Blood sugar double risk you didn’t know about: How black coffee and no sleep can push up levels

 Source: https://indianexpress.com/article/health-wellness

Getting less than six hours of sleep regularly can interfere with your body’s ability to regulate blood sugar.

A young patient of mine reported that her blood sugar levels were not quite in range despite keeping herself active and eating clean. We had suggested lifestyle correction as the first step to control her body weight but she said her regular exercises were tiring her out. Meanwhile her blood sugar levels showed an uptick. What was going wrong?

Then I asked her if she was sleeping enough. “Honestly, I sleep about five hours a night, sometimes less. I have a lot of daily deadlines to meet, so I rely on coffee — maybe five or six cups a day — to stay alert,” she told me. There lay my answer. Poor sleep and caffeine are bad news for blood sugar.

Sleep and blood sugar spikes

Getting less than six hours of sleep regularly can interfere with your body’s ability to regulate blood sugar. Poor sleep stresses the body. This means your body produces more cortisol, a stress hormone. Cortisol makes it harder for the sugar-regulating hormone insulin to do its job, which means your blood sugar levels can rise. Even if your diet doesn’t change, sleep deprivation can push your blood glucose up. Your body becomes less sensitive to insulin, and your liver might release more glucose into the bloodstream thinking you’re in stress mode.

But isn’t black coffee good for diabetes?

Only in moderation. One or two cups a day usually don’t cause problems. But having five or six cups can backfire, especially when you’re not sleeping enough. High caffeine intake increases adrenaline and cortisol levels, just like lack of sleep does. Together, they create a double impact on your glucose control. So, caffeine indirectly raises your blood sugar, too.

Plus, excessive caffeine can lead to poor sleep quality — even if you do manage to get to bed on time. It becomes a cycle: less sleep, more coffee, more stress hormones, and higher blood sugar.

Studies suggest that in some people, especially those with prediabetes or type 2 diabetes, high caffeine consumption can reduce insulin sensitivity. This means that their bodies require more insulin to bring blood sugar levels down after meals, putting extra strain on the pancreas and increasing the risk of hyperglycemia.

Sleep is essential for glucose metabolism. And caffeine, though helpful in small doses, should be limited—especially if you’re using it to compensate for inadequate rest.

The ideal combination

Start by aiming for at least seven to eight hours of sleep per night. Try reducing your caffeine to two cups a day — preferably before 2 pm. Then monitor your blood sugar. You’ll likely see improvement within a week or two. These small lifestyle changes can go a long way in protecting your health — especially if you’re at a risk for diabetes or already managing it.

 

What’s spiking BP in women in their early 30s and 40s faster than men?

 Source: https://indianexpress.com/article/health-wellness

Women between 30s and 40s often begin transitioning through perimenopause, a phase marked by fluctuating and gradually declining estrogen levels. (Representational)

Lately, I have been seeing a lot of women in their 30s and 40s with complaints of hypertension or high blood pressure. And I noticed that most of them lived in some of Mumbai’s most polluted areas. While the impact of pollution is generally associated with respiratory health, in women it can impact their biology and hormones.

Pollution and Blood Pressure

Research indicates that women may experience more pronounced cardiovascular responses to air pollution than men. Exposure to pollutants like fine particulate matter (PM2.5) and nitrogen dioxide (NO₂) has been linked to steeper blood pressure spikes in women. This is because of two reasons. One, women typically have smaller airways, which may allow pollutants to exert a greater physiological impact and obstruct them further. Second, their hormonal cycles and stress levels heighten their sensitivity to environmental triggers.

Hormonal Shifts and Cardiovascular Risk

Women between 30s and 40s often begin transitioning through perimenopause, a phase marked by fluctuating and gradually declining estrogen levels. Estrogen, known for its protective effects on the cardiovascular system, helps maintain blood vessel flexibility and suppresses inflammation. Pollutants like PM2.5 damage cells and trigger inflammation, which, in the absence of adequate estrogen, can damage walls of blood vessels—a precursor to chronic high blood pressure.

