Tag: DIABETICS

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How to deal with a frozen shoulder

Every patient has a unique experience with frozen shoulder. Early appropriate intervention can reduce the severity of your personal case…writes Dr Biren Nadkarni

A Frozen shoulder is a disorder that causes stiffness and discomfort in the shoulder joint. Frozen shoulder, also known as adhesive capsulitis, occurs when the connective tissue around the shoulder joint becomes swollen and rigid. It’s a painful disorder that causes a reduction in shoulder range of motion without any indications of arthritis.

This inflammation can make it difficult to do everyday tasks, and as the illness progresses, your discomfort and stiffness grow progressively more debilitating.

What exactly is frozen shoulder?

Shoulders are made up of bones, ligaments, and tendons that are wrapped in a connective tissue capsule. When the capsule around the shoulder joint thickens and tightens, it gradually restricts movement. The condition usually occurs in three distinct stages:

Freezing Stage

This happens between six and nine months. Your shoulder hurts to move, and you’ve lost a lot of range of motion.

Frozen Stage

This period lasts four to twelve months, during which time your pain may become more bearable, but your mobility may deteriorate as your stiffness develops.

Thawing Stage

You may notice that your mobility improves and that you may resume numerous tasks six months to many years following the beginning of symptoms.

Every patient has a unique experience with frozen shoulder. Early appropriate intervention can reduce the severity of your personal case.

Link between Diabetes and Frozen Shoulder

The higher your risk, the older you are or the longer you have had diabetes. Because uncontrolled blood sugar levels can alter collagen, a crucial protein that makes up your connective tissue, people with diabetes are more likely to develop frozen shoulder.

When sugar attaches to collagen, it becomes sticky, restricting mobility and causing your shoulder to stiffen. When you try to work through the stickiness, you will experience mild to severe pain. In certain circumstances, moving your shoulder is impossible.

What are the other risk factors?

If your shoulder is immobilised for an extended period of time, such as when it is in a cast, you run the risk of getting frozen shoulder. After an injury, such as a rotator cuff tear, the disease can also develop.

Women are more prone to frozen shoulder than males, those between the ages of 40 and 60 are the most likely to get it.

Diagnose and Prevention

Frozen shoulder can be diagnosed only on the basis of signs and symptoms. A physician, on the other hand, would usually make the diagnosis by examining your active range of motion (by asking you to move your shoulder) as well as your passive range of motion (by moving your arm for you).

Unfortunately, there is no way to guarantee that frozen shoulder will not occur. However, remember that the greatest protection is to keep your blood sugars as low as possible.

Beyond that, maintaining a regular stretching and physical exercise programme is critical to maintaining your shoulder’s range of motion.

Remember that while you can’t predict whether or not you’ll develop frozen shoulder, you can put yourself in the best possible situation.

Treatment for Frozen shoulder

Most patients will, of course, choose non-operative therapies initially, such as physical therapy and non-steroidal anti-inflammatory drugs.

Some people choose for steroid injections to relieve joint discomfort and enhance range of motion, but keep in mind that if you have diabetes, they might cause dangerously high blood sugars that can last up to a week, so talk to your doctor first.

For the most part, these measures should be effective. If symptoms do not improve, more extensive procedures such as open capsular release or arthroscopic surgery (together with physical therapy) may be considered.

A few pointers on how to deal with a frozen shoulder

While frozen shoulders are common among diabetics, there are some things you may do to avoid or treat them.

* Maintain as close to normal blood sugar levels as possible.

* Before you acquire frozen shoulder, exercise and stretch your shoulders on a regular basis.

* Anti-inflammatory medications can be used to relieve pain.

* Strengthen your shoulder and enhance range of motion with the help of a physical therapist.

* If nothing else works, surgery may be an option.

* Don’t wear a shoulder sling or cease using your arm entirely.

A frozen shoulder can be uncomfortable and restrict many of your everyday activities, but the good news is that with proper treatment, the disease usually resolves.

