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Best Diabetes doctor. Best Kidney specialist. WHAT IS DIABETES? Its full name is Diabetes Mellitus, but it’s generally called Diabetes. It is a medical term for a group of chronic diseases in which the body fails to complete the conversion of certain foods into energy. Normally, during digestion, the body changes sugar, starch, and other foods into a form of sugar called glucose. The blood carries this glucose to the body’s cells, where, with the help of insulin (a hormone produced in the pancreas), it changes into quick energy for immediate use or storage for future needs. This process of turning food into energy is crucial, because the body depends on energy for everything from thinking to physical activity. In Diabetes, the food is turned into glucose readily enough but cannot enter the body’s cells as lack of insulin production or its effect on the cells in the body. The most common forms of Diabetes are Type I and Type II. In Type I, the person’s pancreas does not produce enough insulin so the supply of glucose can be used. As a result, very high blood sugar and other metabolic abnormalities occur. In the absence of insulin, the metabolic abnormality is quite severe. As a result, these people are picked up quite early because of their symptoms. In Type II, the pancreas produces enough insulin, but the body’s cells can’t use it properly. This means that the unused glucose once again causes high blood sugars. Prevalence of Diabetes in The United States There are about 18 million people with Diabetes in the United States; half of them are still not diagnosed. About 90-95% of these people have Type II Diabetes. Diabetes and its complications are the sixth leading cause of death in the United States, outranked by heart disease and cancer. Diabetes is a major cause of blindness in adults, and causes diabetics to suffer heart attacks twice as often as non-diabetics. The life expectancy of those with some form of Diabetes is one/third shorter than the general population. The most important thing is to recognize Diabetes early so the treatment can be started before the disease has had a chance to damage your health.
PCOD, PCOS Polycystic Ovarian Syndrome is a common complex metabolic disorderin young females. It is an insulin resistant state that is also responsible for type II diabetes. It is going to be seen more often and often poorly treated by doctors, because it encompasses dermatologic, gynecological, endocrine and psychological problem. Only a physician who can look at it holistically can completely treat PCOD properly. In this condition a garland pattern of cysts develop in the ovary and start producing abnormal hormones. Excessive hair growth on face, chin, lips and other parts of the body is very common. As a result patients end up in waxing parlors and laser clinics. This can be devastating for a young female. All these treatment are not going to be successful, unless the hormonal imbalance is resolved in PCOD. While at the same time male pattern baldness and thinning of hair is very common. Acne is another traumatic experience and sometimes may be very severe. Again they will see a number of dermatologists for acne, but proper treatment of the hormonal imbalance will give very gratifying results. There is also associated black pigmentation on the face, neck, arm pit and other parts of the body. One of the common problems is central obesity associated with menstrual abnormalities in young girls and women. As time goes on this leads to infertility and patients end up in fertility clinics for IPF ( In Vitro fertilization). But only when the metabolic derangement is resolved, fertility is assured even without the expensive procedure of IVF. The irregular bleeding can be very embarrassing and may lead to anxiety and depression. Emotional distress ranging from anxiety to depression is very common. Hence in the treatment of PCOS an experienced physician in this area is crucial for the success of medical treatment. Eventually patients will go on to develop type II diabetes. For more information, please visit www.diabeteshypertension.com Dr Narendra K Gupta, Specialist in PCOD. Best PCOS doctor in Gurgaon and Delhi
Diabetes is of two types. In type I diabetes, there is total absence of Insulin and hence the blood sugar derangement, quite extreme. As a result they will get admitted to hospital at the time of diagnosis. Insulin injections are a life savior and a must. They require a long acting insulin called basal insulin and a meal time short acting insulin. It forms 3-5% of Diabetic cases. Best diabetes doctor. Best hypertension doctor.
Medical treatment of Diabetes. There are two types of diabetes. In Type 1 diabetes there is total absence of Insulin production. Hence life is dependent on Insulin for these patients. The patient gets very sick, if the insulin is not taken for a couple of days. Usually we use two types of insulin. A basal insulin which takes care of the daily metabolism of the patient and a meal time bolus to cover the rise in sugar with meals. Once we figure out how much the patient needs, we have to adjust their doses depending on type and quantity of diet and exercise. Type II diabetes which accounts for 95% of diabetes patients, is an insulin resistant state with a relative decrease in insulin production in the presence of insulin resistance. Most doctors are inclined to treat this as a sugar diabetes problem. As a result are caught up in chasing the sugar with insulin or Sulphonylureas drugs. But this is a silent vascular disease and a “silent killer”. This is a complex metabolic disease. It is a combination of 4 major abnormality often referred to as the “terrible quartet” comprising of central obesity, high blood sugar, high blood pressure and a complex cholesterol abnormality. It is pivotal in type II diabetes; we address all four problems simultaneously. In order for the patient to do well, we must look at the patient holistically. Doctors need to assess the blood pressure, pattern of Cholesterol abnormality and fix their insulin resistance. Chasing the sugar, is a myopic approach to sugar control and increase in weight. Patients continue to gain weight and we keep increasing the dose of the medicines. Finally the patient is put on insulin and the patient never succeeds but continues to being a victim of diabetes and continues to have vascular events like, vision deterioration, stroke, heart attacks, kidney failure and amputation of the limbs. But today we have good medicines for insulin resistance, vascular-protection, cardio-protection, eye protection and kidney protection. Patient can be helped with good and appropriate treatment to become a “victor” and have hope of a better tomorrow. The doctor must spend the time to listen and assess the patients needs and a customized approach of medical management can reduce complications and perhaps reverse some of the complications that have already happened. Diet and exercise and life style modification will always play a pivotal role in the final outcome. For more information please visit www.diabeteshypertension.com. Dr Narendra K Gupta, best diabetes doctor in Gurgaon and Delhi
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
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