What is HbA1c(A1c) test , How to control HbA1c? What is a normal HbA1c level?

What is HbA1c(A1c)?

HbA1c is a blood test that shows your average blood sugar levels over the past 2 to 3 months. sometimes it is also called just A1c or haemoglobin A1c.

It can be performed at any time and doesn't require any preparations. It can be done in fasting or post-meal condition. It is different from a finger prick test. A finger prick test is a snapshot of blood sugar levels at a specific time and on a specific day.

What is its complete form?

HbA1c stands for glycated haemoglobin. Your red blood cells(RBCs) contain haemoglobin which plays important role in the delivery of oxygen. The total life span of RBCs is 90 to 120 days. Haemoglobin remains glycated for about 90 to 120 days and its value is proportional to the average blood glucose level during this period.

What it is used for?

This test is used to diagnose diabetes and monitor diabetic patients for blood sugar control. It is also used to review medications and diet plans.  Your doctor decides whether you fall into the normal, prediabetic or diabetic category based on your HbA1c levels.

What is the normal range?

A young healthy person usually has HbA1c  between 30 to 33mmol/mol (4.9 to 5.2%).

According to the 2010 American Diabetes Association(ADA) Standards of Medical Care in Diabetes, a normal HbA1c value is less than 39mmol/mol (<5.7%).

If your HbA1c value is 39 to 46mmol/mol (5.7 to 6.4%) then you fall in the prediabetics category.

HbA1c above 46mmol/mol (>6.4%) is in the diabetic range.

What is the recommended value for diabetic patients?

If you are diabetic, the International Diabetes Federation and the American College of Endocrinology recommend HbA1c values below 48 mmol/mol (<6.5%), while the American Diabetes Association recommends HbA1c below 5.3mmol/mol (<7%). 

What is the importance of HbA1c?

If your HbA1c is higher than the recommended values then you must consult your healthcare provider. High HbA1c is directly related to the development of diabetes-associated complications. 

How to lower HbA1c?

Lots of things can cause your HbA1c to change. You can visit your local healthcare provider or your diabetic team to review your medications and diet plan. Here are some things that can decrease your HbA1c levels,

• Visit your healthcare provider and review your medications
• Regular exercise
• Follow a diabetes diet plan
• Avoid alcohol intake
• Stop smoking
• Cut down carbohydrate intake
• Keep track of your caloric intake
• Eat a fresh, healthy and balanced diet
• Maintain a healthy weight

How often do I need the test?

It depends on your diet, medications, local health guidelines, and type of your diabetes. Always consult your healthcare provider and diabetes team for consultation and further information.

Usually, this test is done after 3 to 4 months.

It is always advised to consult your healthcare provider. This is information is provided here only for education and awareness purposes.

What is diabetes? What are symptoms of diabetes? How it is diagnosed and what is the trearment?

Diabetes mellitus

Overview

Diabetes mellitus is a chronic condition that is diagnosed when you have raised blood sugar levels. The main cause of diabetes is an absolute or relative deficiency of insulin in your body. Most of your food turns into sugar(glucose) in your body. Whenever you eat your blood sugar level rises which signal the pancreas to release insulin.

Insulin is a hormone that helps in regulating blood sugar levels. Insulin helps your body in consuming sugar. When there is a deficiency of insulin blood sugar level rises. There are different types of diabetes mellitus such as type 1 diabetes, type 2 diabetes, gestational diabetes, and some rare types(MODY and LADA). 

Types of Diabetes

Type 1 diabetes: 

Type 1 diabetes(previously known as insulin-dependent) is a disease of childhood. Your body's defence mechanism turns against your own pancreatic cells resulting in the destruction of insulin-secreting tissue. There is no insulin to process your blood sugar. This is called absolute deficiency of insulin. As a result blood sugar level rises.

Type 2 diabetes: 

Type 2 diabetes(previously called insulin-independent) is basically diabetes in adulthood and is usually diagnosed by the age of 35 years old. It runs in families because it has a strong genetic preponderance. It is caused by a relative deficiency of insulin which means your cells don't respond to insulin or there is resistance to the effects of inulin. As a result, cells are unable to process blood sugar and blood sugar level rises. It is also strongly associated with Obesity and metabolic syndrome.

