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How to treat and reduce the blood sugar level?

How to treat and reduce the blood sugar level?

 

High blood sugar level is also called Hyperglycaemia in medical terms. Nowadays, it is a prevalent issue among most individuals, both men, and women who are suffering from diabetes. Basically, it affects those who have type 1 and type 2 diabetes.

Apart from that, high blood sugar levels not only affect people who have diabetes but also affect those who are seriously ill due to stroke or a heart attack. Sometimes this term called Hyperglycaemia is confused with hypoglycemia, in which blood sugar drops down. The problem of high blood sugar level is no doubt very discomforting due to which you might want to know the medication or natural ways to reduce the blood sugar level.

So, before we discuss how to reduce the blood sugar level or best supplements for how to lower blood sugar level, let’s discuss its symptoms: –

  1. Feeling very painful and short-tempered.
  2. Urinary frequency
  3. Tiredness
  4. Unwanted weight loss
  5. Dry mouth
  6. Blurred vision
  7. Easy infections like skin infection, thrush, etc

 

Now let’s talk about the best treatment for diabetes: –

  1. Reduce the intake of carbohydratescarbohydrates- FENFURO

Many researchers have studied and proved that if a diabetic person eats a low carbohydrate and high-protein diet, it reduces blood sugar level. Side by side, you can also take the best supplement to lower blood sugar for the best results after thorough research of the benefits and side effects of each.

 

  1. Always eat low glycemic index foods.

If a diabetic person eats the food after measuring its glycemic index, it will lower down blood sugar level. If the score is below 55 on the glycemic index, the diabetic individual can eat that food.

Such foods include: –

  • Legumes
  • Sweet potatoes
  • Meat
  • Green leafy vegetables
  • Low-fat milk
  • Non-starchy vegetables
  • Various nuts and seeds

 

  1. Don’t eat large meals.

If you want to lower down blood sugar level, then ensure that you control the intake of carbs. Apart from that, eat small meals at one time; spreading out one meal into two-three. According to many doctors, if you eat small meals throughout the day, it will help regulate blood sugar levels up to a great extent.

  1. Exercise regularly

Apart from taking a supplement to help lower blood sugar or the best medicine for diabetes, exercise is another critical way to reduce it. No doubt, it is a practical and effective way to lower blood sugar. It has been proven that exercise helps in stabilizing blood sugar levels for 24 hours.

The reason is when the body does physical activity, then it needs glucose for more energy. As a result, the cells deliver this glucose all over the body.Excercise- Fenfuro

  1. Take insulin

Insulin is the main thing in the human body, which lowers and spikes the blood sugar level. In the case of a high blood sugar level, the body has low insulin. So, if the individual stabilizes the insulin level, then it helps in lowering down sugar level.

To get an immediate effect, you can talk to your doctor about how much time it will take to lower your sugar level.

  1. Drink lots of water

This is another way to lower blood sugar levels. If a diabetic person drinks lots of water from time to time, then it helps in reducing sugar levels.

The bottom line

Ensure that you talk to your doctor before taking the best treatment for diabetes or trying any supplements that raise blood sugar levels—the reason for this is that it can deliver excess side-effects, which can be very serious.

Fenfuro is a fantastic product because it’s equipped with the power of Fenugreek seeds that are dominant in maintaining a healthy blood glucose level. Fenfuro is a beautiful blend of the innovative production process and a rich mixture of flavonoids and saponins. It is a patented and clinically evaluated product.

Fenugreek seeds extract | FENFUROAll these ingredients play a valuable role in Fenfuro that powers it to battle with diabetes. The product is clinically evaluated and has no side-effect. Besides, it’s 100% natural, and beyond doubt, you can trust the power of Fenfuro for treating diabetes the right way.

References:

https://www.healthline.com/nutrition/15-ways-to-lower-blood-sugar#TOC_TITLE_HDR_2

https://www.medicalnewstoday.com/articles/320738#lowering-blood-sugar-levels

https://www.diabetes.co.uk/how-to/bring-down-high-blood-sugar-levels.html

https://www.everydayhealth.com/diabetes/9-tips-lower-blood-sugar-naturally/

 

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PATIENT EMPOWERMENT: TAKING CHARGE OF DIABETES

Nowadays, diabetes, particularly type 2 diabetes, is one of the fastest growing chronic diseases in the society. Tight blood glucose control, dietary requirements and intake of regular medication are only few things that a diabetic patient needs to manage in order to prevent long-term complications. Assured continuity of care does not only create many challenges for the patient but also for the treating physician who will need to support the patient’s management strategies.

PATIENT EMPOWERMENT refers to a process that enables and facilitates behavior change. The key to empowerment does not necessarily means better compliance to what the doctor says or prescribes but rather in the opportunity to increase patients’ self-sufficiency to improve their decision-making capabilities.

Research has shown that diabetes education is central to effective self-management behavior, which in the long term can influence clinical and psychological outcomes.

Approaches have now moved from purely educational interventions to those that empower patients based on the assumption that they are managers of their own health. Diabetes education together with patient empowerment has shown to be the key for effective self-management behavior. When delivered through information and communication technologies (ICT), this solution has shown to lead to better health outcomes.

