalt,” “maltitol,” “mannitol,” “sorbitol” and “xylitol.” Although sugar alcohols are lower in calories than is sugar, sugar-free foods containing sugar alcohols still have calories. And in some people, sugar alcohols can cause diarrhea.

Reconsider your definition of sweet
Diabetes nutrition does not have to mean no sweets. If you are craving them, ask a registered dietitian to help you include your favorite treats into your meal plan. A dietitian can also help you reduce the amount of sugar and fat in your favorite recipes. And don’t be surprised if your tastes change as you adopt healthier eating habits. Food that you once loved may seem too sweet — and healthy substitutes may become your new idea of delicious.

Blood Tests May Show Inherited Diseases in Fetuses

November 26th, 2008 admin Diabetes 1 Comment

Doctors may soon be able to diagnose inherited diseases such as cystic fibrosis, thalassaemia and sickle cell anemia in fetuses by simply testing a blood sample taken from the mother.

Until now, prenatal diagnoses of such disorders have been possible only through invasive procedures like amniocentesis, which carry a risk of fetal miscarriage.

Amniocentesis is the extraction of a small amount of fluid from the sac surrounding a developing fetus.

But scientists in Hong Kong and Thailand may have found a way to diagnose in fetuses such “monogenic” diseases, which are caused by a single error in a single gene in the human DNA.

This is only possible because fetal DNA circulates in maternal blood, a discovery Lo and his colleagues made several years ago.

Many scientists have since been trying to find the best way to differentiate fetal DNA from maternal DNA, before they can even get down to looking for any anomalies in the fetal DNA. But these efforts have not met with much success.

In an article published in the Proceedings of the National Academy of Sciences, Lo and his colleagues said they had devised a counting system that could “bring non-invasive prenatal diagnosis of monogenic diseases closer to reality.”

Using highly precise digital blood testing technology, both mutant and normal DNA sequences are counted in maternal plasma and that is then used to calculate the number of mutant genes inherited by the fetus and to determine the probability of the fetus developing any monogenic disease.

Lo, however, noted that the accuracy of this method would depend on the concentration of fetal DNA in maternal blood.

Thalassaemia is a blood related genetic disease that can result in reduced fertility or even infertility. Early treatment can improve the quality of life of patients.

Cystic fibrosis affects the respiratory, digestive and reproductive systems and can lead to fatal lung infections.

Depression Linked to Poorer Diabetes Control

November 21st, 2008 admin Diabetes 1 Comment

Depression may make it harder for people with diabetes to keep their blood sugar levels in check, researchers have found.

In a study of more than 11,000 U.S. veterans with type 2 diabetes, the investigators found that over a decade, those diagnosed with depression consistently had a higher average hemoglobin A1C level — a standard measure of long-term blood sugar control.

The findings are concerning, in part, because studies have found that diabetics have a higher risk of depression than non-diabetics. It is estimated that about 30 percent of people with diabetes also suffer from depression at some point.

“Our study shows that depression is a major and important comorbidity in people with type 2 diabetes,” Dr. Leonard Egede, one of the researchers, said.

He and his colleagues at the Medical University of South Carolina, in Charleston, report their study findings in the journal General Hospital Psychiatry.

Briefly, the researchers analysed records from 11,525 mostly male veterans treated for type 2 diabetes between 1997 and 2006. At the outset, 6 percent also had a diagnosis of depression. On average, the researchers found, this group consistently showed a higher hemoglobin A1C level over the years.

The difference between groups was small — a gap of 0.13 percent overall — but for any one person, even a slightly higher hemoglobin A1C, sustained over time, can raise the risk of diabetes complications, Egede noted.

The reasons for the findings are not clear, but one possibility is that dealing with depression makes it harder for diabetics to manage their blood sugar with lifestyle measures and medication.