Advanced Diabetes Treatment from Best Hospitals in India – Diagnosis and Surgery

diabetes

DIABETES MELLITUS – The Sweet Silent Killer is a disease that occurs due to a problem in insulin production or insulin uptake by the body cells. Type 1 or Insulin dependent Diabetes mellitus (IDDM), affecting the children and adolescents is associated with little or no insulin production by the pancreas as the pancreas (beta cells) is defective. Type 2 or Non-Insulin Dependent Diabetes Mellitus affecting the middle aged and elderly obese individuals with sedentary lifestyle and poor eating habits, is associated with the problem in insulin uptake and subsequent glucose metabolism by the body cells. Both conditions can be very disabling if not managed correctly as uncontrolled rise in blood sugar levels can damage the eyes, kidney, heart, nerves, foot, skin etc. Timely treatment is essential to prevent loss of vision, kidney failure, paralysis or even amputation

diabetes endocrinology Treatment and Management of diabetes has revolutionised in India over the years with the focus of management shifting from treatment of complications to their prevention through control of blood sugar levels.World class care and state of art diagnostic and treatment facilities are now available at many hospitals across India. The diabetic centres are run by highly experienced Endocrinologists specialising in the management of diabetes and diabetic educators who counsel the patient about the disease and help them to manage their condition better. These centres also boast of skilled surgeons who can carry out vascular surgery bariatric surgery on these patients. Dieticians work towards the patient’s diet and Physiotherapists work on foot care, weight reducing exercises and lifestyle modification of these patients, providing a holistic approach to treatment of Diabetes.

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These centres provide globally accepted diagnostic and treatment options like:

1. Magnetic resonance angiography done to study the condition of the blood vessel. Any narrowing of the blood vessels supplying the heart, brain, eyes, nerves and legs can be visualised using radio opaque dye. The dye highlights the narrowed portion of the artery.

2. Advanced digital foot pressure measurement to diagnose any developing wound or ulcer in the foot. It can also check for defective blood supply in the foot that can cause gangrene.

diabetes-check 3. Glucometer is used by patients to check their blood sugar levels daily. These are designed keeping in mind any visual disability or hand tremors that affect the patient. Daily values are recorded which are then seen by the doctor at the time of visit.

4. Continuous Glucose Monitoring System is the latest FDA approved technology for home use by the patient. A tiny sensor, fitted under the skin of the patient, measures the sugar levels in the tissue fluid and sends radio waves that are recorded on a pager like device. It can measure continuously over a period of 72 hours. The sensor needs to be replaced after a week. The values are downloaded and reviewed during doctor visit.

5. Encourage activity and diet log by patients to understand their exercising and eating habits for accurate advice.

diabetes pump 6. Insulin Pump is a lifesaving device for the patients with type 1 diabetes. The device supplies slow acting insulin on continuous basis to the patient which reduces the need for daily oral medications or painful injections. They keep the glucose levels around the baseline preventing any sudden spikes or lows helping in better management.

7. Bariatric surgery is recommended for highly obese individuals whose weight cannot be lowered through dietary restrictions or structured exercises. Generally men over 100 kg and women over 80 kg are advised to go for this surgery if the excess weight is causing joint pain, high blood pressure, increased cholesterol and stress on the heart. The surgery is done to decrease the food intake or reduce the absorption of food nutrients. The techniques involved are :

Adjustable gastric banding: An inflatable band is used to reduce the size of a patient’s stomach restricting quantity of food consumed at a time. Fastest and least invasive weight loss surgery technique that can be reversed if required.
Vertical sleeve gastrectomy: Restricts food intake by removal of major part of the stomach. The vertical sleeve gastrectomy procedure is irreversible.
Roux-en-Y gastric bypass: Roux-en-Y gastric bypass, a popular procedure combines both principles of bariatric surgeries- restricting food intake and reducing absorption of nutrients by the body. The stomach is cut into two parts. The upper part is connected directly to lower part of small intestine, thus reducing food intake and areas for food absorption.
Bilio-pancreatic diversion with a duodenal switch: This procedure is like gastric bypass. However, a lesser portion of the stomach is removed in this case and the small intestine is bypassed. This technique is not very popular as it is the most complicated of all weight loss surgeries.
Bariatric Surgery can be an open or a laparoscopic one the latter being preferred by most patients as it less painful, does not generally cause post-operative complications and involves less recovery time.
Post-surgery a patient needs to religiously follow a strict diet and exercise regimen to keep the weight under control. In many cases patients may also require to undergo further surgery to deal with loose fat.

diabetes-causes 8. Diabetic Foot – Care And HBOT Poor blood supply to the nerves of the legs results in diabetic neuropathy in which patient complains of loss of sensation, pain and tingling in one/both legs. The foot becomes vulnerable to wounds that do not heal resulting in ulcers. Amputation is done to save the limb in such cases. At Diabetic centres, patients are taught proper foot-care, early wound detection and its management. Hyperbaric (HBOT) is the latest technique to treat stubborn un-healing ulcers. Poor blood circulation causes poor oxygen supply to the wound leading to delayed healing. Pressurised pure oxygen is supplied to the wound-bed to facilitate healing in HBOT.

diabetes-causes 9. Diabetic Vascular Diseases Diabetes makes small and big arteries vulnerable to thickening. Increased plaque formation causes narrowing of arteries (Atherosclerosis) affecting the blood supply to the heart, brain, kidney, eyes, nerves primarily. Treatment of vascular diseases involves bypass grafting, stenting, angioplasty to removal of blockages and surgeries to correct retinopathy, nephropathy and neuropathy.

10. Diabetic Eye Disorders diabetes-causes Diabetic retinopathy refers to eye diseases primarily caused by long-term, high and uncontrolled blood sugar levels, leading to damage of blood vessels in the retina. The longer a person has diabetes, the higher their chances of developing diabetic retinopathy and increased risk of developing cataract (clouding of eye’s lens) and glaucoma (increase in fluid pressure inside the eye), leading to optic nerve damage and loss of vision.

Signs & Symptoms Many people with early diabetic retinopathy have no symptoms before major bleeding occurs in the eye, the same holding true for proliferative retinopathy as well. At this advanced stage, there is high risk for vision loss. About half of the people with proliferative retinopathy also have Macular Oedema, where fluid leaks into the centre of the macula, causing blurred vision. This can also develop without any symptoms whatsoever. Don’t wait for symptoms, because it may be too late to save complete vision.

But some of the symptoms given below may occur:

Blurred vision and slow vision loss over time
Floating opaque spots
Shadows or missing areas of vision
Trouble seeing at night
Sudden bleeding from the eye

Treatment of Diabetic retinopathy Better control of blood sugar levels, high blood pressure and high cholesterol levels slows the onset and progression of retinopathy Proliferative retinopathy is treated with scatter laser treatment If the bleeding is severe, a surgical procedure called a vitrectomy, is employed to remove the blood from the centre of the eye. It may also be used to repair retinal detachment Low vision services and devices may be used to help those who have already suffered some vision loss due to diabetic retinopathy

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I had so many apprehensions and concerns prior to coming to India for surgery that I needed badly to regain my health. "Thanks for your always prompt responses to my volley of questions and concerns. I could not have managed even a step without your staff's excellent care. I couldn't be happier with the Indian hospitals, surgeon, physicians and their expertise. Everyone is very professional yet compassionate. All staff nurses and doctors are very attentive. My stay during treatment in India was very comfortable

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