Inhaled Insulin has been withdrawn from the world market, due its side effects.

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When you have diabetes, stress can significantly affect your ability to control the disease. If you are under stress, you may skip meals or forget to take your medicines, which will affect your blood glucose level. Learning to deal with this stress is especially important if you have diabetes.

Although you can’t completely remove stress from your life, there are several ways you can reduce it. And by learning to better cope with stress, you can help keep your diabetes under control. Here are some tips.

Fight Stress With a Positive Attitude

When things seem to be going wrong, it’s always easier to see the bad instead of the good. Find something good in each important area of your life: work, family, friends, and health. Thinking about the good can help you get through the bad times and the stress.

Be Nice to Yourself

What are your talents, abilities, and goals? Are you expecting too much from yourself? Don’t expect more of yourself than you have or are able to give.

Accept What You Cannot Change

For those stressful situations or problems that cannot be changed, develop a simple plan of action. Ask yourself the following questions:

• “Will this be important two years from now?”
• “Do I have control over this situation?”
• “Can I change my situation?”

Talk to Someone About Your Stress

Don’t keep everything bottled up inside. If you don’t want to talk with a family member or close friend, there are counselors and clergy trained to provide support and insight. Ask your doctor for recommendations if you would like to see a psychologist or counselor.

Exercise

The benefits of exercise in reducing stress are well known, particularly for someone with diabetes. Exercise gives you a feeling of well-being and may relieve symptoms of stress.

Take Time to Relax

Practice muscle relaxation, deep breathing, meditation, or visualization.

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Hoping for a beer at the ball game, or a glass of wine with dinner?

If you have type 2 diabetes, that’s probably OK as long as your blood sugar is under control, you don’t have any complications that are affected by alcohol (such as high blood pressure), and you know how the drink will affect your blood sugar, according to the American Diabetes Association.

An alcohol-containing drink a day might even help your heart (though if you don’t already drink, most experts say that’s not a reason to start).

In moderation, alcohol may cut heart disease risk
According to a study by researchers at the Harvard School of Public Health, women with type 2 diabetes who drank relatively small amounts of alcohol had a lower heart-disease risk than those who abstained. A second study found that men with diabetes had the same reduction in heart risk with a moderate alcohol intake as non-diabetic men.

In general, the recommendations for alcohol consumption for someone with type 2 diabetes are the same as anyone else: no more than two drinks per day for men and no more than one drink per day for women. (Make sure to measure: A drink serving is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor such as scotch, gin, tequila, or vodka.)

People with diabetes who choose to drink need to take extra care keeping food, medications, alcohol, and blood sugars in balance.

Janis Roszler, RD, a certified diabetes educator in Miami, Fla., recommends:

• Mixing alcoholic drinks with water or calorie-free diet sodas instead of sugary (and calorie- and carbohydrate-laden) sodas and other mixers.
• Once you have had your drink, switch to a non-alcoholic drink, such as sparkling water, for the rest of the evening.
• Make sure you have an eating strategy and plan in place to avoid overeating and overdrinking in social situations. Alcohol can make you more relaxed, and may lead you to make poor food or drinking decisions.
• Don’t drink on an empty stomach because alcohol can have a very rapid blood glucose lowering effect, which is slowed if there is food in your stomach.
• If you’re going to have a drink, wear your diabetes identification bracelet or necklace.

“If you become hypoglycemic and there is alcohol on your breath, police or paramedics may mistake your condition for being drunk and may not get the care you need,” says Roszler.

Alcohol may also worsen nerve damage
Some people with diabetes, though, should not consume alcoholic beverages.

Drinking can worsen nerve damage from diabetes and increase the pain, burning, tingling, and numbness that people with nerve damage often experience.

If you have complications related to your diabetes, you should be more careful about your alcohol intake. More than three drinks a day can worsen diabetic retinopathy. And even if you have fewer than two drinks per week, you can increase your risk of nerve damage (alcohol abuse can cause nerve damage, even in people without diabetes). Alcohol can also raise levels of fat called triglycerides in the blood.

Here’s something else to consider: Researchers at Kaiser Permanente in California wanted to see whether there is a relationship between drinking and diabetes self-care behaviors. The team examined survey data for 65,996 adults with diabetes to determine their levels of alcohol consumption and adherence to good health habits, such as testing their blood sugar, getting their A1C levels checked, and taking their medicines.

