Diabetes and Diet

One of the best things you can do for your health is to know how to detect diabetes before it becomes an even bigger problem in your life by not taking care of it. Believe it or not there are quite a few people out there who don’t exactly know what diabetes is. Diabetes is a disorder characterized by hyperglycemia or elevated blood glucose (blood sugar). When the amount of sugar in our blood runs too low or too high it is quite typical for anyone to not feel very well. Diabetes is a term generally used when speaking of a person who has a blood sugar level that is consistently high. Millions of Americans have diabetes; however most of them do not realize it. In the long term diabetes can cause complications concerning the kidneys, eyes, heart, nerves and blood vessels.

There are two types of diabetes; Type 1 and Type 2. Type 1 diabetes (insulin deficiency) means there is not enough insulin being produced. Type 2 diabetes (insulin resistance) occurs when there is plenty of insulin being produced but cells in our bodies are very resistant to it’s action, which in turn causes your blood sugar to consistently be high.

The most common symptoms of hyperglycemia, otherwise known as diabetes, would be frequently hungry, frequently thirsty and frequently urinating. Apart from those symptoms other symptoms that may occur are fatigue, weight loss, blurred vision, wounds healing more slowly, dry mouth, impotence, dry/itchy skin and recurrent infections.

Even though diabetes may sound like a horrible disease it can be easy to live with. The key to doing that is to take care of yourself. Many people do not take care of themselves because they refuse to admit there is something wrong with them health wise. They won’t even admit it to themselves. So, what happens when they do this? They try to survive without taking medication(s) they need or doing anything in their life to help keep their bodies healthy. Don’t do this. The only thing it can lead to is an unhealthy body, physically and mentally, and possibly depression in the long run.

If you wish to watch your blood sugar, whether you are diabetic or not, there are many things you can do at home. Purchase a blood glucose monitor. This can easily be purchased at your local pharmacy or online. There are websites that will tell you how high and or low your blood glucose level should be, though your blood glucose monitor should come with an instruction manual which supplies this information as well. One of the best things a diabetic can do is exercise and eat properly. Not only does exercise help to keep your body in good condition on the outside but it helps on the inside as well. However, if you are a diabetic do not do anything involving weight training. Studies suggest that this can affect your blood glucose level by increasing it.

If you wish to learn more about diabetes look up the American Diabetes Association online.

Jacob Mabille
http://www.articlesbase.com/diseases-and-conditions-articles/detecting-diabetes-and-caring-for-it-48518.html

Diabetes is a disorder that affects the way your body uses food for energy. Normally, the sugar you take in is digested and broken down to a simple sugar, known as glucose. The glucose then circulates in your blood where it waits to enter cells to be used as fuel. Insulin, a hormone produced by the pancreas, helps move the glucose into cells. A healthy pancreas adjusts the amount of insulin based on the level of glucose. But, if you have diabetes, this process breaks down, and blood sugar levels become too high.

Main Causes of Diabetes

We know that diabetes develops as a result of your body’s cells not getting enough insulin (a hormone which helps convert blood sugar/glucose into energy). This is usually because your pancreas fails to generate enough insulin or because your body’s cells start to resist insulin. Although we know what leads to the development of diabetes we do not currently know why this happens in certain individuals and not others.

This means no matter how much or how little insulin is made, the body can’t use it as well as it should. As a result, glucose can’t be moved from the blood into cells. Over time, the excess sugar in the blood gradually poisons the pancreas causing it to make less insulin, and making it even more difficult to keep blood glucose under control. Obesity is a leading cause of insulin resistance; 90% of people with type 2 diabetes are overweight.

here are some common diabetes causes that include genetic causes as well as environmental causes. The risk of diabetes is higher if there is a family history of diabetes. Environmental factors that can lead to the onset of diabetes include poor diet, lack of exercise, obesity, and stress. Diabetes is a disease that can be prevented – or controlled once a diagnosis has been made.

Type 2 diabetes usually occurs gradually. Most people with the disease are overweight at the time of diagnosis. However, type 2 diabetes can also develop in those who are thin, especially the elderly.

Diabetic Symptoms

Type 1 diabetes is usually recognized in childhood or early adolescence, often in association with an illness (such as a virus or urinary tract infection) or injury.

The extra stress can cause diabetic ketoacidosis.

Cuts or sores that take a long time to heal.

Slow-healing wounds.

Frequent urination (especially at night)

Diabetes Treatment

Intranasal, Transdermal

Other routes for the delivery of insulin have also been tried. Intranasal insulin delivery was thought to be promising. However, this method was associated with poor absorption and nasal irritation. Transdermal insulin (skin patch delivery) has also yielded disappointing results to date. Insulin in pill form is also not yet effective since the digestive enzymes in the gut break it down.

