Understanding Diabetes and Navigating Life with Diabetes - मधुमेहलाई बुझ्नु र मधुमेहको साथ जीवन निर्बाहा कसरी गर्नु

 

What is diabetes?

मधुमेह भनेको के हो ?

 Diabetes mellitus is a chronic medical condition characterized by high levels of glucose (sugar) in the blood. This occurs either because the pancreas does not produce enough insulin (a hormone that regulates blood sugar) or because the body's cells do not respond properly to insulin.

मधुमेह एक जटिल चिकित्सा अवस्था हो जुन रगतमा ग्लुकोज (चिनी) को उच्च मात्राको कारणले हुन्छ।अग्न्याशयले पर्याप्त मात्रामा इन्सुलिन (रगतमा चिनीको नियमन गर्ने हर्मोन) उत्पादन नगर्दा वा शरीरका कोषहरूले इन्सुलिनलाई ठीकसँग प्रतिक्रिया नदेखाउँदा यस्तो हुन्छ।

 

what are the risk factors?

जोखिम कारकहरू के के हुन्?

  Smoking, tobacco and alcohol consumption

  धुम्रपान, सुर्ती  रक्सीको सेवन

Unhealthy food habits

अस्वास्थ्यकर खानपानको बानी

Overweight

अधिक वजन

Sedentary lifestyle

गतिहीन जीवनशैली

Age more than 45 years

उमेर ४५ वर्ष भन्दा बढी

1st degree relatives with diabetes

मधुमेह भएका पहिलो तहका नातेदारहरू

Comorbidities: High blood pressure(Hypertension), Dyslipidaemia(Abnormal cholesterol level), Pancreatic diseases

उच्च रक्तचाप, डिस्लिपिडेमिया (असामान्य कोलेस्ट्रोल स्तर), अग्नाशयी रोग

 

what are the symptoms and when to see a doctor?

लक्षणहरू के-के हुन्  कहिले डाक्टरलाई भेट्ने?

 Increased frequency of urination(Polyuria)

पिसाब को आवृत्ति मा वृद्धि (पोलियुरिया)

Increased thirst(Polydipsia)

तिर्खा बढेको  (पोलिडिप्सिया)

Increased hunger(Polyphagia)

भोक बढेको  (पोलिफागिया)

Dryness of mouth

मुख सुख्खा हुनु

Increase or decrease in weight

तौल मा वृद्धि वा कमी

Burning micturition

पिसाब पोल्नु

Increased tiredness

थकान बढेको 

Tingling sensation in the limbs

अंगहरूमा झम्झमाउने संवेदना

Decrease in vision

दृष्टिमा कमी

 

How to control blood sugar level?

ब्लड सुगरको मात्रा कसरी नियन्त्रण गर्ने ?

 This requires perfect balance of three factors: Physical activity, Healthy Diet and appropriate medications.

यसको लागि तीन कारकहरूको सही सन्तुलन आवश्यक : शारीरिक गतिविधि, स्वस्थ आहार  उपयुक्त औषधिहरू

 

Diabetes Care

मधुमेह को देखभाल

 Blood sugar tests:Hba1c(Average blood sugar lever over past three months), Fasting blood sugar and Post prandial blood sugar level should be tested according to physicians advice routinely

ब्लड सुगर टेस्टः एचबीए१सी (विगत तीन महिनामा औसत ब्लड सुगर लेभल), फास्टिङ ब्लड सुगर  पोस्ट  प्रान्डियल ब्लड सुगर लेभल नियमित रूपमा चिकित्सकको सल्लाहअनुसारपरीक्षण गर्नुपर्छ 


Blood pressure should be checked regularly

रक्तचाप नियमित रूपमा जाँच गर्नुपर्छ

Cholesterol level should be tested every 3-6 months

प्रत्येक - महिनामा कोलेस्ट्रोलको स्तर परीक्षण गर्नुपर्छ

Urine and creatinine should be tested every 6 months

पिसाब  क्रिएटिनिनको हरेक  महिनामा परीक्षण गर्नुपर्छ 

Eye examination should be done every 2 years

प्रत्येक  वर्षमा आँखा जाँच गराउनुपर्छ

Foot should be checked everyday for any wounds or injuries

खुट्टाको कुनै पनि घाउ वा चोटपटकको लागि हरेक दिन जाँच गर्नुपर्छ

Electrocardiography should be done every year

इलेक्ट्रोकार्डियोग्राफी प्रत्येक वर्ष गर्नुपर्छ

 

Diabetic foot care

डायबिटिक फुट केयर

Wash your feet every day with luke warm water and soap

हरेक दिन तातो पानी  साबुनले खुट्टा धुनुहोस्

Dry your feet well, especially between the toes

आफ्नो खुट्टा राम्ररी सुकाउनुहोस्, विशेष गरी औंलाहरूको बीचमा

Moisturise your feet, but not between the toes

आफ्नो खुट्टालाई मोइस्चराइज गर्नुहोस्, तर औंलाहरूको बीचमा होइन

Check your feet for blisters, cuts or sores

फोका, काटिने वा घाउ भएमा आफ्नो खुट्टाजाँच गर्नुहोस्

Keep your toenails at a reasonable length

आफ्नो खुट्टाको नङलाई उचित लम्बाइमा राख्नुहोस्

Wear clean socks that aren’t too big or small

धेरै ठूलो वा सानो नभएको सफा मोजा लगाउनुहोस्

Keep your feet warm and dry with shoes that fit comfortably

आरामले फिट हुने जुत्ताले खुट्टालाई न्यानो  सुख्खा राख्नुहोस्

Never walk barefoot indoors or outdoors

घरभित्र वा बाहिर कहिल्यै पनि खाली खुट्टा हिँड्नु हुँदैन

Examine your shoes for things that might hurt your feet

खुट्टादुख्ने कुराहरूको लागि आफ्नो जुत्ता जाँच्नुहोस्

 

