Tag Archives: diabetes

World Diabetes Day | 2019 Awareness

November 13, 2019Awareness Day/Month#CausesOfDiabetes, #DiabetesCampaign, #DiabetesPrevelance, #TuracozHealthcareSolutions, #TypesOfDiabetes, #WorldDiabetesDay, diabetesTuracoz Group

The campaign “World Diabetes Day (WDD)” was launched in 1991 jointly by International Diabetes Federation (IDF) and the World Health Organization (WHO) to address the growing concerns about the rising health issues posed by diabetes. It was officially recognized by United Nations in 2006 and is marked every year on November 14^th, to commemorate the birth anniversary of Sir Frederick Banting, who along with Charles Best co‑discovered insulin in 1922 (1).

The condition

Diabetes is a metabolic disorder characterized by hyperglycemia which results from defects in insulin, secretion, insulin action, or both. A long‑term uncontrolled hyperglycemia can cause damage, dysfunction, and failure of the eyes, kidneys, nerves, heart, and blood vessels (2).

Classification:

Diabetes can broadly be classified into two main categories:

Type 1: In this case, body’s own immune system attacks and destroys the cells in pancreas that produce insulin. Although it can occur at any age, but it is prevalent more among children and young adults who require daily dose of insulin to stay alive.
Type 2: This situation arises when body does not make or use insulin efficiently. it is the most common type and can occur at any age, but middle‑aged and older people suffer from this condition mostly.

Other forms of diabetes include: Gestational diabetes, monogenetic diabetes, and cystic fibrosis related diabetes (3).

Symptoms

Symptoms associated with diabetes in general includes:

Increased thirst and urination
Increased appetite
Fatigue
Blurred vision
Numbness or tingling in the feet or hands
Sores that do not heal

Unexplained weight loss (4).

Causes

Type 1 diabetes is a result of auto immune destruction of beta cells of the pancreas. It may also occur due to certain genetic and environmental factors, such as viruses.
Several factors are involved in causing type 2 diabetes such as obesity, physical inactivity, insulin resistance, genes, and a history of diabetes in the family.
It is believed that gestational diabetes can be caused by hormonal changes during pregnancy along with genetic and lifestyle factors (4).

Prevalence and some statistics

People with diabetes have risen sharply from 108 million in 1980 to 422 million in 2014. Prevalence of diabetes among adults over 18 years of age has almost doubled from 4.7% to 8.5% within the same time period.
Prevalence of diabetes has become a serious health concern specially in middle‑and‑low‑income countries.
As of 2016, approximately 1.6 million deaths were attributed to diabetes only and in 2012, around 2.2 million deaths were reported globally due to high blood glucose.
As per an estimate by WHO, diabetes was the 7^th leading cause of death in the year 2016 (5).

The campaign and the aim

At present WDD is the largest diabetes campaign having presence in more than 160 countries and a reach to more than 1 billion people. It is represented by a blue circle logo adopted by the UN resolution on diabetes on 2007. The color blue signifies the unity among global diabetes community against the epidemic (6).

WDD serves as:

Platform for promoting IDF advocacy efforts throughout the year.
Global driver to promote the importance of taking coordinated and concerted actions to confront diabetes as a critical global healthcare (1).

What’s in store for 2019?

WDD will be observed November 14^th on Thursday this year which is just around the corner. On this day, millions of people around the globe organize events and activities raising awareness about diabetes (6). The campaign projects a dedicated theme every year which runs for one or more year. For the year 2019, the theme is ‘Family and Diabetes’ with an intent to raise awareness about the effect that diabetes has on the family and support network of those who are suffering as well as promoting the role of family in the management, care, prevention, and education (1).

Diabetes affecting family members

Diabetes can be considered as a family disease since the other members of the family somehow get affected if someone, specially a child is diagnosed with it. It is for this reason that it can be regarded as a form of chronic illness like any other chronic illnesses (7).

In a survey named DAWN2 involving 2000 family members of those affected by diabetes reported that 1/3^rd of those experienced a notable burden and negative impact of diabetes, including effects on their emotional wellbeing, financial situation, leisure activities, and physical health (8).

Some of the risks, that family members of those affected by diabetes, experience, can be categorized as (9):

Biological risk: it has been shown that there exists a correlation (0.34 and 0.38) on BMI ranges of those suffering from diabetes and their partners. Partners of those with diabetes have been found to have higher BMI than their counterparts with non‑diabetic partner.
Health behavioral risk: a study involving multiethnic sample of > 500 patients suffering from type 2 diabetes and their partners showed that significant correlation exists between factors such as; consumption of fat, consumption of carbohydrates, total physical activity, and indulging in smoking and alcohol.
Affective/emotional risk: it is reported that female partners of diabetic patients have higher mean level of depressive effect. For male partner, the mean level of depressive effect was comparatively lower but still higher than that of the control subjects.

