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British Medical Journal Warns of The Dangers of Detox

The arrival of the New Year means that many adults across the world will make New Year’s Resolutions in order to inspire them to make lifestyle changes in 2017. Each year, for example, one in three Americans will make a resolution to better themselves in some way, although approximately 75% of these resolutions will be abandoned or fail. The most popular New Year’s resolutions focus on losing weight and living a more healthy lifestyle, which is why many adults choose to begin the New Year with a detox programme, in order to rid their bodies of all the excess toxins they have accumulated throughout the holiday season. However the British Medical Journal are now warning of the dangers of restrictive herbal detox, highlighting several cases where the dietary restrictions imposed by many detox programmes had led to seizures, hospitalization, and long term health problems. This is often as a result of dangerously low levels of sodium in the body caused by the detox restrictions, according to BBC news. The severely restrictive nature of many extreme detox programmes means that The British Dietetic Association does not encourage people to begin herbal detox programmes.

Natural Herbal Weight loss Alternatives

7The good news is, there is a better route to weight loss than through intensive (and now potentially dangerous) long term detoxification. Within our highly regarded range of supplements and nutraceuticals, we offer Furoslim Irvingia Gabonensis, which is a leptin regulator designed to counterbalance leptin resistance (which plays a major role in the development of obesity) Individuals who are resistant to leptin find it difficult to lose weight, which is why using a herbal supplement such as this one to stimulate the production of the leptin chemical can speed up the metabolism and prove to be a very useful weight loss tool. Of course it is important to acknowledge that there is no magic weight loss solution (either herbal or medical) that can work in isolation, and taking Furoslim works best in conjunction with a healthy diet and regular exercise, but when you choose to take this kind of weight loss supplement, you will see that your weight loss takes place on a significantly improved timescale, which should provide the motivation you need to stick with your programme. We recommend that individuals who choose to take Furoslim commit to doing so for a period of 10 weeks, in order for their Leptin sensitivity to develop and other lifestyle changes to begin having an impact.

Alternative Detoxification Programmes

If you are still keen to begin your new year with a detoxification programme then why not instead opt for a holistic detox, where the focus is on drinking more water (between 8-10 glasses a day) and removing processed and unhealthy foods from your diet, replacing them with nutrient rich fruits and vegetables instead. A holistic detox is a much more gentle concept where the focus is on improving your lifestyle without the assistance of herbs or any additional medical intervention. Individuals undergoing a holistic detox programme do so from the comfort of their own home, and replace their formerly unhealthy dietary choices with a range of rich vegetables such as cilantro, spinach, beets and other green leafy vegetables: these can either be eaten raw, lightly steamed, or blended to create a nutrient rich smoothie that really packs a punch. Provided that you do not place any extreme restrictions on your diet, and that your detoxification does not last more than seven days, there are no real health dangers associated with opting for a holistic detox, although many dietitians would suggest that simply changing your diet, living a healthier lifestyle and exercising more in the long term would be a better way to stimulate weight loss.

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Obesity is a dangerous health condition that can have a negative long term overall impact on your health: obesity can lead to heart disease, increase your likelihood of developing certain types of cancer, lead to the development of diabetes, and cause long term joint and muscle pain. If you are struggling to control your weight then any small steps you can take to begin your weight loss journey (whether that is to walk more, detox your diet or take a weight loss supplement) are likely to be positive for your long term health. Why not start your path towards improved health today?

Post written by Anne Creswell

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Launched New Product- GCB70 (Supports Healthy Metabolism)

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HIGH BLOOD SUGAR UNDER PREGNANCY: WHAT TO DO!

HEALTHY PREGNANCY for a woman is the one in which she keeps her blood glucose (sugar) levels in target range i.e. both before she is pregnant and during her pregnancy.

In any case, if a woman is planning to get pregnant, it is the best time to control the blood glucose levels before getting pregnant because high blood glucose levels are harmful for the baby during the first weeks of the pregnancy (even before knowing that you are pregnant). Babies born to women with diabetes, especially women with poor diabetes control are at greater risk for birth defects.

REQUIRED BLOOD GLUCOSE TARGET IN PREGNANCY

Before eating: 60-119 mg/dL
1 hour after meal: 100-149 mg/dL

IMPORTANCE OF PLANNING PREGNANCY IN DIABETES

If you have diabetes during pregnancy, you can still manage the situation by proper planning of your pregnancy. You need to pay special attention to your health and you may need to see doctors who specialise in treating diabetes or its complications.
Pregnancy causes a number of changes in the body, so it might be a requirement to change how you manage your diabetes. Even if the woman had diabetes for years, it may still be a requirement for changing the meal plan, physical activity routine and medicines. As the woman gets closer to the delivery date, the requirements might change again. Thus, planning of the pregnancy becomes a critical task in diabetes.

