Dr. Reema Kashiva

Diabetes specialist in Pune

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Diabetes Treatment in Pune

To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus (T2DM). Changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term.The evidence supporting the role of exercise, medical nutrition therapy, glucose monitoring, and antiobesity measures including pharmacotherapy and bariatric surgery.The optimum dietary macronutrient composition remains a subject of interest; however, several studies have shown that dietary measures are effective in weight reduction irrespective of the composition (low fat vs low carbohydrate), provided there is adequate energy restriction, reduction in saturated fat to less than 7%, and adequate provision of dietary fiber.Although low-fat and low-carbohydrate diets are both effective in producing weight loss, their effect on lipid profile may differ. Low-carbohydrate diet may yield greater reduction in triglyceride with higher improvement in high-density lipoprotein, but with higher low-density lipoprotein levels in comparison to low-fat diet. Lower consumption of total and saturated fat and processed foods, and higher consumption of fibers, whole grains, fruits, and vegetables have been shown to improve glycemic control in patients with diabetes. In clinical trials, nut consumption increases satiety, have a neutral effect on glucose and insulin, and a beneficial effect on lipid profile.Artificial sweeteners may cause diarrhea; otherwise, they are safe when used according to Food and Drug Administration (FDA) recommendation. Although diabetic subjects may have increased oxidative stress, placebo-controlled trials have not demonstrated any clear benefit attributable to antioxidant supplementation.

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Diabetes and Obesity

Diabetes is a disease characterized by high levels of blood glucose resulting from defects in insulin production, insulin action or both. Obesity and type 2 diabetes are diseases that can substantially decrease life expectancy, diminish the quality of life and increase healthcare costs. The incidence of obesity and diabetes continues to rise by epidemic proportions. The term “diabesity” has been coined to describe obesity-dependent diabetes. Body mass index has a strong relationship with diabetes and insulin resistance. In obese individuals, the amount of nonesterified fatty acids, glycerol, hormones, cytokines, proinflammatory markers, and other substances that are involved in the development of insulin resistance, is increased. The pathogenesis in the development of diabetes is based on the fact that the β-islet cells of the pancreas are impaired, causing a lack of control of blood glucose. The development of diabetes becomes more inevitable if the failure of β-islet cells of the pancreas is accompanied by insulin resistance. Weight gain and body mass are central to the formation and rising incidence of type 1 and type 2 diabetes. This literature review will demonstrate the facts that link obesity with insulin resistance and pancreatic β-cell dysfunction. In conclusion, new approaches in managing and preventing diabetes in obese individuals must be studied and investigated based on the facts.  

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