Keep a check on diabetes to avoid visual impairments

Keep a check on diabetes to avoid visual impairments

Diabetes, if not checked in time, may lead to serious eye problems that may even lead to blindness in later life, health experts have warned.

High blood sugar from diabetes is associated with damage to the tiny blood vessels in the retina, which leads to diabetic retinopathy.

“Diabetes mellitus causes blindness by many mechanisms such as retinopathy, cataract formation (whitening of the lens of the eye), glaucoma (elevated eye pressure) and eye blood vessel blockage,” Md. Ashraf Ganie, Associate Profesor, Endocrinology and Metabolism, AIIMS, New Delhi, told IANS.

The serious eye problems caused by diabetes may show no symptoms or mild vision problems, but eventually it may cause blindness,” he added.

“People with a long duration of uncontrolled diabetes are prone to retinal damage, which may cause either PDR (Proliferative Diabetic Retinopathy), CSME (Clinically Significant Macular Edema — the build-up of fluid in the macula, the vision area at the centre of the retina) or Proliferative Vitreoretinopathy. It can further lead to retinal thickness, retinal detachment and blindness,” Mihir Raut, Physician and Tutor Diabetology at Nanavati Super Speciality Hospital, Mumbai, told IANS.

“Diabetic retinopathy includes swelling in the macula. It can affect either of the genders. Risk increases with increasing age, though it is more dependent on duration and control of diabetes,” said Ritesh Narula, Consultant, Retina and Uvea services, Centre for Sight.

Diabetic retinopathy is an ocular manifestation of diabetes, a systemic disease that affects up to 80 per cent of all patients who have had diabetes for 10 years or more.

Women who develop or have diabetes during pregnancy may also see the rapid onset of diabetic retinopathy.

According to experts, the condition of diabetic retinopathy can develop in anyone who has Type 1 or Type 2 diabetes, but mostly people with Type 1 diabetes are at the higher risk.

Initially there are no symptoms of early diabetic retinopathy. It may depend on the system and organ involved. Most of the diabetic patients are advised to have their eyes checked by an eye specialist on a regular basis.

“The symptoms come in an advanced stage of diabetic retinopathy when one starts experiencing blurring of vision which cannot be corrected by glasses or sudden loss of vision,” Neeraj Sanduja, Senior Consultant, Opthalmology, Fortis Memorial Research Institute here, told IANS.

Apart from eye problems, uncontrolled diabetes can lead to heart problems, stroke, genitourinary problems, nerve damage, foot problems, skin diseases, sexual problems and depression.

Sometimes people with diabetes don’t realise that they have the disease until they begin to have other health problems like heart disease, eye complications, kidney disease, nerve damage, foot problems, skin complications, dental disease, erectile dysfunction and the like,” Mudit Sabharwal, Consultant Endocrinologist at Pushpawati Singhania Research Institute (PSRI) here, told IANS.

Laser treatment is usually very effective against diabetic retinopathy for preventing vision loss if it is done before the retina has been severely damaged. Surgical removal of the vitreous gel (vitrectomy) may also help in improving vision if the retina has not been severely damaged.

“Diabetic retinopathy can be treated with laser or injections in the eye. Advanced cases may need vitreoretina surgery,” Narula added.

Diabetic complications can be prevented by maintaining a good lifestyle, such as maintaining blood glucose values in the normal range by diet, exercise, medication, self-monitoring of blood glucose and yearly screening and a complete body check-up, including the eyes and heart.

“There is no satisfactory treatment for diabetic retinopathy. The key lies in prevention (by good glucose control) and early detection by annual fundoscopic examination by a qualified eye specialist,” Ganie added.


Birth control pills may increase the risk of stroke: Experts

Birth control pills may increase the risk of stroke: Experts

Apart from obesity, birth control pills and additional factors such as smoking, high blood pressure or diabetes may put women at increased risk for the most common type of stroke, health experts suggest.

Oral contraceptives increase the risk of ischemic strokes, caused by a blood clot that blocks or plugs a blood vessel in the brain.

