https://www.facebook.com/109718627059040/

Medical World Dr Rana Sanjay, Dr Rana S P Singh, Patna (2025)

14/08/2025

🤔Understanding the Link Between Diabetes and Fatigue
👌Diabetes, whether Type 1 or Type 2, disrupts the body’s ability to regulate blood sugar (glucose).This imbalance can have a profound impact on energy levels.
🫵High Blood Sugar (Hyperglycemia): When blood sugar levels are consistently high, glucose cannot effectively enter cells to provide energy. This can lead to a feeling of sluggishness, tiredness, and mental fogginess. The body also tries to eliminate excess glucose through urine, leading to frequent urination and dehydration, which can further contribute to fatigue.
🫵Low Blood Sugar (Hypoglycemia): Conversely, when blood sugar levels drop too low, the brain and other organs don’t receive enough glucose to function properly. This can cause symptoms like weakness, dizziness, shakiness, sweating, and extreme tiredness.
🫵Other Factors: Beyond blood sugar fluctuations, other diabetes-related factors can contribute to fatigue:
🫵Inflammation: Chronic inflammation, often associated with diabetes, can contribute to feelings of tiredness.
🫵Complications: Diabetes complications like nerve damage (neuropathy), kidney disease, and heart disease can also cause fatigue.
🫵Medications: Some diabetes medications can have side effects that include tiredness.
🫵Sleep Apnea: People with Type 2 diabetes, especially those who are overweight or obese, are at higher risk of sleep apnea, a sleep disorder that disrupts sleep and causes daytime sleepiness.

🤔Why do I feel tired after eating when I have diabetes?
👉Feeling tired after eating, especially after consuming a large meal high in carbohydrates, can be a sign of high blood sugar. The body struggles to process the sudden influx of glucose, leading to a temporary energy slump.
🤔Can low blood sugar cause sleepiness?
👉Yes, low blood sugar (hypoglycemia) can cause various symptoms, including weakness, dizziness, and extreme tiredness. It’s important to treat low blood sugar promptly by consuming a quick source of carbohydrates.
🤔How can I improve my energy levels if I have diabetes?
👉Improving blood sugar control through diet, exercise, and medication (if prescribed) is crucial. Getting enough sleep, managing stress, and addressing any underlying health conditions can also help.
🤔When should I see a doctor about fatigue related to diabetes?
👉If you experience persistent or excessive fatigue, it’s important to consult your doctor. They can help identify the underlying cause and recommend appropriate treatment strategies.
🤔Can diabetes medication cause tiredness?
👉Yes, some diabetes medications can have side effects that include fatigue. If you suspect your medication is causing tiredness, discuss it with your doctor.
🤔Is sleep apnea related to diabetes?
👉Yes, sleep apnea is more common in people with Type 2 diabetes, especially those who are overweight or obese. If you experience excessive daytime sleepiness, snoring, or pauses in breathing during sleep, talk to your doctor about getting screened for sleep apnea.
🤔What dietary changes can help with diabetes-related fatigue?
Focusing on a balanced diet rich in whole grains, fruits, vegetables, lean protein, and healthy fats can help stabilize blood sugar levels and improve energy. Limiting processed foods, sugary drinks, and refined carbohydrates is also important.
This information is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
✒️🩺 Dr Rana SP Singh senior physician and diabetologist Patna Bihar 🇮🇳 India 🪷

