Full name of this physical disorder consists of two words. Diabetes’ and ‘Mellitus’. There is another word ‘Insipidus’ also aligned with the two words. In fact the word (or term) ‘Diabetes’, which owes its origin to Unani language, means ‘That which comes out or that which flows’ and the term ‘Mellitus’ (a word of latin origin) means ‘sugar’ or ‘honey’. Hence, the term ‘Diabetes Mellitus’ means flow of sugar. The Ayurvedic term ‘Madhumeha’ means ‘Rain of honey’ stands for ‘Sugar’. Hence, Diabetes Mellitus and ‘Madhumeha’ are synonyms and they convey the same sense. Diabetes Insipidus is characterized by the persistent excretion of excessive quantities of urine of low specific gravity but this is not a specific kind of ‘True Diabetes’. But when the urine is loaded with excessive content of sugar and the urinary flow, irrespective of the quantity passed in 24 hours, is also on higher side, it may be called of diabetic origin. Diabetes Insipidus can be deduced by excessive thirst and urinary flow in large quantity. When the body fails to utilize the released quantity of sugar, it spills over in to the blood stream and renders the blood laden with sugar. When blood fails to absorb sugar, the excessive quantity passes on to kidneys and loads the urine with sugar.

Do not infer diabetes when there is sugar in urine only but when blood-tests reveal presence of sugar therein (in the blood) then diabetes Mellitus (DM) will be a confirmed diagnosis, calling for a further thorough probe.


Mere presence of sugar in urine is no definite sign or symptom of diabetic status of a person. But, its presence in urine is a forewarning that something is wrong somewhere. And what is wrong and where, will be determined and disclosed by patient’s objective and subjective symptoms, as also by clinical tests. Merely a single test report should never form basis for confirmation of diabetes unless repeated tests, after a gap of 4-5 days, show presence of sugar in urine, then only patient’s blood sugar should be tested and if blood is also shown to have sugar, in that case it becomes a confirmed case for ‘Diabetes Mellitus’ calls immediately which for a doctor’s advice and guidance.

To repeat, mere passing of excessive amount of urine does not confirm diabetes and also large amount of sugar in urine is also not a confirmed symptom of diabetes. But presence of large percentage of sugar in urine and blood is really ‘Diabetes Mellitus’ which should be attended to, after proper investigations and tests.

There is, sometimes, confusion about ‘enuresis’ and diabetes. Enuresis is actually ‘bed wetting’ which often occurs in infants, young people or old persons and usually occurs at night. It is involuntary flow of urine passed while sleeping, especially when the patient is unable to control pressure or urine. In infants and children, it gets automatically cured but if it continues even in or upto old age, then causes may have to the traced to some other disorders.

Diabetes is rightly claimed to be prominent silent killer disease, for the simple reason that it is the only disease which ranks only to cancer. It is a disease which has been baffling the patient and the medical profession alike, for its onset, progress and treatment, and also due to various hypothesis and causes which cause onset of this lingering and baffling disease. The doctor and the patient have to maintain a close contact, in order to avoid further complications. Most of the diabetics lead quite a healthy and fairly long span of life, provided they are motivated, and guided by their physicians, at regular intervals.

Our so- called high profile and modern life-style have further added to diabetic’s dilemma, confusion and lopsided approach. Mass of wanted/unwanted suggestions, myths theories and the so-called ‘effective and curable medicines’ have further complicated this already confused disease. We are today, as confused about diabetes as we were earlier, when diabetes was considered as an incurable and killer disease. Even uptil now there is no definite curative remedy which can rid the patient of this physical upset. Thus the patient becomes a confused entity (lot) due to the reason given above. Let us agree on one point, at least that diabetes is not, at all, curable, and is positively manageable, treatable and controllable, and the only condition is that the patient has to be under guidance, care of his physician. Further, there is no escape from periodical tests also. Any indiscreet deviation could suffice to further complicate the disease.

In order to get so- called ‘Permanent and Finally Curable remedies’ the patient, in his eagerness and anxiety, runs from pillar to post, to seek relief and cure, which (two) factors land him in a state of dismayed uncertainty. He fails to stick to one system of treatment or a single physician, because his anxiety and eagerness do not let him have any respite. In such an awkward situation he prefers to use ‘home remedies’, ‘Magical Cures’, quackeryemanating formulae.’ This way, his wayward and casual approach lands him into such a complicated state, from which he cannot make a retreat.

