Frequently Asked Questions

Most of the food we eat is turned into glucose (sugar) for our bodies to use for energy. The Pancreas, an organ near the stomach makes a hormone called insulin to help glucose get into our body cells. When you have diabetes, your body either doesn’t make enough insulin or can’t use its own insulin very well. This problem causes glucose to build up in your blood. It is important to remember that diabetes cannot be cured but is controllable to a large extent and at Diabetes - Sweet and Simple; we help you simplify all that’s diabetes.

Ref: Centres for Disease Control and Prevention. Take Charge of Your Diabetes. [Monograph online] 4th edition. Atlanta: U.S. Department of Health and Human Services, 2007.

Type1 Diabetes Mellitus: In people with Type1 diabetes or insulin dependent diabetes, the body does not make sufficient or any insulin to meet the needs of the body. It is most often diagnosed in children and adolescents. Therefore, people with Type 1 diabetes need to take insulin every day.

Type2 Diabetes Mellitus: Type2 diabetes, also called non-insulin dependent diabetes is the most common type. In people with type 2 diabetes, either the person is not making enough insulin, or the body is resistant to insulin and cannot use it properly. This type of diabetes is more common in adults and older people. It can be managed through a combination of oral medication, and/or insulin, diet and exercise.

Gestational Diabetes Mellitus: This type of diabetes is seen in pregnant women. If diabetes is not properly managed at the right time, it can lead to complications. Hence, in this type of diabetes there is a need to be extremely cautious about blood glucose levels.

Please remember, controlling each of these types of diabetes requires different steps. Ask your doctor for more information.

Ref 1: Centres for Disease Control and Prevention. Take Charge of Your Diabetes. 4th ed. [monograph online] Atlanta: U.S. Department of Health and Human Services; 2007.

Ref 2: Diabetes Public Health Resource .Atlanta, USA: Centres for Disease Control and Prevention; 2012[Updated 2012 February 16; cited 2012 April 4]. Available from: http://www.cdc.gov/diabetes/consumer/learn.htm#3

Diabetes often goes undetected early because the early signs and symptoms that occur are vague and indistinct. Diabetes can be confirmed only after a lab test. However, here are some signs and symptoms that are associated with high blood glucose levels:

• Being very thirsty and urinating a lot
• Having blurry vision
• Feeling very tired most of the time
• Unexpected weight loss
• Having very dry skin and sores that are slow to heal
• Getting more infections than usual
• Loss of sensation or tingling feeling in the feet
• Vomiting

If you have one or more of these diabetes symptoms, see your doctor right away. The doctor will ask you to get a blood test done to check your blood glucose levels, the most reliable way to know if you have diabetes.

Ref: Centres for Disease Control and Prevention. Take Charge of Your Diabetes. [Monograph online] 4th edition. Atlanta: U.S. Department of Health and Human Services; 2007.

Insulin is a hormone (chemical substance), made by the pancreas, an organ situated near the stomach. The pancreas release insulin into the blood, which helps the glucose that comes from the food to enter the cells in your body. If the pancreas do not make enough insulin or if your body is resistant to the insulin produced, then the glucose cannot get into your cells. So, insulin stays in your blood and increases your blood glucose levels causing diabetes.

Ref: Your Guide to Diabetes: Type 1 and Type 2. [Monograph online].Atlanta: U.S. Department of Health and Human Services, National institutes of health; 2008.

Unfortunately, once diagnosed with diabetes, it is not curable. Diabetes may be kept under tight control with proper choice of foods that do not raise blood glucose, along with exercise, medication and/or insulin. In type1 diabetes, the cells of the pancreas that produce insulin are destroyed. Once the cells are destroyed, they will never make insulin again, so people with type1 diabetes will always need to take insulin. Type2 diabetes is reversible at a stage, when an individual is identified to be at risk of acquiring diabetes. Ask your doctor for more information on this topic.

Ref: Overweight [Internet]. Alexandria, Virginia: American Diabetes Association; 1995-2012 [cited 2012 April 10]. Available from: http://www.diabetes.org/diabetes-basics/prevention/pre-diabetes/if-you-have-prediabetes.html

Family history plays a significant part in susceptibility to diabetes because of the genes being passed from biological parent to the child. But, just because your father and/or mother have diabetes doesn't mean that you will develop diabetes. Apart from heredity there are other risk factors such as being overweight or obese, physically inactive, history of high blood pressure and cholesterol, history of diabetes during pregnancy (gestational diabetes) etc. also increase your risk of developing diabetes.

