‘Heredity loads the gun, you pull the trigger’

Consultant Diabetologist, Dr. Rajiv Kovil, of Preventive Diabetes Care Centres specializes in diabetes and diabetes foot care. The expert took time off his busy schedule to answer a wide range of questions from Sify readers in an exclusive chat.

We bring you the chat transcript.

What are the chances of curing Type-1 Diabetes with the Stem Cell Therapy? and Are they also use full in treating type- 2 Diabetes, i know in type-2 chances are not there but still if i am wrong?
Stem cell therapy will offer relief to most disorders ion future .. as of today type1 diabetes is where it is researched & will be helpful .. but still a long way to reach as an affordable & mainstay in therapy

My mother (58) is a diabetic. She has cardiac problems and physically she is very weak. Her weight is just 40 Kgs. She is taking her medicines (for diabetics as well as for her cardiac problems). Wht wud be your suggstn for her healthy well-being? Thx.
I think lean diabetic with complications are better off on insulin.. consult your diabetologist & put her on insulin

How to avoid skin problems by a diabetic patient?
Its a difficult thing to do good blood glucose control & hygiene & avoidance of triggers is the only way out

Do ayurvedic massages help improving diabetic health?
Ayurvedic medicines are not scientifically tested hence should not be used

Why fasting sugar rises and what precautions should we take?
Fasting sugar is purely from the liver’s glucose output. one can suppress it by eating dinner early, exercising after dinner & re-evaluating medical therapy

i have dm since last 10 yrs, on medication gliclaz-m bd & glyciphage 1gm 3 times.my blood sugar fluctuates from 100 fasting to 190 & 120 pp to 240 pp
I think you need some titration in your dosage .. check your Hba1c if it is more than 8 you need to add on

my mothers sugar level shooted uto 570, a month back, since she had lots of jackfruit/ mangoes during season. Now she is under insulin of 30//15 in mrng/evng.It is stabilising.What r the food habits to be followed
eat regularly eat on time & have a high roughage, low carbohydrate meals

What all should you do to keep the BS level under control. My mother is going for a walk of about 30+minutes in the morning and at times is taking some fruits and occassionally sweets
I think what she is doing is pretty fine.. just monitor closely to pick up any early warning signs

Is diabetis heriditary. My father doesn’t have but my mother has. I have got tested and it is not there as of now. I am now 43+ yrs
heredity loads the gun you pull the trigger you can prevent diabetes by adopting a rigid lifestyle

What r the essential food habits for a diabetic. What they should eat and what not to eat and what to avoid taotally
Eat according to timings and not according to hunger, eat every 3 hourly prevent large meals & have early dinner & reduce carbohydrate portions per meal

Gd Evng. I am a diabetic , 53 yr old 150 before fasting and 300 aftr fast.have severe itching and all joint pains . prescribed gluconorm sr 1 nite and day. i look young and smart basically a sales guy. pls advice how to get rid of itching and diabetes..
better control of blood sugar .. gluconorm is a good drug but you need to add on consult your doctor

How much one should walk for preventing/maintaining/reducing diabetise
ideally at 80% of your heart rate for 150 mins per week

Howducing the diabetise? much one should walk for preventing/maintaining/re
ideally one should walk at 80% of your heart rate for 150 mins per week

hello Doctor, will pranayama helpful to prevent or reduce dabetise?
yes there is data to say that yoga does help in diabetes

hello doctor, I have a herdity of diabetics so what are the ways to prevent the diabetis
exercise & a good lifestyle is the only way to prevent diabetes soince it is a lifestyle disorder

Can Diabetes type -II be cured with Stem cell therapy in children?
we dont know what the future holds as of now no

I have observed many diabetics in my family-though they were taking regularly medicines, Insulin their sugar levels were keep increasing every year finally drove them to critical stage Tell me is it any use d medicines Insulin etc?
Diabetes is a progressive destruction of the cells which make insulin you need 50% of insulin secretory capacity gone down to develop diabetes & it progresses with the years of diabetes

