Diabetes Guidelines

In today’s world, it seems that almost any topic is open for debate. While I was gathering facts for this article, I was quite surprised to find some of the issues I thought were settled are actually still being openly discussed.

If you base what you do on inaccurate information, you might be unpleasantly surprised by the consequences. Make sure you get the whole Sugar Free story from informed sources.

Perhaps your weakness is pistachio ice cream, brownies with nuts, or pancakes covered with syrup. Many of us crave sweets—sometimes throughout the day. Some of us may even be addicted to sugar. The problem is, large helpings of sugary foods can lead to substantial weight gain. But eating sugar-free does not necessarily guarantee weight loss.

A food may be sugar-free and still contain a great amount of calories and carbohydrates. You may be thinking that you can lose weight simply by using sugar substitutes. However, this is a naïve way of thinking, since some sugar substitutes increase your intake of both calories and carbs. For instance, the sugar substitute fructose adds calories and carbs to your daily diet. These types of sugar substitutes are often called sugar alcohols or polyols.

It should be stated that polyols can be highly beneficial. For instance, while they offer a sugary taste, they have fewer calories than sugar. They are particularly advantageous for people with diabetes and, unlike sugar, they do not cause tooth decay. You can find polyols in a number of baked goods and candies. Interestingly enough, they can even be found in mouthwashes.

Given the fact that polyols are low-cal, they can be helpful in a weight management program. Fortunately, there are a number of desserts that are both sugar-free and delicious. For instance, sugar-free lemon cheesecake is a healthy alternative to the typical high-calorie cheesecake. You can also make butterscotch and pumpkin pudding by using sugar-free butterscotch pudding mix.

A sugar-free version of Old-Fashioned Applesauce cake is made with reduced calorie margarine, Splenda, and unsweetened applesauce, while light chocolate peanut butter pie can be created with sugar-free chocolate pudding and fat-free whipped dessert topping. Meanwhile, sugar-free strawberry pie can be made with diet Sprite or 7-Up and sugar-free strawberry gelatin.

The American Diabetes Association heartily endorses sugar-free diets. The organization also recommends consuming at least five servings of fruits and vegetables each day; a half-dozen servings of breads and cereals; no more than three servings of low-fat milk or yogurt, lean meats; and a limited amount of sweets and desserts.

When you dine in restaurants, the Diabetes Association recommends that you save half your meal for the next day in order to avoid calorie overload. You might also consider sharing a meal or dessert with someone else. Also, you might want to substitute a salad for potatoes. In addition, you should ask that your dressing or sauce be served on the side in order to attempt to control portions.

It is interesting to note that a food can be labeled “no sugar added” and still contain sugar. The label refers to the fact that no table sugar is involved; however, the food could still have its share of natural sugars. As a result, no-sugar-added food could have as many calories as other types of food. In addition, the Diabetes Association cautions that eating protein alone will not enhance your muscles. Rather, you need exercise to strengthen your muscles.

While eating sugar-free food can be beneficial, the Diabetes Association offers other tips for attempting to lose weight and keep it off. In general, the guidelines call for reducing calories and fat, exercising each day, not skipping breakfast, and maintaining a food log which indicates everything you have consumed on a daily basis.
Lessening your dependence on sugar can be an important first step toward improving your diet. But, as we have seen, simply eating sugar-free will not guarantee that you will achieve the weight loss you’re looking for. Weight reduction takes a great deal of discipline and patience. You did not gain all of your extra weight in a single day, so you can’t expect to be rid of it instantaneously.

Before cutting out sugar entirely from your diet, it’s best to check with your doctor. He or she can also give you some effective weight management techniques. It’s always best to have a medical doctor overseeing your weight loss plan. That can help to ensure that you maintain good health during the weight reduction process. With dedication and hard work, you can achieve your weight loss goals. You yourself may be astounded at your progress, once you begin a sensible diet plan.

This article’s coverage of the information is as complete as it can be today. But you should always leave open the possibility that future research could uncover new facts.

J. Brian Keith
http://www.articlesbase.com/health-articles/sugar-free-dos-and-donts-and-more-25790.html

Carbs are a part of nearly every dieter’s vocabulary. A number of diets are famous for fighting carb consumption. But you should know that not every carbohydrate is created alike. While it is true that you can lose weight by cutting carbs, carbs are also necessary for a good diet.

