Q. My family has fixed up my marriage with a girl who is distantly related to me. A few days back, she personally told me that she has type -1 diabetes. Now, she is taking insulin injections. I like her openness as she has frankly told me everything about herself. I want to know if this will affect her health in future? Also, will this affect our future child? Can you please clear my doubts?

A. As per information you have provided your fiancee is suffering from Type 1 Diabetes Mellitus (DM). Following information will help you.
Type 1 DM is a disorder which invariably starts in early childhood. Because of antibodies in blood these persons do not produce insulin hormone which is essential for keeping blood glucose under control. Because of deficiency of insulin these patients have high blood glucose levels which cause various problems both acute and chronic (long standing). These patients are dependent upon insulin and must take insulin lifelong to stay healthy.
These patients have to keep blood glucose under control with diet, exercise and insulin. In case they are not able to control then they can land up in complications which can trivial to very serious. For example long standing poor control can cause damage to eyes, kidneys and nerves. If they stop taking insulin or get some infection then can have acute complications like ketoacidiosis. Regarding children, they have higher chances of getting this type of DM.
Now in present era the treatment has changed lives of millions of Type 1 diabetic patients and they are leading healthy, productive and purposeful life. One example is Wasim Akaram the former Pakistani captain.
The bottom line is if treated well and patient can get good family support then can lead near normal life.
I must appreciate the girl ho is bold enough to tell you about her illness before marriage.

Q. I am 43 years old. On a routine check my fasting blood sugar (FBG) was found to be 136 mg/dl and HbA1c was 6.6%. Sometimes, I feel a slight irritation on the penis and thirsty too. Is this condition reversible? My family doesn't have a history of diabetes. Please help.

Q. I am 69 years old and have developed diabetes recently. I am taking glycinorm M40 in the morning; and metformin 500 mg in the night. My sugar levels are very much under control. I walk daily for 15 minutes and take the right foods. I am surprised that even after taking one or two mangoes, my sugar levels are less than normal the next day. My doctor has banned mangoes for me. Is it harmful if I take one or two mangoes?

A. You seem to be doing quite well, overall. After a mango your sugar will probably rise for some time, so if you check post meal values they will be high. By the next morning they will be down again. If you check your post meal (2 hours) values and if they are below 160 despite the mango slice, it is OK. You can then have an occasional mango slice only.

Q. I am diabetic since the age of 25. My doctor said that I am not a juvenile diabetic. At present I am taking Human Mixt Insulin 15 units in the morning and 12 units in the evening. My current levels are under control and have good health. If I am not a juvenile diabetic, then why do I have to take insulin? Can young diabetics have normal children? There was an article in the newspaper, that it is very difficult for young diabetics to get married? How far is it true?

A. You may or may not be dependent on insulin. Your doctor would tell you why insulin was started. But insulin is in any case the best medication for diabetes.
Yes, diabetics do have normal children. If it is male diabetic then no problem at all but if it is female diabetic then during pregnancy a very tight control is required and pregnancy should be by choice and not by chance and blood sugars should be well controlled during pregnancy.

Can a diabetic person go in for a bypass surgery?

Q. My mother is diabetic type II patient. Last year she was complaining of chest pain and when we got some stress tests done, they diagnosed that some part of her heart was not receiving oxygen. So they gave blood thinners like Lipanthyl and also advised her to take CedoCard only if she gets chest pain. We took her to hospital recently and did some overall routine tests and doctor suggested Angiogram. Now she has been advised to get Bypass Surgery done because they think she has 3 blockages in the coronary arteries and they think the blocks are significant. Is bypass necessary because has not been complaining of any chest pain for few months now? What are the risks for a 60 year old female with acute diabetes?

A. Right at the outset, let me tell you that its impossible to give definitive advise regarding bypass surgery without actually seeing the angiography film or having a detailed angiography report. However, going by the fact that she has got blockages in all the 3 major coronary arteries and these are long blocks, I think she would need some kind of intervention. Whether it is angioplasty or bypass surgery, depends on the coronary angiography findings. Lots of patients, especially if they are diabetics, do not complain of chest pain and they remain totally symptom free and the first presentation is heart attack which is a rather serious thing. It is therefore mandatory that these patients should undergo intervention and in your mother's case most probably bypass surgery, as the blockages are long and she is diabetic also. Regarding risks of coronary artery bypass surgery, now days we are doing almost 100% of surgeries without the use of cardiopulmonary bypass or heart lung machine and the risk in these patients have steadily come down. If the heart function is normal and there are no other complicating factors in the form of any damage or blockage of arteries of the brain, then the risk of surgery should be in the range of 1%. However, if the heart is damaged or there are other risk factors involved then the risk may proportionately increase.