07/08/2025

CKM syndrome is a complex disorder made up of cardiovascular disease, kidney disease, obesity and Type 2 diabetes. These four connected conditions share risk factors and can lead to one another. People often have more than one of these diseases at a time. Your stage at diagnosis can tell you the severity of your condition.
🙂What is CKM syndrome?
👉CKM syndrome (cardiovascular-kidney-metabolic syndrome) is a newly named medical condition that affects most of your major organs, like your heart, kidneys, brain and liver. This complex disorder consists of four related medical issues and notes the links between them. These conditions are:
Cardiovascular (heart and blood vessel) disease.
Kidney disease.
Type 2 diabetes.
Obesity.
The letters CKM stand for cardiovascular, kidney and metabolic. Metabolic means getting energy from food. Obesity and Type 2 diabetes are metabolic conditions. Each of the four conditions in CKM syndrome can lead to or worsen one another.
People often have more than one of these conditions at a time. This isn’t surprising because these conditions share a connection through your blood. After you digest what you eat or drink, nutrients and energy travel through your blood to your body’s cells. Your heart and blood vessels circulate your blood through your body. And your kidneys filter wastes out of your blood. For good health, your body needs all of these systems to work well.

Having more than one of the listed conditions gives people with CKM syndrome risk factors for the others.
🙂How common is CKM syndrome?
👉As a newly identified condition, CKM syndrome doesn’t have a history of data like conditions researchers found years ago. But 1 in 3 American adults has at least three of the risk factors for cardiovascular-kidney-metabolic syndrome.
🙂What are the symptoms?
👉CKM syndrome symptoms may include any of the issues you get with the four conditions that make up cardiovascular-kidney-metabolic syndrome, like:
👌Chest pain.,Shortness of breath.Syncope (passing out).Swelling in your legs, feet, hands or ankles.Pain in your legs while walking.Tiredness.
Loss of appetite or an increase in appetite.
The need to p*e more often.Dry skin.Sleep apnea.
Gout.
🙂What causes CKM syndrome?
👉Extra adipose tissue (body fat) or body fat that’s abnormal causes CKM syndrome. This type of tissue releases substances that inflame and damage tissues in your heart, kidneys and arteries. Inflammation makes insulin less effective. It also encourages plaque and kidney damage to develop.
🙂What are the risk factors for CKM syndrome?
👉Risk factors for CKM syndrome include:
Obesity.Extra body fat around your waist.High cholesterol.High blood pressure.Kidney disease.
Diabetes.Metabolic syndrome.
🙂What are the complications of this condition?
👉Complications of CKM syndrome include:
Heart failure.Arrhythmias (abnormal heart rhythms).Heart attack.Stroke.
🙂Diagnosis and Tests
🤔How is CKM syndrome diagnosed?
👉Healthcare providers can use multiple tests to diagnose CKM syndrome.
These include:
Checking your blood pressure.
Ordering a lipid panel.
Checking your blood sugar.
Checking your kidney function.
Measuring coronary artery calcium.
Measuring BMI (body mass index).
Providers can screen children for these issues to give them an early start at preventing cardiovascular-kidney-metabolic syndrome.

A healthcare provider can use test results to diagnose you with CKM syndrome. Then they’ll choose from stages that progress from 0 to 4, with 4 being the highest-risk stage for cardiovascular disease.
🤔CKM syndrome stages
The CKM syndrome stages are:

Stage 0: You have no risk factors.
Stage 1: You have extra body fat, especially in your belly.
Stage 2: You have Type 2 diabetes, high triglycerides, high blood pressure or kidney disease.
Stage 3: You have early cardiovascular disease (but no symptoms) or a high risk of it.
Stage 4: You have cardiovascular disease (with symptoms), extra body fat and risk factors for metabolic conditions. You may or may not have kidney failure.
You can change the stage you’re in by making changes to improve your health.
🤔How is CKM syndrome treated?
👉Treatments for cardiovascular-kidney-metabolic syndrome vary by which of the related conditions you have. In treating CKM syndrome, healthcare providers can tailor a plan just for you. With multiple organs involved in CKM syndrome, your best bet is a treatment plan with input from several providers.

At an early stage, you may only need to make some lifestyle changes, like getting more physical activity.

