November 28, 2016

Ambala sees hike in maternal mortality rate

The maternal mortality rate (MMR) has increased in the district. The Health
Department recorded the MMR at 109 so far this fiscal while it was 84 during
the corresponding period last year.

As per the data procured from the department, as many as 14 women have
died since April this year while there were 11 such fatalities during the corresponding
period last year. Sources said a report on the MMR and infant mortality rate was
presented before the Deputy Commissioner during a meeting recently.

Deputy Commissioner Prabhjot Singh said, “The Health Department has been
asked to prepare a report showing the cause of these deaths. The officials have
been told to analyse each case so that the MMR could be improved and better
services provided to the pregnant women.”

Deputy Civil Surgeon (Mother and Child Health) Dr Sangeeta said, “I have
already reviewed 12 deaths. The deaths were coincidental. No such case has come
to notice where the expecting woman did not get treatment on time. We will submit
the report soon.” Health officials claimed that 99.6 per cent of the deliveries were
institutional. As per the data procured from the department, the MMR was recorded
at 90.04 in 2013-14 while it was 88.68 and 71.84, respectively, in 2014-15 and
2015-16.

Chief Medical Officer Vinod Gupta said, “The department keeps track of all
maternal deaths and these get reviewed every month at two levels, including by the
CMO. An uptrend has been witnessed in the MMR, which is a matter of concern for us.

Source: The Tribune

November 25, 2016

सर्दी से बचाएंगे देसी तरीके

आयुर्वेद के अनुसार सर्दियां सेहत बनाने का मौसम है। इस मौसम में जुटाई गई रोगों से लड़ने 

की ताकत पूरे साल के लिए हमें चुस्त, दुरुस्त और मस्त बनाए रख सकती है। जरूरत है तो 
अपने खान-पान और रहन-सहन को देसी खुराक देने की, बता रही हैं इंदे्रशा

सर्दी के मौसम का भरपूर फायदा उठाने के लिए दो चीजों का ध्यान रखना जरूरी है। एक, 
आहार कैसा हो और दूसरा विहार कैसा हो। सामान्य शब्दों में कहें तो खान-पान और रहन-सहन। 
जैसे-जैसे ठंड बढ़े, वैसे-वैसे खान-पान में परिवर्तन करना शुरू कर देना चाहिए। बाहरी तापमान 
से तालमेल बैठाने के लिए इस मौसम में शरीर का भीतरी तंत्र ज्यादा मुस्तैदी से काम करने 
लगता है। बाहर पड़ रही शीत का संपर्क हमारी त्वचा से बना रहता है तो शरीर के भीतर मौजूद 
जठराग्नि प्रबल हो जाती है और इस तरह सर्दियां शरीर की पाचन-शक्ति में इजाफा कर देती 
हैं। बाकी मौसमों की तुलना में हमारा शरीर खाए-पिए को अच्छे से ग्रहण कर पाता है।

आलस से बचें
सर्दी के मौसम में आलस से बचना चाहिए। आयुर्वेद के अनुसार आलस वात प्रकृति के लोगों 
का सबसे बड़ा दुश्मन है। गर्मी के ठीक विपरीत सर्दी में दिन में सोने की आदत नहीं बनानी 
चाहिए, अन्यथा शरीर में भारीपन, सर्दी-जुकाम आदि का आक्रमण आसानी से हो सकता है। 
शीतकाल में रातें लंबी होती हैं यानी प्रकृति ही हमें लंबे विश्राम का वक्त देती है। विश्राम के 
इस समय को कम नहीं करना चाहिए। भरपूर नींद लें।

हाजमा सही रखें
देर रात में भोजन न करें और भोजन कर लें तो ज्यादा देर तक जगें नहीं। ठंड की शुरुआत 
होने पर खाने में घी, दूध, मलाई, उड़द की दाल, तिल जैसी चिकनाई वाली और पौष्टिक चीजों 
का सेवन करना शुरू कर दें।

