free diabetic camp

dr satyajit sahu at free health camp 

dr satyajit sahu has seen 400 diabetic patient on free check up camp at khandelwal clinic kota  oraganise as free diabetic camp on 28 april 2011


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Diabetics suffering from kidney failure should eat a diet low in protein, sodium, potassium, phosphorus and dairy.

About 30 percent of people with type 1 diabetes and 10 percent to 40 percent of those with type 2 diabetes eventually develop nephropathy, or diabetes-caused kidney failure, according to the National Kidney Foundation. Although existing kidney damage cannot be reversed, future kidney damage in diabetics can be stopped or slowed by following a specific, specialized diet aimed at conserving existing kidney function.

1.                                                           Limit Protein, Salt, Potassium & Phosphorous

o                                                                Diabetics suffering from kidney failure should eat a diet low in protein, sodium, potassium, phosphorus and dairy. LifeClinic.com says men should limit their protein consumption to 5 to 6 ounces a day and women to 3 to 4 ounces a day. A low-protein diet appears to reduce protein in the urine and increase protein in the blood, which helps diabetics with kidney failure preserve their existing kidney function.

Sodium and potassium intake should also be limited. Herbs and spices can be used as a substitute for salt, but sodium substitutes that use potassium should be avoided. In terms of fruit, kiwis, nectarines, cantaloupe, prunes, raisins, bananas and oranges should be completely avoided because of their high potassium content. Fruits such as apples, grapes, peaches, plums, tangerines and pineapples can be eaten in moderation. Potatoes, spinach, asparagus, pumpkin, squash and tomato should also be avoided because of their high potassium content. All other vegetables can be eaten in moderation.

Diabetics suffering from kidney failure should also avoid foods high in phosphorus. These include chocolate, nuts and beer, among others. Dairy should be limited to half a cup a day because of its high phosphorus and protein content. Cheese, in particular, should be avoided or eaten in very small, infrequent servings. For the most part, whole grains can be eaten freely, as long as blood sugar levels are controlled.

Kidney problems in diabetics are further complicated because sugar intake must be kept low in order to regulate blood sugar levels. Because of the many food limitations and restrictions on diabetics suffering from kidney problems, it can be difficult for these people to consume enough calories to meet their nutritional needs. Calories should be added through starches and vegetables rather than proteins, dairy and high-sugar fruits. It is extremely important for diabetics with kidney failure to drink enough water, although exact water and liquid intake should be determined by the patient's doctor.

How strictly a diabetic patient must adhere to the above diet depends on the stage of kidney failure. Diabetics in the early stages may be able to consume higher levels of protein and potassium than those at the end stages. A nutritionist or nephrologist (kidney specialist) should be able to determine the patient's stage and dietary needs.

 If you are diabetic, then you know how important it is to stay on the proper diabetic diet. Diabetes can affect the kidneys, so often a good diabetic diet will include foods healthful for renal functioning. Diabetic and renal diet guidelines are promoted to encourage people suffering from diabetes or kidney failure to do everything they can to eat in the most healthful way possible for their conditions.

1.                                                           Low Sugar

o                                                                Sugar should be eliminated as much as possible. Any packaged foods should be chosen based on their low-sugar content.

Low Salt

o                                                                Salt can tax the kidneys and raise the blood pressure. Avoid adding salt to food and try to buy foods that are lower in sodium.

Low Protein

o                                                                Protein can also tax the kidneys. Try to avoid eating high protein foods or limit your protein intake to 8 ounces per day.

Low Potassium

o                                                                Potassium is regulated in the kidneys, so try to avoid eating foods high in otassium, such as bananas.

Low Dairy

o                                                                Dairy products can aggravate blood sugars and strain the kidneys, so try to limit the amount of dairy products you include in the diet.

 Overview

An Indian meal of naan, potatoes and a mango lassi to drink may be delicious and classic Indian fare, but it's not appropriate for a diabetic diet . Fortunately, you can enjoy the spicy flavors of Indian cuisine without paying for it with a high blood sugar reading later. Consider adding these Indian foods to your healthy diabetic diet.