Fortunately, the risk of type2 diabetes can be reduced by watching their weight, eating healthy food and being physically active / exercising. It is also important to have regular check-ups with your doctor. For further information on this topic you can refer to this useful link http://diabetes.niddk.nih.gov/dm/pubs/causes/

Ref: Causes of Diabetes [Internet]. USA: National Institutes of Health; 200 8 March [updated 2011 December 5; cited 2012 April 18]. Available from: http://diabetes.niddk.nih.gov/dm/pubs/causes/

Risk factors for type2 diabetes include old age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity.

Risk factors for type1 diabetes are less well defined than for type2 diabetes. Autoimmune, genetic, and environmental factors are involved in developing type1 diabetes. Risk factors for gestational diabetes are family history and obesity.

Ref: Diabetes Public Health Resource .Atlanta, USA: Centres for Disease Control and Prevention; 2012[Updated 2012 February 16; cited 2012 April 4]. Available from: http://www.cdc.gov/diabetes/consumer/learn.htm#3

Diabetes is a lifelong condition that may lead to other health complications. Research studies indicate that type1 diabetes cannot be prevented. But the good news is that if you are at risk of developing diabetes, you can take steps to prevent type2 diabetes. Maintaining healthy weight, being physically active and eating healthy foods can help to lower your chances of getting diabetes (type2). It is also important to have regular tests done to know your blood glucose levels based on your doctor’s recommendation.

Ref: Prevention [Internet].Belgium: International Diabetes Federation; 2011[Updated 2011; cited 2012 April 10]. Available from: http://www.idf.org/types-diabetes.

Being overweight is only one of the risk factors for developing diabetes. Other risk factors such as family history, ethnicity and age also play a role. Unfortunately, too many people disregard the other risk factors for diabetes and think that weight is the only risk factor for type 2 diabetes. Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.

Ref: Diabetes Myths [Internet]. Alexandria, Virginia: American Diabetes Association; 1995-2012 [cited 2012 April 10]. Available from: http://www.diabetes.org/diabetes-basics/diabetes-myths/

The diet recommended for people with diabetes is a healthy diet for everyone. So, you are not required to buy special foods. Healthy diet is synonymous with healthy eating.

Healthy eating for people with diabetes includes:

• Limiting foods that are high in sugar and salt.
• Eating smaller portions spread out over the day.
• Being careful about when and how many carbohydrates you eat.
• Eating a variety of whole-grain foods, fruits and vegetables every day.
• Eating less fat and limiting your use of alcohol.

This is an approach, which would be endorsed by most dieticians. You should have your own meal plan. Ask your doctor to give you the name of a dietician who can work with you to develop a meal plan. Adding a no calorie sweetener such as Splenda to your diet plan helps ensure that you limit your sugar but do not sacrifice the "sweetness", - so controlling your diabetes stays sweet and simple.

Ref: Diabetic Diet [Internet]. USA: National Institute of Health; 2012 [updated 2012 March 30; cited 2012 April 10]. Available from: http://www.nlm.nih.gov/medlineplus/diabeticdiet.html

Several good dietary methods are available to meet the diet and nutritional goals of people with diabetes. General dietary guidelines recommended are:

• Carbohydrates should provide 45 - 65% of total daily calories. The type and amount of carbohydrate are both important. Best choices are vegetables, fruits, beans, and whole grains. These foods are also high in fibre.
• Fats should provide 25 - 35% of daily calories. Monounsaturated (such as olive oil and nuts) and omega-3 polyunsaturated (such as fish and walnuts) fats are the best types. Limit saturated fat (red meat, butter) to less than 7% of daily calories.
• Protein should provide 12 - 20% of daily calories, although this may vary depending on an individual’s health requirement. Fish, soy, and poultry are better protein choices than red meat.

Ref: Diabetes diet - General Dietary Guidelines [Internet]. Baltimore USA: University of Maryland Medical Centre (UMMC); 2011 [cited 2012 April 4]. Available from: http://www.umm.edu/patiented/articles/ what_general_guidelines_a_diabetes_diet_000042_2.htm

The carbohydrate in food makes blood glucose levels go up, but that does not mean that people with diabetes should avoid carbohydrates completely. Foods that contain carbohydrate also tend to contain a lot of other healthy nutrients. Today, most people with diabetes are encouraged to eat a balanced diet containing; grains, vegetables, fruits, meat and dairy products.

