Managing Diabetes: Dr. Hiren Patt’s Expert Advice for Mr. Patel
Dr. Hiren Patt, an Endocrinologist, guides a 24-year-old male named Mr. Patel through tests, diagnosis, and management of diabetes. The consultation covers understanding diabetes types, testing procedures, lifestyle changes, ideal weight recommendations, and dispelling myths about curing diabetes. Dr. Patt emphasizes the importance of medication compliance for kidney/liver protection. The narrative follows Mr. Patel's journey towards controlling his diabetes with lifestyle modifications and medical treatment, addressing concerns about side effects.
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Presentation Transcript
How to Manage DM ? Dr Hiren Patt D.M. (Endocrinology)
Mr Patel 24 years/male Height Weight 160 68 Mother & Father: DM Glucometer (RBS) 186
Am I Diabetic ? Dr Hiren: Need to do proper tests. FBS PPBS HbA1c
Am I Diabetic ? Dr Hiren: Need to do proper tests. Mr Patel 138 214 6.6 % FBS PPBS HbA1c
Am I Diabetic ? Dr Hiren: Need to do proper tests. Mr Patel 138 214 6.6 % DM 126 200 6.5 % FBS PPBS HbA1c You have DM
Pre-DM FBS PPBS HbA1c 100-125 140-199 5.7-6.4 %
Types of DM Type 1 DM Type 2 DM DM in pregnancy Other types
Reason for DM at 24 years? Family h/o DM Mr Patel: But, They got DM at 50 years of age Dr Hiren: You are overweight Mr Patel: My weight is only 68 kg
Ideal Weight Height 155 160 165 170 Ideal Weight 53 56 59 63 Overweight: 12 kg
Can I Cure DM ? You can t cure DM, but you can control DM Mr Patel: Can I cure my DM with Karela juice? Dr Hiren: No
Mr Patel Started walking: 20 min/day Karela juice: 1 glass/day After 3 month 156 244 FBS PPBS 138 214
Mr Patel Comes Back Mr Patel: What should I do ? Dr Hiren: You have to take Rx Mr Patel: I am worried that it will damage my kidney/liver Dr Hiren: This is not a pain killer. In fact by controlling your DM, it protects your kidney/liver from getting damaged by DM.
Mr Patel: What are the side effects of medicines ? Dr Hiren: Not much. 1) stomach upset 2) low sugar
Mr Patel: I want to take minimum medicines. Dr Hiren: Ok. That s possible. I need weight loss of 8 kg. Mr Patel: How do I lose weight ? Dr Hiren: Tell me your diet & activity.
Daily diet Breakfast: 2 bhakhri + 1 cup tea (buffalo milk) Lunch: 3 Roti + 1 bowl sabji + 1 bowl rice + 1 bowl dal + butter milk Evening snack: samosa/vada pao/sandwich + 1 cup tea Dinner: 1 bhakhri + 1 bowl sabji + 1 bowl khichdi + 1 glass milk
Activity 8 am wakes up 9 am breakfast 10 am to 6 pm - M.B.A. Executive (sitting job) 7 pm dinner 8 pm to 8.30 pm walking (3-4 days/week) 8.30 to 10.30 pm - T.V./laptop
Weight = Savings Savings = Earning expense If you want to lose weight Reduce your earning (diet) Increase your expense (exercise)
Reduce your Earning Carbohydrate Fat Potato Sweet potato Sweets Maida Bhakhri Thepla Paratha Naan Kulcha Soft drinks Juice Oil Butter Ghee Fastfood Junkfood Packaged food Fried food
Preferred diet Fruits: Apple, orange, mosambi, papaiya, watermelon Salads Veg soup/Tomato soup Green vegetables Sprouts/dal Buttermilk/low fat milk Egg white
Mr Patels New Diet 9 am: 1 cup tea/milk (low fat) + sprouts 11 am: 1 fruit + 4 almonds 1 pm: 1 salad + 1 green veg + 1 dal + butter milk + 1 roti 4 pm: 1 fruit + sukha bhel/veg soup/tomato soup 7 pm: 1 salad + 1 green veg + 1 roti/half khichdi + butter milk + 1 dal 10 pm: 1 cup milk + 2 walnuts
What About Expense ? 8 to 9 am: table tennis 9 to 10 pm: walking
Glucose Monitoring Mr Patel: How frequently I should check sugar levels ? Dr Hiren: FBS/PPBS (monthly), HbA1c (3 monthly)
Glucometer Mr Patel: Is Glucometer readings accurate? Dr Hiren: No. But, still you can use it as per the doctor s advise.
Mr Patel After 3 months Lost 10 kg weight Weight: 68 -> 58 kg FBS 105 PPBS 132 HbA1c 5.6 %
Mr Patel: Is DM under control? Mr Patel 105 132 5.6 % DM - Control < 130 < 180 < 7 % FBS PPBS HbA1c
Mr Patel: What will happen if DM is not controlled ? Dr Hiren: Retina (Eyes) damage Heart attack Kidney failure Brain stroke Foot problems Infections
Monitoring for Complications of DM Once in a Year Kidney Creatinine Urine Alb/Creat ratio Eye Liver Heart Cholesterol Foot Fundus SGPT, SGOT BP, ECG Lipid profile Examination
Conclusion Experience (not weight) should increase with age Weight management (Diet & Exercise) are more important then medicines Periodic sugar monitoring & consultation with doctor is must