भोजन से दस-पंद्रह मिनट पहले करीब दस ग्राम अदरक के छोटे टुकड़ों पर सेंधा नमक छिड़क 
कर चबा-चबा कर खाएं। इससे भूख खुलती है, तेज ठंड से बचाव होता है और प्रदूषण का 
असर भी शरीर पर कम होता है।
सर्दी में ज्यादा समय तक खाली पेट न रहें। वैसे भी भारतीय परिस्थितियों में सर्दी के दिनों 
में शरीर को आमतौर पर ज्यादा कैलरी की जरूरत पड़ती है। गुड़, मूंगफली और तिल की पट्टी 
व सूखे मेवे इस मौसम के लिए भरपूर ऊर्जा के स्रोत हैं। याद रखें, हाजमा दुरुस्त हो तो ही 
पौष्टिक और गरिष्ठ चीजें खाएं, वरना पहले हाजमा ठीक करें। प्राकृतिक चिकित्सा के तरीके 
से एनिमा लिया जाय तो पाचनशक्ति को मदद मिलती है। आधा चम्मच छोटी हरड़ का चूर्ण 
रात में गुनगुने पानी से कुछ दिनों तक लेने से कब्ज खत्म होता है और पाचन को बल 
मिलता है। सवेरे गुनगुने पानी में नींबू निचोड़ कर पीने से भी पाचन ठीक रहता है।

व्यायाम करना न छोड़ें
सर्दी के मौसम में शरीर के अंगों को भरपूर हरकत देने पर भी ध्यान देना चाहिए। स्वस्थ 
लोग भारी व्यायाम कर सकते हैं, पर सामान्य लोगों को भी हल्का-फुल्का व्यायाम करना 
चाहिए। करीब सभी तरह के आसन इस मौसम के लिए उपयुक्त हैं, पर प्राणायामों में 
शीतली-शीतकारी प्राणायाम नहीं करने चाहिए, क्योंकि इससे शरीर में ठंड का आभास होता 
है। इस समय भस्त्रिका, कपालभाति, अनुलोम-विलोम के साथ सूर्यभेदी प्राणायाम करना 
चाहिए। धूप में बैठ कर तेल की मालिश करना शरीर को विटामिन-डी देने का बढ़िया तरीका 
है। त्वचा निरोग रहती है। मांसपेशियों को ताकत मिलती है। मालिश के लिए सरसों, तिल 
या जैतून का तेल लें।

सर्दी के खतरों से बचें
जुकाम, खांसी
कम तापमान की स्थिति में अगर सावधानी न रखी जाए तो सर्दी, जुकाम, खांसी, गले में 
खराश का संक्रमण आसानी से हो जाता है।
- सवेरे-शाम तुलसी, अदरक और लौंग का काढ़ा बना कर पिएं। अधिक उपयोगी बनाने के 
लिए मुलहठी और दालचीनी का चूर्ण भी मिला सकते हैं।
- दिन में दो-तीन बार गर्म पानी में सेंधा नमक मिला कर गरारे करें। खांसी के अलावा 
गले की खराश, इन्फेक्शन आदि में भी राहत मिलेगी।
- लहसुन की पांच कलियों को घी में भून कर दिन में दो बार खाने से भी आराम मिलता 
है। लहसुन में मौजूद एलिसिन रसायन एंटी बैक्टीरियल, एंटीफंगल और एंटीवायरल प्रभाव 
रखता है।
- तुलसी के पंद्रह-बीस पत्ते पीस कर इसमें एक चम्मच शहद मिलाएं और दिन में दो बार 
खाली पेट चाट लें। यह सर्दी की तकलीफों से रक्षा करता है। रोग प्रतिरोधक शक्ति भी बढ़ती है।
- गर्म दूध में आधा चम्मच हल्दी मिला कर पीने से जल्दी राहत मिलती है।

हृदयाघात
डॉक्टरों के मुताबिक इस मौसम में एंजाइना और दिल का दौरा पड़ने की आशंका 50% तक 
बढ़ जाती है। तापमान में बदलाव के कारण दिल की धमनियों में सिकुड़न आ जाती है। 
ऑक्सीजन की आपूर्ति और खून के बहाव पर दबाव पड़ने लगता है। मौसमी अवसाद और 
विटामिन-डी की कमी के कारण भी रक्तचाप बढ़ने लगता है। डॉक्टर की बताई दवाएं लेना 
न छोड़ें। 
- फाइबरयुक्त भोजन अधिक लें।
- हरी सब्जियां, अंकुरित अनाज व सूखे मेवे लें। पानी खूब पिएं। पाचन ठीक रहता है। 
मौसमी अवसाद से बचते हैं।
- खाली पेट लौकी का जूस पिएं। इसमें तुलसी और पुदीने के चार-छह पत्ते मिला लिए 
जाएं तो और अच्छा है। धमनियों के अवरोध में भी फायदा मिलता है। - विटामिन-डी 
का स्तर बनाए रखने के लिए सुबह की गुनगुनी धूप सेकें।