Tandoori Roti

Tandoori is a fibre-rich, whole-grain bread that's more diabetic-friendly than refined Indian breads like chapati and dosa. Because whole-wheat bread is digested and absorbed more slowly than white bread, it reduces the risk of dangerous blood sugar spikes. Additionally, regularly consuming  whole grain can boost your cells' sensitivity to insulin, according to the November 2003 "American Journal of Clinical Nutrition." More insulin-sensitive cells can help make managing your blood sugar easier.

Channa Masala

Channa masala is a flavorful chickpea-based South Indian classic bursting with dietary fiber. Karen Collins of the American Institute for Cancer Research states that beans like chickpeas contain ample amounts of soluble fiber. Soluble fiber delays digestion of carbs, helping you achieve even blood sugar levels. Additionally, the soluble fiber in chickpeas can help decrease elevated cholesterol levels.

Vegetable Curry

Bland vegetables transform into mouth-watering superfoods when prepared as Indian vegetable curry. Containing a variety of nutrient-dense veggies like eggplant, spinach and carrots, vegetable curry is an excellent source of low glycemic index vegetables. The glycemic index is a measurement of how rapidly the carbs in a food end up as blood sugar. Including low glycemic index carbs in your diabetic diet can help you keep your blood sugar levels in check, the Glycemic Index Foundation reports.

Bhindi

Bhindi is a flavor-packed Indian side dish containing the vegetable okra. In addition to being a fibrous, low glycemic vegetable, okra contains compounds that can reduce the risk of diabetic kidney damage, the November 2010 edition of the "Jilin Medical Journal" states. In the study, 72 diabetic volunteers were given a diabetic diet or the same diet containing daily okra. The okra group had healthier kidneys at the end of the six-month followup period compared to those who didn't eat okra.

Understanding the risk of type 2 diabetes

 Type 2 diabetes occurs when people can't properly convert food to energy that the body's cells can use.

Food is broken down into a blood sugar called glucose. Then a pancreatic hormone called insulin is supposed to convert glucose to energy.

When this process doesn't work correctly, too much glucose builds up in the blood, and the individual cells become starved for energy. And over time, high blood glucose can lead to serious complications, such as heart and kidney disease, stroke or blindness.

The National Diabetes Information Clearinghouse mentions these potential risk factors for type 2 diabetes:

• Being overweight.
• Having a family history of diabetes or cardiovascular disease.
• Having high blood pressure or high cholesterol.
• Having pre-diabetes.
• Being of Asian, African, Pacific Island, American Indian, Alaskan or Hispanic descent.
• Being 60 or older.
• Having had gestational diabetes while pregnant.
• Exercising fewer than three times per week.

Sample 2000 Calorie Diabetic nephropathy Menu

Sample 2000 Calorie Diabetic Menu

• The following menu will maintain not only low caloric intake, but low glucose levels to help manage diabetic neuropathy.

BREAKFAST: 2 slices whole wheat toast, 4 tsp. natural peanut butter, 1 banana and 8 oz. of 1 percent milk.

LUNCH: a small salad consisting of lettuce, radish, cucumber, 1/2 cup carrots, 1/2 cup green pepper (diced) with 3/4 cup tuna fish packed in water and 1 tbsp. low-fat ranch salad dressing. Top it off with 10 small green olives. 12 soda crackers (unsalted tops), 1 peach and water or sugar-free beverage.

DINNER: 6 oz. sirloin steak (with the fat trimmed), 1/2 cup cooked onions and 1/2 cup cooked mushrooms, 1 tsp. canola oil to saute the onions and mushrooms for topping steak, 1/2 cup cooked spinach, 1 large baked sweet potato (approximately 9 oz.), 2 tbsp. sour cream (optional) and water or sugar-free beverage.

SNACK: 1/2 cup strawberries.

Why Add Carbs?

