Category: General

It is not unusual for someone with diabetes to experience fatigue despite normal glucose levels. This persistent tiredness can stem from various factors beyond blood sugar control.

Diabetes itself: Fluctuations in blood sugar, even within normal ranges, can affect energy levels. This could happen especially when taking medicines like sulphonylureas and insulin. Certain diabetes-related complications like heart disease, especially heart failure, may cause exhaustion in addition to shortness of breath on exertion.

Psychological Aspects: Depression and anxiety are prevalent among those with diabetes, often leading to increased fatigue. The mental burden of managing diabetes can also be overwhelming.

Lifestyle Influences: Lack of physical activity, poor sleep quality, and being overweight significantly contribute to fatigue. Regular exercise and a balanced diet can help mitigate these effects.

Medications: certain medicines for managing diabetes complications, like medicines for neuropathy and blood pressure, may cause tiredness.

Dietary aspects: sometimes, poorly designed and restrictive diets, which may provide inadequate calories and low protein, may cause fatigue.

Other diseases: people with diabetes may have other diseases like thyroid diseases, adrenal problems and anaemia, which may lead to tiredness

Understanding the multifaceted nature of fatigue is crucial for effective management and improving overall well-being in diabetes patients. Talk to your doctor to find a reason for your fatigue.

Dr.Mathew John MD,DM

The time it takes to see results from intermittent fasting depends on your specific goals.
The benefits of short-term intermittent fasting are promising for weight loss, gut, and metabolic health. Long-term intermittent fasting will be needed for lifelong health benefits like decreased inflammation and reduced risk of chronic disease.

Intermittent fasting yields noticeable results within 1-4 weeks, including weight loss, improved energy levels, better blood sugar control, and reduced inflammation. By 4-12 weeks, expect continued weight loss, improved insulin sensitivity, lower blood pressure, and enhanced fat burning. After 3-6 months, significant weight loss (3-8%) and improved body composition are achievable, alongside enhanced metabolic health, reduced chronic disease risk, and improved mental clarity.

Realistic expectations include:
– Weight loss: 0.5-1 kg/week
– Improved health markers (blood pressure, cholesterol, blood sugar)
– Increased energy and mental clarity
– Reduced inflammation and oxidative stress

For optimal results, consider:
– Starting slowly and adjusting your fasting schedule
– Eating nutrient-dense foods during your eating window
– Staying hydrated and managing hunger pangs
– Monitoring progress and adjusting your approach
– Consulting a healthcare professional before beginning

Dr. Tittu Oommen MD, DM

It is very common for people with various medical conditions to do IF. People with diabetes may be on multiple oral medicines or insulin when planning to fast. People with heart disease may be on various drugs to control their blood pressure and heart health and to prevent blood clotting. They must discuss this with their physicians before starting IF.

The general principles are as follows:

• People with type 1 diabetes should observe IF only with caution. They should be fully aware of the actions of insulin, risks of hypoglycemia and diabetic ketoacidosis, and collaborate with their doctor for the same.
• People with type 2 diabetes on medicines that do not produce low glucose can observe IF. However, they should discuss the spacing of medicines in relation to their food and fasting time.
• People with type 2 diabetes on insulin or other agents that reduce blood glucose should consider dose adjustments of their medicines during IF.
• Certain medicines like statins, aspirin, and medicines for heart health (like beta blockers, ACE inhibitors, and SGLT2 blockers) may be required irrespective of weight loss. The safety of IF in people with compromised heart function is not known.
• When people lose weight, the dose of blood pressure medicines may require a change. Hence, discuss with your health care provider before trying IF and start only after getting the concurrence of the doctor and dietician.

Dr. Deepa G, MHSc (Diab), Dip (Diab)

During intermittent fasting, it is essential to monitor the food intake. People on IF have a reduced caloric intake compared to those on a regular diet. For most people on IF, regular food intake during the feeding interval will compensate for the nutritional requirements, including protein and vitamins. However, not everyone is the same.

People with obesity often have multiple nutritional deficiencies, such as Vitamin B12, Vitamin D, retinol, beta carotene, iron, and iodine. These deficiencies may worsen when these individuals go on a calorie-restricted diet or IF. Many vegetarians also go on IF. They are also bound to have Vitamin B12 deficiency, for which most sources are of animal origin.