Role of family members in diabetes management

A family can play a crucial role in managing diabetes of the affected member. Having them involved in the self‑care interventions may help in achieving positive outcomes for the diabetics (10).

Families are required to share responsibilities and reconsider role of family as a result of diabetes. Reports have suggested that low level of conflicts, unity, and efficient organization patterns are linked with better treatment adherence (11).

The Family Approach to Diabetes Management (FADM) is a novel model that focusses on determining and exploring different ways of intra family communication having either positive or negative impact on clinical outcomes while keeping patient and family self‑management at forefront. It has been shown that engagement of entire family is easy to adjust as well as cost‑effective into standard diabetes care in addition to offering positive clinical outcome pertaining to general quality of life and A1C results (12).

Studies have shown that family members while participating in health interventions for diabetes care improves their own knowledge about the disease and inculcate skills necessary to support their loved ones. Family’s participation benefits their own health behaviors and health outcomes (10).

Turacoz Healthcare Solution is committed to raise awareness about diabetes management, prevention and educating people so as to make them help their near and dear ones suffering from this chronic lifestyle disorder to maintain and live a healthy life. Family’s engagement in diabetes care can significantly improve the outcomes and also make other family members learn about the management of diabetes.

If you have any queries, email us at [email protected]

References

About World Diabetes Day. International Diabetes Federation. Available at: https://worlddiabetesday.org/about/
Diagnosis and classification of diabetes mellitus. American Diabetes Association; 2013: 36(S1). 67‑74. Available at:https://care.diabetesjournals.org/content/36/Supplement_1/S67
What is diabetes? National Institute of Diabetes and Digestive and Kidney Disease. Available at: https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes
Symptoms and causes of diabetes. National Institute of Diabetes and Digestive and Kidney Disease. Available at:https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes
World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/diabetes
Getting Ready for World Diabetes Day 2019. Diabetes self‑management. Available at: https://www.diabetesselfmanagement.com/blog/getting-ready-world-diabetes-day-2019/
The family approach to diabetes management: Theory into practice toward the development of a new paradigm. Diabetes Spectrum. 2004; 17(1): 31‑36. Available at: https://spectrum.diabetesjournals.org/content/17/1/31
Family matters in diabetes. The Lancet Diabetes and Endocrinology. 2018; 12(6): 911. Available at: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(18)30317-6/fulltext
Fisher L. Family relationships and diabetes care during the adult years. Diabetes Spectrum. 2006; 19(2): 71‑74. Available at: https://spectrum.diabetesjournals.org/content/19/2/71
Baig AA, Benitez A, Quinn MT et al. Family interventions to improve diabetes outcomes for adults. 2015; 1353(1): 89‑112. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624026/
Ahmed Z, Yeasmeen F. Active family participation in diabetes self‑care. A commentary. Diabetes Management. 2016; 6(5): 104‑107. Available at: https://www.openaccessjournals.com/articles/active-family-participation-in-diabetes-selfcare-a-commentary.pdf
Solowiejczyk J. The family approach to diabetes management: Theory into practice toward the development of a new paradigm. Diabetes Spectrum. 2004; 17(1): 31‑36. Available at: https://spectrum.diabetesjournals.org/content/17/1/31

Diabetes Prevention Tips

November 5, 2019Tips#AvoidJunkFood, #DiabetesPrevention, #ExerciseRegularly, #QuitSmoking, #TuracozHealthcareSolutions, #TypesOfDiabetes, #YearlyCheckups, diabetesTuracoz Group

According to statistics by the WHO, “The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014.” Also, “In 2016, an estimated 1.6 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012.”
It is astounding how many people are affected by this chronic disease. Diabetes occurs when the pancreas does not produce enough amounts of insulin for the body or when the body cannot effectively make use of the insulin it produces. Insulin is essential to the body as it is responsible for regulating blood sugar. Unbalanced (high) blood sugar levels are what causes diabetes.
Diabetes is categorized into the following four types:

Figure 1: Types of diabetes

Insulin is the hormone which is highly essential for maintaining proper blood sugar levels, for the adequate functioning of the entire body. If, for some reason the body produces unbalanced levels of this hormone, over time, high blood glucose can lead to the following problems:

Figure 2: Problems due to high blood glucose levels

Diabetes imposes many restrictions on life and one can take several steps to prevent developing it. Here are some of the suggested diabetes preventions tips:

Exercise daily:

The most common advice anyone can give to stay mentally and physically fit is to workout daily. The applications of exercising daily are endless and when it comes to preventing diabetes, it is highly beneficial. Exercising regularly increases the insulin sensitivity of your cells. This basically means that less insulin is used up to keep your blood sugar levels under control.

A study published on NCBI found that people with prediabetes who trained under moderate-intensity experienced an increase in insulin sensitivity by 51%. And people who adopted high-intensity exercises measured an increase of 85%.

Even though the results vary, it’s totally up to you to choose what style of training program you wish to follow. Straining your body will do you no good, but also taking it casually will never be beneficial.