PREGNANCY COMPLICATIONS DURING DIABETES

As given above, there is a risk of birth defects in the babies born under diabetes. Other complications of high blood sugar before and during pregnancy are:

In mother:

Worsening of diabetic eye problem
Worsening of diabetic kidney problem
Infections of the urinary bladder & vaginal area
Preeclampsia (high blood pressure with proteins in the urine)
Difficult delivery or C-section

In baby:

Premature delivery
Birth defects involving weighing too much or too less or having breathing problems
Increased risk of losing baby through miscarriage
Glucose in a pregnant woman’s blood passes to the baby. If your blood glucose level is too high during pregnancy, so is your baby’s glucose level before birth. In some cases, it has also been seen that after delivery, the baby’s glucose level may drop quickly and go too low.
Prolonged jaundice (yellowing of skin)

LABORATORY EXAMINATIONS REQUIRED BEFORE PREGNANCY
(Under risk of diabetes)1

Examinations before pregnancy suggested by doctor includes:

HbA1c levels (glycosylated hemoglobin)
High blood pressure
Heart disease
Kidney, eye and nerve damage testing
Thyroid test

HEALTHCARE TEAM2

Medical team containing healthcare professionals of diabetes and pregnancy will ensure for the best care. This healthcare team may include:

Medical doctor:

You will need monitoring and advice on glucose control during and after your pregnancy.

Obstetrician-gynecologist:

Has experience treating women with diabetes. You will see your OB/GYN regularly throughout your pregnancy.

Nurse:

Who provides prenatal care and advice on managing diabetes.

Dietitian:

A registered dietitian to help with meal planning. A healthy diet for glucose control and nutrition has never been more important than now.

Psychologist:

To help you cope with stress, worry, and the extra demands of pregnancy.

Pediatrician:

Doctor who will care for children

OTHER CONSIDERATIONS FOR MANAGEMENT OF DIABETIC PREGNANCY3

Exercise:

Exercise as much as possible. Take 30 minutes of walk on regular basis. It will help to control your diabetes and will help to have healthy pregnancy as well.

Healthy lifestyle:

Along with getting your blood glucose levels in your target range, it is important to establish healthy lifestyle habits as well that will reduce the risk for complications and improve the health of the baby. For women with diabetes, this lifestyle change means an HbA1c as normal as possible (less than 7%), achieving or maintaining a healthy body weight, improving diet and exercise and having a pre-pregnancy exam.

Folic acid consumption:

Women with diabetes should take a higher dose of folic acid. The normal daily dose for women trying to get pregnant and for pregnant women is 400µg. It will prevent birth defects in the brain and spinal cord.

Simultaneous medications:

If you take drugs for conditions related to your diabetes, such as high blood pressure, these may have to be altered because they may interfere with the development of the baby inside the womb.

Monitoring:

Expect to monitor your blood glucose levels more frequently during pregnancy. Your eyes and kidneys will be screened more often to check they are not deteriorating in pregnancy, as eye and kidney problems can get worse.

Breastfeeding:

It is recommended to feed the baby after birth as soon as possible– within 30 minutes – to help keep the baby’s blood glucose at a safe level.

Risk of gestational diabetes:

About 4% of all pregnant women without preexisting diabetes will develop gestational diabetes sometime around the 28-week. Gestational diabetes occurs when the mother’s body becomes resistant to insulin, causing glucose levels to build up in the blood. As with type 1 and type 2 diabetes, high blood glucose levels can cause problems for both mother and baby. Women with gestational diabetes usually get a special meal plan and are encouraged to exercise; they also have to test their blood glucose and may need to inject insulin. Gestational diabetes usually goes away after pregnancy, but brings an increased risk for the condition in pregnancy.

Smoking:

Smoking is especially harmful for people with diabetes. Smoking can increase diabetes-related health problems such as eye disease, heart disease, kidney disease and amputations. If you smoke, talk with your doctor about how to quit.

Herbal Supplementation:

Fenfuro is a first of its kind patented and clinically evaluated supplement for effective management of blood glucose levels. FENFURO is a group of furostanolic saponins, derived from fenugreek seeds (Trigonella foenum graecum) by innovative process. One of the most important properties of fenugreek seed extract is blood sugar level (BSL) lowering property. Various studies have investigated blood cholesterol-lowering and blood glucose lowering properties of fenugreek seed extract. FENFURO contains a rich variety of saponins and flavonoids. All of these substances are known to lower blood lipid levels and play valuable role in glucose regulation.fenfuro@
Thousands of women each year are able to monitor diabetes in pregnancy. Remember to manage the glucose levels, prioritize proper nutrition and exercise and stay connected to healthcare team. Medically management of diabetes is the key to the success of pregnancy.

REFERENCES

https://medlineplus.gov/diabetesandpregnancy.html
http://www.webmd.com/diabetes/pregnancy-diabetes-and-pregnancy#1
http://americanpregnancy.org/pregnancy-complications/diabetes-during-pregnancy/
http://www.nhs.uk/conditions/pregnancy-and-baby/pages/diabetes-pregnant.aspx
https://www.niddk.nih.gov/health-information/diabetes/diabetes-pregnancy
http://www.diabetesforecast.org/2010/aug/a-guide-to-pregnancy-with-diabetes.html?referrer=https://www.google.co.in/?referrer=http://www.diabetesforecast.org/2010/aug/a-guide-to-pregnancy-with-diabetes.html?referrer=http://www.diabetesforecast.org/2010/aug/a-guide-to-pregnancy-with-diabetes.html?referrer=https://www.google.co.in/?referrer=http://www.diabetesforecast.org/2010/aug/a-guide-to-pregnancy-with-diabetes.html?referrer=https://www.google.co.in/?referrer=http://www.diabetesforecast.org/2010/aug/a-guide-to-pregnancy-with-diabetes.html

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DIABETES-INDUCED ERECTILE DYSFUNCTION

ERECTILE DYSFUNCTION (ED) is the inability to get or maintain an erection firm enough for sexual activities. In India, more than 10 million cases per year originate due to erectile dysfunction. It can cause stress, relationship strain and low self-confidence.

