Exercise reduces insulin resistance: Dr. Kovil

crop2_240x240_24mar14Dr. Rajiv Kovil is a Consultant Diabetologist at Dr. Kovil’s Diabetes Care Centre, the first Preventive Diabetes Centre & Diabetic Foot Clinic in Mumbai, KLS Memorial Hospital and Holy Spirit Hospital among others. He is a founder member of United Diabetes Forum, a forum of practising diabetologists in India. He has also written various articles on diabetes for medical journals such as Asian Journal of Diabetology and Medical Image.

His Preventive Diabetes Centre & Diabetic Foot Clinic is an initiative to provide preventive diabetic measures as well as to function as a specialized Foot Clinic for diabetic patients not only in terms of equipment but more importantly in terms of expertise.

Dr. Rajiv Kovil answered Sify readers’ queries related to the above in an exclusive chat. Read the transcript below.

which are the fruits good for diabetic person?
sweeter the fruit smaller the size

any life style changes needed for diabeties ?
diabetes is a lifestyle disorder… change habits to improve outcomes

what medicine is good for daiabeties?
your doctor is your best guide there are 7 groups to choose from

From what age should tests be done to detect diabetes?
no age is risk free.from a very earlyu age if there is a family history

Is it possible to cure diabetes completely?
no it is not

What kind risks revolve around adolescent diabetes?
childhood diabtes needs an etiological classification..it needs proper evaluation before one can decide on therapy and risks

adolescent diabetes if occurs can be controlled or can it be cured completely?
can be controllled

What are the many causes for adolescent diabetes?
children don’t play they are infront of the computer plus an enormous amount of study stress

My son is 12yrs. He has no control on his appetite. Is slightly overweight. Please guide. I am worried for him since I have heard about adolescent diabetes.
make him play and stop watching te idiot box and playing video or comp games

What are the right fats in a diet for a Diabetic?
the amount of fats is important..a balanced fat intake with a right mix of saturated and unsat fat is required

What are the right carbohydrates in a diet?
its always the amount..reduce carb c ontent in food

Should fruit juices and soft drinks be completely avoided by Diabetics doctor?
preferably yes.. in small amounts accepted

What is your suggestion on the daily calorie intake for Diabetes 2 patients for men as well as women?
it has to be decided taking into consideration your weight bmi your activity and complications

What are the risk factors of Diabetes 2?
sedentary lifestyle, poor eating habits, lack of exercise,.. heredity loads the gun you pull the trigger

What kind of complications can occur due to diabetic foot?
diabetic foot is the largest cause of non traumatic amputations in the world

What are the early symptoms of diabetic foot?
tingling numbness to absent sensations

Is it safe to apply some kind of moisturiser or cream on foot daily?
yes apply never rub

I am a female aged 40 yrs. Sometimes my toe nail goes pale and goes for a recycle completely. Why does this happen?
could be fungal infection on the nails ..

What type of footwear is advised? Closed shoes or open sandals?
wide toe box, well fitting heel id what is recomended

Doctor I want to know about foot care. What precautions should we take on daily basis?
don’t walk bare foot.. use appropriate footwear, get the foot evaluated annually

Does eating in small portions help to prevent or control diabetes?
yes that’s the best way to treat glycaemic excursions

With so much information on other diseases being cured completely why do you think Diabetes is still being controlled and not cured?
diabetes is a disorder hence can only be controlled

What is your say on the treatment of Diabetes in India?
we need more structured care and better follow ups of patients and a lot of public awartenesss

crop1_240x240_24mar14Can a diabetic monitor one’s condition at home? How?
yes glucometers are good and a fantastic tool

What areas are generally affected by diabetes doctor?
diabetes can naffect every system, heart kidney , nerves and eyes are the common affections

Are there any symptoms if the blood sugars go low?
multiple symptoms from sweating to palpitations.. anything abnormal n a diabetic first consider low sugars

Does diabetes also relate to some vitamin deficiency?
no

Do potatoes and bananas raise one’s sugar levels for a normal person as well? So should their intake be avoided or should it be reduced?
these are products which have high glycaemic index and preferably restricted

Is sugar consumed from fruits safe for diabetics?
yes fruits can be consukmed in limited amounts

Are wheat chapattis not good enough to prevent diabetes? Should it be replaced by multigrain or any other grain? Please guide.
it is always the amount of starch rather than the type of starch

Does consuming green vegetables everyday prevent diabetes? Have they to be leafy?
include raw in your food daily yes it helps

What about sweeteners, artificial/ herbal?
artificial sweeteners are safe and can be used to sweeten tea coffee and milk

Sir what do you have to say about the diabetic chocolates and sweets available in market today? Are they safe?
diabetic sweets are sugar free they are not caloric free.. artificial sweeteners are safe

I am 27yrs female very fond of chocolates. Is it okay to have a chocolate bar 3-4 times a week?
eating sweets doesn’t increase your risk of diabetes..and even the nvice versa

What is your suggestions to a diabetic who has high blood pressure?
high bp and diabetic kidney and heart disease go hand in hand.. get a proper screening opn target organs

I want to know about the symptoms and types of Diabetes dr.
type 1, type 2, secondary diabetes and diabetes in pregnancy.. most are asymptomatic except type 1

When and why does gestational diabetes occur?
pregnancy and placental hormones induce insulin resistance which in individuals whose pancreas cannot compensate will develop GDM

What all precautions should a woman take doctor to prevent diabetes?
there is no gender discrimination. eat well, on time , limit carb portions, eat early and exercise daily

Can diabetics conceive a healthy baby Sir?
if you are t6yalking abpout alady with diabetes. she is what we call pregestation diabetes. she needs proper pre conceptional counselling a programme and can conceive only when her metabolic parameters are fine

If one of the parent has diabetes, is it that the child will also get diabetes at some stage of life?
the chance is 3o percent.if both parents have it increases to about 70 percent

Does diabetes diagnosis mean no sweets at all?
no it doesn’t.. it means monitored eating using meal plans and exchange plans.. eating sweets without reason is an addictive behaviour

How to keep a check on one’s carbohydrate intake everyday to control diabetes?
we are a carb eating population. stop the count of rotis per person. include raw food. reduce the oil consumption at source..

How helpful is a glucose monitor?
glucose monitors area tool to guide patient and doctor ,..if used rightly it will surely improve outcomes

Can you guide on blood sugar monitoring?
depends on whether the patient is on insulin, oral drugs , has complications or id pregnant.. usually premeal plus bedtime is
what we advise

Are there any side effects to Diabetes medications or Insulin?
each medicine which has an effect will have a side effect., there is vigilance across the globe.none have life threatening or organ threatening side effects

Please give some important diet tips to prevent Diabetes. Thank you.
eat according to time and not hunmger. eat early , have small frequent meals, have early dionners, include atleast 3 servings of salads in ur food daily

Should white rice be completely avoided to prevent diabetes?
White polished rice has a high glycaemic index. it increases the blood sugar rapidly. again exchange meals by reducing carb content inother foods one can have rice in limited amounts

How does exercise or any other physical activity help to prevent diabetes?
exercise has multiple benefits.it reduces insulin resistance which is the core defect in diabetes. it reduces sugar, blood pressure, lipids and reduces the stickiness of blood

How many tsps of sugar is healthy on per day basis?
if you are a well controlled diabetic you can have exchange meals where the carb is substituted from the food and sugar can be taken

Good afternoon Dr. Is diabetes only about controlling our sugar intake?
no diabetes is a vascular disorder sugar is the trigger but it is a diffuse disorder and affects all systems. a comprehensive check up is rewcomended regularly

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