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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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Type 2 Diabetes and Sleep Troubles

Sleep is important for everyone, but it’s especially important when your body experiences changing blood sugar levels and other symptoms of type 2 diabetes. “Sleep deprivation causes changes in the effectiveness of the body’s control of appetite, which can lead to weight gain, higher blood sugar, and increased resistance to insulin,” says Richard Castriotta, MD, director of the division of pulmonary, critical care, and sleep medicine at the University of Texas Health Science Center at Houston. 

Although sleep is very important when you have type 2 diabetes, you may find you can’t sleep when you need it most. One explanation for the problem seems to be the connection between diabetes and sleep apnea. Sleep apnea is a condition that’s characterized by periods of halted breathing while you’re asleep, which wakes you up repeatedly throughout the night, leaving you fatigued and not well rested in the morning.

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Both type 2 diabetes and sleep apnea are health concerns that are linked to obesity, so experts have long recognized a connection between the two. However, only recently has it been realized how closely these conditions are tied to one another. “There’s much more interrelation between the two conditions than we thought,” says Betul Hatipoglu, MD, a physician in the Cleveland Clinic’s department of endocrinology, diabetes, and metabolism. “In fact, one may actually contribute to causing the other, and vice versa. Recent studies have shown that sleep apnea actually increases insulin resistance, hunger, and other type 2 diabetes symptoms,” Dr. Hatipoglu says. “Other studies have shown that treating sleep apnea also improves the symptoms of type 2 diabetes.”

Other Sleep Issues You Might Face 

Another problem that disrupts sleep is frequent urination, a common symptom of type 2 diabetes. You can’t sleep if you have to keep getting up to go to the bathroom. Hatipoglu says this problem is usually tied to high blood pressure, which is also common with type 2 diabetes. As your blood pressure goes up throughout the night, the need to urinate increases. “If this occurs more than once a night, we view it as an issue that needs to be treated,” Hatipoglu says.

Having type 2 diabetes may also lead to other disorders that make it harder to sleep. “In addition to sleep apnea, people with type 2 diabetes are at increased risk for restless leg syndrome (RLS) and periodic limb movements in sleep (PLMS), as well as neuropathy and pain-associated sleep disruption,” Dr. Castriotta says. “RLS causes difficulty falling asleep because of strange feelings in the legs beginning in the evening before sleep. PLMS may cause either sleep-maintenance insomnia (difficulty staying asleep) or a feeling of non-refreshing sleep and daytime sleepiness due to slow, rhythmic limb movements during sleep.”

Tips to Get a Good Night’s Sleep

The first step in managing your sleep problems with type 2 diabetes is to see a doctor or a sleep specialist. Sleep apnea is a serious, potentially life-threatening problem that needs medical attention to remedy. Frequent urination and other sleep-depriving issues should also be treated by a medical professional.

In addition to talking to your doctor and seeing a sleep specialist, here are some additional strategies that may help you sleep:

Reduce your caffeine intake: Caffeinated beverages can keep you up at night and increase the urge to urinate throughout the night. If you can’t cut caffeine out entirely, Hatipoglu recommends to at least eliminate your intake in the afternoon and evening.

Curb the use of electronics in the bedroom: Television is a no-no in the bedroom, as it will keep you up when you need to be focusing on resting. Watch TV in another room, and turn it off at least an hour before you want to nod off. Try reading a book or listening to relaxing music instead.

Keep your bedroom cool, dark, and calm: Removing all light from the room, using light-blocking curtains, and outfitting your bed with appropriate bedding helps to create an atmosphere that is conducive to sleep.

Create a regular bedtime schedule: Hatipoglu says you need to train your body to get a good night’s sleep. One of the most important ways you can do this is to create a scheduled bedtime and stick to it as closely as possible each night. You can incorporate things into this routine that get your body ready for bed, such as having a few sips of relaxing chamomile tea, meditating, or doing deep breathing exercises before you close your eyes.

Sleep issues are a troubling side effect of type 2 diabetes that can leave you feeling tired all the time. By taking these steps and working with your medical team, you should be able to have sweet dreams every night.

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.

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Best and Worst Foods for Diabetes

 

When you’ve got diabetes, your food choices matter a lot. Some are better than others. To help you choose the best and worst foods from major food groups, use this guide.

Foods that are in the “worst” group can be occasional treats. In general, however, it will be easier to manage your diabetes if you choose most of your foods from the “best” lists.

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Diabetes and Breads, Grains, and Other Starches

Your body needs carbs but you want to choose wisely. Use this list as a guide.

Best Choices

•         Whole-grain flours, such as whole wheat flour

•         Whole grains, such as brown rice

•         Cereals containing whole-grain ingredients and little added sugar

•         Whole-grain bread

•         Baked sweet or white potato or baked steak fries

•         Whole-grain flour or corn tortillas

•         Corn, popcorn or products made from corn

Worst Choices

•         White flour

•         Processed grains, such as white rice

•         Cereals with little whole grain and lots of sugar

•         White bread

•         French fries

•         Fried white-flour tortillas

Vegetables and Diabetes

Most vegetables contain fiber and are naturally low in fat and sodium (unless they are canned or frozen in sauces). Starchy vegetables, such as potatoes and corn, aren’t included in this category. They are considered part of the breads, grains, and other starches group.