To begin with, we should define our terms. Carbs are derived from a number of different sources. They are present in bread, pasta, fruits, and vegetables. There are also a number of different types of carbs. For instance, carbs come in the form of sugars, starches, and fiber.

For the most part, the digestive system divides carbs into sugar molecules which can be taken into the bloodstream. The majority of carbs are transformed into glucose or blood sugar. In this way, carbs provide energy for our bodies.Those who lack sufficient carbs in their diet may suffer from fatigue.

Carbs can be filled with nutrients. For instance, fruit contains vitamins A and C, fiber, and folate. Vegetables are also a good vitamin and fiber source; in fact, they usually contain a greater variety of minerals than other foods do. Whole grains can provide you with fiber, protein, and B vitamins. Legumes can provide you with protein, iron, and potassium.

But carbs can also be potentially bad for your health. For instance, cookies, potato chips, and soft drinks also contain carbs in the form of sugar and flour. You should know that refined carbohydrates have been linked with diabetes and heart diseases, making these carbs a dangerous choice.

There are a number of good reasons to ban these carbs from your diet. For instance, they are extremely high in calories and offer little in the way of nutrients. Because they contain no fiber, they will not keep you satiated. In fact, such carbs offer you zero nutrients, but plenty of fat.

Therefore, you should avoid processed grains and sugars. Instead, eat whole grains, fruits, and vegetables to maximize your nutritional intake.Instead of eliminating carbs completely from your diet, simply ban those that increase the size of your waistline.

There is another way to think about carbs. You can generally divide them into two categories: simple and complex. A simple carb, such as sugar, promotes weight gain. As a result, you should select low-sugar foods, especially low-sugar beverages. In contrast, complex carbohydrates promote weight loss.

Health experts recommend that dieters consume between 55 and 65 percent of their calories from these types of carbs. Such carbs include fruits and vegetables and a number of other natural foods.

But it isn’t enough to simply eat fruits and vegetables. You also need to avoid fattening sauces and condiments such as mayonnaise and butter. By adding butter to your broccoli or mayonnaise to your potatoes, you can raise the calorie amount exponentially, sabotaging your diet.

The U.S. Department of Agriculture promotes a food pyramid that recommends as many as eleven servings of bread, pasta, and cereal. However, a number of dieticians are suggesting that Americans should cut the carbs – period. In one poll, 81 percent of the respondents said they were abiding by a low-carb diet.

It is interesting to point out that neither the American Heart Association nor the American Diabetes Association believes that the glycemic index should be considered when following a weight loss plan. While the Diabetes Association concedes that various foods offer different glycemic responses, the Association’s leaders believe the most critical factor is the number of carbs rather than the form of the carbs consumed.

Granted, dietary information about carbs can be confusing. However, a number of dieticians say that, while you might not want to cut carbs out of your diet entirely, you should eat carbs only in moderation.

Health experts also say that you should limit your carb intake to good carbs and pass up the bad ones.By following such a plan, you should have energy – but you shouldn’t pack on the weight. It may be difficult at first to follow such a diet plan, since many of us are conditioned to eat bad carbs in order to elevate our moods. In time, however, you may find that you enjoy the fruits and vegetables you’re eating, and you may not even miss those tortilla chips.

Paul Hata
http://www.articlesbase.com/nutrition-articles/carbs-the-good-the-bad-and-the-healthy-523043.html

To compare the role of glibenclamide and pioglitazone drugs in type 11 non- insulin dependent diabetes mellitus patients.

Introduction:-

Diabetes comes from the greek word for ‘SIPHON” which one is the first term and implies for a lot of urine is made .The trm “mellitus” comes from a laton word, “met” which means “honey” and was used because the urine was sweet (Wheeler,2004)

Diabetic ketaocidosis is one of life threatening condition requiring some data hospitalization and treatment. Recognition of this condition is of almost importance, because even small delays can have an impact on survival (Nattrass, 2006). Hypoglycaemia are involved in insulin induced episodes in individuals with diabetes. Probably the major factor prescribing, insulin treated patient from achieving the glucose targets needed to prevent diabetic complications. The incidence of hypoglycaemia reflects the inadequancy of current mathods of insulin delievery which lead ot inappropriately high insulin concentration, particularly some persons after eating more foods at night onset of blindness and also a major risk factor heart disease and stroke

(Heller, 2003).

