8/19/2010

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Diabetes India - Diabetes

DIABETES : MYTHS AND REALITIES

Dr Sarita Bajaj, MD(Medicine), DM(Endocrinology, AIIMS), Associate Prof Medicine, MLN Medical College, Allahabad.
Many myths exist regarding all aspects of diabetes and they are very important from the point of view of treatment as they often come in the way of compliance. 1. Excessive intake of sugar and sweets causes diabetes. Not so.

No scientific data supports this statement. However overeating (of especially sweets) may lead to obesity which can certainly unmask diabetes in those who have a tendency to develop it. So those with a strong family history should try to maintain their ideal body weight by good wholesome diet and regular exercise. 2. Presence of urine sugar confirms diabetes. No.

Blood glucose testing is mandatory for diagnosis, never urine glucose alone. Diabetes may be diagnosed by (1) symptoms of diabetes plus a casual plasma glucose concentration of 200mg/dl or greater (2) fasting plasma glucose of 126mg/dl or greater. These criteria should be confirmed by repeat testing on a different day. 3. Hyperglycemia is invariably symptomatic. No.

Patients with very high blood glucose values may be totally asymptomatic. Diagnosed diabetics represent only the tip of an iceberg. The majority are undiagnosed. So have your blood glucose tested at regular intervals irrespective of whether you have any complaints or not. 4. Diabetes is infectious. It is multifactorial in origin. 5. Rice is prohibited in diabetes. No. Not true at all.

Rice and wheat are similar types of carbohydrate and they can easily be interchanged. 6. All carbohydrates are to be avoided in diabetes. No.

This is not only incorrect but dangerous too. Glucose is required for energy production by all, including diabetics. In case carbohydrates are completely curtailed energy production will be carried out from fats and this will result in production of ketones (Ketosis) which are toxic to the body. Ketosis may be fatal. 7. Fasting is useful in diabetes. Wrong.

Fasting is prohibited in diabetics especially those on medication (Insulin or tablets). Fasting, if coupled with anti-diabetic treatment may lead to hypoglycemia- a state of low blood glucose. In case one keeps a fast without antidiabetic treatment blood glucose is liable to rise and if the fast is prolonged ketosis may result. 8. Honey cures diabetes. Honey, jaggery (gur) and sugar are prohibited in diabetes. 9. Fruits are harmful in diabetes. Incorrect. Not so.

In fact fresh fruits are always recommeded in diabetics. The rule is one fruit a day on an exchangeable basis. As far as possible fruits should be taken whole (with peel) which will increase the fiber content and thereby keep diabetes in check. 10.Walking barefoot is good for diabetes. No.

Walking is the best exercise for a diabetic, but never barefoot. Diabetics are prone to loss of sensation of feet and ulceration which takes a long time to heal. Gangrene may result resulting in amputation. 11. Oral hypoglycemic agents (drugs used to treat diabetes) No. are habit forming. Drugs should be prescribed once diet and exercise therapy together are not enough to control diabetes. They are given in addition and not as replacement for diet and exercise. They may be mandatory and required for lifetime in certain diabetics, while others may need them intermittently. 12. All the oral hypoglycemic tablets are the same and may Never. be interchanged. Many patients change their tablet if a particular tablet is not available for any reason. This too is not only incorrect but may be dangerous as most medicines have different onset and duration of action and are prescribed under different sets of conditions. 13. Additional indiscretion. tablets/insulin may do after a dietary Never.

Many patients take an extra half to one tablet with a feast hoping that the irregularly committed during the party may be covered However this will

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18. Cure of diabetes is possible in other pathies. No

Diabetes India - Diabetes

recognized in time and can be easily treated. Fatal hypoglycemia is known to occur with oral hypoglycemic agents too, which patients are bissfully unaware of.

Diabetes is incurable in any pathy. Patients should not accept any tall claims without scientific evidence otherwise they may harm only themselves. The mainstay of treatment is diet control and regular exercise. Blood glucose levels may stay normal for an indefinite period by this regimen. That does not mean that diabetes is "cured" because it is a life long disease. It can only be conquered not decimated.

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