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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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Signs of High and Low Blood Sugar

 

One of the challenges of managing diabetes is maintaining consistent blood sugar (glucose) levels. Even with diligence, some situations can cause high blood sugar, or hyperglycemia, while others can bring on low blood sugar, or hypoglycemia.

There’s a lot you can do to minimize blood sugar ups and downs andavoid complications by monitoring your blood sugar levels with a glucose meter. How often to test depends on many factors, including the type of diabetes you have, any complications you’re facing, and the therapies you’re on, says Amber Taylor, MD, director of diabetes at the Center for Endocrinology at Mercy Hospital in Baltimore, Md.

It’s also important to know the signs of both high blood sugar and low blood sugar, and what actions to take to bring blood sugar levels back to a desired range.

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About High Blood Sugar (Hyperglycemia)

Common signs of high blood sugar include frequent urination, feeling thirsty, eating more food but not gaining as much weight as usual, fatigue, dry or itchy skin, and more frequent infections, says Athena Philis-Tsimikas, MD of the Scripps Whittier Diabetes Institute in La Jolla, Calif.

A blood sugar reading above 180 milligrams per deciliter (mg/dL) is considered above normal and can bring on these symptoms, although it’s possible to have high blood sugar without any symptoms, Dr. Philis-Tsimikas says. A reading above 300 mg/dL is considered severe. If your blood sugar is above 250 mg/dL for two days, Philis-Tsimikas advises informing your doctor and asking for specific recommendations for treatment. Having blood sugar levels above 300 mg/dL for more than a week can lead to more severe symptoms such as nausea, drowsiness, blurred vision, confusion, and dizziness, especially when standing up from a sitting or lying position.

Ways to treat high blood sugar include:

  • Taking your prescribed medications as directed
  • Eating fewer carbohydrates with your meals
  • Exercising regularly with your doctor’s guidance

About Low Blood Sugar (Hypoglycemia)

When your blood sugar drops rapidly or when the reading falls between 50 to 70 mg/dL if you take medications for diabetes, Philis-Tsimikas says you may experience early symptoms of low blood sugar such as shaking, sweating, rapid heartbeat, headache, hunger, weakness, fatigue, impaired vision, anxiety, irritability, and dizziness.

Blood sugar values that drop below 50 mg/dL are considered severe and can lead to more significant and dangerous symptoms such as difficulty concentrating, confusion, loss of consciousness, and seizures. If you experience more than two blood sugar readings below 50 mg/dL in a week, notify your doctor and go over your treatment plan.

To treat blood sugar below 70 mg/dL, Philis-Tsimikas recommends ONE of these options:

  • Drink one-half to one cup of juice, skim milk, or regular soda OR
  • Chew five to six hard candies OR
  • Take four glucose tablets OR
  • Swallow one tube of glucose gel

Then, check your blood sugar in 15 minutes. If it’s still below 70 mg/dL, eat more sugar. If your symptoms don’t stop, call your doctor or seek medical attention. If your blood sugar returns to normal, be sure to eat at your next scheduled meal or snack.

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

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Diabetes and Foot Care

It is predicted that by 2030 diabetes mellitus may afflict up to 79.4 million individuals in India. Diabetes is fast gaining the status of a potential epidemic in India with more than 62 million diabetic individuals currently diagnosed with the disease. Diabetes can be responsible for many health complications in patients, like kidney damage, nerve damage, stroke, heart attack or loss of vision. But what puts a patient in hospital most often is a foot infection or diabetic foot. (Diabetes and its complications)

 Image 1                                                Image 2                                                                          

The legs have the longest nerves and arteries. For people with long-term blood sugar, high blood glucose causes damage to nerves and blood vessels. With narrowing of arteries, adequate oxygen and nutrients do not reach the nerves in the legs. As a result, legs experience diminished sensation and stability, which makes the feet more vulnerable to wounds. The wounds are difficult to heal because blood sugar often causes poor blood circulation in the lower limbs.