Many, but not all, of the symptoms of diabetes can be controlled by the administration of insulin. The forms of insulin available early in the 20th cent. had to be injected frequently because they were quick-acting. Later modifications gave the insulin solution a more prolonged action so that hypodermic injections could be made less frequently. Some now control their insulin levels via a small, portable insulin pump. In certain cases of mild diabetes, oral medications that stimulate production of insulin can be taken in lieu of insulin

“Diabetes knowledge, treatment, and prevention strategies advance daily. Treatment is aimed at keeping blood glucose near normal levels at all times. Training in self-management is integral to the treatment of diabetes. Treatment must be individualized and must address medical, psychosocial, and lifestyle issues.”

Peter rodrick

Diabetes Type 2, or adult-onset diabetes, is a chronic disease where either the body does not produce enough insulin or the cells do not react normally to insulin. This affects the way the body metabolizes sugar (glucose). Diabetes Type 2 may be present for years before the person knows it. People may have high blood sugar levels when their diabetes is first diagnosed. Diabetes type 2 is one of the most prevalent reasons of hyperglycemia.

Insulin circulates throughout your network of blood vessels along with sugar, and acts as a key, opening channels that line your cells, which allows sugar to exit your bloodstream and enter your cells where it is used for energy. When insulin is not able to do its job, the cells can’t get the sugar they need, and too much sugar builds up in the blood. Insulin resistance, which is very common, doesn’t cause type 2 diabetes by itself. The pancreas usually rallies to compensate for the resistance by pumping out more insulin.

The overworked pancreas may eventually stop producing enough insulin and the person with type 2 diabetes may need to take daily injections of insulin. Blood samples are taken at intervals for 2 to 3 hours. Test results are compared with a standard and show how the body uses glucose over time.

Insulin levels drop as a result of decreased production, and blood glucose levels are allowed to rise to very high, toxic levels. Although diet and exercise, along with supplementation, are still strongly recommended, a number of prescription drugs might also be necessary. Insulin is a hormone made by the body to regulate the amount of sugar in the blood. High levels of sugar in the blood can seriously affect other body systems, particularly over long periods of time. Insulin is a hormone produced by the beta cells of the pancreas, an organ behind the stomach.

Regular exercise 3-5 times a week will not only keep your heart rate and blood levels in the right places but also ensure you are maintaining your body and reducing the risk of diabetes. Regular exercise tackles several risk factors at once. It helps you lose weight, keeps your cholesterol and blood pressure under control, and helps your body use insulin. Regular exercise helps control the amount of glucose in the blood. It also helps burn excess calories and fat so you can manage your weight. Regular exercise also may help lower blood lipids and reduce some effects of stress, both important factors in treating diabetes and preventing complications.

Exercise and weight loss are very important to prevent Type 2 Diabetes from worsening. Exercise increases the body’s energy level, lowers tension, and improves your ability to handle stress. Living with type 2 diabetes is a life changing experience.

Medical management of type 2 diabetes is essential, along with nutrition counseling, medication use, behavior change therapy, and physical activity as the focuses of therapeutic intervention. There are identifiable limitations (e.g., presence of complications leading to impairment or disability) and precautions (e.g., degree of metabolic control) to be addressed when developing a physical activity program. Medically speaking, endocrinology involves the diagnosis and management of these illnesses. Endocrinology is often associated with the study of diabetes and metabolism, or with reproductive medicine. Medicines for diabetes and other health conditions may need to be adjusted if a person is also using a dietary supplement.

Sandy Klocinski

To compare the role of glibenclamide and pioglitazone drugs in type 11 non- insulin dependent diabetes mellitus patients.

Introduction:-

Diabetes comes from the greek word for ‘SIPHON” which one is the first term and implies for a lot of urine is made .The trm “mellitus” comes from a laton word, “met” which means “honey” and was used because the urine was sweet (Wheeler,2004)

Diabetic ketaocidosis is one of life threatening condition requiring some data hospitalization and treatment. Recognition of this condition is of almost importance, because even small delays can have an impact on survival (Nattrass, 2006). Hypoglycaemia are involved in insulin induced episodes in individuals with diabetes. Probably the major factor prescribing, insulin treated patient from achieving the glucose targets needed to prevent diabetic complications. The incidence of hypoglycaemia reflects the inadequancy of current mathods of insulin delievery which lead ot inappropriately high insulin concentration, particularly some persons after eating more foods at night onset of blindness and also a major risk factor heart disease and stroke

(Heller, 2003).

TYPES OF DIABETE MELLITUS

Type II diabetes is a complex metabolic disorder associated with, b -cells dysfunction and with varying degree of insulin resistance primary pathogenic factors leading insulin resistance leading to type 2 diabetes and decreased insulin, secretion which arise from abnormalities with in liver, skeletal muscle and pancreatic b -cells (charles & clark, 1996).

