Diabetes & Early Aging

Early Aging & Diabetes –

Ageing the process of growing old is defined as the gradual biological impariment of normal function probably as a result of changes made to cells and structural components. These changes woule consequently have a direct impact on the functional ability of organs and ultimately the body as a whole.

Diabetes (also called as madhumeha in ayurveda) has today become a disease that not only has its own effects due to increase in blood sugar but also has a characteristic tendency of enhancing ageing induced body transformations. In other words, for someone 30 years of age with diabetes versus someone with 30 without diabetes, it may have been felt that patient with diabetes may actually have been 40 in terms of their actual physical age. 

Early ageing which is a sequelae of diabetes is enhanced by additional factors including environmental pollution, lifestyle habits and inappropriate dietary habits.Aging is the continuous process which can not be stopped, Diabetes works as catalyst to speed up this process hence signs & symptoms of early aging occurs in the people having diabetes –Fatigue, Early greying of hair, dryness of skin,Sexual weakness, irritability etc. are common.

As per Ayurveda (the Indian system of medicine which means the“ science of life and longevity.”), in every ten year of life span, human body gradually looses  important body building factors(including growth factors, hormones and antioxidant mechanisms) & vital energy  which are responsible for aging. Restoration of this vital energy can be done because Ayurveda is not merely concerned with the management of an illness but is also concerned about maximizing the life span and providing optimal living.

There are Manifold health management methodologies mentioned in Ayurvedic texts-to push-back early aging & Diabetes. Ancient Indian seers advocated the modes:

           -Life style modifications

      -Vaya sthapan dravya (Anti aging compounds)-

a)    By directly enriching the nutritional intake of the body

b)    By improving digestion and metabolism and thereby promoting nutrition.

c)    By promoting the capability of srotas/microcirculatory channels in the body,

·                       - Rejuvenation therapy (Rasayan Chikitsa) -It provides spiritual aid to the body as well, thereby bringing the body out of its state of natural or man made loss. It also claims at holding back the process of aging. Rasayana-chikitsa basically boosts vital energy of life and immunity .

So any diabetic  person should take rejuvenating preparations to maintain good health and

stay young.

Dr.M.S.Singhal

Dr.Alka Singhal 

How to stop sugar cravings?

 Try to  Control sugar Cravings -

•                    Have a non-sweet breakfast containing a protein food. Choose a whole grain plus the appropriate protein source for your body : eggs, smoked fish, lean poultry sausages, soy products, beans, nuts or seeds.
•                   Include adequate high-quality protein at lunch. Choose the protein-rich foods best for your body   Like  eggs, fish, poultry, lean beef or pork, nuts, seeds or legumes.
•           Avoid excess raw fruits, raw vegetables and juice.
•           Include cooked leafy greens daily, especially if chocolate cravings are a problem.
•            Drink green tea daily especially when sugar is craved.
•            Avoid frequent intake of artificial sweeteners.
•            Reduce or eliminate refined sugars(sucrose, fructose, fruit juice,  
•             honey, syrups).
•           Get adequate full-spectrum lighting. Take a 20 minute walk outdoors in the early            morning, sit near a bright window or use full-spectrum lighting in your work space.

DIABETES SOLUTIONS: Ayurveda & Diabetes

DIABETES SOLUTIONS: Ayurveda & Diabetes: DIABETES & AYURVEDA When should you seek Ayurvedic intervention ? It is presumed that only 10 percent diabetics are aware of their disease...

Ayurveda & Indian Scenario of Cardio Vascular Disease

Indian scenario of Cardiovascular disease

 Although the prevalence of  CVD in India was reported to be comparable to that in united states in 1969s when the US had the second highest CVD mortality in the world, with big geographic difference between different parts of India were present.

Ancient Indian physician Charak and Sushruta Some 2800 years earlier identified the Cardiac disorders as  disorders effecting the people of upper socio economic classes who were Obese,  Lethargic,  Consuming large quantities of fatty food and sweet drinks etc. But there have been limited studies on CVD in India, at Present India is also in a high risk group for the development of  CVD. Some subsets such as immigrants urban and upper socio-economic classes have an unusually high incidence of the disease and mortality. Indians frequently get the disease at a comparatively younger age in the absence of the accepted risk factors.

The prevalence of CVD varies between  4-6 % in rural Indian to 10-12 % in Urban North West India.  How ever in urban south Indians the prevalence is about 16%. The absolute risk of CVD differs from culture to Culture which empahsises the role of various factors responsible for CVD.