KEY ELEMENTS OF EMPOWERMENT

 2

 

  • Diabetes awareness
  • Education & training
  • Support of healthcare providers

CHARACTERISTICS OF AN EMPOWERED ACTIVATED PATIENT

 3

 

  • He understands his health condition and its effect on his body.
  • He feels able to participate in decision-making with his healthcare professionals.
  • He actively seeks out, evaluates and makes use of information.
  • He feels able to make informed choices about treatment.
  • He is able to challenge and ask questions of the healthcare professionals providing their care.
  • He takes responsibility for his health and actively seeks care only when necessary.
  • He understands the need to make necessary changes to his lifestyle for managing their conditions.

HOW TO EMPOWER PATIENTS?

 4.jpg

 

  • DIABETES EDUCATION

Diabetes education for the nurses is vital in forming solid knowledge that will equip them to be able to properly educate their patients.

Poor education not only reflects in poor health for the patient but also leads to serious complications and early death imposing a large economic burden on the individual and healthcare systems.

Benefit: This would reduce excess costs for emergency department care and care needed for complications concerning uncontrolled diabetes. A lot of the complications that diabetics face could be prevented easily.

There is a large amount in the community of diabetics that simply do not care about their nutrition or health and are unwilling to make any sort of lifestyle change, those people aside; there is no excuse for the overwhelming amount of complications that some diabetics suffer from due to the lack of knowledge.

A patient with uncontrolled diabetes deals with physical ailments; people with uncontrolled type 1 diabetes often feel ill, experience cognitive dysfunction, have difficulty maintaining their weight at a desired level, and experience fluctuating moods.

Diabetes education can greatly decrease hypoglycemic events in patients with diabetes.

  • SELF MANAGEMENT

5Self-management is seen as a key capability for Patient Empowerment and emphasizes that persons with chronic diseases has the central role in managing their health.

Self-management is what people do to manage their diabetes or other chronic condition and its effects on their physical health, daily activities, social relationships and emotions.

Mindful eating: Mindful eating empowers the patient to make flexible decisions through the challenges of life. Mindful eating is one way to get closer to meeting the true needs and in the process gradually allows a person to live the life more fully.

Putting someone on a diet that says to avoid rice, “sweets”, “anything white” or “everything fried” automatically creates cravings and (even worse) guilt if they finally respond to their cravings. When a person gives into their cravings, the patient takes the wrong way & fails to manage diabetes.

  • INTERNET

6Only the internet allows us to set up an independent global diabetological service. The only thing users would need a computer and access to the internet. This service can serve unlimited number of people in the world along with medical consultation.

The key issue for patients & healthcare professionals is how to deliver personalized behavioral support in ways that are affordable and can reach to maximum number of patients. The internet offers several advantages in this regard because it is available 24 hours a day with very low cost.

Benefits

  • It does not require large investments.
  • It does not imply high fees.
  • It can easily be enriched with new information which immediately becomes available to the target group of users in any location in the world.
  • Help patients to monitor their diet and medicinal doses
  • Help both the patient and doctor to monitor the long term effect of the interventions

We cannot empower patients!

We only can provide a framework (tools, services, etc.) that makes it easier for patients to empower themselves.

REFERENCES

 

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BE CAREFUL WITH YOUR EYES DURING DIABETES!

DIABETIC EYE DISEASE is a serious condition to be found in the diabetic individuals who face problem in their eyes. This disease has the potential to cause severe vision loss and blindness. Diabetic eye disease has no early stage symptoms. There is no pain and vision may not change until the disease becomes severe. It is always shown when the disease starts to spread in the whole eye resulting in blurred vision.

Diabetic eye disease comprises a group of eye conditions including

  • Diabetic retinopathy
  • Diabetic macular edema (DME)
  • Cataract
  • Glaucoma
  • DIABETIC RETINOPATHY

1

As its name shows, this eye disease is related to “diabetes” and “retina”. The high blood sugar affects the tiny blood vessels in the light-sensitive tissue called the retina that lines the back of the eyes, causing diabetic retinopathy. It can cause blood vessels in the retina to leak fluid or hemorrhage (bleed), distorting vision. Thus, it is the most common cause of vision loss among people with diabetes.

It is the leading cause of vision impairment and blindness among working-age adults. Because diabetic retinopathy often goes unnoticed until vision loss occurs, people with diabetes should get a comprehensive dilated eye exam at least once a year.

Who is likely to get diabetic retinopathy?

Anyone suffering with diabetes can develop diabetic retinopathy. The longer someone has diabetes, the more likely he or she will get diabetic retinopathy. It is estimated that 40-45% of those with diagnosed diabetes have some degree of diabetic retinopathy.

How is it diagnosed?

Eye examination is done to detect diabetic retinopathy. The eyes should be dilated during the exam, which means eye drops are used to enlarge the pupils. This dilation allows the eye care professional to see more of the inside of the eyes to check for signs of the disease.

  • DIABETIC MACULAR EDEMA (DME)

 2

A consequence of diabetic retinopathy, DME is swelling in an area of the retina called the macula. This occurs due to the building-up of fluid called edema in the macula. The macula is very important for the sharp, straight-ahead vision which is important for reading, driving and recognizing faces.

