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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

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

CHARACTERISTICS OF AN EMPOWERED ACTIVATED PATIENT

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  • 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?

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  • 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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SPORTS & EXERCISE TO CONTROL BLOOD GLUCOSE

Maintaining the blood glucose levels under required range is always a difficult task for diabetic individuals. It is always under attention for diabetics to know what to do to keep the blood glucose (or sugar) in range, even under the most challenging circumstances.

There are many prevention and treatment strategies to lower the sudden hikes in the blood glucose levels, which are either suggested by the doctor or healthcare professional or practiced by the diabetic individual itself. The initial step taken by any diabetic individual is to increase the physical activity, which is also suggested by doctors. It is reported that physical activity contributes highly in maintaining blood glucose levels in the body.

HOW THE PHYSICAL ACTIVITY & BLOOD GLUCOSE LEVELS ARE LINKED?

  • Physical activity can lower the blood glucose for up to 24 hours or more after work out by making the body more sensitive to insulin.
  • Checking the blood glucose levels frequently before and after exercise can help to see the benefits of activity.
  • The results of blood glucose help to see how the body reacts to different activities.
  • Understanding these patterns can help to prevent the blood glucose from going too high or too low.

HOW PHYSICAL ACTIVITY ACT INSIDE BODY TO LOWER BLOOD GLUCOSE LEVELS?

Blood glucose levels are increased when either the insulin is not synthesized inside the body or the insulin is not responding to the blood glucose to transfer it to the cells (insulin resistance). Any of the two conditions can develop diabetes.1

During exercise, the demand for fuel increases inside the body and the body responds accordingly.

  • Glucose stored in the muscle is burned very quickly.
  • At about the same time, glucose stored in the liver is released into the bloodstream (like fast fuel injection).
  • Fat is released from special cells called adipocytes. This fat along with glucose makes its way through the bloodstream to the muscles to be used for fuel.
  • Once the fuel reaches the muscle, it must enter through special pathways so that the muscles can use it for energy.

By using the above given pathways, physical activity or exercise maintains blood glucose levels in any of the following ways:

  • Insulin sensitivity: Insulin sensitivity is increased with regular exercise, so the cells are better able to use available insulin to take up glucose during and after activity. This enhanced insulin sensitivity may continue for many hours after the exercise is over, depending on the extent of the activity. The more intense and prolonged the activity, the longer and greater the enhancement in insulin sensitivity.
  • Energy production: When the muscles contract during activity, it stimulates another mechanism that is completely separate of insulin. This mechanism allows the cells to take up glucose and use it for energy whether insulin is available or not.
  • Weight management: Exercise burns calories and builds muscles, which in turn helps the body burn more calories. In people with either type 1 or type 2 diabetes, having too much body fat inhibits insulin from working (to control blood glucose levels). To reach and maintain a healthy weight, just eating right isn’t enough – people need to exercise.

This is how exercise can help lower blood glucose in the short term. And when the body is active on regular basis, it can also lower the glycosylated hemoglobin.

CAREFUL SELECTION OF EXERCISE

Exercise to lower blood glucose levels should be chosen after complete advice from healthcare professional and after completely studying the pros & cons of that specific exercise.

  • Rise in blood glucose due to exercise: It has been suggested that instead of lowering blood glucose levels, some exercises or physical activities raise the glucose levels too.

Reason: It is not unusual to experience a blood glucose rise at the onset of high-intensity exercise. This is caused by a flow of stress hormones that oppose insulin’s action and cause the liver to dump extra glucose into the bloodstream. The supply of glucose becomes more than the requirement by the body. The muscles cannot burn the glucose as fast as the liver is producing it, resulting in increase in blood glucose levels.

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Exercises, which increase blood glucose levels

  • Weight lifting (particularly when using high weight and low repetitions)
  • Sports that involve intermittent “bursts” of activity like baseball or golf
  • Sprints in events such as running, swimming and rowing
  • Events where performance is being judged, such as gymnastics or figure skating
  • Sports activities in which winning is the primary objective
  • Fall in blood glucose due to exercise: Exercise contributes quite well in maintaining blood glucose in diabetic patients. Sometimes, the blood glucose levels fall more than the required levels. This can be understandable by concentrating the mechanism of lowering blood glucose by exercise.