(Dr. Biren Nadkarni,Sr. Consultant Orthopedic and Joint Replacement Surgeon)

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Health Lite Blogs

Diabetic cases soar in India

Lack of sleep linked to diabetes, says expert.

From the times of World War I, tincture iodine was the treatment of choice for most ulcers — diabetic or non-diabetic.

Diabetes has become a major healthcare challenge in India. In 2019, 77 million people were living with diabetes in the country. The number is expected to rise to 101 million in 2030 and 134 million in 2045.

Diabetes is associated with multiple complications such as nerve damage and poor blood supply, which makes the foot more prone to ulcers. Diabetic foot ulcers have a tendency to get worse pretty fast if not treated early.

Dr Arun Bal, Consultant Diabetic Foot Surgeon, S.L. Raheja Hospital, Mumbai, said, “High blood glucose is associated with multiple healthcare disorders and foot ulcers are one of the common complications of uncontrolled diabetes.”

Explaining the consequences of the condition, Dr Bal said, “Diabetic foot ulcers are stubborn and if not treated in time, can result in amputation. Around 85 per cent of diabetes-related amputations start with foot ulcers, but the awareness about the condition is poor in India. People often try to manage the ulcers on their own. They often reach the doctor late and there’s no other option other than amputating the limb.”

Speaking about one of his patients, Dr Bal said, “A 64-year-old male with a history of Type-II Diabetes for eight years presented himself with a right toe swelling and ulceration for three months. Each time this swelling occurred during this period, he ignored it as the affected region lacked any sensation.

“A few days later, he had another episode of swelling of the same toe and presented to his family physician with redness, oedema and extensive ulceration in the same region. He was referred to me by his physician. After a complete examination, amputation of the right toe was suggested by me. The toe could have been saved if the patient had consulted me earlier.”

Treatment of diabetic foot ulcers has evolved, thanks to the latest research and new molecules. From the times of World War I, tincture iodine was the treatment of choice for most ulcers — diabetic or non-diabetic. The evolution of iodine has ensured that better-acting iodine is now available for the management of ulcers.

Cadexomer iodine is the latest form of iodine that is now used for managing most cases of diabetic foot. This molecule ensures patients do not have to go daily for a change of dressing, thereby reducing the financial burden on the patient. Additionally, Cadexomer Iodine has shown to be effective in the treatment of ulcers, thereby reducing the requirement of surgery.

Dr Bal added: “In the case of the man I just mentioned, timely intervention with the right treatment could have helped us avoid the amputation of the affected toe. Cadexomer iodine has proven to be the dressing of choice for such complicated wounds in diabetic patients because of the safe and prolonged duration of antiseptic action.”

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COVID-19 Health Lite Blogs

India sees rise in Covid triggered diabetic cases

Among patients who are already diabetic, more than 60 per cent of patients showed worsening of glycemic status, which persisted for more than three months…reports Asian Lite News.

Covid-19 infections, which started about two years ago, has contributed to nearly 25 per cent rise in diabetic patients in the country, revealed OPD data of a private hospital here on Friday.

With almost 77 million people living with diabetes, India is often referred to as the diabetes capital of the world.

Covid, which is a viral infection that causes various inflammatory reactions, is known to lead to various recurring and new health ailments such as hypoxia, weakness, weight-loss, hair-loss, myocarditis, thyroid. But, diabetes is reportedly one of the most common after effects of the infectious disease.

Doctors at Indraprastha Apollo Hospitals examined data from OPDs of the last two years. They found that among patients with confirmed Covid-19 infections, there was nearly 25 per cent of new onset of diabetic patients.

Stress induced hyperglycemia — high blood sugar — was seen in 10 per cent of patients who had Covid-19 infection.

Among patients who are already diabetic, more than 60 per cent of patients showed worsening of glycemic status, which persisted for more than three months.

“Diabetes in itself is a pro-inflammatory state posing a risk of an inflammatory response along with Covid-19 which leads to aggravation of blood sugar levels. Those who are known diabetic, Covid-19 caused abnormal values of blood surpass (above the normal range),” said Dr. Subhash Kumar Wangnoo, Senior Consultant Endocrinologist and Diabetologist, at the hospital, said in a statement.