Since CVD are Multifactorial in origin therefore the increased
susceptibility of the disease usually associated with increased prevalence of these factors in India -  

      -     High Prevalence of Obesity Particularly Central Obesity with high Hip-Waist
            Ratio.

      -     High Prevalence of Non Insulin Dependent Diabetes Mellitus, Impaired Glucose                                    Tolerance Or Increased Concentration of fasting plasma  Insulin .

             Indians have     shown 2.0-3.0 high prevalence of NIDDM

      -     Presence of Dyslipaedimia -High Plasma Triglyceride, Low HDL & High
            Cholesterol Level.

      -     Prevalence of Small Dense LDL particles.

      -     Hyperinsulinaemia, Elevated Proinsulin And Insulin Ratio.

      -     Increased Consumption of Lipoproteins

Simultaneously the type of conventional diet pattern appears to have significant role in promoting the present epidemic of the disease amongst them. The typical Indian diet is cereal based with  increased consumption of total fat and its subtypes may have the pathogenic role in the development of the disease. The basic defect in the Indian diet is the virtual deficiency of highly  unsaturated n-3 fats. The traditional Indian cooking were replaced by n-6 enriched oils. This leads to impairment of  destruction of alpha lipoenic acid and blocks the only available source for obtaining the highly unsaturated n-3 essential fats. So the diets derived from refined cereals and high fat diet with an physiological concentration of n-6 fat elevated n-6/n-3 ratio is a major coronary risk factor in the epidemiology of Indians.

In rural India the prevalence of CVD is also increasing, the reasons are the food habits, Medium Physical activity, Low body weight, Hypercholesteremia etc. Most of the Indian rural population belongs to the poor socio-economic group and the habit of chewing tobacco and smoking are very common which is the major risk factor if  CVD. The unknown CVD cases are also common in rural India .

There are no reports of decline of CVD in India Where as there is marked reduction in the incidence of disease in several western countries.

So we must have to focus on the fact that CVD needs to be prevented and physicians should make every effort to modify reversible risk factors. Primary care physicians are in ideal position to play major role in Preventing the  progression of CVD in India  by Providing some basic Guidelines to the patients prone to the disease.

Ayurveda the holistic Science of India has lot to offer to Medical Science in prevention of  such type of disorders by its unique concepts of Life-style, Diet,  Seasonal regimens and line of treatment which are completely suitable and acceptable by Indians. Only the motivation is required to refresh the knowledge of this oldest Indian science, Which not only deals with the diseases but  deals with the Body, Mind & Disease simultaneously  and that can reverse the major risk factors of  such type of Progressing diseases in India.   

 Dr.M.S.Singhal                                                                                                       Dr.Alka Singhal

Ayurveda & Diabetes

DIABETES & AYURVEDA

When should you seek Ayurvedic intervention ?

It is presumed that only 10 percent diabetics are aware of their diseases. The rest discover it accidentally in routine examination for any surgery , insurance or pregnancy. The news comes with as much shock as disbelief , and nearly 65 percent of causes disregard the diagnosis . while this should be the time to seek Ayurvedic intervention , most of them drift to western meditation.

As a result of this , use of Ayurvedic regimen and modification in the lifestyle are pushed to the backburner , lack of both leads to further imbalance in three doshas , vata , pitta , and kapha . diabetes only seek Ayurvedic when most of the things have alipped  out of their hands , and when they do , they expect miracles . It is better to take preemptive preventive actions in diabetes than curative steps in the same.

It has been observed that the use of western medication regularly or irregularly , with or without exercise , diet control , and lifestyle change , gives rise to a number of complication . what is surprising is that people contemplate of taking up Ayurveda for these complications rather than diabetes , which they should have in the beginning. Here is the list of a couple of complication that push a diabetes to Ayurvedic intervention.

a)      when high doses of medication fail to reduce rational blood sugar level.

b)      A diabetic is not ready to inject insulin.

c)      In case of insulin resistance

Apart form that what hassles a diabetic is a beeline of western medicine – induced symptoms like muscular weakness , pains and aches , weight loss , constipation , depression , irritability , sleeplessness , blurring of vision and sexual debilities..

While seeking Ayurvedic intervention , diabetics have been observed of asking some very blunt and demanding question , like : “can I stop insulin injections from today’’, “How far Iam be before Ican give up these injections forever,” and “can you guarantee me a cure by the Ayurvedic formulation you are recommending !!” diabetes is a lifestyle disorder , and an Ayurvedic expert was never a part of a prospective diabetic’s lifestyle , when he or she was “including much” and trying to catch up with a problem. Still these question ?

