CHANGE LIFESTYLE - REDUCE WEIGHT

CHANGE LIFESTYLE - REDUCE WEIGHT

Compiled by

Ms. Uma Shakthi, Dietitian

Dr.Mohan's Diabetes Specialities Center

      In today’s fast-paced world with the increased usage of convenience foods, fast foods and decreased physical activity, weight management has a very important place.Weight-gain occurs, when the daily intake of calories is greater than what is required and when a person does not do enough exercise to burn the calories consumed in food. In most of the developed and developing countries, 50 percent of the population suffers from malnutrition.Malnutrition includes not only under-nutrition but also over-nutrition. Persons who are plump and stout seem healthy but they are actually not. Due to abundant availability of food and increased economic status, parents buy their children whatever they ask for to eat. Children are generally influenced by the colourful ads from the media. Daily intake of unbalanced diet, indulging in sedentary activities like video games and TV and long hours of tuitions become a contributing factor for developing obesity and other non communicable diseases in the future.

Obesity refers to the amount of fat that gets deposited over the body parts particularly around the waist and hip region. Because of this, people weigh more than they should.

                                  How can we know whether a person is obese?

There is a simple way. By subtracting 100 from your height (cm), you can obtain your ideal body weight. There is one more way which requires a little mathematical calculation. That is your BMI {Body Mass Index = Weight in kg/ height * height (m2)}.  In order to check these values, consult your nutritionist for guidance.

What are the reasons for obesity?

Family history, dietary errors, sedentary lifestyle, hormonal imbalance and mental disturbances are the main contributing factors. When the parents or grandparents are obese, children acquire their obesity gene and become obese.

Some people continue to eat even after satiety has set in. Just for relishing the taste, they ignore the signal sent by the brain to stop eating. Some nibble their snacks once in half an hour and move towards food when they are depressed. Because of these, they eat more than they require leading to weight gain.

Sedentary lifestyle is the second important factor contributing to weight gain. Now a days, children no longer walk to school. Mechanization has made us lazy. Our physical activities are replaced by machines. To burn the calories, you need to do some form of exercise.

What are the health effects of obesity?

      Obese persons are prone to non communicable diseases like diabetes, heart diseases, cancer, osteoporosis, stress, obstructive sleep apnoea, etc.

How to control or prevent obesity?

We need to rely on 4 pillars

1         1. Diet

2         2. Exercise

3         3. Lifestyle modification

           4. Medication

Diet:

Choose low calorie foods and fibre rich foods. Most of the low calorie foods are rich in fibre.

1. Instead of having plain idly/ dosa, make vegetable idly, vegetable dosa or oothappam.

2. Use whole wheat bread instead of white bread

3. Make chapathi out of soya, oats, bajra and ragi.

4. Tofu can be used in place of paneer

5. Prefer buttermilk and  lemon juice over high calorie beverages or cool drinks

6.Replace snacks with salads

7. Have small frequent meals.

8.    Eat in a calm environment

Physical activity:

Regular walking is recommended. Inculcate a hobby that involves more physical activity. Instead of watching a cricket match in TV, go and play outside yourself.  It relaxes your mind too. Excuses are not excusable!

To follow these, you need to get motivated to change your lifestyle. You must have control over yourself. Making a lifestyle change will give long term benefits not only to you, but also to the future generations. 

HEALTH BENEFITS OF FISH

HEALTH BENEFITS OF FISH

Compiled by, 

Ms.Jayshree. S.S
Assistant Manager, Nutrition & Dietetics

Dr.Mohan's Diabetes Specialities Center

            Among the sea foods, fish is the most nutritious. There are different types of fish. Though they differ according to the sources, all fish have many health benefits and medicinal properties.

         In previous times, fish has been widely used to improve the blood circulation and remove the toxins from the body. Essential fatty acids are the main reasons to make fish a special nutrient rich food.

         Essential fatty acids are necessary to prevent skin infections like psoriasis. They are essential to improve the immune function. Fish is generally potassium rich, which help in reducing blood pressure and other cardiac disorders.  Fish contains ample amounts of vitamin D, calcium and phosphorus, which are the basic micro-nutrients required for formation and strengthening of bones.