Reason: The muscle cells have special receptors (called insulin receptors), like doors, that allow glucose to pass from the bloodstream to the muscle. These doors do not open unless they are unlocked by insulin. The good news is that exercise has an insulin-like effect, making insulin work better in the body. During physical activity, the doors swing open easily, allowing more and more glucose to enter the muscle cells to be burned up for energy. The problem is that as you continue to exercise and glucose continues to leave the blood, you may end up with low blood glucose. Thus, the exercise to lower or maintain glucose levels should be chosen after accurate advice from health professional.

Exercises, which maintain blood glucose levels

  • Aerobic exercise: 3Aerobic exercise helps the body to useinsulin  It makes the heart and bones strong, relieves stress, improves blood circulation and reduces the risk of heart disease by lowering blood glucose and blood pressure and improving cholesterol levels.

Recommendation: 30 minutes of moderate-to-vigorous intensity aerobic exercise at least 5 days a week or a total of 150 minutes per week is recommended to maintain blood glucose.

Aerobic exercises include brisk walking, indoor cycling, dancing, low-impact aerobics, swimming, tennis, stair climbing, jogging, hiking, ice-skating, etc.

  • Strength training: 4Strength training (also called resistance training) makes the body more sensitive to insulin and can lower bloodglucose. It helps to maintain and build strong muscles and bones, reducing the risk for osteoporosis and bone fractures. The more muscle you have, the more calories you burn – even when your body is at rest.

Recommendation: It is recommended that doing some type of strength training at least 2 times per week in addition to aerobic activity is helpful in maintaining blood glucose levels.

Some of the strength training activities include weight machines, lifting light weights, heavy gardening to keep & build muscles, etc.

  • Light activities: 5If you are sitting for a long time, such as working at a desk or watching TV, do some light activity for 3 minutes or more every half hour to maintain the blood glucose levels.

Light activities include leg lifts or extensions, overhead arm stretches, walking in place, torso twists, side lunges, etc.

Thus, moderate physical activity advised by health professional should be chosen to lower blood glucose levels. If you combine physical activity with a reduced-calorie eating plan, it can lead to even more benefits. The additional benefits may include improved cholesterol levels, less sleep apnea and being able to move around more easily.

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BE PHYSICALLY ACTIVE. BE PATIENT. BE DIABETES-FREE.

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.

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.

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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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GLYCAEMIC INDEX (GI) & DIABETES MEAL

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

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

capture-2IMPORTANCE OF GI

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

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

GLYCAEMIC INDEX AND DIABETES MEAL

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

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

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

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

BENEFITS OF LOW GLYCAEMIC INDEX DIET IN TYPE 2 DIABETES

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

 LOW GI FOODS (GI ≤ 55)

Foods with low GI have been given as following:

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

TIPS FOR DIABETICS

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

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

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

 

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

    capture-6

    CONCLUSION

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

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

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

REFERENCES

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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.

 

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Top Diets for Diabetes

According to government figures, more than 85 percent of people with type 2 diabetes are overweight or obese (although excess weight isn’t the only risk factor for this type of diabetes). But for people with type 2 diabetes who fall into that 85 percent, dropping the pounds can help stabilize blood sugar levels and even eliminate the need for blood sugar medication. 
 Capture
So which diet can help you achieve your weight-loss goals? There’s no one right answer. But, says Nora Saul, RD, CDE, a certified diabetes educator and manager of nutritional education at the Joslin Diabetes Center in Boston, “people who have blood sugar can, with a little forethought, use many of the healthy popular diets.” 

Weight-Loss Plans for Type 2 Diabetes 

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 If you have type 2 diabetes and want to lose weight, here are some sensible diet options to try. 
 
DASH Diet: “Although originally designed to lower blood pressure, DASH — or Dietary Approaches to Stop Hypertension — is an all-around good eating plan,” says Saul. In fact, U.S. News and World Report rated the DASH diet as tops for treating diabetes in a May 2011 article. That’s because the diet is high in fruits and vegetables, which means it’s high in fiber, antioxidants, and potassium. It’s also high in low-fat dairy, calcium, lean protein, and whole grains. “It has meal plans for different calorie levels,” says Saul, which allows flexibility according to your weight. 
 