दमा
ठंडी हवाओं के साथ सर्दी-जुकाम और गले में सूजन पैदा करने वाले बैक्टीरिया दमा रोगी 
की मुसीबत और बढ़ा देते हैं।
- कहीं भी सर्द-गर्म वातावरण में अचानक प्रवेश करने से बचना चाहिए।
- सिर व कान ढक कर ही बाहर निकलें।
- पानी गुनगुना करके पिएं।
- कफ बाहर निकालने वाले और आयरन जैसे तत्वों से भरपूर चीजें खाएं। खजूर खाना 
फायदेमंद है।
- इनहेलर तथा डॉक्टर की सुझाई दवाइयां साथ रखें। 
- धूम्रपान सांस की तकलीफों को बढ़ाता है। प्रत्यक्ष व अप्रत्यक्ष दोनों से बचें। 
- दो चम्मच मेथी दाने एक लीटर पानी में डाल कर आधे घंटे तक उबालें और छान लें। 
अब इसमें दो चम्मच अदरक का रस और एक चम्मच शुद्ध शहद मिला दमा के रोगी को 
पिलाएं। रोज सवेरे यह करें।



जोड़ों का दर्द
सर्दी शरीर में वात और कफ की वृद्धि का मौसम है। चूंकि जोड़ों का दर्द वात असंतुलन 
की वजह से होता है, इसलिए जाहिर तौर पर सर्दी में तकलीफ बढ़ जाती है। हल्का-फुल्का 
व्यायाम जरूर करें। वात का प्रभाव कम करने वाली चीजों को अपने आहार में शामिल करें।
- सौ मिली. दूध में इतना ही पानी मिलाएं और दस लहसुन की कलियां डाल कर उबालें। 
पानी जल जाए तो लहसुन खाकर घूंट-घूंट कर दूध पी लें। इससे जोड़ों के दर्द में फायदा 
मिलता है।
- जिन जोड़ों में दर्द हो, वहां सरसों के तेल में लहसुन और अजवायन पका कर उस 
तेल से मालिश करनी चाहिए।
- चुकंदर और सेब भरपूर खाएं, इससे यूरिक एसिड सही रहता है।

Source: Hindustan Newspaper

November 22, 2016

Where a pregnancy costs mother her life


In India, 55,000 pregnant women die every year due to preventable causes such as lack of access to healthcare services, corruption and caste prejudices

Earlier this month, Banbari Adivasi’s unnamed granddaughter died of malnutrition, starving for days after her 19-yearold mother, Jasoda, died at childbirth.

“My son Sajjan works as a labourer in Rajasthan and after his wife’s death, went back and left the baby girl with us,” said Banbari, a 42-year-old resident of Shivpuri in northern Madhya Pradesh’s rural hinterlands. He has tuberculosis and is too ill to continue working as a labourer.

As his wife Ramkumari, 35, now supports the family by going to the forest to forage for fruits, roots and honey to sell, Banbari’s job is to stay home with his five other children and newborn grandchild. “When her mother died, there was no one to feed her.”
In desperation, Banbari even considered giving away the little baby to another family, but then she fell ill. “I tried, but I did not know how to look after the baby,” he says. Admitting the baby to the SNCU (special new born care unit) at the district hospital in Shivpuri could not save her life.

Jasoda and her daughter aren’t the only ones. Each year, 55,000 women die in India from preventable pregnancy-related causes. In most cases, infections and disease are compounded by chronic hunger and malnutrition — and a lack of access to affordable pre-birth healthcare services because of corruption or caste bias.

The maternal mortality rate (MMR) — deaths per 100,000 live births — fell from 212 in 2007 to 167 in 2013 but too many women are dying still.

