Diabetes means excessive urination and mellitus means sweet. Diabetes is a disease of calories, not only sugar. Around 50% of the patients don't even know that they have diabetes. Dal, rice, roti, sabji, along with that we add farsan and sweets, that is wrong. Why does diabetes start from the feet? It starts from the color chain of the nail and goes to a big gangrene. This whole thing comes under diabetic food problems.
We have increased fast food in our diet. Farsan, excess sweets, the complications of diabetes like on the eyes, kidney, heart, feet. To get rid of all those things, uncontrolled diabetes should remain for 10-15 years. So, the earlier you detect it, the earlier you take preventive steps on it, you can definitely avoid your complications and live a healthy life for a long time. And if you are in the early stage, you can reverse it and.
Come back to a non-diabetic or normal life. Today, India has become the Diabetic Capital of the World. Unfortunately, so many people have pre-diabetes and diabetes. Most people don't even know that they have diabetes. That's why this whole podcast is dedicated to only diabetes awareness. Because today, we have a guest in the Doctor Series, who is a diabetic foot specialist.
He has 15 years of experience. He has consulted more than 5,000 to 7,000 diabetic patients. He has been a part of 4 international clinical trials and research, including Atlanta and Paris. And he is a person who is going to tell you in a very simple language, what to do so that if you already have diabetes, you can manage it, you can reverse it. And what to do if you want to prevent diabetes. So, please share this podcast with those who have diabetes.
Or have a family history of diabetes. Or those who want to prevent it. Because this is going to be very valuable. So, if you are watching this on YouTube, don't forget to share it. If you are listening to this on Spotify or Apple Podcast, make sure that you share about this also. I am extremely happy to welcome Dr. Harshal Shah. Thank you so much, sir.
Thank you very much for inviting me. How are you feeling? Very fine. Thank you for giving me this opportunity to serve the society and community. Thank you. Thank you so much. Sir, first of all, there are crores of people who have diabetes.
Why has this diabetic epidemic increased so much? According to recent data, there are 7 crore official diabetic patients in India. And a study shows that around 50% of the population does not even know that they have diabetes. If you add that to this, then you will get 10 crore diabetic patients in India alone. In the world, there are about 50-60 crore patients with diabetes.
Now, if you look at it very fast, there will be no house where you will not find a diabetic patient. Diabetes has become a very common word. If you go anywhere, you will get this discussion, you will get to hear this, you will get patients. There are many reasons for this. The main reason is our lifestyle. We have adopted a very unhealthy lifestyle now. We have reduced our physical activity to a great extent.
For small things, we have become dependent on vehicles. We do not want to walk from our house to the end of the street. If we get a vehicle, we will feel good. Sedentary lifestyle. If you look at it now, AC office, AC car, AC house. Whatever it is, we want to do it while sitting. We do not want to do any physical activity. The second is diet.
We have adopted a very bad diet now. Before I came to diet, the sedentary lifestyle you told. Somewhere, do you agree that people who have started earning a lot of money, luxury has come in their life, comfort has come. Somewhere, by reducing their physical activity, they are becoming smart like a phone and they are becoming dumb themselves. You said the right word.
The automation that happened or the modernization that we call, that happened. All the gadgets that came in it. You start with the smallest thing. Washing machine. The ladies of our house used to do the housework. Now there are robots in the house for cleaning. Washing machines have come. From there, the children had to play.
When we were young, we used to play outdoor games. Indoor games used to be a very rare thing for us. Now any child will have an iPad or mobile in his hand. That means his entire childhood has shifted to mobile. So this thing has started from there. Earlier we did not have such easy commute options. So we used to walk a lot. We used to walk a lot. All those things have also reduced to a large extent now.
So we have adopted an unhealthy lifestyle in every way. In which sedentary lifestyle and important thing is diet. Our original diet was healthy. Leaving all that, we have become dependent on Western diet. Or we have adopted that. We have increased fast food in our diet. Farsan, excess sweets, excess soft drinks, cola etc. By doing that, we have ruined our lifestyle to a large extent.
In addition, fruits and fibers are very essential in our diet. Which we have almost stopped. And the most important thing in recent times is stress. The 3-4 main important things are unhealthy lifestyle, unhealthy diet. And the most important thing is stress. Everyone from a small child to an elderly person. No one lives without stress.
But earlier there were options to relieve stress. Now we have lost that. And we don't want to do it. And stress level is a big culprit to increase diabetes so fast. Absolutely. So you have told us to sit, not to do sedentary lifestyle, not to exercise, not to be active. Secondly, the changes in our diet which have happened today.