South Beach Diet: The South Beach Diet is a modified low-carb diet that emphasizes healthy fats. If you want to try it, Saul advises sticking to the maintenance phase of the diet. “The initial phases are too low in carbohydrates,” Saul points out. Yes, people with diabetes have to watch how many carbs and the type of carbs they eat, but you don’t want to cut them out entirely. “I encourage whole grains,” says Saul, who warns against eliminating any specific food group, even for weight loss. (Note: Everyday Health is the publisher of SouthBeachDiet.com.) 
 
Weight Watchers: Weight Watchers is a popular commercial weight-loss plan. It’s also a good choice if you have type 2 diabetes, in part because the system provides group support and accountability in addition to a structured eating plan. People with diabetes might need to make some modifications to the diet plan, however. For example, explains Saul, in the latest version of Weight Watchers counting system or “points,” fruit has zero points. But for people with blood sugar, a serving size of fruit does count toward total carb intake for the day. 
 
Mediterranean Diet: Though not a specific eating plan, a Mediterranean diet mimics the way that people who live in countries around the Mediterranean Sea, such as Greece and Italy, tend to eat. Rich in beans, nuts, fruits, vegetables, grains, and seafood, it isn’t so much a weight-loss diet as a different way of eating. “People lose weight because they are full and are not eating a lot of the empty calories they consumed before,” says Saul, who says this concept works well for people with blood sugar, too. 
 
Atkins Diet: The Atkins Diet gained fame as the diet that led the low-carb diet revolution twice. This diet may be a good option for some people and can help manage blood sugar levels, but it can be too restrictive and may not be a long-term lifestyle choice for everyone with blood sugar. However, reading about and trying out this diet could be a learning experience in terms of understanding how carbs function in your diet. 
 
Jenny Craig: Jenny Craig (now rebranded as Jenny) is a personalized eating and diet program that includes a lot of support as well as prepackaged meals. The catch is that it can be costly and, although the diet plan is intended to ultimately help you make your own meals and food choices, some people might find it difficult to get out of the habit of relying on a stocked freezer. Finally, people with blood sugar that is not adequately controlled may be discouraged from enrolling. 
 
GI Diet: A low glycemic index (GI) diet is an excellent choice for people with type 2 diabetes, Saul says. This one might require some research and study until you understand exactly where foods fit in the glycemic index and how you can include the right ones in your diet. The glycemic index lets you know how fast a 50-gram portion of a carbohydrate food raises blood sugar in comparison with white bread. The lower the number, the better the food is for controlling blood sugar
 
Whatever diet you decide on, there are a few overarching principles that should guide your choice. Among them, look for diets that include food you like (or will come to like) and that don’t rely on expensive supplements or tools. And be sure to check with your doctor before beginning any weight-loss regimen.
Use Supplement for Blood sugarFENFURO Regular intake of FENFURO can control the blood sugar level effectively. 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.
The statement and product have not been evaluated by the FDA to diagnose, treat, cure or prevent any disease.
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Pre Diabetes: Everything You need to Know

Pre Diabetes: Everything You need to Know

Simply put, if you have pre diabetes (impaired glucose tolerance), your blood sugar (glucose) is raised beyond a healthy level but is not so high that you have blood sugar. While pre diabetes does not mean you have blood sugar, you are at a far greater risk of developing Type 2 diabetes than someone who does not have pre diabetes. You are additionally at a greater risk of developing cardiovascular diseases like heart disease and peripheral arterial disease.

This article will cover the basics of pre diabetes and the most effective course of treatment if you are diagnosed. Ultimately, lifestyle changes focused on diet and exercise are the most effective preventive measures you can take against the onset of type 2 diabetes.

The Relationship between Blood Glucose and Insulin

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As your food is being digested, various foods are broken down into sugars or glucose, which pass through your stomach and into the bloodstream. Though, to remain healthy, a person should not have blood glucose levels that are too high or too low.

So what does the body do when blood glucose levels begin to rise after you eat? The body releases a hormone called insulin which transports glucose from your blood to your cells which use some glucose for energy while the rest is converted into stores of energy otherwise known as glycogen or fat.