TYPES OF DIABETE MELLITUS

Type II diabetes is a complex metabolic disorder associated with, b -cells dysfunction and with varying degree of insulin resistance primary pathogenic factors leading insulin resistance leading to type 2 diabetes and decreased insulin, secretion which arise from abnormalities with in liver, skeletal muscle and pancreatic b -cells (charles & clark, 1996).

GESTATIONAL DIABETUS MELLITUS

SECONDARY DIABETUS MELLITUS:

Secondary diabetes is due to disease of the pancreatic and endocrime system, genetic disorders, or exposure to chemical agents.

Type – I diabetes formerly known as insluin dependent diabetes mellitus (IDDM), is characterized by the destruction of the pancreatic beta cells that produces inslulin

Type – I diabetes formerly known as insulin dependent diabetes(IDDM),is characterized by the destruction of pancreatic beta cells that produces insulin.Type-1 diabetes occures most often in children and young adults but it can occures at any age.(Anderson et al 2007).

Type-11 diabetes is not straight uprward. A pancreas that does not produce enough insulin. Liver that release too much glucose,muscle cells that do not readily take in glucose.(Carren 2008)

Many genetic factors are involved in the development of diabetes.Because of new genetic methodology researchers are closers to identifying all of the cadidate gene for both non –insulin dependent and insulin dependent diabetes(Bernhard,1995).

Woman who had gestation diabetes are more likely to develop Type-11diabetes themselves.Pergnant women with diabetes are another disadvantaged group.They need much more intensive antenatal care and close monitoring of blood sugar,blood pressure and weight.(jawed2006)

Over weight children the progression of child obesity into adulthood is associated with early develop of complications, including IgpG2 diabetes and cardiovascular disease.Type diabetes is the most common clinical form of diabetes accountingforabout 90% of all cases,it is currently undergoing world wide epidemic. Type 11diabetes mellitus is caused by body’s infective use of insulin, it is often results from excess body weight and physical inactivity(WHO 2007).

PREVALACES& IINCIDENCE

:

Diabetes mellitus increases with aging, in 200 the prevalance of diabetes,it was estimated to be 0.19% people<20 years old and 8.6% in people>20 years old.There is considered geographic variation in the incidence of both type-1 and type-11 diabetes mellitus.Scavandinvian has the highest incidence of type-1 diabetes mellitus e.g in Finland, the incidence is 35/100,000 per year the pacific rim has a much lower rate in japan and china the incidence is 1 to 3/100,00 per year of type-1 diabetes mellitus, Northern Europe and the United States share an intermediate rate (8to17/100,000 per year).The prevalence of type 11 diabeties mellitus is highest in certain pacific island, intermediate in countries such as India and the United States, and relatively low in Russia and China.This variability is likely due to genetic, beharioral and enviromental factors(Power 2005).Diabettes mellitus prevalance also arises among different ethic population within a given countries it is common inall ethnic groups its prevalance increased with age and more than 5% of individuals of more than 65 years of age have diabetes mellitus (David Owerback 1988).The World wide prevalence of diabetes mellitus has risen dramatically over past two decades.The prevalence of type11 diabettes mellitus is expected, type 11 diabetes mellitus is more prevalent among Hispanies Native Americas,African,American,and Asians, pacific Islanders than in non- Hispanic whites,the incidence is essentially equal in woman and men in all populations. Type 11 diabetes is becoming increasingly common because people are living longer,and the prevalence of diabetes increases with age it is also seen more frequently now than before in young people, in association with the rising prevalenceof childhood obesity although type11 diabetes still countries with the estimated nubers of cases of diabetes in 2000and 2030.

Rank Country

2000 Individuals country with diabetes (milloins)

Country

2030 Individuals with diabtes (Million)

India

31.7

India

79.47

China

20.8

China

42.3

USA

17.7

USA

30.3

Indonesia

8.4

Indonesia

21.3

Japan

6.8

Pakistan

13.9

Pakistan

5.2

Brazil

11.3

Russian federation

4.6

Bangladesh

11.1

Brazil

4.6

Japan

8.9

Italy

4.3

Philippines

7.8

Bangladesh

3.2

Egypt

6.7

(Wareham& FOROUHI 2OO6)

DRUG TREATMENT OF DIABETIES MELLITUS

:

Biguanides lower blood glucose, they increase glucose uptake and utilize in skeletal muscle there by reducing insulin resistance, and reduce hepatic glucose production (gluconeogenesis).Lower blood glucose, addionally reduces low denisity and very low denisity lipoproteins (LDL and VLDL) respectively. Metformin has a half life of about 3 hours and is excreted unchanged in the urine.Clinically metformin used in type 2 diabetic who are obese and who fail treatment with diet alone.Adverse effects are produced dose related gastrointestinal disturbances e.g anorexia,diarrhoea,nausea,lactic acidosis rare but potentially fatal toxic effect.(Dale,2003).

