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Shachi says

Some sources of stress are never going to go away, no matter what you do. Having diabetes is one of those. Still, there are ways to reduce the stresses of living with diabetes. Some of us have created psychotherapy practices solely to help people living with diabetes. Diabetes comes with great change and great loss. You lose your way of living, your lifestyle. The loss of one's past lifestyle would be less traumatic if it is addressed and processed out in psychotherapy. It is a very traumatic event in the beginning and the traumas continue while living with it. As time goes on, depression can set in. Whether it is because a person is struggling to manage the day-to-day tasks or a person is dealing with complication, it is best to get emotional help to adjust. Higher levels of anxiety, fear and guilt come along for the ride. In the here and now, diabetes management is like having a second job. If you have ever had 2 full-times jobs you probably can relate to some of the emotional stress and anxiety living with diabetes comes with.Fear sets in even if you have no complications, and for some people, those thoughts become a consistent part of everyday life. This causes problems with relationships and the individual's emotional well-being.Psychotherapists help facilitate growth and change in their clients. So clients with diabetes can find those answers and come to acceptance around living with chronic illness. One of the interesting facts and most problematic is that most people have lived with diabetes for 5 to 15 years. During that time blood sugars rise and the symptoms of high blood sugars start impacting a person’s life long before diagnosis.The symptoms mirror the symptoms found in depression. High blood sugars trigger depression and depression causes poor motivation to control one's diabetes management, in turn causing higher blood sugar. This process is an endless cycle if left alone but support groups can help. Knowing other people in the same situation helps you feel less alone. Making friends in a support group can lighten the burden of diabetes-related stresses. For some people with diabetes, controlling stress with relaxation therapy seems to help, though it is more likely to help people with type 2 diabetes than people with type 1 diabetes. This difference makes sense. People with type 1 diabetes don't make insulin, so stress reduction doesn't have this effect. Some people with type 2 diabetes may also be more sensitive to some of the stress hormones. Relaxing can help by blunting this sensitivity. Another way to relax your body is by moving it through a wide range of motion.Stress blocks the body from releasing insulin in people with type 2 diabetes, so cutting stress may be more helpful for these people. Also,Going to a therapist can help you turn that around. Once you get your depression under control, your blood sugar should follow suit. It's not easy but it is a lot easier with someone to talk to without bias or judgment, and the therapist comes into play. Another way to loosen up is through movement- circling, stretching, and shaking parts of your body. To make this exercise more fun, move with music.Replace bad thoughts with good ones.Each time you notice a bad thought, purposefully think of something that makes you happy or proud. Or memorize a poem, prayer, or quote and use it to replace a bad thought.Whatever method you choose to relax, practice it. Just as it takes weeks or months of practice to learn a new sport, it takes practice to learn relaxation.
Some sources of stress are never going to go away, no matter what you do. Having diabetes is one of those. Still, there are ways to reduce the stresses of living with diabetes. Some of us have created psychotherapy practices solely to help people living with diabetes. Diabetes comes with great change and great loss. You lose your way of living, your lifestyle. The loss of one's past lifestyle... (Read More)
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Is smoking related to diabetes?

Shachi says

People with diabetes who smoke have higher blood-sugar levels and less control over their blood-sugar levels than nonsmokers with diabetes. Yes,smoking causes type 2 diabetes. In fact, smokers are 30–40% more likely to develop type 2 diabetes than nonsmokers. And people with diabetes who smoke are more likely than nonsmokers to have trouble with insulin dosing and with controlling their disease. Smoking affects circulation by increasing heart rate and blood pressure and by making small blood vessels narrower. Smoking also makes blood cells and blood-vessel walls sticky, and allows dangerous fatty material to build up. This can lead to heart attack, stroke and other blood vessel disease.Young adult smokers with diabetes are two to three times more likely to be sick than nonsmokers with diabetes. People with diabetes who smoke are more likely to: ---Die from heart disease, suffer from circulation problems in their feet and legs, and develop blood vessel disease in the legs. ---Have pain and need amputation of a limb due to blood vessel disease in the legs. ---Develop life threatening kidney disease ---Have problems with movement and flexibility in the joints ---Develop nerve damage which can lead to numbness and pain ---Develop problems with getting or maintaining an erection, due to the effects of smoking on the blood vessels of the penis ---Develop gum disease which can lead to tooth loss ---Suffer eye damage. If you have diabetes and smoke, quitting smoking is one of the best things you can do to manage your diabetes and stay healthier for longer. The more cigarettes you smoke, the higher your risk for type 2 diabetes. No matter what type of diabetes you have, smoking makes your diabetes harder to control. If you have diabetes and you smoke, you are more likely to have serious health problems from diabetes. Smokers with diabetes have higher risks for serious complications, including: Heart and kidney disease Poor blood flow in the legs and feet that can lead to infections Ulcers and possible amputation (removal of a body part by surgery, such as toes or feet) Retinopathy (an eye disease that can cause blindness) Peripheral neuropathy (damaged nerves to the arms and legs that causes numbness, pain, weakness, and poor coordination) If you are a smoker with diabetes, quitting smoking will benefit your health right away. People with diabetes who quit have better control of their blood sugar levels.
People with diabetes who smoke have higher blood-sugar levels and less control over their blood-sugar levels than nonsmokers with diabetes. Yes,smoking causes type 2 diabetes. In fact, smokers are 30–40% more likely to develop type 2 diabetes than nonsmokers. And people with diabetes who smoke are more likely than nonsmokers to have trouble with insulin dosing and with controlling their... (Read More)
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Shachi says