DME is the most common cause of vision loss in individuals with diabetic retinopathy. About half of the people with diabetic retinopathy will develop DME. Although, it is more likely to occur as the diabetic retinopathy worsens, DME can happen at any stage of the disease.

Often, DME is associated with:

  • Diabetes for an extended amount of time
  • Severe hypertension (high blood pressure)
  • Fluid retention
  • Hypo-albuminemia (low levels of protein in body fluids)
  • Hyperlipidemia (high levels of fats in the blood)

What could be the symptoms for DME?

Common symptoms of DME are blurry vision, floaters, double vision and eventual blindness if it goes untreated.

  • CATARACT 3

Diabetic Cataract is a condition when the eye’s naturally clear lens becomes cloudy. Adults with diabetes are 2-5 times more likely than those without diabetes to develop cataract. Cataract also tends to develop at an earlier age in people with diabetes.

How diabetes contributes in developing cataract?

Light doesn’t pass through the lens as it should and isn’t properly reflected onto the retina (the light-sensitive tissue lining the back of the eye). As a result, vision becomes cloudy, distorted or blurry. 

The eye’s lens gets its nutrients from aqueous humor which is the fluid filling the front portion of the eye. Aqueous humor provides oxygen and glucose as an energy source for the body’s cells. In diabetic condition, sugar levels rise in the aqueous humor and in the lens. High levels of glucose in the lens cause it to swell, affecting clarity of the vision.

The lens also has an enzyme that converts glucose to a substance called sorbitol. When sorbitol collects in the lens, it can affect cells and naturally-occurring proteins, causing the lens to become less clear and more opaque. This condition eventually leads to cataract formation.

  • GLAUCOMA

Diabetic Glaucoma is a group of diseases that damage the eye’s optic nerve – the bundle of nerve fibers that connects the eye to the brain. Some types of glaucoma are associated with elevated pressure inside the eye. In adults, diabetes nearly doubles the risk of glaucoma.4

How diabetes contributes in developing glaucoma?

Under diabetic condition (high blood glucose), the retina becomes starved of oxygen and starts to develop new blood vessels & stimulus for these newly developed blood vessels. This triggers new blood vessel formation in the ocular anterior segment and interferes with the normal internal drainage system of the eye leading to elevated intraocular pressure, a condition referred to as glaucoma. If the pressure is high or continues for a long time, usually years, the nerve at the back of the eye may become damaged, and eventually the sight may be affected.

What are the symptoms of this eye problem (glaucoma)?

There may be no symptoms of this eye problem at all until the disease is very advanced and there is significant vision loss. In the less common form of this eye problem, symptoms can include headaches, pain in the eye, blurred vision, watering eyes, halos around lights and loss of vision.

PREVENTION & TREATMENT

  • Treatment of diabetes: If you are diabetic, you can help prevent or slow the development of diabetic retinopathy by treating diabetes through: 5
  • Taking the prescribed medication for diabetes
  • Sticking to diet
  • Exercising regularly
  • Controlling high blood pressure
  • Avoiding alcohol and smoking
  • Treatment of diabetic retinopathy varies depending on the extent of the disease. People with diabetic retinopathy may need laser surgery to seal leaking blood vessels or to inhibit other blood vessels from leaking. Your doctor might need to inject medications into the eye to decrease inflammation or stop the formation of new blood vessels.

People with advanced cases of diabetic retinopathy might need a surgical procedure to remove and replace the gel-like fluid in the back of the eye, called the vitreous. Surgery may also be needed to repair a retinal detachment. This is a separation of the light-receiving lining in the back of the eye.

  • Treatment of diabetic macular edema (DME) can be treated with several therapies that may be used alone or in combination. Anti-VEGF drugs are injected into the vitreous gel to block a protein called vascular endothelial growth factor (VEGF), which can stimulate abnormal blood vessels to grow and leak fluid. Available anti-VEGF drugs include bevacizumab, ranibizumab, and aflibercept which are approved by the U.S. Food and Drug Administration (FDA) for treating DME.

In focal/grid macular laser surgery, a few to hundreds of small laser burns are made to leaking blood vessels in areas of edema near the center of the macula. Laser burns for DME slow the leakage of fluid, reducing swelling in the retina.

Corticosteroids, either injected or implanted into the eye, may be used alone or in combination with other drugs or laser surgery to treat DME. But DME patients who use corticosteroids should be monitored for increased pressure in the eye and glaucoma.

  • Treatment of glaucoma requires lowering the eye’s pressure by increasing the drainage of aqueous humor or decreasing the production of the fluid. Medications can accomplish both of these goals. The basic treatment for glaucoma in diabetes is eye drops, and the commonest is one of the beta-blocker drops such as betaxalol, teoptic (cartelol), or timolol.
  • Treatment of cataract involves surgery in which the lens is removed and replaced with an artificial one.Cataract surgery is generally safe, so the point at which an operation is undertaken depends partly on the individual.