The key to keeping blood glucose levels at your goal, is to balance the food you eat with your physical activity and any pills or insulin you take. Consider making an appointment with a registered dietician or your doctor, who can review your individual needs and circumstances and help you tailor a nutritional diet plan that’s right for you.

Ref: Carbohydrates and Diabetes[Internet]. Alexandria, Virginia: American Diabetes Association; 1995-2012 [cited 2012 April 10]. Available from: http://www.diabetes.org/food-and-fitness/food/planning-meals/ carb-counting/carbohydrates-and-diabetes.html

The concept of six small meals a day for people with diabetes has been supported by the American Diabetes Association. Some of the reasons for people with diabetes to eat at regular intervals are listed below:

• Helps to maintains more consistent blood sugar levels:When people with diabetes eat six meals at regular intervals throughout the day, blood sugar does not have time to drop to any significant degree.
• Reduces the urge to binge: Frequent meals, decrease your risk of over eating.
• Promotes hydration: Most people accompany their meal with a drink like water, this promotes better hydration.
• Decreases hunger sensation: Especially in those who are reducing calorie intake to promote weight loss. Also improves the body’s metabolism.

Ref: Diabetic Diet Tips [Internet]. Life tips; 2012 [cited 2012 April 10]. Available from: http://diabetes.lifetips.com/cat/63323/diabetic-diet/index.html

For people with diabetes, snacks between meals helps to keep blood sugar levels stable and sustain high energy through the day. When it comes to snacking, people often think of foods that are high in sugar, salt and fat, but you have lots of other options. Instead of buying fried and unhealthy snacks, you can plan ahead and pack a healthy snack from home. Choose foods like whole grain biscuits, sprouts, nuts or cereal mix made with roasted oats. Keep plenty of fresh fruits, vegetable salad and sandwiches made of whole wheat bread in your fridge that is ready to grab and go.

Ref: Food and Fitness: Snacks [Internet] Alexandria, Virginia: American Diabetes Association; 1995-2012 [cited 2012 April 10]. Available from: http://www.diabetes.org/food-and-fitness/food/planning-meals/snacks/?loc=askthedietitian

For people with diabetes, artificial sweeteners may be a good alternative to sugar. However, there are several sugar substitutes available and it is important to choose one that:

1. Tastes like sugar so you do not have to sacrifice the taste
2. Can be boiled/ cooked so you can use it for desserts and not just beverages
3. Is a safe and healthy option for people with diabetes and the whole family, especially in long-term regular usage

A no calorie sweetener such as Splenda from Johnson & Johnson is a sugar substitute that fulfils all these criteria and is a healthy choice for people with diabetes or people looking to lose weight.

Ref: Splenda Products FAQ’s [Internet].USA: McNeil Nutritionals, LLC; 2012[cited 2012 April 4].Available from: http://www.splenda.com/faq/no-calorie-sweetener

Here are some ways that alcohol can affect your diabetes:

• While moderate amounts of alcohol can cause blood sugar to rise, excess alcohol can actually cause your blood sugar levels to fall.
• Beer and Wine contain carbohydrates and may raise your blood sugar.
• Alcohol stimulates your appetite, which can cause you to overeat and may affect your blood sugar control.
• Alcohol can interfere with the positive effects of oral diabetes medicines or insulin.
• Alcohol may increase triglyceride levels and blood pressure.
• Alcohol can cause flushing, nausea, increased heart rate.

For these reasons, alcohol is best avoided for people with diabetes. If you’re going to drink, do so in moderation. Choose calorie-free drink mixers, and drink only with food, preferably with high-fibre snacks like raw carrots.

