prediabetes http://www.telegraphindia.com/1161114/jsp/knowhow/story_118991.jsp

There has been an increase in the number of diabetic patients in India from 11.9 million in 1980 to 64.5 million. In fact, in the last 15 years, diabetes patients have increased by a 100 per cent. Also, 77.2 million people in India have pre-diabetes. They are not yet diabetic, but with fasting glucose levels in the 100 and 125mg/dL range, they have "impaired glucose tolerance" and are in real danger of eventually developing diabetes.

The pre-diabetic state was originally tested in people 35 and older, but now even preteens are developing impaired glucose tolerance. The explosion in the percentage of people with this condition has coincided with the popularity of cheap, calorie-dense, fast food; aerated, sugary, bottled drinks and home-based entertainment - from television, cell phones and computers - leading to sedentary or "couch potato" lifestyles.

Pre-diabetes is likely to be present at any age if:

♦ The BMI (weight divided by height in meter squared) is more than 25;

♦ The fat is concentrated around the abdomen;

♦ The lipid profile is abnormal;

♦ The blood pressure is above 140/90;

♦ There is a family history of diabetes;

♦ The skin on the folds of the neck and elbows is black and velvety in appearance, a condition known as "acanthosis nigricans";

♦ There are symptoms of increased fatigue, hunger, thirst and urination;

♦ If a woman have polycystic ovarian syndrome (PCOS) or diabetes during pregnancy or delivered a baby heavier than 4kg.

Anyone who exercises less than three days a week, and repeatedly has two consecutive days without physical activity may also become pre-diabetic.

After the age of 45, it is better to test for diabetes even if you are asymptomatic. If the sugar values are normal and there are no risk factors, the test should be repeated every three years. Children aged 10 and older should be tested for diabetes if they are overweight and have at least two risk factors.

To prevent pre-diabetes from becoming full-blown diabetes, maintain ideal body weight. This should be combined with regular exercise.

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CALCULATE YOUR SUGAR SCORE

• Age: If you are younger than 35, add 0 to your score
If you are between 35-49, add 20
If you are 50 or older, add 30

• Abdominal obesity: If waist size is less than 80cm (in women) or 90 (in men) add 0
If waist size is between 80-89 cm (in women) or 90-99 cm (in men), add 10 to your score
If waist size is more than 90 cm (women) or 100 cm (men), add 20 to your score

• Physical activity: If you exercise regularly and do strenuous work, add 0 to your score
If you either exercise regularly or do strenuous work, add 20
If you do not exercise and do sedentary work, add 30

• Family history: If there is no family history of diabetes, add 0
If one  parent is diabetic, add10
If both parents are diabetic, add 20

If your score is:
• >60: There is a very high risk of having diabetes
• 30-50: The risk of having diabetes is moderate. It is recommended you get blood tests done
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Source: Madras Diabetes Research Foundation, Chennai

Dr Gita Mathai is a paediatrician and author of StayingHealthy in Modern India. Mail your questions to yourhealthgm@yahoo.co.in

eczema

Don’t scratch that itch

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Your Health - Dr. Gita Mathai

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• 

  Skin deep
  Keep eczema away
  
  Use a non-perfumed, moisturising soap. Apply lotion or oil after a bath. Add a tablespoon of coconut oil to the bathwater
  
  Apply mild steroid creams (only with a prescription) for relief. Avoid oral steroid medication
  
  For relief from scratching, take anti-allergy pills that do not make you sleepy
  
  Reduce stress with exercise, yoga and meditation

Eczema is a common skin condition, affecting 10-30 per cent of the population. The word is derived from Greek ekzein, which means ‘boil over, break out’. It is diagnosed when the skin is chronically inflamed in certain areas, with redness, itching and rash. The constant itching makes people scratch. Children are sometimes unable to reach the area, whereupon they rub it against clothing and available hard surfaces. The affected area may then begin to bleed or become secondarily infected. The skin can eventually become thickened and leathery.

The most common type of eczema is called “atopic dermatitis”. It starts in childhood. Affected children have close relatives with atopic dermatitis or other allergies such as constant sneezing. The attacks may be triggered by exposure to allergens in food such as cow’s milk, peanuts or food colouring. Contact with wool or synthetic fibres may aggravate the itching. Perfumes, soaps and detergents may also be precipitating factors.

Atopic dermatitis appears on the front or back of the knees, around the elbow, at the neck, on the scalp, hands or cheeks. It can appear as itchy dry red areas, which can eventually become discoloured. The itching can be severe enough to interfere with schoolwork, daily activities and disrupt sleep.

Infants fed on cow’s milk or formula can develop eczema because of cow’s milk protein. Sometimes rashes make their first appearance during weaning, when solid food like egg is introduced.

Most children grow out of their eczema. They start getting better around the age of one and are completely “cured” by the age of four.

Eczema may also be “contact eczema” where the reaction occurs only in areas in contact with the allergen. This is particularly common with nickel-plated artificial earrings or necklaces. Changing your brand of soap or shampoo can also precipitate a reaction. This type of eczema is easy to treat. Just removing the precipitating factor will make it clear up rapidly.

Sometimes the palms and soles of the feet are affected. Blisters form, the skin becomes rough and it may flake off. This is called dyshidrotic eczema.

Nummular or discoid dermatitis occurs in adults as oval-shaped patches, or blister-like sores. They occur on the arms, hands, feet and chest. They exude fluid, become scaly and can get secondarily infected.

Seborrhoeic dermatitis appears on the scalp (dandruff, cradle cap in infants), nose, around the umbilicus, sides of the nose, eye and skin folds under the breast. On the scalp, applying mineral oil, brushing away the flakes and then using an antidandruff shampoo usually clears the flakes.

Dr Gita Mathai is a paediatrician with a family practice at Vellore and author of Staying Healthy in Modern India.