“Women who take birth control pills are slightly at higher risk of stroke as a result of the high estradiol content in these contraceptive pills, which also increases the risk of blood clots,” Vipul Gupta, Additional Director, Neurointervention Surgery, and Co-Director, Stroke Unit, Artemis Hospital, Gurgaon, told IANS.

“The risk also increases for a woman during pregnancy as the increased blood pressure puts stress on the heart. Also migraine can cause chances of stroke three times up in women,” Satnam Singh Chhabra, Head Neuro and Spine Surgeon, Sir Ganga Ram Hospital, added.

Women who smoke are also advised against taking birth control pills as this may increase the risk of a stroke.

Stroke is a serious medical emergency causing premature death and disability. It occurs when blood flow to an area of brain is cut off; brain cells are deprived of oxygen and begin to die.

“A stroke occurs when blood supply to a part of the brain is suddenly cut off. The brain cells in the immediate area begin to die because they stop getting the oxygen and nutrients they need to function,” Gupta explained.

Apart from the ischemic stroke, there is the hemorrhagic stroke caused by a blood vessel that bursts and bleeds into the brain.

“Rheumatic heart disease and atrial fibrillation in younger females is emerging as major cause of strokes,” M.G. Pillai, Head of the Cardiology Department at Nanavati Super Speciality Hospital, Mumbai, told IANS.

When brain cells die during a stroke, the abilities controlled by that area of the brain such as memory and muscle control are lost.

The treatment for stroke may also depend on its type. An ischemic stroke in many cases can be reversed through medicines but only if it is detected within three hours of its occurrence. Treating a hemorrhagic stroke involves finding the cause of bleeding in the brain and controlling it.

“Depending on the damage and overall health of a patient, one can regain the lost abilities to some extent through rehabilitation and medicines,” Chhabra explained.

Unlike ischemic strokes, hemorrhagic strokes aren’t treated with antiplatelet medicines and blood thinners because these medicines can worsen the bleeding.

Advanced scans, such as CT angiography, perfusion imaging and MRI are also done to evaluate the site of blockage and quantify the extent of the brain that can be salvaged.

Gains can happen quickly or over the time depending on various factors like the area of the affected part, how much is affected and the patient’s motivation. The most rapid recovery usually occurs during the first three to four months of a stroke.

“The cure for a stroke depends on the amount of area damaged. If the damage is fatal then it may take months to heal and if the damage is normal, the patient may recover within a week or two,” Kishan Raj, Consultant Neurologist at IBS Hospital, Faridabad, explained.

According to experts, 80 per cent of all strokes are preventable. This starts with managing key risk factors, including high blood pressure, smoking, atrial fibrillation and physical inactivity.

Strokes are life-changing events that can affect a person both temporarily or permanently.

After a stroke, successful recovery will often involve specific rehabilitative activities such as speech therapy, physical therapy to help a person re-learn movements and coordination along with occupational therapy to help people improve their ability to carry out routine daily activities.

Men can also get osteoporosis

Men can also get osteoporosis

Long thought to be a “women’s disease”, osteoporosis can affect men too because apart from the hormonal changes around menopause, factors such as low testosterone levels, sedentary lifestyle choices, excessive consumption of alcohol and smoking or tobacco-use can also contribute to the disease, health experts suggest.

Osteoporosis, which causes bones to become weak and brittle, affects more women because they tend to have thinner bones than men. Moreover, it is also known that as women reach menopause, their vulnerabilities to the disease go up because estrogen, a hormone in women that protects bones, decreases sharply during this time.

“Though women are more prone to osteoporosis it is also found in men, and testosterone being low in levels or deficient, low levels of vitamin D and calcium, lifestyle habits that include smoking, alcohol consumption, and lack of exercise are the primary factors to blame,” Rana K. Chengappa, Clinical Director, Sports Medicine, AktivOrtho, an orthopaedic, neurological and gynaecological rehabilitation centre here, told IANS.

A recent study by researchers at Harvard Medical School found that visceral, or deep belly, obesity is a risk factor for bone loss and decreased bone strength in men.