Ref: Diabetes Health Centre: Diabetes and Alcohol [Internet]. WebMD; 2005-2012[updated 2012 April 10; cited 2012 April 4]. Available from: http://diabetes.webmd.com/drinking-alcohol

It is a common myth that if you have diabetes you shouldn't eat fruits because they are sweet. Fruits are a great source for anti-oxidants and other micronutrients, which is good for health, especially for people with diabetes. Fruits that are particularly good for people with diabetes include citrus fruits like oranges and sweet limes (mausambis); berries like strawberries; and apples. Fruits that Indians typically love but should be consumed carefully are grapes and mangoes, especially for people with diabetes. Visit this link for more information on this topic http://www.diabetic-dieting.com/fruit-list.html

Ref: Food and Fitness: Fruits [Internet] Alexandria, Virginia: American Diabetes Association; 1995-2012 [cited 2012 April 10]. Available from: http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/fruits.html

Dietary supplements are vitamins, minerals, and other nutritional components such as herbs. There is not enough research to support specific dietary supplements for diabetes. On-going studies point to three minerals that may be helpful to people with diabetes:

• Chromium may help control blood glucose levels and aid weight loss.
• Magnesium levels are often low in people who have problems with insulin secretion and in people with complications of diabetes.
• Vanadium may increase the body's sensitivity to insulin.

If you are not cautious, diabetes and dietary supplements can be a dangerous mix. Talk with your doctor about it. He or she can discuss the possible benefits and risks of dietary supplements for you.

Ref: Diabetes Health Centre: Diabetes and Dietary Supplements [Internet]. WebMD; 2005-2012[updated 2012 April 10; cited 2012 April 4]. Available from: http://diabetes.webmd.com/diabetes-dietary-supplements

Regular exercise is certainly a vital aspect of diabetes management plan. Regular exercise is known to benefit people with diabetes in a number of ways like

• lower your blood glucose and your blood pressure
• lower your bad cholesterol and raise your good cholesterol
• improve your body's ability to use insulin
• lower your risk for heart disease and stroke
• keep your heart and bones strong
• keep your joints flexible
• lower your risk of falling
• help you lose weight
• reduce your body fat
• give you more energy
• reduce your stress levels

For additional information on this topic, click on this link. http://diabetes.niddk.nih.gov/dm/pubs/physical_ez/index.aspx

Ref: What I need to know about Physical Activity and Diabetes [Internet]. USA: National Institutes of Health; 2008 March [updated 2011 December 6; cited 2012 April 4]. Available from: http://diabetes.niddk.nih.gov/dm/pubs/physical_ez/index.aspx

Exercising regularly helps to keep your blood glucose levels under check. Hence, regular exercise or any kind of physical activity like walking, swimming, dancing, riding a bicycle, playing a sport, etc. can have a positive impact on people with diabetes. When you combine regular exercise with other vital aspects of your diabetes management plan like controlling your diet and taking medication and/or insulin, will help make it sweet and simple to control your diabetes. Kindly consult with your doctor for more information on this topic and plan your exercise with his/her guidance.

Ref: What I need to know about Physical Activity and Diabetes [Internet]. USA: National Institutes of Health; 2008 March [updated 2011 December 6; cited 2012 April 4]. Available from: http://diabetes.niddk.nih.gov/dm/pubs/physical_ez/index.aspx

Any physical activity that engages the large muscles and elevates breathing is beneficial for people with diabetes. This includes activities like doing housework, taking the stairs instead of the elevator, walking around the house or offices, playing with kids, taking the dog for a walk, a gym work out amongst others. It should be remembered that more than the type of exercise it is important to do the exercise regularly. Consult with your doctor for the right exercises that can help you control your diabetes.

Ref: What I need to know about Physical Activity and Diabetes [Internet]. USA: National Institutes of Health; 2008 March [updated 2011 December 6; cited 2012 April 4]. Available from: http://diabetes.niddk.nih.gov/dm/pubs/physical_ez/index.aspx

Physical exercise is complicated for children with Type 1 diabetes (most common type of diabetes in children). But with proper guidance, participation of children (age group of 6-18 years) in exercises/sports can be a safe and an enjoyable experience. With the increased prevalence of overweight and obesity, physical activity like playing a sport has become a critical component for weight management in children. This journal article gives you more information related to this topic. http://adc.bmj.com/content/90/12/1215.full

Wolfsdorf J I. Children with Diabetes Benefit from Exercise. Archives of DISEASE IN CHILDHOOD-2005;90:1215-1217.doi:10.1136/adc.2005.082446.

For controlling blood glucose, walking is the best exercise for elderly people with diabetes, especially for those who can’t workout at the gym. Elderly people who are identified as the highest risk for falls seem to benefit from regular exercise. Ideally, an exercise program of balance, strength, flexibility, and walking are shown to reduce the risk of diabetes related complications. However, some people who have a chronic disease, such as a heart condition, arthritis, or high blood pressure etc. should plan their exercise program under the care of a doctor and talk to him/her about the types of physical activity that are appropriate for their health.

