Hello Diabetes Dr. Sunil Gupta

Globally 8th March is marked as the “International Women’s Day”, while in India 10th March is being recognized as National “Gestational Diabetes Mellitus (GDM) Awareness day” on the occasion of birthday of Dr. V. Seshiah (Padmashri), who has done the pioneering work in the field of pregnancy diabetes in our country.

High blood glucose in mother during pregnancy enters into foetal circulation which stimulates beta cells of foetus to secret insulin, causing hyperinsulinemia in the developing foetus. This increases the risk of developing non-communicable diseases like diabetes, obesity, hypertension & heart disease in their adolescent & adult life. Early detection & intense treatment of high glucose of pregnancy can save these children from developing diabetes in future, which is termed as “Primordial Prevention”. Thus every pregnant woman should be screened for diabetes at the first antenatal visit.

Also, 50% of GDM women develop frank diabetes in 1-5 years after delivery. So, after delivery every GDM women should screen herself for diabetes after 6 weeks, 6 months and then annually to avoid future complications.

“If you educate a man, you educate a man but if you educate a woman, you educate the generations,” said Dr. Gupta, on this occasion, while emphasizing upon the mission education of hello diabetes. Recorded on 8th March 2024.

Amongst, known people with diabetes, 50% of them are women. These women are more prone to have hypertension, coronary artery disease stroke, cancer etc., versus non-diabetic women of the same age. Most of the young women with diabetes can get married and get conceived with proper care of blood glucose, blood pressure, cholesterol & weight. But preconception counselling is must and they should visit their diabetologist before getting conceived to take fitness for pregnancy.

According to the ICMR data, published in Lancet Journal (2023), 101 million people have diabetes and approximately 140 million have pre-diabetes in India. Almost 50% of these people with pre-diabetes are likely to develop diabetes in next 5-10 years. Thus, it is important for all of us to focus on prevention strategies for this group of people. Recorded on 23rd February 2024.

Traditionally, it is presumed that diabetes, if seen in children and young adults will expectedly a case of Type 1 Diabetes Mellitus (Insulin Dependent Diabetes Mellitus), while those who develop in middle and old age will be Type 2 Diabetes Mellitus. But nowadays, many people are developing Type 2 DM between 20-35 years of age, and due to childhood obesity, Type 2 DM is also seen in the teenagers. There is another type, which is called as 1.5 diabetes, this is a slowly progressing disease, which behaves as Type 2 DM in the beginning but becomes Type 1 Diabetes Mellitus after 1-2 years and they have GAD-65 Antibody positive. It is also called as LADA (Latent Autoimmune Diabetes in Adult or slow onset Type 1 DM). Serum C-peptide levels, GAD-65 antibody and clinical features that can differentiate Type 1 DM v/s Type 2 DM, when present in young age. Recorded on the 12th January 2024

Sitting is a new Tobacco. If you are sitting for a long time, you are likely to enter into a high risk zone of developing diabetes & other co-morbid diseases. So try to be physically active & if you are in a sitting job, try to get-up and move after every 1 hour. To check whether you are diabetic or not, get your Glycosylated Haemoglobin A1c (GHb%) test or Oral Glucose Tolerance Test (OGTT) with 75gm of glucose. OGTT is the gold standard for the diagnosis of diabetes, informed Dr. Sunil Gupta. Answering on a query online, Dr. Kavita expressed that calories distribution is different for different person and also depends on whether you are sedentary or moderate or hard worker. While answering a question on millets, she said that people with diabetes may consume millets as they are rich in fibre & micronutrients. The post prandial blood sugar spikes, can be controlled by splitting of meal or changing the order of the meals, she added. Diabetes is your life partner and one should take it’s care with utmost personal attention, quoted Dr. Gupta.
Recorded on 9th February 2024.

Everyone is aware of Type 1 DM (Insulin dependent diabetes, seen commonly in children) & Type 2 DM (usually seen in adults & majority are controlled on oral drugs & Lifestyle Modification ). Gestational Diabetes Mellitus (GDM) is a kind of diabetes, which appears in the 2nd or 3rd trimester of pregnancy and disappears after delivery. GDM occurs when the woman’s beta cells are not
able to overcome the antagonism created by the anti-insulin
placental hormones of pregnancy. Which causes increase in the blood glucose during pregnancy. Women with a history of GDM are at increased risk of future diabetes; predominately type 2 diabetes, as are their children.
Almost every 5th or 6th pregnancy women in India, may have GDM. Diabetes In Pregnancy Study Group of India (DIPSI) recommends fasting or non-fasting Oral Glucose Tolerance Challenge Test with 75g of glucose with a cut-off of ≥ 140 mg/dl after 2-hours, Every pregnant woman should be screened for glucose intolerance in the first trimester itself. If found negative, the screening test is to be performed again at 24th – 28 th week and finally around 32 nd – 34 th week. Once diagnosis is made, Medical Nutritional Therapy (MNT) is advised initially for two weeks. If MNT fails to achieve control i.e., FPG ≥ 90mg/dl and/or 2 hr PPG ≥120mg/dl, oral drugs or insulin may be initiated.

Recorded on 28th January 2022.

As the festive season approaches, it is important for people with diabetes (PWD) to celebrate festival with a balance approach. Sankranti is marked by the exchange of a typical sweets (laddu & chikki) made of Til and Gud (Sesame & Jaggery). Sesame seeds (Til) have many benefits to and is good source of iron, magnesium, vit –B, protein, fibre and calcium. Jaggery is rich in iron & has thermogenic effect. PWD should avoid sweets in all such occasions. Rarely if you consume in a very small amount, it should not be taken immediately after the meal, and should be taken 3-4 hrs after the meal. Mindful eating is the success mantra to enjoy festive seasons without disturbing blood sugar level. Monitor blood sugars regularly, stay physically active and stay hydrated.
You can do additional exercise to burn the extra calories consumed during celebration of the festival.
Recorded January 14, 2022.