When you are not eating, blood glucose levels will begin to fall as do insulin levels. Some glycogen or fat is then converted back into glucose and released from the cells back into the bloodstream.

A Normal Blood Glucose Level

Your blood glucose level literally refers to the amount of glucose in your blood. A normal blood glucose level should hover between 4 and 8 millimoles per litre (mmol/L). Usually, blood glucose levels are lowest in the morning and highest after eating.

Understanding Diabetes

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Type 1 and type 2 are the two main forms of blood sugar. At this time, type 1 diabetes is not preventable and cannot be cured. Type 2 diabetes is the most common form.

Type 1 Diabetes

In this form of diabetes, beta cells in the pancreas stop producing insulin and so, the level of insulin in the bloodstream drops quickly. Formerly known as juvenile, early-onset or insulin dependent, this disease can develop rapidly and is treated with insulin injections and diet.

Type 2 Diabetes

On the other hand, the symptoms of type 2 diabetes develop over a longer period of time because the body is still producing insulin. Unlike type 1 diabetes where the body stops producing insulin, a person with type 2 diabetes does not make enough insulin or cannot use insulin properly otherwise known as insulin resistance. This means that you need more insulin than normal to keep blood glucose levels down.

What is Pre Diabetes?

The most common form of blood sugar, it is estimated that between 1 and 3 out of every 4 people with pre-diabetes will develop type 2 diabetes within 10 years.

The World Health Organization (WHO) defines a pre diabetic as someone who has:

  • A fasting blood glucose of less than 7 mmol/L; AND
  • An HbA1c blood test level of 42-47 mmol/mol (6.0-6.5%).

Pre diabetes develops for the same reasons as type 2 diabetes i.e. your body is not producing enough insulin or it is not using insulin properly.

Some risk factors include:

  • Being overweight or obese
  • Having a family history of diabetes i.e. a close relative
  • A sedentary lifestyle
  • High blood pressure and high cholesterol
  • PCOS, a hormonal disorder in women
  • A history of gestational diabetes

Symptoms Check

Pre-diabetics typically have no symptoms however a blood test can reveal that you have a raised blood sugar level. If you have high blood pressure, high cholesterol and/or a history of heart attack or stroke, your doctor will also likely recommend a blood test to check your glucose levels.

Can it be treated?

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Knowing whether or not you have pre diabetes is valuable information because the progression to Type 2 diabetes can be treated and prevented. Regular blood tests occurring at least once a year are necessary to monitor blood glucose levels in addition to lifestyle changes.

A healthy diet consisting of whole plant foods is absolutely necessary. Staples including brown rice, lentils, beans, legumes, green vegetables like spinach, broccoli and peas, root vegetables like potatoes and yams and fruits like apples, mangos, pears, apricots, blueberries, bananas and melon are incredibly beneficial foods that should be consumed daily and abundantly.  

Clinical researcher and author Dr. Neal Barnard is treating and even reversing type 2 diabetes with a high fiber, low fat plant-based diet. In fact, a study published in the August 2006 issue of Diabetes Care found Dr. Barnard’s treatment to be 3 times more effective than the American Diabetes Association’s guidelines on how to control blood sugar.

In addition to a diet rich in whole plant foods, natural supplements are worth considering.

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Fenugreek, for example, 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. FENFURO is a group of furostanolic saponins derived from fenugreek seeds by innovative and patented process. It 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 has been clinically evaluated for safety and efficacy.  For more information visit www.fenfuro.com.

With regular exercise, healthy diet and natural supplements, the onset of type 2 diabetes can be prevented.

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The Pre-Diabetes Diet Everyone Needs

Expect to see the number of people with blood sugar rise dramatically over the next 40 years. If nothing changes, according to the Centers for Disease Control and Prevention, as many as one in three adults could have the disease by 2050.

Prediabetes-Diet-Plan

Currently 26 million American adults are living with blood sugar. Another 79 million are estimated to have Pre-diabetes, a condition marked by above-normal blood sugar levels that aren’t high enough to be diagnosed as type 2 diabetes. If there’s a silver lining to these alarming statistics, it’s that there’s plenty you can do to prevent the disease or slow the progression, including eating a balanced diet.

