In India 101 millions people above 18 year age have diabetes & 135 millions have pre diabetes (> 18yrs age) thus, almost every 4th adult have some form of dysglycemia. Earlier data showed that diabetes prevalence in urban people is 10-12% and in rural it is around 6-8 %. Uncontrolled diabetes is mostly associated with complications related to heart, eyes, kidneys, nerves etc. All these complications are preventable through control of blood glucose, blood pressure, lipids & following healthy lifestyle. Type 2 diabetes & pre-diabetes, if detected early, can be prevented by lifestyle modification. Dr. Gupta said that “Genes are the loaded guns and it is the environment which pulls the trigger.” More over diet & exercise play an utmost important role in achieving glycemic, lipid & blood pressure targets, expressed by Dr. Kavita, They added that “Man is the only animal who eats even if he is not hungry”, thus, the awareness should start from schools to prevent childhood obesity. Which ultimately leads adult obesity, diabetes & other non-communicable diseases.

Broadcasted on - 8th Dec 2024

We in India celebrate 14th November as Children’s Day, which is the birthday of the 1st Prime Minister of India Shri Jawaharlal Nehru. Similarly, World Diabetes Day is celebrated on the same date to mark the birthday of Dr. Fredrick Banting who discovered insulin along with Charles Best in 1921, for the treatment of diabetes. In January 1922, Leonard Thompson, a 14-year-old boy became the first human being to receive insulin injection. Millions of people with diabetes around the world do not have access to diabetes care. People with diabetes require ongoing care and support to manage their condition and avoid complications. Thus, the theme for World Diabetes Day for the year 2021-23 is Access to Diabetes Care. The focus is to provide people with diabetes the importance of having access to the right information and care to ensure better treatment and management. Dr. Kavita Gupta highlighted about how to celebrate your Diwali in a healthy way. She discussed on alternatives to simple sugars, fried items, transfat, portion control and mindful eating. Let us listen to the podcast……!

Broadcasted on 10.11.2023

Uncontrolled high blood sugar damages nerves and interferes with their ability to send signals, leading to diabetic neuropathy. High blood sugar also weakens the walls of the small blood vessels (capillaries) that supply the nerves with oxygen and nutrients. High blood glucose levels and high levels of fats, such as triglycerides, cholesterol can damage nerves. Different types of nerve damage cause different symptoms. Symptoms can range from pain and numbness in your upper & lower limbs & it may also affect the functions of internal organs, such as heart and urinary bladder, sex organ etc. The most common symptoms of diabetic neuropathy are numbness, tingling, a burning feet, aching, cramps and weakness. There are different types of neuropathy, the Peripheral Neuropathy (very common and typically affects feet and legs), autonomic neuropathy (causes damage to nerves that control internal organs, leading to problems with heart and blood pressure, digestive system, urinary bladder, sex organs, sweat glands, and eyes. ). Peripheral neuropathy can be detected with the filament test or biothesiometer. Cardiac autonomic neuropathy requires multiple tests through Cardiologist. Keeping your blood sugar, cholesterol & blood pressure within a healthy range and avoiding alcohol & smoking is the best way to decrease the developing of diabetic neuropathy. Broadcasted on 27.10.2023

Wish you all a Happy Navratri festival. Many people with diabetes wishes to practice fasting during these 9 days of Navratri. So, during fasting they should practice smart fasting, keep yourself hydrated, include healthy fat like nuts, seeds, avocados in your diet. Eat at small intervals. Avoid high fat & tried foods. Check your blood sugars regularly. Always consult the physician before fasting. (Narrated by Dr. Kavita Gupta)

Dr. Sunil Gupta expressed his view on lipids. Lipid abnormalities are observed in 70-80% of PWD. This include high triglycerides increase in smaller & denser low density liproproteins (LDL) particles & decreased levels of high density liproproteins (HDL). Every person with diabetes should check their lipid profile annually. In case of abnormalities, they need to re-check lipid levels, 6-8 weeks after initiating lipid lowering therapy. PWD have 2-3 times increased risk of coronary artery disease (CAD) versus their non-diabetic counterpart’s, and dyslipidemia is one of the strong contributing risk factor for CVD.

Broadcasted on - 13.10.2023

Insulin is a hormone secreted by Beta – Cells of pancreas. People with Type 1 DM require insulin throughout their life to manage their blood sugar as their body produces no insulin or very little insulin. In T2DM, insulin is required when people with diabetes (PWD) on oral drugs, fail to adequately control blood glucose or when they present with severe symptomatic hyperglycaemia (where FBG > 250mg & or PPBG > 350mg/dl or GHb- >9-10 % along with symptoms) to reduce beta cell exhaustion & glucose toxicity. It can be given in combination with metformin. It is a temporary condition & insulin can be stopped, once noromoglycemia is achieved in case of Type 2 DM.

