How Much Physical Activity Is Recommended to Improve Metabolic Health?

Recommended Physical Activity to Improve Metabolic Health

Physical activity is a cornerstone of good health, especially when it comes to improving metabolic health and reducing the risk of chronic diseases like type 2 diabetes, heart disease, and obesity. But how much exercise is enough, and what types are most effective? Let’s explore the latest recommendations, the science behind them, and practical tips for integrating more movement into your daily life.

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Why Is Physical Activity So Important for Metabolic Health?

Metabolic health refers to your body’s ability to maintain optimal levels of blood sugar, cholesterol, blood pressure, and waist circumference. Poor metabolic health is linked to insulin resistance, which can lead to type 2 diabetes and other complications.

Regular physical activity:

• Increases insulin sensitivity, helping your cells use glucose more efficiently
• Reduces body fat, especially harmful visceral fat around the abdomen
• Lowers blood pressure and improves cholesterol levels
• Reduces inflammation and oxidative stress
• Supports healthy weight management

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The Gold Standard: 150 Minutes Per Week of Moderate-Intensity Activity

What Does This Mean?

Health authorities like the World Health Organization (WHO), American Diabetes Association (ADA), and Centers for Disease Control and Prevention (CDC) recommend:

• At least 150 minutes per week of moderate-intensity aerobic activity, or
• 75 minutes per week of vigorous-intensity aerobic activity

Moderate-intensity activities include:

• Brisk walking (at a pace that makes it hard to sing but easy to talk)
• Cycling at a leisurely pace
• Water aerobics
• Dancing
• Gardening or yard work

Vigorous-intensity activities include:

• Running or jogging
• Swimming laps
• Fast cycling
• Aerobic or fitness classes
• Competitive sports (e.g., soccer, basketball)

How to Structure Your Week:
You can break this down into 30 minutes a day, five days a week, or shorter bouts (at least 10 minutes each) spread throughout the day.

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For Even Greater Benefits: Aim for 300 Minutes Per Week

If your goal is to lose weight, maintain significant weight loss, or further improve metabolic markers, increasing your activity to 300 minutes per week (about 60 minutes a day, five days a week) of moderate-intensity exercise offers additional benefits:

• Greater reductions in blood sugar and insulin resistance
• Improved cardiovascular fitness
• Enhanced mood and mental health
• Lower risk of certain cancers

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Strength Training: Don’t Overlook Muscle Power

While aerobic activity is vital, strength or resistance training is equally important for metabolic health.
Recommendations:

• Engage in strength training exercises at least two days per week.
• Target all major muscle groups: legs, hips, back, abdomen, chest, shoulders, and arms.

Examples:

• Weightlifting or using resistance machines
• Bodyweight exercises (push-ups, squats, lunges, planks)
• Resistance band workouts
• Yoga or Pilates

Benefits:

• Builds lean muscle, which burns more calories at rest
• Improves insulin sensitivity
• Strengthens bones and joints
• Reduces risk of falls and injuries, especially as you age

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Reduce Sedentary Time: Every Move Counts

Even if you meet the weekly exercise guidelines, prolonged sitting can still harm your metabolic health.

• Stand up and move around every 30–60 minutes.
• Take short walking breaks at work.
• Use a standing desk or take calls while walking.
• Do simple stretches or household chores throughout the day.

Research shows that breaking up sedentary time with light activity can improve blood sugar control and lower cardiovascular risk.

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Combine Aerobic and Resistance Exercise for Best Results

Studies consistently show that combining aerobic and resistance training produces the greatest improvements in insulin sensitivity, blood sugar control, and overall metabolic health.

• If you’re new to exercise, start with activities you enjoy and gradually increase duration and intensity.
• Mix up your routine to keep it interesting and challenge different muscle groups.

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Practical Tips for Getting Started

• Set Realistic Goals: Start with small, achievable targets and build up over time.
• Track Your Progress: Use a fitness tracker, journal, or app to monitor your activity.
• Find a Workout Buddy: Exercising with a friend can boost motivation and accountability.
• Make It Fun: Choose activities you enjoy—dancing, hiking, swimming, or group classes.
• Incorporate Activity Into Daily Life: Walk or cycle for errands, take the stairs, or play active games with family.