Quit Smoking:

Smoking has been associated with many major diseases and conditions. It has been proven to be the major cause of many health conditions, which includes heart diseases and cancer to various organs, such as the lungs, mouth, breast, digestive tract and prostate. Tobacco usage has no proven benefits and even second-hand exposure to tobacco smoke can be very harmful.

A research paper published in 2012 on the NCBI website states that smoking and second-hand smoke exposure is linked to type 2 diabetes.

An analysis of over one million people, showed that smoking was found to increase the risk of diabetes by 44% in average smokers.

Once you quit smoking, the effects on the body it had seem visible as they subside. Smoking is closely linked to the risk of diabetes, and quitting has been shown to reduce this risk.

Avoid processed foods:

Fitness cannot be achieved if you aren’t doing justice with your diet. Any experienced athlete or bodybuilder will always say one thing, 70% diet and 30% gym is what results in a fine toned body. Processed or “junk” food damages your body from both the inside and outside. It is linked to various heart diseases, obesity and to diabetes.

These food products are high in vegetable oils, refined grains and preservatives, which when consumed over a long period of time, increase the risk of developing diabetes. Cutting back on these unhealth packaged foods can prove to be very helpful.

To be healthier, from both the inside and outside, it is recommended to adopt a diet consisting of minimum amounts of carbs and a diet high in fiber. Also portion control is one thing that people should be conscious about. Believe it or not, eating an unhealthy amount of healthy food can also lead to many unwanted problems.

Visit your doctor from time to time:

Get yourself checked annually. One of the best ways to stay on top of any disease or ailment is to be aware of it before the symptoms start to set in. At your annual physical, make sure to get a blood pressure check, an eye exam, and screenings for other complications such as kidney damage, nerve damage, and heart disease. To make sure you aren’t developing diabetes, blood-glucose levels also need to be measured.

Prevention is always better than cure! Follow these tips to notice a change in your lifestyle.

Turacoz Healthcare Solutions aims to spread awareness about diabetes. We urge the people to exercise regularly and stay fit. Adopting a balanced diet and limiting the intake of sweet substances is highly beneficial and helps in cutting down the risk of developing diabetes. Smoking is one habit that should be dropped. Quitting the use of tobacco products not only helps with reducing the risk of diabetes but also other bodily diseases such as cancer and heart diseases.

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It’s about the Blue Circle: Diabetes, its types and challenges

November 1, 2018Awareness Day/Month#ChallengesinDiabetesDiagnosis, #DiabetesAwarenessMonth, #DiabetesManagement, #prediabetes, #TuracozHealthcareSolutions, diabetesTuracoz Group

Not everything sugar is good for you! The overdose of sweetness in your life can be fatal as the threat called ‘Diabetes’ is hovering over the head of millions of people around the globe. It has emerged as the leading cause of blindness, kidney failure and lower limb amputations, globally.

The worldwide commonness of diabetes among grown-ups of the age 18 years and above has ascended from 4.7% in 1980 to 8.5% out of 2014, i.e. 108 million to 422 million.

In 2016, an expected 1.6 million deaths were straightforwardly caused by diabetes. Another 2.2 million deaths were inferable from high blood glucose in 2012. As per WHO estimates, diabetes was the 7^th prominent cause of deaths in 2016. Diabetes has been prevalent in the middle and low-income nations.

When talking about Asian countries, India accounts for the most number of diabetic people. As per WHO, India is on the top of the list of the countries with highest number of diabetic people. Currently India represents 49% of world’s diabetic population, with around 72 million cases in 2017 and this figure is expected to rise by more than double by the next decade.

A month dedicated to Diabetes:

The month of November is observed as Diabetes month and November 14^th of every year is celebrated as World Diabetes Day in order to raise awareness about Type 1 and Type 2 diabetes, considering the gravity of the ailment.

The theme for the year 2018-2019 is “The Family and Diabetes”.

We all have come across a pink ribbon for breast cancer awareness, a red ribbon for AIDS awareness, etc. The World diabetes is denoted by a Big Blue O.

The blue colour is intended to summon the shade of the sky, and the circle is an image of solidarity. This symbol thus stands for “unite for diabetes”.

What is diabetes?

Diabetes is a critical, long lasting condition where your blood glucose level is extreme. It is chronic disease in which he pancreas either are unable to produce insulin or the body is not able to efficiently use the insulin formed.

Be it any type of diabetes, it holds one thing in common which is that they cause the patients to form extreme level of glucose (sugar) in their blood. It is true that the human body needs glucose as it is the source of energy but excessive formation of it is not good for the body.

Glucose is formed when our body breaks down the carbohydrates which we consume in form of solids or liquids and this glucose is then diffused to the blood. A hormone named ‘Insulin’, secreted by pancreas, helps the glucose in the blood to enter the cells and provide us energy.

