Modified Lifestyle Management of Type-2 Diabetes Mellitus in Old Age Prof. Dr. Vipin Mishra MBBS,...
-
Upload
della-ramsey -
Category
Documents
-
view
219 -
download
0
Transcript of Modified Lifestyle Management of Type-2 Diabetes Mellitus in Old Age Prof. Dr. Vipin Mishra MBBS,...
Modified Lifestyle Management of Type-2 Diabetes Mellitus in Old Age
Prof. Dr. Vipin MishraMBBS, MD, PhD, DM (Endocrinology) AIIMSCommonwealth Fellow in Endocrinology (UK)
DirectorInstitute of Diabetes & Endocrinology
Jaypee Hospital, Noida
www.drvipinmishra.com
Type-2 Diabetes Mellitus
• Chronic metabolic disease.
• Leads to serious long term complications.
• Lifestyle management is the basic and most important aspect of treatment
• Early and intensive treatment is the key to have an active, enjoyable long life
Lifestyle Management of T2DM• Diet• Exercise• Yoga• Fixed diurnal routine• Sound sleep• Financial security• Enjoy vacations• Pursue hobbies• Have friends• Have family• Have work• Love humour• Have a Guru• Manage the mind• Know yourself
Lifestyle Management of T2DM
• Diet• Exercise• Yoga• Fixed diurnal routine• Sound sleep• Financial security• Enjoy vacations• Pursue hobbies• Have friends• Have family• Have work• Love humour• Have a Guru• Manage the mind• Know yourself
Dietary Considerations
• Eat proper food, and Eat less• Food should be easily digestible• Calorie restriction, avoidance of sugars and fats,
limitation of proteins• At some point of time, limitation or avoidance of
uncooked cellulose• Small multiple meals / or 2-3 regular meals
Dietary Considerations
Food must be divided in four classes –– A. Prohibited Foods: Sweets, Fried food, fats, red meat
and high caloric vegetables like potato, Arbi
– B. Minimum Intake: Carbohydrates like bread, rice, pasta, noodles etc.
– C. Normal Intake: Proteins (Milk and milk products, white meat, pulses) and seasonal fruits
– D. Liberal Intake: Salad, green vegetables, clear vegetable soup, sprouts, lemon water
No overeating ever
Distribution of calories
• Calories should come from different sources as follows –• Complex carbohydrates: 50-60%• Proteins: 20-25%• Fats : < 25% : Saturated 5%, PUFA 5-8%, MUFA 12-
15%• High fiber content – soluble and insoluble
Lifestyle Management of T2DM• Diet
• Exercise• Yoga• Fixed diurnal routine• Sound sleep• Financial security• Enjoy vacations• Pursue hobbies• Have friends• Have family• Have work• Love humour• Have a Guru• Manage the mind• Know yourself
Exercise
• Aerobics increases insulin sensitivity• Blood sugar is reduced significantly• Improves cardio-vascular, musculo-skeletal, respiratory
and digestive systems• Improves sleep• Improves feeling of well being• Retards ageing• Walk, cycling, outdoor games, swimming
Exercise
• Other forms of exercise are also equally important• Pressure exercises help build muscle tone and bulk. This
improves peripheral glucose disposal.• Stretching and movement improves functions of the
muscles and soft tissue• Pressure exercises should not be initiated in seventies or
when there are many co-morbidities
Lifestyle Management of T2DM• Diet• Exercise
• Yoga• Fixed diurnal routine• Sound sleep• Financial security• Enjoy vacations• Pursue hobbies• Have friends• Have family• Have work• Love humour• Have a Guru• Manage the mind• Know yourself
Yoga
• Yoga is pure magic, Improves every aspect of metabolism
• Retards ageing, Prevents complications• Maintains weight, Maintains figure• Postures keep the soft tissue flexible and supple• Pranayam has strong metabolic effects• Meditation gives peace and tranquility and avoidance of
phases of excitement and depression
Lifestyle Management of T2DM• Diet• Exercise• Yoga
• Fixed diurnal routine• Sound sleep• Financial security• Enjoy vacations• Pursue hobbies• Have friends• Have family• Have work• Love humour• Have a Guru• Manage the mind• Know yourself
Fixed Diurnal Routine
• All body functions are rhythmical
• Maintenance of bio-rhythms improves every aspect of metabolism and retards ageing
• Regular sleep wake cycles ensure ideal hypothalamic functions
• Minimizes glycaemic variability
Lifestyle Management of T2DM• Diet• Exercise• Yoga• Fixed diurnal routine
• Sound sleep• Financial security• Enjoy vacations• Pursue hobbies• Have friends• Have family• Have work• Love humour• Have a Guru• Manage the mind• Know yourself
Lifestyle Management of T2DM• Diet• Exercise• Yoga• Fixed diurnal routine• Sound sleep
• Financial security• Enjoy vacations• Pursue hobbies• Have friends• Have family• Have work• Love humour• Have a Guru• Manage the mind• Know yourself
Lifestyle Management of T2DM• Diet• Exercise• Yoga• Fixed diurnal routine• Sound sleep• Financial security
• Enjoy vacations• Pursue hobbies• Have friends• Have family• Have work• Love humour• Have a Guru• Manage the mind• Know yourself
Lifestyle Management of T2DM• Diet• Exercise• Yoga• Fixed diurnal routine• Sound sleep• Financial security• Enjoy vacations
• Pursue hobbies• Have friends• Have family• Have work• Love humour• Have a Guru• Manage the mind• Know yourself
Pursue Hobbies
Do what you love doing as much and as frequently as possible
This tends to transform your system in a big way When you whole-heartedly follow your passion, your
consciousness moves to a different level of existence It is not like doing anything. Action becomes inaction.
