Dr. Patil's Diabetes, Thyroid & Hormone Clinic | Dr. Himanshu Patil

Diabetes Care

Newly Diagnosed with Diabetes

Being diagnosed with diabetes can be a shock When newly diagnosed with diabetes, most people find themselves in a state of shock. However, being diagnosed with diabetes doesn’t prevent you from leading a ‘normal’ life.

Most people receive great care from their General Practitioner and healthcare team, although some people report having just been given some tablets and been told to get on with it.

If this happens to you, make sure your doctor finds time to discuss your condition with you, or refer you to someone who can answer your questions better than they can.Feel free to bring up any topics or questions there and the community will do their best to help you out.

If you have any question or concern about your Prediabetes Problems then you should talk to Dr. Himanshu Patil as he will be best person to advise you.

Diabetes Care

Type 1

Type 1 diabetes is an autoimmune disease that causes the insulin producing beta cells in the pancreas to be destroyed, preventing the body from being able to produce enough insulin to adequately regulate blood glucose levels.
Type 1 diabetes may sometimes be referred to as juvenile diabetes, however, this term is generally regarded as outdated as, whilst it is commonly diagnosed in children, the condition can develop at any age.
Insulin dependent diabetes is another term that may sometimes be used to describe type 1 diabetes. Because type 1 diabetes causes the loss of insulin production, it therefore requires regular insulin administration either by injection or by insulin pump.

Type 1 Diabetes Symptoms

Type 1 diabetes symptoms should be acted upon immediately, as without treatment this type of diabetes can be deadly.

Symptoms Include

  • Above average thirst
  • Tiredness during the day
  • Needing to pee regularly
  • Unexplained weight loss
  • Genital itchiness

Type 1 Causes

Type 1 diabetes is caused by a fault in the body’s immune response in which the immune system mistakenly targets and kills beta cells, the cells in the pancreas responsible for producing insulin.

As more insulin producing cells in the pancreas are killed off, the body can no longer control its blood glucose levels and the symptoms of diabetes begin to appear.

What causes the initial fault in the immune system is yet to be discovered, however, research suggests that the condition results from a combination of genetic predisposition with an environmental trigger.

What triggers the immune system to behave this way is yet to be conclusively identified. To date, the strongest evidence points towards a virus as being the most likely trigger.

Treatment for Type 1 Diabetes

The impairment of the pancreas’ ability to produce insulin in type 1 diabetes means that insulin treatment is necessary.

Type 1 Diabetes & Complications

Short Term Complications

Short term complications can occur if blood glucose levels go too low or if insulin injections are missed. The short term complications that can occur are:
  • Hypoglycemia – too low blood sugar levels
  • Ketoacidosis – which can occur if insulin doses are missed or blood glucose levels become too high

Long Term Complications

Type 1 diabetes can lead to the development of the following long term diabetes complications:

  • Heart disease
  • Stroke
  • Retinopathy
  • Kidney disease
  • Neuropathy

Whilst the list of complications is a scary prospect, the chances of developing these can be significantly reduced by maintaining good control of your blood glucose levels and ensuring you attend all your diabetic complication screening appointments.

Complications

Diabetes Complications

Uncontrolled diabetes can lead to a number of short and long-term health complications, including hypoglycemia, heart disease, nerve damage and amputation, and vision problems.

The majority of these diabetes-related conditions occur as a result of uncontrolled blood glucose levels, particularly elevated blood sugar over a prolonged period of time.

It is essential that diabetics are aware of the complications that can occur as a result of diabetes to ensure that the first symptoms of any possible illness are spotted before they develop.

How Common Are Complication's Of Diabetes?

It is common for most people with diabetes to begin to develop complications after having diabetes for a number of years.

With good diabetes control and living a healthy, active lifestyle, it is possible for people to go a number of decades complication free.

However, if you have had less well controlled diabetes, have led a less healthy lifestyle, or had undiagnosed diabetes for a number of years, the complications of diabetes are more likely to develop earlier.

Why Do Complication Occur?

Scientists still do not fully understand how complications develop. 

 What is known, however, is that high blood glucose levels cause damage to the blood vessels and nerves which supply our organs and therefore result in impaired functioning of any affected organs. 

How Do I Prevent Complication's?

The risk of developing complications can be reduced by following a number of healthy lifestyle steps:

  • Achieving good control of your blood sugar levels. 
  • Losing weight – if you are currently overweight or obese
  • Eating a healthy, balanced diet
  • Taking regular physical activity – at least a total of 2 and a half hours each week
  • Avoiding Alcohol.
  • Quitting smoking

Living With Diabetes

Living With Diabetes

Diabetes & Stress

Stress, whether physical stress or mental stress, has been proven to instigate changes in blood sugar levels, which for people with diabetes can be problematic.

