DIABETESHYPERTENSION 5350c5bc4ec0a40f442ed9f8 False 75 0
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Medical treatment of Diabetes. There are two types of diabetes. In Type 1 diabetes there is total absence of Insulin production. Hence life is dependent on Insulin for these patients. The patient gets very sick, if the insulin is not taken for a couple of days. Usually we use two types of insulin. A basal insulin which takes care of the daily metabolism of the patient and a meal time bolus to cover the rise in sugar with meals. Once we figure out how much the patient needs, we have to adjust their doses depending on type and quantity of diet and exercise. Type II diabetes which accounts for 95% of diabetes patients, is an insulin resistant state with a relative decrease in insulin production in the presence of insulin resistance. Most doctors are inclined to treat this as a sugar diabetes problem. As a result are caught up in chasing the sugar with insulin or Sulphonylureas drugs. But this is a silent vascular disease and a “silent killer”. This is a complex metabolic disease. It is a combination of 4 major abnormality often referred to as the “terrible quartet” comprising of central obesity, high blood sugar, high blood pressure and a complex cholesterol abnormality. It is pivotal in type II diabetes; we address all four problems simultaneously. In order for the patient to do well, we must look at the patient holistically. Doctors need to assess the blood pressure, pattern of Cholesterol abnormality and fix their insulin resistance. Chasing the sugar, is a myopic approach to sugar control and increase in weight. Patients continue to gain weight and we keep increasing the dose of the medicines. Finally the patient is put on insulin and the patient never succeeds but continues to being a victim of diabetes and continues to have vascular events like, vision deterioration, stroke, heart attacks, kidney failure and amputation of the limbs. But today we have good medicines for insulin resistance, vascular-protection, cardio-protection, eye protection and kidney protection. Patient can be helped with good and appropriate treatment to become a “victor” and have hope of a better tomorrow. The doctor must spend the time to listen and assess the patients needs and a customized approach of medical management can reduce complications and perhaps reverse some of the complications that have already happened. Diet and exercise and life style modification will always play a pivotal role in the final outcome. For more information please visit www.diabeteshypertension.com. Dr Narendra K Gupta, best diabetes doctor in Gurgaon and Delhi
In the medical treatment of hypertension, there are many factors to take into account before starting treatment. The medical conditions of the patient, Obesity, Life style, diet and ethnic background. Life style modification comprises of low salt, exercise and stress reduction with relaxation exercise with things like Yoga and Meditation. It is very important to watch the salt in the diet. The patient’s sleep is also important. Snoring is associated with obstructive sleep apnea and resistant and severe hypertension. Walking is a great unwinding exercise and decreases the adrenaline associated with high blood pressure. A physician has to take into account the pre morbid condition of the patient. We also have to take into account if the patient has diabetes, obesity, heart disease or kidney disease. This is not a comprehensive advice regarding high blood pressure. For further information, please go to www.diabeteshypertension.com We have a vast array of medications to choose from in our medical management of high blood pressure. There are several classes of medications available and today we have some very inexpensive and excellent medications for hypertension. There are hundreds of drugs, but an appropriate choice is made after listening to the history of the patient and a good physical examination. Too many doctors are trigger happy to quickly prescribe a medication for a patient without due consideration of the patient. Most of the harmful affects of high blood pressure can be prevented with appropriate medical treatment. Dr Narendra K Gupta, specialist in hypertension. Best high blood pressure doctor.
Insulin is not the solution but the problem in type II diabetes. As you all know there are two types of diabetes. Type I diabetes, where there is total absence of Insulin production. Insulin is the key to their survival and will get very sick within days if they do not get insulin. On the other hand type II diabetes is an insulin resistant state with the production of insulin eventually fails to produce more in the presence of resistance to insulin action. The blood sure goes up about 15 to 18 years after the problem has started. It has become fashionable by doctors to give glucose reducing medicines, because we are myopically look at the elevated blood sugar. It is common for primary care physicians to give Sulfonylurea class of drugs and try to control blood sugar. Almost all patients will gain weight and the medication dose will have to be increased to control sugar and eventually when they fail, patients will be started on insulin. If you happen to go to an Endocrinologist he is more than happy to start you on insulin because it is all about sugar control. They have treated type I diabetes this way. However there is a far better way and that is to fix the insulin resistance which is the fundamental problem. Once we deal with this fundamental problem the need for Sulfonylurea and insulin progressively decreases to the extent that they can be stopped and life becomes stable and weight loss occurs. What is very important to realize that type II diabetes is a complex metabolic disease where diabetes, obesity, high blood pressure and high cholesterol coexist. Insulin at high levels in circulations promotes the high blood pressure and is a stimulant for the atherosclerosis which is the “Silent Killer” in type II diabetes. So I am here by providing hope to patients with diabetes to not only do well with sugar control but also reduce significantly the other problems that kills in diabetes. Insulin is not the solution but the problem, It is this high levels Best Diabetes doctor in Gurgaon. Best obesity expert in Delhi
Is Diabetes just a disease of blood sugar?? When should we start the treatment of Diabetes? It is very dangerous to think so. In type 1 diabetes there is total absence of insulin and blood sugar goes up, leading to atherosclerosis or narrowing of the small vessel in nerves, eyes and kidneys. But type II diabetes is a very complex metabolic disease. It is this type of diabetes that is rapidly increasing. The first thing that sets in is central obesity i.e. weight gain around the belly button and insulin resistance as a consequence. At this stage the cholesterol gets deranged with decrease in the good cholesterol HDL and increase in Free Fatty Acid and Triglycerides. These have a toxic effect on various muscles in the body, called apoptosis. This is also responsible for the damaging effect on the liver, leading to fatty liver and liver failure.The Cholesterol continues to get deranged and as a result we have disease and narrowing of large vessels in the body. A number of patients will present with Heart attack, stoke or kidney failure. There is further increase in insulin resistance as time goes on, leading to high insulin levels. High Insulin causes the BP to slowly and progressive increase and atherosclerosis or hardening of the large vessels to progressively get worse. So we have to remember that far before blood sugar rises in type II diabetes the vascular disease has started playing havoc in the body. When this process has gone on for 15 to 18 years then the blood sugars start to rise. We have a very casual approach to diabetes and it can cause significant damage by the time it is diagnosed. We should amtocipate the problem and start treating at Pre Diabetes stage. Dr. Narendra Gupta, Best Diabetes doctor in Delhi. Best Diabetes doctor in Gurgaon. Best Diabetes doctor in INdia
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