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Shachi says

Diabetic ketoacidosis(DKA) is an acute, life threatening metabolic acidosis which mostly complicates type 1diabetes. When cells don't get the glucose they need for energy, body begins to burn fat for energy, which produces ketones. Ketones are acids that build up in the blood and appear in the urine when body doesn't have enough insulin. They are a warning sign that diabetes is out of control or that you are getting sick. High levels of ketones can poison the body. When levels get too high, a person can develop diabetic ketoacidosis, or DKA. Self-Care at Home Home care is generally directed toward preventing diabetic ketoacidosis and treating moderately to elevated high levels of blood sugar. Ø If have type 1 diabetes, should monitor blood sugars as instructed by health care practitioner. Check these levels more often if feel ill, if you are fighting an infection, or if you have had a recent illness or injury. Ø Be alert for signs of infection and keep yourself well hydrated by drinking sugar free fluids throughout the day. The goals of treatment: Ø Improving Circulating Volume and Tissue perfusion Ø Decreasing serum glucose and osmolarity Ø Clearing blood and urine ketones Ø Correcting electrolyte imbalances Ø Identifying and treating the underlying cause FLUID AND ELECTROLYTES As it takes about 48-72 hours for DKA to develop, full replacement of the previous losses and correction of acid-base disturbances should be done with the same speed. Initially the fluid of choice is normal saline. 1 litre should be infused in the first 1 hour; The next 1 litre in the next 2 hours; 2 litres in the next 4 hours; 2 litres in the next 8 hours. i.e. about of saline should be monitored by BP, CVP, pulse an skin turgor. If the sodium levels are >150 mEg/I, half normal saline can be used. When the blood sugar levels reach around 250 mg/ld, the fluid should be changed to 5% dextrose saline drip (along with administration of insulin) to prevent hypoglycemia. Care should be taken not to infuse large amount of fluid too rapidly in elderly patients and especially those with pre-existing heart disease, congestive cardiac failure or renal failure. Insulin It is now well-accepted that a slow, steady infusion of insulin is ideal- often in adults after a bolus of 0.1-0.2units/kg body weight. If this is not possible an hourly small injection of short or rapid acting insulin is equally effective. The recommended insulin infusion dose is 0.1unit/kg/hour Potassium Potassium levels should be monitored regularly. Initially it may be low, normal or high. If it is low, start a potassium drip immediately with 40 meg of KCI per litre of fluid to begin with making sure that the urine output is adequate (>50 ml/hr). If the response is not adequate, adjust the dose of the KCI drip accordingly. If patient is taking oral feeds, oral potassium can be formula. Next Steps Follow-up In cases of mild dehydration with borderline diabetic ketoacidosis, may be treated and released from the emergency department providing that you are reliable and will promptly follow-up with your health care practitioner. Whether you are released to go home or monitored in the hospital, it is important that close monitoring of blood sugar and urinary ketone levels be continued. Elevated blood sugars should be controlled with extra insulin doses and drinking plenty of sugar-free fluids. Long-term care should include periodic follow-up with health care practitioner to achieve good control of blood sugars. Care includes screening for and treating the complications of diabetes by periodic blood tests of hemoglobin A1C, kidney function, and cholesterol, as well as an annual eye examination and regular inspection of the feet (for evidence of wounds or damage to nerves).
Diabetic ketoacidosis(DKA) is an acute, life threatening metabolic acidosis which mostly complicates type 1diabetes. When cells don't get the glucose they need for energy, body begins to burn fat for energy, which produces ketones. Ketones are acids that build up in the blood and appear in the urine when body doesn't have enough insulin. They are a warning sign that diabetes is out of control... (Read More)
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Why is smoking hard to quit?

