Preventive Diet for Diabetes

Previously I wrote about the basic shift in perspective as far as diabetic diet was concerned. Today I will throw some more light on how a diabetic diet can be as valuable to anyone even without diabetes yet not a compromise on taste. The essentials to prevent diabetes through your diet and not as a cure to the disorder.

Don't be turned off by the fact that I am recommending a diabetic diet for all, because practically a preventive diabetes diet is what we all need given that we live in an ever growing stressful environment. Preventive therapy takes a lot of effort and because you really don't see the disease or disorder lurking around you don't even feel the effect it has on your body. Preventive therapy as in case of diabetes is your best bet than a curative one and you'd want to take my word for it. 

Prevent Insulin Resistance - Most of the diabetic cases now days arise due to lifestyle hazards and not genetically as is the myth that diabetes is an inherent disorder from generation to generation.  The reason for such lifestyle oriented diabetic cases that enter the type II or Non Insulin Dependent Diabetes Mellitus vicious cycle is because their cell membrane are laden with adipose tissue (fat) not permitting insulin receptors to bond with the insulin flowing through the blood stream of the localized organ. If more cells of vital organs or long limbs are fat laden insulin resistance of the body progresses into a full fledged diabetes mellitus. So how do we save ourselves from entering into this grave mouth of diabetes? Keep your total fat intake in the form of oil, animal fat up to 3 tsp a day i.e. 500 gm per month. Do not go into binging on empty caloric foods like sugar, alcohol, sweetened aerated drinks, sweetened anything. White sugar anyways is ageing accelerator so I would rather go sugar free and low fat. But just having appropriate diet won't qualify to burn the already stored fat, a moderate intensity exercise regime consisting of equal cardio to resistance training of 35 minutes each on alternate days a week is a must do.

Prevent Oxidative Stress - Well it goes without saying that the immediate reason that worsens diabetes mellitus or its anvil in our body is the ever increasing pollution of toxins due to stress, substance abuse, chemical environment, physical pollution like dust, unhygeinic conditions etc. These factors lead to accumulative oxidation due to free radicals causing more stress which is a chain reaction as explained in earlier post. Each one of us even kids are subjected to this oxidation in the body leading to multiple lifestyle disorders like diabetes, ageing, heart disease, neurological problems, liver disorder etc. Douse your system in fresh fruits everyday that is my pill to health and I keep repeating it. The next best way to prevent free radicals from causing damage to your tissues is via omega 3 and omega 6 fatty acids. Omega 3 and 6 fatty acids or better described as n3 and n6 are the modern world elixir to longevity present in tiny amounts yet very effective. Salmon, walnuts, pistachios, soyabean, trout, tuna, mackrel, rice bran oil, safflower oil, olive oil, fresh olives, any dry nut are great sources of n 3 and n 6 however the ratio of n3:n6 should be calculated by your registered dietitian while planning your diet routine.

Regularity of meals - This one fact is taken for a royal ride in today's scenario. If you are too busy to eat your food or snack in given time intervals do not pester people with your health issues and how you plan to start it next monday or the first day of next month or whenever. You need to make a simple choice, what is important to you pleasing yourself with the "I'm so busy" line or pleasing yourself with "my health is first, rest can wait" attitude. Regular meals gives insulin secretion a flow and regulates the body's metabolism to perform optimally not stting it off the track to go into a sudden jerk every now and then. When your body functions in rhythmic manner fat, protein and carbohydrate metabolism work in sync with each other and the opposite is also true which leads to the body always storing fat to save itself from the starvation you impose on it everyday and then a gush of fatty food immediately afterward. Regular meals regulates insulin thereby regulates carbohydrate metabolism giving sufficient energy to the body hence regulating fat and protein metabolism. Erratic habits of eating can land you into insulin resistance. Eating every 3 hours between breakfast to dinner is a non compromise. The hour gap between your dinner to next day's breakfast should not exceed 10 hours no matter what.