             Fish is a well known galactogogue which improves the breast milk secretion. Certain varieties of fish contain iron that prevents anemia. All types of fish contain high biological value proteins which are easily assimilable to build muscles. Small fish are very low in calories. It is helpful for those who want to reduce weight. Magnesium content in fish prevents muscle cramps. Selenium content gives fish the antioxidant properties.  

              Selection of a healthy fish is very important. Consuming contaminated fish causes many health problems. While buying fish, look for the eyes. Eyes must be bright and bulgy. Body should be firm. Gills must be bright red in colour. Intestines must be removed before refrigerating. Otherwise intestinal germs can affect health. Use of cod liver oil prevents vitamin E deficiency. Fish fry, cutlet, biriyani and a few other recipes can be enjoyed throughout the week.

                                                                                      

HEALTH BENEFITS OF WALNUTS

HEALTH BENEFITS OF WALNUTS

Compiled by, 

Ms.Jayshree. S.S
Assistant Manager, Nutrition & Dietetics

Dr.Mohan's Diabetes Specialities Center

          Walnuts are the richest sources of nutrients among the nuts and oils seeds. The kernel of a walnut contains essential fatty acids. Young walnuts contain some vitamin C also. Apart from this, walnuts have many health benefits. Traditionally, walnuts have been used to treat intestinal worms.

        Many studies have proved that by adding walnuts to a cholesterol lowering diet, LDL (Bad) cholesterol level can be reduced by 10%. This is because of the linoleic acid in the walnuts which helps to keep the blood thin and prevents clots and blockages in the blood vessels. They help in weight reduction and reduce the risk of other non communicable diseases like diabetes, high blood pressure, etc.

         Walnuts give good amounts of B vitamins, essential for keeping the nervous system healthy. Walnuts are good sources of copper, necessary for keeping the immune system functioning correctly. Vitamin E and linoleic acid in walnuts help to maintain the skin structure. These nutrients help to improve general smoothness and softness of the skin.Walnuts can be eaten raw after breaking the shell. They can also be eaten along with salad.

RIGHT FOOD AT RIGHT TIME

Right food at Right time

Compiled by
Ms. Uma Shakthi, Dietitian
Dr.Mohan's Diabetes Specialities Center

          Jobs that require working in shifts are quite common today. Globalization has had such a phenomenal impact that round-the- clock service has become a necessity in almost every sector, forcing people to work in shifts. For such workers, a balanced diet, adequate water, a proper schedule for eating food and sleeping, a regular interval for recuperation from exhaustion, time with family and friends exist only in dreams, assuming they get to at least close their eyes for a peaceful moment.

          The condition of the night shift workers is the most pathetic, given that they have to adapt to a total reversal from the basic human nature, ultimately forcing them lead a nocturnal life. This not only affects their eating and sleeping habits but also gradually deteriorates the overall physical, psychological, behavioral and emotional health.

“Right food at Right time” – the mantra is no more in existence.

The problem:

The workers’ sedentary lifestyle in performing a monotonous job, the over-tasking deadlines imposed and high demand for performance and productivity ultimately affects their overall health.

• Obesity and constipation results from physical inactivity while back pain, neck pain and other spinal cord related disorders may be attributed to the constant sitting posture which may be referred to as Repetitive motion injuries (RMI). RMI are the illnesses or injuries that result from weeks, months and years of overuse of human joints.
• Insomnia and irregular sleep are the common disorders among such workers. While day shift workers get little sleep at night due to strenuous work, night shift workers rarely sleep during the day owing to noise and other disturbances from the surroundings.
• As these kind of jobs needs to be done in a centralized air-conditioned area, workers sweat less and drink less or no water during the whole day leading to the accumulation of toxic wastes on their body that are usually eliminated through sweat.
• Almost 10-12 hours of continuous strain may result in job stress. Job stress is felt when job requirements do not match the capabilities, resources or needs of the workers leading to fatigue, tension headaches, anxiety, irritability, depression and suppression of immune system.
• When one is constantly exposed to the radiation emitted by the LCD monitors, their eyes tend to become dry causing poor vision, which is generally called computer vision syndrome (CVS).

The solution:

Is there any solution?

How can one manage without quitting the job?

           When one searches the solutions for these problems, one may consider the dietary modifications as the easiest one. Workers especially those in nightshifts can alter their biological clock properly by scheduling the meal and snacks time along with regular break time.

           Amongst the many varieties of food available, choosing the right food is in your hands. Plan in such a way that there is 4-5 hours of gap between two larger meals. Take food only when you are physically hungry.