Improving insulin sensitivity by activating certain genes involved in fat synthesis and carbohydrate metabolism Rosigilitazone and Piogiltazone are currently approved.Thiazolidinediones. Thiazolidinediones do not cause hypoglycemia when used alone,although they are usually taken in combination with sulfonylurease.

In some incouraging studies, thaiazolidiniones have produced very favorable effects on the heart, including reducing blood pressure and improving triglycerides and cholestrol levels including increasing HDL level,the good cholestrol. They may also block a molecule called 11 Best HSK that may play a significant role in metabolic syndrome,as well as diabetes type11. One study also sugessted that Rosiglitazone may even improve beta cells functions and so help prevent progression of diabetes.Anemia, weight gain, increased risk of fluid buildup, may worson heart failure.Troglitazone,was withdrawn after a few reports of heart failure.Liver failure abd death.Current Thiazoldinediones don not appear to pose the same effects on the liver although there have been a few reports of liver injury.

In patients with dietry failur the choice of a sulfonylurea agent or insulin therapy has been controversial and empric in favour of insulin therapy are the studies, who reported marked improvement post receptor diagnostic after intensive short term therapy in untreated type 2 diabetes mellitus (Scarlett et al,1984) Sulfonylureas further classified into two groups or generations based on their potency,duration,drug interaction,side effects profiles. Sulfonylureas enhance insulin action in cells in culture and stimulate the synthesis of glucose transporters (Jacobes et al 1998).A sulfonylurea drug should normally be the insulin secretagogue of choice, NICE (National Institute for Clinical Excellence) also recommends that a generic ,drug should be perscribed (Scsade et al1998).

RESEARCH DESIGN AND MATERIAL AND METHODS:

This study was conducted in the deprtment of Pharmacololgy and Therapeutics,Basic Medical Science Institute,Jinnah,Postgraduate Medical Centre,karachi under kind supervision od DRr:GhulamRsool Mashori,Associate Professoer and Head OF Department Of Pharmacology and Therapeutics in colloboration with Medical Outpatient Department Unit111 and Filter Clinic, Medical Department, JPMC,Karachi.

Seventy NIDDM (type-II)diabetic patients were initially enrolled in the study from the filter clinic/ out patient department Medical Unit III ,and diabetic clinic.Out of this 60 diabetic patients were associated in whole period of study, remaining 10 patients were dropped due to poor comlpiance or change in residential place.All the patients were divided in two main groups,groupI and in group II these patients were selected in this study according of inclusion and exclusion criteria.

INCLUSION CRITERIA

:

• Newly diagnose patients of non Insulin Dependent Diabtes Mellitus.
• Diagnsed patients of diabetes also including having no any history medication.
• Having either sex of age between 30 to 60 years.
• Diagnosed patients who were Non Insulin Depedent Diabetes Mellitus who were treated with Pioglitazone.
• Diagnosed patients who were Non Imsulin Depedent Mellitus, who were treated with drug Glibenclamide.

EXCLUSION CRIRERIA

:

• Patients suffering from blood pressure.
• Patients suffering from liver disease.
• Patients suffering from cardiac disease.
• Pregnancies and lactating women.
• Patient suffering from renal disorders.
• Patients having serious complications.

MATERIAL:

1. Lacets.
2. Lancet Hlder(Abbots easy touch TM2 lot 03 Asee).
3. Glucometer(Medisense) optilim one touch(Abbotts).
4. Blood glucose nest trpis (IVD for Invitro diagnostic use (Abbott Labortries,Medisense UK Ltd,Abigngdon,Ox14ITR,Masde in UK). Stored between minimum 30?, (4°-30° C) and Maximum 40°C (39°-86°F).
5. Weight Machine Model No 1101 Lot No.312. TANTIATA.

DRUGS

Tab:Daonil 5 mg (Aventis Pharma)

Drug category:Sulphonylurea.

Generic Name: Glibenclamide.

MFGLIC:No.000007 RegistrationNO.000220

MFG Date:0-06

EXP Date:7-10

Lot NO:B230

Tab:piozer (Hilton Pharm) PvtLTd.