• Why would a diabetic diet include carbs when carbs turn into sugar in the bloodstream? Actually the diabetic diet requires the intake of complex carbs. Complex carbohydrates do not cause a spike in blood sugar because they are digested slower than regular carbs and they make you feel full faster. About 50 percent of the diabetic diet should consist of complex carbohydrates like those found in whole grains, including whole grain breads, brown rice and beans, potatoes (particularly sweet potatoes) and fruits and vegetables.

Keeping a Good Balance

• Meat, dairy, poultry, fish and healthy fats along with carbohydrates (nuts, breads, pasta, rice and potatoes), green leafy vegetables and fruits should all be included in the diabetic diet. The American Diabetes Association has established guidelines for the diabetic diet to include the following:

Choose a variety of foods that are nutrient-dense from the basic food groups.

Eat fruits and vegetables that are fiber-rich.

Diabetics should have 2 1/2 cups of vegetables and 2 cups of fruit daily.

At least half the grains in a diabetic diet should be whole grains.

Minimize the amount of saturated fats and trans fatty acids consumed by choosing lean meats and poultry, and low-fat or non-fat dairy products.

Eat fewer than 2,300 mg of sodium per day.

Diabetic nephropathy is the term used to describe kidney damage caused by the progressive effect of diabetes Roughly 25 to 40 percent of individuals with insulin-dependent diabetes also suffer from nephropathy's effects. Approximately five to 15 percent of non-insulin-dependent diabetes patients also suffer this form of kidney damage. As with other diabetes complications, dietary control is an important factor in limiting the damage caused by diabetic nephropathy.

1.                                                           Detection

o                                                                According to the Cleveland Clinic, if you suffer from diabetic nephropathy, the definitive marker of your condition is the presence of abnormally high amounts of the blood protein albumin in your urine. This condition is known as macroalbuminruria. Your doctor may also detect other signs of kidney degradation, including abnormal results of tests that measure your ability to excrete certain waste products in your urine. As your kidney damage worsens, you may experience symptoms including high blood pressure (hypertension), swelling in your ankles or legs, itching, weakness, decrease in your red blood cells (anemia), nausea, vomiting and an increase in urination, especially at night.

Sodium

o                                                                Diet affects the progress of your diabetic nephropathy in two main ways. First, your condition can make you extremely sensitive to sodium, and your daily sodium intake can have serious effects on your level of hypertension. Minimizing your daily sodium can help you meet hypertension goals set by your doctor, and can also significantly lower your risk for stroke. Additional benefits include decreases in any abnormal enlargement of your heart muscle caused by hypertension (a condition called left ventricular hypertrophy), as well as a decrease in the protein in your urine. Doctors at the Cleveland Clinic recommend a daily sodium intake of 2.3 grams or lower.

Protein

o                                                                Excess protein consumption can also worsen the effects of your diabetic nephropathy. This is true because the breakdown of proteins in your body creates a relatively large amount of waste that must be excreted through your urine. When added to the excessive protein content in your urine triggered by nephropathy, large amounts of dietary protein can potentially increase your rate of kidney degradation. To keep your nephropathy under control, you may need to lower your protein intake to a daily range between 0.8 grams for every kilogram of your body weight and 0.6 grams per kilogram. You may also need to avoid the use of any protein supplement products. Consult your doctor for specific guidelines on protein restriction.

Diabetes

o                                                                Beyond the particular dietary requirements of diabetic nephropathy, you will also need to follow a general dietary plan to manage your diabetes. In particular, you will need to eat a combination of carbohydrates, fat and protein that allows you to properly control the amount of glucose (sugar) in your blood. If you take insulin to treat your diabetes, you may need to adjust your daily insulin dosages based on your food intake. Consult your doctor for the details of food's  value to diabetes and insulin use. You may also consult a nutritionist for help in proper meal planning and sodium and protein control.

Prevant diabetes

YOU DON’T HAVE TO KNOCK YOURSELF OUT TO PREVENT DIABETES!

Studies show that people at high risk for type 2 diabetes can prevent or delay the disease if they lose as little as 10 pounds—by walking 30 minutes 5 days a week andmaking healthy food choices.

