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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 behaviour 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 behaviour, 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 behaviour. When delivered through information and communication technologies (ICT), this solution has shown to lead to better health outcomes.

KEY ELEMENTS OF EMPOWERMENT

 1

 

CHARACTERISTICS OF AN EMPOWERED ACTIVATED PATIENT

 2

  •  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?

 3

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

4Self-management is seen as a key capability for Patient Empowerment and emphasises 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

5Only 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 personalised behavioural 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

Categories
blog Diabetes

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

 

Categories
blog Diabetes

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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blog Diabetes

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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blog Diabetes

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.

1

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.

3

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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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.

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METFORMIN

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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:

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  • 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

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  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

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  • 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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What You Need to Know About Type 2 Diabetes

The Facts 

Type 2 Diabetes, the most common form and also referred to as adult onset diabetes, is a problem in which blood glucose levels rise above normal. The pancreas produces more insulin in response however, over time, the pancreas cannot keep up and make enough insulin to keep blood glucose at a normal level otherwise known as insulin resistance. When there is not enough insulin to move sugar into your cells, the body will rely on alternative sources of energy like from your tissues, muscles, and organs.

At first, the symptoms may be mild and easy to dismiss, however type 2 diabetes develops slowly and worsens over time. 

The Symptoms

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Frequent Urination:

Elevated glucose levels force fluids from cells, increasing the amount of fluid delivered to your kidneys. This increases urination and may cause dehydration.

Constant thirst :

As water is leached from your body, your tissues become dehydrated leading to constant thirst, a common symptom of diabetes. 

Fatigue :

Glucose is the human body’s primary source of energy. When cells cannot absorb sugar due to insulin resistance, you may become fatigued or feel exhausted.

Blurred vision :

In the short term, high glucose levels can cause swelling in the lens of the eye leading to blurry vision. This is a temporary problem that can be corrected by getting blood sugar under control. However, if glucose levels remain high over a long period of time, other eye problems can occur.

Recurring Infections and Sores :

Elevated glucose levels slow down the healing process therefore, injuries like cuts and sores stay open longer making you more susceptible to infection.

If you experience any of these symptoms on a regular basis, consult your doctor who may recommend a simple blood draw to test for diabetes. Routine diabetes screening typically begins at age 45 however you may begin earlier if you are overweight, sedentary, have a family history of type 2 diabetes, and are at a higher risk due to high blood pressure, high cholesterol and high triglycerides.

As the disease progresses unchecked, the symptoms will become more severe and potentially life threatening.

High blood sugar levels over a long period of time can produce symptoms including:

    • Yeast infections
    • Slow-healing cuts or sores
    • Dark skin patches 
    • Foot pain
    • Numbness in extremities or neuropathy 

If you’re experiencing two or more of these symptoms, consult your doctor immediately. Without treatment, diabetes can become fatal.

The causes of type 2 diabetes are still under research however, a number of doctors believe the disease is a result of a combination of factors.

The Causes

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Specifically, insulin is a naturally occurring hormone produced by the pancreas and released when you eat. Insulin helps transport sugar from your bloodstream to cells throughout your body where it’s used for energy. When a person is diagnosed with type 2 diabetes, it means that the pancreas can no longer produce insulin efficiently forcing the pancreas to work harder. Over time, this damages cells in the pancreas eventually rendering the pancreas unable to produce insulin at all.

This causes a build-up of glucose in the blood stream leaving the body starved of energy. Though, doctors are unsure of what triggers this series of events.

Cell dysfunction in the pancreas or with cell signaling and regulation may be part of the problem. A genetic predisposition may further be a factor in addition to obesity, which increases the risk of insulin resistance and diabetes.

While more research is needed fully understand the exact causes of type 2 diabetes, we are aware of certain factors that put people at a greater risk of developing the disease.

Risk Factors

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  • Certain factors are out of your control:
  • A family member who has type 2 diabetes puts you at a greater risk.
  • While you can develop the disease at any age, your risk increase as you age, particularly after age 45.
  • African-Americans, Latinos, Asian-Americans, and American Indians are at a higher risk than Caucasians.
  • A condition known as polycystic ovarian syndrome (PCOS) increases the risk in women.