If you’re at a middle stage, you may need to take medicines to manage blood pressure, cholesterol and blood sugar. People who have obesity may need medicine to decrease their appetite. Down the road, your provider may need to adjust how much of these medicines you take.
At more advanced stages, you may need:

Stents to hold blocked arteries open for blood flow.
Heart procedures like cardioversion or ablation.
Open or minimally invasive heart surgery.
Kidney dialysis.
Weight loss (bariatric) surgery.
😱Complications/side effects of the treatments
Lifestyle changes don’t have any side effects, but many medications do. Talk to your provider if you have side effects that bother you. Surgeries and dialysis can put you at risk for infections and blood clots. Ask your provider about possible complications for the procedure you’re having.
🤔What can I expect if I have CKM syndrome?
👉With CKM syndrome, you can expect to have symptoms of the specific conditions involved. But having more than one condition can complicate your healthcare. Researchers are hoping for a future where everyone gets holistic treatment for CKM syndrome instead of treatment for one body system at a time. If you’re seeing multiple providers and you’re getting conflicting advice, speak up and ask for clear direction.
🤔Can CKM syndrome be prevented?
👉Yes, some people can prevent CKM syndrome with a healthy lifestyle. For others, a healthy lifestyle may only slow the progression of CKM syndrome. Based on your family history, a healthcare provider can help you identify areas where you could have risks for cardiovascular-kidney-metabolic syndrome. They can work with you on a plan to be at your healthiest.
🤔How can I lower my risk?
👌There are many ways you can lower your risk of CKM syndrome, like:
Eating healthy foods.
Getting enough sleep.
Avoiding to***co products.
Managing blood pressure, blood sugar and cholesterol levels.
Getting regular physical activity (30 minutes a day).
Staying at a weight that’s healthy for you.
🤔How do I take care of myself?
You can take care of yourself by keeping healthy habits and following your provider’s advice. Ways to care for yourself may include:
Eating nutritious foods.
Getting physical activity.
Checking your blood sugar regularly if you have Type 2 diabetes.
Checking your blood pressure regularly with a home monitor.
Taking medications for the conditions you have.
✒️🩺 Lion DR RANA SANJAY PRATAP SINGH
(Dr Rana SP Singh, Senior physician and diabetologist Patna Bihar 🇮🇳 India 🪷)
🥇DC - FIRST AID EDUCATION AND EMERGENCY RELIEF, LIONS CLUB INTERNATIONAL DISTRICT 322E
🥇DIABETES CHAIRPERSON - LIONS CLUB OF PATLIPUTRA ASTHA

02/08/2025

🤔What Is the Difference Between and ?
🫵Metabolic dysfunction-associated fatty liver disease (MAFLD) occurs when excess fat builds up in the liver.
MAFLD can progress to metabolic dysfunction-associated steatohepatitis (MASH), which, in addition to fat buildup, causes inflammation and fibrosis (scar tissue buildup). Untreated MASH can turn into cirrhosis (severe scarring) and ultimately liver failure.
About 24% of adults in the United States have MAFLD, while 1.5-6.5% have MASH.Understanding the similarities and differences between the conditions can help in early diagnosis and treatment.
🤔Symptoms of MAFLD vs. MASH
🫵MAFLD typically has few or no noticeable symptoms. In some cases, it may cause symptoms ike nausea, vomiting, and fatigue. If not managed well, MAFLD can progress to MASH, which causes serious symptoms due to liver inflammation and damage. MASH may also lead to cirrhosis, causing permanent liver scarring and damage.
🫵While MAFLD and MASH share some common features, their symptoms can differ significantly. You may experience one or more of the following symptoms if diagnosed with each of the conditions:
⚡
👌Flu-like symptoms Fatigue and weakness ⚡ Nausea and vomiting
👌Stomach symptoms Upper abdominal pain and bloating⚡ Ascites (buildup of fluid in the abdomen)
👌Neurological (brain) symptoms Sleep disturbances ⚡Confusion
👌Other symptoms Excessive thirst⚡ Easy bruising or bleeding, jaundice (yellow eyes and skin), and severe skin itchiness
😊Differences
MAFLD occurs when there's a buildup of fat in the liver, and MASH is a later stage of MAFLD. Although MASH develops from MAFLD, the two conditions have several differences:
👏Severity
: This type of liver disease causes fat to build up in the liver. The early stages of this condition are mild compared to the later stages.
: This is a more severe stage of MAFLD symptoms, with increased fat buildup in the liver. Additional symptoms include inflammation (swelling) and liver damage.
As cirrhosis worsens, it can cause portal hypertension (high blood pressure that affects blood flow to abdominal organs), jaundice (yellowing of the skin and eyes), and hepatic encephalopathy (toxin buildup in the brain, causing confusion or difficulty thinking).
Untreated cirrhosis may eventually lead to liver failure or hepatocellular carcinoma (HCC), a type of liver cancer and the leading cause of liver transplants.9 MAFLD won't turn into cirrhosis and liver failure unless it advances into MASH.
😊Different Treatment Options
MAFLD: No FDA-approved medications are currently available to treat MAFLD. Treatment options for MAFLD focus on lifestyle changes like maintaining the weight you and your healthcare provider discussed was optimal for you, exercising, avoiding alcohol, and eating a balanced diet.