And as the maternal death rates remain the highest in the populous states of Assam, Bihar, Madhya Pradesh, Odisha, Rajasthan and Uttar Pradesh, the total number of women dying is also high.

To tackle this, Prime Minister Narendra Modi launched the Pradhan Mantri Surakshit Matritva Abhiyan two weeks ago to provide free antenatal — before childbirth — care to pregnant women on the 9th of every month at government health centres and hospitals across India’s 687 districts.

Building on the National Health Mission’s flagship Janani Suraksha Yojana (JSY), all pregnant women must be given a physical and abdominal examination, a tetanus shot and 100 ironfolic acid tablets.

They must also be tested for anaemia, high blood pressure, high blood sugar (gestational diabetes) and other problems linked with pregnancy to lower India’s MMR and infant mortality rate (deaths of children under five years of age per 1,000 live births).

MOTHERLESS CHILD
Women in the lowest socio-economic sections in India are two-and-a-half times more likely to die of childbirth, largely because they don’t get the medical support they need to deliver a healthy baby. Jasoda’s death is a case in point.

“Maternal deaths are not just about a woman dying, it also adversely affects the health of newborn and surviving children, who get trapped in a vicious cycle of malnutrition, stunting and wasting,” says Ajay Yadav, founder of the NGO Badlav (Change), who has been working on health and nutrition in Madhya Pradesh.

Incomplete antental care also lowers the chances of the mother’s and child’s survival. Malti Adivasi, 19, wife of Ram Lakhan, 25, lost her nine-month-old daughter Lakshmi to malnutrition earlier this year. She had delivered in a hospital but was not given iron-and-folic acid tablets or advice on feeding her baby after delivery. Lakshmi was given the BCG vaccine against tuberculosis and polio vaccine at birth, after which she got no vaccinations.

“Malnutrition begins after six months when the baby needs additional nutrition, which the mother is not able to provide. That’s when weight drops and wasting sets in, making the baby susceptible to infections such as pneumonia and diarrhoea,” said Pramod Tiwari from the Manav Foundation, Sheopur.

STATE OF CARE
Frequent infections aggravate chronic hunger with most severe acute malnutrition deaths taking place between nine months and five years.

Apart from saving mothers, antenatal care and institutional deliveries boost chances of newborn survival. The mother gets a tetanus toxoid shot to lower risk of infection during delivery, iron and folic acid to boost blood haemoglobin levels, and nutritional advice on feeding the newborn within the first hour of birth.

Breast milk contains all the nutrients a baby needs in the first six months of life and nursing a newborn within one hour of birth delivers highly nutritious colostrum (first milk) that protects against common childhood infections such as diarrhoea and pneumonia and boosts mental and physical development.

Under the JSY, all services for the mother and her newborn are free and incentives are given to families to opt for institutional deliveries, yet corruption and apathy in the public health system make the poor hesitant in accepting services.

“Hospital staff sometimes demand a bribe up to ₹500 for a delivery because they know mothers get ₹1,400 for an institutional delivery. But since that money is transferred directly to the parents’ bank account, villagers have no money to give hospital and clinic and so they opt for home deliveries,” says Yadav.

“Caste plays a role in the exclusion from health services, with marginalised tribes like the Saharias losing out both nutritionally, socially and economically,” says Yadav. “Unless delivery becomes inclusive, children will continue to be orphaned.”

 Source : HT 







November 21, 2016

Cancer-specific health policy: Should you take it or not

Past one decade has seen significant changes in the healthcare industry of India. 
This is evident from the fact that the total spend on healthcare has been around 
5% of the GDP in 2013 and expected to maintain the similar level during 2016 as 
well. Every year around billions of dollars are being spent alone on the research 
on finding the best treatment for critical diseases. However, with the arrival of 
state-of-the-art technology and more effective medicines to counter critical diseases, 
the critical care treatment has seen a steady rise in the past few years.

Critical illness treatment
The burgeoning middle class and the lower middle class, which jointly forms 
a major chunk of India’s population are worst affected by this. With this steady 
increase in the cost of critical illness treatment in India, Indians are finally waking 
up to the fact that buying a health insurance is unavoidable.