Father,75yrs diabetic for 20yrs. multiple problems cardiac,hypertensive,Schizophrenia. good control over diabetes, taking Glisen PM and Galvus 50mg. fasting 80-110, PP 140 after dinner. any side effects frm these drugs?
Pioglitazone is under srutiny due to some problems.. let it be monitored by hios doctor regularly

husband, 58, diabetic for 28 yrs. BS always 350-400 range. not eating sweets. on 1 Glynus MF morning, noon, evening before meal. taking insulin inj (insujan-n) 10g daily. v active and can do any kind of work. how to control his BS.
I think he needs better insulin coverage & latest methods of monitoring including CGMS

I am 39. in Sep 10 fasting 91, PP 93. Since last month, feeling fatigue; nw fasting 111,PP 151. Doc advised me no sugar, no rice. But I can take fruits. Cholosterol 200, LDL 140 & HDL 38. Wt 61 kgs, ht 5’7. active life, walking. pl suggest diet plan
Fruits can be taken but no fruit juice

what is the risk if we eat sugar, ice cream or a sweet if the BS around 200. can rice be taken daily in small qty; what organs of the body it affects
Rice has high glycaemic index ..as a thumb rule eat carbohydrates in moderation & eat roughage in adequate amounts.. but you can always take rice in small amounts

Mom, 58 diabetic since 2004, under control. Has feet pain,doc said weak nerves. Past 10 yrs cough with sputum, no remedy. Few mnths ago, sudden left ear deafness. Tests done, cause nt found.antibiotics, no use. pl suggest med for strong nerves.
Deafness is related to diabetes, foot pain if it is evaluated there are medications to give her symptom relief vis pregabalin .. consult your doctor before starting

I am taking oral medication Glyciphage 1 grm tabs. From last year I started taking Humiinsulin. My sugar level is around 260 post lunch. Recently I came to learn about fenfuro tabs. Do you suggest me taking fenfuro tabs?
no there are better medications available ..

I regularly feel pain on my foot, my father is diabetic from last 1 year, none of my family members is diabetic except my father. my blood sugar test (H1B1), shows my blood sugar is excellent control. Why do i get pain on foot? Please advice
Get the foot evaluated first for nerve & blood supply problems then medications can be started

is there any way to prevent a baby from diabetes if the mother has gestational diabetes?
Mothers gestational diabetes doesnt put the baby at risk .. what kind of a lifestyle the baby adopts will define his future

My dad 62 yrs old he is diabetic since 15yrs he is having blood sugar around 300. he takes insulin in morning and night. in the afternoon he takes tablet. at night before eating he takes 60ml of brandy everyday does this effect seriously to his health.
well alcohol does affect blood glucose control apart from its harmful effects on liver & the nerves

pl suggest breakfast diet for diabetics
breakfast is going to be a carbohydrate diet & post breakfast glucose values are usualy the highest in India. try including a lot of proteins, egg white, pulses & whole grain cereals

how to prevent diabetes with diet?
regular eating loww carb foods & exercise

how to care for diab feet if we are in warm climate cant wear socks all the time
Wearing a good footwear can prevent foot infections in most circumstances

I was brutally hurt while playing football with some friends at a beach. The wound did not heal for 3-weeks. Could this be a symptom of diabetes?

you havent mentioned your age .. you need a check anyways

shd diabetics avoid carbs completely
No one should be on a low carb diet

what is the chance to get diab if father, grandma were diabtic
With a single parent it is around 30% but if 2 generation with younger onset of diabetes then it is called MODY which is usually inherited

hi, when does diabetes start affcting nerves
If your blood glucose remains high & nerves get affected

wat fruits must diabetics avoid
none ..sweeter the fruit smaller the size.. have fruits as mid meal snacks

My daughters are insulin resist inherited from biological mom who’d gestational diab. no diet, exercise works. On the advice of a dietologist, allergy test was done. She is allergic to grains, milk, eggs, spices. She is demotivated now. any medications?
Motivate them & prevent diabetes & PCOS ..A good warm inclusive coherent family environment where everybody eats to plan & everybody exercises will motivate them