Gestational diabetes:

It is defined as high blood sugar levels during pregnancy. It can happen at any stage of pregnancy but it is more common in second and third trimesters. 

Some hormones produced by the placenta have insulin-blocking effects. Women suffering from this condition may experience complications during pregnancy and delivery. Both mother and child have an increased risk of developing diabetes in the future. It is diagnosed by prenatal screening rather than symptoms.

What are the symptoms of diabetes?

There is a long list of symptoms because there are several types of diabetes.

Symptoms of type 1 and type 2 diabetes

• Failure to thrive
• Increased urination(polyuria)
• Increased thirst(polydipsia)
• Constant hunger(polyphagia)
• Fatigue
• Weight loss 
• Vision problems
• Loss of muscle bulk
• Losing weight without trying
• Body aches and fatigue
• Sores that heal very slow
• Getting a lot of infections such as vaginal, gum, and skin infections

Symptoms of gestational diabetes

There are no specific symptoms of gestational diabetes. Some women may experience symptoms the same as described for diabetes type 1 and type 2. This is usually diagnosed on prenatal screening. It happens to millions of pregnant females who experience this condition during their pregnancy.

How to diagnose diabetes?

It is diagnosed by taking a blood sample. A fasting blood sugar level is required to diagnose type 1 and type 2 diabetes. But if your random blood sugar levels are off the charts then a fasting sample is not required. WHO also recommends testing for HbA1c levels for diagnosis. 

To diagnose gestational diabetes, a screening test is done at 24 and 28 weeks of pregnancy. OGTT is the screening test for this condition which takes two hours.

What are the treatment options for diabetes?

Type 1 and Type 2 diabetes:

Insulin is the primary drug of choice for type 1 diabetes as there is an absolute deficiency of insulin. 

There are multiple options to treat type 2 diabetes. Your doctor may advise you to reduce your weight, exercise regularly and cut down your carbs to control your blood sugar levels in type 2 diabetes. Some patients can maintain a normal blood sugar level by modifying their diet and lifestyle. If these measures fail to control blood sugar levels then your doctor may start oral hypoglycemic drugs with or without insulin to maintain normal blood sugar levels.

Insulin and some oral hypoglycemic drugs can be used to treat gestational diabetes.

Following advice is given to every diabetic patient,

• Maintain a healthy weight
• Follow a diet plan
• Exercise regularly
• Eat healthy and fresh food
• Cut down your carbohydrate intake
• keep a record of your blood sugar levels

Do I have diabetes?

If you have any doubts or questions please let us know. It is always advised to consult your local healthcare provider for further information and assessment.

How to lose belly fat? What is obesity? What are the causes of weight gain?

 

What is obesity?

Definition: According to the WHO, Obesity or overweight is defined as having an excessive or abnormal accumulation of fat in your body that impairs your normal health.

Obesity is measured by the BMI calculator. Online calculators are available to help you in keeping track of your weight. BMI=weight in kg/height in meter square.

·       Being overweight is defined as having BMI more than or equal to 25, and

Obesity is defined as having BMI more than or equal to 30.

In 2016 more than 2 billion people were overweight. Now, this value has doubled.

What are the causes of obesity or weight gain?

All causes of obesity and overweight are preventable and modifiable. It is the imbalance of calories consumed and calories burned. Overeating and consumption of junk food is the major cause of obesity. Whenever you eat more than your body requires for daily life, extra calories are stored in the shape of fat cells. Some important causes are

Eating more than the required calories: Eating food that is high in sugar and fat content.

Sedentary lifestyle: Moving less and eating more.

Lack of exercise: Lack of exercise results in the accumulation of extra calories in the shape of fat cells in your belly.

Eating junk food: Eating out a lot and ordering starter desserts can be high in sugar and fat content.

Poor eating habits: Packed junk food and soft drinks also contain high amounts of sugar.

Genetics: Genetics also play a role in obesity but it is rare.

Drugs: Certain drugs may result in increasing your weight. Drugs such as steroids are drugs used to treat epilepsy, diabetes mellitus, depression, and, schizophrenia. Always consult your local healthcare provider for further information and assessment.

