I’m a borderline case, what can I expect ?

Have you been diagnosed with borderline high blood sugar levels? In your case the blood sugar levels recorded are higher than normal, but not high enough to be full-fledged Diabetes. This is referred to as the Prediabetes stage which can be reversed by following recommended guidelines.

During this phase, your pancreatic cells are still producing a little amount of insulin to convert carbohydrates into sugar, however, Insulin produced by the pancreas is not sufficient to remove sugars effectively, keeping the blood glucose level high.

It has been observed that people with Prediabetes may not take this condition seriously. However, research suggests that the sooner one begins to take precautions, the better are the chances of reversal of this condition.

Some quick tips

Make small changes and be a winner!
- Prediabetes can eventually lead to Type 2 Diabetes; however, this development can be easily prevented. It requires small efforts and minor changes in your lifestyle. Research shows that reducing your body weight by just 5 -10 %, to begin with, makes a remarkable difference in the natural Insulin production in the body. Weight loss can also delay the onset of Type 2 Diabetes significantly.
Watch your portion sizes
- Dieticians round the globe suggest having 3 main meals and 3 mini meals to have a good control of your glucose levels.
  You may choose to use smaller plates for meals to check on serving portions to begin with. The plate method advocated by ADA is specially designed for people living with Diabetes or Prediabetes. This approach advises that you fill half of your plate with fibrous fruits and vegetables; one quarter with low carbohydrates, such as brown rice or a baked potato; and the last quarter should be lean protein, like grilled fish or chicken.
Never skip meals
- Eat regularly. It is always a good idea to follow a regular meal pattern and not skip meals. People who eat regular meals, beginning with healthy breakfast, are healthier, more energetic and weigh less than those who skip meals.
  Consume mini meals. Eating healthy mini meals and snacks such as fruits, multigrain bars and low-calorie preparations help you to not only control your blood sugar, but also hunger pangs and prevents you from overeating and binging.
Limit tobacco and alcohol consumption
- Research suggests smoking may aggravate complications from Diabetes, such as heart diseases and may lead to nerve and kidney damage. It is, therefore, highly advisable to significantly limit or give up on smoking.
  Alcohol consumption can have a strong impact on your blood sugar levels; they often spike blood glucose levels leading to poor diabetes management. It is a good idea to take your doctor’s advice on whether you can consume alcohol, and how much. In any case, please remember to always eat a snack or a meal while consuming alcohol to prevent fluctuations or spiking of blood glucose levels.
Exercise
- Exercise is integral to a healthy lifestyle. If you have been diagnosed with Prediabetes, it is even more essential for you to have a fitness routine.
  It is a good idea to check with your doctor before you starting any exercise program. However, a daily walk of 30 – 45 minutes usually makes a good starting point. You may also choose from a wide variety of exercise regimes such as Yoga, Pilates, Tai chi, Swimming, Dancing and Jogging.
Acquire as much information as you can
- It is believed an informed person can make better decisions. Hence we urge you to make an effort to learn about food and lifestyle changes that will help you manage your condition better.
Take help and support from your family
- Research suggests that it is easier to manage Diabetes more effectively with family support. Your partner, family, and friends can play a huge role in motivating you and helping you adhere to your diabetes management programme.
  It is a good idea to check with your doctor before you starting any exercise program. However, a daily walk of 30 – 45 minutes usually makes a good starting point. You may also choose from a wide variety of exercise regimes such as Yoga, Pilates, Tai chi, Swimming, Dancing and Jogging.
Last but not the least
- Always maintain a positive approach. Studies suggest that people who consider Prediabetes as a burden or stress are often unsuccessful in managing this condition. Hence, with a positive mind and attitude you can successfully control your blood glucose levels and come on top of your condition.

What I can do as family/friend of a diagnosed Prediabetes?

Studies reveal that a majority of partners and family members may be equally worried upon detection of their partner’s Prediabetes/Borderline condition. But the good news is that you and your family can play a very important role in arresting and reversing the condition. Research suggests, Partners and family members who actively take interest in managing Prediabetes/borderline condition with in their spouses have been very successful in achieving excellent results.