Pollutants of Concern

PM2.5 stands out as the most hazardous. These microscopic particles can penetrate deep into the lungs and even enter the bloodstream, igniting inflammation and damaging blood vessels. Nitrogen dioxide (NO₂) from vehicle exhaust leads to arterial stiffness. Carbon monoxide (CO) interferes with oxygen transport, forcing the heart to work harder, while ozone (O₃)—though less studied—has been shown to exacerbate cardiovascular and respiratory conditions. In urban areas, where traffic, construction, and industrial emissions converge, daily exposure to this toxic mix becomes unavoidable.

Many offices and homes suffer from poor ventilation, leading to constant exposure to indoor air pollutants as well. Combined with chronic stress, irregular routines, and limited physical activity, this creates a high-risk environment for cardiovascular problems.

Urban working women also often deal with long screen hours, shift work and low sun exposure — factors that further disrupt metabolic balance and vitamin D levels, both of which are closely linked to blood pressure regulation.

Taking Control: Prevention and Management

Since hypertension is a silent killer, women must do the following:

• Monitor regularly: Schedule routine check-ups for blood pressure, cholesterol and lipid profiles.

• Stay protected: Use indoor air purifiers and wear N95 masks when pollution levels are high.

• Eat smart: Adopt an anti-inflammatory diet rich in antioxidants, fibre and Omega-3 fatty acids.

• Move daily: Engage in regular physical activity, preferably indoors or in clean-air zones like parks.

• Manage stress: Practise mindfulness techniques such as yoga, breathing exercises, or meditation.

• Track the air: Use air quality index (AQI) apps and avoid outdoor activity during peak pollution hours.

 

Doctors revive heart attack patients in remote TN pockets with a little help from WhatsApp: How a hub and spoke model works

 Source: https://indianexpress.com/article/health-wellness

A study conducted by the Institute of Cardiology at Madras Medical College connected 188 smaller hospitals, which do not have catheter labs for angioplasty procedures, to 18 big hospitals in Tamil Nadu as part of a “hub and spoke” therapy model.

What if a person suffers a heart attack in a remote village and the local health centre doesn’t have a cardiologist or the infrastructure to do an angioplasty — a procedure to remove blood clots from heart arteries? The patient can still live and recover if the centre is connected to a bigger hospital through a chat platform, where specialists can recommend clot-dissolving drugs to local healthcare personnel and buy some time for the patient to get to a bigger hospital for surgical interventions.

A study conducted by the Institute of Cardiology at Madras Medical College connected 188 smaller hospitals, which do not have catheter labs for angioplasty procedures, to 18 big hospitals in Tamil Nadu as part of a “hub and spoke” therapy model. Cardiologists at bigger hospitals read the ECG, patient history and test results, suggested drugs and procedures, all through WhatsApp, improving the odds of patients at smaller centres surviving a heart attack.

What a pilot study shows

The study, which covered 71,000 people over five years, was able to demonstrate that just by providing guidance to the smaller hospitals on WhatsApp, more lives could be saved. Within five years, nearly one in five patients treated for heart attack in the hub hospital came from a spoke hospital, indicating how the linking system improved access. In the second phase of the study done with six hub hospitals, the doctors saw a remarkable increase in the proportion of people who got any intervention from 52.6 per cent in 2019 to 87.1 per cent by 2022.

The findings, which were recently published in the Indian Journal of Medical Research, are significant because they lay the template for broad-basing cardiac care to cover the last mile. With more Indians experiencing heart attacks in their early years, such a public health intervention can make heart care accessible even during emergencies. The data is from the cardiac care policy implemented by the government of Tamil Nadu.

Why this model can reduce deaths from heart attacks

“The sooner a person can undergo a procedure to open up a heart blockage or at least get a medicine that can help in dissolving the clot, the more muscles we end up saving. Sadly, a very small proportion of people receive these timely interventions,” said Dr G Justin Paul, professor at the Madras Medical College who designed the model. He also leads the state government’s heart attack management programme team.

“There are two types of heart attacks. A STEMI (ST-elevation Myocardial Infarction) is a major heart attack where the clot blocks blood flow completely to a part of the heart, resulting in muscles dying. Non-STEMI is referred to as a minor heart attack. Once the heart muscles die, there is no way of reviving them. However, there is now enough evidence to show that giving the clot-dissolving drug immediately and then doing the procedure within 24 hours is also equally effective. While most hospitals may not be able to do the procedure, they can certainly give the drug and then move the patients to the bigger hub hospital,” said Dr Paul.

