Centre for Excellence- DIABETES MELLITUS

Vision & Mission

To create awareness on root cause for diabetes which will ultimately help to reduce the prevalence rate
To carry out research on diabetes with alternative medicine which will ultimately help to improve the treatment of patients with diabetes.
To set up centres of excellence in diabetes across Pondicherry & Tamilnadu]
To help individuals without diabetes to live a full and healthy life

Diabetes Mellitus
When there is a lack of insulin / insufficient insulin secretion (Type I) or cell resist to uptake glucose even in the presence of insulin (Type II) leads to “Diabetes Mellitus”. Result’s in abnormally high amount of glucose in the blood stream causing from frequent urination to premature death. During 2012 about 1.5 million deaths due to diabetes making 8th leading cause of death.

Diabetes Mellitus- Just ahead
In India numbers climbed from 11.9 million in 1980 to 69 million during 2015. Awareness and education is the key role especially in screening, control and better management for diabetes and more than 80% of population well aware about diabetes, but still India is second largest, next to China in diabetes population. By 2030, India will become the DIABETES CAPITAL of the world with estimate to have 79,441,000 cases and WHO also project that diabetes death will double between 2005 and 2030.

Prevention is better than cure
About 99% of the awareness studies and education based only on treatment aspect like symptoms, screening, management, complications etc but scanty on preventive aspects by creating knowledge and awareness on root cause for diabetes for which the people must be sensitized to change their life style. Prevention is better than cure -Diabetes prevention should be the public health priority in order to reduce death and financial burden, warrants awareness and research focused on preventive efforts rare than treatment.

Root Cause for Type 2 Diabetes

Hereditary
Diabetes may be inherited and has a tendency to occur in families, it may be there is an increased risk of them developing diabetes in later life.

Stress
Physiological response to stress is an activation of the hypothalamic-pituitary-adrenal axis and subsequent release of corticosterone from the adrenal cortex which stimulate a rapid access to stored energy (fat & glucose) to help the body to react faster. The cortisol facilitates a quick release of glucose from the liver into the bloodstream, and this helps to accelerate the heart rate, raise blood pressure and strengthen muscle in order to fight or flee. When the danger is over, normal people regain their normal relaxed state quickly because the normal body have the ability to secrete more insulin to restore the excess of glucose in the bloodstream back into the liver. However, human body may not cope with this process cycle, especially when stress persists for a longer period of time (chronic stress). As the excess of glucose build-up in the bloodstream, causing hyperglycemia, and thus results in Type 2 diabetes.

Obesity
Overeating, stresses the endoplasmic reticulum membranous inside the cells. When the endoplasmic reticulum has more nutrients to process than it can handle, it sends an alarm signal to dampen down regulation of the insulin receptors on the cell surface. This translates to insulin resistance and to persistently high concentrations of the sugar glucose in the blood leads to type 2 diabetes.

Western diet
Rich in over-refined sugars, refined oils, highly refined & saturated fats rich omega 6 with trans forms of fatty acids, animal protein, polished grains and less plant-based fibres, low nutritional value with high glycemic food leads to unviable of essential fatty acids omega 3 of cis form, inturn cells readily take the availale Omega-6 or trans forms by which the ratio of Omega6: Omega-3 essential fatty acids ratio of 1:1 on cell member was reduced to >20: 1 reduce insulin receptor on the cell membrane, artificial ‘trans’ replacing the naturally occurring ‘cis’ form by which cell membrane showed more rigidity by reducing the fluidity and permeability for most of the substances including glucose and high glycemic index food quickly digest and absorb into the blood stream leads to shoot-up glucose in the blood stream immediately after food intake.