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Special Considerations

• Medical Conditions: If you have chronic health issues or have been inactive, consult your healthcare provider before starting a new exercise routine.
• Older Adults: Balance exercises (like tai chi or yoga) are recommended to reduce fall risk.
• Children and Teens: Should aim for at least 60 minutes of physical activity daily, including aerobic and muscle-strengthening activities.

Final Thoughts

Any increase in physical activity is beneficial for metabolic health. Whether you’re just starting or looking to enhance your routine, remember that consistency is key. Find activities you enjoy, mix up your workouts, and make movement a regular part of your life.

Your body—and your metabolism—will thank you for every step, squat, and stretch!

Dr Manohar K N

MD, DNB, MNAMS,  
Triple FRCP (Edinburgh, Glasgow & London), 
FEAC - Fellow of Euro-Asian Academy of Cardiology 
Fellow of RSSDI, Fellow Diabetes India
www.drmanoharkn.com/

 

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Pregnancy and Diabetes: Managing Blood Sugar Levels Safely

 

Pregnancy and Diabetes: Managing Blood Sugar Levels Safely

Pregnancy is a time of excitement and anticipation, but it also brings unique health challenges—especially for women living with diabetes or those who develop gestational diabetes. Managing blood sugar levels during pregnancy is crucial for the health and safety of both mother and baby. Here’s a comprehensive guide on how to navigate this important journey.

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Understanding the Risks

Diabetes during pregnancy can take several forms:

• Pre-existing Type 1 or Type 2 Diabetes: Women who already have diabetes before becoming pregnant.
• Gestational Diabetes: Diabetes that develops during pregnancy, usually detected between 24 and 28 weeks.

Uncontrolled blood sugar can lead to complications such as:

• High birth weight (macrosomia), increasing the risk of difficult delivery or cesarean section
• Preterm birth
• Preeclampsia (high blood pressure during pregnancy)
• Increased risk of birth defects
• Low blood sugar (hypoglycemia) in the newborn
• Higher risk of developing type 2 diabetes for both mother and child later in life

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Blood Sugar Targets During Pregnancy

Maintaining blood sugar within target ranges is essential. The typical goals recommended by experts are:

• Fasting blood glucose: 70–95 mg/dL (3.9–5.3 mmol/L)
• 1-hour after eating: <140 mg/dL (7.8 mmol/L)
• 2-hours after eating: <120 mg/dL (6.7 mmol/L)

Your healthcare provider may adjust these targets based on your individual needs.

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Strategies for Safe Blood Sugar Management

1. Frequent Monitoring

• Check your blood sugar levels several times a day—before meals, after meals, and at bedtime.
• Keep a log of your readings to share with your healthcare team.

2. Healthy Eating

• Work with a registered dietitian or diabetes educator to create a meal plan tailored for pregnancy.
• Focus on:
• Whole grains, fresh fruits, and vegetables
• Lean proteins such as poultry, fish, tofu, and legumes
• Healthy fats from nuts, seeds, avocado, and olive oil
• Limit processed foods, refined sugars, and sugary drinks.
• Eat small, frequent meals to help maintain steady blood sugar.

3. Physical Activity

• Regular, moderate exercise (like walking, swimming, or prenatal yoga) can help control blood sugar and improve overall well-being.
• Always consult your doctor before starting or modifying your exercise routine.

4. Medication Management

• Insulin: Safe and effective for use during pregnancy when diet and exercise are not enough.
• Oral Medications: Some, like metformin, may be used after the first trimester if recommended by your doctor. Not all diabetes medications are safe in pregnancy, so never change your regimen without medical advice.
• Adjustments to medication doses are often needed as pregnancy progresses.

5. Regular Medical Check-Ups

• Frequent prenatal visits allow your healthcare team to monitor your and your baby’s health closely.
• Additional ultrasounds and fetal monitoring may be recommended.
• Blood pressure and urine checks help screen for complications like preeclampsia.

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The Importance of a Support System

Managing diabetes during pregnancy can be overwhelming. Don’t hesitate to seek support:

• Join a diabetes or pregnancy support group.
• Involve family members in your healthy lifestyle changes.
• Communicate openly with your healthcare team about any concerns or challenges.

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After Delivery: Postpartum Care

• Blood sugar levels often return to normal after gestational diabetes, but ongoing monitoring is important.
• Women with gestational diabetes have a higher risk of developing type 2 diabetes later in life—regular check-ups and a healthy lifestyle are key.
• Breastfeeding is encouraged and can help with blood sugar control.