I am diabetes paitent last two year. Please advise me what medician take or food. Currently i am taking metformin 500mg. Valuation suger level is fasting 113 and PP-140.
I think you are doing well

MY FASTING SUGAR IS 140 while randon at & pm is 120. I take GLYSIPHASE 1M daily
Take longer acting metformin ,hence the fasting will be well covered

My two hrs PP is 145. My fasting is 105. Please advise if OK. This is with dietary restrictions. Cannot take medication as it leads to hypoglaecemia.
i think you are a prediabetic ..exercise is fine for you

sir, when can we expect oral insulin?
may be in 4-5 years

sir, when can we expect oral insulin in indian market?
may be 4-5 years

I am 31 Male years and I was recently diagnosed DM-2. I am controlling it through life style changes and a dose of Metformin 500 Mg a day. I want to know the long term effect of controlled diabetes (10-20 Years).
ther is a legacy effect to good sugar control . if you keep a good system early on in diabetes you are bound to get benefits overa period of time.. hence continue your good efforts

sir, which is more serious type 1 or 2 diabetes? which comes from wrong diet?
type2 is from wrong lifestyle.. both have different sets of complications & prevention strategies

pl suggest what to eat at dinner if fasting is 100 pp is 140
all meals are low carb high roughage balanced meals

son eats lots of chocolates, will he get diabetes, very active boy
no he wont but it is not a good habit in the long run & will exhaust insulin reserves & lead to obesity

mom diab, arthritis. any complications will come?
Well yes arthritis prevents activity which makes you sedentary hence you are at high risk

how to prevent cholesterol if we are diabetic
low fat diet, exercise & regular lipid profile checks

Also let us know which research institutions / hospitals in india / abroad offer stem cell treatment for diabetes?
It is still experimental dear & in phases of study ..but will eventually come in

Am 37 yrs old male, diagnosed with diabetes 7 years back, is stem cell transplant now avialable in India / abroad as a commercial treatment for diabetes, have seen news Ad’s, If its avaialable what ware factors for fitment for this treatment?
Wait for sometime before it can be offered as a treatment

40 yrs, diabetes from last 8yrs. taking 20 units lentus insulin once daily follwed by Gluconorm 3G twice. Evening reading 300 some time. do runing 1 km & walking 2 km. What else is required.
Change in medication .. check hba1c & then consult your doctor

1. How do we know whether any one is affected by Diabetic or not? 2. What are precaution steps we have to take to avoid Diabetic problems?
Check blood glucose regularly, prevent diabetes by adoptiong ahealthy lifestyle

To moniter blood glucose level which one is ideal in known diabetic, HbA1c or Fasting & PP blood glucose? What is your advice if HbA1c is less than 6%; pp above 170mg/dl? change the drug combination?
Ideally hba1c & F /PP should match if they dont patient needs CGMS

Im 43, diabetic. on Amaryl 2 mg,Janumet (1000 mg Metformin hydrochloride) twice daily before brkfast and dinner. is thr any specified time period of breakfast/dinner or is it ok to take them just before bf/dinner? Do ayurvedic medicines like Fenfuro help?
amaryl 1/2 hr prior , janu before or after

i’m 66 male, acute copd. i was never diabetic, but when i was admitted in hospital in jan and feb due to copd attacks, i became diabetic. i heard strong medication has made me get diabetes. taking melmet sr-500 mg one and half tab daily. is this good?
If you are a COPD then may be a steroid induced diabetes & may be steroids may be your mainstay in the treatment of the lungs & hence may have developed diabetes due to them

Is it possible to reverse Type 1 diabetes.
there is data on vaccines given early during the course causing some remissions

My son is 1.9 yrs old, type 1 diabetic..on daily insulin dose Nova mix 30 once in morning and evening…..disease was detected when his age was 1.1 years. Kindly tell us by when we will be able to breakthrough the permanent cure of this disease…..
We are working towards a cure for type 1 diabetes & the whole world is actively involved in nresearch at curing & preventing type1 diabetes..as of now there insulin & insulin pumps remain the main stay in treatment

check Hba1c .. do CGMS & get in touch with your doctor