Why exercise is advised in diabetic patients

Diabetes mellitus is a condition characterized by elevated blood sugar value. Apart from that there is alterations in blood lipid value and blood pressure. In diabetic patients exercise will help to decrease the blood sugar and also increases the sensitivity to insulin.

Other positive effect of exercise in diabetic patients

1. Decrease the heart attack risk

2. Decrease the blood pressure.

3. Exercise will help to reduce the muscle mass.

4. Reduce the body fat.

5. Produce weight loss.

Recommend exercise in diabetes

Diabetic people are advised exercise 150 minutes/week that is distributed at least over 3 days, moderate aerobic physical activity and resistance training.

Precaution before starting exercise in diabetic patients.

Since  diabetic patients are at high risk for heart disease without pain exercise tolerance test may be done in the following situations.

1. Age  more than 35 yrs

2. Duration of diabetes more than 15 yrs in type 1 diabetes and more than 10 yrs in type 2 diabetes.

3. If the patient has complications of diabetes such as kidney disease ,eye disease

4. Blood vessel occlusion in limbs.

5. Other risk factors for heart disease.

Those patients who have proliferative diabetic retinopathy should avoid vigorous exercise because of the chance of bleeding in to eye. 

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Drugs used for treatment of heart attack patients.

Heart attack occurs when there is reduced blood supply to heart. It is an emergency situation and immediate medical care is required. Here in this article we will tell you some of the drugs and their aims. It is always good to have these in your mind

Following are the aims of treatment.

1.Immediate stabilization of patient.

2.longterm symptom control.

3.Cure of the condition if possible.

Drugs used for the treatment are given below.

1. Antiplatelet drugs –Aspirin and Clopidogrel, it is a group of powerful drugs that will prevent the blood clotting.

2. Nitrates will help to reduce the pain

3. Betablockers decrease the heart rate, blood pressure and improve the oxygen supply to heart.

4. Statin will reduce the blood cholesterol. Stabilize the plaque so prevent further attack.

5. ACE Inhibitors- role is to reduce the blood pressure, dilate the blood vessels and increases the blood supply.

6. Angiotensin II Receptor Blockers will increase the blood supply to heart.

7. Clot lysis with streptokinase give immediate improvement.

8. Diuretics remove excess salt and water from the body so help the heart to work properly.

9. Digoxin improve the function of heart.

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Tips to keep your heart young and healthy

Here are few tips that will help to keep your heart healthy and young

1. Avoid fried foods.
2. Avoid fatty foods such as beef, pork and mutton.
3. Eat small fish such as sardine that is good for your heart.
4. Take un cooked vegetables daily such as cucumber ,carrot, tomato and onion.
5. Reduce salt intake.
6. Take high fiber diet including green leafy vegetables and legumes such as . Soybeans, fava beans, peas ....
7. Avoid egg yolk which has high cholesterol content.
8. Avoid eating fried foods and salty foods such as chips and corn while reading and watching television.
9. Better avoid milk and dairy products.
10. Avoid hotel foods and if inevitable take only vegetarian food.
11. It is better to prevent diabetes and if already present strict control is necessary.
12. Strict control of blood pressure is advised.
13. If possible avoid using lift and climb the staircase.
14. Better to walk small distances rather than using a vehicle.
15. If your work demands sitting for long hours better to take rest and walk in between.
16. Walk for 40 minutes daily.
17. Avoid smoking and alcohol consumption.
18. Maintain body weight , weight should be in proportion to your height.
19. Better to go to bed early and wake up early in the morning.
21. Even if you have to do heavy work do it systematically and ensure adequate rest and enjoyment in between.
22. It is better to practice yoga and meditation.
23. For a happy family environment healthy sexual life is inevitable, avoid extramarital relationships which is a frequent source of mental stress and risk factor for heart disease.

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Medicinal effect of garlic in heart patients.

Medicinal effects of Garlic (Allium sativum) is known from the ancient days itself. It is used for treatment and prevention of many disease. Heart attack patients get several benefits with garlic intake. 