Unfortunately, the research in this area is minimal in terms of concrete suggestions for people observing IF. The general tips are as follows.

1. Longer IF or calorie restriction duration may result in micronutrient or protein deficiency.

2. Certain food habits or avoidance of certain foods (e.g. dairy products) may result in deficiencies of specific micronutrients.

3. It is advisable to consult with a qualified dietician to see if the diet followed during IF/calorie restriction is adequate to meet nutritional requirements.

4. Consumption of a multivitamin tablet to meet the recommended dietary allowance of vitamins and minerals is recommended in most people on IF.

If you are already taking medicines, you should consult with your treating physician to see if you can continue them during IF.

Dr. Mathew John MD, DM

Intermittent fasting is a powerful approach to improving overall health and losing weight. By incorporating one of these four methods into your lifestyle, you can experience numerous benefits, from weight loss and improved metabolism to reduced inflammation and increased longevity. There are various types of intermittent fasting.

16:8 Intermittent Fasting

This simple and sustainable method involves eating during an 8-hour window and fasting for the remaining 16 hours. This method can easily be incorporated into the person’s daily routine, such as skipping breakfast or delaying dinner.

5:2 Intermittent Fasting

For those looking for a more intense approach, the 5:2 method involves eating regularly for 5 days and limiting calories to 500-600 on the other two days.

Eat-Stop-Eat

This unique approach involves fasting for 1-2 non-consecutive days per week, allowing eating freely on the other days. It is a great way to simplify your eating schedule and reduce overall calorie intake.

One Meal a Day (OMAD)

For the most dedicated individuals, OMAD involves eating only one meal daily and fasting for the remaining 23 hours.

A person who decides to do IF can adopt any of these measures according to their wish. It is not known if one method is better than the other. However, consulting with a healthcare professional before starting OMAD is essential, as it may not be suitable for everyone.
Remember, it’s crucial to consult with a healthcare professional before starting any new diet or fasting regimen, especially if you have any underlying health conditions. With the right approach and mindset, intermittent fasting can be a powerful tool for transforming your health and well-being.

Ms. Revathy V. K, MSc

Before starting intermittent fasting (IF), consider the following points:

1. Consult a healthcare professional to ensure IF suits your health. If you have diabetes or hypertension and you are on medicines, talk to the endocrinologist about adjusting the same.

2. Consult a qualified dietitian to determine the best IF type for you and receive guidance throughout the process.

3. Ease into fasting by starting with shorter periods and gradually increasing duration. If alternative days of fasting make you tired, move to fasting for 24 hours to a time-restricted eating pattern.

4. Focus on nutrient-dense meals after fasting, including:

– Low-calorie, high-protein foods (pulses, legumes, fish, eggs, lean meats)
– Dietary fibres from vegetables and fruits
– Good fats and complex carbohydrates
– High-protein, low-carb meals at the end of your eating period

5. Stay hydrated by drinking 3-4 liters of water daily.

6. Avoid unhealthy foods like junk food, deep-fried foods, sweets, and sugary beverages.

7. Manage hunger pangs during fasting with:

– Aerobic exercise
– Meditation
– Herbal or black tea without sugar

8. Be mindful of your emotions and distinguish between true hunger and hedonic drive to eat.

Remember, it’s essential to listen to your body and adjust your approach as needed. With patience and persistence, you can successfully incorporate intermittent fasting into your lifestyle.

Ms. Sreekutty S, MSc

Intermittent fasting (IF) has taken the world by storm as a highly effective dietary approach for weight loss. Celebrities and individuals alike are embracing this ancient practice, which involves alternating periods of eating and fasting to promote overall health and well-being. But how does it work?

The Science Behind Intermittent Fasting

IF is based on the simple concept of restricting your eating window, allowing your body to enter a fasting state for an extended period. When you fast, your liver glycogen stores are depleted, and your body switches to burning fat for energy, a process known as metabolic switching. This leads to fat loss while preserving muscle mass.