Less Physical activity
Physical activity is nothing but any form of movement that result in burn calories, which includes simple walking, cleaning, gardening, playing etc in our day to day life. Mechanism behind the physical activity in relevant to diabetes is that upon physical activity utilize stored glycogen found in muscle are utilized by which excess glucose in the blood stream can be stored again as glycogen in the muscle by which maintained glucose level in the blood. As muscle cell lacks glucose-6-phosphatase that stored glycogen cannot be converted into glucose to release in the blood stream as like liver. Hence stored glycogen should be utilized by the muscle cell only upon physical activity. Due to technology and modern living have removed many regular forms of physical activity for our daily actives like, walking / bicycling replaced with bike and cars, stairs replaced with elevators, washing machines replaced our cleaning cloths by hands, dishwasher replaced dishes washed by hand, lifting water from the well replaced with pump-motors, grinding flour and grains by hand mill replaced with electric Mixer Grinders, even children and adolescent were left their physical games like cricket, football, kabadi etc to online internet games in computers, tablet and smart phones of screened based recreation leads less physical activity result in type 2 diabetes.

So far through this Centre for Excellence

More than 10,000 school & college students get sensitized on root cause for type 2 diabetes on preventive aspect
Apart, more than 32,000 general healthy public get sensitized on root cause for type 2 diabetes on preventive aspect

Target
To sensitize more than 5,00,000 students and general healthy population in Pondicherry and Tamil Nadu to sensitize the root cause for type 2 diabetes on preventive aspect to reduce the prevalence rate in future.

Services

Diabetic awareness classes on preventive aspects
School health programmes for diabetic awareness on preventive aspects
Free medical camps
Free blood glucose estimation
Free insulin distribution for poor patients

To Have | Not To Have | Frequently Asked Questions | Reach Us

Have regular physical activity to utilize glycogen stored in the muscles by muscle cell
Have healthy food rich in omega-3 fatty acids of cis forms with rich in fibre content
Have traditional, non-tropical vegetable oils
Have green leaves vegetables
Have Low glycemic index food (brown rice, wholegrain, carrots, cauliflower, mushrooms) for slow digestion and release of glucose in the blood slowly & steadily
Have food only when you feel hungry don't dump & clock your diet
Have whole grains and seeds

How blood glucose level maintain in the body?
The consumed food materials is metabolized to release as glucose in the blood stream, inturn beta cells secrete insulin which aids the glucose to get into the cells for normal metabolism (fuel energy for the cells), then excess glucose are stored as a glycogen in the liver and muscle cells. When blood glucose level too low, the level of insulin declines and glucagon makes the liver to convert stored glycogen into glucose which is released into the blood stream, makes the blood glucose level back to the normal level.

What is diabetes?
Lack of insulin / insufficient insulin secretion (Type I) or cell resist to uptake glucose even in the presence of insulin (Type II) leads to “Diabetes Mellitus.

What is random plasma glucose?
RPG test done at any time of the day to check the blood sugar level. If the RPG value is ≥200 mg/ dL (11.1 mmol/L) of blood, it indicates that the person may diabetes.

What is fasting plasma glucose?
FPG tests done after 8–10 hours overnight fasting before breakfast. An FPG value ≥126 mg/dL (≥7.0 mmol/L) indicates that the person has diabetes.

What is Glycated haemoglobin?
Glycated haemoglobin (HbA1C) measures how well the blood glucose has been controlled over the past 3 months. If the HbA1C is ≥6.5% (47.0 mmol/ mol), it indicates the presence of diabetes.

What is Oral glucose tolerance test?
OGTT is checked in the fasting state and then 2 hours after drinking a certain amount of glucose, if the 2-hour value is ≥200 mg/dL (11.1 mmol/L), it indicates the presence of diabetes.

What is pre-diabetes?
Prediabetes is a condition in which the blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. If the HbA1C is between 5.7% and 6.4%, or the FPG is more than 110 mg/dL but less than 126 mg/dL, or the OGTT (2-hour glucose test) is between 140 and 199 mg/dL, then condition is said to be pre-diabetes.

What is insulin resistance?
Insulin resistance (IR) is a pathological condition in which cells fail to respond normally to the hormone insulin.

What is gestational diabetes?
Gestational diabetes is a temporary type of diabetes that develops during pregnancy (gestation).