You may already know that Prediabetes is a warning condition, but studies are on our side saying the condition can be reversed by bringing in lifestyle changes and following low carb diets, exercise regimes and incorporating lifestyle changes.

Equip yourself first
- Reading and collecting information on diabetes yourself can be very helpful for you to understand what your partner is going through physically and emotionally. You may also choose to take guidance from a certified diabetic educator or a physician to help your partner in the best possible ways.
Support your partner mentally and emotionally
- Psychologists suggest that people living with Prediabetes/Diabetes undergo tremendous emotional turmoil. Feelings such as anxiety, fear, guilt, anger, frustration and denial are bound to be experienced. As a family member / partner you should try to be supporting and understanding of these emotional ups and downs. You are also advised to consult a certified diabetic educator to help you motivate your partner in dealing with this condition.
Participate in arresting Prediabetes/borderline condition
- It is always easier to approach a challenge as two people rather than one. By working together not only are you motivating yourself but you are also acting as a check for the other person. Planning goals together is very helpful in attaining successful results, it is a good idea to discuss and chalk out plans mutually before starting to follow any regime for management of this condition. Research suggests that partners, who ate the same food, and did combine exercises yielded better results than self-managed programmes.
  Reminding your partner to adhere to the Prediabetes management programme may help in controlling high glucose levels in people with Borderline conditions. You may also choose to follow “eating by the plate method” advocated by ADA and try various diets.
  However, it is important to beware that constant nagging, complaining or forcing may backfire in managing this condition. It’s advisable to set realistic goals, and handle situations compassionately.
Empower and replenish yourself
- Research shows family and partners undergo tremendous mental and physical fatigue. Remember to take care of yourself too, because you may also undergo mental and physical stress while looking after your companion.
  Ensure that you have time for yourself and for pursuing the interests you enjoyed before Diabetes made an appearance in your life. Pamper yourself and remain cheerful.
  It is important to strike a balance in order to manage your personal and professional life. Set realistic goals and do not give up. Eat a well-balanced healthy diet and learn different ways to cope up with stress. To know more read the below tips to manage compassion.

To read more on Diabetes, click on the link below.

Diabetes

Exercise for Diabetic Patients

As you may already know Diabetes is referred to as a “lifestyle disease”. One of the reasons contributing to the condition is sedentary living. Regular exercise and undertaking physical activities of one’s choice can play an important role in Diabetes management.

Research indicates that people living with Diabetes, who undertake some form of regular physical activity or have an exercise routine not only have a better control over their blood sugar levels but are also better able to handle the stress

According to Prof. Sheri Colberg-Ochs, PhD at Old Dominion University, Virginia, USA, physical activity can aid in Insulin secretion and keeping the blood glucose level in control. Working out regularly also keeps a check on obesity and movement coordination, as according to research, people living with Diabetes are prone to dis-balancing and falling. Falling down may further lead to conditions such as fractures and restricted locomotion, which can add to unwanted stress and pain in people living with Diabetes.

The good news is that exercises do not necessarily have to be necessarily boring and monotonous. You can invite friends and family to try out new activities and routines with you.

Exercise Tips

Water Aerobics

Muscle toning exercises in water are one of the best ways to beat the heat in the summers. One can try it in the pool with the entire family. Check out the places where you can try water aerobics in Delhi/NCR in our website and have fun with your family.

Swimming

Swimming stretches and relaxes your muscles and doesn’t put pressure on your joints, which is great for people with diabetes. For those with diabetes or at risk for developing diabetes, studies show it improves cholesterol levels, burns calories and lowers stress levels. To get the most benefit from swimming, we recommend that you swim at least three times a week for at least ten minutes and gradually increase the length of the workout. Make sure to have a snack and monitor blood sugars. Lastly, let the lifeguard know that you have diabetes before you get in the pool.

