Dr Rajiv Desai
An Educational Blog
Novel Approach to Diabetes Mellitus
Novel Approach to Diabetes Mellitus: ________ The figure below shows diabetic patient self-administering insulin injection: ________ My novel hypothesis on diabetes mellitus (DM): _ Everybody knows that insulin is the only treatment of type 1 diabetes mellitus (T1DM). However in type 2 diabetes mellitus (T2DM) diet, exercise, oral hypoglycemic agents (OHA) precede insulin therapy and only when OHA fails or severe diabetes at onset warrant insulin therapy. There are reports of short term early insulin therapy in all T2DM to protect b-cells of pancreas. I propose a hypothesis that every T2DM patient needs insulin treatment from day one of diagnosis and it ought to be continued indefinitely. By the time diagnosis of diabetes is made, 50 to 80 % of b-cells of pancreas are dead (dysfunctional). The logic is that exogenous insulin will reduce load on surviving b-cells of pancreas, protect surviving b-cells and achieve better glycemic control and […]
SELF MONITORING (MEASUREMENT) OF BLOOD GLUCOSE (SMBG)
_______ SELF MONITORING (MEASUREMENT) OF BLOOD GLUCOSE (SMBG): _______ _______ Prologue: Way back in 1991, on a Sunday afternoon, a young Parsi lady from Mumbai who was holidaying in a nearby village came to me with sudden breathlessness at my nursing home at Vapi, 160 km north of Mumbai. Clinical examination was normal except severe breathlessness. I suspected diabetic ketoacidosis and asked about history of diabetes. Patient and her relatives flatly denied any history of diabetes and told me that she was investigated in Mumbai for weakness recently and there is no diabetes. In those days, glucometer was not available in India. We used to blood sugar by Folin-Wu method. Being Sunday, laboratory was closed, so I could not do blood and urine sugar. I believed the story of relatives, ignored my gut feeling of diabetes, did ECG and X-ray chest which were normal, gave some primary care and sent […]
OBESITY
OBESITY: _ _ Prologue: It only needs a daily excess of energy of 100 kilocalories (the equivalent of a small chocolate bar) to lead to an increase of around 5Kg of fat over 12 months or 50 Kg over 10 years. For thousands of years obesity was rarely seen. Obesity is a modern problem – statistics for it did not even exist 50 years ago. The increase of convenience foods, labor-saving devices, motorized transport and more sedentary jobs means people are getting fatter. It was not until the 20th century that it became common, so much so that in 1997 the World Health Organization (WHO) formally recognized obesity as a global epidemic. The WHO describes the “escalating global epidemic” of obesity as “one of today’s most blatantly visible — yet most neglected — public health problems”. Obesity is a bigger health crisis globally than hunger, and the leading cause of […]