We can only advise the diabetics, with all the honest sincerity, that there is reason for them to get panicky, disgusted or become a social recluse. Reasonable and regular caution is and should be the watchword for all diabetics and laxity in abiding to lay-down principles and irregular approach should be given a go bye once forever. Do not be ever scared and horrified that you have a dreaded disease, instead assure yourself that you are having a disease which has definite treatment which you can control.

In this book and attempt has been made to educate the patient about causes, effects and complications, cautions, diet, medicines and above all certain myths about diabetes have been removed or, at least an effort has been made to reply to certain apprehensions and myths which often arise in a diabetic’s mind. The information disseminated in this book and the suggestions given, should serve as a guideline to the diabetic. Let us not lose sight of the fact that, unless and until a diabetic’s mind. The information disseminated in this book and the suggestions given, should serve as a guideline to the diabetic has strong mental will, positive approach, a desire to learn and follow prudently and discreetly the suggestion, he may not derive any benefits. Will to learn and determination to follow the advice of his doctor are unquestioned prerequisites not for diabetics alone but all patient s suffering from other ailments.

To add to the patient’s knowledge, charts on height, weight, diet, alternate diets and diet substitutes have also been given, which hopefully will serve as guidelines. Such guidelines are merely suggestions, based on mass usage thereof, but certain modifications and adjustments cannot be ruled out. Medicinal courses and the medicines have been suggested in should be the real guide for a diabetic patient.

Some of the unavoidable technical words had to be used in this book but, to obviate the said difficulty of readers, a glossary, explaining in simple words the meaning of such terms, has been given at end of the book, which way often be referred to, as and when required. Let us pray for welfare of all and disease for none:

‘Let all the person be happy, without diseases, look to brighter side and let no person have even on iota of pain.’

From now onwards whenever and wherever the word ‘Diabetes’ is used, it will mean ‘Diabetes Mellitus (D.M) and it will also stand equally well for Glycosuria and ‘Diabetes Insipidus’ because symptoms, in the latter two disorders, will also be noticed is Diabetes Mellitus. It would be more correct and precise if we say that Diabetes (or true Diabetes) should mean to convey presence of sugar in blood and urine, along with undermentioned symptoms:-


SYMPTOMS


1. Excessive Thirst: The patient consumes large quantity of water, quite often and in short pauses.

2. Excessive urination: Patient goes to closet again and again, passes large amount of urine. Gets up frequently, at night to vacate bladder, and passes large quantities of water.

3. Excessive Hunger: Patient has a voracious hunger. He becomes a greedy later, if not a glutten, He eats too often and too much but, inspite of excessive eating, he feels hungry and demands food every now the then.


4. Getting Fatigued: He gets tired easily even after exerting a little and also gets out of breath.

5. Loss of Weight: Inspite of consuming large quantity of food and other eatables, he feels like taking food again and again but, despite all this, he continues to lose weight.

6. Pruritus: Pruritus in intense itching of skin. But, in diabetes, there is pruritus on and around genitals and the patient, in his eagerness to gain relief, goes on scratching until there is bleeding from his skin.

7. Eye Problems: His vision becomes opaque and hazy, his retina is adversely affected. The cataract has an earlier onset. His sight is masked, weak and fatigued. Neglect may lead to even total blindness.

8. Neuropathy: It is symptom which is characterized by weak and numb nerve-power. He often says that his calves and legs are weak and senseless, his thinking power has been adversely affected, his organs are not strong enough to carry the weight of his body.

9. Pain in Body: He often complains of pains all over the body, especially in legs.

10. Malaise: Patient remains gloomy, inert and runs away or shuns to do any labour. He is often in a state of run-down of body. Not only his body but his mood also shows a depressed state. And mentally also he remains in a ‘what to do’, ‘what next’ or ‘nothing to do’ mental framework. He becomes a schizophrenic embodiment.

11. Skin Infection: pimples, scratches, rough skin, dry skin, unhealthy skin are the usual symptoms.

12. Late Healing of wounds: This a common complaint on diabetics that their wounds do not heal quickly. In fact, diabetics develop low reactive power which fails to control infections, with the result the even small and ordinary infection-based or other wounds and injuries refuse to show any declining trend. The diabetics are warned to keep their feet well protected from injuries, burns, contusions, and other such maladies. If there is bleeding they must attend to the same, to have the bleeding stopped forthwith.

13. Sexual Apathy or Sexual Excitement: Male patients either lose their urge to perform sex acts or become repugnant to sex matters. Conversely, some of the patients get easily excited and yearn for satiation of their sexual desires.

14. Phimosis: It is common complaint with diabetic males whose prepuces get constricted and thus, can’t be drawn up the glans-penis. When the foreskin cannot be drawn back, after having been once drawn up, it is called ‘Para-Phimosis.’ If Phimosis be a complication of infancy stage, then it is of congenital origin and diabetes will further compound the already existing problem.