Get this in line you won't see the face of diabetes ever let only any lifestyle disorder. If you think you can't follow these basic principals without compromising on the palate well do I have some surprise for you ? But for that you'll have to wait for the upcoming recipe posts. Till then...

Wish you wellness.

Share|

Diet for Diabetes - A Shot in the perspective - I

Shot in the perspective or mind is a very appropriate phrase I could use in the title whenever "Diet for Diabetes" is asked. I am equally fed up of so many farce diets by not qualified people are sprawling over the net since time it all started. For a percent of diabetic patients you will always have 99 % advisers around them to speak on what diet will 'cure' them or rid their diabetes off, or even is 'good for diabetes'. As a health professional who has done more work on multi factorial disorders and diseases one such being diabetes I can safely speak on behalf of all registered dietitians that there is a lot people need to understand with regards to food and lifestyle habits whilst controlling the blood glucose levels and insulin levels. Today I teach you what exactly are the key pointers you need to understand, accept and adapt towards diabetes mellitus.
1. Sugarbabes - Well you can forget about it totally!!! C'mon you didn't have to land on this blog to know that for a fact. Trusting by now you know your blood stream is filled with excess sugar your body doesn't know how to dispose off, sugar is the last thing you need to think of. But what you could do is replace it with sucralose derivatives as a sugar free option. Make sure its not aspartame or saccharin. Your body does not need sugar right now it needs instant energiser try giving it the energy it needs by supplementing with complex whole carbohydrates instead of simple sugars. That brings us to our next point.

2. Carbwire - There is a lot spoken, written and heard about carbs and their role in diabetes but really do people still get it ? First of all leave the calculations of the diet to a dietitian and no other professional. Secondly your senses should ward you off from anything white in colour (My reasoning doesn't aim at the colour white but what it indicates 'refine') because that only translates the carbohydrate source is refined. We are looking for whole carb source like unpolished, unprocessed, and not cut into minuscule pieces by means of well refinement again. We are talking about brown rice (looks red striped), whole wheat flour, whole wheat porridge, whole wheat breads and pasta. Why whole ? What whole foods add on is fibre (soluble or insoluble) and fibre absorbs excess fat, slows the food glucose to enter the blood stream through the intestinal wall slowing and steadily. It doesn't let a gush of glucose into the blood to have a galvanic release of insulin leaving your body unbalanced and no less of tortured within trying to adjust to the shock effect. You also want to replace all simple sugars with whole fruits, again for fibre but more so for the antioxidant infusion in the system. We have previously gone through the effects of oxidative stress in diabetes and we sure want to counter that as much as possible.

3. Flushing oxidative stress - More than anything after you have dealt with the sugar free diet you need to flood your blood stream and other tissues with antioxidants. Your numero uno enemy isn't diabetes but the oxidative stress that accelerates with it drawing you closer to complications. Oxidative stress although present in non diabetes condition as well can be combat with atleast 4 fruits a day and that does not equal to preserved fruits or juices, squashes, syrups. Real fresh fruits whole from the orchard. We are also keen on consuming through the day at least 3 nuts (almond, walnut and apricot) and for those who are by now gasping "nuts are high on fat", well good news 3 nuts a day won't burden the fat metabolism infact it might help it contrarily. Omega 3 and 6 fatty acids are responsible for lowering your oxidative stress affecting the lipid in the blood stream therefore nuts are a must. Then we bring ourselves to the veggies, 3 grand helpings (bowls) of either raw or cooked veg, could be salad, main course, sandwich, but of course wholesome and not heavily bruised in soups and juices. The purpose of not consuming juices and soups is not to stuff your stomach but to fill it with real bio-enzymes from produce and that can happen when you eat them whole or raw (as possible).