While stress can affect diabetes control, both directly and indirectly, it can also be caused by various diabetic factors such as being diagnosed with diabetes, adjusting to a diabetes treatment regimen, or dealing with psychosocial pressures of the disease.

What Can Cause Stress?

We live in a very stressful society which is constantly putting us under pressure. This pressure can sometimes be too much to handle, leading us to feel “stressed out”.

This everyday feeling can be caused by simple things such as:

  • Work pressure
  • Marriage and relationships
  • Parenting/children
  • Health problems such as diabetes (see below)
  • Financial insecurity
  • Traffic

How Does Stress Affect My Diabetes?

 It is widely recognised that people with diabetes are who regularly stressed are more likely to have poor blood glucose control. 

How Can I Combat Stress? 

There are a number of ways you can alleviate the feelings of stress. These include:

  • Taking regular exercise or joining a sports team
  • Going on holiday
  • Listening to music
  • Practicing yoga and breathing exercises
  • Mindfulness meditation

The ultimate aim of these exercises/activities is relaxation, which is key to controlling stress.

Diabetes Checks

 Diabetes check ups are an extremely important part of diabetes care. 

Diabetes Check Ups

 Daily diabetes check ups should include feet and blood sugar. 

 A variety of weekly and monthly check ups can help you to look after your diabetes. 

 You should also check blood pressure and review medication at Regular Interval’s. 

  If you have any question or concern about your Diabetes Check Ups Concern, then you should talk to Dr. Himanshu Patil as he will be best person to advise you. 

Diabetes & Sex

Both type 1 and type 2 diabetes can lead to complications. In some cases, sexual performance can be affected by diabetes.

Up to 50% of men and 25% of women may experience some kind of sexual problems or a loss of sexual desire as a result of diabetes.

I Am a Diabetic Man, What Kind Of Problems Could Diabetes Cause My Sex Life?

For men, diabetes can cause damage to the nervous system over a sustained period of time, also known as diabetic neuropathy. One aspect of this is the potential for diabetes to damage the erectile tissue leaving it impossible for a man to achieve or maintain an erection.

Almost 1 in 3 men with diabetes suffer from erectile dysfunction.

Guides for men:

Erectile Dysfunction

Problems ‘downstairs’ will affect up to 33% of men.

Erectile Dysfunction

Impotence

Impotence can be caused by a number of issues.

Impotence in Men

Testosterone

Levels of testosterone in men naturally decrease after 40.

Low Testosterone

Erectile dysfunction can be the way in which men discover that they have diabetes.

However, through strict management if the disease through diet, exercise, pills and insulin injections, minor sexual problems usually recede and it is possible for the man to achieve and erection.

I Am a Diabetic Woman, What Kind Of Problems Could Diabetes Cause My Sex Life?

For some women with diabetes, vaginitis (inflammation of the vagina) can be recurrent.

Vaginitis can be brought on by a number of different ways including bacterial inbalance of the vagina (bacterial vaginitis) yeast infections (thrush) or from chemical irritation, such as from soaps or fabric conditioners.

This can make sex painful, and is heralded by itching or burning sensations.

Cystitis can also be a recurrent problem for women with diabetes.

Could My Blood Sugar Level Affected My Performance Level?

Having high or low blood glucose levels may lead to you feeling more tired or lethargic and therefore less up for sexual intercourse. 

In men, high and low blood sugars can affect your ability to maintain erection and achieve ejaculation. In the case of hypoglycemia, this is usually easy to remedy, although it may spoil the mood.

I Am Worried About My Diabetes Effects My Sex Life? What Should I Do?

 The initial action one should take it to contact your doctor and discuss it with him. Often, these issues can only be addressed by seeking professional help. 

 If you have any question or concern about your Sexual Life, then you should talk to Dr. Himanshu Patil as he will be best person to advise you. 