“It is important for men to be aware that excess belly fat is not only a risk factor for heart disease and diabetes, it is also a risk factor for bone loss,” one of the researchers, Miriam Bredella, told a meeting of the Radiological Society of North America.

Osteoporosis is a serious disease that occurs when the body loses too much bone or makes too little bone. As bones become less dense, they weaken and are more likely to break.

“Osteoporosis mean holes in the bones. This weakening of bones may increase the risk of fractures. The disease itself, though silent, can result in fractures of important bones like hips, spine and wrists,” Sanjay Agarwala, Head-Orthopaedics and Traumatology, P.D. Hinduja National Hospital, Mumbai, explained.

There are many health problems such as celiac disease, inflammatory bowel disease, kidney or liver disease, cancer and rheumatoid arthritis that can also increase the risk of osteoporosis.

“Many health problems like blood disorders, digestive disorders, autoimmune disorders and neural disorders may increase the risk of osteoporosis. Usage of high dosage of certain medicines for a long time may also reduce the bone mineral density,” Pradeep Moonot, Orthopaedic Surgeon, Breach Candy Hospital, Mumbai, noted.

While some of the risk factors for osteoporosis, such as body type, family history and age, are beyond our control, the experts suggested that there are several ways to prevent and control osteoporosis such as getting involved in physical activities, yoga, dancing and aerobics.

“Weight-bearing exercises such as running, jogging, walking, climbing stairs and yoga help a lot in reshaping our bones,” said Vinay Gupta, Head of Department and Senior Consultant, Orthopaedics, Saroj Super Speciality Hospital here.

“Your diet should include low fattening dairy products like toned milk, yogurt and low-fat cheese, fresh fruits and green vegetables,” Chengappa added.

The trouble with osteoporosis is that it is a silent disease and one gets to know only after suffering a fracture after a trivial fall or after a backache investigation that reveals a compression fracture of the spine.

“One of the ways to detect it is to do a Bone Mineral Density (BMD) test which gives us information on bone density,” Chengappa said.
“Women who have achieved menopause and men beyond 70 need to take special precautions to avoid falls,” said Raman Kant Aggarwal, Team Orthopedics, Fortis Escorts Heart Institute in the capital.

The experts also warned that as osteoporosis often limits mobility, it may also lead to feelings of isolation or depression in long-term sufferers.

Heart failure not as life-threatening as heart attack: Experts

Heart failure not as life-threatening as heart attack: Experts

Heart failure may be a serious health hazard but not life-threatening like a heart attack, health experts say.

“Heart failure refers to the heart’s inability to circulate blood through the body. Blood flow is slower than normal, which compromises the blood flow to the vital organs of the body like kidneys, liver and brain, leading to the malfunction of these organs,” Subhash Chandra, Chairman, Cardiology, BLK Super Speciality Hospital, New Delhi, told IANS.

Heart failure is not similar to a heart attack and it is important for people to understand the difference, the experts said.

“Heart failure refers to the condition wherein the blood pumping capacity of the heart is reduced. Heart attack is secondary to blocked coronary circulation. Blood supply to muscles of heart is cut or drastically reduced,” Salil Shirodkar, Interventional Cardiologist at Mumbai’s Nanavati Super Speciality Hospital, told IANS.

According to the experts, two types of heart dysfunctions can lead to heart failure — systolic heart failure and diastolic failure.

Systolic heart failure is the most common cause of heart failure and occurs when the heart is weak and enlarged and the muscle of the left ventricle loses some of its ability to contract or shorten, whereas diastolic failure is when the muscle becomes stiff and loses some of its ability to relax.

As a result, the affected chamber has trouble filling with blood during the rest period that occurs after each heartbeat.

Heart failure is caused by many conditions that damage the heart muscle, including coronary artery disease (CAD), heart attack, cardiomyopathy — disease of a heart muscle.

“The main causes of heart failure are blockages in the blood vessels supplying blood to the heart leading to heart attacks, weakness of the heart muscles either because of unknown reasons or because of some infection, drugs, diabetes, etc.; high blood pressure is also one of the main causes of heart failure,” Vishal Rastogi, Head of Department, Heart Failure Clinic, Fortis Escorts Heart Institute, told IANS.

