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Handling diabetes during pregnancy
Common shoulder injuries: ensure early diagnosis
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Handling diabetes during pregnancy
To prevent excess spontaneous abortion and congenital malformations in infants of diabetic mothers, diabetes care and education must begin before conception. Planning is a must for pregnancy. There are no contraceptive methods that are specifically contraindicated in women with diabetes. The selection of a method should focus on its proven high degrees of effectiveness. Gestational diabetes is a condition that develops during pregnancy. The mother has an abnormally large amount of sugar in her blood. It usually resolves itself after the baby is born, unlike other types of diabetes which are lifelong conditions. Diabetes develops when the body can't produce enough insulin, a hormone made by the beta (ß) cells of the pancreas. Insulin regulates the amount of sugar available in blood for energy, and enables any sugar that isn't immediately required to be stored. Your body has to produce extra insulin to meet your baby's needs, especially from mid-pregnancy onwards. If your body can't manage this, you may develop gestational diabetes. Your blood sugar levels may also rise because the hormonal changes of pregnancy interfere with insulins function. If you are found to have sugar in your urine when you go in for the antenatal check up, your doctor will probably suggest that you have what is called a random blood glucose test to get a more accurate estimate of the amount of sugar in your blood. If the result is high, you will be referred for a glucose tolerance test. Women at the risk of diabetes mellitus are generally obese, older mothers, women with a parent or sibling who is an insulin-dependent diabetic, women with a family history of type 2 diabetes, women with high blood pressure. In case women are on oral medication for preventing diabetes, it should be stopped long before planning a pregnancy. We generally suggest women to move to insulin injections and a healthy diet prior to planning a pregnancy.
Problems for mothers with GDM The main problem with having too much sugar in your blood is that it crosses the placenta to your baby, which means that he can grow very large. A big baby may make labour and delivery more difficult and your chances of needing a caesarean section are increased. There is more likelihood of your baby being jaundiced or having breathing problems if he has to be born surgically. During pregnancy, there is increased incidence of diabetic retinopathy and exaggeration of pre-exiting retinopathy in the case of an expectant mother with GDM.
Problems for babies born to mothers with GDM Some researchers believe large babies are more prone to obesity later in life. As adults, they are also more likely to develop diabetes. Babies born to women who were diabetic before they became pregnant have a greater risk of health problems -- especially if the pre-pregnancy diabetes was poorly controlled.
PREVENTION OF GDM A few women with very severe gestational diabetes that can't be controlled by diet and exercise may be prescribed insulin injections. You may even be taught how to give these to yourself. Whether you need insulin injections or have a milder form of gestational diabetes, your baby will be monitored closely and you will probably be advised to have frequent ultrasound scans to check on how he is growing. It would be wise to invest in a glucometer to monitor your blood sugar levels before and after the meals every day at home. This will also help your doctor chart your blood sugar levels and keep an eye on your baby's wellbeing as well.
TESTING FOR GDM Ideally, all pregnant women should be tested to rule out gestational diabetes. Screening should be done between 24-28 weeks in all pregnant women of average risk. It should be done earlier as soon as possible, even at first initial visit, in patients with a high risk of GDM (marked obesity, personal history of GDM, glycosuria, or a strong family history of diabetes, or a bad obstetric history). If they are found not to have GDM at that initial screening, they should be retested between 24 and 28 weeks of gestation. The writer is Senior Consultant, Fortis Hospital, Mohali
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Common shoulder injuries: ensure early diagnosis Shoulder
problems are commonly encountered in the form of muscle pain, decreased range of motion which are easily rectified by conservative treatment vis-a-vis rest, etc. Rotator cuff injury, dislocation, overuse injuries need to be diagnosed early and treatment initiated in time. Shoulder afflictions affect muscles and tendons rather than the bones. Muscles and ligaments provide stability and motion to the shoulder. Ligaments of the shoulder are relatively lax in comparison to other ligaments in the body to allow an extensive range of motion. These muscles/ligaments undergo a great amount of stress particularly during overhead activities. Generally, individuals ignore the pain and underestimate the extent of injury as steady pain, weakness in the arm and limitations of joint motion become part of the daily routine. Causes Activities involving excessive, repetitive, overhead motion while playing golf, swimming, tennis and weightlifting, etc. During falls. Injury while lifting heavy objects. Most power lifters experience some form of shoulder pain/injury while bench press/lifting overhead weights. When ignored, pain aggravates forcing many to abandon the sport. Symptoms
