Diagnosing Diabetes!

Diabetes is diagnosed either by suspicion by the patient or the Doctor, when the following signs and symptoms are noticed.

Clinically it is suspected when there are some signs and symptoms noticed either by the patient or by the Doctor. As mentioned in the earlier articles, it can be a typical symptoms like Poly urea (frequent urination), Poly phasia (frequent hunger) or Poly dypsia (Excessive thirst). Or other symptoms or signs like Weight loss or gain, Fungal infections especially in the genitalia, teeth infections, non healing wounds etc.

It is also diagnosed accidentally or incidentally when a person undergoes pre employment health check, periodically check like annual check, check up before undergoing any operation or even during taking a policy.

During any health check, if the HbA1c (Glycosylated haemoglobin) is found to be more than 7 %, it indicates the person to be diabetic.

Confirmation of diabetes is always by Blood Test. The test is called Glucose Tolerance Test (GTT) . The test can be explained as follows

The person is asked to have a normal meal in the previous night, and asked to attend the hospital in the morning (on empty stomach) . Whereupon the Fasting Blood sample and Urine sample is taken.

The patient is given 75 gms of glucose. Every half an hour, blood and Urine samples are drawn and examined.

If the 1 & 1/2 hr blood sample is more than 180 mgs/dl (deci liter), the patient is pronounced to be a diabetic. The threshold level of blood sugar in normal kidneys is 180 mgs/dl and when the blood sugar is more than 180 mgs/dl, the glucose passes through the kidney and appears in the urine.

The normal blood glucose in fasting should be between 70 - 110 mgs/dl.
Post prandial (after food) blood glucose should be below 140 mgs/dl

When Post prandial is between 140 - 180 mgs/dl, the stage is considered to be glucose intolerance or Pre diabetes stage.

When Post prandial is more than 180 mgs/dl, it is considered to be Frank diabetes or overt diabetes.

These Pre diabetes group of people have great potential to become diabetic and have great scope for post phoning the occurrence by taking advise from doctors and also following the diet discipline, exercise etc

We shall cover the areas in the coming weeks

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Source: Written for Spice your Life, by Dr. Nagarathnam Jetti, MBBS,DPH,DIH,FIAOH.

Healthy Snack for Diabetics ~ Chickpea Salad or Sundal!

I know I had promised to come up with menu and diet details for Diabetes. So first in the series is going to be a simple one that's quite common in atleast the South Indian homes. I remember my Amma making this so often when her father was with us for a while. The evenings used to be some salad or the other for sure. Then Dad insisted she makes some evening snack and some legume used to find its way to evening snack.

When we talk about a Diabetic diet, there are many factors that we got to consider. First being, they should eat small measures about 4 -5 times a day, ensuring they keep their sugar levels on control. This means they cannot stuff themselves with heavy meal in one serving. So they will have to split accordingly and at the same time ensure they don't stay hungry.

This simple and quick Indian salad ensures we address the protein requirement and also mental satisfaction.



Ingredients Needed:

Chickpea - 1 cup
Onions - 1 big
Coriander leaves handful
Curry leaves handful
Green chillies - 2 long

For Seasoning

Oil - 1/2 tsp
Mustard Seeds - 1/2 tsp
Urad dal - 1/2 tsp
Salt to taste

Method to prepare:

Wash and Soak Chickpea for atleast 6 hrs or over night. Wash and pressure cook till tender.

Then take a kadai and add oil. Once its hot, add mustard Urad dal. Then add the curry leaves and chopped onions along the chopped green chillies. Saute well.

Once the onions turn pink add the cooked chickpea and salt. Simmer for 5 mins for the salt to absorb.

Finally garnish with coriander leaves

I normally pressure cook the chickpea with little salt, so adjust it while sauteing. The onions are not browned, but are left pink so that they still maintain the crunchiness.

Serving Tips: If you are serving this to others, you can even garnish fresh grated coconut, especially the kids will love it. But diabetics can avoid this garnish as its not advisable to consume coconut.

Coconut Dates Boorelu ~ a treat to Kids!