Insulin remains the drug of choice during major surgery or in presence of any infection or during any acute illness. 20-30% of T2DM may required insulin within 3 years of diagnosis of diabetes, as they fail to respond to oral drugs, and almost 90% will fail to respond to the maximum dose of oral glucose therapy in 14-16 years duration of diabetes. Importantly, most of the people will need insulin sooner or later in the natural course of T2DM. Insulin therapy can be used alone or in combination with oral drugs to maintain normoglycaemia. Insulin is the best drug of choice in diabetes management. (Recorded 22nd Sept 2023)

India is the second Capital of diabetes in the World and hosts approx. 10 crores diabetics & 13 crores pre diabetics according to the recent lancet study. People with T2DM are usually treated with oral drugs, but in some cases, C- peptide test is done to check whether insulin is being produced properly by the pancreas. People with low C- peptide do not respond to oral drugs & need insulin therapy. Oral drugs are of different types and have different mechanism of actions.

The dose and type of oral drugs are prescribed on the basis of overall profile of an individual. One size may not fit all. Every medicine have its effects and side effects. Some increase the risk of hypoglycemia, while some may increase weight, some work on postprandial sugars, now-a-days, oral drugs like SGLT2 inhibitors are introduced which are beneficial for heart kidneys, liver etc. and also helps in reducing weight, which is one of the major concern nowadays. These SGLT2i can also be given to non –diabetic people with heart failure or kidney disease.

Various oral glucose lowering drugs are metformin (improves insulin sensitivity), sulphonylureas (reduces blood glucose by stimulating beta cells of pancreas), meglitinides (short-acting glucose lowering drug), pioglitazone (improves glycemia by reducing insulin resistance), alpha - glucosidase inhibitors (controls post prandial blood glucose), Oral GLP-1 analog Semaglutide (not only control blood glucose, but reduces weight, have low risk of hypoglycemia & good for heart and kidney functioning).

Thus, always start your medicine by consulting your doctor. Self medication can be harmful.

Insulin requiring diabetes mellitus (IRDM) is an uncommon form of diabetes seen in rural people with low –socio economic background in India. They present with very low BMI (< 18.5 kg/m2 ) with symptoms of severe weight loss and very high blood glucose. Despite very high blood glucose, they don’t develop diabetic ketoacidosis as we see in Type 1 Diabetes. They don’t respond to oral drugs & need insulin throughout their life. Secondary Diabetes also occurs due to pancreatitis either alcoholic & non-alcoholic. There are several reasons for pancreatitis like infection, smoking, auto- immune, alcoholism and gallstones, etc. Post pancreatitis diabetes may present with pancreatic calcification called as Fibro-Calculus Pancreatic Diabetes (FCPD).They also need insulin therapy. Secondary Diabetes Mellitus can also occur due to drugs like steroid therapy & drugs used in Oncology, HIV cases etc. People with few endocrine diseases can also develop secondary DM.

People with T1DM have to take insulin every day, often 4 or 5 times daily. There are different types of insulin & are grouped according to their action profile and content like Rapid or short acting insulin helps to reduce meal time blood glucose, while intermediate and long- acting insulin acts as basal insulin. Mixed insulin are combination of either rapid acting or short acting along with intermediate insulin. Every insulin has its own action profile. Insulin needs to be stored correctly at temperature of 2-8◦C in freeze during hot summers and can be stored at room temperature during winters and rainy season. Correct insulin technique, storage, site rotation all plays a vital role in insulin absorption.

Diet also plays a vital role in management of T1DM. To achieve target A1C goal and target blood sugars, it is important to understand how to balance between food intake, physical activity and insulin. Making healthy food choices & portion control has long term effects on blood sugars. Eating constant amount of food daily and adjusting insulin accordingly helps to improve blood glucose levels. What to eat, how much to eat plays crucial role in blood sugar control. They need to keep balance between macronutrients & micronutrients. Carbohydrates are the main source of the energy & have great impact on blood glucose levels. The amount of carbohydrates in meals can be calculated with the help of carb counting. Keeping watch on carbs in your meals can help match your insulin according to blood glucose and also helps in maintaining target blood glucose levels. Recorded on 28.07.2023.

Children and adults with Type 1 Diabetes Mellitus (T1DM) are at high risk of the acute and chronic complications. The acute complications are Hypoglycemia (low sugar attack) and Diabetic ketoacidosis (DKA). Diabetic ketoacidosis (DKA) is a life-threatening problem that usually affects people with T1DM. It occurs when the body starts breaking down fat at a rate that is much too fast. The liver processes the fat into a fuel as ketones, which causes the blood to become acidic. Diabetic Ketoacidosis begins with mild ketosis in a person with T1DM due to their high blood glucose, dehydration, infection or same precipitating cause. It should be checked in urine ( by keto-Diastix ) if fasting glucose is more than 250mg/dl or Postmeal / Random Glucose is> 350 mg/dl or during any episode of vomiting, fever abdominal pain, drowsiness or any sick day symptoms. (Recorded on July 14 2023 at Akashvani Nagpur)

Hypoglycemia means when the blood glucose falls to below 70mg/dl, which requires to be corrected by oral glucose or Sweets or any available food. Mild and moderated hypoglycemia can be managed at home, but severe hypoglycemia presents with unconsciousness, abnormal behaviour, seizures or rarely paralysis which needs hospitalization. To prevent hypoglycemia, much effort must be invested in education regarding risk factors, warning signs, and treatment of hypoglycemia at an early stage. Also Diabetic Identity Card (DIC) plays an important role. Every diabetic should have DIC which will help them in emergency conditions to get the immediate treatment.