Shachi says

Quitting smoking is extremely difficult for many reasons. Here are just 2: 1. Nicotine is one of the most addictive substances Nicotine can have a calming, satisfying effect, and the more you smoke, the more your body needs the nicotine to feel normal. 2. Smoking fits into many activities Smoking can be psychologically associated with many things you do every day, such as drinking coffee or alcohol, driving, and talking with friends who smoke. And smoking may be an automatic response to times when you are bored, angry, or upset.
Quitting smoking is extremely difficult for many reasons. Here are just 2: 1. Nicotine is one of the most addictive substances Nicotine can have a calming, satisfying effect, and the more you smoke, the more your body needs the nicotine to feel normal. 2. Smoking fits into many activities Smoking can be psychologically associated with many things you do every day, such as drinking coffee or... (Read More)
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Shachi says

Many of the lifestyle habits we have acquired—and enjoy—have damaging effects on our health—and on type 2 diabetes. Smoking and type 2 diabetes are especially bad combination because smoking raises blood sugar levels, making it harder to control your diabetes. It also intensifies the negative effects of medical conditions that many people with type 2 diabetes already have, like heart and blood vessel disease. How smoking affects your health Smoking is an acknowledged cause of cancer of the lung, mouth, throat, and bladder. It also: 1. Reduces the amount of oxygen that reaches the tissues, potentially leading to a heart attack, stroke, miscarriage, or stillbirth. 2. Raises cholesterol levels and the amount of some other fats in your blood—again increasing the risk of heart attack. 3. Makes blood vessels smaller, which can lead to blood vessel disease, leg and foot infections, and foot ulcers. 4. Makes it easier to get colds and respiratory tract infections. 5. Raises the risk for limited joint mobility. 6. Increases blood pressure. 7. Affects sexual ability and may contribute to erectile dysfunction. .
Many of the lifestyle habits we have acquired—and enjoy—have damaging effects on our health—and on type 2 diabetes. Smoking and type 2 diabetes are especially bad combination because smoking raises blood sugar levels, making it harder to control your diabetes. It also intensifies the negative effects of medical conditions that many people with type 2 diabetes already have, like heart and blood... (Read More)
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Shachi says

People with diabetes can develop many different foot problems. Even ordinary problems can get worse and lead to serious complications. Foot problems occur when there is nerve damage, also called neuropathy. This can cause tingling, pain (burning or stinging), or weakness in the foot. It can also cause loss of feeling in the foot, so you can injure it and not know it. Poor blood flow or changes in the shape of your feet or toes may also cause problems. Dos and Don'ts for Diabetic Foot DO'S Keep your blood sugar levels within a good range. Never walk barefoot Check your feet every day with a mirror for cuts, blisters, red spots, swelling, colour changes, open sores, and ingrown toe nails. Wash your feet everyday with water and soap. Water should be of room temperature. Dry your feet in between the toes. Use powder if needed Keep the skin soft and smooth. Apply skin lotion over top and bottom of feet but not between your toes. Trim your toenails straight across and file the edges with nail file. Wear comfortable, well-fitting shoes. Inspect the inside of shoes for foreign objects and torn linings. Change your socks daily. Prefer cotton seamless socks. Protect your feet from hot and cold. Wear socks at night in winters if you feel cold. Put your feet up when sitting. Move your ankles 2-3 times a day. Plan your physical activity with your doctor. Get your feet checked by your doctor periodically. DON'TS Don't walk barefoot, even indoors! Don't smoke. Smoking reduces blood circulation; in diabetics, this can lead to the loss of a limb. Don't cut corns or callouses yourself. Avoid open-toed shoes, particularly sandals with thongs between the toes. Do not wear tight fitting footwear. There is specially designed footwear for diabetics. Contact your diabetes care provider for that. Don’t use hot water bottles or heating pads Don’t use chemical agents or blades to remove corns and calluses, go and see your podiatrist. Don’t wear tight socks or knee-highs. Contact your doctor for even minor foot problems. Do not try to treat it yourself.
People with diabetes can develop many different foot problems. Even ordinary problems can get worse and lead to serious complications. Foot problems occur when there is nerve damage, also called neuropathy. This can cause tingling, pain (burning or stinging), or weakness in the foot. It can also cause loss of feeling in the foot, so you can injure it and not know it. Poor blood flow or changes... (Read More)
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Shachi says