After I made those yummy boorelu with dal, I had the batter still left. My kids liked the boorelu quite a lot and since the batter was still around, I was thinking what else can go into this. I really don't mind giving the kids, deep fried ones. After all the running and activities they do, its enough to burn them all. Moreover, they enjoyed deep fried snacks. But enjoy they burn them out.

With no offense to anybody, I have seen many mothers feeling very concerned that they have obese kids but fail to look for the root cause. There is no harm in giving oily stuff frequently provided you make sure they burn them out. Ensuring they are actively involved in physical activities, gets you the solution. When the kids are physically active, we need not worry about feeding them fats or deep fried snacks.


I have been in this situation couple of times. Once Konda refused to eat anything when she was about 3 years. It continued for almost two days, finally when she asked for tea, I had to give in as Dad said its fine to give even that if they want only that to eat/drink. Tea is much better than Coffee, of course for kids you feel bad to give. But what Dad says is, kids eat when they are hungry. they will never starve. Its only the moms who feel over protective and overfeed them.

Its been a rough path, but I have got used to feel detached when they refuse to eat what I want them to eat, because its healthy. Instead think of such alternative snacks which gets them eat these stuff, which they otherwise won't

So once in while, its fine to indulge them to a deep fried snacks. And these are very tasty ones. It has the goodness of dates stuffed within.

Ingredients Needed:

All purpose flour/ Maida - 1 cup
Salt a pinch
Sugar - 2 tsp (opt)
Water as required to make a thick batter
Oil for deep frying.

For the stuffing:

Fresh Coconut - 3 tbsp
Dates - 5 -6 (without pits)

Method to prepare:

Mix the batter to a thick consistency.

Meanwhile, chop the coconut into smaller pieces and roughly run the coconut and dates in the mixie to get a well formed stuffing. The stickyness from dates will get the coconut to bind well. Shape them into desired balls.

Heat the pan or kadai with oil. Once its hot, roll or dip the stuffing into the maida batter and gently drop into the oil. The batter has to be thick, so mix little quantity as you go. The balls have to be well coated.

Turn on both sides and cook well. Drain on a kitchen towel.

The sweetness from the dates is enough to make this sweet. There is no need to add extra sugar.

Diabetes Diagnosing, why early?

I had spent 60 years in India till I came to this Island recently, I used to hear that India has been pronounced as diabetic capital of the world. This was almost authentic, coming from various medical organizations at national and international level. It is estimated to between 10 to 15% incidence in urban areas. If we take the absolute figures out of the 1 billion and odd population, it is definitely number one in the world. I do not know whether we should be proud of this dubious distinction.

After coming over here, I have seen few things very obvious. Entire cultivable land is filled with sugar cane and nothing but sugar cane. People are very disciplined, and at the same time fun loving. It is a five day working week and after 4 pm you cannot expect any body to work, it is even difficult to find shops open. The incidence of diabetes here is between 20 to 25%. It is unbelievable! Is there any connection between Ubiquitous presence of sugar cane and extremely high incidence of diabetes.

With this I want to proceed to the next discussion on diabetes.

I know many of you are very keen to know about “How to diagnose Diabetes Mellitus?” But before that, there is this all important question we need to ask first “Why to diagnose Diabetes and why early?”

There are clear and proven advantages to the individual and the family when diabetes is detected at the early stage. Even before Diabetes manifests in some form, or before the body gives us signals about the presence of this disorder, we stand to be at advantage, if we take pro active steps towards diagnosing early.

Almost all chronic diseases like Diabetes Mellitus, Hypertension, Heart disease, Cancers etc run sub clinically for quite some time before our body sends out signals or show early symptoms. By that time it may be late to achieve control and by then, our body would have had some damage done already.

If we look at the major contributing factors for diabetes, we can point fingers at obesity, hypertension, stress and other modern lifestyle activities. Plus, a very important factor being family history. If a person has a family history of diabetes, with parents or grand parents known to be diabetic, he or she is a potential diabetic. It means he or she can become a diabetic any time.

