How to prevent and control diabetes

In an online chat with Get Ahead readers on November 7, Dr Phulrenu Chauhan from Hinduja Hospital answered queries on control and prevention of diabetes.

Here's the unedited chat transcript:

DR: MY FASTING IS 145 AND PP IS 165.BUT HBA1c is 6.9 - reduced from 701 since six months.May I have any advise on this?

Phulrenu Chauhan: you need to go on strict diabetic diet with a help of a dietician and at least do a regular brisk walk for half hour to 45min daily. if you are overweight or obese and recheck HBA1C after 3 months

poorani vaidyanathan: I have diabetes for 12 years. so far all my wounds are healing. is it true that next stage wounds will not heal. how to prevent it?

Phulrenu Chauhan: the only way of preventing any kind of infection or non healing wounds is to keep your blood sugars controlled all the time.

Ashok Sharma: is diabetics curable? Can a diabetic patient be considered as normal patient if his sugar is under normal range without using medicines?

Phulrenu Chauhan: Diabetes is not curable, only controllable. This can be done either with medications or life style modifications.

basheer: [SKB] How can the combo of Blood Pressure and Diabetes be controlled?

Phulrenu Chauhan: Life style modification, control on weight, regular 3 to 6 months check on advice of treating doctor and medications to be taken regularly strictly under doctors advice

guddy: Does emotional stress affect blood sugar?

Phulrenu Chauhan: Yes it can.

surendar gade: I am 35 years old 2 n half years back I found diabetic since then i am using metformin 500mg tablet with regular walking and diet till now it is normal it is never crossed 100 and 130 mg till now should i continue the same medicine or change the medicine please give me suggestion

Phulrenu Chauhan: Since the blood sugars are well controlled, continue the same medications. You can do a HBA1C every months which will be an average sugar control reading.

PRANAV BODAS: sir , my wife have dibities , pp reding 160,so any help full tips for

Phulrenu Chauhan: Since only PP reading is high, change in diet and regular simple exercises such as walking for half hour to 45 mins daily might help.

Mrs-Sudha-Nair nair: G A NAIRI am 66 years oldI have stopped medication since June 2013. Dibetic was detected in 2007 ,was on Amaryl 1 Tab 1 mg per day till June . Developed Hypo in JuneFS &PP 100 &130 for last 4 months with strict diet and regular exerciseShould i continue the same routine without medicine.

Phulrenu Chauhan: Yes continue the same routine and please do a Serum Creatinine level.

gentechglb@rediffmail.com: Dear sir,my s creatinine 1.2 & right kidney ;8.8X4cms,left kidney;8;8X4cms one doctor tells normal report ,another doctor says 3rd sage which is correct what is the normal value & size of kidney what i have to do

Phulrenu Chauhan: Size of the kidney is not always suggestive of kidney functions. You should do a Serum Creatinine annually and also Urine for Micro Albumenurea

vijay: • Will the child have 10-15% chance of developing type 2 diabetes when their parents have type 2 diabetes? And if one identical twin has type 2 diabetes, does there is a 75% likelihood of the other twin developing type 2 diabetes also.

Phulrenu Chauhan: The chance of developing Type 2 diabetes in child is high as 20-30% if one parent is a diabetic and almost of 50-60% if both parents are Type 2 diabetics. If one twin has Type 1 diabetes, the chance of the second one to develop Type 1 is about high as 10-15%.

snehashish-Daschoudhary: WHAT ARE THE SIDE EFFECTS OF DIABETES MEDICINEAND ALSO ANY NEW DIASES FORM. (I AM GOUT AS WELL AS HYPO TYROID PATIENT)

Phulrenu Chauhan: each medication has its own side effects and should be discussed with the treating doctor.

Sanjay Dhamsania: I have read that carbohydrates. raises the sugar level. Being a vegetarian, what other food options do I have, if I want to restric my carbs.?

Phulrenu Chauhan: You should be on a well balanced diet containing about 50-60% carbohydrates, about 30% of proteins and 10% of fats.

Gogan Dutta: I am 41 years old I have diabetes since last 2 yearsso what is the method to control my diabetes

Phulrenu Chauhan: Life style modification, control on weight, regular 3 to 6 months check on advice of treating doctor and medications if required.

Sanjeev kumar: At what stage of blood sugar level , one should go for medicine?

Phulrenu Chauhan: If after trying life style modifications, fasting blood sugar is more than 120 and post lunch blood sugar more than 150 or 160 (depends on the age of the patient). Then one needs to go on medications.

Medothul Richa: [SKB] will u tell me how to be careful who are in primary stage of diabetics and going to other form medicine is helpful besides allopathy

Phulrenu Chauhan: Strict diet control, daily exercises and a regular check of blood sugars is required to begin with.

swati sontakke: what r the symptons of daibities? did it will continue if any fore father has? if yes, did the son has or grandson or next generation how to avoid?

Phulrenu Chauhan: Type 2 diabetic is inherited from one generation to the other and is far more common in the present or the next generation. One has to keep control on child's eating habits, weight and should be physically active on daily basis. If there is a strong family history, blood sugar testing should start as early as 30 to 35 years.

soma lingdaur: what are excises and diet recommended for type 1 and type 2 persons

Phulrenu Chauhan: For both Type 1 and Type 2 diabetic patients, diet should be discussed with the help of a dietitian which contain about 50-60% carbs, 30% proteins and remaining fats. For exercises, any form of aerobic for at least half hour to 45 mins daily is recommended depending upon the age of the patient.

