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Is Diabetes just a disease of blood sugar?? When should we start the treatment of Diabetes? It is very dangerous to think so. In type 1 diabetes there is total absence of insulin and blood sugar goes up, leading to atherosclerosis or narrowing of the small vessel in nerves, eyes and kidneys. But type II diabetes is a very complex metabolic disease. It is this type of diabetes that is rapidly increasing. The first thing that sets in is central obesity i.e. weight gain around the belly button and insulin resistance as a consequence. At this stage the cholesterol gets deranged with decrease in the good cholesterol HDL and increase in Free Fatty Acid and Triglycerides. These have a toxic effect on various muscles in the body, called apoptosis. This is also responsible for the damaging effect on the liver, leading to fatty liver and liver failure.The Cholesterol continues to get deranged and as a result we have disease and narrowing of large vessels in the body. A number of patients will present with Heart attack, stoke or kidney failure. There is further increase in insulin resistance as time goes on, leading to high insulin levels. High Insulin causes the BP to slowly and progressive increase and atherosclerosis or hardening of the large vessels to progressively get worse. So we have to remember that far before blood sugar rises in type II diabetes the vascular disease has started playing havoc in the body. When this process has gone on for 15 to 18 years then the blood sugars start to rise. We have a very casual approach to diabetes and it can cause significant damage by the time it is diagnosed. We should amtocipate the problem and start treating at Pre Diabetes stage. Dr. Narendra Gupta, Best Diabetes doctor in Delhi. Best Diabetes doctor in Gurgaon. Best Diabetes doctor in INdia
High blood pressure is also a fairly common life style disease which is getting more common. When we look at the blood pressure there are 3 numbers that come into the equation. Systolic blood pressure, which is the higher number and reflects the stiffness of the blood vessels which is also called hardening of the blood vessels or atherosclerosis. This is progressively elevated as we age. The second number is Diastolic blood pressure or the lower number. This is often associated with younger age and resistance to blood flow. This can be very high with narrowing of the blood vessels to the kidneys. The third number is the pulse rate. This can also affect the blood pressure. The higher the pulse rate the higher the blood pressure. Dr Narendra k Gupta, best kidney specialist. Best High blood pressure expert
Insulin is not the solution but the problem in type II diabetes. As you all know there are two types of diabetes. Type I diabetes, where there is total absence of Insulin production. Insulin is the key to their survival and will get very sick within days if they do not get insulin. On the other hand type II diabetes is an insulin resistant state with the production of insulin eventually fails to produce more in the presence of resistance to insulin action. The blood sure goes up about 15 to 18 years after the problem has started. It has become fashionable by doctors to give glucose reducing medicines, because we are myopically look at the elevated blood sugar. It is common for primary care physicians to give Sulfonylurea class of drugs and try to control blood sugar. Almost all patients will gain weight and the medication dose will have to be increased to control sugar and eventually when they fail, patients will be started on insulin. If you happen to go to an Endocrinologist he is more than happy to start you on insulin because it is all about sugar control. They have treated type I diabetes this way. However there is a far better way and that is to fix the insulin resistance which is the fundamental problem. Once we deal with this fundamental problem the need for Sulfonylurea and insulin progressively decreases to the extent that they can be stopped and life becomes stable and weight loss occurs. What is very important to realize that type II diabetes is a complex metabolic disease where diabetes, obesity, high blood pressure and high cholesterol coexist. Insulin at high levels in circulations promotes the high blood pressure and is a stimulant for the atherosclerosis which is the “Silent Killer” in type II diabetes. So I am here by providing hope to patients with diabetes to not only do well with sugar control but also reduce significantly the other problems that kills in diabetes. Insulin is not the solution but the problem, It is this high levels Best Diabetes doctor in Gurgaon. Best obesity expert in Delhi
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