It can originate by poor long-term blood sugar control. Erectile dysfunction can also be linked to other conditions common in men with diabetes, such as high blood pressure and coronary artery disease.

PREVALENCE

An estimated 10% of men aged 40 to 70 years have severe ED, and another 25% have moderate erectile dysfunction. ED tends to become more common as men age, though it does not usually occur on aging.

For many men, other health conditions, such as diabetes, contribute to the likelihood of developing ED. The association between Diabetes and ED was first documented in 1978.

 

It is estimated that:

  • Men who have diabetes aretwo to three timesmore likely to develop erectile dysfunction (ED).
  • Abouthalf of the menwho are diagnosed with Type 2 diabetes will develop ED within 10 years of their diagnosis.
  • Adopting a healthier lifestyle may help reduce your risk.

DIAGNOSIS OF ERECTILE DYSFUNCTION

1

There are no formal tests to diagnose erectile dysfunction. Laboratory tests can help identify the causes of ED. Initial tests should include HbA1C, free testosterone, thyroid function tests and prolactin levels. However, patients who do not respond to pharmacological therapy or who may be candidates for surgical treatment may require more in-depth testing, including nocturnal penile tumescence testing, duplex Doppler imaging, somatosensory evoked potentials, or pudendal artery angiography.

REASON FOR ERECTILE DYSFUNCTION IN DIABETES

Diabetes is associated with many serious health complications. Erectile dysfunction is one of those complications, which originates mainly due to diabetic neuropathy. Diabetic neuropathy is a condition when high blood sugar levels causes nerve damage in various parts of the body such as hands, arms, legs and feet which results in pain, tingling or numbness.2

  • Damage to penile nerves: Diabetes can cause damage to nerves (neuropathy) throughout the body including the nerves to the penis. Damage to penile nerves can interfere with the body’s ability to send messages to and from the penis, which can lead to ED.
  • Narrowing or hardening of blood vessels: Diabetes can intensify a condition known as atherosclerosis, in which the blood vessels become narrow or harden. Narrowing or hardening of these blood vessels prevents blood flow into and out of the penis, which can cause ED.
  • Nitric oxide production: Men with diabetes need to control their blood sugar levels. The body is unable to produce required Nitric Oxide (NO) in the presence of high blood sugar levels and vascular tissues don’t respond as effectively to NO. When enough blood flows into the penis, penile veins close off and block the blood from flowing out. This process results in an erection. If the body becomes unable to produce required NO or if the penile tissues do not respond to NO, the pressure of the blood flowing into the penis is not sufficient to trap the blood and penis will not get hard, resulting in ED.
  • Testosterone deficiency: About 12% of men with diabetes have low levels of the male hormone testosterone, which is required for normal erectile function.

 3

TREATMENT STRATEGIES

Diabetes is a lifetime chronic health condition, though both Type 1 and Type 2 diabetes can be well controlled through medications, proper diet, and exercise. Although ED can become a permanent condition, this typically isn’t the case for men who experience occasional erectile difficulties.

  1. Lifestyle change

If a person has diabetes, he may still be able to overcome ED through a lifestyle change that includes sufficient sleep, no smoking and stress reduction. There are several lifestyle changes that a person can make to not only help with diabetes management, but also to lower the risk of ED. You can:

  • Blood sugar control through diet: 4Eating a diabetes-friendly diet will help to better control the blood sugar levels and lessen the amount of damage to the blood vessels and nerves. A proper diet geared at keeping the blood sugar levels in check can also improve the energy levels and mood, both of which can help reduce the risk of erectile dysfunction. It is also considered working with a dietitian who is also a certified diabetes educator to help adjust the eating style.
  • Reducing alcohol consumption: Drinking more than two drinks per day can damage the blood vessels and contribute towards ED. 5Being mildly intoxicated can also make it hard to achieve an erection and interfere with sexual function.
  • Stop smoking: Smoking narrows the blood vessels and decreases the levels of nitric oxide in the blood. This decreases blood flow to the penis, worsening erectile dysfunction.
  • Regular exercise: 6
  • Adding regular exercise to the routine not only helps to control the blood sugar levels, but it can also improve circulation, lower stress levels and improve the energy levels. All of these can help combat ED.
  • Get more sleep: Fatigue is often to blame for sexual dysfunction. Ensuring that you get enough sleep each night can lower the risk of ED.
  • Stress levels:Stress can interfere with sexual arousal and the ability to get an erection. 7Exercise, meditation and setting aside time to do the things that you enjoy can help to keep the stress levels down and lessen the risk of ED. If symptoms of anxiety or depression are starting to develop, consult the doctor.
  1. Oral medications:Erectile dysfunction medications include sildenafil (Viagra, Revatio), tadalafil (Cialis, Adcirca), vardenafil (Levitra, Staxyn) or Avanafil (Stendra). These pills can help ease the blood flow towards the penis, making it easier to get and keep an erection.