MASH: The U.S. Food and Drug Administration (FDA) approved a drug, Rezdiffra (resmetirom), for treating MASH with moderate or severe fibrosis. Rezdiffra works by lowering the buildup of fat in the liver. Healthcare providers recommend taking this medication alongside a healthful diet and regular exercise to maximize its effectiveness and slow disease progression.
😊Lifestyle Changes for Symptoms
Your healthcare provider may recommend lifestyle changes that can improve MAFLD and MASH.
Some strategies for relieving symptoms include:12
Maintain the weight discussed with your provider
Eat a well-balanced diet
Exercise regularly
Limit sugar
Avoid saturated fats found in meat, poultry skin, and certain milk and dairy products.
🥺Risk Factors
Since MASH is a more advanced stage of MAFLD, both conditions share common risk factors.
These risk factors include:
Obesity
High cholesterol (a fatty substance found in your liver and intestines)
Type 2 diabetes
Metabolic syndrome (traits and conditions linked to obesity)
😊Diagnostic Approaches
Healthcare providers may try to diagnose MAFLD and MASH similarly by reviewing your medical history and performing a physical exam to check for symptoms and diagnostic tests.
😊During your exam, your provider may ask you about:
👌Your diet
Medications you're currently taking
Other health conditions you have that may increase the risk of MAFLD or MASH
Some tests that can help diagnose both conditions include blood tests, such as liver function tests (to see how well your liver is working), and imaging tests like ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI).
😊When To Seek Care and Who to Contact
If you start experiencing symptoms of MAFLD or MASH, you may want to contact a hepatologist (a doctor specializing in diagnosing and treating liver conditions).
✒️🩺 Lion Dr Rana Sanjay Pratap Singh Dr Rana SP Singh senior physician and diabetologist Patna Bihar 🇮🇳 India 🪷 🙏

30/07/2025

🤔 type 2 and Silent ?
👉 You probably don't think of a heart attack as the kind of thing that could happen without you even knowing it. But it can, and it's more common than you might think.

It's called a silent heart attack. It can happen to anyone, but diabetes makes you more likely to have one. You might not feel anything at all. Or it could feel mild, like heartburn or the odd ache or pain. It might seem so minor that you just shrug it off and think it's just part of getting older.
But a heart attack is serious business, whether you have symptoms or not. That makes it really important to keep up with all your regular checkups. Make sure you get in tune with your body so you're aware of subtle changes.
🤔How Could It Be Silent?
👉One of the common effects of diabetes is a type of nerve damage called neuropathy. Usually it causes problems like numbness, tingling, or weakness in your hands and feet. But it doesn't always stop there.
You can also have damage in nerves that lead to your heart, bladder, and blood vessels. When that happens, you might not get important warning signs like pain or discomfort.