The Benefits of Intermittent Fasting

IF has a profound impact on metabolic regulation, influencing circadian clocks, gut microbiota, and lifestyle behaviors. By restricting food consumption to daytime hours, IF leverages circadian biology to improve metabolic health. The benefits are numerous:

• Improved insulin sensitivity
• Reduced cholesterol and blood sugar levels
• Enhanced physical performance
• Improved thinking and memory ability

Combining Intermittent Fasting with Exercise

Studies have shown that combining IF with moderate aerobic exercise increases fat oxidation and leads to significant fat loss. This makes IF an efficient dietary plan for weight loss, with noticeable results in as little as a month to three months.

By understanding the science behind IF and incorporating it into your lifestyle, you can unlock a host of benefits and achieve your weight loss goals. Consult with a healthcare professional to know how you can get the benefit of IF.

Ms. Sreekutty S, MSc

Vaccines are usually used to prevent diseases caused by viruses or bacteria. There are various viral diseases which may lead to cancer, and we have vaccines that prevent them. Here are some of them

1. HPV vaccine: Human papillomavirus (HPV) causes cervical cancer in women. It can also cause cancers of the anus, vagina, oropharynx, head and neck. Vaccines against HPV, like Gardasil and Cervarix, reduce the risk of cervical cancer and genital warts. Various variants of these vaccines can be used to prevent infections with various strains of the virus.

2. Hepatitis B vaccine: The Hepatitis B virus causes acute hepatitis B, which may lead to chronic hepatitis, cirrhosis and hepatocellular cancer. Hepatitis B vaccine prevents hepatitis B, reducing the risk of hepatocellular cancer.

HPV vaccines are recommended for girls and boys from 9 years of age. If the vaccination age is less than 14 years, two doses are given at six months intervals. If the person is 15 years or older, three vaccine doses are used. Since there are different types of HPV vaccine, it is essential to discuss the type of vaccine and its particular schedule with your doctor.

Mrs. Rejitha Jagesh M Sc

Pneumonia, a severe lung infection, affects people of all ages. Pneumonia can lead to hospitalization and death, especially in those who are young and old, those with other illnesses like diabetes, kidney disease, heart disease and those who are immunocompromised.

Infective pneumonia can be bacterial or viral origin. Among the viruses, influenza A and B are common viruses, along with COVID-19 and respiratory syncytial virus. Pneumococci, followed by Hemophilus influenza, cause the most common bacterial pneumonia in the community. Various atypical organisms also cause pneumonia.
Various vaccines can help prevent different forms of pneumonia. Some of the commonly available are

1. Pneumococcal vaccines: common ones include Prevenar and Pneumovax 23. These vaccines are given according to the medical conditions and age of the person
2. Flu vaccine: quadrivalent flu vaccine is used annually to prevent influenza (commonly called H1N1!)
3. Hemophilus influenza B: mostly in children
4. COVID vaccine: various types of vaccine against SARS-CoV2
5. BCG: against tuberculosis
6. Respiratory Syncytial Virus: a vaccine is available against RSV
7. TdAP: against tetanus, diphtheria and pertussis

In our patients with diabetes, we recommend routinely using flu and pneumococcal vaccines to reduce the risk of infections. Talk to your doctor to see if you require any vaccines.

Dr. Deepa G, MHSc (Diab), Dip (Diab)

Influenza, often called the flu, is an infection of the nose, throat and lungs. The flu is caused by a virus. The reports of illnesses and deaths by the H1N1 virus and H3N2 virus reported in the news recently are various varieties of flu.

Most people with the flu get better on their own. However, influenza can cause severe complications for some groups of people. In general, people at higher risk for complications are young children, especially children aged 12 months and younger, pregnant women, adults over age 65 and people with certain medical conditions like asthma, diabetes, kidney & liver diseases, etc. Flu is well known to trigger heart attack and stroke in older people. In people 65 years of age and older, flu-related hospitalisation and deaths are increasing each year.

Flu vaccination prevents more than 100,000 flu-related hospitalisations annually. The flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 50%, resulting in less hospitalisation, fewer ICU admissions, and fewer deaths. Also, among people with diabetes and other chronic diseases, flu vaccination has been shown to be associated with reduced hospitalisations due to the worsening of their chronic conditions. More people getting vaccinated with the flu vaccine will prevent the spread of infection.

In many countries, flu vaccination is a part of their national immunisation program. This includes the USA, the UK, many European countries and Gulf countries. It is taken as an annual vaccination. Speak to your doctor whether you require a flu vaccine.

Dr. Tittu Oommen MD, DM