Best Choices: 

•         Fresh vegetables, eaten raw or lightly steamed, roasted, or grilled

•         Plain frozen vegetables, lightly steamed

•         Low sodium or unsalted canned vegetables

•         Lettuces, greens, kale, spinach, arugula 

Worst Choices:

•         Canned vegetables with lots of added sodium

•         Vegetables cooked with lots of added butter, cheese, or sauce

•         Pickles (if you need to limit sodium; otherwise, pickles are okay)

•         Sauerkraut, (same as pickles; limit only if you have high blood pressure)

 Fruits and Diabetes

Fruits have carbohydrates, vitamins, minerals, and fiber. They are naturally low in fat (except for avocados) and sodium. Most fruits have more carbs than do vegetables.

Best Choices:

•         Plain frozen fruit or fruit canned in fruit juice

•         Fresh fruit

•         Sugar-free or low-sugar jam or preserves

•         No-sugar-added apple sauce

•         100% fruit juice                                               

Worst Choices:

•         Canned fruit with heavy sugar syrup

•         Chewy fruit rolls

•         Regular jam, jelly, and preserves (unless portion is kept small)

•         Sweetened apple sauce

•         Fruit punch, fruit drinks, fruit juice drinks

 Diabetes and Meat and Other Protein

This category includes beef, chicken, fish, pork, turkey, seafood, beans, cheese, eggs, nuts, and tofu.

Best Choices:

•         Baked, broiled, grilled, or stewed meats

•         Lower-fat cuts of meat, such as top sirloin

•         Turkey bacon

•         Low-fat cheeses

•         Skinless breast of chicken or turkey

•         Baked, broiled, steamed, or grilled fish

•         Tofu lightly sautéed, steamed, or cooked in soup

•         Beans

•         Eggs

•         Nuts

Worst Choices:

•         Fried meats

•         Higher-fat cuts of meat, such as ribs

•         Pork bacon

•         Regular cheeses

•         Poultry with skin

•         Fried fish

•         Fried tofu

•         Beans prepared with lard

Dairy and Diabetes

This group includes milk and foods made from milk, such as yogurt and sour cream. Milk has a lot of protein and minerals, including calcium.

Best Choices:

•         1% or skim milk

•         Low-fat yogurt

•         Low-fat cottage cheese

•         Low-fat or nonfat sour cream

•         Frozen low-fat, low-carb yogurt

•         Nonfat half-and-half

Worst Choices:

•         Whole milk

•         Regular yogurt

•         Regular cottage cheese

•         Regular sour cream

•         Regular ice cream

•         Regular half-and-half

Diabetes and Fats, Oils, and Sweets

Eating too much of these kinds of foods can lead to weight gain, making it harder to keep diabetes under control.

Best Choices:

•         Baked snacks, such as baked potato chips, baked corn chips, puffed rice, or corn snacks, in small portions

•         Vegetable oils, non-hydrogenated butter spreads, margarine

•         Reduced-fat mayonnaise

•         Light salad dressings

•         Air-popped or calorie-controlled popcorn

Worst Choices:

•         Snacks fried in fat, such as potato chips, corn chips, pork rinds

•         Lard, hydrogenated vegetable shortening, butter

•         Regular mayonnaise

•         Regular salad dressings

•         Butter-flavored stove-top popcorn

Beverages and Diabetes

Some drinks have lots of carbs but very little nutrition. Others may be a better choice most of the time.

Best Choices:

•         Water, unflavored or flavored sparkling water

•         Light beer, small amounts of wine or non-fruity mixed drinks

•         Unsweetened tea (add a slice of lemon)

•         Coffee, black or with added low-fat milk and sugar substitute

•         Plain coffee and hot chocolate

•         Sport drinks, in limited quantities

Worst Choices:

•         Regular sodas

•         Regular beer, fruity mixed drinks, dessert wines

•         Sweetened tea

•         Coffee with sugar and cream

•         Flavored coffees and chocolate drinks

•         Energy drinks

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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.

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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.

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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.

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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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Natural treatment of Diabetes

 

Our grandmas have been telling us about the usefulness of certain herbs and spices but it took researches from renowned institutions to establish them as the alternative treatments for Diabetes. We have compiled here a list of natural remedies to control the silent killer- diabetes:

Fenugreek- Fenugreek seeds (Methi Dana) are known for their sugar lowering properties. FENFUROTM is a first of its kind, safe nutraceutical derived from fenugreek seeds through a patented process.  Through its unique scientific process, FENFUROTM 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. FENFUROTM 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. FENFUROTM is the first dual action insulin sensitizer.

A clinical evaluation of FENFUROTM was carried out on a total of 154 Type 2 diabetics for a period of 3 months, to determine it’s 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 FENFUROTM.

Mango leaves- The mango leaves can help reduce the intestinal glucose absorption and proves to be beneficial in diabetes management. 

Fig Leaves- Chewing a few fig leaves on empty stomach is said to bring down the sugar level.

Cinnamon- Who can resist the aroma of this rich spice? But apart from a taste and aroma enhancer, it reduces blood sugar level too.

Bitter Gourd- As the name suggests it is bitter but it proves to be the sweetest as it really helps control the diabetes. 

Neem- Neem, a tree that is believed to have anti-bacterial and anti-fungal property, has anti-diabetic properties as well. 

Holy Basil- No wonder our grandma always told us to eat tulsi leaves or have tulsi leaves tea. This is truly a miracle plant with many health benefits. 

Jamun- Jamun helps control the blood sugar. But be careful, too much of it can cause sore throat too.

Caution: Please make sure you consume organic products as the increased use of pesticides has made it unsafe to consume these natural products.

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