Ref: Growing Stronger-Strength Training for Older Adults [Internet].Atlanta, USA: Centres for Disease Control and Prevention; 2011 February 24[updated 2011 February 24 2011;cited 2012 April 27].Available from: http://www.cdc.gov/physicalactivity/growingstronger/exercises/index.html

Exercising for about 30 minutes per session, for at least 5 days a week is good enough. This has been found to be quite effective for controlling blood sugar. Consult with your doctor for the right exercises and time duration for you.

Ref: What I need to know about Physical Activity and Diabetes [Internet]. USA: National Institutes of Health; 2008 March [updated 2011 December 6; cited 2012 April 4]. Available from: http://diabetes.niddk.nih.gov/dm/pubs/physical_ez/index.aspx

For people with diabetes, taking precautions prior to start of an exercise program is as important as exercising itself. Before starting an exercise regime, the first step is to check with your doctor about your health condition. Some vital precautions to take before starting an exercise regime are as follows

• Wear good, protective footwear to help avoid injuries and wounds to the feet.
• Always carry your identification (ID) with you to get quick help in case of emergency
• Ask your doctor whether you should check your blood glucose level before exercising.
• If your blood glucose level is below 100, it is advisable to have a snack before exercise.
•  Drink plenty of fluids to avoid dehydration, as it can raise your blood glucose. Before exercising, avoid alcohol and certain medication which increase the risk of very low blood glucose.

Ref: Exercise-Exercise’s Effects on Diabetes [Internet]. USA: University of Maryland Medical Centre; 2011 [updated 2011; cited 2012 April 29]. Available from: http://www.umm.edu/patiented/articles/what_effects_of_exercise_on_diabetes_000029_4.htm

Check your blood glucose levels soon after exercise and again a few hours later. Check more often after a strenuous workout. If your blood sugar is low, eat a small carbohydrate snack. Look for patterns and changes in blood glucose levels based on the exercise and level of exertion. This will help you identify what changes in medication and food are needed.

Ref: Diabetes Exercise checklist [Internet]USA: WebMD;2005-2012[updated 2012;cited 2012 April 29].Available from: http://diabetes.webmd.com/diabetes-exercise-checklist?page=2

If you think you have low blood glucose while exercising check your blood glucose right away using a glucose meter. If your blood glucose is below 70 mg/dl, follow the “Rule of 15”immediately. It means consume about 15 grams of carbohydrate (1- 2 teaspoons of sugar or honey or ½ cup of fruit juice). Wait for 15 minutes and check your blood glucose levels again. If it is still below 70 take another 15 grams of carbohydrates. If your blood glucose is not below 70mg/dL but it is over an hour for the next meal, have a small snack like a cracker, a small sandwich or half a cup of milk.

Ref: Briscoe JV. Hypoglycemia in Type 1 and Type 2 Diabetes: Physiology, Pathophysiology, and Management. Clinical Diabetes July 2006 vol. 24 no. 3 115-121

Before getting a test done for diagnosing diabetes, your doctor will take your medical history, including information about the symptoms, risk factors for diabetes, past and present medical problems, current medications, allergies to medications, family history of diabetes, personal habits and lifestyle. A number of laboratory tests are available to confirm the diagnosis of diabetes. Talk to you doctor, he/she will examine your health condition and recommend you the kinds of tests you need to get done. You can get it done either at the laboratory or at your doctor’s clinic/hospital.

Robert FJ. Diabetes. Emedicinehealth [Internet]. USA:WebMD;2012[cited 2012 April 30].Available from: http://www.emedicinehealth.com/diabetes/page5_em.htm

Tracking your diabetes is the first step to managing and controlling your condition. This day-in and day-out responsibility is largely up to you, so that you can lead a healthy life.

For a person with diabetes, it is important to track the following:

• Blood glucose
• HbA1c (Glycated haemoglobin)
• Blood pressure
• Blood lipid content (cholesterol)

The most important aspect of diabetes that needs to be tracked is your blood glucose level. Keeping your blood glucose at or near normal can help prevent or delay serious complications such as eye problems, kidney disease and nerve damage.A blood glucose meter brand such as OneTouch has a range of products that can help you track your blood glucose levels.