In as far as diabetes is concerned , Ayurveda offers much to a diabetic when western medicine has almost given him or her up. Despite this ,if a diabetic wants to see considerable improvement by using Ayurvedic intervention , the best outcome depends on the trust a diabetic bestows in Ayurveda and its expert.

Diabetes & Associated factors

Diabetes is a  Complex systemic disease,In addition of increase in mortality rate due to this disease morbidity associated with diabetes & its related illness has a great economic impact on our society.

Therefore, the diagnosis of this disease should no longer be missed. Although all type of diabetes have hyperglycaemia ( High level of Sugar in blood) in common ,but its cause may vary, diabetes occurs mainly by the deficiency of insulin hormone or the presence of factors that disturbs the action of insulin. 

Some common factors associated with Diabetes are as under-

• Larger dose & Prolong use of Drugs as -corticosteroids, OCP(Oral Contraceptive Pills), Diuretics etc.
• Diseases of Pancreas(gland secreting insulin)
• Sever & prolong illness
• Constant Moderate/Severe stress
• After burns/accidents
• Prolong chemical exposure

& many others

So instead of family history of the diabetes if anyone suffered/suffering from the above said factors must go for the checkups biannually.

• Patients visiting their Family Doctors/OPD of Hospitals should have a urine test especially if their symptoms are unexplained.
• Some patients do not explain their symptoms properly which may mislead the physician--be vigilant about your body.
• Symptoms like wt.loss, weakness & lethargy are most commonly misinterpreted-Tonics & other health supplements are taken without consulting the doctor, worsen the disease, if present.

Classically Diabetes manifests with the triad of symptoms as excessive thirst(polydipsia),excessive urination(polyuria),& excessive hunger(polyphagia)

But now any unexplained symptom may represent Diabetes.Some common symptoms are-

• Tiredness, Feeling of unwell
• Excessive Thirst/dryness of mouth
• Detoriating Vision
• Pain in shoulder/feet
• Excessive/burning urination
• Weight loss/gain –sudden
• Vaginitis /Balanitis
• Gynaecological disorders in females
• Foot/heel ulceration
• Undiagnosed fever

Should not be ignored because in some persons  the symptoms develop rapidly but in some very slowly (few days to few months) depending upon individuals immune system

Hence until its clinical & pathological detection, understand your body language & do not let the Diabetes to control you, Prevent & Control it.

Dr.M.S.Singhal

Diabetes origin from Haridwar

The history of origin of various diseases like Fever, Tuberculosis, Skin diseases and Diabetes begins in the Pauranik (mythological) stories in ancient India. As one of the reference of Shiv Purana., Origin of Diabetes is claimed from Kankhal (subtown of Haridwar (Uttarakhand), INDIA, where a yagya (Fire sacrifice) was performed by King Daksha in which all the Devas, Rishis ,Munis were invited .But the invitation was not given to Lord Shiva.

All the invities were offered a very rich diet i,e Havish (made up of mainly with Sugar & Ghee) & was consumed heavily by the invities All the guests took rest for a long period while staying there. But Lord Shiva because of his insult was very annoyed and ordered Veer bhadra to destroy the yagya .By the destructive acts of Veerbhadra , Stampede occurred. To save themselves everybody rushed here & there, by this critical and stressful situation many diseases occurred and Diabetes was one of them .As we see today the main causative factors of the disease are- Sedentary lifestyle, Rich Diet & Stress.

And as per the above mentioned story all these factors were present &confirms the Origin. (Ref: Charak Samhita/Nidansthan/chapter-8/11).

Later the main symptom in Ayurvedic texts is described that insects and flies are attracted to the urine of some people and that the urine tastes sweet (Sweet Urine Disease)  

In Sushruta Samhita (2500 BC) the detailed description of  Diabetes includes symptoms, Diagnosis, prognosis & Treatment ,is available.   

Diabetic Diet Book - Hindi

A Book on Diabetic Diet in Hindi “Madhumeha  Vyanjan Nirdeshika” written by Dr.Alka Singhal  & Dr.M.S.Singhal  was released on World Diabetic Day - 14/11/10 at Singhal Diabetic Clinic, Hardwar By Jagadguru Shankracharya  Shri Rajrajeshwar ji.

Why diabetics do not achieve satisfactory glycaemic control?

Why diabetics do not achieve satisfactory glycaemic control?

Diabetes is a disorder which usually progresses overtime & is known to effect whole body from head to toes.