A non-diabetic person’s pancreas realizes when the glucose enters the blood and eventually releases the right amount of insulin helping the glucose to enter the cells. This whole process doesn’t function properly in a person affected by diabetes.

The 2 main type of diabetes are: Type 1 and Type 2. They’re diverse conditions, yet they both are serious.

Type 1 and type 2 diabetes:

People with Type 1 diabetes are not capable of making insulin, but the case differs for the person with Type 2 diabetes. The person with latter form of diabetes has either insufficient amount of insulin produced, or the insulin formed doesn’t work effectively. Around 90-95% of a diabetic cases accounts for Type 2 diabetes.

In both types of diabetes, the glucose is unable to enter the cells and thus start accumulating into blood, causing various health issues such as heart problems, issues with eyesight, adverse effect on kidneys, etc.

Symptoms of Type 1 diabetes:

Polyuria (increased frequency of urination)
Feeling excessively thirsty (polydipsia)
Frequent hunger
Weight loss
Changes in eyesight
Tiredness

Symptoms of Type 2 diabetes:

These are almost similar to the Type 1 diabetes but may remain undiagnosed in initial or early stage and hence the complications arise.

Other rare types of diabetes are:

Maturity onset diabetes of the young (MODY): A rare types of diabetes that runs in family and is caused by a change or mutation in a single gene. So if any parent has this mutation, there are 50% chances that their child will inherit it from them and even can develop it before the age of 25 irrespective of their weight, lifestyle, etc.
Neonatal diabetes: It is spotted under the age of 6 months. In it the mutation of genes affects the insulin formation resulting in a high blood glucose level. Around 20% of people affected by this have developmental delay or epilepsy. It’s different from Type 1 diabetes on the point that Type 1 doesn’t affect a person below the age group of 6 months.
Wolfram syndrome: A rare type of genetic disorder which is also acknowledged as DIDMOAD syndrome, pertaining to its 4 common features (Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy & Deafness).
Alstrom syndrome: It is also a rare genetically inherited condition which has features like Retinal decay, loss of hearing capacity, obesity, kidney failure, rheumatic problems, etc.

People suffering with Type 2 diabetes have quite a few issues when monitoring their health, like:

Monitoring their blood sugar level at regular intervals, throughout the day.
Consuming a diabetic-friendly diet
Exercising on daily basis to stay fit and maintain weight.
Taking the daily dose of medications.
Frequently visiting the doctor for check-ups.

What makes this a tedious task is that only 1% of diabetic people’s time is spent under the guidance of a healthcare expert, rest 99% are managing it on their own. Self-management is the toughest form of management.

Adhering to a strict and healthy diet becomes quite a difficult task for people today, considering their hectic life schedule.

The most crucial aspect in case of diabetes is early diagnosis. The prediabetes is very important in determining the factors related to Type 2 diabetes. When talking about the challenges in diabetes diagnosis, the awareness of the disease is the most crucial part. The prediabetes stage is the phase when one needs to get alert in order to avoid further complications in diabetes and reach out for early and timely diagnosis.

What is prediabetes?

It is concerned with the pre-diagnosis of diabetes. It is basically a warning signal for a person whose blood sugar level is higher than normal. Though it is not considered as diabetes, but still implementing a healthy lifestyle from thereon can help reduce the risk of forming Type 2 diabetes later.

By adapting a healthy lifestyle, eating healthy and exercising daily and maintaining a healthy weight can prevent prediabetes from converting into diabetes.

Prediabetes strikes when your body starts encountering trouble with the use of insulin. It is yet not clear as to what causes the insulin process to go astray in some people.

Here are the risk factors that contribute to the development of prediabetes:

Weight issues: Being overweight i.e. having a BMI more than 25 can result in prediabetes.
Absence of exercise: Not doing any form of physical activity can result into mismanagement of weight and leading to problem like obesity which is the root cause of prediabetes.
Family history: If someone in your close blood relation or a family member near to you has diabetes, then you are likely to develop it too, as it is hereditary in nature.
Age: Getting older has its own set of cons and one such is the risk of developing diabetes. People with age 45 & above can expect to be at the risk of prediabetes and post 65, this risk increases even more.
Other health issues: People with high blood pressure/hypertension are at the risk of getting type 2 diabetes.
PCOS: In women, PCOS (Polycystic Ovarian Syndrome), wherein multiple cysts get formed into ovaries, increases the risk of developing prediabetes as one cause for these cysts can be insulin resistance.
Gestational diabetes: If a woman has developed diabetes during the pregnancy, there are higher chances of developing prediabetes in the long run.