Ramaswamy Madhusudhan: How can the combo of Blood Pressure and Diabetes be controlled?

Phulrenu Chauhan: Life style modification, control on weight, regular 3 to 6 months check on advice of treating doctor and medications if required.

somanadham nalla: will u tell me how to be careful who are in primary stage of diabetics and going to other form medicine is helpful besides allopathy

Phulrenu Chauhan: Strict diet control, daily exercises and a regular check of blood sugars is required to begin with.

sajjan-kumar-saha: Does diebetis has any link with intake of sugar?

Phulrenu Chauhan: Once a diabetic, you have to control the sugar intake

Mohammed-Gori Madiwale: will u tell me Is there any side effect of insuline

Phulrenu Chauhan: Per se insulin very rarely causes any side effects. If taken in excess, it causes a fall in the blood sugar. Rarely patients maybe allergic to certain forms if insulin.

Zalazi Kallangoden: Dear Doctor,I am diabetes for a year now. Am taking metphormin 500 SR daily one. doing regular exercise and control on diet. still my sugar level is more than 200.

Phulrenu Chauhan: You need to meet with the diabetic specialist. Either a change of medication or addition of another group of diabetic tablets is required.

Hanosh Varghese: Any one-time (Country treatment like Ayudveda) medicine is available or pancreas operation / replacement is effective ?

Phulrenu Chauhan: No

poorani vaidyanathan: my cousin had 3 heart attacks and his kidneys are affected. he can drink only 750 ml water a day. it happened because he is diabetic. I am also diabetic and 55 years old. How can i prevent internal damage?

Phulrenu Chauhan: Regular checks and control of blood sugars and annual body check which covers all the body system is required.

Rajesh Kar: Is it possible to prevent the onset of heriditary diabetes with lower free sugar intake and proper exercise

Phulrenu Chauhan: Yes, however one needs to keep a check on the blood sugar levels even after life style modifications.

RK: MadamMy father is a 62 year old diabetic patient and under strict food and diet , medicine control . His reading is 1180 this week and he is under continuous medication also but sugar level does not come down. Doctor doubts on hereditary problem or enzyme issue not sure about truthness. Please suggest a way to get rid of this.

Phulrenu Chauhan: He needs to be seen by a diabetic specialist.

Rajan Venkiteswaran: I am taking Gemer Forte 1twice a day my PLBS is always in normal range while FLBS is a little high. Why so?

Phulrenu Chauhan: Probably you are a little overweight or obese and not exercising adequately. Hence fasting blood sugar is on the higher side.

shrenik: What is the best way to tackle sudden increase in diabetics level due to stress. My dad recently got high diabeties suddenly because of tension in business. He took insulin injections for some time and now it is under control without insulin. Dr. Chauhan is there any way to keep the same under control

Phulrenu Chauhan: Blood sugar levels are extremely volatile and change within a matter of minutes. Since he is well controlled at the moment without insulin, continue the same treatment. if the present treatment cannot tackle the excursion, one can take insulin for a short period.

sajjan-kumar-saha: What are the symptoms to identify Diabetis ?

Phulrenu Chauhan: Unless the blood sugars are very high, patients are asymptomatic. With high blood sugar there could be weight loss, increase frequency of urination, increase thirst, leg pain, tiredness, weakness etc.

venkataraman srinivasan: My wife is 54 years old and is taking Insulin twice a day and still her sugar level is not reducing she is having more than 200 level also taking medicines

Phulrenu Chauhan: Please check on her food intake and excercises and also adequate caloric requirement has to coincide with the insulin timings. Here a dietician would be very helpful.

RAJIVSAS: I am 40 years old having type 2 diabetes and controlled by medicines. I feel tired and lethargic most of the times. Pls suggest some remedy.

Phulrenu Chauhan: Inspite of your diabetes being strictly controlled, if you are feeling lethargic then check CBC, Creatinine, TSH, Vit B12 and Vit D3 levels.

yogesh shah: how to control diabetes?

Phulrenu Chauhan: Regular check of blood sugars, keep weight and diet control and life style modifications.

Mahesh Venkatesh: Sir I am now 51. I am TypeII diabetic. Since Last 2 years i am taking one Diapride M1 tablets before food in the morning. But some times i feel to urinate very frequently with low quantity. Why? should i change the tablet or what?

Phulrenu Chauhan: First check whether your blood sugars are controlled. If so, then do Urine examination for infection. And follow up with your regular doctor.

Muktesh k Bimal: Good Afternoon.What is the early symptoms of diabetes

Phulrenu Chauhan: Unless the blood sugars are very high, patients are asymptomatic. With high blood sugar there could be weight loss, increase frequency of urination, increase thirst, leg pain, tiredness, weakness etc.

abani samal: I am diabetic since last 2 years (age 33 yrs). Can I regular use sugar substitute i.e sugar free for Tea/Coffee

Phulrenu Chauhan: Yes you can within limits though.

ranjan-meher: i am 38yr old , diabetic is herediatory. first time observed before 5 years and control by diet and some yoga. last year it was 250mg in PPBs and after four months it was control to 130mg. again few days back it was 230mg. till now i am not taking any medicine, can i start medicine or can try by exercise and diet

Phulrenu Chauhan: Since you are already dieting and exercising but still the sugars are high, you need medications.