“Use of steroids, due to serious manifestations of Covid-19 in treatment, further worsened the glucose levels in the patients. Stress response due to acute infection like Covid, increases the blood surpasses values through Hb1ac, which may be normal. This we term it as new onset of diabetes due to Covid-19,” he explained.

Hence, for an early and better diagnosis patients who have been administered steroids owing to serious manifestations of Covid-19 are advised to keep a regular check on blood sugar levels post their recovery from the virus, the doctor suggested.

Diabetes also further predisposes patients to various comorbidities including kidney disease and cardiovascular ailments. Other factors contributing towards a spike in the cases of diabetes are access to calorie dense food, erratic diet patterns and sedentary lifestyle.

“Adopting a healthy lifestyle, which includes daily exercise and avoiding unhealthy eating habits, such as consumption of processed foods and smoking cessation, can significantly bring down the risk of diabetes. Raising awareness and bringing about a shift in lifestyles of our population has to be a critical element in our prevention strategy,” said Dr Ashutosh Goyal, Senior Consultant, Endocrinology, Paras Hospitals.

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Lifestyle Lite Blogs

An apple a day keeps the ‘DIABETICS’ away

The fruits listed below are not just diabetic-friendly but are loaded with fiber and water content which can slow down the sugar spikes and sugar absorption rate…writes Monika Manchanda

Eating fruits is one of the most satisfying ways to tackle sweet-tooth cravings while meeting your nutritional needs. Despite many studies and research on fruit consumption in diabetes, there are a lot of speculations on the right kind of fruit consumption and its relation to blood sugar levels.

Eating seasonal and locally available fruit has many health benefits ranging from reducing sugar and inflammation levels to fighting high blood pressure — thanks to their abundant vitamins and mineral presence! They are a powerhouse of antioxidants like vitamins A, B, C, E, and minerals like iron, calcium, magnesium, and fiber.

The fruits listed below are not just diabetic-friendly but are loaded with fiber and water content which can slow down the sugar spikes and sugar absorption rate.

Apples are not just nutritious and filling; According to a Study, they are significantly associated with a lower risk of type 2 diabetes if consumed in moderation. Turns out there is a truth in the old saying, “An apple a day keeps the doctor away”, after all!

Avocados are a great source of healthy fats and more than 20 vitamins and minerals. They are high in fibbers as well, and have been linked with lowering the risk of diabetes.

Berries: Adding berries is one of the best ways to add a variety to your diabetes-friendly diet. You can choose from blackberries, blueberries, or strawberries because all of them are power-packed with antioxidants, vitamins, and fibers.

Papaya is rich in natural oxidants, which makes it a perfect pick for people with diabetes. It reduces the chances of future cell damage.

Star fruit: This sweet and sour fruit is rich in dietary fiber and vitamin C. It also positively impacts anti-inflammatory processes and can help repair cell damage, and it has minimal fruit sugars as well.

Kiwi fruit is an excellent source of Vitamin E, K, and potassium, and they are low in fruit sugars as well, which makes it a perfect diabetic-friendly fruit.

Melons (Musk melon and watermelon): Powerful hydrating fruits like cantaloupe and melons are recommended for people with diabetes, and people with the risk of developing diabetes. Eat-in moderation for multiple nutritional benefits like fiber, potassium, magnesium, vitamin B, and C.

Dragon fruit is full of dietary fibers, vital vitamins, minerals, and antioxidants.

Pear are nutrient-rich, and they are known to fight inflammation and improve digestion.? Studies also suggest that consuming pears along with a healthy diet reduces the risk of type 2 diabetes.

Orange: This citrus fruit is full of fiber that helps slow down sugar absorption into the bloodstream, and its vitamin C component helps improve immunity levels.

Add fruit to your salads to enjoy their goodness with a sprinkle of cinnamon, it tastes better and reduces sugar spikes . Add nuts like walnuts and almonds to complement your fruit snack. you can also add flaxseeds to balance the glycemic load in the body.

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