Tai Chi

It is a Chinese form of exercise, which uses slow & smooth body movements to relax the mind and body. In 2009, researchers at the University of Florida studied 62 Korean women assigned to one of two groups

a) Control group and an exercise group that began a regular practice of Tai Chi.

b) people who practised some other physical activity. Those who completed the tai chi sessions showed significant improvement in blood sugar control. They also reported increased vitality, energy and mental health.

Frog leaps/ Spot jogging

Are you bored and tired of going to the gym but miss the running/cardio and the treadmill? Try spot jogging with music on and then jump with a squat (frog leaps). It is believed to be extremely beneficial in toning and strengthing muscles. You are advised not to do it if you have arthritis, knee and foot problems.

Power Yoga

A traditional form of exercise mixed with latest strengthening postures, power yoga incorporates fluid movements that build flexibility, strength and balance. It is helpful for people with a variety of chronic conditions, including diabetes. It lowers stress and improves nerve function, which leads to an increased state of mental health and wellness. According to the ADA, power yoga may improve the blood glucose levels due to improved muscle mass.

Zumba

A unique form of strengthening work out which elevates your heart rate and the best part about doing Zumba is it is done along with catchy beats. Zumba burns up to 500 calories but it is not advisable for people with arthritis, knee and foot problems.

Various other dancing forms

Dancing is not only great for your body. Various forms like Salsa, contemporary, hip-hop, freestyle are the unique way to de-stress also. The mental work to remember dance steps and sequences actually boosts brain power and improves memory. For those with diabetes, it is a fun and exciting way to increase physical activity, promote weight loss, improve flexibility, lower blood sugar and reduce stress. Chair dancing, which incorporates the use of a chair to support people with limited physical abilities, makes dancing an option for many people. In just 30 minutes, a 150-pound adult can burn up to 150 calories.

Bhangra

A leading endocrinologist Doctor Sanjay Kalra recommends Bhangra a popular dance form which has originated from Northern India but practised worldwide. A 45-minute Bhangra performance regime can burn out up to 600 calories, and also help you lower your blood sugar levels and check on obesity.

Fun Activities With Family

Water Workouts

Water workouts stretch and relaxes your muscles and doesn’t put pressure on your joints, which is great for people with diabetes. For those with diabetes or at risk for developing diabetes, studies show swimming and water exercises such as aqualates, aqua aerobics, aqua yoga improves cholesterol levels, burns calories and lowers stress levels.

Cycling

Cycling is a recommended sport for people living with diabetes, it can be conducted either at your own pace or at a set distance which challenges your aerobic endurance by helping you burn calories and keep your glucose levels under control. Research suggests that if you cycle for 45-60 mins a day, this will help you achieve your physical activity targets in keeping a check on your blood glucose levels. People with diabetes must check their glucose levels before beginning cycling and must not cycle in rocky and unstable terrain to avoid falls and wounds.

Adventure

To break the monotony of the fast-paced city life, and lifestyle people with diabetes may choose to opt for something adventurous like adventure theme parks, visit adventure places, or enjoy the thrill of flying a Cessna and paragliding. Trekking and camping can be also a very exciting way to burn calories as well as enjoy a family trip. This list is not exhaustive; you can recommend your way of breaking the monotony and add to our list. However, people living with diabetes are recommended to check few things while opting for adventurous holidays and recreations.

Laughing activity clubs

Scientific studies confirm stress and diabetes have a direct connection; stress often leads to erratic glucose levels. To keep the stress under control one of the easiest ways is joining a laughter club. Laughter helps keep diabetes under control and it is similar to “exercising”. Laughter improves the overall performance of the heart’s muscular function and helps ward off cardiovascular disease and lower blood glucose levels.

Running Clubs

Running can improve your health and help with losing weight in an extremely manageable way for people with diabetes, while providing immense satisfaction and reward in the process.

Running can be the ideal form of exercise for people with diabetes as it helps the body’s sensitivity to insulin. This can be especially useful for people with type 2 diabetes to help combat insulin resistance.

To read more on Diabetes, click on the link below.

Diabetes Types & symptoms

Understanding Diabetes

What is Diabetes?