Unfortunately, along with unhealthy lifestyle, there is also unhealthy diet. And thirdly, you have told us more than that. More than exercise and diet. Which is stress. So we will definitely talk about all three. We will see what to do. Even though modernization has happened, westernization has happened.
We have gadgets, we can't go away from it. We can't go away from AC room. Even then what should we do so that we can stay healthy and free from diabetes. But whoever is listening. First of all, according to me, diabetes in my experience. Because when I consulted a lot of people for lifestyle. Mostly people get to know late that I have diabetes. So how important is it to get blood reports tested in that?.
What is the role? It is a very unfortunate thing. When you ask someone for reports. First of all, he takes it negatively. Correct. And if you get it checked. If everything is fine in it. Then he will say that I got so many reports for so much money.
And everything came normal. We make him understand that it is good that it came normal. If it came abnormal, then it was a problem. He thinks that money has been wasted. It is very important to change this mindset. First of all. And blood reports after certain age. If your family history is positive. If someone in your family has diabetes.
Father, mother, uncle, brother. Anyone. So at an early age, just as a preventive measure. If it is not there, it is very good. But if it is there, you can act for it. It is important to do it for that. After the age of 35 or 40. After 35 or 40 years. Once a year.
I mean, the way you can do everything. You can take a vacation. You can enjoy everything. So there is a little portion for health too. A little time. And give it to him a little dedicatedly. So that it will be good for you. Absolutely. And it is very important to do these things.
And the earlier it will be detected. The earlier you will act on it. The more you will be able to stop the problems and complications ahead of it. You will be able to live a good healthy life. Absolutely. Absolutely Sir. You told right. Because in our podcast.
In the Doctor Series. Ophthalmologist came. Eye specialist. So he gave a very good idea. Which can apply the same here. Which is that you celebrate your birthday every year. So the next day of the birthday. The day before that. You decide.
That day everyone has to do check-up. It can be an eye check-up. Or it can be a diabetes test. Or it can be an overall blood report test. I think that could be a wonderful idea. So if I talk about me. So every 6 months. There is a ritual in our house. That every 6 months.
All four of us get a report together. To be specific. Our blood report is going to be the day after tomorrow. So we make sure that we know every 6 months. Because I think. Pre-diabetes. There is an awareness stage. To become aware. So that you don't get diabetes.
So if you can give a little light on this. What is the difference between pre-diabetes and diabetes? And what is the difference between HbA1c. Which is a marker. How much sugar is there in your hemoglobin. What is it exactly? How can people read it? I will start with a very simple definition. Maybe a lot of people don't know about it.
Because it has come from medical science, Greek and Latin languages to a large extent. So, diabetes mellitus, we use the word DM in short form. We use diabetes mellitus. What is the definition? What is diabetes? Diabetes means excessive urination. And mellitus means sweet. The word that has been derived is diabetes mellitus.
There are two types of diabetes. One is diabetes insipidus and the other is diabetes mellitus. The word diabetes mellitus has been derived from this. Diabetes means excessive urination. And mellitus means sweet. Excessive sweet urination. This definition has been derived from this word. And what is the first definition?.
Diabetes insipidus. Insipid means tasteless. That is not sweet. Excessive urination but not sweet urination. It is a very rare thing. But diabetes mellitus is common. We use the word DM. So, sweet urine. Yes, excessive urination.
And mellitus means sweet. Excessive sweet urination. This definition has been derived from this word. Just for information. This is very important. I did not know. What is this? If you want, there are two parts to it. Type 1 diabetes and type 2 diabetes.
Type 1 diabetes is usually in children. It is called juvenile diabetes. And type 2 diabetes is called adult diabetes. It happens after a few years. There is a lot of difference in these two. The line of treatment is also different. The causative factors are also different. The etiology is also different. What is the reason?.
What is the mechanism? I will focus on that too. But you said pre-diabetes. And diabetes. What are the differences between the two? The broad definition of WHO. If you want to confirm diabetes. It will be confirmed from your blood sugar level. Fasting blood sugar.
Means you have not taken anything for 8 to 10 hours. Suppose you finished your dinner around 8 or 9. After that you have not taken anything other than water. If you get your blood sugar report at 6 or 8 in the morning. It is called fasting blood sugar. And postprandial blood sugar. Means blood sugar after 2 hours of eating. Which is called PPBS. It can be either lunch or dinner.
Post lunch or post dinner. Usually your major meal. Sugar after 2 hours of eating. The definition is. If your fasting blood sugar is below 110. Less than 110. Then it is considered that you are non-diabetic. If your blood sugar is between 110 and 126. Means around 111 to 125.