What is meant by essential fatty acid?
Omega 3 and omega 6 are called essential fatty acids, since it Cannot be synthesized in the body and Must be obtained only from external food source

What are the foods rich in omega-3 fatty acids?
Flax seed oil, Walnut, fish oil, Salmon fish, spinach, soybeans, Chia seed, Oysters

How beta cells damaged in type 1 diabetes?
It is an autoimmune disease were Beta cells damaged by their own host antibody

Why insulin resistance observed in type 2 diabetes?
When endoplasmic reticulum has more nutrients to process than it can handle, it sends an alarm signal to dampen down the insulin receptors on the cell surface. This translates to insulin resistance and to persistently high concentrations of the sugar glucose in the blood leads to type-2-diabetes.

Why insulin receptor decline in the cell membrane?
Less intake of omega-3-fatty acids essential fatty acids of cis and intake of rich omega 6 fatty acids in Trans forms leads to disappearance of insulin receptors in the cell membranes.

Which form of fatty acid is good for health?
Polyunsaturated fatty acids (PUFA) is good for health since it is liquid in the room temperature as well as in the refrigeration, while unsaturated fatty acids liquid only in the room temperature and saturated fatty acids solid in both room and refrigeration temperature. As liquidity make more permeability of the cell membrane to intake glucose and other materials.

Whether Cis or Trans form of fatty acid is good for health?
‘cis’ configuration in a natural unsaturated fatty acid has hydrogen atoms on the same side of the carbons, resulting in a kink in the fatty acid chain, more permeability and good for health. Hydrogenation of oil, on the other hand, places hydrogen atoms on opposite sides of the carbon in a so-called trans configuration, causing the hydrocarbon chain to be relatively straight, much like a saturated fatty acid, more rigidity and become solid in the room temperature.

Why physical activity/ exercise regularly are good for health?
As muscle cells lack glucose 6-phosphate, the glucose stored in the form of glycogen in the muscle cell must be utilized only by the muscle cell, as like liver it cannot be release glucose into the blood stream. Hence only through physical activity by doing exercise the store glycogen should be utilized.

What is Low glycemic index (LGI) food?
Those food materials which are slowly -digested, absorbed & metabolized, by which release glucose in the blood slowly & steadily example:

What is meant by glycation?
Glycation is the covalent bonding of glucose to a protein or lipid molecule by which destroys the function of many enzymes leads to insoluble, harder, less elastic.

Why retina (retinopathy) and kidney cell (nephropathy) are damaged in diabetes patients?
As glucose diffuse without the aid of insulin in Nerves & Brain, RBC, Retina and Kidney cells leads to the formation of glycation results in retinopathy, nephropathy and neuropathy.

Why wounds are not healed quickly in the diabetic patients?
Formation of glycation in the arterial & capillary wall becomes hard, less permeable to nutrients, oxygen, resist for diapedesis (phagocyte cells squeezed out form the circulation to the infected area (tissue) to engulf foreign particles) and become rigidity, hence no new blood vessels are formed near the wound area to heal.

Why type 1 diabetes patients looks lean?
The starvation cells requires glucose as an energy for normal metabolism. Since type 1 diabetic patients lack insulin production, glucose available in the blood stream cannot be utilized by the starved cells leads to elevated blood glucose in the bloodstream. Also the stored glycogen in liver are released as glucose in the blood stream leads furthur elevation in glucose concentration. To obtain energy , fats stored especially in the adipose tissues are breakdown and released in the blood stream. Hence, type 1 diabetic patients appears lean physically but have high blood cholesterol level.

Why type 2 diabetes patients looks so obese?
In the presence of insulin + glucose in blood stream, insulin convert the glucose into saturated body fat and stored in the adipose tissue from liver and make the patient obese.

When ketoacidosis is formed?
Especially in type 1 diabetes when cell are starved for glucose. Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids and accumulation of keto acids that the pH of the blood is substantially decreased.

How to prevent diabetes?
Everyone should have

Physical activity with low glycemic food intake
Avoid Western style food with omega 6 fatty acid / trans- unsaturated fatty acids
Avoid refined foods and oils
Split the quantity of food from 3 to 5 times a day
Ensure food rich in omega-3 fatty acids with cis-unsaturatted fatty acids
Avoid gluten based food items to avoid generation of auto antibodies

Centre for Excellence- DIABETES MELLITUS

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