Being a potential diabetic and not taking measures to prevent, is like detecting the presence of a rat in the house only after the riot. We need not wait till the damage is done, to start corrective measures.

Which is why we should diagnose / detect or look for the presence of Diabetes at early stage. Early detection can be easily done through periodic or annual check up. Through regular and periodic checks, the earliest warning signals can be detected so that steps can be taken by that potential diabetic to postpone or prevent the occurrence.

Hence there is a great need for regular Annual health checks for all the people above 30 years of age.

But on the other hand, although diabetes is believed to be genetic, there is no guarantee that it cannot occur in other individuals. Because of the high and increasing incidence of Diabetes among all the populations of the world. Nowadays it is seen to occur in individuals where it is not known to be in the family.

As we already saw, below are the Types of Diabetes:

1. Type 1 Diabetes/childhood Diabetes/Insulin dependent Diabetes
2. Type 2 Diabetes/Adult Diabetes/Maturity onset Diabetes in young (MODY).
3. Gestational Diabetes-that occurs only during pregnancy.

I would be talking more about how to Diagnose - Type II / Adult Diabetes / "Maturity onset Diabetes in young" and its nature.

Classical symptoms:
Poly urea – frequent urination
Poly phasia – frequent hunger
Poly dypsia – frequent drinking (Excessive thirst)

By the time these classical symptoms appear, it is very sure the diabetes must have established in the body and some organs must have been damaged already.

Apart from the above, you can also look out for these are other symptoms & Signs:

Giddiness, tingling and numbness in the palm and soles, itching in some parts of the body, loss of weight, gaining weight, lung infections especially tuberculosis, fungal infections in the female genitalia, itching and fissures in the tip of the skin of male genitalia, any wound in the body not healing in time, blurring of vision and diminishing vision.

Some other signs & symptoms :- That like symptoms one may notice fatigue, weakness and loss of appetite, Red swollen and tender gums, gum infections, loosening of teeth and infections in the mouth.

Among some sections of Indians, there is a belief that if there is tingling in the palms, they are going to get some money, but infact it may be the hint given by the body to indicate that he a diabetic.

Diabetes has no racial or religious or regional discrimination or sexual discrimination but ladies have an additional risk of becoming diabetic during pregnancy (Gestational Diabetes) Also the dietary habits of certain regions makes the inhabits prone to diabetes sooner than others. For example people who have excessive consumption of Tapioca, are at higher risk of developing the disorder than others.

But let me again reiterate, Diabetes is not a disease, but a metabolic disorder. If one gets awareness and knows how to prevent, it can be controlled.

Now that we know that the sub clinical diabetes can slowly damage almost all the organs of the body, we can be sure our body will give out hints or signals about the imminent occurrence of the overt Diabetes.

But in our so called fast life, we tend to ignore these symptoms and some times hush them with self medications.

During my collage days, there was a saying among the medicos, “If one knows fully about syphilis, he knows full medicine”.

But now that the incidence of syphilis has almost come down to zero, the saying is applicable to Diabetes.
We can confidently say that “If one knows fully about Diabetes, he knows full medicine”.

Because the diabetes affects all systems of the body and spares nothing. It affects the family system and social system also.

And, I used to say that “A diabetic should know more than what a doctor knows about diabetes”
It means a Diabetic should ultimately become a doctor whether a doctor becomes a Diabetic or not, for better living.

In the coming sessions, we will see about how to clinically diagnose diabetes.

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Source: Written for Spice your Life, by Dr. Nagarathnam Jetty, MBBS,DPH,DIH,FIAOH.

An Introduction to Diabetes ~ What is Diabetes?

I know its been a while since the first article on the introduction and I haven't made any progress with the topics. I am sure with this post, I will progress more in covering most of it.

Source: Written for Spice your Life, by Dr. Nagarathnam Jetty, MBBS,DPH,DIH,FIAOH.

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What is Diabetes?

Diabetes is a metabolic disorder. Metabolism is the way the body uses digested food for growth and energy. Glucose is the end product of our food after all the processes of ingestion, digestion, assimilation and absorption. Which means anything that is consumed, finally breaks down into glucose, the form of sugar in the blood.