Then you are pre-diabetic. And if your blood sugar is above 126. Then you are diabetic. This is the universal definition. Universal guidelines. Same way PPBS. The blood sugar after 2 hours of eating. If your blood sugar is below 140. Then you are considered to be non-diabetic.
If your blood sugar is between 140 to 200. Means around 141 to 199. Then you are pre-diabetic. And if your blood sugar is above 200. Then you are diabetic. The important word you stressed is pre-diabetic. So many youngsters. And middle age. Say 25 to 45.
Who are working. I have said earlier. Who have high stress level. Or their lifestyle is not good. They are in the range of pre-diabetic. If you are pre-diabetic. Then how will you know. At least once in a year. For middle age.
Not frequently. But at least once in a year. And whatever you do. Give some time to your health. And do some reports. Then you will know. And one more word. Reversal. If you are pre-diabetic.
And if you adapt your lifestyle. And bring some modifications. Then you can definitely convert from pre-diabetic to non-diabetic. But if you are in the range of pre-diabetic. If you are in the range of pre-diabetic for a long time. If you have not changed your dietary habits. And lifestyle. Then you will definitely go from that.
To diabetic. And slowly this thing will keep on increasing. Progressive disorder. Then one level will come. That you will be on multiple medicines. Or you will become medicine dependent. And many times it is late. By then in the body. Complications of diabetes have also started.
Many patients are like this. Diabetes comes with complications. And complications are not so easily. In such a short time. In that also we use the word honeymoon phase. Diabetes is detected. Like marriage. First 5-10 years are very good. Mutual understanding is good.
Love is good. Some big problems usually start after 10-15 years. In that early diagnosis. The day you have diabetes. Before that 10-15 years. You will not have much complications. Diabetes complications. Like on the eyes. On the kidneys.
Heart. On the legs. To have all these things. Uncontrolled diabetes should be there for 10-15 years. As soon as you detect it. As soon as you start taking early preventive steps. Then you can definitely avoid your complications. And you can live a healthy life for a long time. And in the early stage.
You can come back to a non-diabetic life. Very true. The ranges that you have told. Less than 110. It comes under the category of non-diabetic. Fasting, blood sugar. I have done some research. On functional nutrition. Or functional medicine practitioners.
Who study advanced nutrition and medicine. I have done some research. In that they say. Even if it is 109. It is in the range. That you are a non-diabetic. But still you should not be happy. Actually your target should be. Less than 100.
Better than 95. Then you will not have any complications in the future. So one is the normal range. One is the optimal range. But you told that those who have pre-diabetes. They can go into non-diabetic. But those who already have diabetes. Can they become non-diabetic? Can it be reversed?.
If it is. It is in the nearby range. And first of all. If you talk about management. If you keep diabetes in the center. If you want to control it. If you want to come out of it. Then what are the things that are necessary? 3-4 main things.
1st is diet. 2nd is physical activity. 3rd is stress reduction. From any mode. Meditation, music therapy. Whatever you do. 4th is medicines. Either insulin or OHA. Drugs.
So what you said. Reversal. The last option is. If the first 3 things are bad. If you can do a good job on it. If you can focus on it. Then definitely. You can reverse it. First of all.
You have to focus on these 3 things. If you have an unhealthy lifestyle. Then try to make it as good as possible. Your sleep hours should be good. Your eating habits should be good. Physical activity. Whatever routine you do. After that. If you don't do any physical activity for health.
Anything can happen in it. Whatever is convenient for you. If you like brisk walking. You can do that. If you like swimming. If you like sports. You can do sports. If you like dancing. You can dance.
It's not that you have to do only one thing. There are many options. You don't have to go to the gym. It's not necessary. Let's break it down. First of all, everyone should be happy. Because it can be reversed. If we talk about diet. We give small steps to people.
First of all. Avoid it. Diabetes is caused by sugar. If I eat a lot of sugar. I get diabetes. Sometimes people get depressed. My uncle never ate sugar in his life. Still he got diabetes. What is the relation between sugar and diabetes?.
There is a saying. If you eat sugar. You will get diabetes. It's not true. If you have diabetes. Eat less sugar. It's not true. If you eat sugar. You will get diabetes.
If you don't eat sugar. You will not get diabetes. It's not true. There is a common myth. I don't eat sugar. Still I have diabetes. I want to say. Diabetes is a disease of calories. Diabetes is a disease of calories.
Not only sugar. And diabetes is a disease of calories, not of sugar. People have such a myth or misbelief that I can take Farsan, there is no problem in that, it is not sweet. But if you go to see, then you have eaten a very deep fried Farsan, so the calories value is very bad and very high. And our body is such that glucose is our main fuel to work on every cell and every tissue of the body. So it understands the same language of glucose that.