Challenges in health management during diabetes:

Absence of disease arbitration for pre-diabetics: As per American Diabetes Association, the predominance of diabetes has hiked up by 40%, during the last decade. Without any mediation, these numbers will constantly rise in the coming years. 1 in every 3 adults is suffering from prediabetes, but dismally only 7-10% are informed of it. In the absence of intervention, around 30% of such people will fall prey to Type 2 diabetes in a time-span of 3 years.
Cohesion with medication: Diabetic people juggle between the costs, avenues, competing arrangements and absence of awareness when they struggling to adhere to the medication.
Expensive treatments: The treatment expenses for diabetes are really high. The minimum cost care is impediment, early diagnosis and treatment soon after to minimize the chances of any complications.
Inclusion for meds and supplies associated with diabetes: The patients today bear a huge responsibility towards their healthcare costs. Along with the payment of rising insurance premiums, they also have to cope-up with the extra costs of co-pays, co-insurance, etc.

Every problem comes with a solution and so is the case with diabetes. Here are the solutions for the complexities of diabetes management:

As mentioned, that early diagnosis is very crucial, staying alert and vigilant about the early symptoms is very important which helps in early detection of diabetes. Symptoms like excessive hunger and urination, excessive thirst, fatigueness, etc. are to be watched out for and in case of any doubt consulting with the physician will help in the diagnostics of prediabetes.
A fasting plasma glucose test is used to detect diabetes (126 mg/dl & more) or prediabetes (100mg/dl-125mg/dl) and provides with the measurement of blood glucose, post eating for a minimum of 8 hours.
Oral Glucose Tolerance is used to measure blood sugar, post 8 hours of eating anything and post 2 hours of drinking glucose drink. It tests diabetes (200mg/dl & above) and prediabetes (140mg/dl-199mg/dl).
There is a random plasma glucose test which in conducted test blood sugar irrespective of when the food is consumed. With particular symptoms like excessive urination, hunger or thirst and weight loss, etc., values of 200mg/dl or more is tested.

Type 1 diabetes is diagnosed earlier as compared to Type 2 diabetes as the symptoms are quite evident and it requires immediate medical care. In case of Type 2 diabetes, the symptoms are too mild to be detected early and can go unnoticed for 7-10 years, inviting more complications and greater health risks.

Now it is about the lifestyle choices that you make. The sedentary lifestyle which people lead today has given birth to various health issues, diabetes being the main. Try to live a more active and healthy lifestyle to prevent yourself against this disease. Healthy eating and healthy living is the key to a healthy life. Being aware regarding the disease can help reduce the risk of its development.

Turacoz Healthcare Solutions-a medical communications company, understands the complexity of diabetes and acknowledges that the hectic schedule of the corporate has fuelled the condition. Turacoz practices a healthy working style for its employees. Practicing desktop yoga, eating healthy and taking breaks in-between work is the culture practiced here. Turacoz values its employees and understands the fact that ‘health is wealth’ and is constantly working towards making work-life healthier for the employees and practicing a active and healthy living style.

Turacoz follows a ‘NO-STRESS’ policy for its employees and believes in keeping the work environment friendly and healthier to avoid any work or workstation related stress and pressure, as stress is also a key factor in triggering diabetes among people.

“Healthy living, healthy eating and healthy working are the mantra for Turacoz Healthcare Solutions”.

Ramadan Fasting and Diabetes Management

June 13, 2016Health & Fitness#HealthcareSolution, #MedicalWriting, diabetesTuracoz Group

Ramadan is a holy month for Muslims in which consumption of food and drinks, medications, and smoking is forbidden between dawn and dusk. During Ramadan, millions of Muslims fast during the daylight hours. People generally consume only two meals per day during this month, one after sunset (Iftar) and the other before dawn (Suhur). However, this can lead to metabolic changes in the body and can give rise to various health complications, especially in diabetic patients. Although any person who is ill or has some medical condition like diabetes can choose not to fast, it becomes a personal decision. In casediabetic patients choose to fast, they should consult their doctors before starting fasting during Ramadan.

Diabetes is characterized by high blood sugar levels in the body due to insulin deficiency or inability of the body to use insulin properly. Long fasting and fluid restriction during the day can lead to dehydration and fluctuations in sugar levels. These patients can experience any one of the following:

Hypoglycemia (lowering of blood sugar levels) due to long fasting hours leading to seizures and loss of consciousness
Hyperglycemia (increased blood sugar levels) due to increased food/sugar intake during Iftar and abstaining the use of antidiabetic medications
Diabetic ketoacidosis (a life-threatening situation) in patients having high blood glucose levels and taking reduced dosage of insulin during Ramadan
Dehydration leading to volume and electrolyte depletion and causing syncope, falls, and injuries

Managing Diabetes During Diabetes:

It is very important that patients with diabetes make a personal choice of fasting during Ramadan only after considering their health condition and proper consultation with their physicians. They should be aware of the associated risks and adhere to the doctors’ recommendations in order to have a safe fasting. Diabetic patients should monitor blood glucose levels regularly during Ramadan. If the blood glucose falls below 70 mg/dL, the fast needs to be ended. Checking blood glucose is very important and does not mean breaking the fast. Secondly, dosage of antidiabetic medications need to be modified during Ramadan. That doesn’t mean that a person has to stop taking his medications. Only the doses will be altered based on his sugar levels and current condition.