Like most of them, you too might be one of those who think that you have your 
health risks covered when you buy a specific health insurance policy and opt for a
comprehensive critical illness cover. Usually the critical illness plans claim a cover 
on major illnesses or medical conditions such as heart attack, stroke, kidney failure 
etc. But have you ever checked if it covers the deadliest of them all, cancer?

Whether or not your health insurance policy will redeem your expenses at any stage 
if you were to be detected with a critical disease such as cancer? In all 
probability you might not have even given it a thought as the very mention of 
cancer can send a  shiver down your spine. Is it overcautious then to think of an 
insurance  policy, which is specifically dedicated to cancer even if you are perfectly
healthy today? Let’s  find some answers.

Rising incidences of cancer
Have you ever wondered how you will cope if you ever contracted this dreaded 
disease? It has been found that one in eight men and one in nine women develop 
some form of cancer during his or her lifetime. Most cancers are caused by the 
genetic changes that can happen anytime during a person’s lifetime as he or she 
ages. Even environmental factors such as tobacco, smoke or radiation can be a 
cause for cancer to happen.

Leading cause of death
Reports suggest that cancer is the leading cause of death in India with about 
1.5 to 2 million cases at anytime, out of which 7 lakh new cases are added every 
year with 3 lakh deaths. Studies by reputed organisations such as WHO suggest 
that by 2026 with an expected increase in life expectancy, the cancer burden will 
increase to about 14 lakh cases per year, which is exactly the double of the current 
figures. The number of new cancer cases in India is expected to increase by 70% by 
2035. Therefore, instead of believing in a myth that cancer cannot happen to you, it 
is better to be prepared in case it does happen to you unfortunately.

High treatment cost
Even though the government has taken steps to provide cancer medication at 
subsidised prices, still a back of the envelope treatment cost analysis shows that 
even in the early stages of cancer, i.e stage one or early second stage for head and 
neck, breast, lung, GI may cost anything between Rs 10 and Rs 12 lakh. Besides the 
actual cost of medication, various other factors like over the counter medication, 
prescription medication, specified dietary supplements, nursing care needed at 
home,  logistical cost involved while visiting the doctor, accommodation cost for 
self or the  person accompanying if visiting a hospital outside the city, one off 
purchases like  wigs, hair pieces, head coverings also add to the staggering cost 
of the treatment.  What is even more alarming that around 10-30% of the treatments 
fail or a relapse  occurs in the first stages of cancer, which almost doubles the 
treatment expenditure in some cases.

Unlike other diseases, early stage cancer patients might not require a hospitalisation 
and are treated more on an outpatient basis. That means that they have to regularly 
visit the oncologist while the treatment is on and follow the post treatment cycle of 
heavy medications, which definitely disturbs the routine professional life of a person.

Study suggests that most cancer patients face financial stress, sometimes hardship, 
by having to deal with massive extra costs, as well as a huge drop in income for 
many  patients at a time when they are going through the severe physical, 
emotional and  psychological impact of a very serious illness. A strong mechanism 
is, therefore,  needed to take care of your financial well-being while you undergo 
the cancer treatment and even after that.

Read between lines
There are chances that you have opted for a health insurance policy to ensure your
financial protection, but have you have ever thought if it is enough in case of a 
critical disease such as cancer? Some of you who are prudent enough might have 
even opted for a critical illness cover in a health insurance policy. But how many 
of you are aware about the definition of ‘critical’ stated in such policies. Such 
policies might give you temporary relief but are applicable only in the advanced 
stages of critical diseases such as cancer. Therefore, it becomes necessary to go for 
cancer-dedicated policies which are specially designed to suit the unforeseen 
financial needs that the dreaded disease might bring along.

Cancer-dedicated policies that are offered by a handful of insurers today offer 25%
of the sum assured to the policyholder on the diagnosis of the disease that takes 
care of the expenses at the initial stages. The amount is credited to the insured 
person’s  account immediately and all his future policy premiums are waived 
till the end of the policy term.

Under unfortunate circumstances where cancer is detected in more than one organ, 
20% of the sum assured is given for the treatment of each organ. In the advanced 
stages, a policy holder can claim up to 100% of the sum assured and even get an 
additional 10% of the sum assured for a period of five years as income. A cancer-
dedicated policy will provide a sum assured of Rs 20-25 lakh for a 30-year-old for a 
mere sum of Rs 4,500- 6,000 per year (on an average) for a term of 35-40 years, 
which is even lesser than the cost of a weekend road trip with your loved ones.