Whatever you will take, it will come directly or indirectly in the form of glucose. Then there will be excess, so it will be stored in fat or other things in the body. So concentrate on calories, not only on sugar. Right, and mainly I think empty calories, that is, there is no nutrition in it at all and they are taking calories. As you said, they are eating Namkeen. Yes, if you are taking soft drinks, it is a very bad thing,.
6-7 times more sugar goes and carbon dioxide goes in the body. And means H2O plus CO2, you are taking H2CO3, you are taking carbonic acid and you are taking excess sugar. You will not get any benefit from this, but still you are taking. If you are eating excess Farsan or packets of food, it is very bad for health. The calorie value is very high, the nutritional value is.
Very low. Okay, so one is Namkeen, then you said soft drink, in which there are empty calories, should I avoid anything other than that? Avoid sugar in raw form. If you are taking anything, like tea, people remember that I can't take anything other than sweet tea. So it takes 15-20 days to change the habit. Right.
I talk about myself, when I started practicing from 2008, then I started drinking tea as a refreshing drink. Even then I used to drink sugar tea. But then I counted that if I am taking 5-6 cups of tea in a day, then if I add 1 spoon of sugar in an average cup, then 6 spoons of sugar is going in the body without reason. So since then I started taking tea without sugar. First, it seems difficult for 7-10 days. And now you have not even taken tea, you have taken lemon.
Juice. And now after 10-15 days, if someone adds a little sugar in your tea, then you will not like it. You will say that I did not like this taste. Means to change a mindset, you have to give 15 days. If you do not start anything, then you have to give 15 days to set it. So those who are thinking that I can't take tea without sugar, then give 15 days to change it.
From 16th day onwards, if you give tea with sugar and without sugar, then they will start preferring tea without sugar. So in raw form, excess sugar, excess white is poison. Whether it is salt or sugar, any excess white, any milk products, should not be taken in excess. Means our habit is that if we take salad, then excess salt is added to it. If we take tea or anything, then excess sugar is added to.
It.If you are taking lemon juice, then it is not necessary that it is necessary to add sugar to it. As a refreshing drink, you can also take lemon and water. You will get vitamin C and instead of water, avoid excess sugar wherever it is coming. There are ice creams, sweets. Occasionally, you definitely do not refuse anything. Means you cannot take this, you have to make it zero, you do not have to do that.
You have to take it in moderation. And let's say there is a client or a patient. They are taking white things like salt, sugar in moderation. Then rice comes in white. People are afraid that they cannot eat rice as they are diabetic patients. So what should people do about it? One such thing is that in white items, as you said, we also take rice.
The grains that are there, the body needs 3-4 things. Carbohydrates are needed. An ideal diet that we call, it should be 50-55% carbohydrates. The remaining amount should be equally fat and equal protein. Means 20% fat and 20% protein. This should be our ideal diet. In fat, there is saturated fat and unsaturated fat.
The portion of unsaturated fat should be more. Then the individual patient or person, his lifestyle, his physical activity, his age, his kidney problem, heart problem and any other comorbid conditions. There can be some changes on the basis of that. But in this broad diet, 50-55% carbohydrates, 20-25% fat and 20-25% protein. It should be like this. So the carbohydrates are mainly found in cereals.
In which there is wheat, rice, millet, barley, corn. The carbohydrates, as you said, how fast the body will absorb it, and how fast your sugar will increase, that is very important. Which we call glycemic index. So the main source is the grains of carbohydrates, in which all these things came. In that, the glycemic index of rice is the highest. Means if you consume that, then your sugar will increase,.
It will shoot very fast in a very short time. May be calorie wise, its proportion will be roughly 80-90% same in all. That is why diabetic patients are told to reduce or avoid it. But you can definitely take it. But in grains, you should be dependent only on rice. This is wrong. Right.
Along with that, may be take some protein and fiber. Yes. So that glycemic index will be balanced. It will be balanced. So you can take rice, but it is not advisable to take excess rice. And if you are taking cereals, then as I said, there is a sequence. On the basis of glycemic index, more glycemic index is the.
Worst. After that comes wheat, after that comes corn, after that comes millet, after that comes barley. Millets. Yes, a movement for millets has started. It is a very good thing that at least 50-60 years ago, when rice and wheat production was not so common in India, then millets were given a lot of importance. Now when things have stopped, if you can include that in.
Your diet, millet, barley, then you can also reduce the requirement of wheat and rice. It is not that you have to take the same every day. But you can bring variations. One day you took millet and barley. One day you ate wheat product. One day you ate rice product. In one meal, you need the same grains. It is our tradition that we add lentils, rice, roti,.