Pregnancy & Diabetes

  • Diabetes & Preparing For Pregnancy 
Preconception care enables you to be well prepared for your pregnancy. With the additional challenges of having diabetes, preconception care carries extra benefits.If you are planning to become pregnant, arrange an appointment with Dr. Himanshu Patil, so that a care plan can be prepared.
  • Medication
Some medications are not recommended for use during pregnancy.This may include some blood pressure lowering medications and some anti-diabetic medication.Your doctor will be able to advise you on any medication changes that may be needed.
  • Diabetes During Pregnancy 
Diabetes and pregnancy requires extra dedication but you should receive excellent care through your pregnancy.We look at some of the risks that are involved as well as how good control can reduce these risks and the care you should expect to receive along the way.
  • Diabetes & Pre-eclampsia
Pre-eclampsia is a condition that causes very high blood pressure and protein in the urine which can occur during pregnancy.Pre-eclampsia results from problems in the development of the placenta.People with diabetes have an increased risk of pre-eclampsia occurring. You will receive blood pressure and urine tests through your pregnancy which should pick up any signs of pre-eclampsia. Large Babies Mothers with diabetes are more likely to have large babies (weighing over 10lbs) than mothers without diabetes.If the baby is large, you may be advised to have induced labour or a cesarean section delivery. Blood Glucose Control Good blood glucose control is important all the way through your pregnancy but is especially important at the start of your pregnancy, in the first trimester.  Keeping your blood glucose under control during your pregnancy requires dedication.
  • Diabetes & Breastfeeding 
Breastfeeding is widely considered to be the best way of feeding your new born baby and this applies to mothers with diabetes as well.We’ve taken a look at some of the common questions that get asked about diabetes and breastfeeding, and provide the answers you need to know.

Type 2

Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body:

  • Being ineffective at using the insulin it has produced; also known as insulin resistance and/or
  • Being unable to produce enough insulin

Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body.

From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison.

This is why people with diabetes are advised to avoid sources of dietary sugar.

The good news is for very many people with type 2 diabetes this is all they have to do to stay well. If you can keep your blood sugar lower by avoiding dietary sugar, likely you will never need long-term medication.

Type 2 diabetes was formerly known as non-insulin-dependent or adult-onset diabetes due to its occurrence mainly in people over 40. However, type 2 diabetes is now becoming more common in young adults, teens and children and accounts for roughly 90% of all diabetes cases worldwide.

How Serious is Type 2 Diabetes

Type 2 diabetes is a serious medical condition that often requires the use of anti-diabetic medication and or insulin. In recent years, it has become apparent that many people with type 2 diabetes are able to reverse diabetes through methods.

Type 2 Diabetes Risk Factor

A number of factors can increase the risk of developing type 2 diabetes. These include:
  • Being overweight or obese
  • Eating an unhealthy diet
  • Physical inactivity
  • Having a first-degree relative with type 2 diabetes
  • Having high blood pressure or raised cholesterol levels
  • Smoking
The likelihood of developing type 2 diabetes is also influenced by genetics and environment.

Symptom's & Diagnosis

The most common symptoms of type 2 diabetes are:
  • Excessive thirst
  • Frequent urination
  • Increased hunger
  • Extreme tiredness
  • Sudden loss of muscle mass
  Some of these symptoms are the same for type 1 diabetes, but in type 2 diabetes they tend to develop more slowly over a period of months or years, making it harder sometimes for people to recognize them as signs of an underlying illness. In fact, many people have type 2 diabetes for a long period of time before being diagnosed with the disease. Type 2 diabetes is frequently diagnosed following the results of either a fasting plasma glucose test or an oral glucose tolerance.

Prediabetes

Prediabetes ( Borderline Diabetes )

Prediabetes, also commonly referred to as borderline diabetes, is a metabolic condition and growing global problem that is closely tied to obesity.If undiagnosed or untreated, prediabetes can develop into type 2 diabetes.

What is Prediabetes?

Prediabetes is characterised by the presence of blood glucose levels.

 Prediabetes may be referred to as impaired fasting glucose (IFT), if you have higher than normal sugar levels after a period of fasting, or as impaired glucose tolerance (IGT), if you have higher than normal sugar levels following eating. 

What are the Symptom's of the Prediabetes?

Many people have prediabetes but are completely unaware of it. This is because the condition often develops gradually without any warning signs or symptoms. In many cases, the sufferer only learns of their borderline diabetic state once the symptoms of type 2 diabetes start to appear. Therefore, being aware of the risk factors is essential.

What are Risk Factor's of Prediabetes?

You should be tested for prediabetes if you:
  • Are overweight or obese
  • Have a close relative (parent or sibling) who currently has or has had diabetes
  • Have high blood pressure, low HDL (‘good’ cholesterol) or high triglycerides
  • Are over the age of 40.

Can I Stop Prediabetes Developing into Type 2 Diabetes?

The good news is that cases of prediabetes that are identified early on can be reversed, preventing them from progressing into full-blown type 2 diabetes.

If you have any question or concern about your Prediabetes Problems then you should talk to Dr. Himanshu Patil as he will be best person to advise you.

Travelling Smart with Diabetes

Travelling Smart with Diabetes

People with diabetes should plan their travel and holidays in advance and seek advice wherever necessary. 

  1. Diabetes Travel Checklist.
  2. Air Travel & Diabetes.

1) Diabetes Travel Checklist.