During Suhur, a diabetic patient should go for healthy breakfast including starchy carbohydrates and some proteins to slow down the digestion and maintaining the feeling of fullness. Breakfast can include: whole grain cereals, some lentils, and low-fat milk. During Iftar, one should drink plenty of fluids, but avoid caffeine and sugar containing beverages. One should not overeat during Iftar and have small meals. Fried food, sweets, and excessive sugar containing foodsshould be avoided.

With proper management plan and regular glucose monitoring, diabetic patients can experience a healthy living and maintain their religious beliefs during the month of Ramadan.

HAVE A HAPPY AND HEALTHY RAMADAN!

Turacoz aims to spread the awareness on various healthcare related issues as a part of their Corporate Social Responsibility (CSR) activity. Our medical writing team is well-versed with recent advances in various therapeutic areas. We provide support in publication writing, clinical research and regulatory writing, medical advisory board meetings and medical marketing services.

Diabetes Tech Advancemnents

November 17, 2015Health & Fitness#10paraun10, #aade, #bgnow, #BigBlueTest, #blueheelsociety, #DiabetesAwarenessMonth, #rwdiabetes, diabetesTuracoz Group

Over the years there are many technological advancements that came into light in the treatment of diabetes. These technological advancements in diabetes care helped from the discovery, production of insulin till the development of less painful ways to deliver it to the patients.

Technological developments will continue and probably even increase, as the epidemic of diabetes continues to grow rapidly. Advances in medical technology can help control diabetes with ease, a more convenient, and a more accurate tool for everyone.

Echo Therapeutics

These are non-invasive, wireless, transdermal continuous glucose monitoring (tCGM) systems for diabetic patients. These provide reliable data continuously, conveniently and in a cost-effective way. Also reduce the dependence on periodic finger stick testing.

Omnipod

These are wireless systems that help in delivering insulin. OmniPod is discreet and durable. Wireless and waterproof, the Pod holds and delivers insulin without tubes or shots. This also programs the personalized insulin delivery, calculates suggested doses, and has a convenient style.

Mobile Devices and Social Media Tools

These help in connecting with others and the healthcare physician. Social media also helps in the maintenance and monitoring of diabetes and helps the diabetic patients connect each other. These websites of diabetes can not only clarify the doubts but also support the patients’ problems. Also mobile devices help in tracking the data and send test results directly to the doctor.

Artificial Pancreas

This is helpful and provides relief for type 1 diabetics. An automated system used to disperse insulin based on changes in blood sugar levels. This is a wearable device acting as an artificial pancreas, the system will enable people living with type 1 diabetes to better maintain blood sugar levels within a target range with minimal effort.

High-Tech Tattoo Sensor

This is again a substitute for the finger-sticking method. This includes a sensor that changes color with rising blood sugar levels. This high-tech tattoo contains a special kind of ink that reacts with glucose and is injected into the outermost layer of skin.

Technology continues to develop and help patients with diabetes with much convenient and easier methods.

Turacoz Healthcare Solutions as a socially responsible company spreads the word and awareness and looks forward to collaboration or associations with other agencies/companies with similar goals and aspirations. We have a skilled and competent team of medical writers, clinicians, researchers and biostatisticians. Our clients include major pharmaceutical companies, hospitals and healthcare professionals. Our experience has been in supporting publications, creating regulatory documents, conducting observational studies, designing and creating for print and digital marketing as well as customizing sessions on medical writing.

#DiabetesAwarenessMonth

November 5, 2015Awareness Day/Month#10paraun10, #aade, #bgnow, #BigBlueTest, #blueheelsociety, #DiabeteAwareness, #rwdiabetes, diabetesTuracoz Group

Reduce your risk today: Eat healthy, Walk more and Weigh less

Lifestyle modification for prevention of diabetes mellitus

Structured programs that emphasize lifestyle changes for preventing diabetes are recommended by the American Diabetes Association (ADA) for people at high risk for developing type 2 diabetes. These include:

Dietary strategies including low intake of dietary fat and reduced calories
Regular physical activity (150 min/week)
Moderate weight loss (7% body weight)

Individuals at high risk for type 2 diabetes should be encouraged to achieve the U.S. Department of Agriculture (USDA) recommendation for dietary fibre (14 g fibre/1,000 kcal) and foods containing whole grains (one-half of grain intake). Low–glycaemic index foods that are rich in fibre and other important nutrients are to be encouraged.

Medical nutrition therapy

Medical nutrition therapy (MNT) is a therapeutic approach for treatment of medical conditions and their associated symptoms via the use of a specifically tailored diet devised and monitored by a medical doctor, registered dietitian or professional nutritionist.

MNT goals for prevention of diabetes

Goals of nutrition therapy for individuals at risk for diabetes or with pre-diabetes

Decrease the risk of diabetes and cardiovascular disease (CVD) by promoting healthy food choices and physical activity leading to moderate weight loss that is maintained.

