Importance of Screening For Diabetes and it's Associated Complications

Diabetes has become a major health threat to the whole world; indeed, the greatest increase will be contributed by India, which has already been declared by the World Health Organization (WHO) as the country with the largest number of diabetics in the world. Diabetes is frequently not diagnosed until complications appear, and approximately one third of all people with diabetes may be undiagnosed, though diagnosed many people are not aware of their condition.



Late detection of diabetes often means that at the time of diagnosis complications have already damaging the eyes, kidneys and nerves. These complications are costly in the physical, financial and psychosocial sense. Early detection and treatment of diabetes may not only improve glycemic control, but also improves blood pressure and lipids.
Who should be screened? In general all adults should be screened at regular intervals
o Family history of diabetes (i.e., parents or siblings with diabetes)
o Overweight (Body Mass Index >25 kg/m2)
o Age >45 years
o Previously identified impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)
o Hypertension (>140/90 mmHg)
o Hyperlipidemia (HDL - 250 mg/dL or both)
o History of gestational diabetes or delivery of a baby over 9 lb (4.1 kg) (ADA -Diabetes Care 2004)



What are the Screening test for Diabetes



Fasting Plasma Glucose: The fasting plasma glucose (FPG) test is the standard test for diabetes. It is a simple blood test taken after eight hours of fasting. The FPG test is not always reliable, so a repeat test is recommended if the initial test suggests the presence of diabetes.



Oral Glucose Tolerance Test: The glucose tolerance test may be more accurate than the FPG in certain groups (e.g., women with a history of gestational diabetes). The test uses the following procedures: I) after an overnight fast Fasting Plasma Glucose test is performed. ii) After this test a person receives 75 g of glucose (100 g for pregnant women) blood samples are taken every half an hour {(fasting-30mts-60mts-90mts-120mts-(five times)} to measure the blood glucose. It not only helps in detecting diabetes but also help to detect the pre-diabetic status, Impaired Fasting Glucose (IFG) & Impaired Glucose
Tolerance (IGT))



Is it important to detect pre-diabetic stage? Yes! Because it is "preventable"
Criteria for the diagnosis of diabetes mellitus



Normal DIABETES



Symptoms of diabetes + Random plasma glucose o Blood pressure check up, regular at every visit for Hypertension (High blood pressure) - should be 40
o An electrocardiogram (ECG), that provides information about the status of heart
o Chest X ray, information about the lungs and shape of the heart and vascular system (aorta and blood vessels)
o Carotid Intima-media Thickness (IMT), marker of early atherosclerosis



Diabetic Nephropathy (Kidney Damage): Person with diabetes are several times more prone to kidney disease than the general population. The earliest manifestation of kidney damage is microalbuminuria, (tiny amounts of protein called albumin are found in the urine). Symptoms include Protein in the urine, High blood pressure, burning during urination, frequent urination, puffiness and swelling around the eyes, hand & feet, excessive itching, nausea, vomiting & weakness.



About 20% of type 2 patients show evidence of microalbuminuria upon diagnosis of diabetes, however, only a small percentage of type-2 diabetics eventually develops kidney disease. Microalbuminuria typically shows up in type 2 diabetics who have high blood pressure. Normal: 15yrs will develop diabetic retinopathy in their lifetime.
Who are more prone to Diabetic retinopathy? : Uncontrolled blood sugar, longstanding diabetes, Hypertension with diabetes & Genetic predisposition.



What are the stages of retinopathy? : Mild non proliferative diabetic retinopathy (NPDR), Moderate-non proliferative diabetic retinopathy, severe retinopathy, Maculopathy and Proliferative diabetic retinopathy. Treatment: Retinopathy can be treated through laser photocoagulation. Screening test: Patients with diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist right from the day of diagnosis of diabetes and every year thereafter. Early detection, timely treatment, appropriate screening and care reduce the risk of vision loss & 90% of diabetes related blindness.



All patients should be regularly screened for risk factors and encouraged at each health care visit to pursue a healthy lifestyle that includes a healthy diet, adequate exercise, weight control and stress reduction. 'Try for good control to be sure, but don't try for perfection. Perfection lasts for a moment, and diabetes lasts a lifetime'. The main theme is to be focus on to 'live a Healthy Life Despite Diabetes'.