• Always prefer fruit and vegetable juices or salads instead of coffee, tea or carbonated drinks. Fruits and vegetables are beneficial in providing antioxidants, phyto-chemicals and fibre which are very much essential to provide relief from constipation, dehydration, fatigue, stress, etc. fruits like papaya, pineapple, dates, oranges, guava, mango and vegetables like carrot, beetroot, cucumber, bitter gourd and greens are useful in balancing abnormal hormone levels. Always prefer brightly colored fruits and vegetables that are rich in carotenoids, which are required to prevent vision problems.
• Do not take rice preparations often as they give more calories leading to weight gain. Take protein foods to normalize the overall metabolism.
• Do not take French fries, potato chips, and savories as snacks because they tend to accumulate fat and cause weight gain. Instead prefer a vegetable sandwich, soup or whole fruit, which is light as well as healthy.
• One can always bring food prepared at home like ragi porridge, oats porridge or barley water.
• Take regular breaks from watching computer screen. Close your eyes for a few minutes to revive retinal production inside the eyes. Focus on some object at a distance, which is green or yellow for a while as it soothes your eyes.
• Ideal sitting posture must be adopted. Keep your feet planted firmly on the floor or footstool to counterbalance the forces on lower back.
• Try to spend time with your family and friends to rejuvenate your mental health.

           A decent white collared job at the cost of personal health is no gain. A proper concern and awareness of one’s own health must not be lost in the pursuit of material benefits. It is the need of the hour.

WINGS TO WARD OFF DIABETES

HEALTH BENEFITS OF BROWN RICE

HEALTH BENEFITS OF BROWN RICE

Compiled by

Shobana S,  Sudha V, Anjana RM,  Mohan V

Rice is one of the most important staples in India. It was first mentioned in Yajur Veda and more than 200,000 varieties of rice are available in India today. Different rice varieties may have different morphological features, cooking, eating, and product-making characteristics. Rice varieties may be broadly classified based on their size, shape, waxy or non-waxy (based on the nature of starch), aromatic (eg. Basmati, Jeerakasambha) or non-aromatic (Ponni; Sonamasuri), red or black rice (based on color) etc., There are different forms of rice, namely brown rice (unpolished rice), hand pounded rice (minimally polished rice), raw (non-parboiled) white rice (fully polished rice), parboiled white rice, quick cooking rice (instant rice) etc., depending on the processing it has undergone. Brown rice is a whole grain which retains 100% of its bran, germ. Brown rice is prepared from paddy (either raw or parboiled paddy of any rice variety) and only the outer husk is removed. Hence it contains all its botanical components and the nutrients provided by them too. The outer layers (bran) and the germ or embryo of brown rice are rich in protein, fat, dietary fibre, vitamins and minerals, whereas the inner portion of the rice grain (endosperm) is rich in starch. 

    

During the process of milling, the paddy is dehusked and the outer layers of the brown rice (bran) and germ are stripped off approximately to an extent of 7-10% leaving behind mainly the starchy inner portion. Generally fully polished rice (white rice) is preferred for its superior appearance, taste, flavor, aroma and textural characteristics. The rice what is being currently served on our plates is the dietary fibre depleted white rice either parboiled or non-parboiled (hence called refined grain) which is highly starchy in nature.

During ancient period, hand pounded rice (not a 100% brown rice) was consumed and today due to the advancements in milling technology (to reduce the loss due to breakage of grains in the traditional handpounding process), the hand pounding practice has vanished and is replaced by modern rice milling machinery which delivers higher yield of polished rice (either raw or parboiled). In the traditional manual practice of hand pounding, the paddy was pounded using a pounder in a stone mortar, which was then winnowed to remove the husk and minimal amounts of bran to yield hand pounded rice and thus minimal degree of polishing. This rice is also nutritionally superior compared to fully polished rice that is being currently consumed. However, brown rice contains the highest nutrients compared to both hand pounded and white rice.

 

  

A study from our centre has shown a strong association between refined grain (polished rice or white rice) consumption and the metabolic syndrome (clustering of metabolic abnormalities including glucose intolerance, central obesity, dyslipidemia and hypertension), and diabetes risk in urban adult south Indian population. The study also reported that almost half of the (50%) of the daily calories in our population were derived from refined grains predominantly polished white rice (on an average the intake was around 250 g of polished rice (uncooked) per day). 