Ref: Prevent diabetes problems: Keep your diabetes under control [Internet]. USA: National Institutes of Health; 2008 February [cited 2012 April 4]. Available from: http://diabetes.niddk.nih.gov/dm/pubs/complications_control/

Everyone’s blood has some glucose in it. Blood glucose goes up after eating, but 1 or 2 hours later returns to the normal range. According to the American Diabetes Association (ADA), blood glucose targets for most people with diabetes before a meal should be between 70 to 130 mg/dL and one to two hours after the start of the meal should be below 180 mg/dL. Ask your doctor about your personal blood glucose target. A blood glucose meter brand such as OneTouch provides range of meters to meet your needs.

Ref: Prevent diabetes problems: Keep your diabetes under control [Internet]. USA: National Institutes of Health; 2008 February [cited 2012 April 4]. Available from: http://diabetes.niddk.nih.gov/dm/pubs/complications_control/

HbA1C (Glycated haemoglobin) is your estimated “average blood glucose”. The more glucose is found in the blood the more glycated haemoglobin (HbA1c) will be present. This blood test is done at the laboratory or in your Doctor’s clinic every 3 to 6 months. It measures the average amount of blood glucose that has been in your blood over the last 3 months. ‘A1c’ tells your average blood glucose over the past 14 days. Both ‘day to day self-monitoring’ and ‘periodic A1C monitoring’ are necessary to keep careful track of your blood glucose control. Your estimated average glucose is strongly linked to your risk of developing long-term complications of diabetes. The closer your average is to normal levels of 6.5% or below, the better for your health.

Ref: 1. The A1C Test and Diabetes [Internet]. USA. National Institutes of Health; 2011 September [cited 2012 April 10]. Available from: http://diabetes.niddk.nih.gov/dm/pubs/A1CTest/A1C_Test_DM_508.pdf

Ref: 2. American Diabetes Association. Standards of Medical Care in diabetes-2012.Diabetes Care-2012 January; Vol. 35 no. Supplement 1 S11-S63 (http://care.diabetesjournals.org/content/35/Supplement_1/S11.full)

Self-monitoring of blood glucose (SMBG) is an important aspect of modern diabetes management. SMBG has been recommended for people with diabetes in order to help achieve a specific level of blood glucose control. Many people use an electronic meter (glucose meter), a small portable device which accurately measures glucose concentrations in a finger prick blood sample.

Blood glucose is best measured at different times in the day to show levels of blood glucose. The frequency of self-monitoring of blood glucose (SMBG) varies from person to person. Blood glucose is most commonly checked before and after meals, before and after exercise or before bed. Ask your doctor for more information on self-monitoring of blood glucose and how often you should check your blood glucose.To know the procedure for self-monitoring of blood glucose, click on this useful link http://www.mayoclinic.com/health/blood-sugar/DA00007

Benjamin EM. Self-Monitoring of Blood Glucose: The Basics. Clinical Diabetes-2002 Noverber 1;Vol. 20: no. 1 45-47. (http://clinical.diabetesjournals.org/content/20/1/45.full.pdf+html)

You will need the following items for testing your blood sugar levels.

Blood glucose meter - reads the glucose levels in your blood.
Test strip - used to collect blood sample.
Lancet or small needle - fits into lancing device, pricks finger, and provides small drop of blood for glucose strip.
Lancing device - pricks finger when button is pressed. Most devices have dials to select how deep the needle goes into the skin.
The above items are available as part of a kit in all OneTouch meters- a blood glucose meter brand by Johnson & Johnson Ltd.

Several different meters are available to help you check your blood glucose levels. Important features to consider when selecting a blood glucose meter are:

• Accurately display results as per ISO standards
• Conveniently small size, so that it’s easy to carry to work or while travelling.
• The display number must be easy to read.
• Must be easy to use.
• It should require small sample of blood and must give quick results.
•  It must have the ability to check blood glucose in other places besides finger.
• It’s optional to have “data management”, such as tracking date and time of blood glucose results.

OneTouch - a blood glucose meter brand by Johnson & Johnson Ltd. has developed a range of meters that provide these features and more. Click on the below link to know more about it www.OneTouch.in

Ref: Diabetes, Blood sugar testing: Why, when and how [Internet]. USA: Mayo Foundation for Medical Education and Research (MFMER); 1998-2012 [updated 2012 January 24; cited 2012 April 4]. Available from: http://www.mayoclinic.com/health/blood-sugar/DA00007

If you have diabetes, then you may need to make day-to-day and often hour-to-hour decisions about treating your blood glucose, exercise and healthy eating. Making those decisions is much easier if you keep track of that data. But tracking data can be overwhelming.