However, you may be able to reduce or even eliminate your chance of developing diabetes by assessing risk factors related to lifestyle:

  • Being overweight means you have higher amounts of fatty tissue which can make your cells more resistant to insulin. In particular, extra fat in the abdomen increases you risk more than extra fat in the hips and thighs. 
  • Your risk increases further if you live a sedentary lifestyle. Regular exercise causes the body to use more glucose for energy and helps your cells respond better to insulin. 
  • Eating high amounts processed food, and foods high in fat, saturated fat, and cholesterol such as meat, dairy and eggs can increase your risk of type 2 diabetes

If you have pre-diabetes or have had gestational diabetes, your risk is also greater.

Figuring how to control blood sugar is paramount especially since a number of serious complications can result from type 2 diabetes.    

 Complications

Diabetes affects virtually every organ in the human body and is life-threatening if left untreated. A number of serious complications include:

  • Bacterial infections, fungal infections and other skin problems.
  • Nerve damage or neuropathy which can cause a loss of sensation or numbness and tingling in your extremities as well as digestive issues such as vomiting, diarrhea, and constipation. 
  • Poor circulation to the feet which slows down the healing process if you have a cut or sore and can lead to infection, gangrene and amputation. 
  • Hearing impairment.
  • Retinal damage or retinopathy and eye damage which can cause deteriorating vision, glaucoma, and cataracts. 
  • Cardiovascular diseases such as high blood pressure, narrowing of the arteries, angina, heart attack or stroke. In particular, women are twice as likely to experience another heart attack after the first one. Additionally, the risk of heart failure quadruples when compared to women without diabetes. 
  • Kidney damage and/or kidney failure. 

Hyperglycemia vs. Hypoglycemia

Hypoglycemia can occur when your blood sugar is low and is often followed by symptoms of shakiness, dizziness, and difficulty speaking. This can usually be remedied with a high sugar “quick-fix” food or drink, such as fruit juice, a soft drink, or a hard candy.

On the other hand, hyperglycemia can occur when blood sugar is high Characterized by frequent urination and increased thirst, exercising and proper nutrition can help regulate your blood sugar level.

How to Treat It

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Type 2 diabetes is a treatable and even preventable disease that affects millions of Americans in the US alone. Only a doctor can test you for diabetes and determine how often you have check your blood glucose levels however, by making some lifestyle changes, you can drastically improve your quality of life.

Nutrition

Include foods rich in fiber and healthy carbohydrates in your diet. Fruits, vegetables, beans, lentils and whole grains help keep your blood sugar levels within a normal range. Medical professionals like Dr. Neal Barnard are using high fiber, low fat plant-based diets as a natural cure for type 2 diabetes. Additionally, eat at regular intervals and until you are satisfied. 

Weight Management

Weight loss and management can significantly improve and even prevent the onset type 2 diabetes therefore, processed food, and foods high in fat, saturated fat and cholesterol such as meat, dairy and eggs are important to keep out of your diet. Reducing your consumption of pure, liquefied fat or refined oils—vegetable oil in particular—will further promote weight loss.

Exercise

Exercise for 30 minutes daily to promote heart health and to help control blood glucose. This is also an effective tool for weight loss and weight management.

Supplements

Add natural supplements to your diet. Fenugreek seed extract is growing in popularity as both a super food and an effective home remedy for diabetes. Studies suggest that fenugreek seed extract contains properties that can lower cholesterol and blood sugar. FENFURO, a group of furostanolic saponins derived from fenugreek seeds, contains a rich variety of saponins and flavonoids, all substances known to lower blood lipid levels and a play valuable role in glucose regulation. For more information, visit www.fenfuro.com.

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Not everyone with type 2 diabetes needs to use insulin. If you do, your pancreas isn’t making enough insulin on its own therefore, it’s crucial that you take insulin as directed. While type 2 diabetes medication is an option, the disease can often be treated and even prevented with a low fat, high fiber plant based diet and regular exercise. 