REFERENCES

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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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DIABETES MANAGEMENT WITH DIETARY FIBER

DIABETES MELLITUS

  • Diabetes mellitus or diabetes is a condition when there is rise in blood sugar levels in the body. The body becomes unable to use blood sugar (via insulin) for energy. During type 1 diabetes mellitus, pancreas becomes unable to produce insulin due to which glucose remains in the blood instead of transferring to the cells of the body. During type 2 diabetes mellitus, either the pancreas does not produce sufficient amount of insulin or the cells become unresponsive to insulin. In both of the conditions, sugar is not transferred from blood to the cells of the body. Thus, blood sugar levels raise causing diabetes.

(http://www.diabetes.org/diabetes-basics/common-terms/)

capture-2 

DIABETES MANAGEMENT

  • Epidemiology: India has the largest number of diabetic people. According to WHO, there were 32 million people diagnosed with diabetes in year 2000. It is now estimated that they will rise to 80 million by the year 2030. Thus, there is a critical need for the strategies to prevent the epidemic of diabetes.capture-3
  • Goals for management of diabetes: The goals for managing diabetes in people are to provide:
    • Relief from diabetic symptoms
    • Prevention of complications such as retinopathy, neuropathy, cardiovascular disease, cerebro-vascular disease, etc
    • Prevention of infections
  • The primary prevention criteria for diabetes by any healthcare provider include healthy life style focusing on proper balanced diet, increased physical activity and weight control. Lifestyle modification is the cornerstone for the management of diabetes.
  • For management of diabetes, dietary modifications are required. They aim to achieve and maintain ideal body weight, euglycaemia and desirable lipid profile.

(http://icmr.nic.in/guidelines_diabetes/guide_diabetes.htm)

(http://icmr.nic.in/guidelines_diabetes/section6.pdf)

ROLE OF DIETARY FIBER

  • Dietary fiber: Dietary fiber is the part of plant food, which cannot be digested by human body. Other food components such as fats, proteins & carbohydrates are broken down and absorbed by the human body. But dietary fiber passes intact through the stomach, small intestine, and colon and out of the body.
    • Availability: Dietary fiber is mainly found in the fruits, vegetables, whole grains and legumes. It provides health benefits such as maintaining blood sugar levels, healthy weight and preventing heart disease.
    • Benefits: The high-fiber diet has many benefits such as,
      • Controlling blood sugar levels by slowing the absorption of sugar
      • Achieving healthy weight by lowering blood cholesterol levels
      • Helps to maintain bowel health
      • Decreases chances of constipation

(http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fiber/art-20043983)

  • Diabetes & dietary fiber
    • Dietary fiber is reported to lower blood glucose levels. The daily intake of soluble fiber results in the prevention of diabetes.
    • Mechanism: Soluble fiber help to control blood sugar levels by delaying gastric emptying, holding back the entry of glucose into the bloodstream and lessening the postprandial (post-meal) rise in blood sugar. Because fiber slows the digestion of foods, it helps to inhibit the sudden spike in blood glucose that may occur after a low-fiber meal. Such blood sugar peaks stimulate the pancreas to pump out more insulin. The cholesterol-lowering effect of soluble fiber may also help people with diabetes by reducing heart disease risks.capture-4

(http://www.diabetes.ca/diabetes-and-you/healthy-living-resources/diet-nutrition/fibre#sthash.dXX6pgRZ.dpuf)

  • It has also been proved by the clinical studies that high fiber diet is beneficial to improve glycaemic control, glycosylated hemoglobin and hyperinsulinemia. It has been shown in the study that increases in bile-acid excretion due to dietary fiber intake is responsible for lowering blood glucose levels. The high fiber diet also helped to lower plasma lipid concentrations.

(http://www.nejm.org/doi/full/10.1056/NEJM200005113421903#t=articleTop)

  • Epidemiological studies suggested 29% reduction in the development of diabetes due to the protective effect of high dietary fiber intake. Increase in dietary fiber intake resulted in subsequent improvements in glycaemic control, reduction in the use of oral medication and insulin doses. Thus, dietary fiber consumption without altering the energy intake from carbohydrates, proteins and fats reduces the need for medication in type 1 and type 2 diabetic patients.

(https://www.researchgate.net/profile/Stefanie_Ferreri/publication/24247618_Health_benefits_of_dietary_fiber._Nutr_Rev/links/00b495391040b77454000000.pdf)

  • Fiber-rich diet for diabetics: It is recommended that an adult male need 38g per day of fiber and female need 25g per day of fiber intake to prevent diseased state. Diabetic individuals should follow following high fiber diet to lower blood glucose levels:
    • Skins and seeds of vegetables and fruit
    • Whole grain bread, pasta, cereal, crackers and rice
    • Barley, beans and lentils
    • Canned beans, chickpeas in salads
    • Ground flax seeds to yogurt, cereal
    • Almonds
    • Fenugreek seeds

(http://www.diabetes.ca/diabetes-and-you/healthy-living-resources/diet-nutrition/fibre)

(http://www.webmd.com/diet/guide/fiber-how-much-do-you-need#1)

  • Fenugreek as dietary fiber: Fenugreek seeds are reported to be a rich source of dietary fiber. Gel fiber present in fenugreek seeds contribute towards anti-diabetic property. The fiber content of fenugreek helps to lower blood glucose levels and delay gastric emptying, thereby preventing the rise in blood sugar levels. Fenugreek seeds contain 50.2% fiber which have hypoglycemic and hypolipidemic effect in diabetic patients.
    • In an animal study, fenugreek seeds extract was administered to diabetic rats. Fenugreek seeds significantly reduced serum cholesterol levels in rats. It was very effective to reduce blood sugar levels also.
    • It is reported that consumption of 25g of fenugreek seeds per day exhibit hypoglycemic effect in diabetic patients.
    • Thus, dietary modification with fiber will be helpful to reduce blood sugar levels in diabetic patients.