GESTATIONAL DIABETUS MELLITUS

SECONDARY DIABETUS MELLITUS:

Secondary diabetes is due to disease of the pancreatic and endocrime system, genetic disorders, or exposure to chemical agents.

Type – I diabetes formerly known as insluin dependent diabetes mellitus (IDDM), is characterized by the destruction of the pancreatic beta cells that produces inslulin

Type – I diabetes formerly known as insulin dependent diabetes(IDDM),is characterized by the destruction of pancreatic beta cells that produces insulin.Type-1 diabetes occures most often in children and young adults but it can occures at any age.(Anderson et al 2007).

Type-11 diabetes is not straight uprward. A pancreas that does not produce enough insulin. Liver that release too much glucose,muscle cells that do not readily take in glucose.(Carren 2008)

Many genetic factors are involved in the development of diabetes.Because of new genetic methodology researchers are closers to identifying all of the cadidate gene for both non –insulin dependent and insulin dependent diabetes(Bernhard,1995).

Woman who had gestation diabetes are more likely to develop Type-11diabetes themselves.Pergnant women with diabetes are another disadvantaged group.They need much more intensive antenatal care and close monitoring of blood sugar,blood pressure and weight.(jawed2006)

Over weight children the progression of child obesity into adulthood is associated with early develop of complications, including IgpG2 diabetes and cardiovascular disease.Type diabetes is the most common clinical form of diabetes accountingforabout 90% of all cases,it is currently undergoing world wide epidemic. Type 11diabetes mellitus is caused by body’s infective use of insulin, it is often results from excess body weight and physical inactivity(WHO 2007).

PREVALACES& IINCIDENCE

:

Diabetes mellitus increases with aging, in 200 the prevalance of diabetes,it was estimated to be 0.19% people<20 years old and 8.6% in people>20 years old.There is considered geographic variation in the incidence of both type-1 and type-11 diabetes mellitus.Scavandinvian has the highest incidence of type-1 diabetes mellitus e.g in Finland, the incidence is 35/100,000 per year the pacific rim has a much lower rate in japan and china the incidence is 1 to 3/100,00 per year of type-1 diabetes mellitus, Northern Europe and the United States share an intermediate rate (8to17/100,000 per year).The prevalence of type 11 diabeties mellitus is highest in certain pacific island, intermediate in countries such as India and the United States, and relatively low in Russia and China.This variability is likely due to genetic, beharioral and enviromental factors(Power 2005).Diabettes mellitus prevalance also arises among different ethic population within a given countries it is common inall ethnic groups its prevalance increased with age and more than 5% of individuals of more than 65 years of age have diabetes mellitus (David Owerback 1988).The World wide prevalence of diabetes mellitus has risen dramatically over past two decades.The prevalence of type11 diabettes mellitus is expected, type 11 diabetes mellitus is more prevalent among Hispanies Native Americas,African,American,and Asians, pacific Islanders than in non- Hispanic whites,the incidence is essentially equal in woman and men in all populations. Type 11 diabetes is becoming increasingly common because people are living longer,and the prevalence of diabetes increases with age it is also seen more frequently now than before in young people, in association with the rising prevalenceof childhood obesity although type11 diabetes still countries with the estimated nubers of cases of diabetes in 2000and 2030.

Rank Country

2000 Individuals country with diabetes (milloins)

Country

2030 Individuals with diabtes (Million)

India

31.7

India

79.47

China

20.8

China

42.3

USA

17.7

USA

30.3

Indonesia

8.4

Indonesia

21.3

Japan

6.8

Pakistan

13.9

Pakistan

5.2

Brazil

11.3

Russian federation

4.6

Bangladesh

11.1

Brazil

4.6

Japan

8.9

Italy

4.3

Philippines

7.8

Bangladesh

3.2

Egypt

6.7

(Wareham& FOROUHI 2OO6)

DRUG TREATMENT OF DIABETIES MELLITUS

:

Biguanides lower blood glucose, they increase glucose uptake and utilize in skeletal muscle there by reducing insulin resistance, and reduce hepatic glucose production (gluconeogenesis).Lower blood glucose, addionally reduces low denisity and very low denisity lipoproteins (LDL and VLDL) respectively. Metformin has a half life of about 3 hours and is excreted unchanged in the urine.Clinically metformin used in type 2 diabetic who are obese and who fail treatment with diet alone.Adverse effects are produced dose related gastrointestinal disturbances e.g anorexia,diarrhoea,nausea,lactic acidosis rare but potentially fatal toxic effect.(Dale,2003).

Improving insulin sensitivity by activating certain genes involved in fat synthesis and carbohydrate metabolism Rosigilitazone and Piogiltazone are currently approved.Thiazolidinediones. Thiazolidinediones do not cause hypoglycemia when used alone,although they are usually taken in combination with sulfonylurease.