Glucose is the main source of fuel for the body and is required for the production of energy. Once digestion is over, next comes the process known as the assimilation. After the digestion process, the glucose that passes into the bloodstream needs to be utilized by cells for growth and energy. To aid the glucose getting into the cells, we require a hormone called the insulin. Insulin is a hormone produced by the pancreas (islets of Langerhans), a large gland behind the stomach.

In normal conditions, the pancreas automatically produces the right amount of insulin required for our body to absorb the glucose. In the diabetics, however, the pancreas either produces little or no insulin and in some cases there is insulin resistance and hence the glucose is not utilized. In that situation, glucose builds up in the blood, overflows into the urine, and passes out of the body in the urine.

Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

Before we proceed to know how to diagnose, lets take a brief look at the types of diabetes prevalent.

What are the types of diabetes?

The three main types of diabetes are

* type 1 diabetes
* type 2 diabetes
* gestational diabetes

Type 1 Diabetes

Type 1 diabetes is an autoimmune disease. Humans have a great Immune system to fight infection. But when this system turns against and starts attacking, especially the insulin producing beta cells, it results in type 1 diabetes. When this happens, the pancreas produces little or no insulin. A person diagnosed with type 1 diabetes must take insulin daily to live.

We do not know exactly why and what causes the body’s immune system to attack the beta cells, but they believe that autoimmune, genetic, and other environmental factors, could attribute to this condition.

Type 2 Diabetes

Type 2 diabetes is the most common form of diabetes. We can easily say about 90 to 95 percent of people with diabetes have type 2. The major contributing factors for this form of diabetes is most often associated with older age, family history of diabetes, obesity, history of gestational diabetes, physical inactivity, and certain ethnicities. About 80 percent of people with type 2 diabetes are overweight.

In the case of type 2 diabetes, the pancreas is usually producing enough insulin, but for unknown reasons the body cannot use the insulin effectively, a condition called insulin resistance. When this happens over a period, insulin production decreases gradually. As in the type 1 diabetes, in type 2 too, glucose builds up in the blood and the body is not able to make efficient use of its main source of fuel.

Gestational Diabetes

Some women develop gestational diabetes late in pregnancy. Although this form of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes have a 40 to 60 percent chance of developing type 2 diabetes within 5 to 10 years. Maintaining a reasonable body weight and being physically active may help prevent development of type 2 diabetes.

In the coming articles, we will see more about How to diagnose and other facts related to Diabetes.

Though most of it may sound very technical, I have tried writing in a style that can be understood by everybody.

I want everybody who reads this be benefited, to take action and act accordingly!

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Looking forward to your feedback and suggestions.

The Diet Solution Program

So just what is The Diet Solution Program? As you probably know most of the new fad diets focus on removing primary food composition categories; that is, fats, carbohydrates, or proteins. Even though most of these can reduce weight, disrupting your body's metabolism and nutrition can only lead to stress, hunger and fatigue. If you have found yourself starving when losing weight only to fall off and gain it back then The Diet Solution Program is the diet for you.

The author, Isabel De Los Rios, has found a refreshing answer to this problem - namely, a diet solution program that focuses on an easier lifestyle change with the added benefit of nutritional value. A certified nutrition, exercise and lifestyle coach, Isabel De Los Rios is owner of New Body – Center for Fitness and Nutrition in New Jersey. In her book, she has brought together the best of her background in sports nutrition and physiology with a focus on metabolism type to create an actionable natural weight loss guide that really makes sense.
So, how does her program work? Her basic dieting concept is that with the right foods, you can eat sizable quantities and lose weight at the same time. Most dieters decrease their overall food intake so much when they want to lose weight that they do lose some pounds, then quickly level off. At that point, they have no choice but to eat even less food, which triggers starvation mode and makes losing weight and feeling good very difficult, if not impossible.

The Diet Solution Program is a full 180 pages of background, inspiration, food & nutrition information - as well as menus, charts and journal templates. It is a complete guide that changes your thinking about food, metabolism and the simple preparation steps you need to lose weight naturally.

