Netholi peera vattichathu

ആവശ്യമുള്ള സാധനങ്ങള്‍ :-

നെത്തോലി ( ചിലയിടത്ത് കൊഴുവ എന്ന് പറയും),  

പുളിഞ്ചിക്ക ( ഇലിമ്പിക്ക) (പുളിഞ്ചിക്കക്ക് പകരം പച്ച മാങ്ങയോ വടക്കന്‍ പുളിയോ ചേര്‍ക്കാം), 

തേങ്ങ തിരുകിയത്, 

ചുമന്നുള്ളി,

ഇഞ്ചി, 

പച്ചമുളക്, 

മുളകുപൊടി, 

മഞ്ഞള്‍ പൊടി,

 ഉപ്പ്

പാചക രീതി:-

നെത്തോലി തലയും വാലും നുള്ളി ഉപ്പിട്ട് തേച്ചു കഴുകി വയ്ക്കുക. പച്ചമുളകും ഇഞ്ചിയും, ചുമന്നുള്ളിയും ചതച്ചത് ഒരു മണ്‍ ചട്ടിയില്‍ ഇടുക. ഇതില്‍ തേങ്ങ മുളകുപൊടിയും മഞ്ഞള്‍പ്പൊടിയും ചേര്‍ത്ത് ചതച്ചത് ഇട്ടു നല്ലപോലെ ഞരടുക. ഇതിനു മുകളില്‍ പുളിഞ്ചിക്ക അരിഞ്ഞതും  നെത്തോലി വൃത്തി ആക്കിയതും ഇട്ടു പാകത്തിന് ഉപ്പും ചേര്‍ത്ത് കുറച്ചു വെള്ളവും ചേര്‍ത്ത് കലക്കി നല്ലത് പോലെ വറ്റിച്ചെടുക്കുക. കറിവേപ്പില ചേര്‍ത്ത് ഇറക്കി വയ്ക്കാം. നെത്തോലി പീര വറ്റിച്ചത് റെഡി. 

WORLD DIABETES DAY - NOVEMBER 14

World Diabetes Day is the primary global awareness campaign of the diabetes mellitus world and is held on November 14 of each year. It was introduced in 1991 by the International Diabetes Federation and the World Health Organization in response to the alarming rise of diabetes around the world. World Diabetes Day is a campaign that features a new theme chosen by the International Diabetes Federation each year to address issues facing the global diabetes community. While the campaigns last the whole year, the day itself marks the birthday of Frederick Banting who, along with Charles Best, first conceived the idea which led to the discovery of insulin in 1922.
Each year, World Diabetes Day is centred on a theme related to diabetes. Topics covered have included diabetes and human rights, diabetes and lifestyle, diabetes and obesity, diabetes in the disadvantaged and the vulnerable, diabetes in children and adolescents and talking about Diabetes

For 2009–2013, the theme is Diabetes Education and Prevention.

World Diabetes Day, on the 14th November every year, has grown from humble beginnings to become a globally-celebrated event to increase awareness about diabetes.

Comprising hundreds of campaigns, activities, screenings, lecture, meetings and more, World Diabetes Day is proving internationally effective in spreading the message about diabetes.

World Diabetes Day 2012:-

The campaign slogan for 2012 is ‘Diabetes: protect our future’ and focuses on supporting children with type 1 diabetes and preventing our current generation of children from developing type 2 diabetes.

This year World Diabetes Day coincides with the beginning of Diwali and as a result the IDF has chosen India as a focus for 2012’s celebrations and has re-named Diwali in 2012 as Blue Diwali.

Who introduced World Diabetes Day?

World Diabetes Day was jointly introduced by the World Health Organisation (WHO) and the International Diabetes Federation (IDF). The global diabetes awareness campaign was introduced amidst concern over an escalating diabetes epidemic.

Why is November 14th World Diabetes Day?

November 14th is a significant date in the diabetes calendar because it marks the birthday of the man who co-discovered insulin, Frederick Banting. Banting discovered insulin in 1922, alongside Charles Best. World Diabetes Day is internationally recognised and is now an official United Nations Day.

World Diabetes Day logo:-

The logo of World Diabetes Day is a blue circle, and this is recognised by hundreds of thousands of people with diabetes throughout the world. World Diabetes Day (whereas Diabetes Week is solely a UK-wide event) is a truly international event, and having a distinctive logo is an essential part of spreading the message about diabetes to as wide audience as possible.

The mission of the International Diabetes Federation is to promote diabetes care, prevention and a cure worldwide. IDF's strategic goals are to:

• Drive change at all levels, from local to global, to prevent diabetes and increase access to essential medicines.
• Develop and encourage best practice in diabetes policy, management and education.
• Advance diabetes treatment, prevention and cure through scientific research.
• Advance and protect the rights of people with diabetes, and combat discrimination.

DIABETES

Diabetes is usually a lifelong (chronic) disease in which there are high levels of sugar in the blood.

Causes, incidence, and risk factors:-

Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both.

To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested:

• A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body.
• An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.

People with diabetes have high blood sugar because their body cannot move sugar into fat, liver, and muscle cells to be stored for energy. This is because either:

• Their pancreas does not make enough insulin
• Their cells do not respond to insulin normally
• Both of the above

There are two major types of diabetes. The causes and risk factors are different for each type:

• Type 1 diabetes can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. Daily injections of insulin are needed. The exact cause is unknown.
• Type 2 diabetes makes up most diabetes cases. It most often occurs in adulthood. However, because of high obesity rates, teens and young adults are now being diagnosed with it. Many people with type 2 diabetes do not know they have it.
• Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not have diabetes.