What more can I do to control my blood sugar level? Q. I am a senior citizen 75 yrs old. I have fairly healthy habits. I exercise daily for 20 minutes & take a brisk walk in the evening for 30 minutes. I am a vegetarian. I have a fasting blood glucose level of 126 & PP reading of 145. This is the first time it has been high. I am observing practical diet control and do not take sugar in coffee or tea. I have started taking roasted, powdered fenugreek (Methi) one spoon in the morning and one spoon at night. Does fenugreek help in increasing insulin secretion and does it help in keeping sugar level within limits? I would appreciate an answer and any other helpful suggestion, besides the usual diet recommendations. A. Your regular walking would definitely be helping control your sugar levels. Methi also helps, perhaps by making the insulin work more efficiently. In fact, you do need to be careful that initially it does not bring the sugar too low. You should get the blood glucose tested at least every 15 days for the next couple of months, and especially when/if you have any symptoms of uneasiness, palpitations, etc, to rule out low blood sugar. You have not given details of your diet. Over the years we have realized that sugar content in the food is not the only important factor in controlling or preventing diabetes. The total calories, and therefore the fat content of your food, is also very important. If you are overweight, you would also benefit from reducing the fat in cooking and milk. In addition, you need to get some tests done: a. Glycosylated haemoglobin to give you the average blood glucose over the past 8-12 weeks: to be done now and every 4-6 months. b. Blood lipid levels: i.e. cholesterol, triglycerides, LDL and HDL cholesterol. c. Retina examination d. ECG. Can insulin cause acidity? Q. My husband is diabetic for the last 3 months. He is on insulin mixtard 30\70, 15 units in the morning and 10 units before dinner. His sugar is under control (100-110) fasting and (75-108) before lunch and (97-130) before dinner. His BP is normal, goes for a 40-50 minutes walk daily. He is on full diet control. His ECG and TMT tests are OK. Now he has acidity problem; is this related to the dose of insulin? Is insulin dose more than needed? Which more tests are required? His age is 38 years. Due to acidity he feels dizzy also. His mother was also diabetic. What do you suggest? A. Insulin is not responsible for acidity. I feel your husband has type 2 Diabetes and if so he may be safely switched over to oral diabetic medications. The decision of which drug depends upon his weight and associated conditions like high BP, high cholesterol etc. In fact most of the type 2 DM patients who are started initially on insulin due to various reasons can be safely shifted to oral medications. On occasions only diet and exercise are good enough to control blood sugars for variable length of time. Please consult your physician / diabetologist. Diabetic diet Q. Diet in diabetes About 6 months back I had high sugar levels and also my BP was on the higher side. But of late I have a controlled diet and I have also stopped sugar intake and i feel better, much better. however off late whenever I have breakfast, which no doubt used to be frugal, I used to develop a pain on my eyes and there used to be heaviness. So i resorted to a brunch... and I felt much better.Also I have reduced my meal intake from 3 to 2, I do not have any titbits or consume coffee or tea unneccessarily. On the contrary i have no craving for fastfood and oily food either.However i want to know what should be my diet chart and also the kind of routine I should follow. I weigh 80 kgs and i do brisk walking regularly. I also travel a lot and so my food routines really get very upset. What else should I do to make myself more healthy and keeping in mind that I a have a high blood sugar problem. my doctor has not presecribed any drugs for controlling my blood sugar...and yes I do not have any history of diabetics in the family.looking forward to your replythanking you. A. Diet plays an important role in the treatment of diabetes. The diet may be used alone or in combination with insulin injections or oral hypoglycaemic drugs.The diet plan of an individual is based on height, weight, age, sex, physical activity and nature of diabetes. More of carbohydrate must be given as complex starches rather than simple sugars as they breakdown more slowly to release glucose in blood. The presence of fibre in complex carbohydrate like grains, vegetables and other starches slows the glucose absorption. One should emphasise more on the high fibre foods instead of high fibre supplements available in the market.Breakfast :Dalia porridge / milk / tea / coffeeBesan chila / vegetable pan cake / stuffed chapatti / sprouts chatApple / papaya / pear / water melonLunch :2 chapattiWhole moong dal / any dal preferably whole dalAny vegetable sabziCurd / vegetable raitaEvening tea :Tea / coffeeMarie biscuits/fruitDinner :Tomato or vegetable soup1 chapattiPaneer and vegetable subziSaladFruit custardTo remember- It is important to control the amount and time of food intake.- Meals should not be missed.- Try to substitute the craving for sweet by taking some fruit.Foods to be avoidedGlucose, sugar, honey, all sweets, chocolates and candies.Foods to be restrictedPotatoes, yam, arbi, sweet potatoes, mangoes, grapes, bananas, alcoholic beverages, fried foods, paranthas, poories, pakoras, mathris, deep fried foods, dry fruits, salad oils, cakes and pastries.Foods to be used freelyGreen leafy vegetables, tomatoes, cucumber. radish, soups, buttermilk, tea and coffee without sugar.