Diabetes is a growing concern, particularly among younger individuals. It is a condition where the body either doesn’t produce enough insulin or/and becomes resistant to insulin. Type 1 diabetes, is diagnosed in childhood and is now being seen in children which can be as young as at six months age. On the other hand, Type 2 diabetes, which was traditionally observed in adults aged 50-70, is increasingly affecting people between the ages of 20 and 40 years.

People diagnosed at young age have longer life span and thus they need to remain more cautious for their blood glucose, blood pressure, cholesterol & weight control targets. To remain complication free for 30-40 years, they need to be more alert than others.

Diet plays a significant role in managing diabetes. The glycemic index (GI) of foods affects how quickly sugar enters the bloodstream. Foods with a high GI, such as simple carbohydrates, can cause rapid spikes in blood sugar levels, while foods with a low GI, like complex carbohydrates, lead to slower, more controlled blood sugar rises. To manage diabetes, it’s essential to focus on portion control, limit sugary foods, and incorporate healthy, balanced meals.

Expert: Dr. Sunil Gupta

Anchor: Pranjali Bawaskar

Recorded on: 31/01/2025

Recorded at: Akashwani Nagpur

The beta cells of the pancreas are responsible for producing insulin, a hormone essential for regulating blood sugar levels. When these beta cells become damaged, insulin production declines, leading to impaired glucose metabolism. As a result, glucose, which is needed for energy, accumulates instead of being properly utilized by the liver, adipose tissue, and muscles. Without sufficient insulin, blood sugar levels rise, potentially leading to diabetes.

Additionally, environmental factors such as obesity and stress contribute to the risk of diabetes. Maintaining a healthy diet and regular exercise can help safeguard against these issues. If you have a family history of diabetes—such as parents, grandparents, uncles, or aunts—it is crucial to minimize environmental stressors to protect your health. Addressing obesity can significantly reduce the risk of future complications.

So Genes are the loaded Guns….. Environment pulls the trigger.

Expert: Dr. Sunil Gupta

Anchor: Swati Huddar

Recorded on: 24/01/2025

Recorded at: Akashwani Nagpur

We Should concentrate on pregnancy, her healthy nutrition, dietary habits, dietary quality, biochemical parameters, and obesity; by focusing on these aspects, we can protect future generations from diabetes. Currently, if we prioritize fetal health, we have the potential to shield future generations from diabetes.

Regarding type 2 diabetes, as you inquired, the initial phase of insulin release does not occur properly in this condition, which means the beta cells struggle to release insulin effectively, resulting in postprandial hyperglycemia and excess sugar being released from the liver, causes fasting hyperglycemia.

Dr. Kavita Gupta highlights that high carbohydrate intake from foods like wheat, rice, and jaggery contributes to elevated sugar levels. To manage this, adjusting meal order and portion sizes can help. Start meals with fiber-rich foods like salads and vegetables, followed by protein sources like pulses, eggs, or lean meats, and then consume roti or rice. Using smaller plates divided into sections—half for vegetables and the rest split between protein and carbohydrates—ensures balanced nutrition. This approach reduces carb intake, prevents sugar spikes, and supports weight management, making it an effective strategy for diabetes control and overall health.

Podcast 10/01/2025

Anchor – Purva Kulkarni

Expert - Dr. Sunil Gupta & Dr. Kavita Gupta

Recorded on: 10/01/2025

Recorded at: Akashwani Nagpur

Episode: 68

Priorities fetal health to shield future generation from diabetes.

Maintaining a healthy weight, eating nutritious foods, and avoiding fast food are key to reducing the risk of diabetes. Currently, nearly one in four adults over 18 is living with diabetes. Women are especially vulnerable during pregnancy due to hormonal changes, making regular screening crucial. Consulting a doctor ensures tailored guidance for managing gestational diabetes effectively.

Uncontrolled blood sugar levels pose serious risks during surgery. While sterile procedures generally avoid infections, high blood sugar can delay healing, increase infection risks, and complicate recovery. In surgeries like bypass operations, infected stitches may lead to scarring or further complications. Stabilizing blood sugar before surgery and maintaining it during anaesthesia are vital for safe outcomes.

Gestational diabetes results from hormones like human placental lactogen (HPL) reducing insulin effectiveness. During pregnancy, the pancreas must produce up to 50% more insulin to meet rising demands. If beta cells cannot keep up, blood sugar levels rise, stressing the body and increasing diabetes risk.