(http://diabeticbar.com/fenufibers.htm)

(http://fenufibre.com/whatIsFenufibre.html)

 

FenfuroTM is a patented and clinically evaluated product for safe and effective management of blood sugar levels. Fenfuro is a first of its kind, safenutraceutical derived from fenugreek seeds through a patented process. Through its unique scientific process, FENFURO concentrates the bioactive part of plants into a manageable dose, while removing the inert parts such as cellulose. Also, since a lot of healthy botanicals are not palatable, consuming their concentrate in capsule form in small dosage is a lot easier. FENFURO contains a rich variety of saponins and flavonoids. These substances are known to lower blood lipid level and help in insulin sensitization and glucose regulation. FENFURO is the first dual action insulin sensitizer.

A clinical evaluation of FENFURO was carried out on a total of 154 Type 2 diabetics for a period of 3 months, to determine its efficacy and safety. At the end of three months 83% of the patients reported decrease in fasting sugar levels and 89% patients reported decrease in PP sugar levels. The patients also showed significant decrease in HbA1C levels as compared to respective baseline value. 48.8% of patients reported reduction in dosage of anti-diabetic therapy after regularly taking FENFURO.

The statement and product have not been evaluated by the FDA to diagnose, treat, cure or prevent any disease.

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DEALING WITH DIABETIC FOOT

DIABETIC FOOT

  • Any ulcer or infection developed on foot during diabetic condition is termed as diabetic foot. It is one of the long-term complications of diabetes mellitus (rise in blood sugar levels). Ulcers or wounds most commonly occur at the bottom of the toe of the patient.
  • Reasons: Diabetes from very long time causes the damage in the nerves & blood vessels of the body which are the major reason behind diabetic foot.2
    • Nerve damage causes the person to lose feeling in the feet. Due to the loss of feeling, foot is exposed repeatedly to
      trauma or injury. Thus, any cut, blister or sore remains undiscovered. So, these minor foot injuries become ulcers & lead to major infections.
    • Blood vessel damage causes narrowing of the area to flow blood and oxygen throughout feet. Poor circulation of blood and oxygen in the foot area causes the wound healing process to slow down. This further worsens the condition of diabetic foot.
    • Sometimes, long-term diabetes loses normal foot arc in the patients. This causes clawed toes or hammer toes, displacement of fat cushion or foot-bottom deformity which further causes abnormal weight bearing in the foot. This changes the shape of the foot. The normal footwear becomes unable to fit properly and pushes the foot towards injury.3

 

  • People with diabetes can develop many foot problems. Neglecting these problems can cause serious conditions which lead to amputation (removal of limb by surgery).
  • According to the research data, foot ulcers within diabetic individuals are around 15% and become as high as 25%.

(http://www.diabetes.org/living-with-diabetes/complications/foot-complications/?loc=lwd-slabnav)

(https://medlineplus.gov/diabeticfoot.html)

 

PREVENTION & TREATMENT OF DIABETIC FOOT

 

  • The primary criteria for prevention and treatment of diabetic foot include the self-management. Foot care is the prime option for diabetic individuals to avoid the foot injury and minimize the chances of the development of diabetic foot.
  • Self-care activities: To keep the feet healthy in diabetic individuals, following self-care activities are recommended by healthcare personnel:4

 

  • Check your feet everyday for cuts, sores or blisters. You can also use mirror, if necessary.
  • Wash your feet everyday in warm and clean water without soaking for long time. Keep your feet dry after washing and be sure to dry your feet between toes.5
  • Keep the feet soft and smooth. Use cream or lotion to keep them soft after washing. Never use any cream or lotion in-between the toes and fingers because this will lead to infection.6
  • Corns and calluses should not be cut. Keep them smooth by rubbing gently in one direction.
  • Trim the toenails according to the requirement. In case of ingrown toenail, consult doctor. Smooth the nails after trimming. There should not be any toenail left sharp which could cause injury.7
  • Wear shoes & socks all the time. Do not walk barefoot, not even indoors because it may cause minor injury to the feet. Wear those shoes which fit comfortably in your feet.8

 

  • Protect the feet from extreme heat and cold. Put sunscreen lotion on the feet to prevent sunburn. Wear socks whenever you feel cold. Keep the feet away from open fires.
  • Physical activities which are easy on the feet should be chosen. Avoid running & jumping. Wear athletic shoes for exercise that fit well and provide good support.
  • Try to perform activities which will keep the blood flowing in the feet such as put the feet up while sitting, wiggle the toes after intervals, move the ankles up & down and do not cross legs for longer periods of time.
  • Avoid smoking because it can narrow and harden the blood vessels, thus, causes blood vessel damage.
  • Check your blood sugar levels regularly.