So during a heart attack that might normally cause big-time pain in your chest, arm, or jaw, you might not notice a thing. It's like someone presses a big mute button on what you're able to feel. But the damage does happen, and the dangerous consequences of a silent heart attack are real.
🤔Signs of Nerve Damage
👉You can help protect yourself by keeping a close eye out for nerve damage. If you catch it early, you might be able to slow it down.
Here's what you can look for:

Feeling dizzy or fainting when you stand up
Hard time doing even limited exercise
Problems p*eing, like having accidents
Sexual problems, such as a low s*x drive
Sweating way more than usual or not at all
Trouble digesting food, like bloating and stomach upset
🤔Symptoms of Silent Heart Attacks
👉Some people don't have any symptoms at all. If you do have them, they may be mild and go away quickly. And you might feel totally fine once the silent attack is done.

You may feel some pain, pressure, or squeezing in the center of your chest instead of on the left side. It may seem like run-of-the-mill indigestion, but if it doesn't go away, it could be a bigger problem.

Here's what else you might notice:

Breaking out in a cold sweat or having clammy hands for no reason
Feeling light-headed
Feeling tired for no reason
Heartburn
Pain in your jaw, neck, or left arm (especially common in women)
Stomach upset
Shortness of breath, even when you haven't done much
👏If you have any of these symptoms, check with your doctor right away.
🤔How Would I Know I Had One?
👉It can be a challenge. In some cases, you'll get symptoms after the heart attack, including:
Feeling very tired
Heartburn that won't go away
Swelling in your legs
Trouble breathing when you never had it before
Other times, it's just chance that you find out you had a heart attack. You could go to your doctor months later and just happen to get some tests that show it.

Your doctor can do a few things to check for signs that you've had one, such as:

Blood tests to look for certain proteins that your heart makes when it's been damaged
Electrocardiogram (EKG), which checks the electrical signals in your heart
Echocardiogram, a type of ultrasound imaging that looks at the heart.
🤔What's the Harm?
👉You need to take a silent heart attack just as seriously as one that has clear symptoms. It can damage your heart and leave scars behind. And that can affect how well your heart works.

Plus, if you don't know you had it, you can't get treated for it. Even if you feel fine afterward, it's still a big deal. Without the right care, your chances of having a second and more serious heart attack go up. That alone is life-threatening, and it raises your odds of getting other serious problems, like heart failure.
✒️🩺 Lion DR RANA SANJAY PRATAP SINGH
( Dr Rana SP Singh senior physician and diabetologist Patna Bihar 🇮🇳 India 🪷)
🥇DC - FIRST AID EDUCATION AND EMERGENCY RELIEF, LIONS CLUB INTERNATIONAL DISTRICT 322E
🥇Diabetes chairperson- LIONS CLUB OF PATLIPUTRA ASTHA

29/07/2025

Many studies have looked at the role of vitamin D in diabetes and have shown an association between low levels of vitamin D and increased risk for type 2 diabetes and its complications. And what’s concerning is that low levels of vitamin D—also dubbed the “sunshine” vitamin—are all too common, especially among older adults and people of certain ethnic/racial groups.
😊How Vitamin D Helps Your Body Use Insulin
Another study tied higher vitamin D to a lower risk of insulin resistance, when the body is unable to respond to or use the insulin that it’s producing. Researchers found that the chance of developing insulin resistance went down with each additional amount of vitamin D supplement taken. Researchers say this might indicate that vitamin D3 is a protective factor in the occurrence of insulin resistance because it helps lower inflammation and inflammation raises your risk for insulin resistance.

More studies are needed to understand the relationship between vitamin D and insulin activity and whether it’s different for certain groups of patients.
😊How Vitamin D Helps Foot Ulcers
One recent study linked low vitamin D levels to a higher likelihood of foot ulcers in older people with diabetes. The study was the first to assess vitamin D levels among people who were in the hospital with a diabetic foot ulcer. Vitamin D levels were found to be steadily lower as the severity of the ulcer worsened. In fact, people with the most favorable foot ulcer (least severe based on the grading scale), had vitamin D levels that were more than twice that seen in people with the worst stage or grade of ulcer.
The study included 339 people aged 60 to 90 who were in the hospital with type 2 diabetes, 204 with and 135 without foot ulcers. Most people, 8 out of 10, had vitamin D deficiency (generally defined as less than 50 nmol/L or less than 20 ng/mL). But vitamin D deficiency was more common among those with a diabetic foot ulcer compared with those without.