In fact, the WhatsApp chat platform also helps the smaller centres share transfer protocols and coordinate patient care with the bigger hospitals. “This system of care worked in Tamil Nadu because of the availability of cardiologists in several Government hospitals, even in those that did not have a catheter lab prior to the study. This may not be true for all of India. However, the model may be modified and adopted,” said Dr Paul.

Benefits in numbers

In the first cluster with 12 hub hospitals, including the key Madras Medical College, the proportion of patients undergoing the stenting procedure after getting the clot dissolving medicine streptokinase increased from 9.1 per cent to 33.2 per cent. The proportion of patients able to receive the procedure within hours of heart attack also increased from 5.7 per cent to 9.7 per cent.

“The cost of angioplasty in a private hospital — which can range from Rs 1.5 lakh to Rs 6 lakh — can be a deterrent. But, more importantly, not all hospitals have the facility to conduct the procedure. This is the reason many may not be able to get the procedure within a few hours of the heart attack,” reasoned Dr Paul.

The results from the second cluster were even more impressive. While the proportion of patients undergoing the procedure immediately remained the same, those getting the procedure after having received the medicine increased from 0.9 per cent to 5.3 per cent. The proportion of deaths also reduced from 8.5 per cent to 5.8 per cent.

While the study used the less costly streptokinase that is given as an infusion, newer drugs can also be used. “These one-shot injections are costly at present, but the price may be brought down by governmental action, much in the same way as the stent prices were lowered,” said Dr Paul.

 

An hour’s screen use in bed increases risk of insomnia by 59%: Why new study calls for sleep hygiene reset

 Source: https://indianexpress.com/article/health-wellness

Scientists have found another reason to put the phone down. A survey of 45,202 young adults in Norway has discovered that screen-scrolling in bed drives up your risk of insomnia by 59 per cent and cuts your sleep time by 24 minutes. However, social media was not more disruptive than other screen activities, according to a new study published in Frontiers of Psychiatry.

Insomnia is defined as trouble sleeping and daytime sleepiness at least three times a week over at least three months. While the study did not determine causality — for example whether screen use causes insomnia or if students with insomnia use screens more — researchers found that using a screen in bed at night makes it much more likely you will sleep less and sleep poorly.

All screen devices to blame: Laptop, mobile, TV and Kindle

Sleep problems are widespread and according to ENT surgeon and sleep disorder expert Dr Seemab Shaikh, even studies from AIIMS have shown that sleep disorders, particularly Obstructive Sleep Apnea, affect 34 per cent of the population, meaning one in three individuals. “Whether it’s a laptop, mobile, TV, or even a Kindle, these devices keep you awake and can distract you from falling asleep. The blue light emitted by these devices hits the retina and activates the cells connected to the brain’s centre, disrupting sleep. This delay in falling asleep leads to a delayed wake-up time, throwing off your entire circadian rhythm. This can lead to short-term memory loss, irritability, mood swings and daytime headaches,” said Dr Shaikh.

Why the type of screen doesn’t matter

Scientists used the 2022 Students’ Health and Wellbeing survey of 45,202 participants in full-time higher education aged between 18 and 28. They sorted responses into three categories, one where participants used social media, one where they did not mention social media and one where participants selected several activities, including social media. Researchers found increasing screen time after bedtime by one hour in any of these categories increased the odds of insomnia symptoms by 59 per cent and lowered sleep duration by 24 minutes. “Using a screen in bed at night makes it much more likely you will sleep less and sleep poorly, but social media use is no worse than any other form of screen time,” said the authors. There was no significant difference between social media and other screen activities, suggesting that screen use itself is the key factor in sleep disruption. This is likely due to time displacement where screen use delays sleep by taking up time that would otherwise be spent resting.

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How to reduce screen use

Researchers suggested stopping screen use at least 30-60 minutes before sleep. “Consider disabling notifications to minimize disruptions during the night,” they said. Dr Shaikh suggests maintaining a sleep diary of consistent sleep schedules, a comfortable sleep environment and avoiding caffeine and alcohol at least six hours before.