In some cases, these drugs may be unsuitable for patients with heart disease. If you are considering one of these drugs and you have heart disease, as many diabetics do, be sure to tell your doctor. In rare cases, the pills may create “priapism,” a prolonged and painful erection lasting six hours or more (although reversible with prompt medical attention).

Herbal supplementation: It has been observed that herbal supplements are proved to be safe and effective to treat erectile dysfunction. Chemforce is a strong dietary supplement for overall energy and vitality in men. Furosap®, the major ingredient in Chemforce has been clinically proven to manage testosterone deficiency in men and is supported by international patents. The active component i.e. protodioscin is known to increase the levels of the hormones such as testosterone, dihydrotestosterone and dehydroepiandrosterone. These improvements in the hormonal levels in men might be responsible to manage erectile dysfunction.

REFERENCES

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DIABETES CAN CAUSE DEPRESSION

DIABETES

Diabetes is a long-term condition that causes a person’s blood sugar level to become too high. It is a metabolic disease and chronic disorder, which results from defects in insulin secretion or action.

Insulin is a hormone, which is secreted by pancreas and lowers the blood glucose level in the body. When insulin secretion or action is disturbed, diabetes mellitus develops.

DEPRESSION

It is a mood disorder and serious medical illness, which can alter the person’s thoughts, behaviour, feelings and sense of well-being. It is a disorder of brain, which can happen at any age, especially in teens and adults.

World Health Organisation (WHO) describes depression as the major cause of disability, which is estimated to account for 12% of the global burden of disease. It is reported to affect approximately 450 million people.

RELATIONSHIP BETWEEN DIABETES AND DEPRESSION

Depression is a very drastic condition becoming common in the general population i.e. approximately 1 in 4 people experience depression in their life and people with diabetes are at more risk to develop depression i.e. up to 50% of people with diabetes are thought to have mental illness such as depression or anxiety. Depressive patients are also at higher risk of developing diabetes. It is also reported that untreated depression can make it difficult to manage diabetes.

CAUSES OF DEPRESSION IN DIABETES

  • The hardship of managing diabetes can be stressful and can lead to symptoms of depression.
  • Diabetes leads to many health complications that may worsen symptoms of depression.
  • Family history of either condition
  • Obesity
  • Hypertension
  • Inactivity
  • Coronary artery disease

According to the above data, the complications of diabetes are major reason behind the development of depression. By treating diabetes or its complications can help in the management of depression too.

SYMPTOMS OF DEPRESSION IN DIABETES

The diagnosis of depression in a diabetic individual is important, which can be done by monitoring the symptoms of depression. These include:

  • No longer finding pleasure in the activities that you once enjoyed
  • Experiencing insomnia or sleeping too much
  • Loss of appetite or binge eating
  • Inability to concentrate
  • Feeling lethargic
  • Feeling anxious or nervous all the time
  • Feeling isolated and alone
  • Feeling sadness in the morning
  • Feeling that you “never do anything right”
  • Having suicidal thoughts
  • Harming yourself

 MANAGEMENT OF DIABETES AND DEPRESSION TOGETHER

Diabetes self–management programs

Diabetes self assessment programs can focus on behaviour and help the people to improve their fitness levels and manage weight loss and other cardiovascular disease risk factors. These programs also improve the quality of life and sense of well being of the affected person.

Diabetes self-management strategies include:1

  • Monitoring blood glucose levels on regular basis
  • Monitoring weight gain/weight loss
  • Regular exercise or other physical activities
  • Healthy eating and planning of diet according to the blood glucose levels
  • Regularity with anti-diabetic medications
  • Consuming lesser carbohydrates2

Psychotherapy

Psychotherapy, particularly cognitive behavioral therapy reported to have improvements in depression patients, which has resulted in better diabetes management. Psychotherapy can be short term or long term.3

Goals of the psychotherapy include:

  • Recognition of potential triggers
  • Identification and replacement of unhealthy behaviors
  • Development of positive relationship of patient with others
  • To promote healthy problem-solving skills

Medication

  • Anti-diabetic medication: For treating depression raised from the diabetic complications, it is better to treat diabetes first. When the diabetes will be treated, depression will automatically be cured. It is better to consume herbal supplements, which can prevent and treat diabetes with much lesser complications.

One such anti-diabetic herbal supplement is Fenfuro. Fenfuro is clinically proven and supported by six international patents for effective and safe management of blood glucose levels.

If cognitive behavioural therapy and anti-diabetic supplementation is not sufficient for the treatment of depression, then, psychotherapist can be consulted to treat with anti-depressant medications. Psychotherapist can prescribe from any of the following anti-depressant categories:

  • Tricyclic anti-depressants: They work by boosting the levels of certain chemicals in the brain that help nerve cells to communicate with each other. If these chemicals are out of balance or don’t work like they should, messages might not make it through the brain correctly that can lead to depression.
  • Selective serotonin reuptake inhibitors (SSRI): They affect the way in which brain uses a chemical called serotonin. Changing the balance of this chemical may help the brain cells to receive messages better and boost mood.
  • Serotonin norepinephrine reuptake inhibitors (SNRI): They block the re-absorption of both serotonin and norepinephrine. Like SSRIs, they improve the way in which brain sends and receives messages.

These anti-depressants should only be consumed after consultation with psychotherapist. Some strong anti-depressants can cause diabetes. Due to this, doctors prescribe small doses initially and increase the dose on requirement.