Researchers said the findings should encourage patients to ask about screening for low vitamin D with a simple blood test and/or whether they should be taking vitamin D supplements, which may help lower risk for foot ulcers. The study also showed that how long someone had diabetes and having high systolic blood pressure (the top number) also increased risk of foot ulcers.

🤔How does vitamin D deficiency affect diabetes?
👉Vitamin D deficiency can negatively impact diabetes management and potentially increase the risk of developing both type 1 and type 2 diabetes. It can impair insulin production and sensitivity, leading to poorer blood sugar control. Additionally, vitamin D deficiency is associated with increased risk of diabetic complications, such as cardiovascular disease and kidney problems.
🤔How Vitamin D Deficiency Affects Diabetes:
👉Insulin Resistance:
Vitamin D plays a role in insulin sensitivity, meaning how well the body uses insulin to regulate blood sugar. Deficiency can lead to insulin resistance, where cells become less responsive to insulin, making it harder to lower blood sugar levels.
👉Impaired Insulin Secretion:
Vitamin D is also involved in the production of insulin by the pancreas. Deficiency may impair the pancreas's ability to produce enough insulin to meet the body's needs, further contributing to high blood sugar.
👉Increased Risk of Type 2 Diabetes:
Several studies suggest that low vitamin D levels are associated with an increased risk of developing type 2 diabetes.
👉Increased Risk of Type 1 Diabetes:
Some research indicates that vitamin D deficiency might be a risk factor for type 1 diabetes, especially in children.
👉Diabetic Complications:
Vitamin D deficiency can exacerbate existing diabetic complications, including cardiovascular disease, kidney problems, and foot ulcers.
👉Reduced Blood Sugar Control:
Overall, vitamin D deficiency can lead to poorer blood sugar control in people with diabetes, potentially increasing the risk of long-term complications.
In essence, vitamin D plays a multifaceted role in glucose metabolism and diabetes management. Maintaining adequate vitamin D levels may be important for both preventing diabetes and improving blood sugar control in those who already have the condition.

🤔Did you know?
👉About 4 in 10 adults are vitamin D deficient, meaning they don’t get or make enough
Vitamin D is found in just a few foods, such as fortified milk and cereals, egg yolks, and fatty fish such as salmon, mackerel, and sardines
It’s called the “sunshine” vitamin because we mainly get it from sunlight
Low vitamin D can affect bone health and it’s also been linked to depression, low energy and certain skin and other conditions.
🤔Discover Your Vitamin D Levels
👌If you’re unsure what your vitamin D levels are, talk to your doctor about getting tested, and ask them about nutrition and how to make sure you have healthy levels of vitamin D and other essential nutrients.
✒️🩺Lion DR RANA SANJAY PRATAP SINGH
(Dr Rana SP Singh senior physician and diabetologist Patna Bihar 🇮🇳 India )
🥇DC - FIRST AID EDUCATION AND EMERGENCY RELIEF, LIONS CLUB INTERNATIONAL DISTRICT 322E
🥇 Diabetes chairperson - LIONS CLUB OF PATLIPUTRA ASTHA