Medical conditions: Certain medical conditions may result in gaining extra weight such as Hypothyroidism and Cushing’s syndrome. Consult your doctor if you have any doubts.

What are the complications of obesity?

Obesity has a direct link with heart disease, hypertension, diabetes mellitus, stroke, and osteoarthritis. In recent clinical and research trials obesity is also associated with an increased risk of developing cancers.

In females, obesity is associated development of subfertility,

hormonal imbalance, and polycystic ovarian syndrome.

16 ways to lose weight without dieting or fasting.

1.       Make your plate green with fresh vegetables and fruits.

2.       Never miss your breakfast.

3.       Use less alcohol.

4.       Avoid soft drinks, replace them with diet soda.

5.       Drink more water.

6.       Exercise regularly, at least 150mins per week.

7.       Avoid junk food and replace them with meat fish and whole grain bakery items.

8.       Do yoga and meditation, it is a proven fact that it helps you lose weight.

9.       Keep a track of your weight.

10.   Keep a calorie diary to maintain a healthy food intake.

11.   Keeping a record of your progress makes it easy to see changes and keep on motivated.

12.   Never give up, losing weight takes a lot of time and patience.

13.   Increase your fiber diet intake, it also protects you from certain diseases and cancers.

14.   Watch less television.

15.   Stay active during your work hours.

16.   Go green with green tea.

Is there any medical or surgical treatment for obesity?

There are some medical drugs such as orlistat and liraglutide. It is always advised to consult your local healthcare provider for assistance.

There are some surgical options to help such as bariatric surgeries which help you in losing your weight. There are criteria based on your BMI for decision-making and choosing an appropriate surgical procedure for you. Your local healthcare provider will help you with further assessment and procedure.

What is stress? | Difference between stress and anxiety.

 What is stress?

It is a phenomenon through which our body responds to an unwanted or harmful situation. It is also triggered when you feel threatened or under pressure. Moments of stress can make you nervous and frustrated. If the triggering situation or entity is persistent, this may lead to the development of chronic stress.

Stress is also helpful to protect you from a harmful situation. It helps you in protecting yourself in a fight-or-flight situation. Stress can become very debilitating when it continues without periods of relief.

What happens to our bodies during stress?

Our body has a system that controls our heart rate, breathing, sphincter tone, sweating, and vision control. This system is called the autonomic nervous system. During stress, this system is activated and we experience an increase in our heart rate, increased sweating,  and difficulty in breathing.

What are the symptoms of stress?

•  Loss of sleep, behavior change, and loss of temper.
• Chest pain and pounding heart.
• High blood pressure.
• Headache, dizziness, and exhaustion.

• Body aches and muscle spasms or pain.
• Loss of sex drive.
• Gut problems.

If not managed properly, what are the results of chronic stress?

Chronic stress can lead to emotional, psychological, social, and nervous breakdowns. In some cases, this may lead to the development of depression, anxiety, behavioral changes, loss of interest, and panic attacks.

Patients who are suffering from chronic stress find their way of relieving it by overspending money, gambling, drinking, showing compulsion in sexual activities, smoking, and using drugs.

What is the difference between stress and anxiety?

Stress is can caused by internal or external triggers.

Anxiety is a response to a threat or doubt about something that is causing you stress.

Stress is usually proportional to the trigger.

Anxiety couples up the external trigger, sometimes making it very difficult to cope. Anxiety takes a trigger and turns it into a bigger problem.

Do I have a stress problem? How to diagnose?

Stress is a subjective feeling. It can't be measured by any device or laboratory test. A patient can inform the clinician about the intensity of his stress.

Your local healthcare provider may come up with a questionnaire method to scale your stress level. It is always advised to contact your local health provider for further assessment.

How to prevent stress?

A person can't completely avoid stress but the level of stress can be reduced by practicing some daily goals.

Always think about accomplishments at the end of the day. 

Exercise daily even when you feel stressed.

Say NO to a person or a situation that makes you under pressure or stressed.

Set some goals for your day, week, or month and take control of your life.