Diabetes affects more than 20 million Americans. Over 40 million Americans have pre-diabetes (which often comes before type 2 diabetes).

Symptoms:-

High blood sugar levels can cause several symptoms, including:

• Blurry vision
• Excess thirst
• Fatigue
• Hunger
• Urinating often
• Weight loss

Because type 2 diabetes develops slowly, some people with high blood sugar have no symptoms.

Symptoms of type 1 diabetes develop over a short period of time. People may be very sick by the time they are diagnosed.

After many years, diabetes can lead to other serious problems:

• You could have eye problems, including trouble seeing (especially at night) and light sensitivity. You could become blind.
• Your feet and skin can get painful sores and infections. Sometimes, your foot or leg may need to be removed.
• Nerves in the body can become damaged, causing pain, tingling, and a loss of feeling.
• Because of nerve damage, you could have problems digesting the food you eat. This can cause trouble going to the bathroom. Nerve damage can also make it harder for men to have an erection.

Signs and tests:-

A urine analysis may show high blood sugar. However, a urine test alone does not diagnose diabetes.

Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL. To confirm the diagnosis, one or more of the following tests must be done.

Blood tests:

Fasting blood glucose level -- diabetes is diagnosed if it is higher than 126 mg/dL twice. Levels between 100 and 126 mg/dL are called impaired fasting glucose or pre-diabetes. These levels are risk factors for type 2 diabetes.

Hemoglobin A1c test --

Normal: Less than 5.7%

Pre-diabetes: 5.7% - 6.4%

Diabetes: 6.5% or higher

Oral glucose tolerance test -- diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours of drinking a glucose drink. (This test is used more often for type 2 diabetes.)

Screening for type 2 diabetes in people who have no symptoms is recommended for:

Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 2 years

Overweight adults (BMI greater than 25) who have other risk factors

Adults over age 45, repeated every 3 years

Treatment:-

Early on in type 2 diabetes, you may be able to reverse the disease with lifestyle changes. Also, some cases of type 2 diabetes can be cured with weight-loss surgery.

There is no cure for type 1 diabetes.

Treatming both type 1 diabetes and type 2 diabetes involves medicines, diet, and exercise to control blood sugar levels and prevent symptoms and problems.

Getting better control over your blood sugar, cholesterol, and blood pressure levels helps reduce the risk of kidney disease, eye disease, nervous system disease, heart attack, and stroke.

To prevent diabetes complications, visit your health care provider at least two to four times a year. Talk about any problems you are having.

Prevention:- 

Keeping an ideal body weight and an active lifestyle may prevent type 2 diabetes.

There is no way yet to prevent type 1 diabetes.

Gestational diabetes

Gestational diabetes is high blood sugar (diabetes) that starts or is first diagnosed during pregnancy.

Causes, incidence, and risk factors:-

Pregnancy hormones can block insulin from doing its job. When this happens, glucose levels may increase in a pregnant woman's blood.

You are at greater risk for gestational diabetes if you:

• Are older than 25 when you are pregnant
• Have a family history of diabetes
• Gave birth to a baby that weighed more than 9 pounds or had a birth defect
• Have high blood pressure
• Have too much amniotic fluid
• Have had an unexplained miscarriage or stillbirth
• Were overweight before your pregnancy

Symptoms:- 

Usually there are no symptoms, or the symptoms are mild and not life threatening to the pregnant woman. The blood sugar (glucose) level usually returns to normal after delivery.

Symptoms may include:

• Blurred vision
• Fatigue
• Frequent infections, including those of the bladder, vagina, and skin
• Increased thirst
• Increased urination
• Nausea and vomiting
• Weight loss despite increased appetite

Signs and tests:-

Gestational diabetes usually starts halfway through the pregnancy. All pregnant women should receive an oral glucose tolerance test between the 24th and 28th week of pregnancy to screen for the condition. Women who have risk factors for gestational diabetes may have this test earlier in the pregnancy.
Once you are diagnosed with gestational diabetes, you can see how well you are doing by testing your glucose level at home. The most common way involves pricking your finger and putting a drop of your blood on a machine that will give you a glucose reading.

Treatment:- 

The goals of treatment are to keep blood sugar (glucose) levels within normal limits during the pregnancy, and to make sure that the growing baby is healthy.

WATCHING YOUR BABY:-

Your health care provider should closely check both you and your baby throughout the pregnancy. Fetal monitoring will check the size and health of the fetus.
A nonstress test is a very simple, painless test for you and your baby. A machine that hears and displays your baby's heartbeat (electronic fetal monitor) is placed on your abdomen.Your health care provider can compare the pattern of your baby's heartbeat to movements and find out whether the baby is doing well.

DIET AND EXERCISE:-

The best way to improve your diet is by eating a variety of healthy foods. You should learn how to read food labels, and check them when making food decisions. Talk to your doctor or dietitian if you are a vegetarian or on some other special diet.

In general, when you have gestational diabetes your diet should:

• Be moderate in fat and protein
• Provide your carbohydrates through foods that include fruits, vegetables, and complex carbohydrates (such as bread, cereal, pasta, and rice)
• Be low in foods that contain a lot of sugar, such as soft drinks, fruit juices, and pastries

If managing your diet does not control blood sugar (glucose) levels, you may be prescribed diabetes medicine by mouth or insulin therapy. Most women who develop gestational diabetes will not need diabetes medicines or insulin, but some will.