Diabetes is an endocrine disorder that elevates your blood sugar levels over a prolonged period of time. It is caused by the malfunctioning of the pancreatic cells, which produce insufficient or no Insulin.

Why is Insulin so vital ?

Insulin is the hormone that is responsible for the process that converts carbohydrates into sugar; which is then stored it in the body for future use. Insufficient or no secretion of insulin from our pancreas leads to an imbalance in the body, causing liver cells to convert glycogen to glucose and accumulate in the blood stream.

Indications of Diabetes

Some of the most common symptoms suggesting the onset of diabetes are frequent urination, frequent thirst, frequent hunger (even after full meals), unexplained burning, itching or rash in the body, specially the foot, bruising easily, slow healing of wounds or clotting of blood when the skin is broken/cut, tingling or numbness sensation in the extremities of the feet and hands as also extremely low energy levels. However, often these symptoms could go unnoticed leading to undetected diabetes. Hence, it is always a good idea to get yourself regularly checked by a doctor for preventive healthcare.

Why did I get Diabetes?

Leading Endocrinologist Dr Sanjay Kalra from Bharti Hospital, Karnal shares his perspective on why diabetes is spreading like an epidemic. Nearly 70 million Indians are living with diabetes today. This is not a small number. Our genetic make-up is tuned such as to store fat reserves in the body in order to survive severe weather conditons such as famine. In ancient times, these stored food reserves or lipids were converted into energy in the bodies of our ancestors, so that they could survive the harsh living conditions. Cut to the present generations, lifestyle, stress levels, sedentary life, lack of physical activity, unhealthy diets, all contribute to surplus reserves for the body. As a result, the pancreas gets overworked and starts malfunctioning.

Am I at Risk?

There are several factors which may cause diabetes but medical science is yet to ascertain the main cause responsible for a specific person. However research indicates that the following conditions make people twice more likely to get diabetes than those without these conditions.

It could be genetic, family history has a strong role. Other factors such as obesity, high blood pressure high triglyceride levels, presence of diabetes autoantibodies, substance abuse, or excessive consumption of alcohol and tobacco.

Diabetes Ranges

Age 20 and above amounts shown as mg/dL
Fasting	Less than 100
Before Meal	70-130
After Meal (1–2 hrs)	Less than 180
Before Exercise	If taking insulin at least, 100
Bed time	100-140
HbA1c	Less than or around 7.0 %

SOURCES: American Diabetes Association. “Standards of Medical Care in Diabetes—2014,” Diabetes Care, January 2014.

Shown above are blood glucose ranges defined by American Diabetes Association. You’re kindly advised to refer to a doctor as the values may differ slightly with different age & gender.

What is Prediabetes?

When the blood glucose levels are borderline or higher than what they should be. But not as high as people with diabetes is known as Prediabetes. This condition is a “whistle blower” and indicates that you may proceed towards diabetes type 2, if you do not make the necessary changes in your lifestyle.

What are the Types of Diabetes?

You may have already undergone tests and your doctor may have already explained if you have Diabetes, and if so, the specific type you are living with. As a general understanding, the following classifications should give a sense of various types of diabetes:

Type 1 Diabetes:
- Type 1 diabetes is when there is insufficient or no production of insulin in the pancreas. This condition requires external insulin to help your body convert sugars to energy.
Type 2 Diabetes:
- Type 2 diabetes is when the pancreatic cells, become insulin resistant due to a defective response in the receptor cells in the body. This is the most commonly found type worldwide.
Gestational Diabetes:
- Gestational diabetes is when blood sugar levels are raised during the time of pregnancy. This is most likely a temporary condition, in which blood sugar levels are often likely to come back to normal after the delivery.
Latent autoimmune diabetes in adults:
- LADA is when autosomal alterations can lead to defective BETA cell function, resulting in Type 1 diabetes. LADA is often misdiagnosed as Type 2 diabetes in India.

Complications

Diabetes is called as a silent killer because many people remain undetected till such time as the consistently high blood glucose levels start affecting other organs such as the heart, the kidney and the liver – referred to as Macro-vascular complications and the nervous system resulting in foot, gum or vision problems called Micro-vascular complications.