The basic breakdown of the book is this:
Section 1 - Focuses on meal planning in order to get the best results for your own metabolism diet type as well as a personal program for success describing the three steps to weight loss.

Section 2 - Specifically dives into very detailed information on what to eat and what to avoid - basically, good vs. bad foods. Plus, she has immediate action steps to remove or change your daily habits. Packed with over 50 recipes in 61 pages, she defines all of the requirements and recommendations for good food in your diet.

Section 3 - Encompasses all the tools to measure your own metabolism type such as Dietary charts (such as glycemic index, food portions) and data, meal journal templates, as well as full calendar example of menus for breakfast, snacks, lunch, and dinner.

Frankly, this book is a welcome relief to the current set of dieting guides on the market today. The only criticism of this guide is something that is, in my opinion, just a lifestyle choice - that is, as much as I know the author wants to promote good nutrition, there really isn't any section devoted to modern lifestyle choices you can make while at work or on the road.

It would be great to have some additional options such as less expensive non-organic market choices, fast food alternatives, and work-arounds when you can't get the recommended choices. Our busy lives make it difficult to get organic foods or plan out our lunches at work. It would have been nice to see a section of some options for those on the run. However, that kind of planning is really something you can easily develop on your own using this guide.

All in all this is a highly recommended dieting guide - it focuses on balanced foods, nutrition, and proper health to lose weight naturally. Order The Diet Solution Program today!

Easy Aloo Paratha and Masala Poha ~ Breakfast ideas for Toddlers!

Since the boys take both breakfast and lunch to their school, deciding on the dishes has become even tough. To add to that, their teacher has asked us to feed them half of their breakfast at home and pack the rest to the school. This way they eat their full and also learn to eat on their own. So while packing their boxes, I also make half of it to be feed while they wait for their auto to come.

Few of the breakfast they like a lot is the Chapatis and Masala Poha. And since they like chapatis, I thought I could get some potato into it to make it more filling. This is very simple and unlike the regular Aloo paratha where you got to stuff it with masala, this is blended into the dough. It makes it easy to prepare and more tasty and soft to eat. I try to make this atleast once a week for their breakfast.

The other dish that they seem to like is the Masala poha made with beaten Rice. This is also a milder version made specially for the young ones. So it becomes a double work for me, when I decide to serve this for the adults in the family. But I guess its worth the effort that they like to eat this.

Aloo Paratha

Ingredients Needed:

Wheat flour / Atta - 1 cup
Boiled Potatoes - 2 medium
Salt to taste
Milk - 1/2 cup
Chili powder - 1/4 tsp or less
Ghee / Butter 1/2 tsp
Water as required
Oil for frying

Method to prepare:

Pressure cook the potatoes till they are tender. Mash it to a fine paste using potato masher or food processor.

In a wide vessel, take wheat flour, mix salt, chili powder and ghee. Then add the potato paste to the flour and knead well. Slowly add the milk and knead to a soft dough. Add water if needed.

Let it rest for 10 mins.

Then divide into equal balls and roll out into small rotis.

Heat a pan and cook the rolled out rotis over hot pan on both sides, sprinkling oil/ghee.

The cooked chapatis are very soft as the potatoes are blended into it.

Masala Poha

Ingredients Needed:

Beaten Rice / Atukulu - 1 cup
Onions - 1/2
Curry leaves - 2 -4
Turmeric powder a pinch
Green chilies - 1 small
Salt to taste
Oil - 1 tsp
Mustard seeds - 1/4 tsp or less

Method to prepare:

Wash Beaten rice in water, and soak for 5 mins.

Drain it in a sieve. Meanwhile chop onions into big squares and slit chilies into half.

Heat a pan with oil and splutter mustard seeds. Then saute onions till they are pink along with curry leaves and chilies. Then add salt and turmeric powder.

After 2 mins, add the drained poha into the pan and combine well. Simmer for 5 mins, till its all mixed.

Chopping the chilies into half and onions as squares makes it easy to be parsed!

Of course the poha won't taste good if curry leaves or onions are not added. But we can always remove them when the babies don't like them!