(http://www.healthsanaz.com/diabetic-foot-care-posters-df19.html)

(https://www.niddk.nih.gov/health-information/diabetes/preventing-diabetes-problems/keep-feet-healthy)

 

DIABETIC FOOT ASSESSMENT QUESTIONNAIRE

 

The problems given in the following questionnaire in a diabetic individual should be minutely handled because they can lead to diabetic foot:

 

  1. Is there any appearance of corn or calluses?

  9

 

  1. Is there any formation of blister on any part of the foot?

 

 10

  1. Are there any ingrown toenails?

 11

 

  1. Is there any formation of bunion beside the toe?

 

 12 

  

  1. Is there any appearance of plantar wart at the bottom of the feet?

 13

 

  1. Is there any formation of hammer toe?

  14

 

  1. Is there any formation of dry and cracked feet skin in grey or red color?

  15

  1. Is there any appearance of foot toe fungal infection?

  16

 

  1. Is there any mild or severe pain in the feet?

 

 17 

 

“Call or see your doctor right away if you have any of these signs to avoid diabetic foot”

 

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Metformin Contraindications & Benefits from Fenugreek

Manage your Blood glucose levels.

1

METFORMIN

download

 

 

 

 

 

 

 

 

 

Introduction

  • Metformin is the first-line medication for type-2 diabetes to control blood sugar levels. It is also used in the treatment of polycystic ovary syndrome (PCOS).
  • It is an “insulin sensitizer” which means that it works to make the cells in the body more receptive to insulin.
  • When the cells are insulin sensitive, they are able to take more glucose from the blood to be used for energy.

(http://www.diabetesselfmanagement.com/blog/diabetes-medicine-metformin/)

Mechanism of action

  • It lowers the blood sugar levels in type-2 diabetic patients by decreasing the amount of glucose released into the blood stream by the liver. Thus, it lowers the glucose production by liver.
  • In type-2 diabetic patients, the glucose production by liver is 3-times more than a normal individual. Metformin reduces this by one-third.

(Kirpichnikov D et al.: Metformin: an update. Ann Intern Med. 2002; 137(1):25-33)

Contraindications

Metformin is generally well tolerated but it has some side effects such as:

glucophage_contraindications

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

  • Metformin is a widely used anti-diabetic drug. Deterioration of sleep is an important unwanted side effect of metformin. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354927/)
  • Lactic acidosis: Most serious side effect caused by metformin is lactic acidosis. Lactic acidosis happens when there is not enough oxygen in the body and too much lactic acid builds up in the blood. Dehydration and drinking large amounts of alcohol can bring on lactic acidosis. Metformin also worsens this state of lactic acidosis. Its symptoms include:
    • Muscle pain
    • Numbness in the arms & legs
    • Trouble breathing
    • Stomach pain
    • Feeling very weak or dizzy
    • Slow or uneven heart rate
    • Nausea with vomiting
  • U. S. Food and Drug Administration (FDA) gave safety announcement regarding metformin use by kidney patients. According to FDA, metformin increases the risk of developing a serious and potentially deadly condition called lactic acidosis in kidney patients consuming metformin.

(https://www.drugs.com/metformin.html)

(Kim M J et al.: Metformin-associated lactic acidosis:predisposing, factors and outcome. Endocrinol Metab 2015; 30:78-83)

(http://www.fda.gov/Drugs/DrugSafety/ucm493244.htm)

Other general reported side effects

  • Minor side effects including diarrhea, nausea and abdominal pain.
  • Metformin does not signal the pancreas to release insulin due to which there is a little risk of low blood sugar (hypoglycemia) when taking this drug.
  • Decreased appetite
  • Heart burn

  

Are you on Metformin for a long time, then answering following five questions is very important

ts_150313_elderly_patient_pill_question_mark_800x600

  1. Do you feel muscle pain?

  2. Do you feel numbness in your arms & legs?

  3. Do you feel weakness or dizziness?

  4. Do you have sleep disorder?

  5. Is there change in your diet?

 

If YES Consult Your Doctor

 

FENUGREEK & DIABETES MANAGEMENT

download (1)

  • Research and traditional usage suggests that Fenugreek seeds (Trigonella foenum graecum) are among the best in terms of safety and efficacy. According to the clinical studies, seeds of Fenugreek are a rich source of fiber and have multiple benefits in patients with diabetes.
  • Mechanism: Soluble fiber in fenugreek seeds helps to lower blood sugar by slowing down carbohydrate digestion & absorption and stimulate insulin.
  • Blood sugar: Animal research suggests that fenugreek may also contain a substance that stimulates insulin production and improves blood sugar control. The bioactive components responsible for anti-diabetic activity of fenugreek are soluble fiber, alkaloids and amino acids. Soluble fibers delay the intestinal absorption of ingested sugar. 4-hydroxyisoleucine amino acid acts on pancreas to increase the release of insulin from islets of Langerhans. Thus, the risk of hypoglycemia, as in the case of metformin consumption, never originates while consuming fenugreek.