Try relaxing exercises such as yoga, meditation, and tai chi. Also, practice muscle relaxing exercises and breathing exercises. always stay positive and be supportive of your family members and colleagues. It is a scientific fact that you can't control everything so learn to let go when circumstances are out of your control. 

When to see a doctor?

It is very common to feel a little stressed. Chronic stress can be debilitating. Try to cope with stress by practicing daily strategies.

If you feel overwhelmed, always consult your local healthcare provider for information and further assessment. 

What is long COVID? What is post-COVID syndrome?

 
What is long COVID?

A strange condition is observed in people who suffered from COVID-19 in the past. Long COVID is also known as post-COVID syndrome. Some people continued to experience some symptoms after recovering from even mild COVID-19 infection. Some clinicians believe it may be possible that a mild infection is not just going away. 

What are the symptoms of Long COVID?

There are many symptoms of long COVID or post-COVID syndrome. Symptoms may range from mild fatigue to debilitating body aches and persistent cough. These symptoms may persist for months to years.

Researchers believe that after having COVID-19, 1 in 5 people has one symptom that is related to the post-COVID syndrome. As it was a pandemic, there are many people who are suffering from the aftershocks of COVID-19.

There are many symptoms of long COVID. we will only discuss those symptoms which are common.

Common symptoms are

• Fatigue
• Body aches and pains
• Fever
• Physical and mental exhaustion

There are some system-related conditions in post-COVID syndrome  such as

• Respiratory symptoms such as persistent cough and shortness of breath.
• Mental health-related symptoms such as loss of sleep, loss of smell and loss of taste, headache, restless leg syndrome, difficulty in concentration, irritability, anxiety, and depression.
• Gut problems for example diarrhea and abdominal pain.
• Heart symptoms such as chest pain or fast beating heart.

And there are many more...

So it is very hard to tell whether a person is really from the post-COVID syndrome. Some symptoms are very similar to other chronic medical conditions such as chronic fatigue syndrome or chronic conditions that develop after infections. It is always advised to consult your healthcare provider for further information and guidance.

What are the risk factors to develop long COVID?

People who had experienced severe COVID-19 are at risk of developing long-COVID.

How to prevent long COVID?

The only way to prevent long COVID is to protect yourself and others from getting the infection. Vaccine against COVID-19 is also the best way of protection. We must follow the guidelines provided by our healthcare system for protection against COVID-19.

Do I have long COVID?

There are no specific tests for long COVID. As there is a long list of symptoms it is very difficult to diagnose. The history of COVID-19 in the past is the only evidence to suggest whether a person is having long COVID or not.

It is always advised to consult your local healthcare provider for further information and suggestions.

How To improve Your Gut Health?

People are asking questions about the relationship between diet and the mind. Many research trials are going on to explore the connection between gut physiology and brain psychology. All dieticians have a strong belief that a healthy and fresh diet has a very strong positive effect on your gut and mind axis. 

Avoiding processed food and drinks is a very good eating habit. Processed food items have many additives and preservatives. These preservatives and additives have so many negative effects on the digestive system of your gut. Try to avoid canned food.

Your gut which is also called the gastrointestinal system, has its own ecosystem having so many hormones, secretions, enzymes, bacteria, acids, and alkalis. In the gut, many bacteria help us to digest our food. 

What to eat for a healthy gut and mind axis?

Fill your plate with fresh fruits and vegetables to have a healthy life and a wealthy mind. Use meat, chicken, and fish to boost your body's defense mechanism.

Healthy food pyramid

Don't think of it as a single meal, take it as a whole-day meal percentage. Let's break it down to the percentage part.
It is 10% sugar and fat, 15% meat fish egg, and milk, 20% fruits, 25% vegetables, and 30% bread, cereals, and pasta.

What is the gut-brain axis?

Gut-brain axis is a bidirectional communication system between the gut and brain. Emotional and psychological stress disturbs your gut motility, hormonal secretion, and microbiota. Commercially available canned, smoked, processed, and preserved food items result in disturbance of the gut ecosystem leading to behavioral and psychological disturbance.

What is monkeypox? How monkeypox spreads? Can humans get monkeypox virus?