Goals of nutrition therapy that apply to individuals with diabetes

Maintenance of

Blood glucose levels in the normal range or as close to normal as is safely possible
Lipid profile that reduces the risk for vascular disease
Blood pressure levels in the normal range or as close to normal as is safely possible

Prevention of, or decrease in, the rate of development of the chronic complications of diabetes by modifying nutrient intake and lifestyle.
Consideration of individual nutrition needs and personal preferences with willingness to change.
Maintenance of the pleasure of eating by only limiting food choices as indicated by scientific evidence.

Goals of MNT applicable to specific situations

For youth with type 1 diabetes, or type 2 diabetes, pregnant and lactating women, and older adults with diabetes, meeting the nutritional needs for such specific times is important.
For patients being treated with insulin or insulin-stimulating medication, self-management training is essential for safe conduct of exercise, including the prevention and treatment of hypoglycaemia, and diabetes treatment during acute illness.

Significance of weight loss in pre-diabetes and diabetic conditions

Weight loss is recommended for all such individuals who have or are at risk for diabetes. In obese insulin-resistant individuals, modest weight loss has been shown to improve insulin resistance.
Physical activity, exercise and behaviour modification are important and most helpful in reducing body-weight.
For weight management, either low-carbohydrate or low-fat calorie-restricted diets may be effective in the short term (up to 1 year).
For patients on low-carbohydrate diets, monitoring of lipid profiles, renal function, and protein intake (in those with nephropathy), and adjustment of hypoglycaemic therapy is recommended.
Weight loss medications may be considered in the treatment of overweight type 2 diabetes patients and can help achieve 5–10% weight loss when combined with lifestyle modification.
Bariatric surgery may be considered for some individuals with type 2 diabetes and BMI ≥35 kg/m2 and can result in marked improvements in glycaemia.

Diabetes Management and Ramadan: What does ADA say?

July 12, 2015Health & Fitnesscomplete health, diabetes, manuscript, medical writings, ramadan, turacozTuracoz Group

Ramadan is a lunar based fasting month for Muslims. Muslims who fast during this time should refrain from eating, drinking, use of oral medications and smoking from predawn to post sunset, with no restrictions on food or fluid intake between sunset and dawn. Muslims with diabetes insist on fasting during the holy month, thus creating challenge for themselves and their health care providers. In this article we enumerated some risk factors associated with diabetic patients and how to manage diabetes in Ramadan, according to the ADA recommendations shared in 2005.

Risk associated with fasting in patients with diabetes.

Hypoglycemia: Reduced food intake is a well-known risk factor for developing hypoglycemia. The effect of fasting during Ramadan on hypoglycemic rates is not well known. But, in a study conducted it was observed that fasting during Ramadan increased the risk of severe hypoglycemia by 4.7 fold in patients with type 1 diabetes and 7.5-fold in patients with type 2 diabetes. In addition, the risk of severe hypoglycemia was more common in patient in whose dosage of oral hypoglycemic agents or insulin was changed as well as those who reported a significant change in their lifestyle.

Hyperglycemia: Glycemic control deteriorated, improved, or showed no change in patients who fasted during Ramadan. A study conducted showed 5 fold increase in the incidence of severe hyperglycemia (required hospitalization) for patients with type 2 diabetes and 3 fold increase in the incidence of severe hyperglycemia with or without ketoacidosis in patients with type 1 diabetes. This can be attributed to excess reduction in medication dose for preventing hypoglycemia. Patients with reported increase in food and/or sugar intake had higher rates of severe hyperglycemia.

Diabetic ketoacidosis: Patients with type 1 diabetes fasting during Ramadan have a greater risk of developing diabetic ketoacidosis, especially if their diabetes is poorly controlled. The risk is increased even further because of excessive reduction of insulin dose as food intake too is relatively reduced during that time.

Dehydration and thrombosis: Fluid intake limitation during the fast if prolonged, leads to dehydration (becomes severe in hot and humid climates and in patients who perform physical labor).

Hyperglycemia causes an osmotic diuresis, adding to the volume and electrolyte depletion. In patients with preexisting autonomic neuropathy orthostatic hypotension may be developed. Syncope, falls, injuries, and bone fractures may occur from hypovolemia and the associated hypotension. Blood viscosity may be increased due to dehydration, which may enhance the risk of thrombosis and stroke.

Managing diabetes in Ramadan

Frequent monitoring of glycaemia: especially important for patients with type 1 & 2 diabetes requiring insulin.

Nutrition: Have a well-balanced diet. Avoid large amount of food rich in carbohydrates and fats at sunset. Foods having complex carbohydrate ((slow digesting foods) should be had as a predawn meal and must be eaten as late as possible before start of daily fast. Fluid intake must be increased during non-fasting hours.

