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Cardiometabolic case on Diabetes: Know Diabetes By Heart
Diabetes produces acute and chronic toxicity to vascular endothelium in the patients resulting in spikes in hyperglycemia due to exposure to postprandial glucose. This causes microvascular and macrovascular complications.Damage to blood vessels starts early in such conditions.CVD and diabetes are interrelated,treatment focuses on the shared pathophysiologic mechanism of the diseases.
About the Speaker
Dr Amit Kumar Dey
Apollo Sugar Clinics, Newtown, Kolkota
Diabetes and Daily Insulin Use
For many individuals with diabetes, daily insulin use is a crucial component of their treatment plan, helping to regulate blood glucose levels and prevent complications. Insulin is a hormone that enables the body's cells to absorb and use glucose from the bloodstream, thereby lowering elevated blood sugar levels. People with type 1 diabetes typically require daily insulin injections or insulin pump therapy to compensate for their body's inability to produce insulin. In type 2 diabetes, insulin may also be prescribed when oral medications and lifestyle modifications alone are insufficient to control blood sugar levels. Managing daily insulin doses requires careful monitoring of blood glucose levels throughout the day to make adjustments as needed.
Diabetes Technologies-Innovations in Monitoring and Management
Continuous Glucose Monitoring (CGM): CGM devices provide real-time glucose data, helping individuals with diabetes track fluctuations and make informed decisions. Insulin pumps deliver a continuous supply of insulin, allowing for precise dosing and reducing the need for frequent injections. Closed-Loop Systems also known as artificial pancreas systems, these integrate CGM and insulin pumps to automatically adjust insulin delivery based on glucose levels. Smart Insulin pens record insulin doses and send data to mobile apps, aiding in medication adherence and tracking. Virtual consultations with healthcare providers enable remote monitoring and adjustments to diabetes management plans. Inhaled Insulin offers an alternative to injections for those uncomfortable with needles. This innovative insulin automatically adjusts its release based on blood sugar levels, mimicking the body's natural response. Implantable devices offer long-term glucose monitoring without the need for frequent sensor changes.
Diabetic dyslipidemia: Approaches
Diabetic dyslipidemia refers to the characteristic lipid abnormalities often seen in individuals with diabetes, including elevated triglycerides, low HDL cholesterol, and increased small dense LDL particles. Approaches to managing diabetic dyslipidemia involve a combination of lifestyle modifications, glycemic control, and targeted lipid-lowering therapies to reduce cardiovascular risk in diabetic patients. Encouraging a balanced diet, regular exercise, and weight management are essential for improving lipid profiles in diabetic patients. Emphasize a diet rich in whole grains, fruits, vegetables, and healthy fats while limiting saturated and trans fats, refined sugars, and processed foods. Emphasize a diet rich in whole grains, fruits, vegetables, and healthy fats while limiting saturated and trans fats, refined sugars, and processed foods. Fibrates can help lower triglycerides and increase HDL cholesterol levels in diabetic patients with high triglyceride levels. medication can be added to statin therapy to further lower LDL cholesterol levels by inhibiting cholesterol absorption in the intestines. These supplements can help lower triglycerides, although their effect on cardiovascular outcomes is still under investigation. These medications can help lower LDL cholesterol levels by binding to bile acids in the intestines.
Tackling NAFLD : Silent Epidemic
Non-Alcoholic Fatty Liver Disease (NAFLD) is a silent epidemic characterized by the accumulation of fat in the liver due to factors other than alcohol consumption. Lifestyle changes play a pivotal role in tackling NAFLD, with emphasis on adopting a balanced diet and engaging in regular physical activity. Reducing intake of sugary beverages, processed foods, and saturated fats can help improve NAFLD outcomes. Weight loss, achieved through a combination of diet and exercise, is one of the most effective ways to manage NAFLD. Regular physical activity not only aids in weight loss but also improves liver health by reducing inflammation. Avoiding excessive consumption of alcohol, even in the absence of alcoholic liver disease, is essential for NAFLD management. Diabetics and those with insulin resistance should work on glycemic control, as uncontrolled diabetes can worsen NAFLD. Incorporating foods rich in antioxidants, such as fruits, vegetables, and whole grains, can help combat oxidative stress in the liver. Omega-3 fatty acids, found in fatty fish like salmon and flaxseeds, may have protective effects on the liver. Limiting the use of certain medications that can harm the liver and discussing alternatives with healthcare providers is crucial for NAFLD patients. Regular monitoring of liver function and liver fat levels can help track the progression of NAFLD and guide treatment decisions.
Type-1 Diabetes in Children
Type 1 diabetes in children is an autoimmune disorder where the immune system attacks the insulin-producing cells in the pancreas. It is usually diagnosed in childhood or adolescence, though it can occur at any age. Children with type 1 diabetes require insulin injections or an insulin pump to manage their blood sugar levels. The exact cause of type 1 diabetes in children is not fully understood, but genetic and environmental factors may play a role. Symptoms of type 1 diabetes in children include frequent urination, excessive thirst, unexplained weight loss, and fatigue. Diabetic ketoacidosis (DKA) is a severe complication that can arise if type 1 diabetes is left untreated or poorly managed. Continuous glucose monitoring (CGM) and insulin pumps have significantly improved diabetes management in children. Children with type 1 diabetes need to follow a carefully balanced diet and monitor their carbohydrate intake. Regular physical activity is essential for children with type 1 diabetes, as it helps control blood sugar levels and promotes overall health. Careful monitoring of blood sugar levels is crucial to prevent hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar) in children.