The importance of knowing the symptoms of Pre diabetes

Pre diabetes or borderline diabetes strikes whose age 20 and over are more than 55 million Americans. Typically, a person would just know which has the status of once he has undergone tests such as plasma glucose test (FPG) and fasting glucose tolerance test (OGTT) oral. Diabetes symptoms include frequent urination, excessive thirst, fatigue and tiredness, increased appetite, blurred vision and in some cases, especially for women, yeast infections and irritation to genitalia. It is important to monitor the manifestations of these symptoms, it may prevent the onset of serious diseases. But exactly how significant?



Be aware of pre diabetes symptoms does notice that once you have noticed that there are some of the symptoms, you can immediately consult a physician. You can set appointments for the tests shall be carried out to determine if the symptoms are linked to diabetes pre or for any other medical condition. Know the symptoms makes you aware of your blood sugar that would undergo regular tests to ensure that your blood glucose within the normal range. And if it is found that you are diabetic, you may make lifestyle adjustments. What are these lifestyle changes?



On knowing that you are diabetic, changes to your eating habits should be done immediately. Follow a diet that consists mainly of low-fat protein, vegetables and whole grains. Break down your meal in several small meals is encouraged. Refraining from eating foods that are low in carbohydrates is also recommended. Less carbohydrates consumed, less product being converted to sugar. Also, should be deprived of desserts such as chocolates and cakes like sodas and sugary drinks. Add only an accumulation of blood sugar. Sufficient amount of fiber rich foods is also a good idea. In addition to changes in eating habits, there is something else that can be done to prevent diabetes symptoms manifest?



Of course, the answer is Yes. Start by reducing the extra pounds off your weight. Obesity is a key factor in diabetes. Trim curb weight down to full blown diabetes occur. In some cases, weight loss you should reverse the pre diabetes. Striving to achieve the normal weight range, have stymied the diabetes symptoms such as excessive eating and excessive thirst. You need an active lifestyle. Daily exercise should be practiced. Just A few minutes walk helps greatly. Other forms of exercise such as swimming and cycling are also ideal weight loss exercises and can give a benefit or two. What are these benefits?



Aside from the great possibility of reversing diabetes healthy eating habits, pre, to undertake regular exercises and weight loss can even prevent the onset of full-blown diabetes. These lifestyle changes may also reduce the risk of other diseases and medical conditions that occur. People with diabetes have up to pre 50% more chances of contracting heart disease and stroke than those who are not. Therefore, it is very important to be aware of pre diabetes symptoms because they serve as your reminder to engage in a healthier lifestyle.

The Importance of Diet For Diabetic Patients

For those that suffer with diabetes there are 3 very important goals in any diabetic health plan. When you are diagnosed with diabetes your doctor will most likely put you on medication and discuss exercise and diet for diabetic patients. Diet is perhaps one of the most important changes you will need to make in your lifestyle, and it is important that you take the time to learn more about why diet is so important.



Diet for diabetic patients can mean the difference between getting your diabetes under control and not being able to control it properly. It is important to determine the number of calories you should have in a day, which should be based on what your ideal body weight is. In addition to that it is important to watch your carbohydrate intake since it has been found that the lower your carbohydrate intake is, the lower your blood sugar will remain.



In addition to watching your carbohydrates you will also want to avoid foods with excess amounts of saturated fat such as those that are in many meat and dairy products, snack foods and processed foods. The ideal diet for Diabetic patients will balance the proper amount of calories, carbohydrates, proteins and healthy fats to keep the blood sugar under control and aid the patient in losing weight.



The amount of food that you eat as well as what type of food you eat will have a definite impact on your blood sugar levels. Look for foods that are nutrient rich complex carbohydrates such as fruits and vegetables. These foods, while they are carbohydrates, when balanced properly are healthy carbohydrates that will help keep your blood sugar lower. Avoid refined foods such as white flour and white sugar as these are what are commonly referred to as simple carbohydrates that break down quickly and will spike your blood sugar rapidly.