Many studies from the western countries have shown risk reduction of obesity, metabolic syndrome and diabetes with consumption of whole grains such as brown rice. However, such a study had not been possible in India due to difficulty in obtaining genuine brown rice in the market. Of late brown rice is gaining importance due to increased awareness on the health benefits of wholegrain consumption and lots of products with labels of  ‘brown rice’, ‘hand pounded rice’ are being marketed widely. The nutrition and ingredient labels are often overlooked by the consumers. There are lots of rice samples with brown color being marketed under the label claims of ‘brown rice’. All the rice that appears brown in color need not be a genuine ‘brown rice’. Nutritionally, brown rice is a healthier option to white rice, as it contains higher levels of dietary fibre, vitamins, minerals and other health beneficial phytonutrients. Polishing decreases these health beneficial nutrients, and increases the rate (speed) of digestion and hence quickly raises the blood glucose (so a high glycemic index food). A study from our centre has indicated that with progressive polishing of brown rice, the dietary fibre content decreased and the available carbohydrate (the carbohydrates which are available for metabolism) content increased. With polishing, the decrease in the levels of proteins, fat, minerals, γ-oryzanol, polyphenols and vitamin E was also observed. Thus the process of polishing not only decreases the dietary fibre content but also the other health beneficial nutrients of rice. Such a polished rice choice being a high GI food and when consumed as a staple (consumed in all meals and in greater quantity) could further increase the glycemic load (GL) of the  diets which are known to increase the insulin demand and elicit higher glycemic and insulinemic responses triggering the risk for type 2 diabetes and obesity.

            

             Recently, a market survey was conducted in the different parts of Chennai in shops, kiosks and super markets regarding the availability of brown rice. Rice samples with label claims of ‘brown rice’, ‘hand pounded rice’ were collected and examined. To our surprise some retailers were selling parboiled polished red rice (kerala rice) [picture 1] as brown rice. It is important for the consumers to know the characteristics of brown rice to make a judicious choice in the market. 

              Brown rice appears brown, glossy and smooth with intact bran and the germ (picture 2). In contrast the polished white rice is whiter and is devoid of the bran and germ (picture 3). 

 

            The Department of Foods, Nutrition and Dietetics Research at Madras Diabetes Research Foundation, Chennai prepared brown rice (0% polish), minimally polished rice (2.3% polish) and white rice (9.7% polish)  from parboiled BPT (Baptla variety) paddy (pictures 4, 5) and their GI was tested. 

              Brown rice showed the least GI compared to the other two rice samples. Moreover brown rice based traditional south Indian preparations (idli, dosa, upma, sambhar rice etc.,) exhibited a lower GI compared to the corresponding white rice based preparations. In addition, our studies with 24 hr glucose monitoring system have also shown significant improvement in the 24 h glucose response of brown rice compared to minimally polished and white rice based diet in overweight adults.

            Further, evaluation of the commonly consumed Indian rice varieties namely; Sonamassuri, Surtikolam and Ponni for GI revealed all of these to be high GI category rice. Hence it is prudent to replace white rice with brown rice and also to lay down stringent food regulations for the label claims for marketing of brown rice in the country. Awareness of the morphological features of brown rice and the health benefits of brown rice will be helpful in popularization of brown rice among the rice eating population of India.

THERAPEUTIC LIFESTYLE CHANGES TO LOWER CHOLESTEROL

THERAPEUTIC LIFESTYLE CHANGES TO LOWER CHOLESTEROL

Compiled by 

 Dr.Saroja Raghavan H.O.D & Senior Manager N&D

 K.Saranya –Executive N&D

If you have high cholesterol and have heart disease or other risk factors for heart disease, Therapeutic Lifestyle Changes (TLC) diet is recommended.

                   

DIETARY TIPS TO LOWER CHOLESTEROL

• Reduce sodium intake to 2400mg per day.
• Limit saturated fats less than 7% of your daily calorie intake
• Eat only enough calories each day to achieve or maintain a healthy weight.
• Choose foods rich in complex carbohydrates such a whole grains, vegetables and fruits.

• Prefer low or non –fat dairy products like skimmed milk, skimmed curd, low fat cheese, butter milk rather than whole milk, butter and full fat cheese.
• Eat moderate amount of lean meat like chicken without skin and fish. Also avoid fatty cuts of meat.