Expectations (prognosis):-

Most women with gestational diabetes are able to control their blood sugar and avoid harm to themselves or their baby. Pregnant women with gestational diabetes tend to have larger babies at birth. This can increase the chance of problems at the time of delivery, including:

• Birth injury (trauma) because of the baby's large size
• Delivery by c-section
• Your baby is more likely to have periods of low blood sugar (hypoglycemia) during the first few days of life.
• Mothers with gestational diabetes have an increased risk for high blood pressure during pregnancy.
• There is a slightly increased risk of the baby dying when the mother has untreated gestational diabetes. Controlling blood sugar levels reduces this risk.

High blood sugar (glucose) levels often go back to normal after delivery. However, women with gestational diabetes should be watched closely after giving birth and at regular doctor's appointments to screen for signs of diabetes. Many women with gestational diabetes develop diabetes within 5 - 10 years after delivery.
Call your health care provider if you are pregnant and you have symptoms of diabetes.

Prevention:-

Beginning prenatal care early and having regular prenatal visits helps improve your health and the health of your baby. Having prenatal screening at 24 - 28 weeks into the pregnancy will help detect gestational diabetes early.
If you are overweight, decreasing your body mass index (BMI) to a normal range before you get pregnant will decrease your risk of developing gestational diabetes.

Type 1 diabetes

Type 1 diabetes is a lifelong (chronic) disease in which there are high levels of sugar (glucose) in the blood.

Causes, incidence, and risk factors:-

Type 1 diabetes can occur at any age. However, it is most often diagnosed in children, adolescents, or young adults.
Insulin is a hormone produced by special cells, called beta cells, in the pancreas. The pancreas is found behind your stomach. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy. In type 1 diabetes, beta cells produce little or no insulin.
Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. The body is unable to use this glucose for energy. This leads to the symptoms of type 1 diabetes.
The exact cause of type 1 diabetes is unknown. Most likely it is an autoimmune disorder. An infection or some other trigger causes the body to mistakenly attack the cells in the pancreas that make insulin. This kind of disorder can be passed down through families.

Symptoms:- 

These symptoms may be the first signs of type 1 diabetes, or may occur when the blood sugar is high:

• Being very thirsty
• Feeling hungry
• Feeling tired or fatigued
• Having blurry eyesight
• Losing the feeling or feeling tingling in your feet
• Losing weight without trying
• Urinating more often

For other people, these warning symptoms may be the first signs of type 1 diabetes, or they may happen when the blood sugar is very high (see: diabetic ketoacidosis):

• Deep, rapid breathing
• Dry skin and mouth
• Flushed face
• Fruity breath odor
• Nausea or vomiting, inability to keep down fluids
• Stomach pain

Low blood sugar (hypoglycemia) can develop quickly in people with diabetes who are taking insulin. Symptoms usually appear when the blood sugar level falls below 70 mg/dL. Watch for:

• Headache
• Hunger
• Nervousness
• Rapid heartbeat (palpitations)
• Shaking
• Sweating
• Weakness

Signs and tests:-

Diabetes is diagnosed with the following blood tests:

Fasting blood glucose level -- diabetes is diagnosed if it is higher than 126 mg/dL two times

Random (nonfasting) blood glucose level -- you may have diabetes if it is higher than 200 mg/dL, and you have symptoms such as increased thirst, urination, and fatigue (this must be confirmed with a fasting test)

Oral glucose tolerance test -- diabetes is diagnosed if the glucose level is higher than 200 mg/dL after 2 hours

Hemoglobin A1c test:-

Normal: Less than 5.7%

Pre-diabetes: Between 5.7% and 6.4%

Diabetes: 6.5% or higher

Ketone testing is also sometimes used. The ketone test is done using a urine sample or blood sample. Ketone testing may be done:

• When the blood sugar is higher than 240 mg/dL
• During an illness such as pneumonia, heart attack, or stroke
• When nausea or vomiting occur
• During pregnancy

The following tests or exams will help you and your doctor monitor your diabetes and prevent problems caused by diabetes:

• Check the skin and bones on your feet and legs.
• Check to see if your feet are getting numb.
• Have your blood pressure checked at least every year (blood pressure goal should be 130/80 mm/Hg or lower).
• Have your hemoglobin A1c test (HbA1c) done every 6 months if your diabetes is well controlled; otherwise, every 3 months.
• Have your cholesterol and triglyceride levels checked yearly (aim for LDL cholesterol levels below 70-100 mg/dL).
• Get yearly tests to make sure your kidneys are working well (microalbuminuria and serum creatinine).
• Visit your eye doctor at least once a year, or more often if you have signs of diabetic eye disease.
• See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes.

Treatment:-

Because type 1 diabetes can start quickly and the symptoms can be severe, people who have just been diagnosed may need to stay in the hospital.
If you have just been diagnosed with type 1 diabetes, you should probably have a check-up each week until you have good control over your blood sugar. Your health care provider will review the results of your home blood sugar monitoring and urine testing. Your provider will also look at your diary of meals, snacks, and insulin injections.
As the disease gets more stable, you will have fewer follow-up visits. Visiting your health care provider is very important so you can monitor any long-term problems from diabetes.