Heart failure can also occur with heart defects present at birth or congenital heart defects.

“Children with congenital heart defects often have slower growth and development and they may be smaller than other children of the same age. They may also have life-long problems with learning difficulties,” Shantala Vadeyar, Group Medical Director, Department of Fetal and Maternal Medicine, Cloudnine Group of Hospitals, Mumbai, told IANS.

Early symptoms of heart failure are fatigue and shortness of breath. These affect daily activities such as walking, climbing stairs or carrying groceries.

The warning signs associated with heart failure includes acute shortness of breath, coughing or wheezing, accumulation of excess fluid in body tissues, tiredness, fatigue, nausea, lack of appetite and an elevated heart rate.

“Basically your heart tries to compensate for its lack of strength by beating more often to help deliver a sufficient amount of blood to your tissues and organs,” Chandra explained.

However, heart failure can be prevented by having proper diet, daily exercise, swimming, jogging, adequate sleep, and minimising stress and tension.

Diabetic or hypertensive patients should be more careful; they should always take the medications as prescribed by the doctor.

“As of now there’s no known cure for heart failure, but there are steps that can be taken to prevent a weak heart from getting weaker,” Chandra said.

“Controlling hypertension, regular medical follow-up with doctors, non-smoking and alcohol consumption in moderation and lifestyle modifications with an effective mix and match of diet, along with daily exercise, are the key to preventing heart failure,” Shirodkar added.

For children with congenital heart defects, it is not all bad news, as some of these defects may be treatable.

“Many congenital heart defects (CHD) can also be treated and children can lead a normal life. It is important that CHD should be detected in the developing baby so that doctors can counsel parents to help them prepare for possible outcomes and surgical interventions,” Vadeyar said.

Surgery may also sometimes prevent further damage to the heart and improve its functioning.

Obesity may hamper your sexual and social life: Experts

Obesity may hamper your sexual and social life: Experts

Obesity is a major health challenge worldwide. Apart from known health hazards such as heart disease and diabetes, it can also prevent sexual intimacy and may ruin your social life, experts say.

India is home to the third-highest number of obese and overweight people, according to recent reports.

Obesity is categorised on the basis of BMI, which is defined as the body mass divided by the square of the body height and is universally expressed in units of kg/m2, resulting from mass in kilograms and height in metres.

Obesity is often associated with laziness and a sedentary lifestyle, which may often percolate into sex lives as well. In men, it also significantly decreases the time they can maintain an erection.

Men who are obese tend to have lower levels of testosterone — the male sex hormone — that helps in development of male sexual organs and strong bones. The reduced levels of this hormone may at times lead to erectile dysfunction.

“Obesity is directly linked to hormonal imbalance and lower testosterone levels, which, in turn, can inhibit sexual desire in men,” Tarun Mittal, Consultant Surgeon (Laparoscopic and Bariatric Surgery), Sir Ganga Ram Hospital, told IANS.

“The increased body fat leads to more sex hormone binding globulins (SHBG) in the system. SHBG is a natural chemical that binds to testosterone, which means that there is less of the sex hormone left to handle the demands of a normal sex life,” Mittal added.

Also, obesity increases the risk of developing a number of serious health conditions, including coronary heart disease, high blood pressure, stroke, Type 2 diabetes, cancer, sleep apnea, gallstones, other heart disease and various types of cancer.

“Obesity can lead to heart problems, breathing difficulties, joint problems and sudden cardiac death,” Ashish Bhanot, Chief Bariatric Surgeon, Apollo Spectra Hospitals, New Delhi, told IANS.

“With a high risk of diabetes and high blood pressure, obesity may also take an emotional toll, as some may experience depression, feelings of social isolation, discrimination and an overall lower quality of life,” Bhanot added.

Further, apart from the physical intimacy, obesity may also affect the social life, as overweight or obese people are more prone to being bullied, humiliated or ostracised. They are also more likely to engage in bullying behaviour.

The fear of bullying may also lead them to exercise less and stay indoors.