Walking barefoot is considered a serious risk factor for diabetic foot ulcers. A 2013 study on daily habits in The Journal of Diabetic Foot Complications shows that the percentage of high-grade foot ulcers was significant in those who walked barefoot or wore ill-fitting shoes. Indians are known to sit cross-legged. Prolonged pressure on feet often leads to nerve damage. Toe rings in Indian women cut off oxygen and blood supply and along with heat and sweat, fungal infection sets in deep inside the foot.

Good blood sugar management and regular foot care help prevent severe foot sores that are difficult to treat and may require amputation. For blood sugar management, regular intake of supplements like FENFURO can be very successful.  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.

fenfuro@

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

 The following are the tips for healthy feet:

Image 4

•Inspect and wash your feet daily: Check your feet once a day for blisters, cuts, cracks, sores, redness, tenderness or swelling. Use a mirror if required. Wash your feet in lukewarm water once a day. Dry them gently, especially between the toes. 

•Don’t remove calluses or other foot lesions yourself:  To avoid injury to your skin, don’t use a nail file, nail clipper or scissors on calluses, corns, bunions or warts. See your doctor or foot specialist (podiatrist) for removal of any of these lesions.

•Trim your toenails carefully: Trim your nails straight across. Carefully file sharp ends

•Don’t go barefoot: To prevent injury to your feet, don’t go barefoot, even around the house.

•Wear clean, dry socks and shoes that fit properly:  Wear socks made of fibers such as cotton. Avoid socks with tight elastic bands that reduce circulation. Always buy comfortable shoes that provide support and cushioning for the heel, arch and ball of the foot. 

•Schedule regular foot checkups.  Visit a podiatrist for regular foot checkups and reduction of early signs of nerve damage, poor circulation or other foot problems. 

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

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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.

Image 3

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

Image 8

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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Diabetes and Depression

According to NICE, people who are diagnosed with a chronic physical health problem such as diabetes are 3 times more likely to be diagnosed with depression than people without it.

Depression can have a serious impact on a person’s wellbeing and their ability and motivation to self-manage their condition.

Depression is the most common psychiatric disorder witnessed in the blood sugar community.

People with blood sugar suffering from depression are at greater risk of suffering from an episode of diabetic burnout which collectively can have adverse effects on physical health and potentially instigate more long term complications both to do with diabetes and independent from the condition.

Diabetes-and-Depression 

What exactly is depression?

Depression is the term given when an individual experiences a number of symptoms including:

  • Persistent sadness or anxiety, a feeling of hollowness
  • An overriding feeling of hopelessness and negativity
  • Feeling helpless and powerless to change your situation
  • Loss of interest in activities or pleasures
  • Lower energy and increased fatigue
  • Insomnia, oversleeping, awakening early in the morning
  • Concentration problems, memory problems and indecisiveness
  • Dwelling on death or suicide
  • Restlessness
  • Weight change and decreased or increased appetite

A diagnosis of depression is made if many of these symptoms are present, continuously, for a minimum of two weeks.

For people with blood sugar, dealing with a lifelong condition and managing the risk of complications can seem like an overwhelming task, particularly for newly diagnosed patients.

Many diabetics struggle to cope with the requirements, feeling overwhelmed and unmotivated.

If diabetes is not faced with an attitude of perseverance and defiance, often depression will prevail.

Depression is the perception of life situations as undesirable. Often, when individuals are faced with adverse events or conditions, they spend huge amounts of effort trying to escape or deny such circumstances.

Avoiding unpleasantness and expending energy trying to minimize discomfort can cause symptoms of depression.

The vicious cycle of depression

cognitive-behavioral-therapy-15-638 

How can depression affect diabetes?

Depression can affect a patient’s capacity to deal with their blood sugar, including managing blood glucose levels appropriately.

Research has found that people who suffer from both blood sugar and depression have poorer metabolic and glycemic control which has, in turn, been found to intensify symptoms of depression.

Additionally, anti-depressants have been found to have hypoglycaemic effects causing serious problems for self-management.

It has previously been reported that depressed people with blood sugar are likely to adherence to medication and diet regimens and subsequently have a reduction in quality of life and increased health care expenditure.

Research has shown that by addressing depression, glycemic control is enhanced, mood and quality of life is significantly improved.

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.