15. Diabetic Gangrene and infection of Toes: In diabetes any foot injury can assume highly serious form, if not treated properly and timely. If any injuries fail to heal then decay of the affected part may occur, which may result into cutting or amputation of toe or any other gangrenous or infected part.

16. Diabetic Coma: it may be cause either due to absence or lack of sugar in the body. We will discuss it, in details at some other place in this book.

The above mentioned symptoms are predominant, out of some of the many symptoms. It is not that all the patients may have all the aforesaid symptoms. Many my have all, some most of the said symptoms, while others may be having only a very few of them.

Heredity is said to be a potential factor for communication of diabetes from mother to her off-spring to her off-spring or if the parents, either both or either of them, has had diabetes, their children will also have diabetes. It is true, to some extent, that if an expectant mother is a diabetic, her off-spring will also be a certainly a diabetic. But results to the contrary have also come to light. Exceptions do prove the rules, but exceptions are the rules themselves. Let us not lose sight of the fact that an off-spring has fairly higher chances of imbibing and inheriting diabetes form its mother at the stage from which she has to offer to her off-spring. But, if the mother had diabetes during period of pregnancy, especially when clinical tests had not revealed anything to the contrary or say that there was presence of sugar in urine and blood, then the off spring is liable to inherit the disorder. But drug-induced diabetes is a transitory metabolic reaction only and even if the disorder is passed on to the off-spring, there is every chance that the infant will be a born diabetic, but his symptoms may subside or even disappear, after the time he gives up breast-feeding.

But mothers, who had been confirmed diabetics prior to conception, will definitely pass on such a disease to her off-spring. It is, therefore on detection of profanely, the mother’s sugar level’ must be maintained within normal ranges so that diabetes is not passes on to her foetus. If diabetes is kept under control, in that case, the infact may not have any symptoms of inherited diabetes, but a risk factor cannot, still, be ruled out.

It may be printed out that diabetes is not a communicable and infectious syndrome, like venereal diseases, AIDS, Tuberculosis etc. as it can’t be transmitted from one person to another. If the child was born as a non-diabetic but his parents were or are diabetics, then the child or a grown up young person will not have any diabetes. But it is also true, that children of diabetic parents are more prone to diabetes, because of the ‘risk factor’. It means that such children are in the ‘red’ and there is every risk of their getting diabetes. But, to say that all of them, will become diabetes, is not fair, except to mountain that they should remain on the guard and take all possible and necessary precautions so as to ward off risk of getting diabetes, for the simple reason that they have high ‘risk factor’ looming largely over them and, as such, parents have also a sacred and social obligation to educate, guide and motivate their children to avoid the causes which can cause such a silent killer to invade their body.

Father and mothers who are indolent, inactive, obese and drunkards eating too much and too often, avoiding and physical exercise, consuming carbohydrates, fats, least of fibre-based green vegetables and fruits, must exert caution and warn their children to keep away from such factors as are patient causatives of diabetes. You cannot have diabetes of yourself and your children cured but can definitely control it by proper treatment, caution, abstention and dietary control.




OBESITY

, joint affections, asthma and dyspnoea, problems in smooth walking, easy fatigue etc. Obesity means accumulation of extra fat on the entire body, especially on and around neck, waste, abdomen thighs and gluteal muscles. Fatness is caused by too much eating, frequent eating, excessive use of fats, carbohydrates, (including fructose glucose, crystal sugar, lactose, cereals, honey, jaggery confectionery’s sugar based products etc), thyroid’s malfunctioning etc. obesity is a common symptoms of senile and easy going, gluttons, inactive and ‘chair-borna’ persons. Obesity is such a diseases (disorder, symptom) that it gives birth to high blood pressure, heart problems, diabetes, gout

Like the symptoms, causes of diabetes are also not few and the mass of causes to which a patient may be subjected should and do, determine as to what is the cause that has triggered this disorder. Truly speaking discerning the cause/causes, is and arduous and laborious task which can be determined by the doctor only and that also , after careful examinations and clinical tests. In brief following factors may be responsible for causing diabetes:

(1) Inadequate secretion of insulin by an endocrine gland, called ‘Pancreas’ which is known as diabetes of pancreatic origin.

(2) Heredity factor.

(3) Obesity or Overweight.

(4) Dietary indiscretion or too much of eating.

(5) Carbohydrate-protein metabolism. Disturbed/imbalanced.

(6) Malfunctioning of other Endocrine Glands, like Thyroid, Pituitary & Adrenal.