You are the most important person in managing your diabetes. You should know the basic steps to diabetes management:

• How to recognize and treat low blood sugar (hypoglycemia)
• How to recognize and treat high blood sugar (hyperglycemia)
• Diabetes meal planning
• How to give insulin
• How to check blood glucose and urine ketones
• How to adjust insulin and food when you exercise
• How to handle sick days
• Where to buy diabetes supplies and how to store them

INSULIN:-

Insulin lowers blood sugar by allowing it to leave the bloodstream and enter cells. Everyone with type 1 diabetes must take insulin every day. Insulin is usually injected under the skin. In some cases, a pump delivers the insulin all the time. Insulin does not come in pill form. Insulin types differ in how fast they start to work and how long they last. The health care provider will choose the best type of insulin for you and will tell you at what time of day to use it. More than one type of insulin may be mixed together in an injection to get the best blood glucose control. You may need insulin shots from one to four times a day.

Your health care provider or diabetes nurse educator will teach you how to give insulin injections. At first, a child's injections may be given by a parent or other adult. By age 14, most children can give their own injections.

People with diabetes need to know how to adjust the amount of insulin they are taking:

• When they exercise
• When they are sick
• When they will be eating more or less food and calories
• When they are traveling

DIET AND EXERCISE:-

People with type 1 diabetes should eat at about the same times each day and try to eat the same kinds of foods. This helps to prevent blood sugar from becoming too high or low. See also:

Regular exercise helps control the amount of sugar in the blood. It also helps burn extra calories and fat to reach a healthy weight.

Ask your health care provider before starting any exercise program. People with type 1 diabetes must take special steps before, during, and after intense physical activity or exercise. See also: Diabetes and exercise

MANAGING YOUR BLOOD SUGAR:-

Checking your blood sugar levels at home and writing down the results will tell you how well you are managing your diabetes. Talk to your doctor and diabetes educator about how often to check.

A device called a glucometer can read blood sugar levels. There are different types of devices. Usually, you prick your finger with a small needle called a lancet to get a tiny drop of blood. You place the blood on a test strip and put the strip into the device. You should have results in 30 - 45 seconds.

Keep a record of your blood sugar for yourself and your doctor or nurse. This will help if you have problems managing your diabetes. You and your doctor should set a target goal for your blood sugar levels at different times during the day. You should also plan what to do when your blood sugar is too low or high.

Low blood sugar is called hypoglycemia. Blood sugar levels below 70 mg/dL are too low and can harm you.

FOOT CARE:-

Diabetes damages the blood vessels and nerves. This can make you less able to feel pressure on the foot. You may not notice a foot injury until you get a severe infection.

Diabetes can also damage blood vessels. Small sores or breaks in the skin may become deeper skin sores (ulcers). The affected limb may need to be amputated if these skin ulcers do not heal or become larger or deeper.

To prevent problems with your feet:

• Stop smoking if you smoke.
• Improve control of your blood sugar.
• Get a foot exam by your health care provider at least twice a year and learn whether you have nerve damage.
• Check and care for your feet EVERY DAY, especially if you already have known nerve or blood vessel damage or current foot problems.
• Make sure you are wearing the right kind of shoes.

PREVENTING COMPLICATIONS:-

Your doctor may prescribe medications or other treatments to reduce your chances of developing eye disease, kidney disease, and other conditions that are more common in people with diabetes.

Expectations (prognosis):-

Diabetes is a lifelong disease and there is not yet a cure. However, the outcome for people with diabetes varies. Studies show that tight control of blood glucose can prevent or delay problems with the eyes, kidneys, nervous system, and heart in type 1 diabetes. However, problems may occur even in people with good diabetes control.

Complications:- 

If you have diabetes, your risk of a heart attack is the same as someone who has already had a heart attack. Both women and men with diabetes are at risk. You may not even have the normal signs of a heart attack.

After many years, diabetes can lead to other serious problems:

• You could have eye problems, including trouble seeing (especially at night) and sensitivity to light. You could become blind.
• Your feet and skin could develop sores and infections. If you have these sores for too long, your foot or leg may need to be removed. Infection can also cause pain and itching.
• Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to heart attack, stroke, and other problems. It can become harder for blood to flow to the legs and feet.
• Nerves in the body can become damaged, causing pain, tingling, and loss of feeling.
• Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can also make it harder for men to have an erection.
• High blood sugar and other problems can lead to kidney damage. The kidneys might not work as wellas they used to. They may even stop working.

Seizures:-

Call your health care provider or go to the emergency room if you have symptoms of diabetic ketoacidosis.

Also call your doctor if you have:

• Blood sugar levels that are higher than the goals you and your doctor have set
• Numbness, tingling, or pain in your feet or legs
• Problems with your eyesight
• Sores or infections on your feet
• Symptoms that your blood sugar is getting too low (feeling weak or tired, trembling, sweating, feeling irritable, having trouble thinking clearly, fast heartbeat, double or blurry vision, feeling uneasy)
• Symptoms that your blood sugar is too high (being very thirsty, having blurry vision, having dry skin, feeling weak or tired, needing to urinate a lot)
• You are having blood sugar readings below 70 mg/dL

You can treat early signs of hypoglycemia at home by eating sugar or candy, or by taking glucose tablets. If your signs of hypoglycemia continue or your blood glucose levels stay below 60 mg/dL, go to the emergency room.


Prevention:-

There is no way to prevent type 1 diabetes. There is no screening test for type 1 diabetes in people who have no symptoms.

Stay up-to-date with all of your vaccinations and get a flu shot every year in the fall.

Type 2 diabetes

Type 2 diabetes is a lifelong (chronic) disease in which there are high levels of sugar (glucose) in the blood. Type 2 diabetes is the most common form of diabetes.