In some incouraging studies, thaiazolidiniones have produced very favorable effects on the heart, including reducing blood pressure and improving triglycerides and cholestrol levels including increasing HDL level,the good cholestrol. They may also block a molecule called 11 Best HSK that may play a significant role in metabolic syndrome,as well as diabetes type11. One study also sugessted that Rosiglitazone may even improve beta cells functions and so help prevent progression of diabetes.Anemia, weight gain, increased risk of fluid buildup, may worson heart failure.Troglitazone,was withdrawn after a few reports of heart failure.Liver failure abd death.Current Thiazoldinediones don not appear to pose the same effects on the liver although there have been a few reports of liver injury.

In patients with dietry failur the choice of a sulfonylurea agent or insulin therapy has been controversial and empric in favour of insulin therapy are the studies, who reported marked improvement post receptor diagnostic after intensive short term therapy in untreated type 2 diabetes mellitus (Scarlett et al,1984) Sulfonylureas further classified into two groups or generations based on their potency,duration,drug interaction,side effects profiles. Sulfonylureas enhance insulin action in cells in culture and stimulate the synthesis of glucose transporters (Jacobes et al 1998).A sulfonylurea drug should normally be the insulin secretagogue of choice, NICE (National Institute for Clinical Excellence) also recommends that a generic ,drug should be perscribed (Scsade et al1998).

RESEARCH DESIGN AND MATERIAL AND METHODS:

This study was conducted in the deprtment of Pharmacololgy and Therapeutics,Basic Medical Science Institute,Jinnah,Postgraduate Medical Centre,karachi under kind supervision od DRr:GhulamRsool Mashori,Associate Professoer and Head OF Department Of Pharmacology and Therapeutics in colloboration with Medical Outpatient Department Unit111 and Filter Clinic, Medical Department, JPMC,Karachi.

Seventy NIDDM (type-II)diabetic patients were initially enrolled in the study from the filter clinic/ out patient department Medical Unit III ,and diabetic clinic.Out of this 60 diabetic patients were associated in whole period of study, remaining 10 patients were dropped due to poor comlpiance or change in residential place.All the patients were divided in two main groups,groupI and in group II these patients were selected in this study according of inclusion and exclusion criteria.

INCLUSION CRITERIA

:

• Newly diagnose patients of non Insulin Dependent Diabtes Mellitus.
• Diagnsed patients of diabetes also including having no any history medication.
• Having either sex of age between 30 to 60 years.
• Diagnosed patients who were Non Insulin Depedent Diabetes Mellitus who were treated with Pioglitazone.
• Diagnosed patients who were Non Imsulin Depedent Mellitus, who were treated with drug Glibenclamide.

EXCLUSION CRIRERIA

:

• Patients suffering from blood pressure.
• Patients suffering from liver disease.
• Patients suffering from cardiac disease.
• Pregnancies and lactating women.
• Patient suffering from renal disorders.
• Patients having serious complications.

MATERIAL:

1. Lacets.
2. Lancet Hlder(Abbots easy touch TM2 lot 03 Asee).
3. Glucometer(Medisense) optilim one touch(Abbotts).
4. Blood glucose nest trpis (IVD for Invitro diagnostic use (Abbott Labortries,Medisense UK Ltd,Abigngdon,Ox14ITR,Masde in UK). Stored between minimum 30?, (4°-30° C) and Maximum 40°C (39°-86°F).
5. Weight Machine Model No 1101 Lot No.312. TANTIATA.

DRUGS

Tab:Daonil 5 mg (Aventis Pharma)

Drug category:Sulphonylurea.

Generic Name: Glibenclamide.

MFGLIC:No.000007 RegistrationNO.000220

MFG Date:0-06

EXP Date:7-10

Lot NO:B230

Tab:piozer (Hilton Pharm) PvtLTd.

Tab:Poizer 15mg

Drug category:Thaiazolinedione.

Generic Name:Pioglitazone Hydrochloride.

MFG LIC: O.000136 Registration No.03270

MFG Date:3-06

EXP Date:3-o9

Lot No:6287

Tab: Poizer (Hilton Pharma)pvt ltd.

PARAMETERS:

Fasting Blood Sugar (FBS).

Random Blood Sugar (RBS).

Weight.

Key words:Diabetes mellitus,Non-insulin diabetes mellitus,Insulin depedent diabetes mellitus, Daonil,poizer,Insulin.

RESULTS:

Table 1

Weight and Blood Sugar level observed on baseline day 0

In group1 and group11

Group 1

Group 11

Pioglitazone n=27

Glibenclamide n=33

Weight

63.37

+ 2.25

¯

62.7

+ 15.56

¯

Fasting Blood Sugar

172.7

+ 13.32

¯

188.42

+ 12.o5

¯

Random Blood Sugar

285.11

+ 15 .532

¯

284.18

+ 17.07

¯

All Values are expressed in Means± SEM.