The usual shoulder problems experienced are the following: Instability: Occasionally, the shoulder joint moves out of its normal position. This may result in subluxation/dislocation of the shoulder joint. Such individuals will experience pain when raising their arm. There is a feeling as if the shoulder is slipping out of place. Impingement occurs when activities require excessive overhead arm movement. Impingement is caused by excessive rubbing of the shoulder muscles against the top part of the shoulder blade called acromion. Rotator cuff injuries: Rotator cuff comprises a group of muscles and tendons that hold the bones of the shoulder joint together while playing golf, swimming, tennis and cricket. These muscles are under constant pressure to keep the humeral head in the glenoid cavity. Muscle weakness with enhanced stress can cause injury or tear of rotator cuff muscles. If not treated well in time, chronic instability and muscle weakness occur. Treatment Home treatment in the form of rest (in a sling) helps. Medication often can help relieve minor aches and pains. The key to recovery is motion. The main deterrent to motion is pain which can be treated in the following manner:
Exercises The following exercises, when done
correctly, go a long way in early and effective recovery Shoulder roll — Standing arms by side, move the shoulders forward and then backward 10 times. Pendulum exercise — Standing leaning over with the affected arm hanging, swing the arm in small circles 20 times clockwise and anti-clockwise. Rotator cuff stretch — Moving the bent elbow at a 90-degree angle towards the other shoulder. Simultaneously, with the other hand, push the elbow towards the shoulder until a stretch is felt over the shoulder. Hold the stretch for a count of 20. Internal/external rotation using the resistance band — Attach the resistance band to doorknob/ wall. Stand with the right side to the wall. Hold the resistance band with the right hand, bending elbow at 90-degree angle, the hand facing forward with the elbow close to the body. Rotate your hand towards the middle of the body. Return to the starting position. Repeat 10 times. Next stand with the left side to the wall. Hold the resistance band with the right hand. Start with the right hand in the middle of the body, the elbow bent at 90-degree. Stretch slowly by moving the arm outwards until the back of the hand facing backward. Repeat 10 times. Arriving at a correct diagnosis is the key to effective treatment of serious injuries. This calls for awareness and early detection by the affected individual. This goes a long way in effective, optimum and early rehabilitation. The writer runs a pain management
clinic in Chandigarh.
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Sleep disturbances decrease after retirement
WASHINGTON: Retirement brings with it a sharp decrease in the prevalence of sleep disturbances, says a new study. The findings of the study suggest that this general improvement in sleep is likely to result from the removal of work-related demands and stress rather than from actual health benefits of retirement. According to the results, the odds of having disturbed sleep in the seven years after retirement were 26 per cent lower (adjusted odds ratio of 0.74) than in the seven years before retiring.
— ANI
Junk food diet 'can give
you depression'
LONDON: People who indulge in diets high in processed food face an increased risk of depression, says a new study. To reach the conclusion, researchers at University College, London, examined the link between the diet and depression. Lead author Dr Archana Singh-Manoux discovered those who ate lots of vegetables, fruit and fish had a 26 per cent lower risk of future depression. On the other hand, a mainly processed food diet, such as sweetened desserts, fried food, processed meat, refined grains and high-fat dairy products, left consumers with a 58 per cent higher risk of depression, reports the British Journal of Psychiatry.
— ANI
Too much diet soda can
damage your kidney
WASHINGTON: Too much diet soda can lead to a decline in kidney function among women, say researchers. The team from Brigham and Women's Hospital has found that individuals consuming a diet high in sodium or artificially sweetened drinks might be damaging their kidney. "There are currently limited data on the role of diet in kidney disease," said Dr Julie Lin, MPH, FASN of Brigham and Women's Hospital. "While more study is needed, our research suggests that higher sodium and artificially sweetened soda intake are associated with greater rate of decline in kidney function." Lin added. — ANI
Hepatitis B doesn't raise
pancreatic cancer risk
WASHINGTON: Contrary to popular opinion, hepatitis B doesn't appear to increase the risk of developing pancreatic cancer, say researchers. However, the overall analysis has revealed that only age is significant predictor for pancreatic cancer. Hepatitis B is an inflammation of the liver caused by a viral infection. "We looked at the incidence of pancreatic cancer among hepatitis B-infected patients over a 13-year period and found that we could not confirm a higher risk for those with a previous exposure to hepatitis B, as a prior study suggested," said Dr Jeffrey Tang, gastroenterologist at Henry Ford Hospital and lead author of the study.
— ANI
Long-term mobile phone use can 'spark tumour rise'
LONDON: A new British study suggests that the long-term use of mobile phones can create up to 1,500 cases of brain tumours per year over the next 20 years. The team led by radiation expert Dr George Carlo reviewed 23 major studies on the effects of cell phones on users to conclude that people using phones for 10 years or more had 34 per cent more chances of developing brain tumours. The report included over 12,000 patients who had developed brain tumours and 25,000 who were tumour-free and has been published in the Journal of Clinical Oncology.
— ANI
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Diabetes