Diabetes online tools and applications are designed to help you with this difficult task of tracking. The data collected is useful to put you and your doctor on the same page. You can do a lot of things using these tools and applications like, collect self-care data, analyse results with easy-to-read comprehensive graphs etc. You can then act on the results to continuously improve your diabetes management. You can quickly perform a variety of tasks even if you have little computer experience.

Ref: Living with Diabetes [Internet]. Alexandria, Virginia: American Diabetes Association; 1995-2012 [cited 2012 April 10]. Available from: http://www.diabetes.org/living-with-diabetes/treatment-and-care/247.html?utm_source=WWW&utm_medium=ContentPage&utm_content=feature&utm_campaign=247

If a person has been living with uncontrolled diabetes, in the long term it can cause serious health problems. Diabetes related health problems or complications can occur in many different systems in the body, and mostly progresses gradually. Over time, high blood glucose may affect your heart, kidneys, nerves, feet and eyes. It can also put you at a higher risk for heart disease, bone and joint disorders.

Fortunately, most diabetes complications can be avoided or effectively treated with early detection and proper medical care. Appropriate treatment plans and advised lifestyle changes such as healthy eating, physical activity, and good control of blood glucose and blood pressure make a big difference in delaying or preventing such complications.

Ref 1: Diabetes Complications [Internet]. USA: National Institute of Health; 2012 [updated 2012 March 26; cited 2012 April 10]. Available from: http://www.nlm.nih.gov/medlineplus/diabetescomplications.html

Ref 2: Complications [Internet]. Alexandria, Virginia: American Diabetes Association; 1995-2012 [cited 2012 April 10]. Available from: http://www.diabetes.org/living-with-diabetes/complications/?loc=DropDownLWD-complications

High blood glucose also known as hyperglycaemia is a condition caused when you don’t have enough insulin in your body. If your blood glucose level is above 180 mg/dL then your blood glucose is above the target range. It can happen if you forget taking your diabetes medicines, eat too much, or don’t get enough exercise. Sometimes, the medicines you take for other problems may cause high blood glucose.

If you’re very thirsty and tired, have blurry vision, and have to go to the bathroom often, then your blood glucose may be too high. Very high blood glucose may also make you feel sick in the stomach. If your blood glucose is high most of the time, call or visit your doctor at the earliest. You may need to make changes to your diabetes medicines and your life-style.

Ref: National Institutes of Health. Your Guide to Diabetes: Type 1 and Type 2. [Monograph online].Atlanta: U.S. Department of Health and Human Services; 2008.

Low blood glucose, also called hypoglycaemia happens if your blood glucose drops too low. If your blood glucose level is below 70 mg/dl then your blood glucose is below the target range. Hypoglycaemia can be caused by overdose of diabetes medicine, missing / delaying a meal, exercising more than usual, or excessive consumption of alcoholic beverages. Sometimes, the medicines you take for other health problems can also cause blood glucose to drop. Low blood glucose can make you feel weak, confused, irritable, hungry, or tired.

If you feel that your blood glucose levels are dropping, confirm by checking your blood glucose levels right away. If it is below 70 mg/dl follow the”Rule of 15”. That is, take 15 grams of carbohydrate (1-2 teaspoons of sugar or honey or ½ cup of fruit juice)-wait for 15 minutes and check again. If still low, repeat the carbohydrate dose and wait for15 minutes, and check to see if the blood glucose is back to normal range.

Ref: National Institutes of Health. Your Guide to Diabetes: Type 1 and Type 2. [Monograph online].Atlanta: U.S. Department of Health and Human Services; 2008.

Ref: Briscoe JV. Hypoglycemia in Type 1 and Type 2 Diabetes: Physiology, Pathophysiology, and Management. Clinical Diabetes July 2006 vol. 24 no. 3 115-121

One of the major complications of diabetes is cardiovascular disease (related to the heart and blood vessels), which can lead to heart attack and stroke. It also causes poor blood circulation in the legs and feet. To check for cardiovascular disease, you will need to get a blood test done to see how much cholesterol is in your blood (at least once a year), and get your blood glucose and pressure checked at every visit to the doctor. Your doctor may also check the circulation in your legs, feet, and neck.