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Conclusion

Pregnancy with diabetes requires careful planning, monitoring, and teamwork with your healthcare providers. By maintaining healthy blood sugar levels, eating well, staying active, and attending regular check-ups, you can greatly reduce the risk of complications and ensure the best possible outcome for you and your baby.

If you are pregnant or planning to become pregnant and have diabetes, talk to your doctor about creating a personalized management plan. Your commitment to good blood sugar control is one of the most important gifts you can give your child—and yourself.

Dr Shilpa Patel
MBBS, MD (Internal Medicine)
PgDip Clinical Endocrinology & Diabetes.
VaidhyaMedical Centre
325, 9th A Main Rd, behind Coffee thindi hotel, HRBR Layout 1st Block,  
Kalyan Nagar, Bengaluru, Karnataka 560043

 

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The Importance of Regular Eye Exams for Diabetic Patients

 

The Importance of Regular Eye Exams for Diabetic Patients

Diabetes significantly increases the risk of developing serious eye conditions that can lead to vision impairment or even blindness. Regular eye exams are a critical part of diabetes management, providing early detection and intervention that can help preserve sight and improve quality of life.

Silent Progression of Diabetic Eye Disease

• Diabetic eye diseases, such as diabetic retinopathy, often progress without noticeable symptoms in their early stages. By the time vision changes become apparent, significant and sometimes irreversible damage may have already occurred.
• Regular eye exams allow for the detection of these conditions before symptoms develop, enabling timely treatment to prevent further deterioration and vision loss.

Key Eye Conditions Linked to Diabetes

• Diabetic Retinopathy: High blood sugar levels damage the blood vessels in the retina, leading to leakage, swelling, or bleeding. If untreated, this can result in blindness.
• Diabetic Macular Edema (DME): Swelling in the macula due to fluid leakage, causing central vision loss.
• Cataracts: Diabetes accelerates clouding of the eye’s lens, leading to blurry vision5.
• Glaucoma: Increased eye pressure damages the optic nerve, with diabetes raising the risk of this condition.

Why Regular Eye Exams Are Essential

• Early Detection: Only a comprehensive eye exam can reveal early signs of diabetic eye disease, even before vision changes are noticed.
• Tailored Treatment: Early detection allows for less invasive, more effective treatment options, ranging from lifestyle changes to medication or laser therapy.
• Monitoring Disease Progression: Regular exams help track changes in the eyes, guiding adjustments in diabetes management and eye care.
• Peace of Mind: Knowing your eye health is being monitored provides reassurance and empowers you to manage your diabetes more effectively.

Recommended Frequency of Eye Exams

• The American Diabetes Association recommends:
• Type 1 Diabetes: First eye exam within 5 years of diagnosis.
• Type 2 Diabetes: First eye exam shortly after diagnosis, as the disease may have gone undetected and eye damage could already be present.
• Ongoing Care: Annual eye exams, or more frequently if any abnormalities are detected or if you are at higher risk.

What Happens During a Diabetic Eye Exam?

• Diabetic eye exams involve a comprehensive assessment, including pupil dilation to allow a clear view of the retina, optic nerve, and blood vessels.
• Advanced diagnostic tests, such as optical coherence tomography (OCT) and fluorescein angiography, may be used to detect subtle changes or complications.

Conclusion

Diabetes can silently threaten your vision, but regular, specialized eye exams are a powerful tool for early detection and prevention of serious complications. By making annual eye exams a routine part of diabetes care, patients can significantly reduce their risk of vision loss and maintain better overall health

 Dr Suman R

Consultant Diabetologist .
Madhumeha Diabetes Center
Shop No, 375, 42nd Cross Road
opp. Vijaya Bank, 8th Block, Jayanagar
Bengaluru, Karnataka 560070.

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Maintain a Healthy Weight to Reduce Insulin Resistance and Improve Metabolic Health.

Maintaining a healthy weight is a cornerstone of preventing and managing insulin resistance and improving overall metabolic health, particularly for individuals at risk for or living with type 2 diabetes.

Why Weight Matters for Insulin Resistance

• Excess body fat, especially around the abdomen, increases the risk of insulin resistance—a condition where the body’s cells become less responsive to insulin, leading to higher blood sugar levels and increased risk of type 2 diabetes.
• Even modest weight loss (3–7% of body weight) can significantly improve insulin sensitivity, glycemic control, blood pressure, and lipid levels, and may reduce the need for diabetes medications.