Poor glycaemic control & chronic hyperglycaemia may lead to many complication such as Retinopathy,Neuropathy,Nephropathy,Cardiac ailments etc..Inspite of availability of effective treatment for diabetics many patients do not achieve optimal glycaemic control some of the common reasons are -

• Patients do not realize the serious & chronic nature of the disease &complexicity of its management takes it very casually.
• Unable to take multiple daily self care decisions that diabetics require.
• Patients are unwilling to follow advice & dietplan suggested by the physician & embark on exercise regimen without the counseling with the physician
• Fear of disease & restricted life style creates psychological distress
• Irregular or self medication with self dose modification as per the convenience
• Negative beliefs about disease & therapies as  regarding  Insulin therapy .or can be completely cured by magical /mystical therapies etc.
• Negative arguments with family members & physician as Why should I go for exercise while I am doing my routine work/ household work or why should I follow diabetic diet while taking medicines
• Our health care system is also developed only to deliever acute symptom care & poorly cofigured to properly educate the people for such disorders So Patient ignores mild symptoms until creates hinderance

Therefore to overcome this problem-

• Self management & diabetic education program is required for each diabetic individual
• Patient must be able to set goals &make frequent daily decisions that are efficient &fit for diabetes & their life style
• Improve quality of life by retarding or pushing back the diabetic complications as the major complications are due to vascular abnormalities & nerve damage which can be quantified at earliest by the third generation techniques available at specialized diabetic clinics as Diabetic Complication Detection Unit.

Dr.M.S.Singhal  Dr.Alka Singhal

   

Diabetes & Family Physician

Today I am sharing the experience of 1997 when we  discussed about the “Role of family physician to control Diabetes Mellitus”  in the conference organised by National Integrated Medical association of India at Saharanpur(U.P.)when the number of diabetics in India were less than 2 million.

But now the scenario is entirely  different , one out of five is Diabetic in Indian population(National data states 5.2 million & NGO data 12.10 million & in coastal region it is <12 % population is Diabetic )this rapid increase is because organised sector to unorganised sector ,layman to literate everyone is taking Diabetes casually & till date the majority of diabetic patients are not aware of the severity & complexity of the   disorder.

Preventive measures for Non Diabetics & proper self care for diabetics is required at large scale to retard this growth of disease ,& I think it is the right time to start National diabetes prevention & control campaign” by the Central Government ,as well as state Government should promote Doctors, Pharmaceutical  companies NGOs  for active participation to save country from Diabetic complications induced financial burden.  

In this regard as I talked on the role of family physician is now more significant , their  efforts can directly  help to improve quality of life & simultaneously pushing back the diabetic complications  as family physician is well aware of the life style, diet pattern ,Financial status etc. Of the families coming to him for various health conditions of their family members so they can easily guide them to manage the diabetes & help them to follow the drug compliance , if a person is diabetic in the family & also suggest them the necessary life style modification to prevent the other to become Diabetic, They may also help in early diagnosis of Diabetes if there is a new abnormal symptom  present in any of the member.

Family physician can also explain the importance of Diabetic Discipline, Myths about Diabetic Diet& many other queries of the patient regarding   diseases condition which definitely help the patient to overcome from the disease  oriented stress which is the major obstacle in disease management as we have seen in our clinical practice .    

They can also provide guidelines on limitations of Medicines, importance of regular examinations & investigations, also suggest the timely visit to the super specialist to manage the  changes coming in the vital organs such as Eye, Heart, Kidney & others.

Family Physician  can also provide immediate care in any diabetic Emergency  & can save the life by providing emergency treatment before referral to higher centre.

Above said are the few example in which family physician has a very important role , & this link between patient-Family physician- specialist- super specialist is the key to provide proper help to diabetics to keep away the fatal complications of the disease.

       So finally I would like to suggest that everyone should  remain in touch with a physician for their daily minor health troubles & also go for periodic examinations  to avoid such disorders take control on you.

Diabetes control and Care Program

Diabetes Control & Care Program

The prevalence of Diabetes is increasing worldwide and now taking  its place in one of the main threat to human health . India have the largest population (by Govt. 4.9 million, while NGO claims more than 12 million) of diabetics and facing a rising steep in diabetes itself and its related complications  such as Cardio-vascular, Renal, Nervous system  along with  Foot and Eye, These complications place huge burden on an individual patient, their family and the community.

Recent advance in Diabetes management may improve or decrease the above said complications. But as diabetes is a silent disease in the first  5-6 years of its onset, result in carelessness, invite such complications which can make life misery and detoriate quality of life.

For diabetics, Improving quality of life with minimal complications is a great challenge. Because this require Patient awareness and compliance towards Life style & diet modification, Pharmacological therapy, Proper monitoring with laboratory assessment of various Physiological parameters.        

