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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.

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  • 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.

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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.

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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.

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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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Beat Type-2 Diabetes with These 5 Tips

Type 2 diabetes is on the rise around the world however, there is much you can do to improve your life if you are diagnosed. Fortunately, the solution to type-2 diabetes doesn’t have to be found in insulin injections. A number of people are finding long term solutions through lifestyle changes.

“Basic principles of good health like eating right, exercising regularly, and maintaining a healthy weight can be as effective as medicine in the management of type 2 diabetes for most people,” says dietitian Sue McLaughlin, RD, diabetes educator and president of healthcare and education for the American Diabetes Association. That’s backed up by the Look AHEAD study, a large clinical trial funded by the National Institutes of Health and the Centers for Disease Control and Prevention. The researchers found that over a four-year period, changes like eating a healthier diet and exercising more led to weight loss and improved diabetes control in 5000 overweight or obese participants with type 2 diabetes.

If you feel ready to make some positive lifestyle changes, below are 5 tips to help get you started.

You Are What You Eat

Keeping a watchful eye on your diet is the first step to managing type 2 diabetes. The healthiest diet for people diagnosed with type 2 diabetes is a low fat, high fiber diet consisting of fruits, vegetables and whole grains. Be especially mindful of foods that are high on the glycemic index (GI), a system that ranks foods according to how they affect glucose levels. High-GI foods include white breads, white rice, and soda.

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Avoid fast food at all costs as well. In a 15-year study of 3,000 young adults, those who ate fast food more than twice a week developed insulin resistance (a diabetes risk factor) at twice the rate of people who weren’t fast food junkies. Plus, fast food is loaded with saturated fats, trans fats, and sodium, which can be especially unhealthy for people with type 2 diabetes.

Lose Weight

Studies find that losing just 10 to 15 pounds can lower glucose levels in people with type 2 diabetes. Managing your weight is critical to managing type 2 diabetes and where your fat is distributed can also affect your diabetes risk and management.

Image 6

People who carry most of their fat in their belly (apple shape) are more prone to type 2 diabetes than those with fat mostly in the thighs, hips, and buttocks (pear shape). A woman whose waist measures more than 35 inches and a man with a 40-inch waist need to lose weight for good diabetes management, according to experts who further note that adding a healthy diet and regular aerobic exercise will help shed weight in the stomach area.

Exercise Regularly

Even if losing weight is a hard fought and lost battle for you, maintaining a healthy level of exercise can make a big difference.

“When you do physical activity, such as walking, your muscle contractions push glucose out of your blood into your cells,” explains McLaughlin, resulting in better blood sugar levels.

Image 7

More intense exercise is even better. In one study of vigorous exercise and type 2 diabetes, women who walked quickly gained more protection from type 2 diabetes than those who walked at a more leisurely pace. Regular weight-lifting sessions can also help regulate blood sugar levels.

Manage Sleep Apnea

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A number of overweight people with type 2 diabetes also have sleep apnea, a condition in which a person stops breathing temporarily while sleeping.

People with type 2 diabetes and sleep apnea are at higher risk of death from heart attack and stroke. According to one study, their blood sugar levels can fluctuate more dramatically while sleeping than in those who have type 2 diabetes, but not sleep apnea, according to one study. These fluctuations have been linked to a higher risk of diabetic complications.

Severe cases of sleep apnea may need to be treated with surgery or by wearing a special device while sleeping, but less severe cases can be managed by losing weight. Talk to your doctor if you suspect you may have sleep apnea — loud snoring is one sign. A special sleep test can diagnose sleep apnea.

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.

Image 2

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.

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Use FENFURO and Reduce Your Risk of Type 2 Diabetes after Pregnancy

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Currently, one in twenty pregnant women will develop gestational diabetes and the risks to women and their children post-delivery are greater than most understand. What is gestational diabetes and how is it caused? Can it be prevented and treated?