Vegetables, along with that we add farsan, add sweets. That is wrong. You got one grain. If you ate wheat, then try that if you have taken wheat, then don't take any other grains. Like rice. Don't take rice or anything else. If you want to take rice product like khichdi or pulao or rice, then in the same meal, avoid wheat.
For a balanced diet, if wheat, rice, millet, barley, anything, green leafy vegetable or green vegetable, as a protein source, you can take dal or jackfruit, anything. And salad. If you take a balanced diet, then it is very good for health. Perfect. Sounds good. Now, many people have diabetes. A new term has come.
Diabeticity. Diabetes plus obesity. What is the connection of obesity with diabetes? As I said earlier, type 1 diabetes and type 2 diabetes. Type 1 diabetes means juvenile diabetes or diabetes in children. In broad terms, insulin dependent diabetes. Right. Its mechanism is immunological factors, which sometimes.
Become the enemy of some proteins in your body. And in that way, it destroys the beta cells of your pancreas, which secrete insulin. It distracts it. So, if the beta cells in your body get damaged, reduced or almost zero, then the body will stop producing insulin. This is the main reason or main ideology of type 1 diabetes. Right. In majority cases.
These children are usually detected at a young age of 20 years. Their only treatment is insulin. If there is a deficiency of insulin in the body, if insulin is zero, then insulin is its only solution. Nothing else will work in this patient or in these children. Right. Definitely, assume the overall population, I said that there are 7.5 crore diabetics in India.
So, somewhere between 5-10% is type 1. Remaining 92-95% are type 2. So, if you go to see that, around 50 lakhs-60 lakhs will be type 1 diabetics. The remaining 6.5 crore will be type 2 diabetics. What can be the reason for that? Type 1 has also increased a lot. Yes. What is the reason for that?.
Mainly… It can be genetic factors. Yes, it can be genetic factors or immunological factors. And some are idiopathic. I mean, science is still exploring it. It is not fixed that this will happen to this and that will not happen to this. This is such a thing. That is also increasing. But it has only one treatment solution.
There is only one thing that insulin is the only treatment for it. There are no other things in it. And it is a very sad thing that it happens in very small children. Who have not even understood what sugar is, what chocolate is.Before that, all those restrictions are imposed on him. The other type 2, which we said is 90-95% and on which you emphasized the word diabetic.
So type 2 is diabetic. The definition I said is a derived definition. And now a medical definition is that relative or absolute deficiency of insulin. That leads to diabetes. Diabetes is a symptom. It has either complete deficiency, which I told you is in type 2, type 1, sorry. And a relative deficiency.
So relative deficiency is also a very important word. So what we call type 2 diabetic, which we call adult diabetic. Or usually what is seen after the age of 25 years. There are two classes in it. One is obese and one is single body, lean and thin. So two main mechanisms work in it. One mechanism, which I said in type 1, the production, beta cells are completely destructed.
Insulin production is completely reduced. Whereas in this type 2 diabetic, insulin is being produced but less. As much as it should be required, as much as it should be produced, it is not being produced. This comes in type 2. But type 2, which we said, out of that also, almost only one-fourth is this. The remaining three-fourths.
In that, the insulin that is being produced, it may be producing more than its normal range. Why is it producing more? Due to this obesity. Which we call obesity or diabetes. Insulin is such a hormone that it binds with its receptor, which is called insulin-insulin receptor mechanism. It will bind to its target, where it has to bind. Through that, it opens the glucose channels.
It is such a thing that the glucose circulating in the blood, it will go inside your cells from there. This glucose channel will open only when insulin will properly bind with its receptor. This is called hormone and receptor mechanism. Insulin-insulin receptor mechanism. When obesity increases, especially central obesity, which increases in abdomen and upper thigh, then this insulin-insulin receptor mechanism is hampered.
Which we call insulin resistance. The more insulin resistance increases, means insulin will not be able to properly bind with its receptor. If it will not be able to bind, then it will not be able to open the glucose channel. If the glucose channel will not open, then the glucose will not be able to reach the cells from the blood. Just like we put petrol and diesel in the vehicle, glucose is the main fuel for the cells.
If it will not get the fuel, then it will not be able to do its work properly. So, it will demand more insulin. As I said, in Type 2 also, in 50-60%, you will see more insulin level. Whenever you do blood reports or C-Peptide, the reason is that if the body does not get glucose, it will think that insulin is less, that is why I do not get it.So, it will secrete more.