Monkeypox

 

Monkeypox is a viral disease(Monkeypox virus or MPV) and there is an ongoing outbreak. This virus is similar to the smallpox virus. This disease is endemic in Nigeria. The initial cluster of cases was confirmed in the United Kingdom in May 2022. This is the first time that monkeypox has spread outside of Africa.

How monkeypox spreads?

A well-known source of spread is a recent visit to Nigeria. It is a zoonotic infection which means it spreads from animals(rodents and primates) to humans and it can also be transmitted from human to human. It is transmitted by direct contact with an infected person specifically those who are having lesions on their skin or genitals. It can also spread by respiratory secretions such as coughing, sneezing, and talking. It can also spread by touching infected surfaces or fabrics. There are reported cases of spread through sexual intercourse specifically men who have sex with men.

What are the symptoms of monkeypox?

• Body rash, may look like pimples or scabs and may be itchy or painful
• Fever
• Body aches
• Rigors and chills
• Enlarged lymph nodes
• Fatigue
• Headache
• Sore throat
• Cough
• Nasal congestion

Sometimes people may experience only flu-like illness before the rash and after one or two weeks all the symptoms are gone.

Duration of symptoms?

Monkeypox symptoms usually start within two to three weeks after exposure. The first symptom to appear is a flu-like illness. After one to four weeks patient develops a body rash. The illness typically lasts for three to four weeks.

Monkeypox test

Monkeypox virus is a double-stranded DNA virus so usually, PCR or nucleic acid testing is done. A blood sample or sample of the skin lesion is obtained for diagnosis. Always contact your local healthcare provider for further information.

When someone should get tested for monkeypox?

If someone thinks that he may have monkeypox it is always recommended to contact your local healthcare provider for help and further procedure.

Does monkeypox have many types?

There are two types of monkeypox, CLADE1 and CLADE2. The recent outbreak is from CLADE2.

Is monkeypox dangerous?

The recent outbreak is from CLADE2. It is rarely dangerous. 99% of patients recover completely. People with a weakened immune system may have a severe illness.

What are treatment options for monkeypox?

There is no specific treatment. symptomatic treatment is given to all patients.

Is there any vaccine for prevention?

The monkeypox virus is genetically similar to the smallpox virus. Vaccines used for smallpox may be beneficial to prevent monkeypox infection.

What is flu? What is seasonal infuenza?

Flu is a contagious viral illness caused by influenza viruses. 

Influenza family is a group of 

viruses ( A,B,C,D). It can affect the nose, throat, or sometimes lungs.

What are the symptoms of Flu?

Flu may present with

• Headache

• Fever

• Body aches

• Runny nose

• Nasal congestion

• Cough

• Throat pain

• Chills and sweats

• Vomiting diarrhea

• Shortness of breath

How Flu spreads?

It is spread by air droplets when a person who has flu coughs,

sneezes or talks.

Air droplets with the influenza virus can infect a person within

 one to two meters of range.

 Who are at risk?

• Young children under age 5 and specifically those under 6 months.

• Old age person of age more than 65.

• Diabetic patients.

• Persons suffering from cancer or malignancy.

• Patients who are receiving chemotherapy, radiotherapy, or steroids.

• Patients who are suffering from chronic ailments ( liver, renal, or cardiac failure).

• Doctors and paramedical staff.

When to see a doctor?

Most people who suffer from flu usually get well on their own within a few days.

 It is a self-limiting disease.

If you have severe symptoms or you have a pre-existing medical condition then 

 

consult your doctor for further advice.

What is the treatment?

Always consult your doctor for treatment your doctor may give you symptomatic 

 treatment. Doctors usually prescribe antipyretics for fever and analgesics for body 

aches. Doctors also advise their patients to take plenty of fluids. If symptoms are 

severe antiviral treatment is also recommended.

 

How to prevent flu?

Annual influenza vaccination is the best way to prevention. 

Also spread can be prevented by taking some measures such as wearing a mask,

covering your mouth while coughing or sneezing, maintaining a distance of one meter,

washing your hands, cleaning workplaces, and avoiding crowds during periods of 

endemics.

What are the complications?

• Pneumonia

• Ear infections

• Asthma flare-ups

• worsening of a pre-existing condition

• acute respiratory distress syndrome