Evidence-Based Benefits of Weight Loss

• Large studies, such as the Diabetes Prevention Program (DPP), have shown that losing just 5–7% of body weight through diet and physical activity can reduce the risk of developing type 2 diabetes by nearly 60% in high-risk individuals.
• Sustained weight loss of more than 10% can offer even greater benefits, including potential diabetes remission, improved cardiovascular health, and better quality of life.

Key Strategies for Achieving and Maintaining a Healthy Weight

• Balanced Diet: Focus on whole foods, higher-fiber carbohydrates, lean proteins, and healthy fats while limiting processed foods and added sugars.
• Portion Control: Eating appropriate portion sizes helps manage calorie intake and supports weight loss or maintenance.
• Physical Activity: Regular exercise, including both aerobic and strength-training activities, increases insulin sensitivity and helps prevent fat accumulation.
• Behavioral Support: Counseling, support groups, and education can help maintain motivation and adherence to healthy habits.
• Personalized Approach: Interventions should be tailored to individual needs, preferences, and medical conditions for the best results.

Additional Considerations

• For some individuals, medications or metabolic surgery may be considered, especially if lifestyle changes alone are insufficient or if there are significant obesity-related complications.
• Ongoing monitoring and support from healthcare professionals are essential to track progress and adjust strategies as needed.

Conclusion
Achieving and maintaining a healthy weight is one of the most effective ways to reduce insulin resistance, prevent or delay type 2 diabetes, and improve overall metabolic health. Even modest weight loss can lead to meaningful health benefits, making small, sustainable lifestyle changes a powerful tool for long-term wellness.

𝗗𝗿. 𝗦𝗵𝘆𝗮𝗺 𝗦𝘂𝗻𝗱𝗮𝗿 𝗖 𝗠
Consultant Endocrinologist
Grapes Diabetes & Endocrine Clinic
1491, first floor, Grapes Clinic, SV Arcade, BEML Layout,  5th Stage, Rajarajeshwari Nagar, Bengaluru, Karnataka 560098

 

 

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Can Fiber Help You Lose Weight?

Dietary fiber is often highlighted as a "secret weapon" for weight loss, and for good reason. In the Indian context, where traditional diets are rich in plant-based foods but modern lifestyles often lead to processed food consumption, understanding the role of fiber is crucial for effective and sustainable weight management.

How Fiber Supports Weight Loss

• Promotes Satiety and Reduces Appetite
  Fiber, especially soluble fiber, absorbs water and forms a gel-like substance in the digestive system. This slows digestion, leading to a prolonged feeling of fullness and reduced hunger, which naturally decreases calorie intake and helps prevent overeating . For Indians who often consume carbohydrate-heavy meals, adding fiber can help manage portion sizes and reduce snacking between meals.
• Regulates Blood Sugar and Reduces Cravings
  Fiber slows the absorption of sugar, preventing spikes and crashes in blood glucose levels. This is particularly beneficial for Indians, who are at a higher risk of developing diabetes due to genetic and dietary factors. Stable blood sugar helps control cravings and supports long-term weight management.
• Improves Gut Health
  Fiber acts as food for beneficial gut bacteria, supporting a healthy microbiome. A balanced gut flora is linked to better metabolism, reduced inflammation, and improved fat regulation-all important for weight loss.
• Reduces Belly Fat
  Some studies indicate that increased fiber intake, especially from whole foods, can help reduce visceral fat-the harmful fat stored around organs. This is significant for Indians, as abdominal obesity is a common health concern.
• Supports Digestive Health
  Fiber helps maintain regular bowel movements and prevents constipation, a common complaint when calorie intake is reduced for weight loss. This ensures efficient elimination of waste and toxins, supporting overall metabolic health.

Types of Fiber and Their Role

• Soluble Fiber: Found in oats, apples, citrus fruits, and legumes, soluble fiber dissolves in water, slows digestion, and increases satiety.
• Insoluble Fiber: Present in whole wheat, brown rice, and many vegetables, insoluble fiber adds bulk to stool and prevents constipation.
• Resistant Starch: Common in cooked and cooled rice or potatoes, this type of fiber acts as a prebiotic and supports gut health.