So, it will secrete more. Now, insulin is such a hormone, let's focus on insulin, it is secreted from the beta cells of the pancreas. It is an amphibolic hormone. It makes something and breaks something. Amphibolic means anabolism plus catabolism. In layman's language, anabolism means building. Catabolism means breaking. So, insulin is an amphibolic hormone.
It is catabolic for glucose. It will work to break it. Rest of the things, it will work to make it. Glycogen is our reserve fuel. In wartime, we store an extra fuel. In the store of glycogen, it reserves a good fuel. So, it will work to make glycogen. It will work to make fat cells, which we call lipogenesis. It will work to build muscles.
It has 3-4 things to make. It has to break one thing, that is why it is amphibolic. If insulin is not able to work properly, it will not work. But, if the level increases, it will promote obesity and fat. It will promote fat. It is a very special cycle. If obesity increases, insulin resistance increases.
If insulin is not available, it increases fat. This cycle will continue. If you don't break it, it will increase harmful things. So, you explained it in detail. If people understand this, they will know the root cause. You just explained 3 things. But, mainly diet plays an important role. Not moving is an important role. If you are taking stress, if I break it down again, it.
Could be that to reduce glucose level, insulin produces beta cells of the pancreas. As soon as the beta cells are released, insulin resistance prevents glucose from entering the pancreas. As glucose and insulin are released, the body stores it in different places. Then, it converts it into fat. Glycogen and then fat.
As it is fat, insulin resistance increases. This cycle continues. Basically, diabetes leads to obesity and obesity leads to diabetes. This cycle continues. For people with diabetes, if they are overweight, it is important to lose fat and to build muscle. I always promote weight training. Muscle building exercise.
Some people just walk. Some people just swim. Some people just do cardio. Do you believe muscle building is important in diabetes? It is very important. If you do good physical activity and build muscle, it has 2-3 benefits. The more the muscle works, the more glucose is needed as a fuel. As I said, it is the main fuel.
For fuel, it needs more glucose. If it consumes more glucose, the blood sugar level will automatically decrease. This is the first benefit. Secondly, if you train any muscle, muscle becomes bulky. Bulky muscle will demand more glucose as a fuel. In future, it will help to reduce blood sugar level. If the basic fuel is depleted, and the body still needs more glucose, then it will utilize your storage in the form.
Of glycogen or fat. The more bulky muscle will utilize glucose, it will also help in fat reduction. If you do good muscle training or isometric exercises to strengthen your muscles, definitely, in future, once the muscle is well developed, if you work on it, it will help in weight reduction and blood sugar reduction. Let's say, you talked about diet and exercises. We can't avoid the inevitable stress.
Do you have any strategies that you suggest to your patients? Stress is in everyone's life. A small child has stress of his level. A school-going child has stress of business, job, and working pressure. Stress is in everyone's life. In a simple language, when we are born, when we are born, we call our heart.
ECG. ECG means Upstroke, Downstroke, Beat Neutral. Upstroke, Downstroke, Beat Neutral. We call it life. The day it becomes straight, we call it death. Life is ups and downs. Everyone can have emotional ups and downs, financial ups and downs, health ups and downs.
Stress is generated from it. Stress is in everyone's life as long as they are alive. But you have to come out of it. No one can reduce your stress. No one can reduce your stress. First of all, whatever circumstances have come in your life, be it health, financial, emotional, or in a relationship, if you stress about it, So, increasing stress will reduce that thing.
Very simple question, first of all. So, every person says that increasing stress has no solution. If you increase stress for that, then again you will increase your blood pressure, increase your blood sugar and deteriorate your health further. So, it is better to first of all have a natural laughing face and keep a good smile on your face. So, you should carry a smile on your face.
It should become your identity. People's stress should reduce by looking at you. You will improve on your own. First of all, adopt that. Secondly, there are many measures that you can take to reduce your stress. There is meditation, simple music. I don't say that you should do X, Y, Z for an hour or half an hour.
For yourself, whatever you like, do it for half an hour. A practical definition of meditation. If you only like the sound of birds, then leave all your gadgets, keep them on the mobile side, don't talk to anyone, just close your eyes and listen to the sound of the birds, in a garden or any convenient place. That is meditation for you. If you like instrumental music, by closing your eyes, with headphones or keeping it simple, you don't have to think of.
Anything else. You don't have to talk to anyone, you don't have to use any gadget. Just be one with it. That is meditation. Whatever you like, do it for half an hour for yourself. It works very well. 20-30 minutes for yourself. Just you and yourself.
This is music therapy. Develop a hobby for yourself. Work on it. If you like gardening, if you like painting, if you focus your mind, your energy on it, on which you are happy, you will automatically reduce your stress level. First of all, think that if I increase my stress, I will come out of it. Otherwise, first of all, stop worrying about it.