FIGURE-1 weight and blood sugar levels observed on baseline (day-o)

In table No shpwing the weight (KG’S) and blood sugar (msg/dl0 levels which is observed on baseline (day-0) in both groups 9group: 1 & group11)

Group: 1 Weight in (Kg’s) mean + SEM) IS 63.37±2.25 Fasting blood sugar 172.7±13.32,and Random

blood sugar 285.11±15.32

Group:11

Weight (KG’s0 (mean +SEM)62.7±1.56 Fasting blood sugar (mg/dl0 188.42±12.05, Random blood sugar is 284.18±17.03.

Figure 2: showing the weight and blood sugar levels observed in base line (day-0) in group: 1 and group 11 weight in 9kg’s) its mean values are 63.37,62.7, Fasting blood sugar in (mg/dl) is 172.71, 188.42 Random blood sugar (mg/dl) is 285.11 &284.18.

TABLE: 2

Peroidic Observation In All Parameters Group1

Goup1(Pioglitazon) n=27

P-value

Day-0

Day-45

Day-90

Day-0to45

Day-45-90

Weight

63.37

±2.25

63.63

±2.26

63.63

±2.23

>0.05

(NS)

>0.05

(NS)

Fasting blood sugar

172.7

±13.32

165.04

±8.98

153.37

±7.59

>0.05

(NS)

0.05

(NS)

Randomblood sugar

285.11

±15.32

279.78

±13.63

255.56

±12.65

>0.05

(NS)

>0.05

(NS)

All values are expressed in Mean±SEM .(NS) Non significant.

Showing the periodic observations in all parameters in group 1 (piogiltazone) (n+27) weight P.value (day 0 to day 45)>0.05 (NS). Fasting blood sugar >0.05 (NS) Random blood sugar >0.05 (NS) P.values day 90 weight >0.05 (N.S), FBS>0.05 (N.S) 7RBS >0.05(N.S) NON SIGNIFICANT

FIGURE:2 Showing the periodic observation in all parameters in group 1 on day0 day 45& day-90.Mean values in weight (Kg) is 63.37,63.26,63.63, fbs (mg/dl) 172.7,165.04,153.37,RBS(mg/dl) 285.11,279.78,255.56.

TABLE NO3

Peroidic Observation in All Parameters Group11

Group 11 (Glibenclamide)

N=33

P-value

Day-0

Day-45

Day-90

Day-0 to 45

Day-45 to 90

Weight

62.7

±1.56

65.64

±2.10

64.55

±1.92

>0.05(NS)

0.05(NS0

Fasting blood sugar

188.42

±12.05

168.45

±10.99

140.06

±5.68

>0.05(NS)

>0.05(S)

Random blood sugar

284.18

±17.03

220.12

±13.39

170.94

±5.80

<0.005 (MS)

0.002(MS0

(s) significant, (MS) moderate significant

All values are expressed in Mean±SEM.

Table No3:

Showing the periodic observation in all parameter in goup:11, Group:11 containing drug (Glibenclamide),no of patients (n=33).It’s P-value on day 0 to day 45 on weight >0.05(NS),FBS>0.05(N.S) RBS<0.005 (MS) <0.01- AND DAY 45 TO DAY 90 WEIGHT >0.05 (NS) FBS (0.05) RBS <0.002(M.S0 moderately significant.

Figure 3:Shwing the periodic observations in all parameters in Group 11 weight 62.7,65.64,64.55,FBS (MG/DL) 188.42,168.45 140.06,RBS(mg/dl) 284.18 220.12, 170.94 (on day-0-day 45 to 90).

DISCUSSION:

In Denmark Beck-Nielsenet al,skillman TG (1981) published studies demonstation that glyburide increased he number of receptors on the monocytes of patients with type 11 diabetes mellitus. Some patients were treated with diet and in cobination of second generation sulfonyureas agents Wie. The numbers of insulin receptors all patients were measured before and after the treatment.Intrvenous glucose test shows the persistent impairent of insulin secretion afterthe starting of drug therapy.However those patient who were on drug Pioglitazone some results were obtained of insulin secretion in the impairment in early drug drug therapy.Clinical observations have suggested that the second generation sulfonylureas may exert their effects by potentiating insulin released by other primary stimulators Insulin secreting drug.

According to the study of WilliamC Dukworth et al(1972), aftr the chronic treatment with sulfonylureas it is well documented that plasma insulin levels were decreased in response to oral glucose load. This apparently occures even though glucose tolerance is improved over pre-treatment, levels,present study clearly support that study.

The result og group 11 correlates with the research conducted by Bonnie &Kimmel (2005) produces the same results as FBS reduces from baseline, and at the end of study,with an overall 23.44%,reduction,while with the results showed at the end of study peroid p-value were (p<0,001).

Similarly Michael Alvarsson et al (2003) conducted a similar type of study and the found and overall changes of change of 22.11% in Fbs and 40.88% in Rbs at the end of trial p-value were (p<0.001).