 It’s summertime, and the living is easy, or so the song goes. However, one of the issues that really irritates people with diabetes – and those who care for them – is the hassle involved in taking your diabetes on holiday. 

Don’t Forget Your Spares.

Not only should you take all your normal kit, you also need to take spares. Then you need to consider how best to carry it. 

If you’re going in the car, then you’ve got space, by comparison to packing – say – for a flying on a budget airline.

Budget or not, the real issue with take a flight is the business of getting you and your diabetes kit through security.

Keeping It With You.

Keep all your medical supplies with you – you really don’t want to lose this stuff when you’re in transit, that really will put a bit of a downer on your get-away break.

When flying, do not put insulin in luggage that goes in the hold, as it could freeze. When in the cabin insulin will be fine – it does not need additional cooling, you just need to avoid extreme hot or cold.

If you are uncomfortably hot or cold, then so is your insulin if it is with you.

Dr. Himanshu Patil Checklist –  Traveller’s Checklist 

  • Tip’s & Travel for Diabetes Patients.

Diabetes Travel : Top Tip’s

 Before making a journey abroad, or even within your own country, everyone needs to plan. If you are diabetic, as well as remembering all of the usual holiday checklist (passport, sunscreen, tickets, etc) there are other factors worth considering. 

Stock up with diabetes drugs and insulin, taking more than you will need. If you are travelling with a partner, make sure they carry half in another case, in the event that one case is lost.

Similarly, make sure you carry a supply as hand luggage. Temperatures in the hold of an aircraft can also become very low, causing insulin to freeze in extreme cases, so all insulin, and other injectable medication, should be kept with you. 

Pack a list of all medication. Carry a simple first-aid kit. Pack an ample supply of food and drink, providing for any delays and making sure you don’t disrupt your usual diet too much.

Pack facilities to test your blood sugar, even if you have an established insulin regimen. Insulin may be absorbed faster in warmer climates.

2) Air Travel & Diabetes

Air Travel & Insulin 

Travelling abroad with insulin has caused many people with diabetes problems in the past. Despite airline security, people with diabetes are able to carry insulin with them in hand luggage.

A letter from your doctor is essential.

It should clearly explain the necessity of carrying both insulin and syringes/insulin pump onboard.

The letter should explain that you need insulin and you should present it at security to staff. If you encounter further problems, speak with a senior manager because air travel and insulin should no longer be a problem for people with diabetes.

How Do I Tell If My Insulin Has Been Damaged During The Flight. 

You should examine the insulin for any trace of crystals.

If some are found, you should discard this insulin and seek local supplies.

Keep an accurate testing routine up to make sure your insulin hasn’t been affected.

Should I Give My Insulin In Cabin Crew?

 It can be standard protocol for cabin crew to request all medication for storage during the flight. 

Will I Be Allowed On The Plane With My Insulin  Syringes/Needles?

With a doctor’s letter in hand, there should be no problem boarding with your insulin.

However, it is worth checking the airline policy before you travel and phoning them up to make sure if you are concerned. 

Airline Food & Diabetes.

Diabetes experts recommend that people with diabetes don’t require specific ‘diabetic’ meals on board; however, the non-diabetic meals may include sweet puddings.

Eating the right food can be even more difficult when you are stuck on an aircraft with a restricted menu.

If in doubt, it may be worth contacting the airline in advance.

Airline meal portions do have a tendency to be quite small and this, together with the long wait times between meals on long-haul flights, means that people with diabetes should go prepared.

 When it comes to dessert, the diabetic Patients’s Should Choose Fruit Instead of Dessert.

Travel Emergencies

Dealing with illness while abroad can be extra difficult for people with diabetes.

Arranging emergency medical treatment will depend on your country of origin, and your doctor and travel agent should be able to advise you on this.

 The following short checklist outlines how people with diabetes going abroad can prepare for travel emergencies. 

Travel Emergency Checklist

  • Get diabetes travel insurance and make sure you are covered
  • Read your policy! Know what your insurer will pay for
  • Know your medication – knowledge of generic names and local brands can make all the difference
  • Keep names and contact details of your healthcare professionals and reliable friends
  • Keep all receipts of everything you pay for, and further evidence if possible such as labels and price tags.

Treatment

Treatment for Diabetes

Treatment for Diabetes

Successful treatment makes all the difference to long-term health, and achieving balanced diabetes treatment can be the key to living with both type 1 and type 2 diabetes. Treatment varies for each individual, not simply on the type of diabetes that they have, but also more individual-specific diabetic treatment differences. Your diabetes treatment and management strategy should be agreed between  your Endocrinologist. If you have any question or concern about your Diabetes Problem, then you should talk to Dr. Himanshu Patil as he will be best person to advise you.
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