From lowering cholesterol to aiding digestion, Fenugreek is a popular home remedy providing a treatment for a number of ailments. In particular, Fenugreek extract has shown to protect people from developing type 2 diabetes, including women with a history of gestational diabetes. FENFURO, a supplement made from Fenugreek extract, is making it easy for women to reap the benefits and prevent the onset of type 2 diabetes.  

This article will tell you what you need to know about gestational diabetes and the power of home remedies.

 The Disorder

Gestational diabetes is a type of diabetes that develops only in pregnant women. This means that your blood glucose or blood sugar is too high. While your body uses glucose for energy, too much in your blood is harmful to both you and your baby.

The disorder is commonly diagnosed during late pregnancy however, if you receive a diagnosis of gestational diabetes early in your pregnancy, you likely already had diabetes before you were pregnant. Receiving treatment immediately is essential for you and your baby to stay healthy. Taking action right away to control your blood glucose level will protect your baby from the risks associated with gestational diabetes.  

The Causes

Pregnant women will develop gestational diabetes when their bodies cannot make enough insulin, a hormone made in the pancreas. Insulin helps the body use glucose for energy and controls blood glucose levels.

Pregnancy causes the production of more hormones and other bodily changes such as weight gain. These changes can cause the body’s cells to use insulin less efficiently, a condition called insulin resistance. This disorder increases the body’s need for insulin and, if your pancreas can’t produce enough insulin, you will develop gestational diabetes.

The Risks

The risks of gestational diabetes can include hypoglycemia after birth, respiratory distress syndrome, jaundice, death and macrosomia, a condition where the baby is born with a larger than normal body which can make delivery more dangerous.

Your baby will also be more likely to become overweight and develop Type 2 diabetes later in life.

For women who developed gestational diabetes during pregnancy, the chances of having high blood pressure, preeclampsia, c-section and developing Type 2 diabetes are potential risks.

Fenugreek for Better Health after Delivery  

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Fenugreek is an herb derived from Ukraine, India, China and the Mediterranean region. The ripe, dry seeds found in fenugreek contain protein, vitamins, niacin, potassium, and disogenin as well as alkaloids, lysine, L-tryptophan and steroidal saponins. Studies suggest that fenugreek seed extract contains properties that can lower cholesterol and blood sugar.

FENFUROTM, a healthful supplement made from fenugreek extract, contains a rich variety of saponins and flavonoids, all substances known to lower blood lipid levels and a play valuable role in glucose regulation. FENFURO is a first of its kind product derived from a single herb with proven results for maintaining blood sugar levels. Patented and supported by scientific research, this product is non-toxic and processed without compromising the chemical properties of the active ingredient.

What’s an Indian kitchen without home remedies? Now, FENFURO has made obtaining the maximum benefits of Fenugreek extract quick and simple.   

While no amount of supplements can make up for a poor diet, consider adding a dietary supplement that will help you manage blood glucose.

For more information visit www.fenfuro.com

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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10 Things Only a Diabetic would understand

  1. You have a space in your home dedicated to diabetes supplies

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  1. Being high means something completely different to you.

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  1. You can calculate insulin on board, carb factors, insulin to carb ratio without hesitation.

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  1. Everyone wants to know why you use a pager.

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  1. You have cases of juice boxes stashed in your house but they aren’t for the apocalypse.

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  1. The pharmacist is a contact in your phone and you both know each other by name.

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  1. Your fridge has never seen a stick of butter. The compartment is used for storing insulin.

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      8. You’re constantly offered sugar-free food that’s full of carbohydrates.

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  1. You click on articles that claim to help you improve glucose levels, only to find an article about prevention. Image 9
  2. You’ve been offered countless diabetes home remedies from friends and relatives. Seriously, why do people do this?

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Fenfuro is a leading provider of Fenugreek seed extract, which 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 play valuable role in glucose regulation. Fenfuro is patented and clinically evaluated. For more information, visit www.fenfuro.com.

 

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