Tab:Poizer 15mg

Drug category:Thaiazolinedione.

Generic Name:Pioglitazone Hydrochloride.

MFG LIC: O.000136 Registration No.03270

MFG Date:3-06

EXP Date:3-o9

Lot No:6287

Tab: Poizer (Hilton Pharma)pvt ltd.

PARAMETERS:

Fasting Blood Sugar (FBS).

Random Blood Sugar (RBS).

Weight.

Key words:Diabetes mellitus,Non-insulin diabetes mellitus,Insulin depedent diabetes mellitus, Daonil,poizer,Insulin.

RESULTS:

Table 1

Weight and Blood Sugar level observed on baseline day 0

In group1 and group11

Group 1

Group 11

Pioglitazone n=27

Glibenclamide n=33

Weight

63.37

+ 2.25

¯

62.7

+ 15.56

¯

Fasting Blood Sugar

172.7

+ 13.32

¯

188.42

+ 12.o5

¯

Random Blood Sugar

285.11

+ 15 .532

¯

284.18

+ 17.07

¯

All Values are expressed in Means± SEM.

FIGURE-1 weight and blood sugar levels observed on baseline (day-o)

In table No shpwing the weight (KG’S) and blood sugar (msg/dl0 levels which is observed on baseline (day-0) in both groups 9group: 1 & group11)

Group: 1 Weight in (Kg’s) mean + SEM) IS 63.37±2.25 Fasting blood sugar 172.7±13.32,and Random

blood sugar 285.11±15.32

Group:11

Weight (KG’s0 (mean +SEM)62.7±1.56 Fasting blood sugar (mg/dl0 188.42±12.05, Random blood sugar is 284.18±17.03.

Figure 2: showing the weight and blood sugar levels observed in base line (day-0) in group: 1 and group 11 weight in 9kg’s) its mean values are 63.37,62.7, Fasting blood sugar in (mg/dl) is 172.71, 188.42 Random blood sugar (mg/dl) is 285.11 &284.18.

TABLE: 2

Peroidic Observation In All Parameters Group1

Goup1(Pioglitazon) n=27

P-value

Day-0

Day-45

Day-90

Day-0to45

Day-45-90

Weight

63.37

±2.25

63.63

±2.26

63.63

±2.23

>0.05

(NS)

>0.05

(NS)

Fasting blood sugar

172.7

±13.32

165.04

±8.98

153.37

±7.59

>0.05

(NS)

0.05

(NS)

Randomblood sugar

285.11

±15.32

279.78

±13.63

255.56

±12.65

>0.05

(NS)

>0.05

(NS)

All values are expressed in Mean±SEM .(NS) Non significant.

Showing the periodic observations in all parameters in group 1 (piogiltazone) (n+27) weight P.value (day 0 to day 45)>0.05 (NS). Fasting blood sugar >0.05 (NS) Random blood sugar >0.05 (NS) P.values day 90 weight >0.05 (N.S), FBS>0.05 (N.S) 7RBS >0.05(N.S) NON SIGNIFICANT

FIGURE:2 Showing the periodic observation in all parameters in group 1 on day0 day 45& day-90.Mean values in weight (Kg) is 63.37,63.26,63.63, fbs (mg/dl) 172.7,165.04,153.37,RBS(mg/dl) 285.11,279.78,255.56.

TABLE NO3

Peroidic Observation in All Parameters Group11

Group 11 (Glibenclamide)

N=33

P-value

Day-0

Day-45

Day-90

Day-0 to 45

Day-45 to 90

Weight

62.7

±1.56

65.64

±2.10

64.55

±1.92

>0.05(NS)

0.05(NS0

Fasting blood sugar

188.42

±12.05

168.45

±10.99

140.06

±5.68

>0.05(NS)

>0.05(S)

Random blood sugar

284.18

±17.03

220.12

±13.39

170.94

±5.80

<0.005 (MS)

0.002(MS0

(s) significant, (MS) moderate significant

All values are expressed in Mean±SEM.

Table No3:

Showing the periodic observation in all parameter in goup:11, Group:11 containing drug (Glibenclamide),no of patients (n=33).It’s P-value on day 0 to day 45 on weight >0.05(NS),FBS>0.05(N.S) RBS<0.005 (MS) <0.01- AND DAY 45 TO DAY 90 WEIGHT >0.05 (NS) FBS (0.05) RBS <0.002(M.S0 moderately significant.