High blood sugar damages nerves, impairing their function and delaying wound healing due to reduced immunity. Nerve damage often starts symmetrically but may affect only one foot. Managing blood sugar is essential for nerve health, faster healing, and preventing infections

Recorded on: 11.12.2024

Recorded at: Akashwani Nagpur

Nervous system is responsible for multiple functions of our body. It is divided into peripheral nervous system (PNS) & central nervous system (CNS).

The PNS has motor and sensory component, while the motor system consists of Autonomic (Involuntary) and somatic (Voluntary). Autonomic Nervous System (ANS) controls our urinary bladder functioning, which if affected can cause reduction of urinary bladder contractibility causing post void retention of urine in bladder, increase frequency of urination & recurrent UTI.

Water intake may need to be restricted in people with poor pumping capacity of heart or kidney failure or any having any other condition with fluid overload.

To maintain overall health, focus on walking more, getting adequate sleep, and staying positive. A cheerful attitude and smiling can contribute to your well-being and that of your loved ones, ensuring a healthier future for everyone.

Recorded on: 29.11.2024

Recorded at: Akashwani Nagpur

Pre-diabetes marks the initial phase of diabetes. A fasting blood sugar level below 110 mg/dL is considered normal. If it ranges from 110 to 126 mg/dL, you are classified as pre-diabetic. The Oral Glucose Tolerance Test (OGTT) involves consuming 75 grams of glucose, followed by a blood sugar test two hours later. A result below 140 mg/dL is normal, while a range of 140 to 199 mg/dL indicates pre-diabetes. Additionally, HbA1c levels provide long-term insights into blood sugar control. Levels below 5.7% is normal, 5.7% to 6.4% indicate pre-diabetes, and 6.5% or higher signify diabetes. All people with diabetes cases progress through the pre-diabetes stage.

World Diabetes Day and Awareness

World Diabetes Day is celebrated on November 14th, coinciding with the birthday of Frederick Banting, the discoverer of insulin. This global initiative, led by the International Diabetes Federation, promotes awareness with an annual theme. The 2024–2026 theme focuses on Diabetes and Well-Being, and the 2024 sub-theme emphasizes Breaking Barriers, Bridging Gaps, highlighting the importance of a fulfilling life alongside managing diabetes.

Gestational Diabetes and Pregnancy Hormones

During pregnancy, placental hormones like human placental lactogen, (HPL), progesterone and estrogen increase insulin resistance by over 50%, impairing insulin's effectiveness. Typically, if someone's pancreas is producing about 50 units of insulin daily, during pregnancy, it may need 75–80 units per 24hr. If beta cells cannot meet this increased demand of pregnancy, blood sugar levels rises, leading to gestational diabetes. A glucose challenge test with 75 grams of glucose, followed by a blood sugar measurement after two hours, acts as a stress test for beta cell function. Levels below 140 mg/dL are normal, while levels above 140 indicate gestational diabetes. Early detection and management are crucial to ensure a healthy baby's birth.

Recorded on: 8.11.2024

Recorded at: Akashwani Nagpur

People with Diabetes are more prone to infections like pneumonia due to weakened immunity, which worsens with prolonged, unmanaged diabetes, especially with age. Vaccinations, such as the pneumococcal 13 vaccine followed by a booster with pneumococcal-23 after 1 year, are essential in reducing the risk of secondary infections, although they do not address allergies.

Obesity significantly contributes to diabetes and related conditions like hypertension, high cholesterol, sleep apnea, and certain cancers etc. In India, obesity affects 40-70% of the population, paralleling global trends. Addressing obesity holistically can prevent diabetes and reduce the risk of multiple health issues.

Dr. Kavita Gupta emphasizes that pre-diabetics can reverse their condition through lifestyle changes. A balanced diet with vegetables, lentils, whole grains, and fiber is key, along with maintaining a healthy weight. Regular physical activity and limiting screen time are equally important to combat sedentary habits. These measures can help transition from pre-Diabetes to non-Diabetes status. In summary, managing diabetes involves vaccinations, healthy eating, weight control, and physical activity. These proactive steps prevent nerve damage, complications of diabetes, and address obesity, improving overall health and quality of life.

