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. 

KNOW THE HIDDEN BENEFITS OF SPICES

       KNOW THE HIDDEN BENEFITS OF SPICES

                                            

                                                  Compiled by

                                         Lizy Bonsal, Dietitian

Dr Mohan's Diabetes Specialities Centre  

 
       

Garlic:  Thiosulfinates (allicin) found in garlic can bring about significant reduction in total cholesterol and in blood pressure; help prevent coronary artery disease and stroke.

Rosemary:  It is a herb which is a rich source of minerals like potassium, calcium, iron, manganese, copper, and magnesium. Potassium is an important component of cell and body fluids, which helps control heart rate and blood pressure. Rosemary also contains very good amounts of vitamin A. Vitamin A is known to have antioxidant properties and is essential for vision. Consumption of natural foods rich in vitamin A is known to help  protect the body  from lung and oral cavity cancers. 

Ginger: It reduces nausea induced by motion sickness or pregnancy and may help relieve migraine headaches.

Celery: It has been used in complementary medicines to reduce blood pressure, to relieve indigestion and as an anti-inflammatory agent. It  is also used as a diuretic to remove excess water from the body.

Fenugreek:  It lowers blood LDL-cholesterol levels by inhibiting bile salt re-absorption in the colon. Fiber, trigonelline present in the seeds helps lower rate of glucose absorption in the intestines and  thus controls blood sugar levels. The seeds are therefore recommended in diabetic diet. Fenugreek seeds are added to cereals and wheat flour (bread) or made in gruel and given to nursing mothers to increase milk production.

Pepper: It has been used therapeutically in dentistry as an antiseptic for tooth-decay and gum swellings.

Coriander seed: It helps to increase bulk of the food by absorbing water throughout the digestive system and helps ease constipation. In addition, dietary fiber  binds  to bile salts (produced from cholesterol) and decreases their re-absorption in the  colon, thus helping to lower serum LDL cholesterol levels. Together with flavonoid anti-oxidants, fiber composition of coriander helps protect the colon mucus membrane from cancers.

Sesame seed: The mineral zinc in sesame seed, promotes healthy bones. Sesame also contains copper which helps in relief of rheumatoid arthritis. Calcium in sesame, helps in the prevention of many health problems, like migraine, PMS (Premenstrual syndrome), Osteoporosis and colon cancer . Magnesium content in sesame, helps to maintain respiratory and vascular health. Sesame seeds are also anti –oxidant and anti depressant. They are also used to treat constipation.

Better Learn About Bittergourd (Bitter Melon)

              Better learn about bittergourd(bitter melon)

Compiled by 

Lizy Bonsal, Dietitian

Dr Mohan's Diabetes Specialities Centre

• Fresh bitter melon is an excellent source of vitamin-C. Vitamin-C, one of the powerful natural antioxidants, helps body scavenge deleterious free radicals- one of the reasons for cancer development.            

• Very low in calories; provides only 17 cal per   100g. The pods are rich in phytonutrients like dietary fiber, minerals, vitamins and anti-oxidants. 
• Bitter melon contains phyto-nutrient, polypeptide-P; a plant “insulin” known to lower blood sugar levels. In addition it also contains a hypoglycemic agent called charantin. Charantin increases glucose uptake and glycogen synthesis in the cells of liver, muscle and adipose tissue. Together, these compounds can cause reduction of blood sugar levels in type-2 diabetes.
• Fresh pods are an excellent source of folate; contains about 72 mcg/100g.  Folate helps to reduce the incidence of neural tube defects in offspring when taken by pregnant women during early pregnancy.

• It is an excellent source of health promoting flavonoids such as beta-carotene, alpha-carotene, lutein, and zeaxanthins.   
•  It also contains good amount of vitamin A. Together, these compounds help act as protective scavengers against oxygen-derived free radicals and reactive oxygen species (ROS) that play a role in aging, cancers and various disease processes.
• Bitter melon stimulates easy digestion and peristalsis of food through the bowel until it is excreted from the body. Thus, it helps in relieving indigestion and constipation.
• The vegetable is also a good source of Niacin (vitamin B-3), Pantothenic acid (vit.B-5), Pyridoxine (vit.B-6) and minerals such as iron, zinc, potassium, manganese and magnesium.

DIABETES IN PREGNANCY - THE NEED FOR EARLY DETECTION

            The World Health Organization's estimation of prevalence of diabetes in adults indicates an expected total tise of more than 120% from 135 million in 1995 to 300 million in 2025. This includes Gestational Diabetes Mellitus (GDM) which is defined as carbohydrate intolerance with first recognition or onset during pregnancy and pre GDM, a term that denotes known diabetic subjects who become pregnant.

          Women with GDM are at increased risk of future diabetes and their children are at risk of childhood obesity and diabetes later in life. This fact should warn the physicians and general public alike to the necessity to devote special attention to this problem. Uncontrolled diabetes in pregnancy leads to spontaneous abortions, birth defects, preterm labor, big baby, hypertension, sudden in-utero death, delayed and difficult labor. 

Source: http://images.mirror.co.uk/upl/m4/sep2009/9/8/big-baby-pic-afp-getty-75711017.jpg

              

            A team approach is needed in management of pregnancy in diabetes with the obstetrician, diabetologist, dietitian and pediatrician working in concert. Intensive monitoring, diet and insulin therapy are cornerstones for management. The importance of educating pregnant women with diabetes about the condition and its management cannot be overemphasized. 

          All pregnant women must be aware of when to screen for GDM and GDM mothers must know about its implications for her and her baby. Fetal growth must be evaluated with ultrasound and fetal echo done to rule out cardiac problems.

          Prevention of adverse maternal and perinatal outcomes in GDM is based on achieving maternal blood glucose as close to normal as possible. Gestational diabetic women require follow up. Glucose tolerance test with 75g oral glucose is performed after 6 weeks of delivery and if necessary repeated after 6 months and every year to determine whether the glucose tolerance has returned to normal or progressed. Diabetes in pregnancy needs holistic care for good health of women and her child.