So if you are still thinking whether or not to opt for a cancer-dedicated product, 
the answer is yes. In case cancer does happen to you unfortunately, your timely 
financial management can ensure that while you focus only on fighting and 
winning the battleagainst the dreaded disease, your worries of being straddled 
with high costs of treatment are automatically taken care of.

Source: The Tribune

November 18, 2016

Diabetes: What the Docs Ordered

SUGAR, STAY SWEET Keeping your blood sugar levels within a specific 
range when diagnosed with diabetes can be challenging indeed.

Here, four doctors share their prescriptions with Saliha Nasline. The bottomline 
is discipline in diet, exercise and regular monitoring

Dr V Mohan, Chairman, Dr Mohan's Diabetes Specialities Centre, Chennai
The late Ravi Baskaran, one of our oldest patients, who was diagnosed to have 
diabetes in his teenage. He was started on insulin injections several times 
a day which he meticulously took all his life. He maintained good control of 
diabetes in the initial years by painstakingly checking his urine sugar by the 
good old Benedict solution method. After several years, he had moved to blood 
glucose testing using a glucometer. All his life, he maintained very good health 
and did not develop any of the diabetes-related complications. He led an active 
life in the corporate world as he was a management consultant. He was an ardent 
cricketer and had played league cricket at the same level. After over 62 years 
of active diabetic life, Ravi finally died at the age of 76 years, not due to diabetes
but due to some other disease. Ravi is actually a role model of how one can have 
a long and healthy life despite diabetes.

MANAGING DIABETES
We have had many cases of children developing diabetes when they are one or 
two years old. But they have grown up to excel in their professions, get married, 
have children and are still alive after 60 or 70 years of diabetes. All these patients 
have followed a strict discipline by maintaining their exercise schedule, taking 
their medicines or their insulin regularly and visiting the diabetes centre for regular 
check-up and advice.

TREATMENT
The treatment style for a patient diagnosed with diabetes for the first time will 
depend on the type of diabetes. In the case of type 2 diabetes, which constitutes 
90-95% of all patients with diabetes, diabetes can be managed by diet, exercise 
and tablets. In the case of insulin dependent, type 1 diabetes, insulin injections 
would be needed several times a day and in the case of certain other forms of diabetes, 
based on the specific type of diabetes, there could be some variation in the treatment 
given. However, in all cases, discipline is very important to maintaining a strict diet 
schedule, regular exercise, medication and self-monitoring.

Dr Srinivasa P Munigoti, Consultant Diabetologist & Endocrinologist, Fortis Hospital,
Bengaluru

37-year-old Sudeep (name changed) is banking professional from Gujarat. He was
unaware of his condition and could not understand the reason for his excessive 
thirst and increased urination. After check up, he came to realise that he had type 2 
diabetes with high levels of sugar. Even though his family had no history of the 
condition, his weight of over 100 kg added to his problem. He was on strict 
diet to control his diabetes and he had to maintain a healthy intake of 1,200-1,400 
calories on a daily basis coupled with physical exercise. He was able to run close to 
35 km per week. With regular exercise and diet routine, Sudeep has fought the 
disease and is off medications for diabetes today . As an end result, he has not only
taken control of his sugar levels but has also lost 20 kg. He has even participated in
marathons. An early diagnosis, a change in his erratic lifestyle and healthy eating 
helped this young professional re gain control on his life.

MANAGING DIABETES
Diabetes can be managed well by adopting the right lifestyle changes and following 
medical advice that may include various medications, regular tests and follow-up 
with doctors.

TREATMENT
A good diabetes treatment always involves diet, lifestyle modifications and right 
medication. There are plenty of good guidelines from a number of medical 
associations, including some Indian associations which are useful. Individual 
treatment for patients is always specifically tailored to their needs after studying 
their medical background.