Everyone can benefit from a healthy eating plan aimed at containing Pre-diabetes, regardless of whether you’re at high risk for developing type 2 diabetes.

7 Golden Rules of Healthy Eating

Here are seven sound diet principles that can keep your blood sugars from creeping upward, among other health benefits.
1. Skip the sugary drinks. No sweet tea. No juice. No soda. No sweetened lemonade. No mocha latte coffee creations.Sugary drinks provide nothing more than empty calories, and they won’t help you feel full. “All the sugary drinks out there are a real risk factor for obesity,” she stresses.
2. Pull back on portions. You still can eat many of the foods you like, just have smaller amounts of them, Borcik says, adding that this is especially true for starchy foods like white rice, white potatoes, and pasta. Cut out high-calorie, junky snacks, and save your decadent desserts for special occasions. Remember that even healthy foods can lead to weight gain if you eat too much of them, and being overweight is a primary risk factor for type 2 diabetes.
3. Fill up on fiber. Eat plenty of high-fiber foods, including fresh vegetables and fruits, beans, and whole grains. Fiber helps you feel fuller longer and can help you eat less to avoid weight gain. At least half your plate should be fruits and vegetables that have been steamed or sauteed in healthy fats. Those veggies can be fresh, frozen, or canned. Just skip the canned vegetables with added salt.
4. Be choosy about fats. Your diet should have some fat, but opt for the healthiest sources: olive and vegetable oils, nuts, seeds, and avocado. Buy low-fat or fat-free dairy products such as reduced-fat cheeses, non-fat or low-fat yogurt, and skim milk.
5. Drink alcohol only in moderation. Men should have no more than two drinks a day, women no more than one. A drink is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of distilled spirits of 80-proof.
6. Choose lean meats. To easily identify lean red meats, look for cuts that have the word “round” or “loin” in their name, such as top round or pork loin. Even with these better-for-you picks, trim all visible fat. Opt for white-meat chicken or turkey without the skin. Adding fish to your diet two to three times a week is part of a diet that can help diabetes prevention. Bake, broil, roast, grill, or sauté rather than fry to keep it lean, Borcik says.
7. Stay hydrated. Drink plenty of water. People often mistake thirst for hunger, which can lead to overeating and weight gain. “Staying hydrated helps to lower your blood sugar, which you should do anyway.”

Diet and Exercise Go Hand-in-Hand

A Pre-diabetes regimen also includes regular exercise, both aerobics and strength training, to help you get to a healthy weight and maintain it once you’re there, says Borcik. Plan for at least 30 minutes a day. She suggests also sneaking exercise into your daily activities by parking farther from the entrance at the mall or your office building, using the stairs instead of elevators, and taking a walk around your workplace at lunchtime.

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The best way to prevent type 2 diabetes is to follow a healthy lifestyle, which includes making smart food choices. If your diet could use a makeover, don’t wait until your doctor sounds the Pre-diabetes alarm to make changes. An ounce of prevention is worth a pound of cure.

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.

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Avoiding Diabetes Complications

 

Having diabetes can result in many other complications, such as damage to the heart, nerves, kidneys, feet, eyes, and skin. If you have diabetes, you may also have a greater risk for osteoporosis, cancer, and Alzheimer’s disease. Some diabetes complications are related to high or low blood sugar, while others are related to how long you’ve had diabetes.

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The best way to mange diabetes and avoid diabetes complications is by monitoring your blood sugar (glucose) with a glucose meter, or glucometer. “How often you monitor your blood sugar depends on the type of diabetes you have, if you have diabetes complications, and your diabetes treatment plan,” says Amber Taylor, MD, director of diabetes at The Center for Endocrinology of Mercy Hospital in Baltimore, Md.

Tips for Controlling Blood Sugar:

Spyros G.E. Mezitis, MD, PhD, an endocrinologist at Lenox Hill Hospital in New York City, suggests these general healthy-lifestyle habits to make controlling your blood sugar easier:

  • Follow a low-fat, low-salt, low-carbohydrate diet.
  • Pass on processed foods.
  • Do at least 20 minutes of aerobic exercise three times a week.
  • Lose weight if you’re overweight.
  • Take any and all diabetes medications as prescribed.
  • Following your insulin treatment program if needed.