Effort is effortless.
Lifestyle Management of T2DM• Diet• Exercise• Yoga• Fixed diurnal routine• Sound sleep• Financial security• Enjoy vacations• Pursue hobbies
• Have friends (Vitamin-F)• Have family• Have work• Love humour• Have a Guru• Manage the mind• Know yourself
Lifestyle Management of T2DM• Diet• Exercise• Yoga• Fixed diurnal routine• Sound sleep• Financial security• Enjoy vacations• Pursue hobbies• Have friends
• Have family• Have work• Love humour• Have a Guru• Manage the mind• Know yourself
Have Family
• Blessed are those families where 3 or 4 generations live together
• Every generation benefits by this loving co-existence
• Senior people must though be all accepting; and non-demanding
• Family enthuses feelings of security and love
Lifestyle Management of T2DM• Diet• Exercise• Yoga• Fixed diurnal routine• Sound sleep• Financial security• Enjoy vacations• Pursue hobbies• Have friends• Have family
• Have work• Love humour• Have a Guru• Manage the mind• Know yourself
Lifestyle Management of T2DM• Diet• Exercise• Yoga• Fixed diurnal routine• Sound sleep• Financial security• Enjoy vacations• Pursue hobbies• Have friends• Have family• Have work
• Love humour• Have a Guru• Manage the mind• Know yourself
Lifestyle Management of T2DM• Diet• Exercise• Yoga• Fixed diurnal routine• Sound sleep• Financial security• Enjoy vacations• Pursue hobbies• Have friends• Have family• Have work• Love humour
• Have a Guru• Manage the mind• Know yourself
Have a Guru• Complete knowledge is an impossibility. Knowledge as a
rule is always incomplete
• There are –– The known knowns
– The known unknowns
– And the unknown unknowns (the unknowable)
• Guru is the one who attracts towards change
• With a Guru, ego evaporates
• You get a real Guru by chance / luck (karmphal); It is though impossible to get a Guru if you don’t want one.
• The Guru is always close to you whom you can’t recognize because of: your own ego
• Never discuss about your Guru with others
Lifestyle Management of T2DM• Diet• Exercise• Yoga• Fixed diurnal routine• Sound sleep• Financial security• Enjoy vacations• Pursue hobbies• Have friends• Have family• Have work• Love humour• Have a Guru
• Manage the mind• Know yourself
What Causes Diseases
• Genetic Factors
• Psychic Factors
• Lifestyle
• Environment
What Causes Diseases
• Genes don’t cause diseases on their own• There is crosstalk between genes and the
internal environment (blood chemistry) (Epigenetics)
• Genes cause diseases only when the blood chemistry gets altered upto a critical level
• Blood chemistry gets altered because of the psychic factors, lifestyle and environmental factors
• Finally lifestyle and environment also ultimately depend on the psychic factors
What Causes Diseases
• The real disease determining internal factor is the ‘Psyche’
• It forces the person to choose a specific lifestyle
• National or group psyche determines the standards of environment
What Causes Diseases
• The ideal psychic state could be described as a situation when the person is in absolute sync with the external situation
• As and when a person is out of sync from the external environment, it is stress
• All changing emotions are stressors
What Causes Diseases• Chronic subtle or gross stress tends to modulate –
– Neuro-peptide secretion– Hypothalamic functions– Hypothalamic – Pituitary – Adrenal axis– Sympathetic / Parasympathetic drives (Cardiac, GI
functions)– Immune system– Inflammation / Fibrosis– Neuromuscular function
• Adverse psychic factors (stress) lead to chronic tissue damage that is slow, steady, progressive, accumulative and irreversible
• Main damager at physical level is inflammation
An ideal mind1. Naturally and spontaneously happy mind
2. Peaceful (non-anxious) mind
3. Satisfied mind
4. Loving mind
5. Positive mind
6. Balanced mind
7. A non-reactive mind
8. Progressive and ever keen to change mind
9. All accepting mind
10.A mind full of gratitude
11.A self-centered mind
Lifestyle Management of T2DM• Diet• Exercise• Yoga• Fixed diurnal routine• Sound sleep• Financial security• Enjoy vacations• Pursue hobbies• Have friends• Have family• Have work• Love humour• Have a Guru• Manage the mind
• Know yourself
Know: Who You Are
You are not just a body and mind phenomenon The physical body and the mind are in a state of
constant flux Behind your changing form is your unchanging real self There is some aspect in your system that is still the
same, as it was when you were born;AND YOU KNOW THAT
Realizing your real self revolutionizes life. Disease and death are impossibilities
Thanks for Your Attention