How to Prevent It

While there is nothing you can do about your genetics, ethnicity or age, the life style changes mentioned in this article can drastically improve your quality of life after being diagnosed with type 2 diabetes and even prevent the disease’s onset. The first step is to consult your doctor who can assess your risk, test your blood for diabetes, and prescribe medications if necessary.

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

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Controlling Type 2 Diabetes With Mindful Eating

Eating right is the key to managing type 2 diabetes. Good food choices are critical for people with blood sugar who want to reduce their risks for heart disease, stroke, and other health problems caused by blood sugar.

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“When someone is diagnosed with type 2 diabetes, they often have a sense that eating and food are things to be conquered,” says Michelle May, MD, a board-certified family physician who practices in Phoenix. That feeling can seem overwhelming. In fact, says Dr. May, some people may eat before they are hungry, motivated by the fear of having hypoglycemia, or low blood sugar. For better control of blood sugar, May counsels her patients to employ mindful eating techniques, an approach to food that can help them manage their diets and their lives.

Mindful eating focuses on tuning in to one’s body to recognize basic hunger signals and notice early hypoglycemic symptoms, like feeling dizzy or shaky, and then eating with increased awareness — paying attention to every bite of food. “You have to be prepared to eat when you need to, to respond to your body’s signs,” says May.

Mindful Eating Ends Blood sugar Diet Frustrations

May describes mindful eating as “eating with intention and attention.” Instead of thinking about “being good” or adhering to a blood sugar diet, May says blood sugar patients should be thinking about why, when, what, and how they eat.

A diabetes patient using mindful eating techniques may express intention as “I want to feel well,” “I want to be healthy,” or even “I want to enjoy the food at this party.” Mindful eaters pay attention to the eating experience by “being in the present moment and noticing how good the food tastes,” says May, “and [being aware that] as you eat, the enjoyment decreases as you get used to the flavors and become sated.” That’s your cue to stop eating.

Foods-that-can-prevent-and-control-diabetes

Paying more attention to when, why, how, and what you eat sounds easy. But “many things can influence your choices and your awareness,” May warns. Among the most common distractions to avoid are eating while driving, eating while watching television, and focusing on cleaning your plate rather than on the food itself. Such habits, May says, not only distract people from what they’re eating, but also from the simple pleasure of eating.

Using mindful eating makes the food you eat much more satisfying. People who are keenly aware of what and how they are eating are “more likely to enjoy flavors and textures and the ambiance of the eating experience,” May says, and they may also enjoy their lives more fully. “If you eat too much, you feel lethargic and regretful; if you eat the right amount, you feel energetic, content, and ready for your next activity,” she explains. Slowing down can also help you fend off obesity — one study found that middle-aged women who rush through their food tend to be heavier than those who savor every bite.

Mindful Eating in Practice

Mindful eating can help you successfully manage blood sugar and get your weight under control, two problems that often go hand in hand. When you’re overweight, says mindful eating practitioner Jonn Martin, 68, of Phoenix, all you think about is food — “what can I eat and when can I eat it?” With mindful eating, Martin learned how to get her food cues from her stomach rather than her head.

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Martin is the mother of seven and had gained more weight after every pregnancy, peaking at 300 pounds. She has had blood sugar for decades and started needing insulin injections in the early 1970s, eventually developing insulin resistance. “My sugar was so out of control,” says Martin, who realized that she had to lose weight to avoid risking her life.

After trying many other diets, Martin enrolled in May’s “Am I Hungry?” class, having heard about it through her health insurer. Though it took time for all the information she learned to register, eventually it clicked. By practicing mindful eating, Martin says, she was able to control what and how much she eats: “All of a sudden you get this little voice in your head that says ‘You can stop’ or ‘You’ve had enough.’”

Being conscious of when to put down the fork has enabled Martin to lose 60 pounds and get better control of her blood sugar as well. As May explains, mindful eating can make you feel less like a slave to blood sugar diet and help you enjoy food in a healthy manner.

Supplements

FENFUROTM is a group of furostanolic saponins, derived from fenugreek seeds (Trigonellafoenumgraecum) 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 is protected by six international patents and is clinically evaluated with proven efficacy and safety.

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