4. Grease Machine - What happens when we come to creme de la creme topic of all diets. Fat. Our focus is not only to curb out excess from the body or from deposition into the body through slow metabolism but also to form a protective medium for nutrients to be transported. I use it in my everyday lifestyle diabetes or not this is a thumb rule for anybody, stick to vegetable source only, blend oils with 20% - 30% Rice Bran Oil with 80 - 70% Pufa or Mufa rich oil like groundnut, sunflower, soyabean, safflower. If you are to use olive oil then I would recommend that you do cook some food in the blend oil since olive oil is MUFA ladden and way to long term consumption of MUFA isn't good news for HDL levels on long term. Lets keep that in mind and constantly use blends as well with olive oil. If you have to under unforeseen contingencies have to eat fat other than what I just recommended, please ask for non trans fatty acids like hydrogenated vegetable fat. Those are a strict NO- NO. Another golden rule keep it under 3 tsp a day and you are good for life. Yes its more than possible to cook regular meals in 3 tsp per person per day, so stop excusing yourself from it.

Keep these basic four pointers in mind and chant them like a mantra if you have to until you get the hang of the same. There are more intricate details of a diet therapy in diabetes which I will discuss in my next post. Till then,

Wish you wellness.

Share|

Neurological complication in diabetes mellitus

There is very little one can do once the nervous system is affected in diabetes mellitus. The nerves once degenerated cannot regenerate nor can new nerves be generated. Therefore diabetic neuropathy is considered a highly difficult complication to deal with. Firstly you need to understand that the complication develops over a period of 10 -15 years so it is already tough to follow through its development stages. But of course one needs to know what can get you there and what needs to be taken care of.

Lets enlist what can go wrong from lowest risk to highest. Well, its a diabetic complication so there won't be less risky either way you look.
1. Tingly Wingly - Not a very good thing if you feel tingly on your arm and shoulders or even your feet. The first sign that you need a neuro consult ASAP. Tingling of the body parts indicate that the nerve endings are degenerating or damaged or lack oxygen and are incapable of completing the neuro transmission to the next nerve ending.

2. Loss of sensation - Take your foot and take pricky but blunt object and try to poke the sole of the foot. When you feel the prick thats normal where you don't it indicates there could nerve damage. Again we now know how diabetes damages organs like in the previous posts. The same is applicable to the nerve ending.

3. Gangrene like degeneration - This may even be gangrene but it is not due to the bacteria clostridium perfringes, although it is due to the anaerobic cell metabolism that leads to muscle loss and nerve damage in the localized area of the extremeties. This is serious to an extent where the body part or limb needs to be amputated. This may spread further and worst is being painless you don't realize it unless its late. It is also complicated as diabetic foot but thats due to harbouring of the bacteria in the lower extremity due to unhygeinic conditions and excess blood sugar acting as good nutrient for the micro organism.

4. Stroke - Neurological damage can range anywhere any how and it need not be only in a localized form. Stroke being the deadliest as its permanent major damage to the body and very few cases recover from it. Stroke is one of the top 5 causes of death worldwide and diabetes is one of the top most reasons for its cause of course heart disease included. Stroke is a result of the oxidative nature of the free radicals in the blood and heart disease clogging the blood supply to arteries in the brain area.Stroke can do damage to vital organs like heart, lungs, kidneys and liver not to mention the brain and spinal cord which in turn cause death.

Although it seems pretty dry as a topic to read about the parameters of stroke or neural damage are huge and need to be explained seperately later. Till then take care.

Wish you wellness.

Share|

Save your heart from diabetic chronic complication

So in the previous post I explained exactly how the chronic complication of diabetes leads to Congestive Cardiac Failure. But there are stages of heart disease in its progression that you must be aware of to trap it at an early stage to save your heart from collapsing due to severe pressure. Here goes the list of stages of heart disease.....

Hyperlipidemia - Its simply means high lipid (fatty acids) levels in the blood. Hyperlipidemia is a sheer result of extremely high fat intake in the diet, lack of exercise, lack of adequate rest, inadequate fat metabolism in the body as a result of the earlier reasons. Lipids like triglycerides (TG), choline and lipoproteins whose levels rise in the blood due to improper fat metabolism of the adipose tissue that stores fat in the body and excessive fat intake in the diet. These lipids go on to form what we commonly term as cholesterol like LDL (bad), HDL (good), VLDL (extremely bad). A rise in blood lipids should be a warning sign at the first instance to cut down on fat and excessive simple sugars in your diet and regulate insulin levels in the blood. It would also indicate in patients suffering from diabetes of the unbalanced blood sugar levels.