EXERCISE TO LOWER CHOLESTEROL

Regular exercise will help to

• Lower triglycerides and LDL (bad) choleseterol level
• Raise your HDL (good) cholesterol level
• Reduce blood pressure
• Shed extra weight
• Improve the functioning of heart and lungs

Start with simple exercises like walking and taking the staircase in your office .If you want to do it more aggressively do brisk walking and cycling. Schedule your exercise program for at least 30 minutes a day.

Change in eating habits and exercise help to reduce your cholesterol level

                

TESTIMONY BY OUR PATIENT - 3

TESTIMONY

NAME OF THE PATIENT: P.SADA (M.NO. 5984),

DARJEELING, WEST BENGAL

I had never heard about Dr Mohan’s Diabetes Specialities Centre till one of my old office staffs from Coochbehar district of West Bengal, a chronic diabetic patient told me about the result he obtained after visiting the centre and advised me to get my problem checked there. During that particular period I was posted as the Additional District Magistrate in the district of North Dinajpur in West Bengal. In view of my deteriorating health condition due to uncontrolled diabetes all my family members advised me to resign from the service. I had also undergone angioplasty in CMC Vellore in April 2004. So I thought that it would be appropriate for me to resign from the service but before that I planned to visit Dr Mohan’s centre once.

It was in the month of May 2005 I along with my wife went to the centre and got checked. On seeing my critical condition, the diabetologist advised me to get admitted as inpatient and accordingly I got admitted the same day. It is unbelievable that after five days my sugar level came down to normal and I was discharged. Gradually my condition started improving and I gave up the idea of resigning from the service. My insulin intake was replaced by oral medicine after 9 months and since then my diabetic problem is completely under control. Since May 2005 I have been visiting the centre once a year for review. In the last visit, I took the life membership at the centre. I have full faith in the treatment that I receive from the centre and suggest all diabetic patients to visit the centre. I find all officials and staff of the centre very helpful, co operative and trust worthy and I expect that this centre would continue to grow as a great service centre in the days to come to help people afflicted with diabetes to ease their problem. I extend my appreciation for satisfactory and trustworthy treatment. 

TESTIMONY BY OUR PATIENT-2

TESTIMONY

PATIENT NAME: MR. KS GANAPATHY (M.NO. 3755)

Before I venture to relate my experience, it is but proper for me to briefly write about my eye problem. It is by pure coincidence that I came to realize that I had vision problem since I had no symptoms whatsoever. I started wearing spectacles since the early 1970s. even my diabetes came to be known only accidentally during early 1989. I have been Dr mohan’s patient since then. Due to my strict diet regimen, proper exercise and regular medicines, my diabetes is under control, thanks to Almighty. I have also been going through annual eye checkups along with my diabetes check up.

During Oct/November 2010, during my annual checkup at Dr Mohans Diabetes Specialities Centre, I was advised that it was better to undergo surgery of both eyes as cataract had developed. With the support and direct monitoring of Dr Mohan, an appointment was fixed with Dr Sivakumar, Eye Surgeon and Consultant Ophthalmologist, DMDSC to whom I was appraised of my health problems besides diabetes. He informed me that my left eye had cylindrival power besides having high spherical power.

While my right eye surgery could done using usual intraocular lens, Dr Sivakumar suggested that the left eye needs to be done with “Toric lens” which could be made to order incorporating suitable cylindrical values, thereby enabling me to use spectacles with lesser weight and lesser spherical power after the operation for the near vision. For this, details scans and investigations were done. While the right eye was operated on 9/12/2010, for the left eye I had to wait for the “made to order” toric lens which was arranged by Dr Sivakumar and this operation was successfully done under the able and suave surgeon Dr Sivakumar on 4/7/2011. After this operation there was remarkable improvement in my vision and I am fully satisfied.

Even before the glasses were prescribed, I could see that my vision had improved considerably. Dr Sivakumar had told me before the operation that once the Toric lens was fixed, I would see phenomenal improvement in my vision, which has been proved right. But for Dr Sivakumar’s excellent and deft handling of the operation and the personal care and attention that he had bestowed on me, I wonder what would have been my position. I am obliged to Dr Sivakumar and to Dr Mohan who closely and personally monitored the operation and my post operative care and follow-up despite his numerous preoccupations and busy schedule. I have been troubling both of them a quite frequently and they were always ready to extend their care to me.