Figure 3:Shwing the periodic observations in all parameters in Group 11 weight 62.7,65.64,64.55,FBS (MG/DL) 188.42,168.45 140.06,RBS(mg/dl) 284.18 220.12, 170.94 (on day-0-day 45 to 90).

DISCUSSION:

In Denmark Beck-Nielsenet al,skillman TG (1981) published studies demonstation that glyburide increased he number of receptors on the monocytes of patients with type 11 diabetes mellitus. Some patients were treated with diet and in cobination of second generation sulfonyureas agents Wie. The numbers of insulin receptors all patients were measured before and after the treatment.Intrvenous glucose test shows the persistent impairent of insulin secretion afterthe starting of drug therapy.However those patient who were on drug Pioglitazone some results were obtained of insulin secretion in the impairment in early drug drug therapy.Clinical observations have suggested that the second generation sulfonylureas may exert their effects by potentiating insulin released by other primary stimulators Insulin secreting drug.

According to the study of WilliamC Dukworth et al(1972), aftr the chronic treatment with sulfonylureas it is well documented that plasma insulin levels were decreased in response to oral glucose load. This apparently occures even though glucose tolerance is improved over pre-treatment, levels,present study clearly support that study.

The result og group 11 correlates with the research conducted by Bonnie &Kimmel (2005) produces the same results as FBS reduces from baseline, and at the end of study,with an overall 23.44%,reduction,while with the results showed at the end of study peroid p-value were (p<0,001).

Similarly Michael Alvarsson et al (2003) conducted a similar type of study and the found and overall changes of change of 22.11% in Fbs and 40.88% in Rbs at the end of trial p-value were (p<0.001).

However a study conducted by (Stone &Brown in (2003) didnot match to our results in the parameter of FBS and observer a reduction of 26.22%.

CONCLUSION:

In the light of study discussion it is obiovus the glibenclamide was more effective,tolerable and safer than pioglitzone in a short duration.Diabetes Mellitus is chronic prolong disease for whole life.Poor community can afford it easily,on base of marketing of this drug in pakistan diabetes patients easily go and purchase economically,in fact ,mostly people buy it from pharmacy without dr’s perscription,because pharmacist and patient both of know about this disease.Just like dispirin as analgesic,it is famous anti-diabetic drug in our states as compared of other anti-diabetic drugs.

REFERNCES:

1. Anderson J,Kendall,Perryman.S etal,”Diet and Diabettes” Diabetes 2006,16(3):17-19-
2. Bui H- Type 1 diabetes in childhood-Medicine 2006,3 ,1-3
3. Bernhard –Diabetes-type 11 diabetes mellitus Diabetes care 1995,19(100:12-17-
4. Clark CM-Oral therapyin type11 diabetes-pharmacological properties and clinical use of current use of currently available agents-Diabetes spectrum 1998,11(4):211-221.
5. Carren M.Types of Diabetes mellitus-Diabettes 2006 10 (3),07-
6. David Owerback NJ-Prevalence in diabetes population-Diabetes 1988,02(6):31-32
7. Dale MM,-Treatment of Diabetes mellitus –pharmacology 20035th edition:287-391.
8. Heller SR –Hypoglycemic in diabetes Ketoacidosis and hypoglycemic-Medicine 2006:34(03):102-110.
9. Jawad F Untraveling the mystry of Diabetes’Diabetes 2006;15(3):13-15.
10. Jacobes D-Insulin-Diabetes 1998;6(3);1160126.
11. Lambert and Bingliy-basic facts-medicine 2006,34(6):3-7.
12. Natters M-Ketoacdosis and hyperglycemia-Medicine 2006;34(3):104-106.
13. Power AC-Epidemiology of type11 diabetes Basic facts of diabetes –Diabetes 2005;1(1)7-9
14. Scarlet Oral therapy in type 11 diabetes sulfonylureas 1984;16(10);3-9.
15. Schade DS et al A placebo controlled randomized study of glimepiride in patients of Diabetes mellitus- Diabetes 19998, 38(7);636-641.
16. Warchman and Forouhi-Epidimology of Diabetes- Diabetes basic facts- Medicine 2006 ;34(2);57-60
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lalaghulamrasool bhurgri

Tight Blood Sugar Control May Put Some Diabetics at Risk
WEDNESDAY, March 2 (HealthDay News) — Intensive blood sugar control doesn’t benefit people with both type 2 diabetes and heart disease — and it may harm them, researchers say.

