Diabetes- The soft and silent killer !

The minute most of us hear “Diabetes”, we think of Blood Sugar.

Blood sugar is elevated level of sugar or glucose in the blood which if unchecked overtime, leads to diabetes. Diabetes is a disease in which the body’s ability to produce or respond to insulin is impaired, resulting in abnormal metabolism of carbohydrates, inability of our body to convert sugar into glucose and subsequently elevated levels of glucose in the blood.

We all know about Type 1 Diabetes, Type 2 Diabetes but whats important is what happens in the body, when we have elevated levels of sugar in the body for long.

Common Effects and Risks associated with high sugar levels and diabetes are:

Diabetes
Diabetes complications affected organs. diabetes affects nerves, kidneys, eyes, vessels, heart, brain and skin

Risk of stroke: Diabetes or elevated sugar levels, increase our risk of stroke, about 4 times more than non diabetics

Risk of Heart Disease:  Diabetes increases risk of heart attack , heart disease. As the blood vessels get damaged, it puts the heart under pressure and an increased risk of heart attacks.  High glucose levels also lead to fatty deposits. Coupled with obesity, high blood pressure, it puts you at a severe risk and an angioplasty  or an open heart bypass surgery may even be required.

Risk of Cataract: Diabetics are at an increased risk of developing cataracts

Risk of Glaucoma: Glaucoma risk is significantly more for diabetics. If left untreated, Glaucoma can lead to blindness.

Risk of Pancreas Malfunction: A malfunction in pancreas leads to diabetes and higher blood sugar levels in turn continue to damage the pancreas.
Risk of Gastroparesis:   Increase in blood sugar levels also makes it hard for the  stomach to empty completely. This also in turn leads to an increase in blood sugar levels. Nausea, vomiting, bloating, and heartburn are common symptoms.
Risk of Kidney Damage:  Unchecked High sugar levels and diabetes, damages the kidneys, leads to diabetic neuropathy and eventually one may need a dialysis or even a kidney transplant.
Risk of Nerve Damage: Diabetics often  have tingling sensation in the foot and suffer from nerve damage. Lack of sensation or peripheral neuropathy is dangerous as due to lack of sensation, one may fail to notice injuries

.
Foot Problems:  Unchecked diabetes can lead to diabetic foot where the entire foot may even need to be amputated.
Ketoacidosis:   In absence of insulin,  the body uses alternate hormones to turn fat into energy, which creates a high level of toxic chemicals such as acids and  ketones, which may lead to a condition called diabetic ketoacidosis.  Diabetic ketoacidosis  often leads to loss of consciousness and other life threatening complications. A Fruity Breath or a sweet smelling breath is often an indicator of diabetes and calls for a check on blood sugar levels.
Visual Problems:  Diabetics often face visual problems, as high glucose levels often lead to swollen, leaky blood vessels in the eye, leading to a condition called diabetic retinopathy.  These vision problems,  may even lead to partial or total loss of vision Vision problems can be gradual hence routine eye checkups if you are diabetic or have pre diabetes are a must.

Risk of damage to blood vessels:  High blood sugar levels or high glucose levels,
restrict blood flow, damaging the blood vessels.

As unchecked diabetes, leads to a host of problems, it is important to make life style changes. Pre diabetes conditions can be reversed by exercise and dietary changes.  Type 2 diabetes can be controlled and even reversed if significant life style changes are made.

One of the most important life style change is to Quit smoking as diabetes and smoking leads to an enhanced risk of heart disease.

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High Uric Acid levels ! Is there something to worry about ?

Uric acid is produced naturally by the body as a result of metabolism. Our kidneys filter and throw out uric acid normally.

In some cases, the body produces more uric acid than it can excrete or the kidneys are not able to excrete uric acid being produced, it leads to a rise of uric acid levels and leads to a condition called hyperuricemia.

Hyperuricemia is defined as an excess of uric acid in the bloodstream. If your uric acid is in excess of 7 mg/dL – you may have hyperuricemia.