Hypercholesterolemia (> 240 mg/dl) - The next step forward to attaining the good 'ol heart disease in diabetes is hypercholesterolaemia. As mentioned above the fatty acids like TG combine with lipoproteins, choline to form a very low density lipoproteins or VLDL. A rise in either TGs or VLDLs is a strong indicator of a possible hypercholesterolaemia in the next 48 hours or more as these go on to form low density lipoproteins or LDL. If the TGs and VLDLs are well within levels they will form high density lipoproteins or HDL (we all have known it is the good cholesterol). Whether the body has more HDL to LDL ratio or less will determine if it goes into hypercholesterolaemia. The standard acceptable ratio of Total cholesterol : HDL is less than 5:1.

Hypertension - With the progression of high cholesterol in the blood hypertension or high blood pressure is not far behind. Hypertension would be influenced by many factors like high blood viscosity due to high blood sugar & high cholesterol levels. But majorly the high blood pressure is the outcome of the hardened and constricted arteries due to cholesterol plaques near the heart. This hypertension in turn puts even more pressure on the already burdened heart for blood circulation. Higher the blood pressure more the chances of chronic complications in diabetes percolating to other organs like brain, kidneys, eyes and lungs. The haemorrhage that can possibly occur in any of these organs can prove to be as fatal as a stroke or failure of the organ.

Arteriosclerosis - When smaller arterial walls have cholesterol plaques as mentioned in the previous post the condition is called arteriosclerosis. Sclerosis literally means hardening of soft tissue. This condition when occurs near vital organs can cause damage and thereby death due to lack of oxygen.

Atherosclerosis - When arteriosclerosis occurs in the coronary arteries supplying blood to the heart and larger arteries with atheromatus plaque (lumped, calcified and large) it is termed as atherosclerosis.

Cholesterol Embolism - Sometimes the cholesterol that forms plaques on the wall of arteries can get dislocated and be carried by blood to other organ. This proves to be clogging of the blood vessel of the other organ and causes purpling and marbled effect of the tissues due to lack of blood circulation in the area thereby lack of oxygen. If the organ to receive the embolic cholesterol is lungs or brain or kidney it could mean damage to their function.

Myocardial Infarction ( Heart Attack) - Well we're almost there to reach a cardiac failure but MI or heart attack as commonly known is more of a symptomatic incidence than a condition. All the above factors accumulate for a heart attack to occur. It is the alarming red alert given by the heart to the body of its inefficiency to circulate oxygenated blood. The blood supply to the heart is clogged, mostly deoxygenated, lactic acidosis driven and the muscles are nearing wastage due to all these reasons. The heart attack is when the left ventricular muscles undergo tremendous pressure while contracting and collapse giving out excruciating pain (angina) through the upper left side of the body. If not first aided well it could also instantly lead to stroke.

Cardiac Arrest - Final curtain call of the heart's life. Once all is said and done by your heart to alarm you as much as it can about its suffering condition through the months it gives up, leaving no time and death assumes.

Although this progression need not be experienced by anybody who suffers from diabetes or doesn't. Since a diabetic patient is suppose to be well informed about its lifestyle changes at time of diagnosis itself. However we still continue to see more medical deaths in the world due to heart disease even though controlling it is the easiest as it can be.

Wish you wellness.

Share|

Diabetes and the chronic complications - Heart Disease

Previously I had written about the acute complications of diabetes mellitus and today I will start a series of blog posts throwing light from my experiences about the chronic or long term complications of the disorder. Chronic complications and its therapy is very close to my life as a wellness coach it has been my subject even when I was doing my post graduate research work on the diabetes. So I will begin with a long term complication thats close to every one's heart - Heart Disease.