Obesity is directly related to presence of excess fat in the body. Sedentary lifestyle, lack of physical activity, excess consumption of sugars and carbohydrates and lack of exercise are the main causes of the increasing numbers of obesity cases.

However, only a limited number of cases are due primarily to genetics, medical reasons, or psychiatric illness.

“Obesity creates a negative self-image. An individual feels demotivated and there’s lack of self-confidence. Such people are unable to accept their weight and their size can leave them sleeping single in a double bed,” Deep Goel, Director (Department of Bariatrics) and Gastrointestinal Onco Surgeon, BLK Super Speciality Hospital, told IANS.

Successful weight-loss treatments can help in fighting obesity. This may include making dietary and lifestyle changes, such as eating fewer calories and getting involved in physical activities.

Surgeries through laparoscopic or robotic approach are also performed for weight loss. Obesity surgery works by helping to reduce the number of calories that are available in your body. Surgery is the only available method for morbidly obese patients.

Bariatric surgery is recommended for people with a BMI of 40 or more or if they have a serious health problem related to their obesity. Bariatric surgery also helps in reducing 70-80 per cent of excess within 6-9 months.

Most of the experts say that the natural way of reducing obesity is by controlling the diet and exercising.

“The best way to overcome obesity is by making certain positive lifestyle changes, exercising and adopting a proper fat-loss diet. A healthy lifestyle eventually helps to overcome diseases and enhances the quality of life,” Rachit Dua, a Delhi-based advanced certified fitness coach and nutritionist, told IANS.

“Saturated fats do not make you fat, excess of sugar and carbohydrate does. So it is generally advised to strictly stay away from sugars and trans fats. Also, do not over-exert your body with exercise, gradually increase the intensity,” Dua suggested.

Daily stress can kill your sex life: Experts

Daily stress can kill your sex life: Experts

Regular stress can not just hamper your peace of mind, affect sleep and weaken your immunity, but prolonged periods of high stress and anxiety can increase blood pressure and cholesterol levels, leading to erectile dysfunction (ED) which will hamper your sex life, experts have warned.

ED is an inability to develop or maintain an erection during the sexual activity. It can have severe psychological consequences as it can limit your intimacy, affect your self-esteem and impact your most important relationship.

“Stress can be responsible for ED. It affects the psychological state of mind where stimulation may not result in erection even if other things are normal,” explained Dr. Vipin Tyagi, surgeon (Robotic and Kidney Transplant) at Sir Ganga Ram Hospital.

ED can happen to men at any age but the risk increases with age. The condition may also significantly increase the mental and emotional stress. Men often have a hard time coping with it.

“While the stress and anxiety are understandable, men should not be hesitant to talk but make a conscious effort to address it. Speaking to someone – either their partner, a family member, a friend or a professional consultant about their condition may ease their stress,” Dr. Rajeev Kumar, a urologist at the All India Institute of Medical Sciences (AIIMS), told IANS.

According to Dr. Ashish Sabharwal, a urologist with Fortis Escorts Hospital, common physical causes of ED includes cardiovascular diseases (CVD). And related conditions like high cholesterol, high blood pressure, diabetes, obesity and metabolic syndrome further increase the risk of ED.

The condition becomes chronic if left unattended for several years but early diagnosis and right treatment can prevent serious side effects like diabetes or cardio-vascular issues.

Oral medications can successfully treat ED in most of the men. Medications can also be injected directly into the penis. According to experts, testosterone replacement may be needed if ED is caused by low levels of testosterone.

“Hormone therapy or surgery can treat the physical causes of the problem and there are penis pumps and penile implants available that can help get an erection,” Rajeev Kumar added.

While a penis pump usually gets removed after an intercourse, a penile implant is more permanent and is inserted surgically into the penis.

“In rare cases, vascular reconstructive surgery might be needed to improve blood flow to the penis,” Rajeev Kumar stated.

Eating food rich in flavonoids such as blueberries, cherries, blackberries, radishes, blackcurrants, apples, pears and citrus products trims down the risk of erectile dysfunction in men, especially in those under 70, a collaborative study from the University of East Anglia (UEA) in Britain and Harvard University in the US recently revealed.