Hyperuricemia has a few major health effects. They are as follows :

Gout
Gout

Gout : It is defined as a type of arthritis that causes inflammation in the smaller bones of the joints. Typically, chalky deposits of uric acid called “tophi” deposit as lumps under the skin causing severe pain and redness specially in the base of the big toe over a long period of time. This tophaceous gout compresses the nerves and is visible to the naked eye – making it disfiguring and making the pain worse. Gout, is characterised by episodes of intense pain. Sometimes uric acid crystals start to deposit in other joints such as elbow, knee, fingers, hand etc and may also damage surrounding cartilege.
Though extremely rare, sometimes, due to damage of the cartilage a joint replacement surgery such as total knee replacement may be required.

Doctors very rarely let patients come to this stage though and prescribe medication to take care of the pain and to shrink the uric acid crystals.

Incase Tophi or the uric acid crystals become too large or become infected, a surgery though rare, may be needed to remove crystals.

Large Tophi may also affect the range of movement of the joint such as hand or knee and a simple surgery may be required.

Kidney Stones : Kidney stones are defined as a hard mass formed in the kidneys due to insoluble calcium compounds. Initially, the kidney stones are small and pass out with the urine; however, over time the kidney stones become larger and block the urinary tract causing a difficulty in the passing of urine and urinary tract infections due to the buildup of bacteria in the tract. A high level of Uric acid is also a predictor and indicate’s renal dysfunction well in advance before the dialysis stage or the kidney transplant stage .
In patient’s with Rheumatoid arthritis or RA, high uric acid levels, call for a visit to the doctor.

Possible surgeries and procedure to take care of kidney stones are SWL(Shockwave lithotripsy), Ureteroscopy, PCNL(Percutaneous Nephrolithotomy ).

PCNL is best for treatment of medium to large stones , for complex stones or if there are too many stones in one kidney and needs a good, trained urologist.

Ureteroscopy is slightly more invasive than Shockwave lithotripsy but is good for stones which are very small and also way down in the urinary tract.

The best way to take care of gout related problems is to prevent hyperuricemia.

The following natural remedies are easy to implement and help prevent hyperuricemia :
Lemon Juice : Lemon is a natural antioxidant and contrary to popular belief, helps neutralise the uric acid in the body. A glass of lukewarm lemon juice water in the mornings before breakfast may go a long way in preventing uric acid buildup.
Apple Vinegar : Vinegar contains malic acid that helps to breakdown uric acid and make the solution alkaline. A glass of water with 2 tablespoons of apple vinegar has anti – inflammatory benefits.
Water : It is supposed to flush out toxins from the body and regulate kidney function. 8-10 glasses of water a day help dilute uric acid in the body and help excrete out the same from the body. Additionally, care should be taken to include water rich fruits such as watermelon and vegetables such as cucumber in ones diet.
Berries : Cherries and other purple or blue coloured berries contain anthocyanin that have anti- inflammatory and anti- oxidant properties and that help lower uric acid in the body. A bowl of cherries a day greatly reduces the risk of hyperuricemia.
These natural remedies are suggested to be followed post a doctor consultation and are by no means an alternative to prescription medication which is critical for treatment of gout.

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Swollen Legs and Feet ! Could it be something serious ?

kidney disease
Edema, swelling in legs

Many of us have swollen limbs, especially legs , ankles, feet which feel soft and cushiony due to water retention.

More often swollen legs and feet can be due to inactivity, sitting and standing at one position without moving.

This pulls the fluid down towards lower limbs, making them swell.

The swelling due to water retention is called edema.

However swollen legs and feet are often a sign of serious health problems such as kidney disease, cardio vascular problems or heart disease, liver disease, hormones being taken during HRT, deep vein thrombosis and sometimes even medication for diabetes and anti depressants.

Chronic pulmonary embolism may also lead to thromboembolism where a blood clot may travel to other parts of the body.

Incase the blood clot travels to the brain, it could lead to partial paralysis and even a stroke. Blood thinners may be advised to reduce risk of clotting.
As a 1st check, your doctor may prescribe diuretics and ask you to cut down on salt.

Then a few diagnostic tests such KFT( Kidney Function test), LFT( Liver function test), Echo, ECG may be advised.

Do watch out for signs like pain in one limb, heat generated in one limb, loss of consciousness, shortness of breath, fast or rapid heart beat and rush to the doctor as you may be experiencing thromboembolism.

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Stop that Kidney Damage !

The kidneys are two fist shaped organs and they are located on each side of the spine.
Kidneys play an important role in our body functioning. They act as filters, flush out toxins from the body and maintain the acid, alkaline balance in the body. Kidney trouble leads to water retention, swelling, oedema and affects quality of life.

