Management of Diabetes is a team effort- Dr. Ramesh Doddanavar

Diabetes Life style – Webinar

Dr. Ramesh Doddanavar, Senior Physician, Diabetologist & Managing Director of Deccan Health Care Centre, Belagavi, well-known name in Diabetes management and dynamic speaker, teacher of eminence, an astute physician with long experience conducted a webinar and interacted with Doctors, Diabetic patients & family members.

High blood sugar in civilized society is a cause of concern. We are 2nd highly diabetic population only next to china. Advances in age, drastic changes in living habits, variations in food habits, sedentary life styles, increase in mental stress, poor family bindings, social disconnect, etc are emerging in escalation of Diabetes in India. The new trend of Obesity is another indiscreet factor chasing young population. In the year 2015 – 7 cr Indian were diabetic, presently above 8 cr are victims of diabetics.

Who are likely to develop Diabetes?

Dr. Ramesh Doddanavar identified that; screening is important for early detection of diabetes. In western population beyond the age of 40 years. For Indian population those who are above 30 years should screen for diabetes at least once in 2-3 years. Those who are Obese, Hypertensive, high cholesterol, family history of diabetes should screen for Diabetes every year. Dr. Doddanavar advised for screening for early detection and initiating quick treatment. He further asked the ladies during gestation who have given birth to large weight baby should go for screening. Those succumb to repeated infections, non-healing ulcers, UTI, TB, early you detect and treat, future complications can be avoided. Further, whose BMI beyond 19-24 should go for screening.

Once Diabetes is detected the patient should visit a Physician and get his all-associated organs like kidney, eyes, heart, neurologic conditions examined by specialist. Dr. Ramesh in the webinar alerted the diabetic population by stating that Diabetes is a silent killer, it may not do much harm initially but long term complications of Diabetes are catastrophic in nature and needs regular visit and treatment as it is a chronic disease.

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Diabetes Management is a team work:

Dr. Ramesh said that Diabetes management is not a single man show. It is a multi-disciplinary team work. It has two components No.1.- Diabetic Management team (Doctor team consists of Diabetes Specialists, Dietician, Foot care specialist, Eye specialist, heart Specialist’s, etc) No. 2 Diabetic and family members. If, both the teams work in conjunction with each other half the battle against diabetes is won said Dr. Doddanavar. It is a progressive disease needs lifelong treatment to avoid complications arising out of diabetes. He recommended a visit to a doctor, once in two months to those whose sugar levels are in control. In case of uncontrolled sugar levels visit to a consultant twice in a week is recommended. He also urged for self-monitoring of sugar levels by glucometer, He insisted to note down all sugar level readings and maintain log book.

Answering to a query on Management of Diabetes- In simple terms he put forward;

The four wheels of chariot in management of diabetes are;

  1. Diet
  2. Exercise
  3. Medicines
  4. Monitoring of sugar levels.
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What to eat how much, when?

Dr. Ramesh said usually we Indians consume food rich in carbohydrates. He advised to reduce carbohydrates. High protein is accepted except in renal cases. He advised to avoid fruits like chikoo, banana, mangoes who are rich in sugar. Apple, papaya, pomegranate can be taken, he also stressed for reducing salt intake. Curds, butter milk, salads can be taken. Dr. Doddanavar cautioned, religious sake fasting may have adverse impact may present in the form of low sugar levels. Over eating after breaking of fasting will result in an increase sugar levels. He asked the diabetic population to consult a doctor before fasting. He recommended equal meal at equal interval; No prolong starvation. He gave simple time table for food intake;

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  • 6 am – Green tea/ coffee without sugar
  • 8 am – breakfast & fruit
  • 1 pm- lunch with salads, all types of vegetables, avoid potato may be allowed once in week.
  • 4 pm- coffee/tea/ tea snacks
  • 8 pm – Dinner (early dinner)
  • 10 pm a glass of milk – to avoid night hypoglycemia.

He said – AVOID- Noodles, Burgers, Samosas, Pizzas, etc are very bad for health. Deeply fried food with spices, soft drinks should be avoided. He raised his concern in increase in trends of computer savvy youngster’s late night eat outs of fat rich food and glued to computers for long hours may present in obesity needs immediate attention.

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Recommendation of Exercise regimen:

Daily aerobic 20 mins, yoga 10 mins, mediation- 10 mins, cycling, swimming, gym, etc. Joining of laughing clubs, socializing with friends and relatives, adopting positive attitude may reduce stress and keep sugar levels in control. Dr. Doddanavar asked the women in folk particularly prolonged sitting in front of TV is harmful may present in early onset of diabetes. He advised to work more, walk more. Small disciplined initiatives like doing your own work, frequent get up-walk, avoiding use of lifts will benefit a lot said. He also advised to perform small house hold chores. He also cautioned not to venture for heavy jogging, power exercise, weight lifting. He advocated to develop good habits like reading, don’t watch mobiles 30 mins before going to bed. Adopting being with nature, bird watching, relaxation techniques etc will reduce stress in turn benefit in keeping the diabetes under control.

Treatment;

Treatment of diabetes involves Oral hypoglycemic drugs, Insulin, Micronutrients supplements. Very good allopathic drugs are available to manage diabetes. If sugar is not controlled with tables then we may begin with insulin. If advised to take insulin please go ahead it is safe and has no side effects. It is myth that once on insulin always on insulin. When sugar levels are controlled insulin can be withdrawn. Dr. Doddanavar asked to maintain HBA1c between 6.5 to 7.

Life style

Diet, Physical activity, deaddiction, adequate sleep, stress management.

Special care

Foot ulcers, gangrene, rashes are common in Diabetics, do not ignore them rush to doctor for early treatment. To avoid septic, keep the toes clean, dry, use Vaseline, trim nails, use proper foot wear.

Low Sugar- Low sugar may present with sudden dizziness, sweating, hand shivering, head ache, avoid skipping meal. When travelling keep some snacks and eat them from time to time. When you are sick, sugar raises.

Caution Diabetes-COVID infection.

Diabetic are prone to infections and covid-19. Be careful. Diabetics likely to develop pneumonia, lung fibrosis. Complications are more. Dr. Doddanavar cautioned the 2nd wave of Corona is active and advised the diabetics to maintain social distancing, wear mask & avoid unnecessary travelling.

Reversal of Diabetes:

Recent onset of mild diabetes could have the benefit of reversal of diabetes. Long Diabetes on Insulin therapy are difficult candidates for reversal diabetes program. As advised in reversal of diabetes program very strict diet, tight exercise schedule may have adverse effect on health. Bariatric surgery for those who are 120+ Kg weight may help. Reversal of Diabetes studies and results are not available in a large group of population

Family history & diabetes

Taking part in an interactive session, Dr. Doddanavar highlighted that, one of the parents having diabetes among 4 sibling one will have diabetes, one may have border line diabetes two will escape from diabetes. If both parents are Diabetes, 2-3 siblings will have diabetes.

In an interesting discussion at the end of session, Dr. Doddanavar revealed that, 60-70% of Type 2 diabetes may develop HTN in the long run. He compared Diabetes & Hypertensions are twin sisters.

As a closing remark, he summed by saying medications alone will not treat diabetes. It is Diet, Exercise, reduction of stress can control diabetes. He advised the diabetic patients to lead a normal stress-free life and adopt exercise regimen as a routine. Organizers thanked Dr. Ramesh Doddanavar for the wonderful and fruitful scientific discussion.

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