 

An hour’s screen use in bed increases risk of insomnia by 59%: Why new study calls for sleep hygiene reset

 Source: https://indianexpress.com/article/health-wellness

Researchers suggested stopping screen use at least 30-60 minutes before sleep. (Photo: Pexels)

Scientists have found another reason to put the phone down. A survey of 45,202 young adults in Norway has discovered that screen-scrolling in bed drives up your risk of insomnia by 59 per cent and cuts your sleep time by 24 minutes. However, social media was not more disruptive than other screen activities, according to a new study published in Frontiers of Psychiatry.

Insomnia is defined as trouble sleeping and daytime sleepiness at least three times a week over at least three months. While the study did not determine causality — for example whether screen use causes insomnia or if students with insomnia use screens more — researchers found that using a screen in bed at night makes it much more likely you will sleep less and sleep poorly.

All screen devices to blame: Laptop, mobile, TV and Kindle

Sleep problems are widespread and according to ENT surgeon and sleep disorder expert Dr Seemab Shaikh, even studies from AIIMS have shown that sleep disorders, particularly Obstructive Sleep Apnea, affect 34 per cent of the population, meaning one in three individuals. “Whether it’s a laptop, mobile, TV, or even a Kindle, these devices keep you awake and can distract you from falling asleep. The blue light emitted by these devices hits the retina and activates the cells connected to the brain’s centre, disrupting sleep. This delay in falling asleep leads to a delayed wake-up time, throwing off your entire circadian rhythm. This can lead to short-term memory loss, irritability, mood swings and daytime headaches,” said Dr Shaikh.

Why the type of screen doesn’t matter

Scientists used the 2022 Students’ Health and Wellbeing survey of 45,202 participants in full-time higher education aged between 18 and 28. They sorted responses into three categories, one where participants used social media, one where they did not mention social media and one where participants selected several activities, including social media. Researchers found increasing screen time after bedtime by one hour in any of these categories increased the odds of insomnia symptoms by 59 per cent and lowered sleep duration by 24 minutes. “Using a screen in bed at night makes it much more likely you will sleep less and sleep poorly, but social media use is no worse than any other form of screen time,” said the authors. There was no significant difference between social media and other screen activities, suggesting that screen use itself is the key factor in sleep disruption. This is likely due to time displacement where screen use delays sleep by taking up time that would otherwise be spent resting.

How to reduce screen use

Researchers suggested stopping screen use at least 30-60 minutes before sleep. “Consider disabling notifications to minimize disruptions during the night,” they said. Dr Shaikh suggests maintaining a sleep diary of consistent sleep schedules, a comfortable sleep environment and avoiding caffeine and alcohol at least six hours before.

 

Lancet study shows Ayushman Bharat helped more people access timely cancer therapy

 Source: https://indianexpress.com/article/health-wellness

While better knowledge and healthcare facilities have reduced delays in starting cancer treatment in India, the decline was steeper among people enrolled in the Centre’s flagship Ayushman Bharat programme, according to a recent study published in the Lancet journal.

In other words, the health insurance-enabled access to therapy helped a larger number of patients. Timely initiation of cancer treatment increased by 36% across the population. However, it increased by 90% among those covered by the insurance scheme after 2018 as compared to the period between 1995 and 2017. The Ayushman Bharat scheme, which provides health cover to the poorest 40% of the country’s population, was rolled out in 2018.

“On World Cancer Day, a study published by Lancet shows that under AB PM-JAY (Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana), timely cancer treatment initiation improved significantly. Patients enrolled saw a 90% rise in access to cancer treatment within 30 days. Delays reduced and financial burden eased, a game-changer for India’s healthcare,” said Union Health Minister JP Nadda on X. He added that PM-JAY was bridging the gap in access to healthcare between rural and urban India, empowering millions to receive timely treatment.

