So here’s the detailed day by day itinerary of my recent Sikkim trip. So much to explore in this beautiful state. We covered Gangtok, Lachung and Pelling. Day trips from each place. Also visited Darjeeling mainly for the heritage train and the zoo. It was an awesome trip and… twitter.com/i/web/status/1…
So we had a flight from Mumbai to Bagdogra (West Bengal) which is the nearest airport. I took an early morning flight (about 3 hrs duration) as the road journey to Gangtok is about 4-5 hours and we wanted to reach by evening latest. We had lunch on the way. After settling in the… twitter.com/i/web/status/1…
Next morning we were planned for local Gangtok sightseeing. Bakthang waterfalls, Institute of Tibetology, Chorten stupa. Some local fruits🍍 on the way too!
“When you have eliminated the impossible, whatever remains, however improbable, must be the truth.”— Arthur Conan Doyle, The Case-Book of Sherlock Holmes
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Get Healthy and Relax
“Intelligence and skill can only function at the peak of their capacity when the body is healthy and strong.” —John F. Kennedy.
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It can affect blood flow to the lower limbs, affecting healing and making prone to infection.
It can affect nerves leading to reduced sensation including pain. #Diabetes#Footcare (2/n)
If you have diabetes & develop a blister or cut or a sore, it could lead to a non healing wound that could progress & some cases requiring surgeries & even amputation. We see many cases in late stages, hence requires intervention. Many are PREVENTABLE. #Diabetes#Footcare (3/n)
This article by @AskDrShashank et al sheds light on role of yoga based lifestyle modifications in Type 2 Diabetes and associated factors #Diabetes #Yoga (2) ncbi.nlm.nih.gov/pmc/articles/P…
This editorial in @j_metb talks about evidence for effect of yoga in #Diabetes and #Prediabetes #Yoga (3)
In the sea of tweets about high glucose levels, let’s not forget something which can be equally important and more dangerous. Hypoglycaemia (low glucose levels). Below are some of the symptoms which can be due to low glucose levels #Diabetes#COVID19#Steroids (1/n)
Many patients who are on steroids may be on medications for hyperglycemia(tablets as well as Insulin). Once steroid dose is gradually reduced, the glucose levels will tend to improve. Some may have low glucose levels in morning too #Diabetes#Hypoglycemia#COVID19 (2/n)
As steroids r reduced & stopped, its important to continue monitor glucose levels & consult ur Dr so the diabetes medicines can be adjustd accordingly. I have seen few cases who continued diabetes medicines & had weakness but didn’t check glucose levels regularly #diabetes (3/n)
This chat with wife of one of my #Diabetes patients adm with #Covid19
1. Please trust the Doctors taking care of you. They know best at that point of time.
2. Steroids may be one of the drugs used for treatment especially when oxygen saturation low (1/n)
3.Steroids can significantly affect glucose levels.They can typically cause rise in after meal glucose levels during the day & morning fasting glucose levels are better
4.Some oral agents (tablets) for Diabetes may need to be stopped on admission(2/n)