I wish to place on record the excellent care and attention being given by the entire team of staff at DMDSC at the operation theatre, the in-patient wards and the ophthalmology doctors, the support staff such as optometrists, nurses, assistants and particularly Mrs. Valli and her team. I will be failing in my duty if I do not make a mention about the personal care that was extended to me by the late Dr Rema Mohan. I do miss this doctor who was a compassionate human being besides an excellent doctor. She was the embodiment of care, compassion and excellent consideration for the health care/ treatment to the patients. In fact, the Indira Eye Institute and a host of her patients like me, miss her very clearly.

Once again I wish to offer a big “thank you” to Dr Mohan and Dr Sivakumar and the whole team at Dr  Mohans Diabetes Spcecialities Centre. This centre is thus not only a world class one for diabetes care but also for Eye Care !

TESTIMONY BY OUR PATIENT

TESTIMONY

PATIENT NAME: MR. SRV PRASANNA (MNO. 156973)

A diabetic for more than fifty five years. I was one of the rarest species during 1959 when my diabetes was detected by my grandfather and father who were doctors. I was started with Boots Co. Insulin plain & Protomine Zine. This combination I was taking once a day for the first twenty years. Then, after coming in contact with Dr. M Viswanathan I was asked to take the Insulin twice a day. It was that I first came across the dietitians who were and who are the main pillars for the case of diabetic patients.

My HbA1c used to be always around 8%. Here I would like to mention one thing. When the HbA1c test was Rs. 250 during 1978 – 80 everywhere in all the diagnostic centre, only in Dr m Viswanathan’s centre it was Rs.30. Even after 30years even now the charge in Dr Mohan’s is only Rs. 290/- where outside in most labs they charge between Rs. 400 to Rs. 450/- for this test. Having crossed 52 years of age as a diabetic without complications I have undergone many hypoglycemic spells (over 5000). Dr Mohan describes me as one of the unique patients who had been on once a day insulin for over 20 years and despite of this I have not developed into any diabetic complication whatsoever. All thanks are due to the Almighty and possibly my genetic condition that I did not develop any complication. Here I would like to mention that diabetes varies from person to person. I would like to thank Dr. Munirathnam Chetty of Coimbatore who tried to put me in the best way and my thanks to all Coimbatorians and friends and relatives who helped me during the hypoglycemic spells. My special thanks and gratitude to my wife and my daughter who have been looking after me so well with utmost care and affection.

I have been successfully working as a self-employed professional photographer and my specializations is taking portraits. I have covered more than 1200 weddings successfully. I would like to mention one more thing. I have been attending so many weddings, where I come across delicious and great food. Its not that I avoid sweets completely. I do take a little, but I also take lot of vegetables and adjust my food accordingly as far as calories are concerned. Sometimes I also increase dose of regular insulin by 5 or 10 units. As patients we have to adjust the dose of insulin and diet since the doctors cannot be with us all the time.

Awareness regarding diabetes was almost nil during 1960s when I used to develop hypoglycemia in my classroom during my 9^th year to 12^th year. My teachers especially male teachers who used to make fun of me stating that the classroom was not a room to have siesta or to eat.

My advice to all the diabetic patients is to never to sleep alone due to possibility of nocturnal hypoglycemic reactions. Here too I would like to mention one thing. Because of low sugar reaction our body gets into so called the somogyi effect (i.e) whenever the low sugar happens our body system pours out all the stored up glucose from the liver and this raises the blood glucose and may even raise it above normal.

I know Dr Mohan ever since he was doing his MD. At that time he did the ECHO test for me. They were surprised to find that my heard was absolutely fine. This was 34 years ago. Even now, I am proud to say that my Echocardiography is absolutely fine.

My tips and suggestions to other diabetic patients are:

1. never sleep alone
2. carry an “I am a diabetic” card when going out.
3. we should learn to monitor ourselves with insulin, taking and food, since doctors cannot be with us always.
4. I feel insulin is the drug of choice for any diabetic. The cost of insulin is very low when compared to the cost of treating complications of diabetes. If by a couple of insulin pricks a day one can live for over 50 years like me without complications, is not insulin a life saver? Hence please don’t refuse to take insulin if your doctor advises you.