 Keep in mind that small steps can lead to big rewards.

Use these tips for ideas to move more and make healthy food choices.

Take your first step today!

Step 1

Move More. Plan to get at least30 minutes of physical activity 5 days each week to help you lose weight.

 You can get this amount in small ways throughout the day.

If you have not been active, talk to your doctor and start slowly to build up to your goal.

Here are some ideas to fit more physical activity into your day.

Park your car farther away from stores,

movie theaters, or your office.

Use TV breaks to stretch, take a quick walk around your home, do some sit-ups, or march in place.

✓ Get your friends and family involved. Set a standing walking date. Or do something that everyone enjoys—shoot hoops, take abike ride, or line dance. ✓ Walk during your lunch break.

✓ Deliver a message to a co-worker in person instead of by email. Take the stairs to your office instead of the elevator.

step2

Make Healthy Food Choices.

Choose foods that are low in fat, sugar, and calories to help you lose weight.

 Limit portion sizes.

 Start today to:

✓Eat a variety of colorful vegetables and fruits. ✓Choose whole grain foods—whole wheatbread and crackers, oatmeal, brown rice,and cereals.

✓Lower fat intake—broil or bake poultry,meats, and fish instead of frying.

✓Lighten your recipes by using nonfat or low-fat milk, yogurt, cheese, sourcream, cream cheese, or mayonnaise.Use cooking spray instead of oil.

✓Avoid getting too hungry by eating a healthy snack between meals.

✓Do not keep chips, cookies, or candy in your home. Instead, for snacks have raw vegetables, fruit, low-fat or non fat yogurt, or a handful of nuts, pumpkinseeds, or sunflower seeds.

✓Choose water to drink.

Studies show that people at high risk for type 2 diabetes can prevent or delay the disease if they lose as little as 10 pounds—by walking 30 minutes 5 days a week andmaking healthy food choices.

 Keep in mind that small steps can lead to big rewards.

Use these tips for ideas to move more and make healthy food choices.

Take your first step today!

Step 1

Move More. Plan to get at least30 minutes of physical activity 5 days each week to help you lose weight.

 You can get this amount in small ways throughout the day.

If you have not been active, talk to your doctor and start slowly to build up to your goal.

Here are some ideas to fit more physical activity into your day.

Park your car farther away from stores,

movie theaters, or your office.

Use TV breaks to stretch, take a quick walk around your home, do some sit-ups, or march in place.

✓ Get your friends and family involved. Set a standing walking date. Or do something that everyone enjoys—shoot hoops, take abike ride, or line dance. ✓ Walk during your lunch break.

✓ Deliver a message to a co-worker in person instead of by email. Take the stairs to your office instead of the elevator.

step2

Make Healthy Food Choices.

Choose foods that are low in fat, sugar, and calories to help you lose weight.

 Limit portion sizes.

 Start today to:

✓Eat a variety of colorful vegetables and fruits. ✓Choose whole grain foods—whole wheatbread and crackers, oatmeal, brown rice,and cereals.

✓Lower fat intake—broil or bake poultry,meats, and fish instead of frying.

✓Lighten your recipes by using nonfat or low-fat milk, yogurt, cheese, sourcream, cream cheese, or mayonnaise.Use cooking spray instead of oil.

✓Avoid getting too hungry by eating a healthy snack between meals.

✓Do not keep chips, cookies, or candy in your home. Instead, for snacks have raw vegetables, fruit, low-fat or non fat yogurt, or a handful of nuts, pumpkinseeds, or sunflower seeds.

✓Choose water to drink.

What is diabetic retinopathy?

What is diabetic retinopathy?

Diabetic retinopathy is a sight-threatening long term complication of diabetes. This leaflet explains how

diabetic retinopathy develops, how it can be treated, how its progress can be slowed and why it is important

for people with diabetes to attend regularly for screening.