Causes, incidence, and risk factors:-

Diabetes is caused by a problem in the way your body makes or uses insulin. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy.

When you have type 2 diabetes, your fat, liver, and muscle cells do not respond correctly to insulin. This is called insulin resistance. As a result, blood sugar does not get into these cells to be stored for energy.

When sugar cannot enter cells, high levels of sugar build up in the blood. This is called hyperglycemia.

Type 2 diabetes usually occurs slowly over time. Most people with the disease are overweight when they are diagnosed. Increased fat makes it harder for your body to use insulin the correct way.

Type 2 diabetes can also develop in people who are thin. This is more common in the elderly.

Family history and genes play a large role in type 2 diabetes. Low activity level, poor diet, and excess body weight around the waist increase your risk. See also: Type 2 diabetes for a list of risk factors.

Symptoms:-

Often, people with type 2 diabetes have no symptoms at first. They may not have symptoms for many years.

The early symptoms of diabetes may include:

• Bladder, kidney, skin, or other infections that are more frequent or heal slowly
• Fatigue
• Hunger
• Increased thirst
• Increased urination
• The first symptom may also be:
• Blurred vision
• Erectile dysfunction
• Pain or numbness in the feet or hands

Signs and tests:-

Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL. To confirm the diagnosis, one or more of the following tests must be done.

Diabetes blood tests:

Fasting blood glucose level -- diabetes is diagnosed if it is higher than 126 mg/dL two times

Hemoglobin A1c test --

Normal: Less than 5.7%

Pre-diabetes: 5.7% - 6.4%

Diabetes: 6.5% or higher

Oral glucose tolerance test -- diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours

Diabetes screening is recommended for:

• Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 2 years
• Overweight adults (BMI greater than 25) who have other risk factors
• Adults over age 45 every 3 years

You should see your health care provider every 3 months. At these visits, you can expect your health care provider to:

• Check your blood pressure
• Check the skin and bones on your feet and legs
• Check to see if your feet are becoming numb
• Examine the back part of the eye with a special lighted instrument called an ophthalmoscope
• The following tests will help you and your doctor monitor your diabetes and prevent problems:
• Have your blood pressure checked at least every year (blood pressure goals should be 130/80 mm/Hg or lower).
• Have your hemoglobin A1c test (HbA1c) every 6 months if your diabetes is well controlled; otherwise every 3 months.
• Have your cholesterol and triglyceride levels checked yearly (aim for LDL levels below 70-100 mg/dL).
• Get yearly tests to make sure your kidneys are working well (microalbuminuria and serum creatinine).
• Visit your eye doctor at least once a year, or more often if you have signs of diabetic eye disease.
• See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes.

Treatment:- 

The goal of treatment at first is to lower high blood glucose levels. The long-term goals of treatment are to prevent problems from diabetes.

The main treatment for type 2 diabetes is exercise and diet.

LEARN THESE SKILLS:-

You should learn basic diabetes management skills. They will help prevent problems and the need for medical care. These skills include:

• How to test and record your blood glucose 
• What to eat and when
• How to take medications, if needed
• How to recognize and treat low and high blood sugar
• How to handle sick days
• Where to buy diabetes supplies and how to store them

It may take several months to learn the basic skills. Always keep learning about diabetes, its complications, and how to control and live with the disease. Stay up-to-date on new research and treatments.

MANAGING YOUR BLOOD SUGAR:-

Self testing means that you check your blood sugar at home yourself. Checking your blood sugar levels at home and writing down the results will tell you how well you are managing your diabetes. A device called a glucometer can give you an exact blood sugar reading. There are different types of devices. Usually, you prick your finger with a small needle called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the device. Results are given in 30 - 45 seconds. A health care provider or diabetes educator will help set up an at-home testing schedule for you. Your doctor will help you set your blood sugar goals.

Most people with type 2 diabetes only need to check their blood sugar once or twice a day.If your blood sugar levels are under control, you may only need to check them a few times a week.You may test yourself when you wake up, before meals, and at bedtime.You may need to test more often when you are sick or under stress. The results of the test can be used to change your meals, activity, or medications to keep your blood sugar levels in the right range. Testing can identify high and low blood sugar levels before you have serious problems. Keep a record of your blood sugar for yourself and your health care provider. This will help if you are having trouble managing your diabetes.

DIET AND WEIGHT CONTROL:-

Work closely with your doctor, nurse, and dietitian to learn how much fat, protein, and carbohydrates you need in your diet. Your meal plans should fit your daily lifestyle and habits, and should try to include foods that you like. Managing your weight and eating a well-balanced diet are important. Some people with type 2 diabetes can stop taking medications after losing weight (although they still have diabetes).

REGULAR PHYSICAL ACTIVITY:-

Regular exercise is important for everyone. It is even more important you have diabetes. Exercise in which your heart beats faster and you breathe faster helps lower your blood sugar level without medication. It also burns extra calories and fat so you can manage your weight. Exercise can help your health by improving blood flow and blood pressure. Exercise also increases the body's energy level, lowers tension, and improves your ability to handle stress. Ask your health care provider before starting any exercise program. People with type 2 diabetes must take special steps before, during, and after intense physical activity or exercise. See also: Diabetes and exercise

MEDICATIONS TO TREAT DIABETES:- 

If diet and exercise do not help keep your blood sugar at normal or near-normal levels, your doctor may prescribe medication. Since these drugs help lower your blood sugar levels in different ways, your doctor may have you take more than one drug.

Some of the most common types of medication are listed below. They are taken by mouth or injection.