Exercise: Normal physical activity may be maintained. Avoid excessive physical activity, which can lead to higher risk of hypoglycemia, especially during few hours before sunset meal.

Breaking the fast: Fast must be broken if

Feeling hypoglycemic (blood glucose of 60 mg/dl). Blood glucose may drop further if treatment is delayed.
Blood glucose reaches 70 mg/dl in first few hours after start of sunset and especially if insulin, sulfonylurea drugs, or meglitinide are taken at predawn.
Blood glucose exceeds 300 mg/dl.
Avoid fasting on sick days

Pre-Ramadan medical assessment: should be undertaken 1–2 months before Ramadan. During this time, appropriate blood studies need to be done and evaluated. Individualized advice must be provided if there is any potential risk to the patient. In addition, necessary changes in diet or medication regimen should be made.

Ramadan-focused structured diabetes education: Healthcare professionals need to be trained to deliver structured diabetes education during Ramadan, which should include:

Glucose monitoring importance during fasting and nonfasting hours.
When fast should not be done or stopped.
Planning of meal if feeling hypoglycemic and dehydrated during long fasting hours.
Timing and intensity of physical activity during fasting.
Importance of diabetes-related medications and its risk during fasting.

Managing of patients with type 1 diabetes

Close monitoring and frequent insulin adjustments are essential for avoiding hypo- or hyperglycemia in patients with type 1 diabetes.
Continuous subcutaneous insulin infusion (pump) management can also be done, but is substantially expensive.

Managing of patients with type 2 diabetes:
Diet-controlled patients : there is a potential risk for occurrence of postprandial hyperglycemia in type 2 diabetic patients. In such cases:

Spreading calories over 2 to 3 smaller meals during the nonfasting interval may help in preventing excessive postprandial hyperglycemia.
Intensity and timing of physical activity may be modified e.g.,2 h after the sunset meal.

Patients treated with oral agents: choice of oral agents should be individualized.
Patients on metformin : have limited possibility of severe hypoglycemia and may fast safely. However, dose timing should be modified so as to provide 2/3rd total daily dose with the sunset meal and the 1/3rd before the predawn meal.
Use of sulfonylurea’s: is unsuitable for use during Ramadan as it posses inherent risk of hypoglycemia. Use of these drugs should be done with individualized with caution. Chlorpropamide use is contraindicated during Ramadan due to risk of prolonged and unpredictable hypoglycemia.
Short-acting insulin secretagogues: could be taken two times daily before the sunset and predawn meals.
Incretin-based therapy: drugs such as Exenatide in particular, can be given before meals to minimize appetite and promote weight loss. Due to its short half-life of 2 hrs, it’s not associated a substantial effect on fasting glucose.
Patients treated with insulin: To maintain necessary levels of basal insulin and preventing fasting hyperglycemia, use of intermediate- or long acting insulin preparations and short acting insulin need to be given before meals. Also, injecting long-acting or intermediate-acting insulin can give adequate coverage in few patients as long as dosage is appropriately individualized.
Insulin Pumps: Frequent glucose monitoring is needed due to failure of the pump infusion site can result in severe deterioration in control over a few hours. Patients with type 1 diabetes must be fully educated and facile about the use of an insulin pump. Before Ramadan, they should receive adequate training and education with respect to self management and insulin dose adjustment. Also, how to adjust their infusion rates as per results of frequent home blood glucose monitoring must be taught.

Pregnancy and fasting during Ramadan: Women with presentational or gestational diabetes are at increasingly high risk and should be strongly advised not to fast during Ramadan. However, if they insist to fast, then special attention must be given to their care. Pre-Ramadan evaluation of their medical condition should be carried out that includes, preconception care with emphasis on achieving near-normal blood glucose and A1C values, counseling regarding maternal and fetal complications associated with poor glycemic control, self management education skills. These patients should be managed in high-risk clinics having obstetrician, diabelogists, a nutritionist, and diabetes nurse educators. Appropriate diet and intensive insulin therapy should be given to pregnant patients. In addition, frequent monitoring and insulin dose adjustment is necessary.

Management of hypertension and dyslipidemia: Dehydration, volume depletion, and tendency towards hypotension may occur with fasting during Ramadan, especially if fasting is extended for long and is also linked with increased perspiration. Therefore, dose and/or type of anti-hypertensive medications should be adjusted for preventing hypotension. Further, proper counseling need to be given and agents previously given for managing elevated cholesterol and triglycerides should be continued.

Key messages

Fasting by diabetic patients should be done after prolonged discussion with their health care provider so as to discuss the risks involved. Patients, who insist on fasting in Ramadan, must undergo pre-Ramadan assessment and receive appropriate education and instructions related to physical activity, meal planning, glucose monitoring, and dosage and timing of medications. Newer pharmacological agents have lesser hypoglycemic potential and can be specifically useful during Ramadan. Similarly, insulin pump therapy can give greater safety in Ramadan setting.