When planning a diet for diabetic patients choose complex carbohydrates such as fruits, vegetables, and whole grains, add some lean protein, and healthy fats, and you will have a diet that will help the diabetic patient lose weight, and keep their blood sugar under control.

Diabetes Diet - The Importance Of Proteins

Implementing a diabetes diet and understanding the importance of proteins that are necessary for your diet is essential to know so that you can achieve optimum health. It is important to realise that protein is part of every cell in your body, which means that it is vital for the growth and repair of tissues throughout your body. They are made up of amino acids that are the building blocks for your body.



The source of protein can be found in plant and animal foods. The main source of protein is found in meat like beef, lamb, pork and chicken. Other sources include fish, shellfish, and dairy products like cheese, milk and yoghurt. For vegetarians they can find protein in legumes like chickpeas, soybeans, tofu, nuts and grains. Certain protein foods like meat are rich sources of micronutrients that can be found in Vitamin B12, zinc, iron and omega-3 fats.



The protein content in food is listed in grams, the majority of our bodies are made up of protein that is found in our muscles, skin and the immune system, and this is why we need protein in our diet for the healthy growth and repair of our bodies.



The most beneficial source of protein comes from nuts, they also contain dietary fibre, and micronutrients and the best part is that they contain a very small amount of saturated fat. You do need to remember not to eat too many nuts, grab a handful from the packet and place in a bowl. Nuts contain a lot of kilojoules so only eat about 30 grams per day. Research has shown that walnuts are beneficial in a diabetes diet as they help to lower cholesterol and helps reduce the risk of a heart attack.



Eggs are also a great source of protein as well as essential vitamins and minerals. It is now known that high blood cholesterol is obtained from eating huge amounts of saturated fat in foods instead of the cholesterol in foods. When buying eggs try to select the omega-3 enriched variety, as they will increase the intake of this good fat along with your protein intake.



It is also important to remember that our bodies cannot collect and store amino acids each day like carbohydrates and fats, so this is why we need a daily supply in out diabetes diet. The amount that is required for a women on average is about 45 grams per day, of course more is required if you are pregnant or breastfeeding. Men require around 55 grams per day. If you are active or still in the growing stage, you will require more protein in your diabetes diet.



Any excess protein that we eat is broken down as a source of energy by our bodies. The importance of proteins in your diabetes diet is essential for you to be able to achieve optimum health.

Diabetic Diet Plan - Knowing Its Importance

The real treatment for diabetes is having a sound nutritional diet. What and how much food you intake everyday derives a significant change is the glucose levels in your body. Improper diabetic diet plan when you are already diabetic leads to disastrous results. A licensed dietician will be a diabetic's guide to good health. Together as a team, they could decide what diet plan they will use.



A diabetic diet plan ensures the person with the proper number of calories, nutrients and carbohydrates he will need for the day. This is without going over the limit on the food they eat. According to the American diabetic association, there is a certain grouping of foods with the same number of calories. Each grouping could be swapped with each other depending on the needs of the person each day. A registered dietician can help you determine the food you could exchange each they while still properly managing your glucose levels.



Carbohydrate counting is important in a diabetic diet plan. This method offers an easier control in maintaining blood glucose levels. There are different types of carbohydrates some are good and some are bad. Good carbohydrates can be found in fiber rich foods. Fruits, green leafy vegetables and whole grain are good food for one who is diabetic. Low fat content dairy products are also good for one who is maintaining their blood sugar levels.



The glycemic index of food is a subject that is debated by diabetic associations throughout the world. There are foods with a relatively high glycemic index that can cause a sugar rise in blood sugar rather than low glycemic foods. High level of glycemic food includes potatoes, water melon and white bread. Low Level of glycemic food is whole grains, dried beans and non-starchy vegetables. A licensed dietician would recommend eating foods that are low in glycemic index for the diabetic diet plan.



A right diabetic diet plan includes not only checking the food you eat. Exercise is one of the best ways to naturalize blood sugar levels. It not only promotes blood circulation but it also reduces the fats and cholesterol in the body. Our body becomes slightly immune to insulin when we are overweight. The insulin levels secreted by the body cannot properly normalize the blood sugar. When this happens the cells couldn't absorb or transpose the glucose to the much - needed energy it needs daily.