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There is an urgent need for strategies to prevent or at least slow down the emerging burden of diabetes apart from treating diabetes and associated complications. Prevention of diabetes and its complications is the urgent need of the hour. Prevention of diabetes can be done at every stage in the natural history of diabetes resulting in four levels of diabetes prevention.
The 3 D’s of the nutrition department -Dietary service, Diet counselling and Diet analysis- contribute significantly to the control of diabetes by prescribing a suitable diet, thus preventing complications.The Department of Nutrition and Dietetics is an essential part of the hospital and dietitians/diabetes educators are a vital link in the paramedical team. The 3 D’s of the nutrition department -Dietary service, Diet counselling and Diet analysis- contribute significantly to the control of diabetes by prescribing a suitable diabetic diet, thus preventing complications. In addition to the obvious function of catering to the nutritional requirements of patients, such a program supplements therapy. It has a direct influence on the morale and attitudes of patients and their families.
Obesity is a chronic disorder with multiple serious health complications. Previously it used to be a concern only for developed countries, but now it is becoming a problem for developing countries as well. There is a global epidemic of obesity with prevalence as high as 30 to 40% in a few regions. In India, approximately 139 million people are obese (INDIAB study). Obesity impairs quality of life and reduces life expectancy. All the effects and complications of obesity appear at a lower body weight and a younger age in Indians as compared to the west.
The Department of Stress Management has been instituted to investigate the psychosocial aspects of diabetes, which may influence the prescribed regimen of self-care, and to conduct interventions for better self-management of diabetes, its complications and related disorders.
The three most important problems for patients with diabetes are stress, anxiety and depression. Generally, we undertake a psychological evaluation of the above-mentioned problems, for appropriate interventions. Remedial measures for behavioural change include patient-education, skills-development and motivation through counselling, as well as, relaxation techniques, viz., deep-breathing, progressive muscle relaxation and biofeedback. If not managed properly, stress could adversely affect health outcomes and lead to poor quality of life. In short, the Department of Stress Management and Counseling seeks to achieve their goals through a combination of behaviour therapy and stress management strategies
At its core, precision is a model that proposes customization of health care with medical practices, testing, decisions and treatments tailored to the individual patient level. Diagnostic tests and therapies are selected not only on the basis of generic symptoms but also by the specific risk factor profile and health history obtained from genetic profiling.
Based on the type of diabetes and the level of sugar control, certain patients may be suggested to start insulin treatment. In addition to timely initiation, regular adjustment of insulin doses based on the sugar levels is critical for improving glycemic control and preventing diabetes-related complications. Based on the pattern of sugar levels, different insulin regimen can be used. The various types of insulin available today differ in their onset and duration of action as well as the cost. The expert diabetes consultants at Dr Mohan’s Diabetes Specialities Centre are at hand to help patients choose the best possible insulin regimens for their glucose profile and lifestyle- a perfect example of the personalized care that we offer. In certain patients. The Continuous Subcutaneous Insulin Infusion pump (CSII) may be an attractive alternative to multiple daily insulin injections. At Dr Mohan’s Diabetes Specialities Centre, we provide patients with the latest information regarding the insulin pump and other recent advances in the field and also provide education and training to help them make the best possible use of these technologies.
Hypoglycemia is a clinical state with low glucose concentration in the blood, usually associated with giddiness, weakness, anxiety, irritability, hunger, palpitation, blurred vision, headache, inability to concentrate, loss of memory, and in severe cases, paralysis, seizures or coma. Patients with diabetes start getting symptoms of hypoglycemia when the sugar levels drop below 70 mg/dl but this can vary widely from person to person. Hypoglycemia usually occurs when a meal is missed or delayed, following unaccustomed heavy exercise or when too high a dose of insulin or diabetes tablets is taken in error. Management of hypoglycemia is important and the patients are advised to carry an ID card stating that they have diabetes to avail help in case of any emergencies. If the patient is conscious, oral glucose (20-30g) in the form of sugar, candy or orange juice can be given. If the patient is unconscious, medical help should be sought immediately.
Diabetes can affect the eye in various ways. Diabetic Retinopathy is a common vision-threatening complication which causes damage to the retina, the light-sensitive layer at the back of the eye. The risk of developing retinopathy is higher for patients who have had uncontrolled diabetes for a long time. It has been estimated that about 70% of patients who have had diabetes for over 15 years will have some damage to their eyes due to diabetes. Efficient methods are available to detect high-risk retinal lesions and blindness due to diabetes which can be prevented if early detection is done and timely treatment is administered.
Diabetes is a major contributing factor for heart disease. Individuals with diabetes are two to four times more likely to develop cardiovascular disease than adults without diabetes. The American Heart Association considers diabetes to be one of the seven major controllable risk factors for cardiovascular disease. Cardiovascular disease is considered to be the major cause of morbidity and mortality among individuals with diabetes. Individuals with diabetes have a higher risk of developing coronary artery disease (CAD), caused by a narrowing or blocking of the blood vessels that go to the heart, heart attack or stroke than individuals without diabetes. People with diabetes also tend to develop heart disease at an earlier age than those without diabetes. Some common risk factors shared by diabetes and heart disease are physical inactivity, unhealthy diet, obesity, high blood pressure and cholesterol, low birth weight, smoking and stress.
Foot pressure distribution measurement system is used for measuring the pressures in regions of the foot that are prone to getting calluses and corns. This instrument is also used for designing special diabetic footwear that effectively redistributes the pressures, thereby preventing the formation of calluses and corns.
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