Dr Anupama N, Consultant-Preventive Medicine, Dept of Preventive Medicine, 
Sakra World Hospital, Bengaluru

A 52-year-old patient came for a health checkup; she was a known diabetic for four 
years and was on two types of medicines. Her sugar levels were uncontrolled. She was 
also on some medicines for high BP and cholesterol; she was very upset with her 
results and did not want to take anymore new medicines. On talking to her about the 
need to control her sugar levels she admitted that she was not very strict with her 
diet and was not compliant with her medications. After counselling, she was happy 
and motivated to follow the diet chart suggested to her. After six months, it was good 
to see that lady had dropped 7 kg of weight and her sugars were very well 
controlled. She acknowledged that good diet and regular exercise helped her achieve 
her target.

TREATMENT
Treatment of diabetes is a holistic approach, a lot of factors need to be kept in mind. 
A patient has to be assessed based on his lifestyle, socioeconomic background, support 
system, age, etc. However, on the whole, a patient should be educated about what 
diabetes  is, its complications and what measures are to be taken for it. It has to be well 
explained  that it is not a curable disease but only one that can be controlled with diet, 
exercise  and compliance with medicines. Another key factor is identification and 
management of stress.

MANAGEMENT
It is a game of will power for the control of sugars through diet and exercise. A lot of 
them go on very strict diet and exercise when they are diagnosed with high sugars, and 
after some time, they give up on it. Hence it is necessary to understand that it requires a 
great effort, which has to be sustained in the long run. Those who manage to do regular 
exercise and healthy diet bring down their sugars well.

Many a time, when patients come to know about their sugar levels for the first time, 
they are in the state of shock or denial. It is very important to know what to tell the 
patient and how much of information they can take in such a state of mind. The 
treatment, whether it has to be on only lifestyle or medicines depends on the severity 
of the diabetes.

Dr Ankush Gupta, Consultant General Medicine, Docs App
The son of a 60-year-old patient asked about his father's diabetes for second opinion 
on Docs App. One month back he was all normal and suddenly sugar levels were high 
in the recent test. We asked all the details about the patient, understood present 
medication,  types of insulin and quantity of insulin, saw the prescriptions and other 
reports, which  were uploaded on the website.

A doctor suggested some course of medicine, lifestyle changes and diet changes 
and asked the patient to get the test done again after five days. Later, the doctor changed 
the levels of insulin, according to the blood sugar values regularly for two months, 
monitoring his lifestyle changes as well. After two months, the patient's blood sugar 
became normal, he is still continuing the medication without any insulin injection.

He is able to maintain the sugar level, with proper diet and lifestyle changes suggested 
by the doctor.

TREATMENT
There are two types of diabetes mellitus. Type 1 is insulin dependent because 
of absolute  lack of insulin. Type 2 usually occurs in people who are over 40 and 
overweight. There is  no lack of insulin but peripheral cells are resistant to insulin. 
Dietary restriction, exercise  and controlling insulin levels are the cornerstones of the 
management of type 1 diabetes. Weight reduction, dietary restrictions, and exercise 
are also proven ways to increase  insulin sensitivity in type 2 diabetes. If optimal 
control of blood glucose levels is not  achieved with weight reduction programme, 
drug therapy is started.

Diabetes is a lifestyle disease which occurs due to sedentary lifestyle and bad 
dietary habits. So lifestyle changes form an important part of treatment of diabetes. 
Avoiding oily, fried foods, food with high glycemic index (sugar, sweets) and taking 
small regular meals at regular intervals is important. Daily 30 minutes of brisk walking 
five days a week is important to reduce weight.

Drug therapy is started mostly after three months of lifestyle management, if optimal 
control of blood glucose is not achieved. Regular follow-up with at least one follow-up 
for three months is needed to check the blood sugar levels and modify medication 
accordingly.

MANAGEMENT
Regular follow-up is very important. Blood sugar level goes up and down depending 
on the patient's weight gain or loss, dietary changes and sensitivity to medicines. 
Normally,  follow up is done after three months to check if medicines are working and 
whether the  patient is following the suggested lifestyle changes or not.

The dose of the medicine can be increased or decreased depending upon the blood sugar 
level or the medicine can be changed if it is associated with side effects or optimal sugar 
level is not achieved. In essence, maintaining lifestyle changes, weight reduction, 
dietary  changes, taking medicines at regular intervals as prescribed and keeping a 
regular follow-up schedule with the doctor will keep the sugar levels and diabetes in 
control.

Source: The Economic Times