Recorded on: 25.10.2024

Recorded at: Akashwani Nagpur

Stress hormones are released immediately during challenging situations, making stress a significant yet subjective experience. These stress hormones increase insulin resistance & cause hyperglycemia unlike physical weight, stress cannot be quantified—it varies for everyone, making it a deeply personal phenomenon. Uncontrolled blood sugar can lead to complications like early-onset cataracts, often appearing as early as 45 or 50, especially in diabetics. Retinal issues and glaucoma are also common, emphasizing the need for annual eye exams. People with Diabetes should inform their doctors and prioritize regular evaluations to detect and manage potential eye complications effectively.

Awareness promoted by the government and media highlights the importance of vaccinations. A disease Herpes zoster or shingles can affect individuals with diabetes. This virus resides in everyone but becomes active when the immune system weakens. Fortunately, a vaccine with 90% efficacy is available for those over 50. Administered in two doses, the first dose is followed by the second after two months, within a six-month window.

Adult vaccination schedules should include common vaccines such as hepatitis B, pneumococcal, influenza, and herpes zoster. Evaluations for neuropathy (nerve damage) and vasculopathy (blood vessel damage) are also critical. Neuropathy affects nerves, while vasculopathy leads to arterial damage.

Dr. Kavita Gupta advises caution during fasting, as starchy foods like potatoes and sabudana can spike blood sugar levels. Instead, opt for foods with a low glycemic index to avoid sugar surges. Increase fiber intake while avoiding sugar and jaggery. Common fasting foods like halwa, sago vada, and khichdi can elevate sugar levels. A better alternative is incorporating salads, roasted chickpeas, lemon water, small amounts of coconut water, or fresh coconut. Bhagar (a low glycemic index grain) combined with vegetables like tomatoes, peas, and carrots is beneficial. Including protein and lean meat can further improve dietary balance.

Recorded on: 11.10.2024

Recorded at: Akashwani Nagpur

The alarming trend shows that every 5th or 6th pregnant woman in India is diagnosed with diabetes, highlighting an urgent need for interventions and enhanced medical treatments. Approximately 24% of adults (Above 18yrs age) in India are affected by dysglycemia (Diabetes & Prediabetes) which, considering the adult population exceeding 90 crores, this indirectly suggests that nearly every 4th & 5th woman of child bearing potential is likely to be having some from of dysglycemia, which itself is a risk factor for Gestational & Pre-gestational diabetes.

Uncontrolled diabetes during pregnancy can lead to severe complications, including miscarriage, larger fetal size, and an increased likelihood of the child developing diabetes and obesity in their future life. Notably, the first 6-8 weeks of pregnancy are crucial, as the baby’s all organs like brain, heart, lungs GI tracts, limbs etc. get fully formed by this time. Instability in a mother’s blood sugar levels during this period can lead to potential organ defects. While infants may appear healthy at birth, they could face health challenges later due to uncontrolled blood glucose of gestation.

Recorded on: 27.09.2024

Recorded at: Akashwani Nagpur

Anchor : Purva Kulkarni

Speaker : Dr. Sunil Gupta

With nearly 40 years of medical experience, I often encounter questions about sugar consumption. My consistent advice is to avoid sweets and focus on managing blood sugar levels, as poor glycemic control can weaken the overall immune system and may trigger infections & other chronic complications. Basal bolus therapy is the best insulin regimen, specially for type 1DM. It involves taking prandial insulin three times daily with meals and administering basal insulin once or twice daily, depending on individual needs. The dose is typically calculated based on body weight and blood glucose readings.

Using Continuous Glucose Monitors (CGMs) helps track blood sugar fluctuations. Uncontrolled blood sugar can lead to serious complications affecting various organs, including the eyes, kidneys, heart, brain and nerves.

Diabetic neuropathy, often referred to as "dry skin syndrome," can cause significant discomfort and pain, including symptoms like burning feet numbness, tingling, insensitive feet etc. Managing blood sugar is crucial in preventing neuropathy. Deficiencies of vitamins like D3 and B12 may experience symptoms of sensory neuropathy. Medications like pregabalin or gabapentin if prescribed by certified registered practitioner can provide relief for neuropathic pain.

Recorded on: 13.09.2024

Recorded at: Akashwani Nagpur

Anchor : Purva Kulkarni

Speaker : Dr. Sunil Gupta