All About Positive Health

My senior colleague was treating a patient for penile infection since some days  but there is no regression of the ulcer .To-day he appeared before me to tell that he urinated somewhere and caught the infection and subsequently the ulceration of penis.This man was in his fifties.This is the usual statement of a patient .I do not understand the rationality.Anyway this patient does not know his diabetic status and my collegue neither bothered to go for that.Several patient with a undiagnosed diabetes mellitus present with with ulceration of penis.The infection of glans and prepuce combined called balanoprosthitis.Now I have ordered  for fasting and post-lunch blood sugar estimation.A culture and sensitivity test of pus as well as a routine and and microscopic test of urine also has been ordered.Even somebody not being a frank diabetic might be suffering from a pre-diabetic state called an impaired glucose tolerant.Here the blood sugar levels are more than prescribed limit but not sufficient to stamp as diabetic.The blood sugar level is something like below.There are several values prescribed by different diabetic associations.

Normal level                      Impaired Tolerance                     Diabetic

Fasting                                   60-110 mgs/dl                         110-126 mg/dl                                       >126mg/dl

Post lunch                                 <140mg/dl                           140-180mg/dl                                     >180mg/dl

Diabetic catch infection in skin and other parts easily.Here, as per researchers the resistance to infection decreases.The white blood cell responsible for the defense against invasion of microbes did not reach the site and there is a dysfunction .So even a trivial infection spreads quickly.

Monitoring the status of diabetes is most important.Many of my patients when asked about the recent value of their blood glucose would give a strange reply.That is I am taking medicines and my ulcer is healing nicely and I do not feel anything bad.These are good personal assessment nevertheless one should go for  regular check up of blood glucose at least in an interval of six months after stabilization .Sometimes blood glucose remains above the strict control level and below the overt level and may not give much of symptoms. And silently eat into the system.
   Monitoring the Glycosilated haemoglobin level once in six months will give a correct idea about the blood glucose level in the last three months. The idea is that when blood glucose level memains constantly above the normal value it gets attached to the haemoglobin inside the red blood cells and that is reflected in the estimation.In addition to it glucometer of good brand can be used to self monitor the glucose level which gives a near normal value .If somthig is suspected from it the glucose level should be confirmed in a good laboratory.
In addition to it estimation of fat component in the blood is also important as this is the friend of high blood glucose level .Together they work out to give the patient a heart attack.

Monitoring of glycosilated haemoglobin level ,blood glucose level in a glucometer and estimation of blood lipids will go hand in hand with a good control of diabetes mellitus.
We call it diabetes mellitus because there is something called diabetes insipidus and renal  diabetes(glycosuria).We will see them later. 

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In India many skip breakfast for various reasons.Ladies specially skip it with a plea that they are busy in household work.These persons many a times suffer from gall bladder stone,obesity and diabetes.
   After the over night fasting ,in the morning body needs energy to start the day’s work.The gall bladder stores and concentrates bile.Bile secretion is stimulated by intake of food and particularly mixed with fatty food.During the night as there  is a fasting state and it remains stored.When one takes breakfast it is empties to mix with the food to help in digestion of food particularity fats.Skipping breakfast keeps the stored bile for longer period of time and in the long run it may get infected to form particulates on the bacterias initiating stone formation.Also it is likely that the concentrated bile is prone for particle formation as such.That bile to fat ratio must remain within normal range.
   Skipping breakfast prompt the individual for interval eating which may fall to a habit ending up in excessive food intake as well as calorie. This in is tern reflected in making the individual obese and the chain reaction of diabetes,hypertension and the kidney diseases etc.

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   So it is ideal to start the day with a good balanced breakfast.In our part it is told that ‘take the breakfast like a prince,lunch like a king and night meal like a beggar’.But here there is rise in incidence of gall bladder stone disease because the saying is seldom followed.

GOOD BREAKFAST MEANS GOOD HEALTH

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