While we all know the cause & effects of heart disease and also why and how it occurs, you need some clarity over how it all starts in a diabetic condition of the body. Well diabetes as I mentioned in earlier posts too isn't the killer its an open invitation to all the diseases that can occur in the body. So what does diabetes aid in to call upon its dear friend heart disease to come and visit for a longish holiday ? We're about to find out. You remember I had written about stress in diabetes previously, well that is the biggest crack in the pandora box. During the progression of diabetes over the years the metabolic stress causes oxidation of the biomolecules by means of free radicals. Free radicals or molecules with extra electron or oxygen molecule with extra electron act as stress producing agents in the blood and in the tissues. How do they do that? Well for starters lets take a peek into our blood stream where along with the usual molecules that constitute the blood (proteins, cells, platelets, gases, fatty acids, cholesterol, antibodies etc) there are molecules that are desperate to react freely with the other constituents of blood. The reason they are so desperate to react or as we chemically put it are highly reactive agents, is because they carry that extra electron which is not necessary for them. In order to rid them of the burden of carrying that electron they seek molecules to accept this electron so as to be oxidized. This reactivity is then passed on to whoever gets that electron leading to a series of reactions amongst molecules either of the same biochemical function or different. This reactivity passing on the electron like playing passing the parcel leads to high reactivity of the all those molecules in the way and accumulates sheer chaos in the blood stream of that part of the body. Chaotic situation leads to stress, stress leads to fatigue after a prolonged time and fatigue leads to collapsing of the body part.

Same is true for development of heart disease in diabetes. After a prolonged uncontrolled hyperglycemia or blood sugar levels there is enough stress accumulation due to the oxidation reactions in the blood stream. This stress leads to the highly reactive oxidated - LDL (bad cholesterol) from the LDL in the blood to create plaques on the walls of the coronary arteries. How does it do that ? It simply damages the wall by reacting to it since its only purpose in life is cause severe reactivity with anything in its way thanks to that oxidized electron it has received. So the sooner the plaque is formed there comes a boat load of other constituents like serum protein, antibodies, platelets, more fatty acids like triglycerols, VLDLs, etc to an extent where these all begin depositing themselves into the dented artery wall. Now the deposited debri of the blood on the wall hardens over a period of time casing the lumen of the artery (passage for blood to flow) to contrict. Remember we are talking about the Coronary Artery here (the one that supplies oxygenated blood to the heart). Which only means that if the heart which pumps oxygenated blood into the body is itself falling short of the same supply how will it carry out its primary function? Its like your fuel provider hasn't had its share of fuel so that its efficient to provide fuel to others. When the arterial wall hardens the supply of oxygenated blood suffers slowly and steadily to an almost trickle. As this condition progresses the high sugar levels in the blood do not help the situation as the body is perennially exhausted and needs oxygen and fuel constantly to combat the burden of burning subsidiary fuel for energy. In addition to that the heart is exhausted to an extent where at one point it starts regurgitating blood in the opposite direction causing fluid accumulation in the body, lack of enough oxygen, no glucose for fuel, and only toxin filled blood to live by. This gives birth to another common chronic complication of diabetes - Chronic Kidney Failure, but that is another post. When the heart has given up the condition is called Congestive Cardiac Failure (CCF). It is so named as the heart is congested with blood and is not physically any blood from its left ventricle into the body. The entire blood circulation is congested with no fresh blood coming in and water accumulation taking place.

There are however many stages of heart disease where you can stop this final stage to occur and sometimes the heart gives up due to excessive sugar levels and stress and succumbs to cardiac arrest instantly. But if you trap the condition at stages of Hypertension, Hypercholestroleamia, or even the first heart attack you can still save the heart from arrest. I will enlist and explain the stages of heart disease upto CCF in my next post, till then if you have any memories or questions regarding the topic please comment or write to me may be we can find a solution for you or your loved one.

Wish you wellness.