(http://www.botanical-online.com/english/fenugreek_diabetes.htm)

OTHER HEALTH BENEFITS

(http://www.uofmhealth.org/health-library/hn-2090006)

  • Inflammation, gastrointestinal problems and muscle pain: Abebe W also suggested that fenugreek is indicated for inflammation, gastrointestinal problems and muscle pain. The bioactive components responsible for this activity of fenugreek include alkaloids, saponins, amino acids etc. These bioactive components contribute to the anti-inflammatory and anti-oxidant property of fenugreek.
  • Cholesterol & heart conditions: Incorporation of fenugreek in the regular diet can promote healthy cholesterol levels and play a role in the treatment of heart conditions like atherosclerosis, also known as “hardening of the arteries.”

(http://www.evitamins.com/a/10-best-uses-fenugreek-452)

  • Appetite: In case of metformin consumption, there is decrease in appetite but while consuming fenugreek, the appetite gets balanced because it increases the production of bile by the liver.

(http://www.fenugreekworld.com/fenugreek-and-fennel-seeds-for-increasing-the-appetite-in-kids/)

  • Heartburn: Fenugreek can be an effective remedy for acid reflux orheartburn. Mucilage of fenugreek seeds coat the lining of the stomach and intestine and soothe irritated gastrointestinal tissues.

(http://www.thehealthsite.com/diseases-conditions/15-health-benefits-of-methi/)

  • Vitamins: It is also rich in many vital vitamins that are essential nutrients for optimum health, including thiamin, pyridoxine (vitamin B6), folic acid, riboflavin, niacin, vitamin A, and vitamin-C.
  • Minerals: Fenugreek is an excellent sources of minerals likecopper, potassium, calcium, iron, selenium, zinc, manganese, and magnesium. Potassium is an important component of cell and body fluids that helps control heart rate and blood pressure by countering action on sodium. Iron is essential for red blood cell production and as a co-factor for cytochrome-oxidases enzymes.

 

FenfuroTM is a patented and clinically evaluated product for safe and effective management of blood sugar levels. Fenfuro is a first of its kind, safe nutraceutical derived from fenugreek seeds through a patented process. Through its unique scientific process, FENFURO concentrates the bioactive part of plants into a manageable dose, while removing the inert parts such as cellulose. Also, since a lot of healthy botanicals are not palatable, consuming their concentrate in capsule form in small dosage is a lot easier. FENFURO contains a rich variety of saponins and flavonoids. These substances are known to lower blood lipid level and help in insulin sensitization and glucose regulation. FENFURO is the first dual action insulin sensitizer.

A clinical evaluation of FENFURO was carried out on a total of 154 Type 2 diabetics for a period of 3 months, to determine its efficacy and safety. At the end of three months 83% of the patients reported decrease in fasting sugar levels and89% patients reported decrease in PP sugar levels. The patients also showed significant decrease in HbA1C levels as compared to respective baseline value. 48.8% of patients reported reduction in dosage of anti-diabetic therapy after regularly taking FENFURO.

 

References

  • Wulffele MG, Kooy A, Lehert P, Bets D, Ogterop JC, Borger van der Burg B, Donker AJ, Stehouwer CD.Effects of short-term treatment with metformin on serum concentrations of homocysteine, folate and vitamin B12 in type 2 diabetes mellitus: a randomized, placebo-controlled trial. J Intern Med. November 2003;254(5):455–63
  • Gupta A, Gupta R and Lal B: Effect of Trigonella foenum graecum seeds on glycaemic control and insulin resistance in type 2 diabetes mellitus: A double blind placebo controlled study. J Assoc Physicians India 2001; 49:1057-1061
  • Abebe W: Herbal medication: potential for adverse interactions with analgesic drugs. Journal of Clinical Pharmacy and Therapeutics 2002; 27:391–40.
  • Mahajan R, Gupta K. Revisiting Metformin: Annual Vitamin B12 Supplementation may become Mandatory with Long-Term Metformin Use. J Young Pharm. 2010Oct;2(4):428-9. doi: 10.4103/0975-1483.71621. PubMed PMID: 21264109; PubMedCentral PMCID: PMC3019388.

 

 

 

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MANAGING TYPE 2 DIABETES & ITS NEUROPATHIC COMPLICATIONS, NATURALLY

TYPE II DIABETES

  • Diabetes is a problem with your body that causes blood glucose levels to rise higher than normal. This is also called hyperglycemia. Type 2 diabetes is the most common form of diabetes.
  • Cause of Diabetes: If you have type 2 diabetes your body does not use insulin properly. This is called insulin resistance. At first, your pancreas makes extra insulin to make up for it. But, over time it isn’t able to keep up and can’t make enough insulin to keep your blood glucose at normal levels.

(http://www.diabetes.org/diabetes-basics/type-2/?referrer=https://www.google.co.in/)2

  • Complications associated with diabetes: Diabetes increases your risk for many serious health problems e. complications such as eye complications (eye damage, vision loss, etc), skin complications (bacterial & fungal infection), kidney failure, cardiovascular diseases (heart problems) and neuropathy (nerve damage from diabetes is called diabetic neuropathy). But, with the correct treatment and recommended lifestyle changes, many people with diabetes are able to prevent or delay the onset of complications.