 

REFERENCES

https://fenfuro.com/product/fenfuro/

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Pushing diabetics to take insulin is a medical scam: Fiona Godlee

Pushing diabetics to take insulin is a medical scam: Fiona Godlee
With diabetes becoming such an epidemic in India, we need to look at the root causes and put money there rather than putting people on insulin.

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DRUG-INDUCED DIABETES

DIABETES is a well-known disease these days. It occurs when the sugar or glucose levels rise inside the human body. This rise in blood sugar levels takes place due to abnormal functioning of the cells known as β-cells of pancreas.

Under normal conditions, these cells release insulin on requirement to transfer glucose from blood to the tissues/cells for energy. This transfer balances blood sugar levels. The misconduct of these β-cells disturbs the balance of blood sugar levels and causes diabetes.

The activity of β-cells can be disturbed due to many reasons. One of those reasons is the consumption of some therapeutic agents.

THERAPEUTIC AGENTS can influence the development of diabetes, especially when pre-existing risk factors are present and these may cause glucose control to deteriorate if administered to those with existing diabetes.

It has been found that drug-induced diabetes can develop at the age of 20 years but it is more prone at the age between 40-60 years. The chances of development of drug-induced diabetes are found to be more in females (70%) as compared to males (30%).

ACTION OF DRUGS INDUCING DIABETES

Therapeutic agents causing diabetes may act either by increasing insulin resistance or by affecting the secretion of insulin or both.

 2

  • Grouping of drugs according to the mechanism of inducing diabetes
    • Drugs that cause diabetes by interfering with insulin production & secretion are:
β-receptor antagonist

(used in hypoglycemia)

 Tacrolimus

(immunosuppressant used in organ transplant)
Priminil (Vacor)

(used as rodenticide)

 Didanosine

(used as anti-retroviral therapy)
Pentamidine

(antimicrobial medication in used in pneumonia)

 L-asparaginase

(as anti-cancer agent)
Diphenylhydantoin

(used as anticonvulsant or antilepptic drug)

 Opiates

(used as pain reliever)

  • Drugs that cause diabetes by developing insulin resistance:
Glucocorticoids

(to control and treat inflammation)

 β-receptor antagonist

(used in hypoglycemia)
Megasterol acetate

(used as anti-cancer drug & appetite stimulant)

 Growth hormone

(growth stimulant)
Oral contraceptives

(used to prevent pregnancy)

 Protease inhibitors

(used as anti-retroviral therapy)
  • Drugs that act both on insulin secretion and resistance:
Thiazide diuretics

(to control blood pressure)

 Diazoxide

(used in treatment of acute hypertension)
Cyclosporine

(immunosuppressant used in organ transplant)

 Atypical antipsychotic

(used to treat psychotic conditions)
  • Treatments that induce diabetes by increasing nutrient flux:
Nicotinic acid

(used in dyslipidemia)

 Total parenteral nutrition

(used in intravenous feeding of person)
  • Grouping of drugs according to the capability of inducing diabetes

These agents may be divided into widely used medications that are weakly diabetogenic and drugs used for special indications that are more strongly diabetogenic.

  • Weakly diabetogenic medications include antihypertensive agents, statins and oral contraceptive pills.
  • Strongly diabetogenic include steroids, antipsychotics and a range of immunosuppressive agents.
  • There are also a number of known β-cell poisons including the insecticide Vacor, alloxan and streptozotocin which can cause permanent diabetes.

TREATMENT & PREVENTION STRATEGIES

  • Management of drug-induced diabetes is important as the diabetes so developed can convert into permanent diabetes for whole life. To prevent the development of diabetes, the blood glucose levels should be monitored regularly.
  • In cases in which the drug that induced diabetes must be continued, insulin therapy is the most efficacious approach. The diabetics should also try to use the lowest effective dose of therapeutic drug, if possible. Whenever is the possibility, the therapy should be altered.
  • A drug which is supposed to have adverse effect on blood glucose level should be avoided in a patient of diabetes, pre-diabetes or insulin resistance.3

Other diabetes management strategies include:

  • Healthy eating: Lifestyle management is the utmost requirement in the  management of drug-induced diabetes. The sweets and fats should be avoided as much as possible. Fruit juice should also be limited. Meals should not be taken more than 3 times a day. Alcohol intake should also be avoided (not more than 1-2 drinks/day) and blood glucose levels should be monitored before & after drinking.
  • Exercise: In drug-induced diabetes, physical activity
    contributes greatly towards the improvement in health. 30 minutes of moderate activity is recommended on regular basis by physicians. It is also required to check the glucose levels before & after the 4physical activity. The meal should also be planned according to the blood glucose levels checked previously.
  • Fenugreek supplementation: Another approach to tackle the drug-induced diabetes is by the treatment of diabetes along-with the on-going therapeutic drugs. It has been reported by many researchers that fenugreek is effective in the management of diabetes mellitus. In animal studies, the diabetes was induced in the animals with the help of alloxan or streptozotocin. Then, they were treated with fenugreek supplements. After some days of treatment on animals, improvements were noticed. There was improvement in the blood glucose levels on regular consumption of fenugreek supplements.5

In an animal study conducted by Babu KR et al., it was seen that fenugreek extract produced hypoglycemic effect in alloxan-induced diabetic rats after 7-21 days of oral administration. Their histopathological study on the rats showed that the alloxan-damaged β-cells were also restored on treatment with fenugreek extract.