• Alpha-glucosidase inhibitors (such as acarbose)
• Biguanides (Metformin)
• Injectable medicines (including exenatide, mitiglinide, pramlintide, sitagliptin, and saxagliptin)
• Meglitinides (including repaglinide and nateglinide)
• Sulfonylureas (like glimepiride, glyburide, and tolazamide)
• Thiazolidinediones (such as rosiglitazone and pioglitazone). (Rosiglitazone may increase the risk of heart problems. Talk to your doctor.)

These drugs may be given with insulin, or insulin may be used alone. You may need insulin if you continue to have poor blood glucose control. It must be injected under the skin using a syringe or insulin pen device. It cannot be taken by mouth. It is not known whether hyperglycemia medications taken by mouth are safe for use in pregnancy. Women who have type 2 diabetes and become pregnant may be switched to insulin during their pregnancy and while breast-feeding.

PREVENTING COMPLICATIONS:-

Your doctor may prescribe medications or other treatments to reduce your chances of developing eye disease, kidney disease, and other conditions that are more common in people with diabetes.

FOOT CARE:-

People with diabetes are more likely to have foot problems. Diabetes can damage nerves, which means you may not feel an injury to the foot until you get a large sore or infection. Diabetes can also damage blood vessels. Diabetes also decreases the body's ability to fight infection. Small infections can quickly get worse and cause the death of skin and other tissues. To prevent injury to your feet, check and care for your feet every day.

Expectations (prognosis):-

After many years, diabetes can lead to serious problems with your eyes, kidneys, nerves, heart, blood vessels, or other areas in your body. If you have diabetes, your risk of a heart attack is the same as that of someone who has already had a heart attack. Both women and men with diabetes are at risk. You may not even have the normal signs of a heart attack. If you control your blood sugar and blood pressure, you can reduce your risk of death, stroke, heart failure, and other diabetes problems.
Some people with type 2 diabetes no longer need medicine if they lose weight and become more active. When they reach their ideal weight, their body's own insulin and a healthy diet can control their blood sugar levels.

Complications:-

After many years, diabetes can lead to serious problems:

• You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind.
• Your feet and skin can develop sores and infections. After a long time, your foot or leg may need to be removed. Infection can also cause pain and itching in other parts of the body.
• Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack, storke, and other problems. It can become harder for blood to flow to your legs and feet.
• Nerves in your body can get damaged, causing pain, tingling, and a loss of feeling.
• Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection.
• High blood sugar and other problems can lead to kidney damage. Your kidneys may not work as well, and they may even stop working.
• Infections of the skin, female genital tract, and urinary tract are also more common.

To prevent problems from diabetes, visit your health care provider or diabetes educator at least four times a year. Talk about any problems you are having.

Call your doctor if you have:

• Numbness, tingling, or pain in your feet or legs
• Problems with your eyesight
• Sores or infections on your feet
• Symptoms of high blood sugar (being very thirsty, having blurry vision, having dry skin, feeling weak or tired, needing to urinate a lot)
• Symptoms of low blood sugar (feeling weak or tired, trembling, sweating, feeling irritable, having trouble thinking clearly, fast heartbeat, double or blurry vision, feeling uneasy)

Prevention:-

You can help prevent type 2 diabetes by keeping a healthy body weight and an active lifestyle.
Stay up-to-date with all your vaccinations and get a flu shot every year.

Urinalysis

Urine appearance and color; Routine urine test
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds that pass through the urine.

How the test is performed:-

A urine sample is needed. Your health care provider will tell you what type of urine sample is needed.
The sample is sent to a lab, where it examined for the following:

Physical color and appearance:

• What does the urine look like to the naked eye?
• Is it clear or cloudy?
• Is it pale or dark yellow or another color?

The urine specific gravity test reveals how concentrated or dilute the urine is.

Microscopic appearance:

The urine sample is examined under a microscope to look at cells, urine crystals, mucus, and other substances in the sample, and to identify any bacteria or other germs that might be present.

Chemical appearance:

A special stick ("dipstick") tests for various substances in the urine. The stick contains little pads of chemicals that change color when they come in contact with the substances of interest.

How to prepare for the test

Certain medicines change the color of urine, but this is not a sign of disease. Your doctor may tell you to stop taking any medicines that can affect test results.

Medicines that can change your urine color include:

• Chloroquine
• Iron supplements
• Levodopa
• Nitrofurantoin
• Phenazopyridine
• Phenothiazines
• Phenytoin
• Riboflavin
• Triamterene

How the test will feel:

The test involves only normal urination, and there is no discomfort.

Why the test is performed

A urinalysis may be done:

• As part of a routine medical exam to screen for early signs of disease
• If you have signs of diabetes or kidney disease, or to monitor you if you are being treated for these conditions
• To check for blood in the urine
• To diagnose a urinary tract infection

Additional conditions under which the test may be performed:

• Acute bilateral obstructive uropathy
• Acute nephritic syndrome
• Acute tubular necrosis
• Acute unilateral obstructive uropathy
• Alkalosis
• Alport syndrome
• Analgesic nephropathy
• Anorexia nervosa
• Atheroembolic renal disease
• Atrial myxoma
• Bladder stones
• Chronic bilateral obstructive uropathy
• Chronic glomerulonephritis
• Chronic or recurrent urinary tract infection
• Chronic renal failure
• Chronic unilateral obstructive uropathy
• Chronic urethritis
• Complicated UTI (pyelonephritis)
• Congenital nephrotic syndrome
• Cystinuria
• Delirium
• Dementia
• Dementia due to metabolic causes
• Diabetes insipidus -- central
• Diabetic nephropathy/sclerosis
• Enuresis
• Epididymitis
• Failure to thrive
• Focal segmental glomerulosclerosis
• Goodpasture syndrome
• Heart failure
• Hemolytic-uremic syndrome (HUS)
• Henoch-Schonlein purpura
• Insulin-dependent diabetes (IDD)
• IgA nephropathy (Berger's disease)
• Injury of the kidney and ureter
• Interstitial nephritis
• Irritable bladder
• Left-sided heart failure
• Lupus nephritis
• Malignant hypertension (arteriolar nephrosclerosis)
• Medullary cystic kidney disease
• Membranoproliferative GN I
• Membranoproliferative GN II
• Membranous nephropathy
• Myelomeningocele (children)
• Necrotizing vasculitis
• Nephrotic syndrome
• Noninsulin-dependent diabetes (NIDD)
• Orchitis
• Ovarian cancer
• Paroxysmal nocturnal hemoglobinuria (PNH)
• Polycystic kidney disease
• Post-streptococcal GN
• Prerenal azotemia
• Primary amyloidosis
• Prostate cancer
• Prostatitis, acute
• Prostatitis, chronic
• Prostatitis, nonbacterial
• Pyelonephritis, acute
• Rapidly progressive (crescentic) glomerulonephritis
• Reflux nephropathy
• Renal papillary necrosis
• Renal tubular acidosis, distal
• Renal tubular acidosis, proximal
• Renal vein thrombosis
• Retrograde ejaculation
• Rhabdomyolysis
• Right-sided heart failure
• Secondary systemic amyloidosis
• Stress incontinence
• Systemic lupus erythematosus
• Systemic sclerosis (scleroderma)
• Thrombotic thrombocytopenic purpura
• Traumatic injury of the bladder and urethra
• Ureterocele
• Urethral stricture
• Urethritis
• Wegener's granulomatosis
• Wilms tumor

Normal Values:-

Normal urine may vary in color from almost colorless to dark yellow. Some foods (like beets and blackberries) may turn the urine a red color.
Usually, glucose, ketones, protein, and bilirubin are not detectable in urine. The following are not normally found in urine:

• Hemoglobin
• Nitrites
• Red blood cells
• White blood cells

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What the risks are:- 

There are no risks.

Special considerations:-

If a home test is used, the person reading the results must be able to distinguish between different colors, since the results are interpreted using a color chart.

Glucose test - blood

A blood glucose test measures the amount of a sugar called glucose in a sample of your blood.

Glucose is a major source of energy for most cells of the body, including those in the brain. Carbohydrates (or carbs) are found in fruit, cereal, bread, pasta, and rice. They are quickly turned into glucose in your body. This raises your blood glucose level. Hormones made in the body called insulin and glucagon help control blood glucose levels.

How the test is performed:-

A blood sample is needed. For information on how this is done, see: Venipuncture.

How to prepare for the test:-

The test may be done in 2 ways:

• After you have not eaten anything for at least 8 hours (fasting)
• At any time of the day (random)

How the test will feel:-

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed:-

Your doctor may order this test if you have signs of diabetes. However, other tests (glucose tolerance test and fasting blood glucose test) are better for diagnosing diabetes. The blood glucose test is also used to monitor patients who have the diabetes. It may also be done if you have:

• A change in behavior
• Fainting spells
• Seizures for the first time

Normal Values:-

If you had a fasting blood glucose test, a level between 70 and100 milligrams per deciliter (mg/dL) is considered normal.

If you had a random blood glucose test, normal results depend on when you last ate. Most of the time, blood glucose levels will be below 125 mg/dL.

Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.
The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What abnormal results mean:-

If you had a fasting blood glucose test:

• A level of 100-125mg/dL means you have impaired fasting glucose, a type of prediabetes. This increases your risk for type 2 diabetes.
• A level of 126 mg/dL and higher most often means you have diabetes.

Higher-than-normal random blood glucose levels may be a sign of diabetes. In someone with diabetes, it may mean the diabetes is not well controlled.  Your healthcare provider will likely order a fasting blood glucose or a glucose tolerance test, depending on your random test result.

Other medical problems may also cause higher-than-normal blood glucose levels, including:

• Overactive thyroid gland
• Pancreatic cancer
• Pancreatitis
• Rare tumors, including pheochromocytoma,acromegaly,Cushing syndrome, or glucagonoma
• Lower-than-normal blood glucose levels (hypoglycemia) may be due to:
• Hypopituitarism (a pituitary gland disorder)
• Underactive thyroid gland
• Insulinoma (very rare)
• Too little food
• Too much insulin or other diabetes medications

What the risks are:-

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

Special considerations:-

Many forms of severe stress (for example, trauma, stroke, heart attack, and surgery) can temporarily raise blood glucose levels.

Drugs that can increase glucose measurements include the following:

• Certain medicines to treat schizophrenia and psychosis
• Beta-blockers (such as propranolol)
• Corticosteroids (such as prednisone)
• Estrogens
• Glucagon
• Isoniazid
• Lithium
• Oral contraceptives (birth control pills)
• Phenothiazines
• Phenytoin
• Salicylates (see aspirin overdose)
• Thiazide diuretics (such as hydrochlorothiazide)
• Triamterene
• Tricyclic antidepressants

Drugs that can decrease glucose measurements include the following:

• Acetaminophen
• Alcohol
• Anabolic steroids
• Clofibrate
• Disopyramide
• Gemfibrozil
• Monoamine oxidase inhibitors (MAOIs)
• Pentamidine

HbA1c

HbA1c is a lab test that shows the average level of blood sugar (glucose) over the previous 3 months. It shows how well you are controlling your diabetes.