Read more on BusinessWeek

Men with diabetes face much more several health concerns, that including increased risk of heart attacks and strokes and impotence (not being able to having or keep an erection though).

Above the age of 50 the likelihood of having other difficulties with an erection occurs in an approximately 50-60% of men with the problem of diabetes.  In reality  men over 70, 90% have erectile dysfunction problems so far .

Diagnosed and controlled  diabetes can be effectively managed to minimise its impact on your health and well being. You can  even prevent or delay diabetes complications those like damage to eye sight and nerve damage to the fingers and toes.  However many men do not realise  just they suffer from the disease.  Around one third of the men population with diabetes are not aware of their
illness.

Diabetes Signs and other Symptoms

If you find yourself with any of these following symptoms, it is really important  that you visit your doctor or health practitioner and get tested for diabetes problem:

â?¢  feeling tired often
â?¢  frequent urination (specially at night)
â?¢  being very thirsty most of time
â?¢  weight loss problems
â?¢  blurry eyesight problems
â?¢  recurring skin, other gum, or bladder infections
â?¢  sores that heal comparatively slowly
â?¢  dry, and itchy skin
â?¢  loss of feeling or tingling in that your feet

Type 1 and Type 2 Diabetes

There are few other different kinds of diabetes:

â?¢ Type 1 diabetes is generally first diagnosed in children, teenagers, or young adults.
â?¢ Type 2 diabetes is the other most common form of diabetes. People can even develop it at any age, but it is often diagnosed in the  later life and is in much more common found in men who are over weight and do little exercise.

What is Diabetes?

Most of the food that we eat is turned into glucose (sugar) for our bodies to use for energy production . The pancreas makes insulin that  which helps sugar get right into the cells. When you have diabetes problems then your body either doesnâ??t make enough insulin or just canâ??t use the insulin it does to make. This causes sugar to build up in your blood then. Over the years  high blood sugar leads to other  problems like heart disease, stroke, blindness, kidney disease, nerve problems, gum infections, and amputations problem.

Diabetes-Related Problems in Men

Men with diabetes suffer more from some  other diabetes-related health problems than women. The American Diabetes Association reports that here:
â?¢ In people who develop diabetes before the age of 30 in context  men develop retinopathy (a vision disorder that can lead to  blindness problems ) more quickly than women in either .

â?¢ Having the major symptoms of peripheral vascular disease (pain in the thigh, calf, or buttocks during exercise) is linked to a two- to three-fold increased risk of the coronary heart disease, stroke, or cardiac failure in men with diabetes problems.
â?¢ Amputation rates from diabetes-related problems that are 1.4 to 2.7 times higher in men than women with diabetes.

dr rony
http://www.articlesbase.com/health-articles/diabetes-risk-for-men-722820.html

French bean: French bean is one of the most commonly used vegetables all over the world. There are several varieties, the most widely used being the French bean, is also known as common or kidney bean. Beans are high in carbohydrates and fiber. They should be eaten liberally to keep diabetes under control.

A decoction prepared from the beans is an excellent remedy for diabetes. This decoction is prepared by boiling 60 grams of fresh kidney bean pods, after removing their seeds, in four liters of water on a slow fire for four hours. It is then strained through fine muslin cloth and allowed to stand for eight hours. One glass of this decoction every two hours during the day is recommended. This treatment should be continued for four to eight weeks along with the prescribed diet restrictions. The decoction must be made fresh every day, as it loses it medicinal value after 24 hours.

The juice extracted from French beans is also valuable in controlling diabetes. It stimulates the production of insulin. This juice is generally used in combination with the juice of Brussels sprouts. The patient must, however be on a controlled diet.

Dr. James Anderson of the Human Nutrition Research Center of the US Department of Agriculture insists that the same foods that lower cholesterol and fight heart disease are also excellent for diabetics, who are at high risk of heart disease. This puts foods like beans that are high in soluble fiber in “highly recommended” category. Dr. Anderson quotes confirm that high fiber foods significantly reduce blood sugar along with cholesterol.

Lettuce: Lettuce belongs to that group of vegetables that contain three percent or less of carbohydrates. It is among the important foods that can be prescribed for diabetes. Diabetics can use it freely.