STUDY FLAGS NEED FOR FACILITIES

While appreciating the government’s health safety net, the study looked at the data of nearly 6,700 cancer patients and made a strong case for a need to increase cancer care facilities such as radiotherapy machines. It found that the highest delay in treatment initiation was for radiotherapy, followed by chemotherapy and surgery. This “is an important argument for strengthening public healthcare infrastructure for provision of radiotherapy to cancer patients in India as well as inclusion of cost-effective chemotherapeutic agents in Ayushman Bharat,” the study said.

It flagged how the estimated 779 radiotherapy machines across the country fell short of the required numbers. Most high income countries have four machines per 10 lakh population while the World Health Organization (WHO) recommends at least one machine per 10 lakh population. By this standard, India would need between 1,350 to 5,000 radiotherapy machines, the study said.

WHICH POPULATION SEGMENT SOUGHT TREATMENT

Researchers compared the people who initiated treatment on time to those who didn’t — meaning, those who started treatment within 30 days versus those who did it after 30 days. They found that timely treatment was started by younger patients under the age of 30 years (77% as compared to 23%), those who were more educated (70.2% as compared to 29.8%), and those who were covered under some scheme (69% as compared to 31%). Nearly 40% of the study participants were not covered by any scheme. Those with higher income were also less likely to delay treatment, according to the study.

The researchers said that the “…expansion of cancer care services under the national flagship insurance program…appear to have helped in decreasing the financial barriers to access and improve early initiation of treatment.”

WHICH CANCERS SAW TIMELY TREATMENT

The steepest decline in delayed treatment was seen for reproductive and genitourinary cancers, followed by breast cancer and blood cancers. The highest delays in accessing treatment were in patients whose cancer stage was not known, meaning it was not mentioned in their patient records.

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The researchers said this might be due to lack of access to proper diagnostic procedures, lack of trained manpower, or paucity of health facilities, leading to uncertainty of staging. This, in turn, may lead to improper or delayed decision-making on appropriate treatment.

Can your hair fall be linked to cold weather? Know what triggers it

  Source: https://indianexpress.com/article/health-wellness

 

Hair loss is a natural process, and the average person sheds between 50 to 100 hair strands per day

One primary factor contributing to increased hair shedding in winter is dryness in the air.

Hair loss is a common concern that often intensifies during the winter months. As a dermatologist, I frequently meet patients who report increased shedding in the colder season, and many wonder whether this phenomenon is genuinely linked to winter.

While it is not entirely inaccurate to say that hair loss appears to be more pronounced during this time, the reasons behind it are multifactorial. First, it is essential to understand the typical cycle of hair growth. Each hair follicle undergoes a growth phase (anagen), a resting phase (telogen), and a shedding phase (exogen). Hair loss is a natural process, and the average person sheds between 50 to 100 hair strands per day. However, during certain seasons, more strands may enter the shedding phase simultaneously, leading to what appears to be excessive hair loss.

Dry air: One primary factor contributing to increased hair shedding in winter is dryness in the air. Cold temperatures, along with lower humidity, can lead to drier skin and scalp. This dryness can result in scalp irritation, dandruff and a disrupted hair growth cycle. The scalp’s natural oils, which are essential for keeping the hair healthy, may be stripped away more easily due to reduced sebum production in colder weather.

Heating devices: Additionally, harsh indoor heating systems further exacerbate dryness, making the scalp more prone to flakiness and inflammation, which can, in turn, contribute to increased hair fall.

Headgear: During the colder months, people tend to wear hats, scarves, and other head coverings more frequently. While these can protect from the elements, prolonged friction or tightness from these accessories may lead to a condition called traction alopecia, where hair is pulled from the roots, causing gradual thinning.

Fewer washes: Additionally, people may wash their hair less frequently, allowing the scalp to accumulate oil, sweat, and product build-up, which can clog follicles and disrupt hair growth.

Diet: During the winter, many people tend to consume fewer fresh fruits and vegetables, which could result in a drop in the intake of essential vitamins and nutrients vital for hair growth. Deficiencies in vitamins like D, E, and B-complex, along with minerals such as zinc and iron, are linked to hair thinning.

Low Vitamin D: Shorter days and decreased sunlight exposure can lead to a reduction in vitamin D levels, which have been associated with hair loss conditions like telogen effluvium, where a larger percentage of hair follicles prematurely enter the shedding phase.