How the test is performed:-

A blood sample is needed. Some methods only require a quick finger stick. Others may need a sample of blood from a vein. For information on how this is done, see: Venipuncture.

How to prepare for the test:-

No special preparation is needed.

How the test will feel:-

When the needle is inserted, you may feel a slight pinch or some stinging. Afterward, there may be some throbbing.

Why the test is performed:-

Your doctor may order this test if you have diabetes. It shows how well you are controlling your diabetes.

The test may also be used to screen for diabetes.

Normal Values:-

An HbA1c of 5.6% or less is normal.

The following are the results when the HbA1c is being used to diagnose diabetes:

• Normal: Less than 5.7%
• Pre-diabetes: 5.7% to 6.4%
• Diabetes: 6.5% or higher

If you have diabetes, you and your doctor or nurse will discuss the correct range for you. For many people the goal is to keep your level at or below 6.5 - 7%.

What abnormal results mean:-

Abnormal results mean that you have had high blood sugar levels over a period of weeks to months.

If your HbA1c is above 6.5% and you do not already have diabetes, you may be diagnosed with diabetes.

If your level is above 7% and you have diabetes, it often means that your is not well controlled. Your target HbA1c should be determined by you and your health care provider.

In general, the higher your HbA1c, the higher the risk that you will develop problems such as:

• Eye disease
• Heart disease
• Kidney disease
• Nerve damage
• Stroke

If your HbA1c stays high for a long period of time, the risk for these problems is even greater. Ask your doctor how often you should have your level tested. Usually, doctors recommend testing every 3 or 6 months.

What the risks are:-

• Obtaining a blood sample from some people may be more difficult than from others.
• Other risks associated with having blood drawn are slight, but may include:
• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

Glucose tolerance test

Oral glucose tolerance test

The glucose tolerance test is a lab test to check how your body breaks down sugar.

How the test is performed:-

The most common glucose tolerance test is the oral glucose tolerance test (OGTT). Before the test begins, a sample of blood will be taken. You will then be asked to drink a liquid containing a certain amount of glucose (usually 75 grams). Your blood will be taken again every 30 to 60 minutes after you drink the solution. The test takes up to 3 hours.

A similar test is the IV glucose tolerance test (IGTT). It is rarely used, and never used to diagnose diabetes. In this test, glucose is injected into your vein for 3 minutes. Blood insulin levels are measured before the injection, and again at 1 and 3 minutes after the injection. However, the timing may vary.

How to prepare for the test:-

• Make sure you eat normally for several days before the test.
• Do not eat or drink anything for at least 8 hours before the test. You cannot eat during the test.
• Ask your health care provider if any of the medicines you take can affect the test results.

How the test will feel:-

Some people feel nauseated, sweaty, light-headed, or may even feel short of breath or faint after drinking the glucose. However, serious side effects of this test are very uncommon. When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed:-

Glucose is the sugar the body uses for energy. Patients with untreated diabetes have high blood glucose levels. Glucose tolerance tests are one of the tools used to diagnose diabetes.
Above-normal blood glucose levels can be used to diagnose type 2 diabetes or high blood glucose during pregnancy (gestational diabetes). Insulin levels may also be measured. (Insulin is the hormone produced by the pancreas that moves glucose from the blood into cells.)
The oral glucose tolerance test is used to screen pregnant women for gestational diabetes between 24 and 28 weeks of pregnancy. It may also be used when the disease is suspected, even though the fasting blood glucose level is normal.

Normal Values:-

Normal blood values for a 75-gram oral glucose tolerance test used to check for type 2 diabetes in those who are not pregnant:

Fasting: 60 -100 mg/dL

1 hour: less than 200 mg/dL

2 hours: less than 140 mg/dL

Note: mg/dL = milligrams per deciliter

The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean:-

Higher-than-normal levels of glucose may mean you have prediabetes, diabetes, or gestational diabetes.

Between 140 - 200 mg/dL is called impaired glucose tolerance. Your doctor may call this "prediabetes." It means you are at increased risk for developing diabetes.

A glucose level of 200 mg/dL or higher is a sign of diabetes.

However, high glucose levels may be related to another medical problem (for example, Cushing syndrome).

What the risks are:-

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

Special considerations:-

• Factors that may affect the test results:
• Acute stress (for example, from surgery or an infection)
• Vigorous exercise

Several drugs may cause glucose intolerance, including:

• Atypical antipsychotic medications, including aripiprazole, olanzapine, quetiapine, risperidone, and ziprasidone
• Beta-blockers (for example, propranolol)
• Birth control pills
• Corticosteroids (for example, prednisone)
• Dextrose
• Epinephrine
• Estrogens
• Glucagon
• Isoniazid
• Lithium
• Phenothiazines
• Phenytoin
• Salicylates (including aspirin)
• Thiazide diuretics (for example, hydrochlorothiazide)
• Triamterene
• Tricyclic antidepressants

Before having the test, let your health care provider know if you are taking any of these medications.

Source: http://www.ncbi.nlm.nih.gov/pubmedhealth/s/diseases_and_conditions/d/
             http://www.diabetes.co.uk/World-Diabetes-Day.html