Onion: The onion has been used as a treatment for diabetes since ancient times. Recent research studies have proved that this pungent vegetable can lower blood sugar in diabetes. In recent investigations in India, scientists fed onion juice and whole onions in does of 25 to 200 grams to a group of diabetics and found that the greater the dose, the faster the decrease in blood sugar levels. It made no difference whether the onion was eaten raw or cooked. It was found that the onion affected the liver’s metabolism of glucose, or release of insulin, or prevented the destruction of insulin. The probable active hypoglycaemic substances in the onion are allyl, propyl, disulphide and allicin. In fact, as early as 1923, researchers had detected the blood sugar lowering properties of onion. And in the 1960s, scientists isolated anti-diabetic compounds from onions, which are similar to the common anti-diabetic pharmaceuticals that are used to stimulate insulin synthesis and release.

Soya bean: Soya bean is one of the most nutritious foods of the great value in the treatment of diabetes. The journal of the American Medical Association quotes from an article by Dr. Christian Becker published in an authoritative German Medical journal. In this article, Dr. Becker points out that the Soya bean bread is a valuable food for diabetics. It contains very little starch, but is rich in fat and protein, both the excellent quality. Soya bean has steadily grown in importance from a therapeutic point of view, since 1910 when studies indicated it to be a valuable part of diabetic diet. Its usefulness in diabetes is attributable not only to its richness in protein and its palatability, but also to its ability to cause, in some unexplained way, a reduction in the percentage and the total quantity of urinary sugar in diabetes patients on the usual dietary restrictions.

Tomato: Tomato with its low carbohydrates contents is very good food for diabetic patients and for those who want to reduce their body weight. It is said to be very effective in controlling the percentage of sugar in the urine of diabetic patients.

Find complete diabetes information, diabetes supply, diabetes treatment, diabetes diet, diabetes causes, diabetes types. More on Diabetes Mellitus Information and Treatment Supply. Also see Natural Ayurvedic Herbal Cure for Diabetes.

Dr John Anne
http://www.articlesbase.com/health-articles/prescribed-foods-for-diabetic-patients-61200.html

I know the fasting level should be 90 or lower and lower than 140 an hour after meals and lower than 120 two hours after meals, but when I eat my afternoon snack, should my sugar level stay constant? Yesterday, I had a dessert for a snack and checked my sugar an hour later. It was 126. A couple hours later, I ate dinner and checked my levels after an hour and everything was under 140. So I guess the question is do I aim for the same guidelines for my snacks as I do for my meals or lower?

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Every diabetic knows that proper diet is crucial to diabetes treatment to achieve and maintain a desirable weight, maintain normal blood glucose levels, and prevent heart and blood vessel diseases. The recommended American diabetes diet is a healthful and moderate amount of meals taken at regular times every day. It consists of fresh fruits, vegetables, and whole grain foods.

While professionals recommend nutritious foods as part of American diabetes diet, they make sure that the diet is motivating and easy to follow. Gone are the days when diabetes diet means strict rules, no sweets, and limited food intake. However, there are still some guidelines that a diabetic should follow in order to maintain a stable level of blood sugar throughout the day and night. Here are some of those:

Based on the American Diabetes Association, your daily caloric intake should be composed of 50 to 60 percent carbohydrates, 12 to 20 percent protein, and up to 30 percent of fat.
Avoid eating heavy meals. Instead, space out your meals throughout the day—three square meals and three to four light snacks are recommended. This will prevent your blood sugar levels to fluctuate.
When you are trying to lose weight, make it a gradual process. Do not forget to consult this with your doctor especially if you are planning to go on a strict diet.
Reduce your intake of saturated fats and cholesterol to help lower your cholesterol.
Use diabetes exchange lists in order to make sure that you are getting a proper mix of calories, carbohydrates, and other nutrients. In this system, foods are grouped according their nutrients. Because the foods are grouped based on their nutrients, you can exchange foods within their group and still get the same nutrient content but without the risk of affecting your blood sugar.
Eat sweets in moderation. Use sugar substitutes like aspartame and saccharin for your desserts. These artificial sweeteners have the same sugary taste like your typical white sugar but with less calories.

The secret to managing diabetes is knowing that foods you should take, being aware as to how much of these foods should you consume in one sitting, and following a regular eating pattern that you yourself created.

Read related article: “Diabetic Diet Exchange List”

I was diagnosed with gestational diabetes recently, and when checking my blood sugar today it has been really high. More than double what it should be. My doc gave me guidelines as to what it should be, but not what constitutes an emergency.