• Basic information of Diabetologist

Diabetes is a metabolic disease where either the hormone insulin is not produced in concentrations normally required to metabolize carbohydrates and ultimately resulting in increase in glucose concentrations in blood. It can also occur if the level of insulin produced is near normal but the receptors to which glucose bind have impaired ability to respond to insulin. Often, diabetes present as a metabolic disease that includes abnormalities in metabolism of fats and proteins along with carbohydrates. Diabetes as a disease can be defined as a group of metabolic diseases characterized by hyperglycemia (elevated blood glucose) resulting from defects in insulin secretion, insulin action, or both. Persistent elevation of blood glucose associated with chronic diabetes is associated with end organ damage including especially the eyes, nerves, kidneys, blood vessels and the heart. To understand the symptoms of Diabetes, you can opt for online consultation with diabetologist

Diabetes is one of the most common metabolic diseases with a complex, multifactorial etiology (causes) and has varied clinical and biochemical manifestations. With modern sedentary lifestyles which includes lack of exercise and consumption of a very high calorie food, diabetes has become a commonplace which is further complicated by coexisting conditions such as obesity and hypertension. As discussed, the main cause of the disease is inadequate secretion and/or impaired action of insulin on target tissues. Depending on the etiology, diabetes can be classified mainly under two categories:

  1. Insulin-dependent Diabetes Mellitus (IDDM)
  2. Non-insulin dependent Diabetes Mellitus (NIDDM)

Other specific types of diabetes that occur are due to genetic defects of the beta cells of the pancreas that secrete insulin such as mature onset diabetes of the young (MODY), genetic defects in insulin action such as Leprechaunism, diseases that affect the exocrine pancreas such as pancreatic cancer and cystic fibrosis which is a genetic disorder affecting the lungs and the pancreas, diseases of the endocrine system such as Cushing syndrome (very high levels of the hormone cortisol which is responsible for the mobilization of glucose in the body), acromegaly (caused by excessive production of growth hormone) and tumors of the adrenal glands (pheochromocytoma), drug induces such as those caused by the overuse of steroids and thiazides and finally caused by infections such as rubella and cytomegalovirus.

Some of these defects are remediable and types of glycemia can also be cured.

Severity of the resultant hyperglycemia and the symptoms and signs vary widely. The vascular damage resulting in microvascular and macrovascular complications depends largely on the degree and duration of hyperglycemia.

Diabetes is characterized by disturbances in carbohydrates, fat and protein metabolism. The clinical symptoms include 

  • Polyuria (excessive urination), 
  • Polydipsia (excessive thirst), 
  • Polyphagia (excessive eating), 
  • Weight loss and 
  • Blurring of vision which usually occur when severe hyperglycemia remains for a long time.

Long-term complications of diabetes are mainly of two types:

  1. Microvascular complications which include retinopathy (disease of the retina in the eye) with potential loss of vision, nephropathy (disease of nephrons, the functional unit of the kidney) leading to renal failure, peripheral neuropathy (diseases of the nerves) with risk of foot ulcers, amputations and charcot joints; and 
  2. Autonomic neuropathy which causes cardiovascular, genitourinary, gastrointestinal and symptoms of sexual dysfunction. 

The macrovascular complications include the diseases of the heart where it causes atherosclerosis and the resultant narrowing of the coronary arteries causing ischemic heart disease and even heart failure. The other indications include peripheral arterial diseases and diseases of the blood vessels of the brain. 

The other common form of diabetes is gestational diabetes that is the diabetes that occur during pregnancy. Sometimes diabetes gets resolved after childbirth but at other times, it can remain and become a chronic problem. This is then treated as regular diabetes.

Diabetes is so widespread in today’s world that physicians or endocrinologists do courses to gain expertise to study, research, treat and manage the disease and its associated complications. The term specifically for the doctor having such an expertise is called a diabetologist. You can book your appointment for online consultation with diabetologist on Mediflam’s website.

  • Why choose online doctor consultation?

With the advent of new technology, it has become very easy to connect to some of the best specialists available in India from the comfort of home. The past history, reports, medications details, etc. can be uploaded to a safe and secure place on the server so that it can be accessed anytime by a specialist with the permission of the patient. The patient doesn’t have to worry to carry the reports and other files every time when seeing a doctor and thus saves the potential of misleading or missed information to be given to the doctor. We at MediFlam offer these services and have empaneled some of the best doctors that are known for their expertise and have a vast experience serving in their respective fields. Diabetologist online consultations can also be very helpful for those who are non-ambulatory that is cannot visit a hospital or a doctor because of old age or some diseases that makes it very difficult to travel. The patients, through online consultation, can at least get an idea of the disease that they are suffering from and can be further advised by the doctor for the course of action on treatment that may include medications or surgery or both.

