How can we prevent Diabetes?

High blood glucose level may also be detected in non-diabetics after major meals. In most of us, even when our blood glucose level skyrockets after a carbohydrate rich meal, our body tames it down in 2-3 hours. Only in diabetics, blood glucose levels persist quite high for most of the time. It is possible to prevent diabetes for ever if we plan the calorie content of our diet. Low glycemic-index (GI) meals with low carbohydrate content should be preferred as compared to fast acting high-GI carbohydrates. Green leafy vegetable, citrus fruits, soybeans, kidney beans, green peas, pistachio, peanuts and walnuts are some low-GI food stuffs you can include in your diet. The bread and chapaties made from wholegrain flour do have low-GI. Fruits and vegetable are also packed with vitamins, minerals and fibre. Fruits and vegetables are beneficial to keep the blood glucose levels within the limits of renal threshold. Protein rich meals have low-GI, help to curb hunger and prevent diabetes. Vegetarians may include legumes, nuts, peanut butter and milk to their diet whereas non-vegetarians may take lean meat, fish and poultry products. Acidic foods have been known to tame blood glucose level. Salad and pickles seasoned with vinegar should be taken with major meals for sustainable metabolism with respect to blood glucose level and prevention of diabetes.

All Diabetics are not Alike!

All diabetics are not alike, so never take medicines for diabetes on the advice of fellow patients. The term diabetes means inordinate and persistent excretion of excessive volume of urine. Diabetes is a disease of carbohydrate metabolism with a variety of causes. Pancreas is directly associated with carbohydrate metabolism and biobalance of blood sugar (glucose) level. All carbohydrates (starches, polysaccharides, disaccharides and monosaccharides) are converted into glucose in our stomach and small intestine, absorbed in blood and taken to liver for storage in liver cells as glycogen for future use. Glycogen is also stored into muscle cells and utilized for muscle function. Insulin produced by the beta-cells in the pancreas helps in the penetration of glucose into liver and muscle cells and further storage as glycogen. Glucagon produced by alpha-cells of the pancreas regulates the conversion of glycogen in glucose through glycogenolysis, when ever glucose level in the blood falls below normal.

Defective metabolism of carbohydrates may lead to alimentary diabetes. The term diabetes insipidus pertains to a condition characterized by excessive intake of water with excessive urination but without any glycosuria (excretion of glucose in urine). Diabetes insipidus due to congenital failure of renal tubules to respond to anti-diuretic hormone (ADH) is termed as diabetes insipidus nephrogenic. Diabetes mellitus (DM) is a condition characterized by an elevated level of sugar (glucose) in blood and urine. Diabetes mellitus may affect both younger (juvenile diabetes) and older people (maturity onset diabetes). Subclinical diabetes refers to a condition where glucose tolerance test is abnormal but clinical signs of diabetes like polyuria (excessive urination with increased frequency of micturition), hunger, thirst and weight loss are absent. Obesity may be associated with diabetes but all obese people could never be diabetics. Fat metabolism is also impaired in diabetes which may lead to hypercholesterolemia and hypertension (high blood pressure) in diabetics. There is a strict need of controlling hypertension and hypercholesterolemia with customized diet, regular exercise and sometimes with medicines. It is advisable never to copy your fellow patient's treatment. Diabetes need your round the clock commitment and if taken care it would reduce your risk of serious complications like renal disease.

Important Tip: Never copy your fellow patient's treatment.

Management of Asthma

The asthma means bronchospasm and for its effective management we need bronchospasm relaxants. There are a variety of preparations containing sympathomimetics in the form of aerosols, inhalations, tablets and syrups capable of producing bronchodilations by stimulating b₂-adrenergic receptors in the bronchial smooth muscle. The choice and mode of treatment depends on the age of patient and severity of asthmatic conditions. Inhalations and aerosols may not be convenient mode of treatment in infants and children. Salbutamol and terbutaline are relatively selective drugs for b₂-adrenergic receptors. These produce optimal bronchodilations at lower concentration than those required to stimulate b₁-adrenergic cardiostimulatory receptors. Respiratory stimulants like doxapram and nikethamide are of no value and may be harmful in cases of asthma. As per the experience of a close friend of mine, sympathomimetics like salbutamol and terbutaline produce immediate relief in reversible bronchospasm associated with asthma and allergic bronchitis. Excessive and long term use of these drugs may cause cardiac arrhythmias.

Xanthine derivative drugs such as aminophylline, theophylline and etophylline are known to produce smooth muscle relaxation and bronchodilation by inhibiting the enzyme phosphodiesterase which leads to an increase in the intracellular levels of cAMP. Xanthine derivatives also produce diuresis (increase in the urinary output) and cardiopulmonary stimulation. Corticosteroids as aerosol inhalation help to reduce the mucosal edema, hypersecretion of mucous and bronchial hypersensitivity. Corticosteroids act by preventing the release of phospholipids from cell membranes in the lungs and their anti-inflammatory action helps to underplay the mediators of inflammation. Oral corticosteroid therapy should be reserved for acute exacerbations and chronic cases but after the radiological evaluation of lungs and investigations of sputum for Mycobacterium tuberculosis (tubercle bacilli or TB) and other bacterial or fungal infections. Asthmatic patients should avoid total dependence on aerosols or inhalations and should ask their physicians to prescribe them oral drugs also for emergency use. A combination of salbutamol and aminophylline or theophylline as tablets or syrup is a reliable form of treatment for asthma advisable under the guidance of a medical practitioner only.