Kidney Disease
Kidney Damage

It is very difficult to detect kidney damage till the last stage as kidneys can continue to function well even when they are 80% damaged, which leads to discovery when the patient has reached end stage kidney disease post which dialysis followed by kidney transplant is the only option

Are there any habits that damage the kidneys every day?

Even though we barely realise it, some of our daily habits contribute to kidney damage. Below is a list of some common habits, taking care of which can help us, prevent the damage to our kidneys.

Being a Pill Popper : Popping medicines without prescription or medicine abuse is dangerous for the kidney and can lead to a condition called rhabdomyolysis which is defined as a breakdown of muscle tissues that releases a damaging protein into the bloodstream – causing it to be transported to the kidneys and in turn, damaging the kidneys causing a need for dialysis.

Drinking too much Soda : 2 cans a day is too much ?According to a study presented in the kidney week in 2013, two cans of soda are enough to cause damage to your kidneys. Researchers from a leading university in Japan divided participants into three groups- one that drinks a can of soda a day, one that drinks two cans of soda a day, and one that does not drink soda. The results were startling – by the end of three years, more than 10% people from the second group developed a disease called proteinuria – a disease that may lead to End Stage Kidney disease.

Eating too much salt : Loading up on too much salt in our diet leads to excess of sodium in our body. Sodium is one of the most abundant elements on earth and is one of the main constituents of salt. However, in high amounts sodium causes kidney damage. This is because kidneys cannot eliminate excess fluid and sodium from the body. The built up sodium and fluid causes high blood pressure which in turn reduces kidney function.

Protein overload : Although protein intake is a must as proteins are the building blocks, a very high protein diet may cause a decline in kidney function in people especially with declining kidney function or kidney disease as the body may not be able to eliminate all the waste products of protein metabolism.

Not drinking enough water : Not drinking enough water also leads to kidney damage. Drinking enough water not only prevents kidney stones but also urinary tract infection because kidney stones are prevented from sticking to together in the presence of hydration while water helps dissolve the antibiotics used to treat UTI’s which makes it more effective in treatment. It also helps the kidneys flush out more toxins and infection causing bacteria by producing more urine.

Not exercising enough : Lack of exercise, promotes kidney damage while exercising increases mobility and circulation in the body causing more absorption and reabsorption by the kidneys; thus, increasing renal function.

Smoking : It promotes kidney damage because increases blood pressure, reduces blood flow to the kidneys, narrows the blood vessels in the kidneys by doubling the endothelium cells in the vessels, and accelerates loss of kidney function. According to statistics, smoking is a cause that can lead to end stage renal disease.

Lack of Magnesium in our diet: High magnesium levels in the body help prevent kidney stones, by preventing the formation of calcium oxalate. This is because kidney stones are formed by the binding of calcium onto oxalate; however, high levels of magnesium cause it to compete with calcium and bind to the oxalate instead – preventing the same.

Not getting enough sleep : Researchers from Brigham and the women’s hospital in Boston evaluated thousands of women and concluded that lack of sleep has a direct correlation with declining kidney function. It has also been suggested that less sleep changes the physiology of the kidney causing kidney damage.

Drinking too much Coffee : Caffeine is a stimulant which increases blood pressure causing more pressure on the kidneys. According to a study in 2002, long term caffeine consumption resulted in kidney failure in obese and diabetics – causing people to conclude that caffeine results in kidney damage.

Holding your pee for too long also affects the kidneys and leads to kidney damage.

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What is Chronic Kidney Disease?

Chronic Kidney Disease:

Chronic Kidney Disease means permanent kidney damage which has been present for at least 3 months and is progressive in nature.

As the disease progress ,toxins and waste products builds up in the blood and cause complications like uncontrolled blood pressure, low haemoglobin levels,weak bones, poor nutrition health and nerve damage.

Chronic Kidney Disease is also a risk factor for the heart disease and increases chances for the heart attack. It is most commonly caused by diabetes and high blood pressure , which have been inadequately treated over a long period of time.

Early detection and treatment can help in slowing the progression of renal disease and prolong the time of dialysis.

Kidney disease if untreated , eventually leads to kidney failure, and then dialysis or kidney transplant remain the only therapeutic option.