Singhal  Diabetic Clinic conducted a telephonic Survey of  6637 patients of uttarakhand  between April 2005 to 2008 Dec. and  found  4.9% population are diabetic, and majority of patients are lacking in achieving glycemic control, laboratory assessment (Pathological Tests) insufficiently done, many of patients did not have essential investigation(Blood Sugar estimation) tested once in preceding 2 yrs, not taken  proper therapeutic  regimn due to carelessness, while many of them due to economic reason.

To improve physician and patient adherence and compliance t standards of the diabetes care  Singhal Diabetic Clinic launched  Diabetes control and Care Program on  ^{26th Jan 2010}  (after completion of its 20 years of practicing) to organize the care for diabetics under one roof, to achieve positive clinical goals in diabetes patients with least  expensive diabetes care, because the success of long term  therapy and monitoring depends upon achieving  target goals of glycemic control with minimal complications.

This  Diabetes control and Care Program of its kind is First in India Which provides such long term regular rebate to the diabetics.

Stress & Diabetes

Tips for stress management-

Stress is also one of the main reason of poor glycemic control So here are a few tips for preventing stress and managing it which will be beneficial for diabetics & other healthy individuals.

Believe that stress can kill and be willing to do something about it.-

Analyses your present life, identify short-term and long-term stress and decide how much   stress you will tolerate.

Remove as many sources of stress as possible.

Develop sensible, rational beliefs and attitudes towards yourself, your job and job   performance.

Develop the requisite skills and behaviors to enable you to do your job to the best of your  ability

Develop a good social support network, both at work and with family and friends.

  Keep as physically healthy as you can through a balanced diet, adequate sleep, exercise,etc.

Change your response to stress, i.e. don’t just become cross, do something constructive   like changing your job, leisure habits and outlook.

Learn to relax.

Dr.M.S.Singhal

Diabetic Discipline

Diabetic Discipline

Diabetic discipline can keep the patient in good health with controlled blood sugar level.

Lifestyle discipline is of great importance, if a person diagnosed with diabetes the first step is to overview the present life style & discuss it with theDiabetologist. & as per the suggestions diabetic should follow the necessary changes according to severity.

If a diabetic do not go for the life style modifications is definetely inviting complications & troubles in near  future associated with Diabetes.

The Indian system of medicine Ayurveda  recommends life style changes in many ways -

• General Seasonal recommendations
• Individual recommendations as per the genetic nature(Prakurti)
• Specific recommendations as per the disease condition
• Recommendations as per age, geographical  status, individual strength, working style etc.

So by balancing the life style which is the part of Diabetic Discipline & this need involvement of the individual towards disease condition & learning more about the diabetes & its complications .If due to ignorance, once the complications starts taking place than it can not be reversed only increasing pattern can be delayed by strict follow up.

So manage the Diabetes with Diabetic Discipline. 

Dr.Alka singhal, Dr.M.S. Singhal

Diabetes Alert-1

Every  Diabetic  must  know that   Diabetes is a complex disorder.

·         No medicine is available till date which can root off Diabetes completely.

·         Decrease in only  blood sugar level  is not the complete treatment of diabetes.

So we want to alert all Diabetics, to not to attract towards the miraculous treatments or short term treatment  advertisements published in various Magazines, News papers & even on Internet.

Such as-

·         Diabetes cure in 3 days/3dose .

·         Eat sugar & sweet with diabetes.

·         Root off Diabetes with herbal medicine.

·         Complete cure of diabetes in 365 days.

·         Stop insulin injections in IDDM patients.

& any more.

Most of such type of treatments  are not scientifically & Clinically screened. So  don’t make your body a experimental laboratory by taking such treatment.This may detoriate the disease condition in long term or may lead to medical emergency by sudden withdrawl  of OHGA/Insulin. Each individual is unique & its type of disease may vary,So proper counseling, Diet Planning, Life style Planning  along with medicine selection by the Diabetologist is needed & followed strictly  to achieve Glycaemic control  complication free Diabetic Life.   

If you really want to start Herbal /Ayurvedic /Alternative  treatment, Consult only qualified physician of specific  science , under his guidance you will get proper care & management of the disease. Ayurveda,the ancient system of Indian medicine have lot to offer  for life style disorders with evidence based formulations designed individually after knowing the genetic & personality traits(Prakarti Analysis) of individuals.

Remember- There are no Shortcuts to manage Diabetes, have patience.

Dr.M.S.Singhal , Dr. Alka singhal