However a study conducted by (Stone &Brown in (2003) didnot match to our results in the parameter of FBS and observer a reduction of 26.22%.

CONCLUSION:

In the light of study discussion it is obiovus the glibenclamide was more effective,tolerable and safer than pioglitzone in a short duration.Diabetes Mellitus is chronic prolong disease for whole life.Poor community can afford it easily,on base of marketing of this drug in pakistan diabetes patients easily go and purchase economically,in fact ,mostly people buy it from pharmacy without dr’s perscription,because pharmacist and patient both of know about this disease.Just like dispirin as analgesic,it is famous anti-diabetic drug in our states as compared of other anti-diabetic drugs.

REFERNCES:

1. Anderson J,Kendall,Perryman.S etal,”Diet and Diabettes” Diabetes 2006,16(3):17-19-
2. Bui H- Type 1 diabetes in childhood-Medicine 2006,3 ,1-3
3. Bernhard –Diabetes-type 11 diabetes mellitus Diabetes care 1995,19(100:12-17-
4. Clark CM-Oral therapyin type11 diabetes-pharmacological properties and clinical use of current use of currently available agents-Diabetes spectrum 1998,11(4):211-221.
5. Carren M.Types of Diabetes mellitus-Diabettes 2006 10 (3),07-
6. David Owerback NJ-Prevalence in diabetes population-Diabetes 1988,02(6):31-32
7. Dale MM,-Treatment of Diabetes mellitus –pharmacology 20035th edition:287-391.
8. Heller SR –Hypoglycemic in diabetes Ketoacidosis and hypoglycemic-Medicine 2006:34(03):102-110.
9. Jawad F Untraveling the mystry of Diabetes’Diabetes 2006;15(3):13-15.
10. Jacobes D-Insulin-Diabetes 1998;6(3);1160126.
11. Lambert and Bingliy-basic facts-medicine 2006,34(6):3-7.
12. Natters M-Ketoacdosis and hyperglycemia-Medicine 2006;34(3):104-106.
13. Power AC-Epidemiology of type11 diabetes Basic facts of diabetes –Diabetes 2005;1(1)7-9
14. Scarlet Oral therapy in type 11 diabetes sulfonylureas 1984;16(10);3-9.
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lalaghulamrasool bhurgri

Diabetes type 2 also known as non-insulin dependent diabetes mellitus is a chronic disease which appears when the insulin produced by the pancreas can not reduce the blood level of glucose. Sometimes diabetes appears when insulin is not produced in a sufficient quantity by the pancreas. The role of insulin is to take the glucose from the blood and lead it inside the body cells which use it to produce energy. If the level of glucose is too high in blood it will be eliminated by the kidneys in urine.

Diabetes type 1 is known to occur during childhood and was named as insulin-dependent diabetes mellitus. The pancreas is not able to produce the insulin any more as the cells responsible to this process have been destroyed by the body. These patients require insulin injections permanently.

Diabetes type 2 occurs mostly during adulthood and is found in 90% of the diabetic patients. In this case the insulin is not produced in sufficient quantities or it is not effective on the body cells. This type of diabetes occurs mostly in obese people and in those who have high levels of cholesterol in blood. Elder people can get affected of this type of diabetes too.

There is another type of diabetes called the gestational diabetes which sometimes occurs in women who are pregnant.

Genetics and family history also have an important role in determining whether diabetes type 2 will install or not. Also, having a sedentary lifestyle, eating junk food will only increase the risk of developing this affection.

Some other risk factors are: the age over 45, high blood pressure, HDL less than 35 mg/dl, triglycerides more than 250 mg/dl and a previous history of personal impaired glucose tolerance.

Most of the diabetes type 2 cases do not present any symptoms at all. In some cases increased thirst, appetite and urination might occur along with blurred vision, fatigue, infections, and erectile dysfunctions.

Diagnosing diabetes is made after the doctor sees the results of some tests. He will ask for fasting blood glucose level (it has to be higher than 126 mg/dl in order for the patient to have diabetes); non-fasting blood glucose level which leads to a suspicion of diabetes if higher than 200 mg/dl and along with symptoms of increased thirst, urination, and fatigue; and positive oral glucose tolerance test (if found higher than 200 mg/dl after 2 hours).

The treatment of diabetes focuses on eliminating the symptoms and keeping the blood glucose levels under control.

At first the doctor will recommend the patient to exercise daily and to keep a diet. Also, monitoring regularly the level of glucose in blood is essential for further treatment measures. If weight is being reduced type 2 diabetes can be managed quite easily along with keeping a diet and exercising. The doctor will help the patient to test his level of glucose in blood by its own; will let him know what he is allowed to eat and what he must avoid; will advise him what to do when he feels sick and will tell him where he can procure his diabetes supplies.