Best Indian Sources of Fiber

• Whole grains: Brown rice, whole wheat atta, millets (jowar, bajra, ragi)
• Pulses and legumes: Chana, rajma, moong, masoor dal
• Fruits: Guava, apple, papaya, orange
• Vegetables: Carrot, spinach, methi, cabbage, green peas
• Nuts and seeds: Almonds, flaxseeds, chia seeds

Should You Use Fiber Supplements?

While natural sources are best, fiber supplements like psyllium husk (isabgol), inulin, and glucomannan can help bridge the gap if your diet lacks sufficient fiber. However, supplements should not replace a balanced diet rich in whole plant foods.

Practical Tips for Increasing Fiber Intake in India

• Choose whole grains over refined grains (brown rice instead of white rice, whole wheat chapati instead of maida-based products).
• Add a bowl of dal or legumes to at least one meal per day.
• Snack on fruits, nuts, or roasted chana instead of fried or sugary snacks.
• Include a variety of seasonal vegetables in your sabzi, salads, and soups.
• Drink plenty of water to help fiber work effectively and prevent digestive discomfort.

Conclusion

Increasing fiber intake is a simple, natural, and effective way to support weight loss and improve overall health. For Indians, embracing traditional, plant-rich foods and making mindful choices about grains and snacks can make a significant difference. Whether you’re aiming to shed a few kilos or simply want to eat healthier, fiber should be a cornerstone of your diet.

 

Dr Manohar K N

MD, DNB, MNAMS,  
Triple FRCP (Edinburgh, Glasgow & London), 
FEAC - Fellow of Euro-Asian Academy of Cardiology 
Fellow of RSSDI, Fellow Diabetes India
www.drmanoharkn.com/

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How Diabetes Affects the Feet: Understanding the Risks and Prevention Strategies

Diabetes is a chronic condition that affects millions of people worldwide, and one of its most significant complications is the impact it has on the feet. Diabetic foot problems can range from minor issues like fungal infections to severe complications such as ulcers and amputations. Understanding how diabetes affects the feet and implementing proper care strategies can significantly reduce the risk of these complications.

Introduction to Diabetic Foot Problems

Diabetes can cause two primary issues that affect the feet: diabetic neuropathy and peripheral vascular disease.

• Diabetic Neuropathy: This condition occurs when diabetes damages the nerves in the legs and feet. As a result, individuals may lose sensation in these areas, making it difficult to detect injuries such as cuts or blisters. Without proper care, these injuries can become infected and lead to serious complications.
• Peripheral Vascular Disease: Diabetes also affects blood flow, leading to reduced circulation in the feet. This poor blood flow slows down the healing process of wounds, increasing the risk of infections and ulcers.

Common Foot Problems in Diabetes

People with diabetes are more susceptible to common foot issues that can escalate into serious complications:

1. Athlete's Foot: A fungal infection causing itching, redness, and skin cracking. It can be treated with antifungal medications but requires careful management to prevent infection.
2. Fungal Infections of the Nails: These infections can lead to discolored, thickened, or brittle nails. The warm environment inside shoes fosters fungal growth, and injuries can increase the risk of infection.
3. Skin and Bone Infections: Small cuts can lead to infections, especially with nerve and blood vessel damage. These infections can be treated with antibiotics but may require hospitalization in severe cases.
4. Abscesses: Infections can create abscesses, which are pockets of pus that may require drainage or surgical intervention.
5. Gangrene: Reduced blood flow can cause tissue death, leading to gangrene. Treatment often involves oxygen therapy or surgical removal of affected tissue.

Complications of Diabetic Foot Problems

The most severe complication of diabetic foot problems is amputation. Foot ulcers that do not heal can lead to infections that spread, necessitating the removal of toes, feet, or parts of the leg to prevent further complications.

Prevention Strategies

Preventing diabetic foot complications involves a combination of good diabetes management and regular foot care:

1. Manage Diabetes: Keeping blood sugar levels under control is crucial. This includes following a healthy diet, exercising regularly, monitoring blood sugar levels, and taking medications as prescribed.
2. Regular Foot Care:
• Wash feet daily in lukewarm water and dry them thoroughly, especially between the toes.
• Use talcum powder or cornstarch to keep skin dry.
• Apply moisturizer to prevent dry skin cracks.
• Wear properly fitting shoes that provide support and cushioning.
3. Screening and Monitoring: Annual foot exams are recommended for all people with diabetes. Those at higher risk should be screened more frequently for loss of sensation and peripheral artery disease5.
4. Education and Awareness: Educating individuals with diabetes about proper foot self-care and the importance of seeking medical attention early for any foot issues is vital.
5. Therapeutic Footwear: Wearing shoes designed to reduce pressure on the feet can help prevent ulcers. These shoes should be prescribed by healthcare professionals.