Share|

Acute Complications in Diabetes Mellitus

Previously I explained how is the metabolic stress in our body caused in Diabetes. Today we see the acute stage complications in Diabetes caused due to this metabolic stress. When I say acute stage complications it is immediate reaction of the body to high blood sugar or lack or increase of insulin/ drugs. In this case scenario the body gives no time and can sometimes go straight into coma. There have been cases where coma is bypassed into sudden death as well. The acute complications of diabetes mellitus are Hyperglycemic Hyperosmolar Non- Ketotic Syndrome , Hypoglycemia, and Diabetic Ketoacidosis. Let us go through the pathophysiology of each separately.

1. Diabetic Ketoacidosis - This is seen mainly in diabetes type I (complete lack of insulin secretion) or sometimes even type II (insulin resistance induced or inadequate insulin secretion). It is a fatal complication and can directly lead to death if undiagnosed or untreated. As I had previously mentioned ketoacidosis is a stage when the body breaks down fatty acids in the absence of glucose. Since the breakdown of fats is an anaerobic activity it is incomplete which leaves behind ketone bodies in the blood. Ketonic accumulation in the system leads to high acidity of the blood. Ketoacidosis leads to vomiting, dehydration due to the excessive urination and water accumulation in the blood vessels, ketone bodies also have an effect of disorientation of the brain leading to a state of confusion. There exist abdominal pain and a palpable abdomen, excessive thirst and deep labored breathing. The other symptoms are fruity odored breath and urine (ketone bodies smell fruity). Therapy requires immediate intravenous hydration and insulin dosage to prevent more ketone formation.

2. Hyperglycemic Hyperosmolar Non-Ketotic Syndrome - Although the name is too long it simply means dehydration of the body tissue without any ketone formation. Like the Ketoacidosis the high blood glucose level reaches a point (> 600mg/dl) where osmosis leads to the water in the cells (tissue) to come out into the blood vessels just so that the solute : solvent ratio is maintained on both ends. However due to extremely high glucose levels in the blood the water shift from the cells to the blood is quite high leading to extreme dehydration, polyuria. This leads to disordered mental functioning, confusion, tremors, and could also go into coma or death. Ketone formation is inhibited due to some insulin presence.

3. Hypoglycemia - One of the most dreaded conditions in diabetes is low blood glucose levels. Due to inaccurate insulin therapy or over dose of diabetic drugs the blood glucose level may hit an all time low. This leaves no glucose in the blood to be metabolized for energy. Due to lowered levels in the blood of glucose the body is depleted of any energy source. The brain takes the first hit where a state of dizziness sets in and leads to coma or unconsciousness.

Treating acute complications of diabetes is extremely important especially with the paucity of time given by the body. When the nutritional and pharmacological therapy of diabetes mellitus are balanced with each other this stage will not be experienced. Next post would be on the chronic complications of diabetes. Let me know through comments of your experiences with the disorder or contact me to know more about it.

Wish you wellness.
Neha Wasnik, R.D

Share|

Metabolic stress in Diabetes Mellitus

It is a well known fact that Diabetes Mellitus otherwise known as DM is a metabolic disorder caused due to the inadequacy of insulin hormone. Metabolic disorders like this one brings in metabolic stress along with it needless to say. However it takes a real long time before the body starts giving out symptoms of this built up stress. What we need to understand is what are the implications of this metabolic stress caused due to DM and how does it all begin? This dual question takes us back to the previous posts of understanding Diabetes Mellitus.


Now lets understand the stress caused in our metabolism due to DM. Stress is caused due to accumulation of reactive oxygen molecules or free radicals in the body. In diabetes this is usually caused by the metabolic impairment of fat and protein metabolism. Due to the resistance to insulin especially in the muscles, liver and fat cells or adipocytes there is increase in free fatty acid deposition in the skeletal muscle cells, this impairs the cellular or mitochondrial energy molecule formation in muscles leading to anaerobic energy formation. Due to the release of free fatty acids on improper fat metabolism to generate energy, there is increase in reactive oxygen molecules forming reactive lipoproteins in the blood or oxidated VLDL or LDL (low density lipoprotein a.k.a bad cholestrol). Oxidated LDL and is the key to the formation of arterial plaques leading to the much infamous atherosclerosis or blockage in the coronary arteries.

