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The Indian Council of Medical Research (ICMR) has released new guidelines on Type 1 Diabetes. Here are key 10 points from the research document.

Healthy diet

To manage Type 1 Diabetes, the ICMR recommends eating a nutritious diet. Carbohydrates should account for 50-55 percent of total calories. Fats should account for up to 30% of total calories consumed on a daily basis. Protein should account for 15-20% of total calorie consumption. Salt intake should be reduced to 2.5 g per day for children aged one to three, 3 g per day for children aged four to eight, 3.8 g per day for children and adolescents aged 9 years and above, and 6 g per day for adults. Processed foods are high in salt, so they should be consumed in moderation.

Exercise

Regular physical activity improves overall well-being, prevents obesity, and lowers cardiovascular risk in Type 1 Diabetes patients. Insulin sensitivity rises during and immediately after exercise, then declines 7-11 hours later. Glycemic regulation may be improved by aerobic fitness. During anaerobic activity, however, catecholamine levels rise significantly, and the pancreas in Type 1 Diabetes patients is unable to boost insulin secretion to counteract the effects of catecholamines. Typically, children engage in short bursts of intensive activity followed by intervals of relaxation. Extra physical activity, however, may necessitate insulin changes on occasion.

Insulin therapy side-effects

Hypoglycemia is the most common adverse effect of insulin therapy and a key stumbling block to maintaining tight glycemic control. Improved glycemic control may result in weight gain. Insulin injection at the same place and frequent use of a blunt needle cause lipohypertrophy. Both the physician and the patient should inspect injection sites on a regular basis, especially if there is unexplained blood glucose variability. One of the negative effects is insulin site infection.

Blood glucose monitoring

In individuals with Type 1 Diabetes, blood glucose monitoring is an important element in predicting glycemic control. In young children, especially those with poor glycemic control, the frequency of daily Self-Monitoring of Blood Glucose (SMBG) might range from four to six times per day. In youngsters with improved glycemic control, a more liberal SMBG of two-three times per day may be recommended. For some people, even monitoring 1-2 blood glucose levels may be difficult due to financial constraints. Testing could be limited to sick days and hypoglycemic episodes, with a "basic minimum" of two to four times per day for two to three consecutive days per month.

Diabetic ketoacidosis

Nausea and vomiting, abdominal pain, acidotic breathing with a characteristic fruity odour, and indicators of dehydration arise as diabetic ketoacidosis (DKA) develops. Although commas are uncommon, the patient is frequently drowsy at the time of presentation. Better access to medical treatment, adequate patient education, and effective communication with a health care provider during an intercurrent disease can all help to prevent DKA.

Vision loss

Diabetic retinopathy is a primary cause of blindness in adults and one of the most common microvascular complications of type 1 diabetes. It is a degenerative illness that, if left untreated, can result in significant vision loss. Patients with type 1 diabetes are more likely to develop cataracts, glaucoma, retinal vein occlusion, and cranial nerve palsies, among other eye problems. Furthermore, cataract surgery might have a long recovery time and is linked to poor visual outcomes in these patients.

Kidney disease

Diabetic nephropathy (DKD) is the leading cause of chronic kidney disease (CKD) in India and around the world. It is marked by albuminuria, a decrease in glomerular filtration rate (GFR), and hypertension, as well as an elevated risk of cardiovascular disease. In recent decades, early diagnosis combined with effective glucose control and blood pressure management has improved the prognosis of these patients.

Neuropathy

In people with type 1 diabetes, neuropathy is a common microvascular consequence. It is linked to a high rate of morbidity and mortality. It is the single most critical determinant in the development of foot ulcers and lower-extremity amputations. There is, however, a scarcity of information on the frequency of microvascular problems in Indian T1DM patients.

Increased death risk

When compared to the non-diabetic population, patients with type 1 diabetes have a higher risk of morbidity and mortality from cardiovascular disease. Coronary artery disease, stroke, and peripheral arterial disease are all examples of this. Cardiovascular events occur more earlier in type 1 diabetic patients than in the general population.

More children affected in India

In India, type 1 diabetes is now being diagnosed in an increasing number of children. This could be due to the fact that the disorder's true frequency is increasing in the country. It could also represent increased awareness and, as a result, better diagnosis of type 1 diabetes.It is also possible that children are surviving longer as a result of earlier diagnosis and treatment.

Read the complete document HERE.

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