Testing the level of glucose in blood can be done by the patient without the doctor’s help. These tests are usually done before meals and at bedtime. The patient will monitor its level of glucose in blood with the help of a glucometer. This device shows quickly the results, in about 30 seconds. All the patient needs to do is prick his finger with a small needle attached to the glucometer and a drop of blood will appear on the finger. This drop of blood will be then placed on the glucometer’s test strip and the results will appear in no time. By keeping a record of the values obtained in several days by the glucometer the doctor will be able to set a more adequate treatment scheme for the patient.

Keeping a diet is very important along with exercising as it can help the overweight patient reach a satisfying weight and reduce the glucose level in blood in this way. The diet will be also set by the doctor and a nutritionist who will choose healthy foods for the patient, in adequate amounts, and will also set a schedule for taking meals.

So, if you want to find out more about diabetes or even about diabetes treatment please follow this link http://diabetes-info-center.com/

Groshan Fabiola
http://www.articlesbase.com/health-articles/essential-tips-in-managing-diabetes-type-2-symptoms-121319.html

How to Deal with Diabetes Mellitus – (Sweet Disease)  – Homoeopathic Approach

     According to recent survey reports about 5% of the total world population is suffering from Diabetes Mellitus. The incidence rate is also reasonably high in India. Currently about 20% of Indian Population is at High risk to develop Diabetes Mellitus in future i.e. they are having abnormal glucose Tolerance test. Studies have revealed that diabetic women suffer more than men. A male who is diabetic has double the chances of a heart failure. In case of women it grows to almost 5 times and it is 8 times more if the patient is a young female.

    Diabetes is associated with long term complications that affect almost every major part of the body. It contributes to Blindness, Heart Disease, Stroke, Kidney Failure, Amputations, and Nerve Damage. Uncontrolled diabetes can complicate pregnancy.

What is Diabetes?

     Diabetes is a metabolic disorder where the human body either does not produce or properly use insulin, a hormone that is required to convert Sugar , Starches and other food into Energy .The human body has to maintain the Blood Glucose level within a very narrow range, which is done with insulin and glucagons.  Diabetes is defined as abnormally High sugar level in blood and presence of sugar in urine due to lack or decreased proportion of  Insulin in human body. The Normal Blood Sugar levels should not exceed more than 100 mg% in Fasting state and 140 mg% , 2 hours after food in take which is called PP ( Post Perandial).

Types of Diabetes

                               Type I : This occur in young people, usually before the age of 20 years. Insulin is essential for its treatment.

                               Type II : It may occur at any age group but usually diagnosed after the age of 40 years. Oral hypoglycemic agents are the choice of treatment. Insulin is required only occasionally for the treatment of Type II diabetes.

                               Gestational Diabetes : It is detected during pregnancy. Treatment is usually not required. Blood sugar levels come down to the Normal after delivery of the baby.

DIABETES (Type – I) Also known as Insulin Dependent Diabetes Mellitus (IDDM ).

     Diabetes mellitus is a syndrome ( group/set of symptoms) characterized by increased level of sugar (glucose) in the blood due to deficiency or inactivity of hormone “Insulin” that is absolutely necessary to monitor glucose metabolism of body. It occurs when Pancreas no longer produces any or very little Insulin. The immune system attacks the insulin producing Beta Cells in the pancreas and destroy them. Insulin is needed in the body to use sugar for producing energy. Approximately 10% of people with diabeteshave Type-I diabetes. Someone with IDDM needs daily injections of Insulin.

            Diabetes is a worldwide disease and if not attended properly leads to serious complications.

IDDM (Insulin Dependent Diabetes Mellitus) or Type 1 diabetes is result of decreased production of hormone ‘”Insulin” by the pancreas (the organ that synthesizes insulin). Various factors including viral infections, stress, certain foods are known to trigger or aggravate the condition. But the root cause is disturbance of immune system where the defense mechanism of own body starts attacking the organs of own body and tissues. Some genetic factors and inborn errors are at the basis of this alteration in the immunity. Type I Diabetes is a constitutional disorder as it is an offshoot of constitutional defects (genetic factors, altered immunity) having an impact on the entire constitution of an individual. Hence it calls for an in-depth constitutional approach for its management.

DIABETES (Type II) or NIDDM ( Non Insulin Dependent Diabetes Mellitus)

          The remaining 90% are  Non Insulin dependent Diabetes Mellitus (NIDDM) or Type II Diabetes .It occurs when the Pancreas does not produce enough insulin or when  the body does not use the insulin though it is produced effectively. It is more frequently observed in individuals who are obese. These are the individuals who have normal or less than normal production of insulin, but more importantly some body mechanism poses obstacle to the action of Insulin. The risk factors for this disorder include age, lifestyle (overeating with inactivity), pregnancy etc. But the most important factor is genetic defect that make one prone to this condition. Diabetes is a constitutional disorder as it is an offshoot of constitutional defect (genetic factors) having an impact on entire constitution of an individual. Hence it calls for an in-depth constitutional approach for its management.