Check for other important co-morbid conditions:

Diabetic Retinopathy
Kidney Disorders
Diabetic Neuropathy
Chronic Vascular Disease
Liver Disorders
Erectile Dysfunction
Polycystic Ovarian Disease

What else do I need to know ?

Often many people remain undetected till such time that consistently high blood glucose levels have already started affecting other organs such as your heart, kidney, liver – referred to as Macro-vascular complications, and your nervous system resulting in foot, gum or vision problems called Micro-vascular complications.
If you are “suffering” from any other life style conditions, “co-morbid conditons” consult your endocrinologist/ diabetologist. Your doctor will prescribe specific medications and solutions to manage this or any other complication.

To read more on Diabetes, click on the link below.

Diabetes food

Diabetes excercise

Diabetes helpful tips – A caregivers guide

Diabetes is a chronic medical condition, which can severely affect the physical and emotional condition of a patient. Family/partners of people living with diabetes may sometimes find caregiving an overwhelming experience, because of the exhaustive demands in diabetes management. They often undergo emotional, mental and physical stress.

Read on to find out what you can do & how you can cope.

Enlighten yourself:

According to ADA, partners/caregivers who do their own little research in diabetes are more equipped and apt in managing diabetes well. Knowing a various aspects of diabetes like what food can be consumed and what self measures one can take to prevent diabetes. Studies reveal books, medical online sites, diabetes communities can be of great help in enlightening about diabetes. Caregivers may also consult a certified diabetes educator to educate themselves about the Do, s and Don’ts of caregiving for people with diabetes.

Avoid “miscarried helping”:

Research suggests, too much nagging can back fire in diabetes management. Psychologist Gerald Straus, calls too much nagging “miscarried helping”.You may be having every intention to help your partner/ patient but studies reveal, miscarried helping may lead your loved ones runningin just the opposite direction”, leading to very poor diabetes management.

Kindness matters:

Research suggests imposing rules and executing doctor’s instructions in the wrong tone or dialect may rub the patient/partner in all the wrong ways. Studies reveal explaining things compassionately, like what you would appreciate your partner/patient to do, and what may disappoint you, can get you better results in treatment compliance. Dr Strauss, ADA suggests, you can take additional help from expert diabetes educators to ensure your approach is well received and followed.

On the other hand, with children, and adolescents one has to supervise, and sometimes might have to be a little strict to ensure treatment compliance..

Bring in changes together:

Research suggests bringing in necessary lifestyle changes in your life too can help enormously to motivate your partner/patient living with diabetes. By adopting healthy changes together, like eating the same diet, one can manage the conditions better, because people living with diabetes will have company, in making efforts to lead a healthy lifestyle. You may choose to make a few sacrifices to let the patient/spouse you are caring for, know that you are fully committed to the diabetes management programme. A caregiver’s role is one of the most important aspects in diabetes management. A compassionate and well understanding partner can help in addressing the diabetes issues more effectively.

Share your feelings:

We understand that caregiving can be stressful at times. Research suggests, caregivers may often suffer from compassion fatigue and burnout. Compassion fatigue is a common condition observed in medical professionals, nurses, and caregivers.

Dr Charles Figley Professor from New Orleans LA defines, compassion fatigue as a state experienced by caregivers, who are preoccupied in constantly caring for patients, which leads to a degree of self-distress, creating a secondary traumatic condition in the caregiver/helper. Hence, it is most important for a caregiver to stay calm, stress free during the diabetes care for the partner.

Feel free to share your feelings with your spouse/patients/doctors whenever you feel absolutely exhausted. Speaking your heart out can be a very good way to lighten up yourself. There are several ways of coping up with compassion fatigue such as taking up recreational activities, outings with the patient/family, yoga & meditation. You may also choose to seek medical advice if you are completely undergoing burn out.