Think about what you can do for it, to come out of the problem. Don't take tension or stress for no reason and spoil your health. To come out of it, there are many options. Meditation, music therapy, if you do a simple physical activity, which is good, like running, walking, gym, swimming, whatever you like, sports, it gives you a sense of well-being. It makes you feel good.
In the evening, if you do something, you will feel fresh compared to the day you didn't do it. There are many things with which you can reduce your stress. Even if you adopt one of these things, it will make a huge difference. Let's say, no one has been diagnosed with diabetes yet, but they will get to know the blood report from there. But let's say, they are not able to do the blood report What are the signs or symptoms that will make them aware?.
If this is happening, should I go and check? There are some basic symptoms of diabetes. It may not be present in everyone, but what are the symptoms of diabetes? You will feel more hungry, thirst, urination, weight loss. Sometimes, like I said, if there is a deficiency of insulin in the body, your muscle mass and fat portion will also decrease. Your extremities will decrease.
Weight will decrease. Easy fatigability. You get tired very easily. Your efficiency will not be the same as before. These are the symptoms. Sometimes, if you have a simple infection, like a simple boil, the normal body covers it with its defense and it becomes normal. It is not getting normal that fast.
The infection is increasing. It is not getting easily under control. There are many patients who have this kind of infection and it does not go away for a long time. Then, their family physician or doctor will tell them to check the sugar. Then, they will be able to detect it. So, you will feel more thirsty, hungry, urination, your weight is drastically decreasing without doing any good.
Physical activity or good diet control. You are hungry, you are eating a lot, but your weight is still decreasing. If you have an injury or an infection, it is not getting healed properly. These are some early symptoms that you can detect. Then, there is family history. This is also a very important thing. If one of your parents has diabetes, then the probability.
Of you having diabetes is around 25%. If both of your parents have diabetes, then the probability of you having diabetes is almost 70-75%. So, if you have family history, you should be aware that it is possible that you have diabetes. It is not necessary that it is possible, but you should be aware of it. The medications for diabetes and its complications can damage different organs. Since you are a food specialist, a diabetic food.
Specialist, would you like to share some awareness about it? Yes, definitely. The three modalities of diabetes are diet, physical activity, and medicines. Medicines are subjective things. When your listener goes to their doctor, there are different types of medicines like OHA and insulin. OHA means oral hypoglycemic agents. There are 5-6 types of medicines.
Each has a different mechanism. Some reduce insulin sensitivity and insulin resistance. Some increase insulin production in your beta cells. Some remove more sugar from your body through your urine, which is called glycosuria. Some medicines reduce the absorption of excess carbohydrates. It is a subjective thing. It depends on the need of the patient.
The consultant doctor will decide what is ideal for the patient. This is the third modality. The fourth modality is stress relief. We talked about its treatment. Now, let's talk about its complications. It is very common that people are scared of the complications after the treatment. Earlier, I told you that in 10-15 years, it is a silent.
Killer. In 10-15 years, it will not show any major symptoms or any major problem. If your sugar level is around 200-300, it is apparently a normal life. The patient is getting to know a lot but nothing major will happen in his life. When this phase goes on the major complication is due to two mechanisms.
One is macrovascular and the other is microvascular. The major problem is related to the arterial system. The process of atherosclerosis which is the accumulation of cholesterol in the arteries. It is said that the process of atherosclerosis starts in the womb of the mother. It is not like the process of atherosclerosis starts in the body. The process of atherosclerosis starts in the body. The process of atherosclerosis starts in the body.
If you have diabetes, if you are obese, your lipid profile means the parameters of fat, triglyceride, blood reports are altered. If you are a smoker, if you have all these things, the process of atherosclerosis will increase by 5 to 7 times. The macrovascular complications which are in diabetic patients due to this, in which the heart has a fast accumulation of cholesterol, and calcium is deposited on it, can lead to a heart attack.
If this happens in the coronary artery, in the heart, if this happens in the brain arteries, in the carotid arteries, it can lead to stroke. If this happens in the arteries of the legs, in the arteries of the legs, it can lead to gangrene, which is called peripheral vascular disease. These are the macrovascular complications. The second one is microvascular, which is a disease of small arteries, due to which your retina, which is the.
Eyelid of the eye, or your kidney, or your leg's limbs, the retina retinopathy, nephropathy, and neuropathy. These three mechanisms are microangiopathic. In this, in the eyelid of the eye, the neovasculation is not small, it is small, the blood stains are formed, your vision is diminished. The vision is lost due to this. And many times, it reaches an irreversible level, that whatever is lost, you cannot bring it back.