The best way to prevent cardiovascular disease is to take good care of yourself and your diabetes. Eat food that is low in sodium and saturated fats. Keep your blood glucose, blood pressure and bad cholesterol (LDL-Low Density Lipoprotein) within the target ranges.

Ref: National Institutes of Health. Your Guide to Diabetes: Type 1 and Type 2. [Monograph online].Atlanta: U.S. Department of Health and Human Services; 2008.

High blood sugar (glucose) increases the risk of diabetes related eye problems. The three major eye diseases that people with diabetes may develop and should be aware of are:

Cataracts: It causes clouding of the eye’s natural lens, thereby causing obstruction of external light from entering the eye, thus impairing the vision.
Glaucoma: It occurs when pressure builds up in the eye.
Retinopathy: Diabetic retinopathy is a general term for all disorders of the retina caused by diabetes.

Hence it’s vital for people with diabetes to keep their blood glucose within the target ranges. If you have diabetes, regular visits to your eye doctor for eye check-ups are important to avoid such problems.

Ref: Prevent diabetes problems: Keep your eyes healthy [Internet]. USA: National Institutes of Health; 2008 November [cited 2012 April 4]. Available from: http://diabetes.niddk.nih.gov/dm/pubs/complications_eyes/index.aspx

Kidney problem caused by diabetes is commonly known as nephropathy. Elevated blood glucose levels coupled with high blood pressure (BP) can damage your kidneys filtration process, it may also overburden the kidneys, affecting its functionality. If diagnosed in advance and with proper treatment, progression of the disease can be delayed.

Some tips to keep your kidneys healthy are: --- Keep a regular check on your blood glucose levels and blood pressure. --- Consult your doctor for the choice of medications, diet and physical activity that you can follow to prevent kidney problems.

Ref: Kidney Disease of Diabetes[Internet]. USA: National Institutes of Health; 2008 September [updated 2010 September; cited 2012 April 4]. Available from: http://kidney.niddk.nih.gov/kudiseases/pubs/kdd/

Foot problems are one of the common complications seen in people with diabetes. It is caused by prolonged high glucose levels, leading to the damage of the nervous system or/and to the blood vessels. This can eventually lead to breakdown of the skin of the foot and sores may develop. Identification of the risk factors in the initial stages is effective for the prevention of these foot problems damage that can result in loss of protective sensation in the feet, poor circulation, and poor healing of foot ulcers. All individuals with diabetes should get regular foot examinations done at the doctor’s clinic.

Ref: Feet Can Last a Lifetime: Health Care Provider’s Guide to Preventing Diabetes Foot Problems

[Internet]. USA: National Institutes of Health; 2000 November [cited 2012 April 4]. Available from: http://www.ndep.nih.gov/media/Feet_HCGuide.pdf?redirect=true

People with diabetes may develop nerve damage throughout the body called diabetic neuropathy. It appears to be more common in people who have problems controlling their blood glucose and those with high levels of blood fat and blood pressure.

Different types of diabetic neuropathy are as following; Peripheral neuropathy, the most common type t causes pain or loss of feeling in the toes, feet, legs, hands, and arms. Autonomic neuropathy causes changes in digestion, bowel and bladder function, sexual response, and perspiration. Proximal neuropathy causes pain in the thighs, hips, or buttocks and leads to weakness in the legs. Focal neuropathy results in the sudden weakness of one nerve or a group of nerves, causing muscle weakness or pain.

Ref: Diabetic Neuropathies: The Nerve Damage of Diabetes [Internet].USA: National Institutes of Health; 2009 February [cited 2012 April 4]. Available from: http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/index.aspx

Both men and women with diabetes can develop sexual problems because of the damage to nerves and small blood vessels. This damage can hinder normal functioning of genitals, contributing to sexual dysfunction. Men may have difficulty with erections or ejaculation. Women may have problems with sexual response and vaginal lubrication. People who keep their diabetes under control can lower their risk of early onset of these sexual problems.

Ref: Sexual and Urologic Problems of Diabetes [Internet].USA: National Institutes of Health; 2008 December [updated 2011 December 6; cited 2012 April 4]. Available from: http://diabetes.niddk.nih.gov/dm/pubs/sup/index.aspx