Make feasible plans

According to the American diabetes association-Setting up realistic goals and taking a step-by-step approach is the easiest and the best way to incorporate lifestyle changes. For example, doing small things at first, like including a 45 minute walking regime daily, may lower your partner/patient blood sugar levels, which can motivate your partner/patient to embrace further inclusions of the diabetes programme. A daily regular regimen followed can help in alleviating the much caused anxiety and helps in keeping a check on the spiked glucose levels.

Make meals interesting:

Studies reveal that meals have been always an area of interest for people with diabetes. Nothing should come your way in serving tasty food, keeping diabetes in mind. Stock your kitchen with healthy fruits and vegetables, so that you can always quickly prepare an interesting snack or meal for frequent munching.

You may want to check out our diabetes friendly recipes, before you step out to shop for grocery for yourself and your partner. We recommend you to have a look at the section-Food as Medicine where our expert Dr. Mona Johar speaks about the right food that can be to prevent and control diabetes.

Have fun while caregiving:

Off-Key Singing

Did you know that you can have fun while caregiving too? Experts say, freestyle singing or off key singing such as singing a parody or making up your own lyrics can be great fun for both the patient & the caregiver. This simple activity can minimize stress. Stress plays a vital role in getting diabetic and controlling when the levels are raised.

Silly Dancing

Taking a break? You may choose to silly dance and request your partner/patient to join you. This is a great stress buster and can bring smiles to the both of you.

Most Important- Take care of yourself:

Studies reveal caregivers often put themselves at last, in terms of caring for themselves. This can really take a toll on both their physical and mental health. Joan Lunden’s “Camp Reveille” exclusively for caregivers suggests that, caregivers must take out time to nourish their soul, mind and body.

The following are the few activities for thecaregiver’s, listed as the caregivers“favourites” that can easily be done in the comfort of their homes.

Meditation – meditation can be done, anywhere, anytime. It delivers a sense of calm and peace, making it an excellent stress and tension reliever. If one can spare 10 minutes or 20 at the beginning or end of your day, it can help ease tension and allow you to gain a new perspective on a stressful situation. There are many forms of meditation, so try a few to find the one that works best for you.

Morning and Evening Stretches – Beginning and ending your day with some gentle stretching can relax and release tired muscles, improving circulation and range of motion. Just a few minutes each morning and evening can make an impact on your day.

Tai Chi – Tai Chi is a Chinese form of workout, which involves a series of slow, graceful movements accompanied by gentle deep breathing. Some describe Tai Chi as “meditation in motion.” It’s an excellent, low-impact exercise that reduces stress and anxiety while getting your energy flowing.

Yoga – Yoga basicallyfocuses on the synchronization of movement and breathing, yoga builds strength, stamina, balance and flexibility. It can help reduce stress and lower blood pressure, while improving your overall fitness. Along with meditation, there are a variety of yoga forms. You may also choose to enrol in a yoga centre.

Pilates – This popular form which focuses on building core strength and torso stability, which improves levels of strength, balance, flexibility, muscle tone, stamina, and general well-being. Pilates is an excellent option for any age or fitness level as the exercises can be done on a floor mat or Pilates equipment at home.

Conclusion- Though diabetes is a chronic disease but managing diabetes can be achieved with the help of lifestyle changes. It is vital for the caregiver and patient to stay happy and cheerful during the journey of diabetes management. Right modalities opted can help manage diabetes and can make the journey comfortable both for the patient and caregiver.

Citations

American diabetes association

www.diabetes.org

www.diabetes.org/food-and-fitness/food/what-can-i-eat/food-tips/quick-meal-ideas

www.joanlunden.com

www.aplaceformom.com

www.everydayhealth.com

Tag: What is Prediabetes?

I’m a borderline case, what can I expect ?

Some quick tips

What I can do as family/friend of a diagnosed Prediabetes?

Exercise for Diabetic Patients

Exercise Tips

Cycling

Adventure

Laughing activity clubs

Running Clubs

Understanding Diabetes

Indications of Diabetes

Why did I get Diabetes?

Am I at Risk?

Diabetes Ranges

What else do I need to know ?

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