People with diabetes are more adversely affected when they get an infection than someone without the disease, because theyhave weakened immune defenses in diabetes. Some types of infection occur more frequently in patients with diabetes. This increased risk is largely attributable to an altered immune response due to chronic hyperglycaemia, but increased susceptibility to infection may also result from diabetic complications such as diabetic neuropathy and vascular insufficiency. Risk of most common infections is only modestly increased (e.g. 1.2 fold), but a number of rare but potentially fatal infections occur primarily or even almost exclusively in patients with diabetes. These include mucormycosis, emphysematous urinary tract infections, emphysematous cholecystitis, necrotizing fasciitis and malignant otitis externa. When you have diabetes, you are especially prone to foot infections, yeast infections, urinary tract infections and surgical site infections.Your insulin injection site can be a possible infection source. Injections provide a potential gateway for certain immune-suppressing agents to enter the blood. Immediate antimicrobial and/or surgical treatment is needed to prevent serious complications from these infections. In general, antimicrobial treatment of infections in patients with diabetes is not different than in patients without diabetes. Glucose lowering therapy often needs to be increased to counter the loss of control associated with infection. Vaccinations against influenza and pneumococcal infections are recommended for patients with diabetes. People with diabetes are reported to experience 21% more infections than the general population. Even so, it seems clear that the risk of many common infections increases in proportion to hyperglycemia. Special problems may also arise in relations to diabetic nephropathy, which may undermine host defences against infection, and peripheral vascular disease which may impair tissue nutrition, oxygen supply and the ability to mount an effective immune response. Peripheral neuropathy also increases the risk for diabetic foot infections. Hyperglycemia may compromise the immune system. Ex-vivo experiments, in which human cells are analysed in a laboratory environment outside of the body, show that innate cellular immunity may be compromised in hyperglycemic conditions. In a hyperglycemic or acidic environment neutrophils and macrophages malfunction, and restoring normoglycemia and a normal pH reverses these abnormalities.The adaptive cellular immune system may also be compromised, but evidence is sparse. T-cell function may be compromised, especially in hyperglycemic conditions. There is no evidence that the humoral adaptive immune system functions differently in patients with diabetes: this is illustrated by the fact that the antibody response to vaccinations seems to be as effective as in healthy controls.
People with diabetes are more adversely affected when they get an infection than someone without the disease, because theyhave weakened immune defenses in diabetes. Some types of infection occur more frequently in patients with diabetes. This increased risk is largely attributable to an altered immune response due to chronic hyperglycaemia, but increased susceptibility to infection may also... (Read More)
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Shachi says