A combination of consuming flavonoid-rich foods with exercise can reduce the risk of ED by 21 percent, the researchers said.

“Apart from the medicines, the most important thing is psychological counseling. ED can be the first indicator of many serious problems like diabetes mellitus , cholesterol or heart disease,” Tyagi said.

Erectile dysfunction can manifest in several ways. If you find that the time it takes for you to achieve an erection has increased significantly or you’re having difficulty maintaining an erection long enough to have intercourse or the frequency of spontaneous erections has decreased, consult a doctor to check for ED.

“Men should make it a point to visit a licensed andrologist or urologist to receive the right counselling and treatment instead of going to fake sexologists or traditional healers,” Sabharwal pointed out.

The bottom line is: Do not hesitate to meet your doctor early to avoid embarrassment in bed.

Binge eating may also trigger depression

Binge eating may also trigger depression

Next time you munch on that mouth-watering pizza with extra cheese or enjoy a king-size burger with French fries and soft drink, remember that too much of junk food can not only add extra kilos around your belly but may lead you to depression, warn experts.

Binge eating episodes lead to obesity which, in turn, causes depression owing to weight stigma, poor self-esteem and reduced mobility.

On the other side, depression may also lead to obesity as such people tend to engage in “emotional binge eating” to deal with the pain of rejection, have poor sleep patterns and turn into couch potatoes.

“Some people especially suffering with atypical depression tend to eat more, sometimes in binge pattern. Owing to increased eating, there is weight gain which leads to further exacerbation of depressive symptoms, explains Ashish Kumar Mittal, MD psychiatry from the All India Institute of Medical Sciences.

“In such people, eating relieves stress for brief duration by providing distraction from disturbing thoughts,” he says.

A typical depression is a subtype of major depression that involves increased appetite or weight gain, sleepiness or excessive sleep, marked fatigue or weakness, mood swings and a feeling of rejection.

“The most common cause of depression is neurotransmitter (a substance in the body that carries a signal from one nerve cell to another) imbalance in the brain, especially involving serotonin and norepinephrine,” Mittal told IANS.

Increased appetite or weight gain, sleeplessness or excessive sleep, fatigue or weakness and anxiety are general symptoms of depression.

People suffering from depression generally eat in binge pattern to comfort themselves but it may be comforting only for a while as it becomes a vicious cycle of eating more to feel better — then feeling worse.

“Psychologically or biologically, it is believed that eating leads to a release of certain chemicals which lead to satisfaction or relaxation. We do have patients who binge eat because of depression,” adds Dr Manish Jain, senior consultant (psychiatrist) from BLK super speciality hospital in the capital.

Apart from depression and stress, other causes of binge eating are lack of confidence, loneliness, family history (related to genes) and hormonal deficiency. Binge-eating disorder is also defined as uncontrollable, excessive eating, followed by feelings of shame and guilt.

People with eating disorders develop habits that can cause a great deal of harm. They may diet, exercise or eat excessively which can have life-threatening or even fatal consequences, including atypical depression.

Experts feel that women suffer a great deal more than men on this front owing to biological and psychological factors. A typical depression is seen two to three times more commonly in women than in men.

“Women suffer twice as compared to men from depression because of multiple factors like hormonal, social position or economic position,” says Jain.

“The most affected age group is 40s but I would like to add that depression is a disease which can occur at any age,” Jain warns.

According to a recent report by the World Health Organisation (WHO), depression is a common illness worldwide, with an estimated 350 million people affected by it.

“People suffering from depression should avoid isolation, substance abuse and unsupervised medicine use. Patients should seek treatment for medical issues, if present,” advises Mittal.

Patient should communicate his suffering to his close family members so that they can help him or her in need.

“It is always better to seek professional help in cases of depression to prevent self harm, social and occupational complication. Treatment of depression is done by proper medication and psychotherapy,” Dr Mittal adds.

Binge eating can be controlled by maintaining a healthy lifestyle, getting engaged in creative work, avoiding junk food, alcohol and smoking and eating balance diet in intervals, the experts advise.