Active ingredient is Allicin which is an odorous sulfurous compound that has several medicinal effect. Following are the benefit of Garlic in heart attack patients. The main abnormality in blood vessels in heart attack patients is atherosclerosis. 

• It helps to reduce the blood clotting. It produce irreversible inhibition of platelet aggregation ,which is a blood component. Major action of drugs given in heart attack patients is to inhibit the platelet, which is responsible for blood clotting.
• Reduction of cholesterol and triglycerides levels which is responsible for formation of atherosclerosis and plaque in blood vessels leading to reduction in blood supply.Several studies showed 9 to 12% reduction in cholesterol and moderate reduction of triglycerides levels with its use.
• Help to reduce blood pressure which is also a risk factor for heart attack .There will be an average reduction of 11mm of Hg in systolic and 6.5 mm of Hg diastolic blood pressure.
• Garlic has anti atherosclerosis action,which help to reduce the formation of new atherosclerosis lesion and prevent the progression of older lesions.

Garlic is available as fresh cloves, powders, extract, tablets. At least one-half garlic clove per day  is required for medicinal effects.Although the tablets and powders are convenient, the amount of active ingredient is insufficient.

Some people may experience gut (gastrointestinal system ) symptoms such as flatulence(gas), chest pain and abdominal pain after garlic intake.

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How will you identify that you have metabolic syndrome.

Identification of metabolic syndrome is important because it will help to predict the risk of future heart disease and diabetic risk. Worldwide more and more people are affected by this. This is due to change in lifestyle and food habits. Metabolic syndrome is highest among native Americans. It has got 5 components. Increased waist circumference is more in females where as fasting triglycerides and hypertension is more common in males.

Five components of metabolic syndrome are the following.

1.Central obesity(waist circumference)

2.Increased triglycerides

3.Low HDL cholesterol.

4.Diabetes mellitus

5.Hypertension

Risk factors of metabolic syndrome

1. Overweight and obesity

2. Aging

3. Heart disease

4. Diabetes mellitus

5. Sedentary lifestyle 

6. Lipodystrophy

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Significance of early diagnosis of heart attack

Chest pain is a Common complaint in  emergency department (ED). Approximately 5% of all ED visits or 5 million visits per year is due to chest pain .There is a wide range of etiologies Cardiac, Pulmonary, Gastrointestinal, Musculoskeletal. Distinguishing these causes matter because management vary  according to etiology.

When there is a block in coronary arteries that supply heart muscle it will produce heart attack .Most common manifestation is  cardiac pain which is called angina pectoris.

Key features of typical cardiac pain

From history 

Location : Pain can be central, left or right part of chest.

Timing : It can be gradual or sudden onset.

Provocation : By exertion.

Quality : Diffuse or constricting type of pain it can be an uncomfortable pressure, fullness, squeezing in the chest.

Radiation : Can radiate to back, neck and arm.

Severity : Severity vary from a scale of 1-10.

Associated symptoms : Breathlessness, sweating, nausea, fainting, feeling of impending doom, cold clammy skin may be present.

When the patient is asked to localize the sensation, he or she will typically press on the sternum, sometimes with a clenched fist, to indicate a squeezing, central, substernal discomfort (Levine's sign). 

                 Levine's sign 

Key Emergency Physical examination 

1. General appearance - Patients are usually anxious and restless.
2. Vital signs - Watch for hypotension or hypertension.
3. Heart - Examine the heart sounds is it muffled? regular? fast?
4. Neck dilated neck vein.
5. Abdominal distension.
6. Lowerlimb oedema and calf muscle tenderness.
7. All these features need not be present in every patients.

Whenever you have chest pain consider above mentioned points you should not ignore the chest pain if  at least one or two features are present  and attend the emergency department and do proper evaluation.Early diagnosis is important because if there is a delay in treatment  more than 6 hours, there will be irreversible damage to heart muscles.

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