For a person with diabetes and CKD, a low protein, high carbohydrate, low sodium and low potassium diet with restricted fluids is a must. Diet management should include the following: 1. The total calories intake should be about 1700 kcal. 2. Protein rich food should be excluded from the diet. 3. Controlling potassium is important. Around 90% of the potassium consumed through our diet is removed by the kidney. The normal level of potassium intake is 3.5-5.0 mEq/L and anything higher than that must be avoided . We mostly consume potassium through milk, yogurt, fruits like avocado, kiwis, oranges, papayas, banana Legumes - nuts; vegetables like beans, potatoes, tomatoes, spinach and leafy vegetables, sweet potato and animal protein. Potassium-based salt products, winter vegetable juices and squash should also be strictly avoided. 4. Kidney diseases and salt are almost synonymous. Higher the salt intake, higher the risk of the CKD, high blood pressure and heart disease. Hence a large amount of sodium intake must be restricted. Canned food, pickles, smoked meat, some frozen foods, processed cheese, packed chips, junk food must be avoided. Develop a habit of reading the labels to get to know the level of sodium in the products we are consuming. Less than 5 mg sodium per serving is sufficient to stay healthy. 5. The limit on protein intake is 0.75g per kilogram of one's total body weight, except for those suffering from hemodialysis. One must consume enough protein to keep oneself healthy but not in excess. Mainly meat, fish and dairy products are the sources of protein. Edibles such as eggs, beef, cheese, bran breads, nuts and vegetable also contain a high amount of protein.Vegetables should be chopped and boiled with excess of water that is drained out to decrease the potassium content 6. Phosphorus consumption for normal people as well as for people with CKD non-dialysis is 2.7 to 4.6 mg/dL. For CKD dialysis patients the target range is 3.5 to 5.5 mg/dL. Anything more than that must be reduced. Poor maintenance of phosphorus can lead to not only total kidney failure but also to bone diseases and heart troubles. Dairy products, nuts and beans (the main sources of phosphorus) and drinks and beverages like cocoa, cold drinks and beer must be avoided. 7. Consumption of fluids is essential for normal people but for a patient of CKD, fluid intake must be watched. More than 48 fl oz (1.4 L) of fluids a day must be avoided. Edible things that are liquid at room temperature are known as fluids. e. g. soups, ice creams, Jell-O, etc. Over-consumption of such fluids can increase the level of phosphorus. Some fruits like apples, orange, grapes and vegetables like lettuce also contain a lot of water. So, avoid such fruits. It's important to have routine medical checkups and keeping a track of the recent changes that occur. -- Proper medication and exercise is a must. --Smoking and alcohol consumption must be reduced, and preferably completely avoided. --No meals should be skipped. --Avoid taking huge meals at a time and divide meals into a 4-times a day pattern. --Lower blood sugar and cholesterol levels must be maintained and observed time to time. --Lastly, the most important thing is to keep your mind healthy and motivated, as it holds the greates power to cure any ailment.
For a person with diabetes and CKD, a low protein, high carbohydrate, low sodium and low potassium diet with restricted fluids is a must. Diet management should include the following: 1. The total calories intake should be about 1700 kcal. 2. Protein rich food should be excluded from the diet. 3. Controlling potassium is important. Around 90% of the potassium consumed through our diet is... (Read More)
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Shachi says

Edema in Diabetic Nephropathy results from buildup of fluid. The kidneys are responsible for filtering bloodstream and removing excess water out of the body. Diabetic kidney disease with severely impaired kidney functions can cause accumulation of fluid in the body. In addition, reduction of blood plasma osmotic pressure due to loss of proteins will lead water to run into tissues, which will also aggravate swelling. The patients may experience swelling in eyelids, limbs, ankles, or short breath. The causes of edema are many. 1. It can be due to the damage of immune system,which leads to the increased permeability of systemic capillary wall causing the water in the plasma to seep into the interstitial space. 2. Hypoproteinemia- it will secrete more secondary aldosterone and antidiuretic hormone and renal tubule will reabsorb more water and sodium, which will cause edema. Along with aggravation of patients′ condition, more and more renal units will be damaged and glomerulosclerosis will occur at more glomeruli. Excessive loss of protein will lead to hypoproteinemia. Loss of protein from glomerular capillaries leads to decrease of plasma colloid osmotic pressure. Plasma colloid plays an important role in regulating the exchange of water inside and outside the blood vessels. So decrease of plasma colloid osmotic pressure will lead to water retention in tissue, which causes edema. So, Patients with Diabetic Nephropathy may need to restrict their dietary water consumption to relieve their edema. Diuretics may be prescribed to remove the excess fluid out of the body.
Edema in Diabetic Nephropathy results from buildup of fluid. The kidneys are responsible for filtering bloodstream and removing excess water out of the body. Diabetic kidney disease with severely impaired kidney functions can cause accumulation of fluid in the body. In addition, reduction of blood plasma osmotic pressure due to loss of proteins will lead water to run into tissues, which will... (Read More)
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