There is no such thing called as a diabetic diet, whatever is good for a normal healthy person, is good for diabetes people also . Healthy eating is essential for everyone to keep themseles fit. Below mentioned are some Dos and Don'ts you should follow: Do’s Ø Include salad (cucumber, tomato, onion, carrot, beetroot and radish) in lunch as well as dinner (without mayonnaise or a high fat dressing). Ø Do not eat fast; masticate and munch your food well before you swallow. Ø Drink a lot of water that will help flush the toxins off your system. Ø Make sure the gaps between your meals are short. Ø Surround yourself with the best choices of healthy foods Ø Be selective about meat choose lean meat Ø Stock up on herbs and spices Ø Choose the best cooking methods Ø Include fresh vegetable salad in every meal. Ø Add wheat bran to your wheatflour. This helps increase fibre in your diet. Ø You can also make diabetic flour by mixing wholegrain cereal, soyabean, blackgram (urad dal), jowar, bajra, Bengal gram (kala chana), wheat bran and barley. Ø Include sprouts in the diet. Sprouts are a fountain of nutrients. Ø Include at least 3-4 servings of yellow, green, orange coloured vegetables in the diet as they provide vitamins minerals, and fiber & are low in carbohydrate. Ø Include fruits like apple, guava, pear, orange or sweetlime in your diet.1 to 2 servings of fruits can be taken in a day as snacks. Ø Use fat free milk, yogurt, and cheese. Ø Eggs whites can be included. Ø White meat - chicken and fish are good sources of protein. Ø Make right choices when eating out. Prefer steamed, grilled or roasted foodstuffs over deep fried and high fat products. Ø Use less oil around 3- 4 tsp of oil per person/day. Ø Have beverages - tea or coffee without sugar or with sugar free in it. Ø Intake of bitter gourd, fenugreek, Indian blackberry (jamun), flaxseed, cinnamon, garlic and onion are known to considerably reduce blood glucose level. Ø If you are on insulin, make sure you have three proper meals with light snacks in between. Ø Take your medicines at the same time every day and exercise at about the same time every day. Ø Have good sleep daily. Ø Check your blood sugar level regularly and also check the other tests such as kidney function, liver function, heart function, ketone levels as required. Ø Check your weight from time to time, and always maintain an ideal body weight. Ø Exercise for 30 to 45 minutes daily as physical activity significantly lowers blood sugar. Never start a new exercise program without consulting either your physician who will evaluate your condition and inform you if there is any limiting condition. Take it easy at first and gradually increase to longer exercise periods. Don’ts v Do not skip meals. Even distribution of food helps prevent high and low blood sugars. v Do not fast or feast. v Do not eat directly after a workout. v Do not overeat. v Do not fry foods. Instead bake, boil, poach or saute in a nonstick pan. v Use less oil in cooking. v Eat less high-fat red meat and avoid organ meats. v Limit the use of condiments such as ketchup, Soya sauce, mustard and salad dressings as they are high in salt and can be high in sugar too. v Limit your salt intake. v Limit the amount of fats and sweets you eat. Fats have a lot of calories. Sweets can be high in carbohydrate and fat. Some contain saturated fats, trans fats and cholesterol that increase your risk of heart disease. Limiting these foods will help you lose weight and keep your blood glucose and blood fats under control. v Avoid white flour, white rice, potatoes, carrots, breads and bananas as they increase the blood-sugar levels. v Avoid milk cream, egg yolk or food items cooked in coconut milk. v Avoid processed, ready-to-eat food preparations, sweets and sugary drinks (canned beverages) that provide empty calories. v Avoid products made up of refined flours (bakery products such as toast, cakes, pastries, white bread) as these products have high Glycemic Index which cause higher spikes in blood sugar. v Choose fresh foods over canned. v Quit smoking. v Stop alcohol consumption. v Do not miss your medicines and do not change the dose of medicine or any medicine mentioned in the prescription without your doctor’s consent. v Do not Cook multiple meals v Do not Supersize portions v Avoid fried foods and sweetmeats.
There is no such thing called as a diabetic diet, whatever is good for a normal healthy person, is good for diabetes people also . Healthy eating is essential for everyone to keep themseles fit. Below mentioned are some Dos and Don'ts you should follow: Do’s Ø Include salad (cucumber, tomato, onion, carrot, beetroot and radish) in lunch as well as dinner (without mayonnaise or a high fat... (Read More)
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