28/07/2025

Lifestyle modifications play a crucial role in managing both diabetes and hypertension. Adopting a healthy diet, increasing physical activity, maintaining a healthy weight, and managing stress are key strategies. Specifically, focusing on a balanced diet, engaging in regular exercise, quitting smoking, and practicing stress-reduction techniques can significantly improve outcomes for both conditions.
👌Dietary Changes:
👉Focus on Whole Foods:
Prioritize fruits, vegetables, whole grains, and lean proteins.
👉Limit Sugary Drinks and Processed Foods:
These can lead to rapid spikes in blood sugar and contribute to weight gain.
👉Reduce Sodium Intake:
Especially important for hypertension management, aiming for less than 2,300 milligrams per day.
👉Consider the DASH Diet:
The Dietary Approaches to Stop Hypertension (DASH) diet emphasizes fruits, vegetables, and low-fat dairy, while limiting saturated and total fats.
👉Portion Control:
Being mindful of portion sizes can help with weight management and blood sugar control.
Physical Activity:
👉Regular Exercise: Aim for at least 150 minutes of moderate-intensity aerobic activity per week, such as brisk walking, swimming, or cycling.
Incorporate Strength Training: Resistance training can improve insulin sensitivity and muscle strength.
Find Activities You Enjoy: This will make it easier to stick to an exercise routine.
Weight Management:
👉Healthy Weight Range: Losing even a small amount of weight can have a positive impact on both conditions.
👉Focus on Sustainable Changes: Avoid fad diets and prioritize gradual, long-term lifestyle adjustments.
Stress Management:
👉Mindfulness and Meditation: Techniques like mindfulness-based stress reduction can help lower blood pressure and improve mental well-being.
👉Deep Breathing Exercises: Regular practice can help reduce stress and anxiety.
👉Adequate Sleep: Aim for 7-9 hours of quality sleep per night.
Other Important Factors:
👉Quit Smoking: Smoking significantly increases the risk of both diabetes and hypertension.
Limit Alcohol Consumption: Moderate alcohol intake or avoiding it altogether is recommended.
Regular Monitoring: Monitor blood sugar and blood pressure regularly as directed by your healthcare provider.
👌Follow Your Doctor's Advice: Adhere to prescribed medications and attend regular checkups.
By making these lifestyle changes, individuals with diabetes and hypertension can significantly improve their health and reduce their risk of complications.
✒️🩺Lion DR RANA SANJAY PRATAP SINGH
(Dr Rana SP Singh senior physician and diabetologist Patna Bihar 🇮🇳 India 🪷)
🥇DC - FIRST AID EDUCATION AND EMERGENCY RELIEF LIONS CLUB INTERNATIONAL DISTRICT 322E
🥇Diabetes chairperson -LIONS CLUB OF PATLIPUTRA ASTHA

28/07/2025

😊Five Evidence-Based Lifestyle Habits People With Diabetes Can Use.
👌Several evidence-based lifestyle habits focusing on the composition, timing, and sequence of meals and on pre- and postmeal exercise can improve diabetes management. Consuming low-carbohydrate, balanced meals and eating most carbohydrates early in the day are helpful habits. Eating the protein and vegetable components of a meal first and consuming the carbohydrates 30 minutes later can moderate glucose levels. Postmeal glucose surges can be blunted without precipitating hypoglycemia with moderate exercise 30–60 minutes before the anticipated peak. Short-duration, high-intensity exercise could also be effective. Premeal exercise can improve insulin sensitivity but can also cause post-exertion glucose elevations. Moreover, high-intensity premeal exercise may precipitate delayed hypoglycemia in some people. Glycemia benefits can be enhanced by eating a light, balanced breakfast after premeal exercise.
👉Meal Composition
In the context of diabetes, it is useful to think of a meal as consisting of just two components: 1) carbohydrates and 2) everything else (i.e., lean protein, vegetables, fiber, and healthy fat). Carbohydrate intake plays a crucial role in shaping the glucose profile, and this fact has been extensively documented. Inasmuch as insulin resistance is the underlying problem, it is logical to control carbohydrate intake. reported that, for patients with type 2 diabetes on a strict low-calorie diet (600 kcal/day), the fat content of the liver and pancreas decreased, fasting glucose normalized within 1 week, and A1C improved from 7.4 to 6.0% in 8 weeks. Hepatic fat is instrumental in increasing insulin resistance in the liver, and fat in the pancreas decreases insulin secretion. Thus, decreased calorie intake is the crucial factor that improves fasting glucose, as well as other metabolic markers.
Add lean protein, nonstarchy vegetables, dietary fiber, and healthy fat to the appropriate carbohydrate serving, and the glucose spikes get smaller and are delayed, leading to lower glycemic variability and better satiety
👉Meal Timing
Meal timing is a more complex issue. Skipping breakfast altogether and eating big suppers late are not diabetes-friendly meal habits. Meal timing is crucial because glucose tolerance is generally diminished in the evening hours, for both healthy people and those with diabetes .