(http://www.diabetes.org/living-with-diabetes/complications/?loc=lwd-slabnav#sthash.VbOb80Xs.dpuf)

 

DIABETIC NEUROPATHY (NERVE DAMAGE)

  • Diabetic neuropathy is a serious complication, where in long term diabetes causes nerve damage. About half of all people with diabetes have some form of diabetic neuropathy. Most common nerve damage with the loss of feeling and pain occurs in the legs, feet, toes, arms and hands. This damage is painful and can cause peripheral neuropathy (can cause tingling, pain, numbness, or weakness in your feet and hands), autonomic neuropathy (affects those nerves in the body that control body pain).

(http://www.diabetes.org/living-with-diabetes/complications/neuropathy/?referrer=http://www.diabetes.org/living-with-diabetes/complications/?loc=lwd-slabnav#sthash.DnMRcyVr.dpuf)

  • Cause of diabetic neuropathy: Diabetes induced oxidative stress is the major cause of nerve cell damage leading to diabetic neuropathy. This can be handled if food or diet rich in the components which can fight against the oxidative stress e. antioxidants is consumed.
  • Diagnosis with common tests: Diabetic neuropathy can be detected by regular foot exams which are to be done each year in patients with diabetes to test pressure sensation, temperature perception, and vibration perception. Nerve conduction velocity tests are also done which record the speed with which the nerves send messages and Electromyogram which checks how nerves & muscles work together.

Fenugreek effectiveness in diabetic neuropathy

It is established that fenugreek seed extract has anti-diabetic effects through several pathways, such as restoring pancreatic β cell function and inhibiting sucrase and alpha-amylase activities. Beside these properties, Fenugreek is reported to have very strong anti oxidant activity as well as neuro protective activity.

It is reported that constituents of fenugreek  may elevate expression of Nerve growth factors (NGF) and brain derived neurotropic factors (BDNF) resulting is protection of nerves cells from oxidative damage and repair of damaged nerves.

FenfuroTM  is a patented and clinically evaluated product for safe and effective management of blood sugar levels. Fenfuro is a first of its kind, safenutraceutical derived from fenugreek seeds through a patented process. Through its unique scientific process, FENFURO concentrates the bioactive part of plants into a manageable dose, while removing the inert parts such as cellulose. Also, since a lot of healthy botanicals are not palatable, consuming their concentrate in capsule form in small dosage is a lot easier. FENFURO contains a rich variety of saponins and flavonoids. These substances are known to lower blood lipid level and help in insulin sensitization and glucose regulation. FENFURO is the first dual action insulin sensitizer.

A clinical evaluation of FENFURO was carried out on a total of 154 Type 2 diabetics for a period of 3 months, to determine its efficacy and safety. At the end of three months 83% of the patients reported decrease in fasting sugar levels and89% patients reported decrease in PP sugar levels. The patients also showed significant decrease in HbA1C levels as compared to respective baseline value. 48.8% of patients reported reduction in dosage of anti-diabetic therapy after regularly taking FENFURO

 

ARE YOU A DIABETIC?

DO YOU HAVE FOLLOWING SYMPTOMS?

YOU MAY BE SUFFERING FROM DIABETIC NEUROPATHY.

  1. Are your legs and/or feet numb?

3

  1. Do you ever have any burning pain in your legs and/or feet?4
  2. Are your feet too sensitive to touch?

5

  1. Do you get muscle cramps in your legs and/or feet? 6
  2. Do you ever have any prickling feelings in your legs or feet?

           7

  1. Does it hurt when the bed covers touch your skin?  8
  2. When you get into the tub or shower, are you able to tell the hot water from the cold water?

          9

CONSULT YOUR DOCTOR

References

  • Kumar P, Kale RK, McLean P, Baquer NZ. Antidiabetic and neuroprotective effects of Trigonella foenum-graecum seed powder in diabetic rat brain. Prague Med Rep. 2012;113(1):33-43. PubMed PMID: 22373803 
  • Gaur V, Bodhankar SL, Mohan V, Thakurdesai PA. Neurobehavioral assessment of hydroalcoholic extract of Trigonella foenum-graecum seeds in rodent models of Parkinson’s disease. Pharm Biol. 2013 May;51(5):550-7. doi:10.3109/13880209.2012.747547. Epub 2013 Feb 1. PubMed PMID: 23368940. 
  • Kumar P, Kale RK, Baquer NZ. Antihyperglycemic and protective effects of Trigonella foenum graecum seed powder on biochemical alterations in alloxan diabetic rats. Eur Rev Med Pharmacol Sci. 2012 Jul;16 Suppl 3:18-27. PubMed PMID:22957414. 
  • Jin Y, Shi Y, Zou Y, Miao C, Sun B, Li C. Fenugreek Prevents the Development of STZ-Induced Diabetic Nephropathy in a Rat Model of Diabetes. Evid Based Complement Alternat Med. 2014;2014:259368. doi: 10.1155/2014/259368. Epub 2014 May 8. PubMed PMID: 25057273; PubMed Central PMCID: PMC4099218.