It has been reported by Gaddam A et al. that fenugreek act by controlling the insulin resistance. The hypoglycemic effect of fenugreek was reported by them in their clinical study on both male and female volunteers having diabetes.

In a clinical study conducted by Verma N et al., fenugreek seed extract (Fenfuro™) exhibited anti-diabetic activity in male & female volunteers diagnosed with type 2 diabetes mellitus. On completion of their clinical study, they found reduction in both fasting plasma and post-prandial blood sugar levels in 83% of the study subjects. Fenfuro™ was also safe during & after the study treatment.fenfuro@

According to many reported animal and human studies, fenugreek is safe and effective in the management of diabetes whether induced by drugs or develops itself. Being an herbal supplement, it does not caused any side effect in any animal or human volunteer.

REFERENCES

 

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Hypertension & Diabetes

Blood pressure is the force of blood against your blood vessels as it circulates. This force is necessary to make the blood flow, delivering nutrients and oxygen throughout your body. High blood pressure, also called hypertension, means there is too much pressure in your blood vessels. It may precede the onset of diabetes mellitus (DM). In many of the cases, both hypertension and diabetes mellitus may be diagnosed together. Diabetic population has almost doubled occurrence of hypertension as compared to non-diabetic general population.

Diabetes and high blood pressure are considered as major cardiovascular risk factors, which mean these can lead to coronary artery disease, stroke, left ventricular hypertrophy, and nephropathy. Patients suffering from both diabetes and high blood pressure have greater risk of atherosclerosis.

What are causes of high blood pressure?2

Are you diagnosed with blood pressure & diabetes?

If yes, then monitor yourself regularly

Learn how to measure blood pressure & blood sugar at home, keep record of these.

What are the recommendations for starting anti-hypertensives?

British Hypertension Society, British Hyperlipidaemia Association and British Cardiac Society have jointly suggested the initiations of treatment of hypertension in diabetics when BP is equal to or more than 140/90 mm Hg. According to the WHO Expert Committee Recommendation in Hypertension Control treatment may be instituted at BP 130/85 mm Hg in a patient with diabetic nephropathy

Are lifestyle modifications recommended for Diabetic hypertensives?

Lifestyle modifications are must for diabetic hypertensive patients. These modifications also correct obesity, hyperglycaemia, hyperinsulinaemia, and act as primary prevention against cardiovascular risks. These will reduce blood pressure and control blood glucose levels.

Regular physical activity

It has been observed that regular physical activity has an independent cardioprotective effect.  Regular aerobic exercise can reduce systolic BP by an average of 4 mmHg and diastolic BP by an average of 2.5 mmHg. It is advised to all patients to become physically active, as part of a comprehensive plan to control hypertension and diabetes, regardless of drug treatment. Aim for 30 minutes of moderate-intensity physical activity on most, if not all, days of the week.

3

Quitting smoking

Quitting smoking may not directly reduce BP, but markedly reduces overall cardiovascular risk. The risk of myocardial infarction is 2–6 times higher and the risk of stroke is 3 times higher in people who smoke than in non-smokers.

Quitting smoking also helps in better management of blood glucose and HbA1c levels.4

Dietary Modification

Adequate intake of dietary-fibre, and K+, Ca++, Mg++ from fresh fruit, green vegetables, and dairy products should be ensured. Mg++ is provided by chlorophyll of green leafy vegetables. Anti-obesity diet should not contain more than 1/3rd of total calories from fat. Of the fat calories, 1/3rd should be derived from saturated fat and 2/3 from poly- or monounsaturated fat.

5

Weight reduction

Every 1% reduction in body weight lowers systolic BP by an average of 1 mmHg. Weight reduction by as little as 4.5 kg reduces BP and/or prevents hypertension in a large proportion of overweight people. Weight loss of 10 kg can reduce systolic BP by 6–10 mmHg.

 6 

 

Reducing Alcohol Intake

Reducing alcohol intake may reduce BP in many patients and also contributes in better management of blood sugar levels.

Co-existence of diabetes mellitus and hypertension increases the risk of macro – and micro-vascular complications. Blood pressure should be measured in supine, sitting, and standing postures in a diabetic patient to detect existence of autonomic neuropathy and drug induced postural hypotension. A good BP control (130/80 or below) prevents or retards the progress of both micro and macro-vascular complications. Tight control of blood glucose levels prevents or delays the progress of micro-vascular complications.

It is very important and must of diabetic hypertensive patients to modify their lifestyle to lead a healthy and happy life.

FenfuroTM is a clinically evaluated dietary supplement for effective management of blood glucose levels. It is supported by 6 international patents.

fenfuro@

References

 

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INSULIN: HEALTH RISKS

Insulin hormone is a chemical messenger secreted by the beta cells of pancreas, which allows the body to utilize glucose from carbohydrates and convert the extra glucose into energy for future use. Insulin maintains the sugar balance in the body by keeping blood sugar level from getting too high (hyperglycemia) or too low (hypoglycemia). Glucose obtained from the food does not directly convert into energy. When we eat food, the blood sugar levels rise and beta cells of the pancreas are then signaled to release insulin into the blood stream. Then the released insulin absorbs the sugar by binding to insulin receptors and converts excess of the sugar in glycogen (energy), which get stored in the liver. It has dual mode of action i.e. an excitatory one and an inhibitory one:

  • It stimulates glucose uptake and lipid synthesis.
  • It inhibits the breakdown of lipids, proteins and glycogen, and inhibits the glucose pathway (gluconeogenesis) and production of ketone bodies (ketogenesis).