Dietary recommendations

कस्तो आहार खाने

The glycaemic index(GI) is a measure used to determine how much a food can affect your blood sugar levels. People with diabetes are advised to consume food products with low GI(45 or less).Low GI foods help to control blood sugar level, manage weight and reduce the risk of diabetes, heart disease and cancer as well. Some of the common low glycaemic foods are as follows:

 

ग्लाइसेमिकइन्डेक्स(जीआईएक उपाय हो जुन खानाले तपाईंको रगतमा चिनीको स्तरलाई कति असर गर्न सक्छ भनेर निर्धारण गर्न प्रयोग गरिन्छ।मधुमेह भएका व्यक्तिहरूलाई कम जीआई (४५ वा सोभन्दा कम) भएका खाद्य पदार्थहरू सेवन गर्न सल्लाह दिइन्छ। कम जीआई खानाले रगतमा चिनीको मात्रा कम गर्न, तौल व्यवस्थापन गर्न  मधुमेह, मुटुरोग  क्यान्सरको जोखिम कम गर्न मद्दत गर्दछ। सामान्यतया न्युन ग्लाइसेमिक खाद्य पदार्थहरू निम्नानुसार छन्:


Most vegetables: Green peas, Onions, Lettuce, CabbageLeafy greens such as spinach, beetTomatoes, CucumbersBrussels sprouts, Broccoli, Cauliflower, Celery, Eggplant, Mushrooms.

अधिकांश तरकारीहरू: हरियो मटर, प्याज, सलाद, बन्दागोभी, सागपात जस्तै पालक   चुकन्दर, टमाटर, काँक्रा, ब्रसेल्स स्प्राउट्स, ब्रोकोली, फूलगोभी, अजवाइन, बैंगन, च्याउ


Certain fruits: Apples, Pears, PlumAvocado, Unripe banana, Peaches, Strawberries, Oranges, Cherries, Coconut, Grapefruit, Cranberries, Blueberries

केही फलहरू: स्याउ, नाशपाती, प्लम, एभोकाडो, काचो केरा, आड़ू, स्ट्रबेरी, सुन्तला, चेरी, नरिवल, अंगूर, क्रैनबेरी, ब्लूबेरी


Whole or minimally processed grainsBarleyWhole wheat, Oat bran and rice bran cereals, Wheat tortilla

पूरा वा न्यूनतम प्रशोधित अनाज: जौ,  गहुँ, ओट चोकर  चावल चोकर अनाज, गहुँ रोटी


Dairy and dairy substitute products: Plain yogurt, Cheese, Milk, soy milk and yogurt

डेरी  डेरी विकल्प उत्पादनहरू: सादा दही, पनीर, दूध, सोया दूध  दही


MiscellaneousNuts and nut butterSeeds such as pumpkin, sunflower seedsPoultry such as chicken and turkeyEggs and egg whitesFish and shellfish

विविध: नट्स  नट बटर, बीउहरू जस्तै कद्दू, सूर्यमुखी बीउ, कुखुरा  टर्की जस्ता पोल्ट्री, अण्डा  अण्डाको सेतो भाग, माछा  शेलफिस

 

Healthy behaviour recommendations

स्वस्थ व्यवहारहरु के हुन् 

Increase physical activity to moderate level for at least 30 minutes per day on 5 days of the week

हप्ताको  दिनमा प्रति दिन कम्तिमा ३० मिनेटको लागि शारीरिक गतिविधिलाई मध्यम स्तरमा बढाउनुहोस

Stop tobacco and avoid harmful use of  alcohol

सुर्तीजन्य पदार्थ बन्द गर्नुहोस्  रक्सीको हानिकारक प्रयोगबाट बच्नुहोस

Eat a healthy diet including 5 servings of locally available fruits and vegetable per day(400-500 grams), limit fat intake and cooking oil to less than two tablespoons per day, restrict salt to less than 5 grams per day

स्थानीय स्तरमा उपलब्ध फलफूल  तरकारीको  सर्भिङ (४००-५०० ग्राम) सहित स्वस्थ आहार खानुहोस्, बोसो को सेवन  खाना पकाउने तेल प्रति दिन दुई चम्चा भन्दा कममा सीमित गर्नुहोस्, नुनलाई प्रति दिन  ग्राम भन्दा कममा सीमित गर्नुहोस्।

 

The principal idea is embracing a healthy lifestyle with the correct balance of physical activity and healthy diet is the key component in managing blood sugar levels and maintaining overall well-being.

मुख्य कुरा शारीरिक गतिविधिको सही सन्तुलनको साथ स्वस्थ जीवनशैलीलाई अँगाल्नु हो  स्वस्थ आहार रगतको सुगरको स्तर व्यवस्थापन गर्न  समग्र कल्याण कायम राख्नको लागि प्रमुख तत्वो हो।


Reference:

 Package of Essential Noncommunicable (PEN) Disease Interventions at Primary Health Service setting (WHO Nepal)


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