Breakfast plays a crucial role in metabolism for people with diabetes . showed that skipping breakfast can increase the risk for type 2 diabetes. reported that eating two big meals, breakfast and lunch, offered improved hepatic fat and fasting glucose levels compared with eating six small meals in people with type 2 diabetes. found that a high-energy breakfast and low-energy supper, combined, decrease overall daily hyperglycemia more efficiently in people with type 2 diabetes compared with a low-energy breakfast and a high-energy supper. These researchers also noticed improvements in weight and various other metabolic markers in overweight and obese women when a high-energy breakfast and a low-energy supper were used . Although breakfast is valuable for metabolic control, it is crucial not to increase overall daily calorie intake when adding it to avoid both weight gain and worsened glycemia.
The second-meal phenomenon can be a versatile component of a well-designed diabetes meal plan. Insulin sensitivity is generally high at the time of the second meal because breakfast brings about favorable hormonal changes . Counterregulation controls the metabolic activities of the body during the several hours of fasting through the night. Exogenous glucose is not available then, and the body uses other fuel sources, including free fatty acids, liver glycogen, and muscle glycogen . Breakfast switches metabolism from the counterregulatory hormones to the incretin-insulin system. Within about 30 minutes of breakfast, exogenous glucose coming from the gut becomes the major fuel for the energy needs of the body. Within 90–120 minutes, free fatty acid levels have fallen , early-phase insulin secretion has improved, and glycogen sparing is underway in the liver and muscles. As a result, insulin sensitivity is high during the second meal of the day.
Diurnal variation in glucose tolerance is another factor that has a bearing on meal timing. In general, glucose tolerance is worse in the evening, for both healthy people and people with diabetes . It is therefore preferable to eat fewer carbohydrates for supper but to add more to the earlier meals, and especially to the second meal. Research has further demonstrated the glycemic benefits of eating early versus eating late. The latter habit has been found to raise fasting glucose in men at risk for type 2 diabetes . A high-energy lunch has been found to be better than a high-energy supper . A high-energy breakfast has also been shown to be better than a high-energy supper .
👉Nutrient Sequencing
Research has also provided data showing the glycemia benefit of eating protein or protein and vegetables before eating the carbohydrate portion of a meal .
👉Meal Frequency
Most studies have found that increased meal frequency is better for minimizing both hyperglycemia and hypoglycemia, provided total calorie intake is not excessive and the bulk of daily energy is not consumed in the evening. Interestingly, when two meals are consumed earlier in the day, offering lower hepatic fat and fasting glucose, some individuals get hypoglycemia . Meal frequency can be individualized to keep glycemic variability low.
👉Exercise-Related Considerations
Exercise is essential for physical health and to maintain optimal body composition. However, exercise can also produce untoward effects such as hyperglycemia or hypoglycemia depending on its timing, intensity, duration, and sequencing. It is therefore crucial to select the right types of exercise and perform it at the right times.
👉Postmeal Exercise
There is general agreement among researchers that timely postmeal exercise lowers blood glucose levels in a variety of populations . However, postmeal exercise with a high energy expenditure may cause hyperglycemia or hypoglycemia . Studies comparing premeal walks and postmeal walks and focusing on the immediate (

Medical World Dr Rana Sanjay

14/08/2025

07/08/2025

02/08/2025

30/07/2025

29/07/2025

28/07/2025

28/07/2025

Address

Website

Alerts

Shortcuts

Share

Category