Free radicals aren't so easily removed from the body as they tend to engage other molecules with them to cause major damage to the tissues in a matter of time. Fat metabolism impairment due to resistance to insulin and lack of readily available glucose molecules to enter the Kreb's Cycle which eventually generates energy in our body leads to the overall metabolic stress caused by the reactive oxygen molecules attached to fatty acids or even protein molecules. Now there is another metabolic stress built up on the side while the free fatty acids and protein molecules are on play and this is due to ketoacidosis. I had earlier mentioned about diabetic ketoacidsis when due to the incomplete breakdown of fats to generate energy there is a formation of ketone bodies or molecules which are the end products of the incomplete fat decomposition cycle. This cycle palys fatal to the liver, kidneys and brain as the level of ketone directly harmful to kidney and brain rises. Primarily this cycle comes to play if the body is thoroughly malnourished and is left with no option but to enter the fat decomposition cycle. Now I have witnessed people fall prey to this and with adequate insulin therapy and nourishment being monitored on an hourly basis this can be reversed. However the danger of this stage is something you don't want to see. The metabolic stress developed with ketone bodies causes disorientation, high acidity in the blood and kidney failure too which inturn is sufficient for the entire body collapse including heart and lungs.

Metabolic stress in DM has major and direct implications on vital organs like kidney, liver, heart and the lungs too. Due to the increasing free radical formation there is an obvious enagagement of visceral or central organs and tissues causing them regular and consistent damage. If the levels of these free radicals isn't controlled physically and biochemically there is no doubt that a major secondary complication will arise soon. I will discuss about the acute complications of Diabetes in my next post. Till then if you have anything about diabetes you want me to write on please leave a comment.
Wish you wellness,
Neha Wasnik
R.D
Related links - Diabetes

Basic metabolic changes in Diabetes Mellitus

Previously on Wellness and I the disorder of Diabetes Mellitus or DM was explained. But as mentioned earlier DM is the metabolic disorder and it largely determines how your body will function there after. Today I will share how to understand DM by knowing about its metabolic changes in the body.
DM as mentioned earlier occurs due to inadequate or complete lack of insulin hormone from the pancreas. This in turn leads to accumulation of glucose molecules in the blood as duely explained previously. This alone changes the original metabolism of our body, but forcing the cells to look out for other sources of energy already stored or easily available in the blood. There are 3 major energy producing biomolecules our body can utilize, viz carbohydrates or sugars, protein or protein molecules and fats. So now due to the unavailability of glucose for the cell it is forced to burn either the fat or the protein whichever is easier. Our body is also a smart piece of engineering designed to save itself first and burn out for the last and that is why it will go for fat deposits in the body before it can burn protein molecules as they are vital for basic functioning of the organs and tissues. However burning up fats doesn't seem to happen completely in the body and it leaves behind at the end of the metabolic cycle keto acids or by products that are not metabolised properly to be ridden from the body. If they start accumulating it can go on to be fatal for the brain and liver. There comes this time where the body can choose to metabolise protein molecules if there isn't enough fatty deposits in the body, this causes rapid increase in the blood acidity and muscle wasting which then weakens the already energy depleted body. As muscle and bone protein form the basic structure of the body if they get utilised to run the body energy station can you imagine how weak our basic structre would become?