Work with your own doctor to personalize this general plan. “There isn’t a best way to manage diabetes — the right approach is the one that works well for you,” Dr. Taylor says. “Different people with diabetes need different treatment plans, and test results are used to watch for and prevent complications.”

There are many diabetes testing and management tools available to you for monitoring your blood sugar, such as glucometers, insulin pumps, and continuous glucose monitors.

At your doctor’s office, the A1C test is an important way to measure your average blood sugar control for the prior three months and gauge how good of a job you’re doing at home. “The A1C target for most people with diabetes is less than 7 percent, which is the lowest risk for complications from high blood sugar,” she says. “Some people, especially younger adults with diabetes, may have an even lower target to help prevent diabetes complications long-term.”

Use Supplement for Diabetes: FENFURO Regular intake of FENFURO can control the blood sugar level effectively. 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.

The A1C test is used to:

  • Confirm that other test results, such as those done by self-testing or by your doctor, are accurate.
  • Show if your treatment plan is successful.
  • Demonstrate that healthy diet and lifestyle choices can make a difference in controlling your diabetes.

Minimizing Diabetes Complications

The best way to prevent most diabetes complications is to see your doctor regularly, and to call him or her if you experience any new symptoms. Some complications, such as eye disorders, occur after many years of diabetes. “It’s essential for people with diabetes to see an eye doctor at least once a year whether they have vision problems or not,” Taylor says. “Ophthalmologists have tools to stop retinopathy and other diabetes-related eye disorders from progressing.”

Good self-care and immediate medical attention for even a minor symptom are important steps in preventing the type of amputations often associated with diabetes. For instance, you can help to prevent foot ulcers by practicing good foot care, but if an ulcer develops, see your doctor or a foot specialist (podiatrist) immediately. “Even small foot ulcers can grow quickly and lead to infection,” Taylor advises. Infections that resist treatment can lead to amputation to stop their spread.

Follow these other steps to better manage your diabetes and help prevent diabetes complications:

  • Make and keep all needed check-ups with your doctors and others on your diabetes team.
  • Keep your immunizations up to date to fight infections.
  • Wear a diabetes tag or ID bracelet so that you receive the right treatment in an emergency.
  • Have a glucagon kit handy in case of a low blood sugar emergency.
  • Take care of your skin and your feet to prevent infections, and check for any signs of infection every day.

“It’s easy to become overwhelmed with all this information,” Taylor says. “When you think of questions, write them down and bring them to your next visit with your doctor. Advocate for yourself, know your targets for A1C, blood pressure, cholesterol, and weight, and do everything in your power to achieve these goals.”

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

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High Blood Glucose and obesity link to cancer

 

High Blood Glucose and obesity could make a person more vulnerable to certain types of cancers and the best way to counter the threat is to lose weight.

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High Blood Glucose and obesity are associated with some types of cancer, including that of the pancreas, oesophagus and breast,” said Edwin Gale, professor of diabetes at Bristol University‘s division of medicine. He was in the city to address a conference organised byIntegrated Diabetes and Endocrinology Academy (Idea), Calcutta.

According to Gale, 40 per cent of these cancers are apparently caused by diabetes and obesity. “High Blood Glucose and obesity leads to insulin resistance in the body that can cause cancer. The best way to reduce insulin resistance is weight loss,” he explained.

Insulin resistance is a physiological condition, where the hormone becomes less effective at lowering blood sugar. This might increase blood glucose levels above the normal range.

“Fat and muscle cells need insulin to absorb glucose. But in an insulin-resistant person, these cells fail to adequately respond to circulate insulin and blood glucose levels rise,” said a doctor at the conference.

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Gale said an obese person had a 30 per cent increased risk of suffering from cancer than a person of normal weight.

“An obese person with blood sugar is more susceptible to cancer than one who is not. Although the exact cause is not clear, the common belief is that insulin resistance is the underlying factor,” said Subhankar Chowdhury, head of endocrinology, SSKM Hospital.

Use Supplement for blood sugar

FENFURO Regular intake of FENFURO can control the blood sugar level effectively. 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.

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