The specific changes in the eye which develop as a direct effect of raised glucose levels on the small blood

vessels in the part of your eye called the retina are known as diabetic retinopathy. Severe changes to these

retinal blood vessels can damage your sight.

The retina lines the inside of the eye and acts rather like the film in a camera. The macula is the small central

part of the retina you use to see things clearly and is the part you are using now to read this leaflet. The rest of

your retina is used to view the world around you and to see in the dark.

Let’s look at how these changes might affect your vision in more detail.

Background Retinopathy

These are earliest changes. Small swellings develop on the blood vessels and appear as tiny red dots. These are

called microaneurysms. Larger red dots are called retinal haemorrhages. They lie within the retina and are rather

like a bruise on your skin. Background retinopathy will not affect your vision and does not need treatment. See

Figure 1

Proliferative Diabetic Retinopathy

With time, the blood vessels may become progressively constricted, starving the retina of oxygen and nutrition.

Different signs can be seen in the retina during this progression. These changes are called “pre-proliferative

retinopathy”.

Eventually new blood vessels may develop on the surface of the retina. This is called ‘proliferative diabetic

retinopathy’. See Figure 2 If this happens your sight will be at risk as these new blood vessels may bleed or may

develop scar tissue.

If the new vessels bleed into the jelly (vitreous) inside the eye you may see a sudden shower of floaters or

cobwebs, or your sight may become completely blurred. This is called a ‘vitreous haemorrhage’. You should

contact your GP or an eye department immediately for advice if you experience these symptoms.

The scar tissue can pull the retina away from the underlying nourishing layers of the eye, causing a drop in

vision. A ‘traction retinal detachment’ requires an operation on the eye.

Diabetic Maculopathy

The other way in which your vision may be affected is due to damage to the blood vessels in the macular

region of the retina. This is called ‘diabetic maculopathy’.

The commonest change is that the blood vessels become leaky. Fats and fluid that are normally carried along

in the bloodstream leak into the macula. Fluid leaking causes water-logging in the retina and is called ‘oedema’.

Because the macula is used for detailed vision this will cause progressive blurring of your vision.

Occasionally, the blood vessels in the macula become so constricted that the macula is starved of oxygen and

nutrition. This is called ‘ischaemic maculopathy’ and it does not usually respond to any type of treatment.

Diagnosis and treatment

At present laser treatment is the only proven treatment for sight threatening diabetic retinopathy (STDR). The

aim of laser treatment is to stabilise the changes caused by diabetes. Laser treatment can control but not cure

diabetic retinopathy and it is likely that it will need to be repeated at intervals during a person’s lifetime.

Laser treatment does not generally improve your sight, although in some cases it might. However if the

changes are not treated it is likely that some, or all, of your sight will be lost.

If you have proliferative retinopathy, or your eye specialist thinks you soon may, a large number of laser burns

will be applied to the outer part of the retina, the part of the retina that allows you to see to the side and in the

dark. If given early this treatment is very successful.

If you have leakage in the macula, threatening or affecting your vision, gentle laser burns will be applied to the

leaking areas. Laser treatment prevents serious sight loss in 60-70% of cases of maculopathy.

Many new treatments for diabetic retinopathy are under research at present.

The importance of screening

Untreated diabetic retinopathy is one of the most common causes of blindness in the working-age population.

Laser treatment is very effective at reducing sight loss but only if given at the appropriate stage in the

progression of changes. Unfortunately diabetic retinopathy does not usually affect a person’s sight until the

changes are quite far gone. At this stage, laser treatment is much less effective.

So it is vital that you attend for screening every year!

If problems are detected you will be referred to an ophthalmologist for treatment and follow up.

Other effects of diabetes in the eye

• People with diabetes may occasionally develop double vision due to paralysis of the muscles that control eye

movement .This is usually temporary and resolves by itself.

• There is a relationship between diabetes and the development of open angle glaucoma. Glaucoma is a condition

causing a rise in the pressure within the eye leading to damage to the delicate nerves at the back of the eye. If

untreated this results in loss of vision. Glaucoma is usually treated with eye drops.