You must now wonder if all this is a natural option chosen by our body if it becomes diabetic or doesn't secrete insulin enough how is it that people suffering from it before being diagnosed appear and live so normally without having problems? Let me throw some light on that one again as I mentioned earlier the body doesn't let it all go untill it can't handle the situation anymore, so its obvious why the symptoms aren't out there for all to see at first. But yes if ignored all hell can easily break loose to the outside. Another part of the metabolic change is the blood content that changes with the growing sugar content and rapid increase in the acidity. The requirement for the water content due to increased solutes in blood shoots up leading to increase in thirst constantly. Due to the breakdown of fats and some protein in the body with the lack of sugar content the body constantly craves for nutrients and hunger pangs increase in rapid succession. The depletion of energy deposits lead to loss of body weight. The idea to keep the metabolism in control is to first get a calculated diet plan and follow it to the TEE as there isn't any other choice and get your medication on time. Controlling the hunger and the wastage of the body can go a long way in dealing with the basics of metabolic changes in diabetes.
There is more on metabolism that we need to understand in diabetes which will follow in the next post.

Wish you wellness,
Neha Wasnik
R.D

Diabetes Mellitus : Bitter sweet tale

This new series of my blog is dedicated to the reason of my being, my grandma who passed away yesterday due to heart failure secondary to diabetes.

Everybody in this world has a story to tell with the subject of Diabetes in one way or the other. We all somehow have been intertwined into this bitter sweet symphony of life called Diabetes whether its in a childhood form or adult form. Some more unlucky of us have lost the dearest parts of our life to it and some are awaiting to face that dreadful moment. I have unfortunately lived through it recently. I am about to share with you through this new series on Diabetes the various obvious things to prevent if A) you or your dear one is diagnosed with Diabetes Mellitus (DM) or B) you would want to prevent lifestyle developed DM.

Diabetes Mellitus or DM as I would refer to it often ahead is an adult onset metabolic disorder of the hormone insulin secreted by the endocrine cells of the pancreas. Insulin to put it in simplest of metaphorical terms acts as a visa for every glucose molecule in our blood to enter any cell. The passport being the sodium molecule which acts as active transporter of the glucose into the cells of the body from the blood stream. To understand how it all occurs or even how it all goes wrong in the case of DM imagine our body cells to be a foreign land and the blood stream to be the airports, glucose molecules as people and sodium channels being airplanes while sodium being the passport carried while boarding the plane, insulin is the visa that needs to be validated before entering the airplane to go abroad. Now imagine what happens if you have the passport but don't get your visa validated at the immigration desk? What happens if there is no visa validation at all for anybody at the airports across the country? What happens to the airports' premises if people are stamping over the other but get no visa to board the plane? Can you see the chaos at all airports bursting out at the seams with people? This is what happens outside every cell in our body when there is lack of insulin secreted or too inadequate to help glucose enter the cell. The glucose molecules start accumulating outside in the blood stream unable to enter the cells to generate energy and hence fuel for the body. This increases the viscosity of the blood and hence the blood pressure over a period of time. Due to the increased pressure there is an increased demand on the heart. Our body is engineered to absorb as much stress to a certain extent without disturbing the outside environment of the body and it is this ability of the body that prevents the diagnosis of DM too soon untill of course the body starts letting out symptoms.

DM like AIDS is not the threatening reason people die but because these disorders easily bring in the diseases that cause death. It is never the immediate cause of death but it sure is the easiest way to introduce it to the body. DM is known to have secondary complications the primary being ophthalmic, kidney failure, heart disease, stroke, skin disease, diabetic foot. All these secondary to DM ailments are the reason for death due to DM not DM alone. Its only when the body goes into ketoacidosis due to extreme acidity of the blood raised by the incomplete breakdown of fat instead of glucose in the body, does it lead to death.

Diabetes alone can be easily kept under control with lifestyle adaptation however it is the general myth that it can be ridden out of our body that needs to be clarified. Insulin secretion stops from pancreas naturally or due to obesity where the fat deposition exceeds on the cells making them resistant to insulin uptake. If insulin secretion stops or is inadequate it will result into diabetes mellitus and that is permanent. However, if that is the diagnosis it should not be necessarily taken as if you were handed your death certificate but instead as a chance to survive keeping your life as normal as it were with some mandatory changes in lifestyle. In the next part I shall reveal more obvious truths about DM and busts some myths too.

Wish you wellness,

Neha Wasnik
R.D