People who drink alcohol, the study found, are less likely to follow recommended practices than those who don’t drink, and the more they imbibe, the less likely they are to stick with recommended health practices.

Although the study doesn’t prove that drinking causes poor health behaviors, it does suggest that drinking is a marker for poor self-care.

You’ll need to test your blood sugar to gauge alcohol’s effect
If you do choose to drink, there are no specific recommendations for one type of alcoholic beverage as better than another. However, the American Diabetes Association notes that light beer and dry wines tend to have less alcohol, carbohydrates, and calories.

It’s important to test before and after having a drink to see the impact on your blood sugar, especially when you’ve first been diagnosed with diabetes or if you’re taking insulin or other medicines that can cause hypoglycemia. Treat abnormal blood sugar levels as directed by your health care team.

Alcohol usually causes blood sugar to drop (while the liver is processing alcohol, it takes a break from its other role of releasing stored glucose as needed). However, alcohol can sometimes raise blood sugar.

“I do drink alcohol in very moderate amounts,” says Donna Kay, 40, of Prairie Village, Kan., who was diagnosed with type 2 diabetes in 2003. She always checks her blood sugar before and after consuming alcohol. “If I’m at a dinner party, I’ll duck into a bathroom,” she says.

“For me,” says Kay, “beer will raise my blood glucose, while a martini will cause it to fall a little. I avoid drinks with fruit juice or a lot of sugar, such as a cosmopolitan or a piña colada. “They are not worth the blood sugar spike or the calories. Also, some alcohol, such as Baileys Irish Cream, has lots and lots of added sugar—I skip the sugary stuff so I can save those carbs for something else,” Kay says.

Red and white wine both have about 100 calories per five-ounce glass; sweeter red wines will have a higher calorie count because of the extra sugar from the grapes. A screwdriver (vodka and orange juice) made up of 1.5 ounces of vodka and eight ounces of orange juice would have 208 calories and 25 carbohydrate grams (all the carbohydrate is from the orange juice.)

You may have to adjust other food choices during the day to accommodate the extra calories and carbohydrates from alcoholic drinks. As a general rule, it is better not to “drink” your calories; healthy food choices should come first.

Source:Health.com

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If anything, the International Diabetes Federation’s (IDF) Diabetes Atlas released early December in South Africa, only confirms what we already know: India has the largest number of people living with diabetes.

It is in the pre-diabetic phase, Impaired Glucose Tolerance, that China overtakes India, both in the prevalence and projections.

The Atlas, third in a series that began in 2000, begins with the preamble: “With the forces of globalisation and industrialisation proceeding at an increasing rate, the prevalence of diabetes is predicted to increase dramatically over the next few decades. The resulting burden of complications and premature mortality will continue to present itself as a major and growing public health problem for most countries.”

The IDF has worked on the Atlas, hoping to create an impact on the public health policy of various governments across the world, advising them to factor diabetes into their plans, according to A. Ramachandran, Director, Diabetes Research Centre and M.V. Hospital for Diabetes, Chennai.

Dr. Ramachandran, who also served on the Atlas Committee where his research has been extensively quoted, says, “we need to push the cause of fighting diabetes with governments. We believe that politicians are convinced by numbers and the Atlas serves to provide the figures to convince them.”

According to the publication, India has 40.9 million people with diabetes in India, and China follows right behind at 39.8 million diabetics.

As for the projections in 2025, India will still top the list, with 69.9 million diabetics but it is estimated that China will meanwhile put some distance between itself and India. China will have 59.3 million diabetics in 2025, the Atlas says.

However, the Atlas throws up figures that put China ahead of India in the pre-diabetic stage defined as Impaired Glucose Tolerance (IGT), again associated with insulin resistance.

In fact, China is currently way ahead of the rest of the world, with 64.3 million people with IGT, and will continue to be in 2025, according to the Atlas, with 79.1 million IGTs. India follows with a current prevalence of 35.9 million persons and a projected total of 56.2 million people in 2025.

Other key inputs in the Atlas are the extensive chapters on diabetes-related complications and cost assessments. “In virtually every developed society, diabetes is ranked among the leading causes of blindness, renal failure and lower limb amputation. Through its effects on cardiovascular disease, it is also one of the leading causes of death.”

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