Sometimes glucose metabolism gets impaired, characterized by hyperglycemia which may be due to either pancreas does not secrete insulin or insulin receptors do not respond to the insulin properly. This condition is also known as diabetes mellitus. So it becomes essential to take the insulin externally.

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Endogenous insulin (that which is found naturally in the body) acts on the principle of feedback. If glucose levels rise when eating something sweet, insulin secretion is increasing, too.

Exogenous insulin Patients suffering from Type I Diabetes are treated by doses of insulin produced by sources external to the body of the patient and administered in addition to the endogenous insulin. This type of insulin produced by sources other than human body is called exogenous insulin.

RISKS OF INSULIN INTAKE

When the insulin metabolism in the body gets impaired, then sometimes it becomes necessary to provide it externally. But there are certain side effects of insulin therapy. These are:

Hypoglycemia: It is the most serious problem associated with insulin therapy and it is also called as insulin reaction. It occurs 2

when blood sugar levels fall below the normal limits. If the insulin dose is high, then the blood glucose levels may decrease abruptly and if remain untreated may lead to seizure, death or coma. Hypoglycemia is associated with increased plasma dopamine, epinephrine and plasma renin activity. Signs and symptoms of low blood sugar are feeling weak, drowsy, or dizzy, experiencing shakiness, confusion, anxiety, nausea, or headache, blurred vision and loss of consciousness.

Weight gain

Weight gain during insulin therapy is the common problem that may be presented as edema. Weight gain may be associated with abrupt restoration of glucose control in a patient whose control was poor previously. It may be due to more efficient use of calories during insulin therapy, suggesting additional benefits of dietary and exercise modifications. Insulin therapy leads to increase in body fat as a result of the elimination of glycosuria and reduction in 24-hour energy expenditure which results in an insulin-associated decrease in triglyceride or free fatty acid cycling, glucose and protein metabolism and hence weight gain.

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Renal problems

Insulin therapy may also cause renal complications such as decreased renal plasma flow, glomerular filtration rate and significantly increased urinary albumin excretion rate. However, these changes are reversible upon resolution of hypoglycemia. Therefore changes in kidney function during insulin-induced hypoglycemia may result from direct stimulation of the efferent sympathetic nerves to the kidney and hormonal counter regulatory mechanisms.

Allergic reactions

Patients on insulin therapy may experience allergic reactions in response to insulin. Sometimes these reactions may be minor like hives or itchiness, but sometimes may be life threatening such as swollen tongue, tightness in chest, difficulty breathing, dizziness or fainting and may need hospitalization. These reactions may be localized (such as rashes at the injection site) or systemic (itching, redness, muscle cramps.).

Hypophosphatemia

Hypophosphatemia is one of the major metabolic complications of insulin therapy, particularly in the patients who are on treatment of diabetic ketoacidosis (DKA) as insulin increases intracellular phosphate transport. Sometimes hypokalemia and hypomagnesaemia may also occur during insulin therapy.

Skin related complications

Other adverse effects of insulin include loss or overgrowth of fat tissue at injection sites. Repeated use of the same injection site increases the risk of lipoatrophy — with time, patients learn that these areas are relatively pain free and continue to use them. However, the absorption of insulin from lipoatrophic areas is erratic leading to frequent difficulties in achieving ideal blood glucose control.

Lipohypertrophy is the most common cutaneous complication of insulin therapy.

Drug interactions

Exogenous insulin interactions include alpha and beta-blockers and other high blood pressure drugs, steroids, hormone-based contraceptive pills, asthma and cold medications, aspirin, thyroid medications, and even other diabetes drugs.

Administration of exogenous insulin provides a different insulin gradient than that occurring after endogenous insulin secretion. Endogenous insulin secretion acts initially on the liver where a major portion of it is taken up and <50% reaches the peripheral tissues. Exogenously administered insulin must circulate through the peripheral tissues before it can reach the liver; therefore, peripheral hyperinsulinemia is necessary to attain adequate insulin to regulate the liver. Another downside of insulin therapy is the need to increase the dose and the regimen complexity with time, the increase in severe hypoglycemia, and the potential increase in mortality as well as the potential increased risk for specific cancers.

It becomes all the more important for medical practitioner, patients and other stake holders to USE EXOGENOUS INSULIN INTELLIGENTLY, CAUTIOUSLY & JUDICIOULY.

References

http://www.iddt.org/about/gm-vs-animal-insulin/allergic-reactions-to-insulin

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GLYCAEMIC INDEX (GI) & DIABETES MEAL

GLYCAEMIC INDEX is the ranking system of carbohydrate-containing food products including vegetables, grains, fruits, etc. These ranks are calculated in comparison to the reference food i.e. either glucose or white bread. Thus, glycaemic index measures the impact of food products on blood glucose levels.