(7) Alcohol

(8) Sugar takes in excess

(9) Drug induced diabetes etc.

Out of the above-mentioned factors, we can further shorten the said list with following major sub-headings.

(1) Heredity

(2) Obesity

(3) Diet & Food

(4) Endocrine Glands’ Malfunctioning

(5) Drug-induced Diabetes.

Now the above factors will be explained in details, under separate individual headings, at later stage.

It is the result of common nutritional disorders and is a trait of the affluent and rich societies since mortality factor is very much aligned to it. It is a breeding ground for most of the killer diseases, as also other ailments which one could avoid easily. Every cause gives rise to an effect and every effect in turn, is capable to causing other effects. The theory of cause and effect fully applies here. An effect must have a cause, similarly, all causes give rise to certain effects in medical parlance. It won’t be out of order to describe the factors which cause obesity which, as is generally and very rightly believed is the mother of many physical disorders (diseases) so, first of all, we will take up those factors.

1. Energy-Intake: Imbalance between energy intake and expenditure thereof causes extra fat in the body, giving rise to many odd clinical signs & causes.

2. Heredity: It has been seen that, in certain, families, there is a tendency to fatness. Eating patterns, genetic factors and activity are closely related t economic, social and cultural factors and such factors are handed down from one generation to another. But, genetic factors do influence body fat and distribution thereof.

3. Endocrine Factors: This factor influences both pathological and physiological states. Hypogondalism, hypothyroidism and hypopituitarism are also contributory factors for causing obesity. Sometimes, Cushing’s syndrome is also accountable for obesity. On the contrary, clinical tests of certain person also do not reveal any endocrine disorder, leaving aside some glaring and rare exceptions. In women, obesity is a common symptom during menstrual periods-at the time of puberty, during menopause and during pregnancy.

4. Social Factors: Our audio-video publicity, in magazines, papers, T.V.radio and other such means have contributed a lot to the changes in our eating patterns, styles and habits. Eating an eatable of a particular brand had become a symbol of social status, problems multiply when we sacrifice out natural instincts to eat, to play second fiddle to fast food, junk food, fried food and canned pouched or bottled food. The bitterest fact is that hunger and satiety are compelled to be relegated to back-seat, instead we are led by external factors, like taste of food, availability and environment. Unluckily, obese persons are more prone to such pranks and temptations. What is required is, either it is not available or what is available is not required. In such case filling the belly seems to be the main object. Obeses persons eat more but have the lowest energy-expenditure. Imbalance between food (more) intake and less expenditure of energy which is main cause for obesity and resultant diseases.
Very often and especially in social gatherings and functions, obeses persons are indiscreet in eating those very food items which are harmful to them. Obese persons are generally avaricious people and they can’t control themselves. They are more led by taste than by necessity.

Expenditure of Energy: simple principle is to eat when you are hungry and never eat stomachful, but these golden principles are given a go-bye by the greedy obese persons. It is also an oft-repeated maxim that ‘After lunch, rests a while, and after dinner ‘walk a mile.’ But ‘rest’ does not and should mean a 2-3 hour sleep after lunch, rather it should be a ‘Nap’ only. Physical activity must commensurate with the amount of food intake. It should not however, construe that exercise will rectify all the dietary over-indulgence.

Obese have been seen to lead an inactive and inert life. When there is no physical activity to expend energy, generated by eating food, there is bound to be extra fat which, inturn, is enough capable to enlarge scope for host of diseases. In whatever form physical activity is resorted to, it must suffice to burn the calories generated by food-intake. It is no use over-loading your system with extra calories, when you do not have an urge to expend energy. It is a also maintained that thermic response to food may be less than normal in the obese persons, thus leading to greater and more conservation of energy.

Drug-Induced Obesity: Constant and prolonged use of oral contraceptives, insulin, steroids, and phenothiazines stimulate appetite and thus the patient is inclined to eat more. After pregnancy and delivery of child, especially when the confined and nursing mothers are given aforesaid medicines, there is every change of their gaining weight, and thus become obese. Pendulous abdomen and heavy back are the symptoms during postnatal period,

General: Obesity should not be confused with weight gain, because one can have over-weight due to retention of fluid in the body, due to renal, cardiac
or hepatic, and clinical tests hardly reveal such manifestations until there is increase, at least by about 15% of extra-cellular fluid.

Obese people should follow, as a matter of practice and conviction, certain norms and disciplines, such as health charts, weight charts, calorie-based diets, alternate diets, height and weight charts (please refer to relevant chapters and also at the conclusive stage of this book, for further guidance and knowledge) to work a scheduled plan so that they can shed their extra weight.