GESTATIONALL DIABETES

          It is a temporary condition which occurs during pregnancy. It affects 0.5%  of pregnant women, with 40% of those cases developing into Type-II Diabetes later in life times. Treatment is usually not required. Blood sugar levels come down to the Normal after delivery of the baby.

SYMPTOMS OF DIABETES

          In both types of Diabetes , Signs and Symptoms are more likely to be similar as the Blood Sugar is High, either due to less or no production of Insulin, or Insulin resistance.

Diabetes can also be asymptomatic, however, the common symptoms are Increased Thirst, Appetite, Increased Urination, Sudden Loss of Weight or Increase in Weight, Easy Fatigability, Pruritis (Itching) – usually around Genital Organs, Numbness of Limbs, Non Haling of Cuts and Wounds, Frequently Changing Vision Power, Recurrent Skin Infections ( Fungal and Pyogenic). Few people are diagnosed only at the time of routine screening test before tooth extraction, operations or before starting the L.I.C. policies. Therefore people suffering with the above mentioned symptoms must go for blood sugar Testing.

Diabetes Type-I

            In type-I the pancreas stops producing insulin due to an autoimmune response or possibly, a viral attack on the pancreas. In the absence of insulin body cells do not get the required glucose for producing ATP( Adenosin Triphosphate) units, which results in primary symptoms in the form of nausea and vomiting. In later stages, which lead to breaking down the muscle tissue and fat for producing energy causing fast weight loss.

Diabetes Type – II

-         Increased Fatigue :- Unexplainable weakness, due to inefficiency of the cell in the metabolizing Glucose the reserve fat of the body is metabolized to gain energy.

-         Polydipsia :- As the concentration of Glucose increases in the blood the brain receives signals for diluting it and in its counteraction patient feels Thirsty.

-         Polyuria :- Increased in urine production is due to excess glucose present in the body, which gets rid of the extra sugar in the blood by excreting it through urine. This leads to dehydration because along with sugar a large amount of water is also excreted out of the body.

-         Polyphagia:- The hormone insulin is also responsible for stimulating  Hunger. In order to cope up with high sugar levels in blood the body produces insulin which leads to increased hunger.

-         Weight Fluctuation :- Factors like loss of water (polyuria), glucosuria, metabo;ism of body fat and protein may lead to weight loss.

-         Blurry Vision :- Hyperosmolar hyperglycemia nonketotic syndrome is the condition when body fluid is pulled out of tissues including lenses of the eye, which affects its ability to focus resulting in blurry vision.

-         Poor Wound Healing :- High blood sugar constrain the flourishing of WBC,(White Blood Cells) which are responsible for the body’s immune system. When these cells do not function properly wounds do not heal properly.

HOMOEOPATHIC APPROACH

             Homoeopathy is based on the principle that disease is a total affliction of body. Moreover homoeopathy recognizes importance of root cause such as genetic and inherited factors as a root of any ailment of the body. The homoeopathy medicines prescribed on such strong footings plays a crucial role in management of many deep-rooted, chronic, difficult diseases; one amongst them being Diabetes. Diabetes cannot be cure completely but can effectively controlled. People with diabetes can lead a healthy life if their blood glucose level is under control. The decrease in life span of a diabetic is restored to normal by maintaining good blood glucose control( 90 – 120 mg/dl Fasting and with less than180mg/dl as PP(2 Hrs. after meals).

     Homeopathic treatment: When we talk about diseases like diabetes, we talk in terms of management rather than cure. Homoeopathy can be a major player in the management of Diabetes. Timely-administered homoeopathy medicines not only assist in maintaining levels of sugar, protein and fat metabolism, but also helps in preventing further progress and hence complications of the disease. The precipitating factors of diabetes like BP, Obesity etc. can be helped by homoeopathic medication. The complications of Diabetes also can be helped tremendously with homoeopathy. If homoeopathic treatment is opted earlier far less number of case would go to the stage of Amputation etc. Even the cases of Non Healing Diabetic Ulcers have been cured with homoeopathy in our AKGsOVIHAMS Medical Center Clinic.We have been able to help the patients of  long standing Diabetes to whom their Antidiabetic medicines stopped affecting anymore and needed the change in group of medication with persistent symptoms and threatening complications , after the proper Constitutiona Homoeopathic medicines ,the same medicines started affecting them once again with no persistence of symptoms and over all relief and comfort in their quality of life. Homoeopathy does help the person in regaining his health.

DIABETES MANAGEMENT

         To keep your blood sugar in control through out the day  you need diet modification, regular exercise and medicine and change in lifestyle by including  yoga, pranayam ,meditation , mental relaxation etc. into your daily schedule.  

Prof.Dr.A.K.Gupta,MD(Hom.)