• People with diabetes are also at increased risk of developing vascular occlusions in the eyes. This is rather like having

a stroke in the eye. In some circumstances this causes a sudden and dramatic drop in vision. In other cases the vision

is not affected. The risk is higher if the blood pressure is also high. Blood thinning drugs, such as aspirin, reduce the

chance of further attacks.

• Probably the most common other eye condition that people with diabetes develop is cataract. A cataract is

cloudiness of the lens of the eye and leads to progressive blurring of vision. As we get older it is common for all of us,

with and without diabetes, to develop cataract. If a cataract affects your quality of life or prevents a good view of the

retina it can be treated by simple keyhole surgery.

Top tips for healthy eyes

Diabetic retinopathy can get worse over time, but the following measures can help to reduce your risks of

developing diabetic retinopathy and to slow the progress of sight-threatening changes.

• Control your blood glucose as effectively as possible.

• See your doctor regularly to check your blood pressure.

• Keep your regular screening appointment.

• Get advice if you have a problem with your sight.

For your eyes and general health, you should also have your cholesterol levels checked regularly and not smoke.

What is diabetes pre-diabetes and types of diabetes?

Q: What is diabetes?

A: Diabetes means that your blood glucose (sugar) is too high. Your blood always has some glucose in it because the body uses glucose for energy; it’s the fuel that keeps you going. But too much glucose in the blood is not good for your health.

Your body changes most of the food you eat into glucose. Your blood takes the glucose to the cells throughout your body. The glucose needs insulin to get into the body’s cells. Insulin is a hormone made in the pancreas, an organ near the stomach. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into body cells. If your body does not make enough insulin or the insulin does not work right, the glucose can’t get into the cells, so it stays in the blood. This makes your blood glucose level high, causing you to have diabetes.

If not controlled, diabetes can lead to blindness, heart disease, stroke, kidney failure, amputations (having a toe or foot removed, for example), and nerve damage. In women, diabetes can cause problems during pregnancy and make it more likely that your baby will be born with birth defects.

 Q: What is pre-diabetes?

A: Pre-diabetes means your blood glucose is higher than normal but lower than the diabetes range. It also means you are at risk of getting type 2 diabetes and heart disease. There is good news though: You can reduce the risk of get­ting diabetes and even return to nor­mal blood glucose levels with modest weight loss and moderate physical activ­ity. If you are told you have pre-diabe­tes, have your blood glucose checked again in 1 to 2 years.

Q: What are the different types of diabetes?

A: The three main types of diabetes are:

• Type 1 diabetes is commonly diag­nosed in children and young adults, but it’s a lifelong condition. If you have this type of diabetes, your body does not make insulin, so you must take insulin every day. Treatment for type 1 diabetes includes taking insu­lin shots or using an insulin pump, making healthy food choices, get­ting regular physical activity, taking aspirin daily (for many people), and controlling blood pressure and cho­lesterol levels.

• Type 2 diabetes is the most com­mon type of diabetes — about 9 out of 10 people with diabetes have type 2 diabetes. You can get type 2 dia­betes at any age, even during child­hood. In type 2 diabetes, your body makes insulin, but the insulin can’t do its job, so glucose is not getting into the cells. Treatment includes taking medicine, making healthy food choices, getting regular physi­cal activity, taking aspirin daily (for many people), and controlling blood pressure and cholesterol levels. If you have type 2 diabetes, your body gen­erally produces less and less insulin over time. This means that you may need to increase your medications or start using insulin in order to keep your diabetes in good control.

• Gestational (jess-TAY-shun-ul) diabetes occurs during pregnancy. This type of diabetes occurs in about 1 in 20 pregnancies. During pregnancy your body makes hor­mones that keep insulin from doing its job. To make up for this, your body makes extra insulin. But in some women this extra insulin is not enough, so they get gestational diabetes. Gestational diabetes usu­ally goes away when the pregnancy is over. Women who have had ges­tational diabetes are very likely to develop type 2 diabetes later in life.