This mechanism damages your kidneys, which is called nephropathy. It is very common. and diabetes, if both are with you, then the probability of this happening increases a lot. And again, diabetes or BP was detected, it will not happen in the first 15-20 years. But nature is very merciful. It has given us two kidneys in one place.
Many times you must have heard that someone donated a kidney, still he is living a normal life. It has given two kidneys, in which billions of nephrons have been given. Means, there are individual units of the kidneys, which purify the blood and filter out the urine and the bad products from it. So, a normal person can say that 40-50% nephrons are working.
The rest are silent, means in the position of rest. When it will take more load, physical load or more water intake, when the circulating volume will increase or its load will increase, then the rest of the nephrons come in recruitment, then they are added. So, till the time, means if 40-50% nephrons are also working well, then your absolute normal excretory product and all that will continue to work. That's why it starts deteriorating, but you don't know in.
The beginning, it doesn't work. When 80-90% nephrons of your kidneys deteriorate, then you feel that my creatinine has increased, protein is going into my urine, my kidney has deteriorated, but till then it is very late. And again, the kidney deteriorates, so you have only two options. This is called end-stage renal disease or chronic renal failure.
Kidney becomes small, the nephrons, out of billions of nephrons, more than 90% nephrons have deteriorated. Now, you have to do either dialysis or have a kidney transplant done. And the third important thing, which is my speciality, I will emphasize on that, Neuropathy. It damages the nerves of the feet. Many people have a common question that why diabetes starts from the feet? Because they see problems in the feet.
Diabetic foot problem starts from simple nail problems. It starts from the color change of the nail and to a big gangrene. This whole thing comes under Diabetic Foot Problems. So, your nerve or your consciousness, as far as it is away from your brain, that is first of all. I am answering a common question that why did it start from the feet? If something touched your right or left foot, then how will.
Your brain sense it? You are a normal person, you are sitting, something came and hit your left foot or something touched you. Your brain immediately found out that something happened in this place on my left, you immediately took your foot. So, how will the brain sense that the consciousness of the foot will go from there to your spinal cord. From the spinal cord, it will go to the medulla oblongata, which is called the long muscle.
From there, it will go to the sensory cortex of the brain, where it will sense that in my left foot, under the thumb, someone bit me or touched me. So, the length of the navel is involved first. That is why Diabetic, Neuropathic problems, problems of loss of consciousness, they start from the distal half of the foot, from the thumb or the finger. This thing, usually the Neuropathy, whose mechanism I said, that the eye lid, the kidney and the consciousness of the.
Foot, the mechanism of its damage is same. So, because of this Neuropathy, means this Neuropathy starts in the foot first, that is why this thing starts from there, slowly, slowly, gradually, if you still have sugar and control, if you don't care about it, then it will go ahead gradually. And this Neuropathy is a very bad thing, through this only, Diabetic foot problems, it goes ahead in a very bad way.
Your senses of your feet will go away, you won't feel cold or hot in your feet, many times you have worn your slippers or footwear, or it has come off, you won't even know that. How you are standing on which surface, there is a stone under your feet, your foot is half crooked, half straight, you won't even know that. This Neuropathy is very big, through which this foot problem starts. This will happen in a very later stage, right?.
Yes. Neuropathy will happen in a very later stage, approximately how many years? 15 to 15 years, if your sugar is uncontrolled, then it will start in 10 to 15 years. And why is this? If we understand in a little easier language, how do these senses go away from the feet? What is the relation between sugar and this? There are two things in this, one is uncontrolled sugar,.
And duration of uncontrolled sugar. Okay. Suppose someone has been diagnosed with diabetes, at the age of 35, he is taking care of his diabetes very well, in every aspect, in diet, in medications, in lifestyle, keeps a good range of diabetes under control, his age is 65, means he is 30 years old, but you won't see Diabetic Neuropathy in him, because even though.
He has diabetes since 30 years, but since 30 years, he has kept diabetes as a friend, has not made it an enemy. So, he will be able to live a good healthy lifestyle even for another 20 years. Right. Suppose there is another person, who has been diagnosed with diabetes at the age of 45, after 10 years, but from the beginning, he has kept diabetes as his enemy, that he will do his work,.
I will do my work, this happens, nothing happens, I am equal, means he didn't take care of his diet, didn't take care of his medication, didn't take care of his lifestyle, then this problem will start in 55-60s. Okay. There are a lot of patients, who have their own problems, they compare it with their brother or cousin, that Sir, I had this problem with him, I had this problem with my leg, this was also detected with.
Me, now nothing has happened to him, why is it like this? But if you see him retrospectively, if you know his history,