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Frequently asked questions about Diabetologist

What are the normal symptoms that indicate the presence of diabetes?

The usual symptoms that occur in diabetes are:

  • Polyuria (excessive urination)
  • Polydipsia (excessive thirst)
  • Polyphagia (excessive heating)
  • Weight loss
  • Non-healing of wounds
  • In the later stages, it may cause blurring of vision due to retinopathy

If you are facing any of the above symptoms you must immediately book your appointment for online consultation with diabetologist.

Can diet and exercise treat diabetes?

Proper diet and exercise can prevent the occurrence of diabetes but once diabetes has been diagnosed it cannot be treated but the blood glucose levels can be kept in check. To achieve this, a proper diet and exercise can help a lot and also help prevent the complications arising out of diabetes. Diabetes is a metabolic disease with a complex, multifactorial etiology (causes) and has varied clinical and biochemical manifestations. With modern sedentary lifestyles which includes lack of exercise and consumption of a very high calorie food, diabetes has become a commonplace which is further complicated by coexisting conditions such as obesity and hypertension. Thus diabetes can be managed and the symptoms can be mitigated but cannot be treated.

Is Diabetes a hereditary disease?

Diabetes has been implicated as a hereditary disease and it is commonly found that a lot of people with a family history of diabetes do have a greater chance of developing the disease. To know more in detail you can opt for diabetologist online consultation.

Can I eat fruits which also have carbohydrates?

Natural sources of carbohydrates like that present in fruits have shown to cause less problems than the artificial sugar. But fruits like mangoes should be eaten with caution as this tend to increase significant amount of sugar and cause problems.

Can diabetes cause gangrene?

Yes. Persistent high sugar that is not controlled can be converted into toxin that damages the blood vessels. Thus the blood supply to that particular part of the body is disrupted which damages its tissues. This can lead to gangrene.

Will I have to take insulin injections for the rest of my life?

If no other medication or therapy works, insulin is the only and the best way of controlling diabetes. Consult your diabetologist doctor and discuss with him/her the various therapies available to treat the type of condition you are suffering from. 

What are the different types of medicines available for diabetes?

There are many classes of drugs available for the treatment of diabetes. Some drugs lower the blood sugar level even when it is not elevated. Such drugs should be used with caution as they can lead to hypoglycaemia and the patient might faint. On the other hand there are some drugs that lower only elevated blood sugar and are quite safe when used. But these are usually helpful only in mild form of diabetes and so sometimes a combination of these drugs are prescribed for better management of diabetes. Insulin therapy is the gold standard and works for every diabetic but it is usually used as the last resort.

  • Brief information about diabetologist

A diabetologist is a doctor who specializes in the study, research, diagnosis, treatment and management of diabetes and its associated complications. You can book your appointment for online consultation with diabetologist on Mediflam’s website. 

  • What are the normal blood sugar levels?

The normal blood sugar levels are highly subjective and can vary among individuals based on their genetic component and the kind of profession that they practice. The standard levels accepted throughout the world are:

  1. Fasting blood glucose level (no food for 8 hours) should be in the range of 80-120 mg/dl 
  2. Two hours after the meal should be less than 180 mg/dl

Is keto-diet effective to treat diabetes?

In the recent times, keto diet has become very popular but its result on control of diabetes are still elusive and not proved. The basic idea is that one should eat low carbohydrate, high fat diet. When the body runs out of carbohydrates as energy source, it starts metabolizing fat converting into ketones that can be then used as a source of energy. This condition is called ketosis and termed as nutritional ketosis when done purposefully. It should not be confused with ketoacidosis which is a dangerous condition occurring in diabetics because of low insulin and hence excessive build-up of ketones. The symptoms of ketoacidosis are frequent urination, excessive thirst, confusion, weakness and fatigue and a fruity odour in the breath due to presence of volatile ketones

  • What are the tests that diagnose diabetes?
    The normal blood tests include 
    • Fasting plasma glucose (FPG) levels which is checking the glucose levels after not having food for 8 hours. The normal range is 80-120 mg/dl
    • Post-prandial blood glucose test which measures blood glucose level approximately 2 hours after the meal. The normal levels are less than 180 mg/dl
    • OGTT (Oral Glucose Tolerance Test) which involves fasting overnight and then drink a very sweet solution that contains 75 grams of glucose. Two hours later blood test is done. Normal levels are less than 140 mg/dl at two hours
    • Haemoglobin A1c test measures the amount of glucose attached to haemoglobin and is mainly used to diagnose prediabetes and Type 2 diabetes (Non-insulin dependent diabetes mellitus, NIDDM)
    • Random plasma glucose (RPG) test measures the blood glucose levels randomly at any time of the day. A level of 200 mg/dl indicates the presence of diabetes and a level of 140-199 mg/dl may indicate presence of prediabetes.
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