Glycaemic index falls under the categories of low, medium or high. High glycaemic index diet raises more blood sugar levels as compared to medium or low glycaemic index diet.

capture-2IMPORTANCE OF GI

After consumption of food, carbohydrates that break down more quickly during digestion and release glucose rapidly into the blood stream tend to have high glycaemic index. Similarly, carbohydrates that break down more slowly, releasing glucose more gradually into the bloodstream tend to have a low glycaemic index. Due to slow release of glucose into blood stream, low-glycaemic index foods tend to prevent diabetes.

Thus, glycaemic index is an important parameter for management of many metabolic disorders. It has been reported that low-glycaemic index diets are associated with decreased risk of cardiovascular disease, type 2 diabetes, stroke, depression, kidney disease, cancers, etc.

GLYCAEMIC INDEX AND DIABETES MEAL

For most of the people with diabetes, first tool for management of blood glucose levels is carbohydrate counting. Glycaemic index is such a tool, which could contribute well to a diabetic person meal for managing type 2 diabetes.

Low glycaemic index diet (GI ≤ 55) will prevent the immediate hike in the blood sugar levels after eating.

capture-3The diet from high GI to low GI can be changed by:

  1. Including one low GI food at each meal (given in table).
  2. Choosing breakfast cereals based on barley, oats (such as porridge), and wheat and rice bran.
  3. Eating grainy breads made with whole seeds, barley and oats instead of white or brown bread.
  4. Eating pulses and legumes (such as beans, lentils and peas).
  5. Eating high fiber foods because it helps slow the digestion and absorption of carbohydrates.

BENEFITS OF LOW GLYCAEMIC INDEX DIET IN TYPE 2 DIABETES

  1. Blood glucose levels are maintained within acceptable range by monitoring the quantity & quality of carbohydrates consumed.
  2. HbA1c levels are also lowered and come under normal range with intake of low glycaemic index diet.
  3. Low glycaemic index diet also normalizes the insulin production in diabetic body.
  4. Low glycaemic index diet also helps to manage LDL cholesterol levels along with free fatty acids. Thus, it is helpful in managing lipid levels.

 LOW GI FOODS (GI ≤ 55)

Foods with low GI have been given as following:

Breakfast cereal
Bran 30 Rolled oats 51
Oat bran 50 Special K 54
Vegetables
Frozen green peas 39 Tomato 15
Frozen sweet corn 47 Chilies 10
Raw carrot 16 Lettuce 10
Boiled carrot 41 Green beans 15
Broccoli 10 Red pepper 10
Cauliflower 15 Onion 10
Cabbage 10 Mushroom 10
Bread
Soya and linseed 36 Whole wheat 49
Wholegrain pumpernickel 46 Sourdough rye 48
Heavy mixed grain 45 Sourdough 54
Fruits
Cherries 22 Plums 24
Grape 25 Peaches 28
Apples 34 Pears 41
Dried apricots 32 Grapes 43
Coconut 45 Coconut milk 41
Kiwi 47 Orange 40
Strawberry 40 Prunes 29
Legumes
Kidney beans 52 Butter beans 36
Chick peas 42 Red lentils 21
Green lentils 30 Pinto beans 45
Blackeyed beans 50 Yellow split peas 32
Dairy
Whole milk 31 Skimmed milk 32
Chocolate milk 42 Sweetened yoghurt 33
Custard 35 Soy milk 44
Snacks & sweet foods
Nut & seeds bar 45 Sponge cake 46
Nutella 33 Milk chocolate 42
Peanuts 13 Walnuts 15
Cashew nuts 25 Nuts & raisins 21
Jam 51 Corn chips 42
Oatmeal crackers 55
Staples
Wheat pasta 54 Potatoes 54
Meat ravioli 39 Spaghetti 32
Tortellini 50 Egg fettuccini 32
Brown rice 50 Buckwheat 51
Barley 22 Yam 35
Sweet potatoes 48 Noodles 47

TIPS FOR DIABETICS

  • Manipulating the sequence in nutrient intake: The glycaemic control in diabetics can be achieved by sequential intake of nutrients. Lipid and protein ingested before carbohydrate reduce postprandial hyperglycemia.Manipulating the sequence of nutrient ingestion might reveal a rapid, feasible, economic and safe strategy for optimizing glucose control in Type 2 Diabetes.

Trico D et al. suggested that high-carbohydrate containing foods should only be consumed after non-glucidic nutrients to combine the positive effects of lipids and proteins on glucose. This manipulation in diet gave a strategy for long-term management of type-2 diabetes.

  • Eat unprocessed food: Unprocessed food should be eaten as much as possible. Whole, unprocessed food usually (but not always) has a lower glycaemic index than the same food when it’s processed.capture-4

  • Avoid overcooked food: Food should not be overcooked because it raises its glycaemic index.

 

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  • High fiber food: Most of the food that is high in fiber takes longer to digest and raises blood sugar slowly.

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    CONCLUSION

Considering the impact of carbohydrates on blood glucose levels, glycaemic index improves the chances of picking the best carbohydrates for managing diabetes. Thus, glycaemic index is a useful approach for a diabetic person.

Glycaemic index also helps to maintain the balance between proteins and lipids. This balance manages the blood glucose levels by slowing the process of digestion.

Glycaemic index helps to interpret that which carbohydrate is beneficial for diabetics and which fast food worsens the condition of diabetes. Thus, if you have diabetes, glycaemic index is made for you. Learning a new way to eat takes time and effort but it contributes greatly to manage diabetes.

REFERENCES