Conclusion

Diabetes can significantly impact the feet, leading to serious complications if not managed properly. By understanding the risks and implementing effective prevention strategies, individuals with diabetes can reduce their likelihood of developing severe foot problems. Regular foot care, good diabetes management, and early intervention are key to maintaining healthy feet and preventing amputations.

Dr. Praveen Kumar N S
MBBS, MD (Gen. Med.), DNB (Endocrinology)
Consultant Endocrinologist & Diabetologist
Dr. Praveen's Endocrine Centre

Mysuru, Karnataka. 570009.

References

1. WebMD: Diabetic Foot Problems: Symptoms, Treatment, and Care
2. Mayo Clinic: Amputation and diabetes: How to protect your feet
3. International Working Group on the Diabetic Foot (IWGDF): Guidelines on the prevention and management of diabetic foot disease
4. Diabetes Journal: Etiology, Epidemiology, and Disparities in the Burden of Diabetic Foot Ulcers
5. Diabetes/Metabolism Research and Reviews: Guidelines on the prevention of foot ulcers in persons with diabetes
6. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): Foot Problems
7. WebMD: Diabetes Foot Care: Tips for Healthy Feet

 

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Post-Meal Walk Timing: How 10–15 Minutes of Walking After Eating Can Dramatically Reduce Glucose Spikes

Emerging research consistently shows that walking for just 10–15 minutes after a meal can significantly reduce post-meal (postprandial) glucose spikes. This simple habit is especially relevant in the Indian context, where high-carbohydrate meals are common and rates of diabetes are rising.

Why Walking After Meals Works

• Enhances Glucose Uptake:
  After eating, blood sugar levels naturally rise as carbohydrates are digested. Walking activates large muscle groups, which increases glucose uptake from the bloodstream, helping to lower and stabilize blood sugar levels.
• Suppresses Glucose Peaks:
  Studies have shown that walking for even 10 minutes after each main meal can reduce daily blood glucose levels more effectively than a single, longer walk at another time of day. This is because the muscles are most effective at absorbing glucose when blood sugar is at its highest, which typically occurs within 60–90 minutes after eating.
• Improves Insulin Sensitivity:
  Regular post-meal walks can improve insulin sensitivity, making it easier for the body to manage blood sugar over time.

Optimal Timing for Post-Meal Walks

• Start Soon After Eating:
  The best results are seen when walking begins within 30 minutes after finishing a meal, ideally before blood sugar peaks. Delaying the walk reduces its glucose-lowering impact, as the peak may have already occurred.
• Duration Matters:
  Even brief walks of 2–5 minutes can help, but walking for 10–15 minutes provides more substantial and sustained benefits. For those with more time, three 15-minute walks after each meal are more effective than a single 45-minute walk once a day.

Practical Tips for Indians

• Make It Routine:
  After breakfast, lunch, or dinner, take a stroll around your home, apartment complex, or neighborhood. This is especially helpful after carbohydrate-rich meals like rice, roti, or sweets.
• Cultural Fit:
  Walking after meals aligns with traditional Indian practices, such as a family stroll after dinner, and is accessible to people of all ages.
• Consistency Is Key:
  Aim to walk after at least one or two main meals daily. Over time, this habit can help with blood sugar control and reduce the risk of diabetes and other metabolic diseases.

Key Takeaways

• Walking for 10–15 minutes within 30 minutes after a meal can dramatically reduce glucose spikes.
• The effect is most pronounced when walking is started soon after eating, during the window when blood sugar typically peaks (60–90 minutes post-meal).
• This simple habit is highly effective, requires no equipment, and fits easily into Indian lifestyles.

Prof(Dr)Tirthankar Mukherjee

MD(Internal Medicine), MRCP(UK)
MRCP(Edinburgh), Fellowship in Diabetes (Chennai)
DNB( Internal Medicine), MNAMS
Physician & Diabetologist
Professor & Senior Consultant (KIMS)Bangalore.

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