Nov
27
Some Issues To Be Aware Of In A Diabetic Diet
Filed Under Health | Comments Off
Brooke Hayles asked:
Diabetes can be controlled effectively by taking exercise regularly and eating a healthy diet. The two main issues that need to be considered by anyone on a diabetic diet are sugar and fat intake. Constant weight monitoring is essential to prevent excessive weight gain as this can contribute to a number of problems.
Medication, Exercise and a Diabetic Diet
There is medical evidence that regular exercise can actually help prevent a person contracting diabetes as well as controlling it. The muscles in the body use up glucose during exercise, which leads to a reduction in the overall levels of sugar in the blood. The minimum recommended amount of exercise for it to be effective is 20 minutes taken three times a week. It is important to consult your medical practitioner before you take up a new form of exercise, especially if you have existing health problems apart from diabetes.
Exercise, on its own, is not sufficient to help control diabetes, which means that a diabetic diet should also be followed. Much of the advice that a dietician will give regarding a healthy diet applies to both diabetics and non-diabetics alike. The key is moderation in all things. However, a diabetic diet does have an emphasis on reducing the amount of sugary foods, especially cakes and cookies, and increasing the complex carbohydrate intake by eating more brown rice and whole-grain foods.
Medication is often not necessary to control diabetes as regular exercise and a diabetic diet is sufficiently effective. There are some diabetics for whom this is not enough and medication is needed. The majority of diabetic medications are taken orally. A diabetic may be prescribed one medication or a combination of different medications to properly control their diabetes.
The five main classifications of diabetic medication that may be prescribed are:
Alpha-glucosidase inhibitors Biguanides Meglitinides Sulfonylureas Thiazolidinediones
Alpha-glucosidase inhibitors
This group of diabetic medications slow down the rate at which sugar is absorbed in the digestive tract. However, it is rarely prescribed on its own as it has potentially serious side effects, including stomach and bowel problems.
Biguanides
Overweight diabetics are most likely to be prescribed this form of diabetic medication as it can help with controlling their weight as well as their diabetes. They cause the insulin to be used more effectively by the body than normal. Side effects are normally minor but can include nausea and diarrhoea. Biguanides can be prescribed on its own or combined with other medication.
Meglitinides
This types of diabetic medication is particularly effective for maintaining low blood sugar levels after eating, especially if a diabetic diet is being followed. The tablets are taken with food and have few, if any, side effects.
Sulfonylureas
By far the most frequently prescribed type of diabetes medication, this helps with insulin production in the body. Although there are few side effects for most people they cannot be taken by anyone with a sulpha medication allergy.
Thiazolidinediones
Perhaps the least used type of diabetic medication, this increases the sensitivity of cells to insulin. There are few or no known side effects with this form of medication.
The majority of diabetes can be controlled by taking one or more of the above oral medications. However, there may be cases where diabetics need to inject insulin. This is especially the case if the pancreas has ceased producing insulin completely as in Type 2 diabetes.
Effective diabetes management can usually be achieved by adhering to a sensible diabetic diet and exercise on a regular basis. In fact, this is often sufficient for most diabetics. It is important to consult with your medical practitioner on a regular basis and monitor your blood sugar levels. He can prescribe some of the many diabetic medications, if necessary. If you are in any doubt whatsoever regarding meal plans for a good diabetic diet or anything else related to your diabetes, you should always seek medical advice. However, the internet has a wealth of articles that you can read to keep yourself well informed about your condition.
Summary:
Exercise, on its own, is not sufficient to help control diabetes, which means that a diabetic diet should also be followed. Much of the advice that a dietician will give regarding a healthy diet applies to both diabetics and non-diabetics alike. The key is moderation in all things.
Christina
Diabetes can be controlled effectively by taking exercise regularly and eating a healthy diet. The two main issues that need to be considered by anyone on a diabetic diet are sugar and fat intake. Constant weight monitoring is essential to prevent excessive weight gain as this can contribute to a number of problems.
Medication, Exercise and a Diabetic Diet
There is medical evidence that regular exercise can actually help prevent a person contracting diabetes as well as controlling it. The muscles in the body use up glucose during exercise, which leads to a reduction in the overall levels of sugar in the blood. The minimum recommended amount of exercise for it to be effective is 20 minutes taken three times a week. It is important to consult your medical practitioner before you take up a new form of exercise, especially if you have existing health problems apart from diabetes.
Exercise, on its own, is not sufficient to help control diabetes, which means that a diabetic diet should also be followed. Much of the advice that a dietician will give regarding a healthy diet applies to both diabetics and non-diabetics alike. The key is moderation in all things. However, a diabetic diet does have an emphasis on reducing the amount of sugary foods, especially cakes and cookies, and increasing the complex carbohydrate intake by eating more brown rice and whole-grain foods.
Medication is often not necessary to control diabetes as regular exercise and a diabetic diet is sufficiently effective. There are some diabetics for whom this is not enough and medication is needed. The majority of diabetic medications are taken orally. A diabetic may be prescribed one medication or a combination of different medications to properly control their diabetes.
The five main classifications of diabetic medication that may be prescribed are:
Alpha-glucosidase inhibitors Biguanides Meglitinides Sulfonylureas Thiazolidinediones
Alpha-glucosidase inhibitors
This group of diabetic medications slow down the rate at which sugar is absorbed in the digestive tract. However, it is rarely prescribed on its own as it has potentially serious side effects, including stomach and bowel problems.
Biguanides
Overweight diabetics are most likely to be prescribed this form of diabetic medication as it can help with controlling their weight as well as their diabetes. They cause the insulin to be used more effectively by the body than normal. Side effects are normally minor but can include nausea and diarrhoea. Biguanides can be prescribed on its own or combined with other medication.
Meglitinides
This types of diabetic medication is particularly effective for maintaining low blood sugar levels after eating, especially if a diabetic diet is being followed. The tablets are taken with food and have few, if any, side effects.
Sulfonylureas
By far the most frequently prescribed type of diabetes medication, this helps with insulin production in the body. Although there are few side effects for most people they cannot be taken by anyone with a sulpha medication allergy.
Thiazolidinediones
Perhaps the least used type of diabetic medication, this increases the sensitivity of cells to insulin. There are few or no known side effects with this form of medication.
The majority of diabetes can be controlled by taking one or more of the above oral medications. However, there may be cases where diabetics need to inject insulin. This is especially the case if the pancreas has ceased producing insulin completely as in Type 2 diabetes.
Effective diabetes management can usually be achieved by adhering to a sensible diabetic diet and exercise on a regular basis. In fact, this is often sufficient for most diabetics. It is important to consult with your medical practitioner on a regular basis and monitor your blood sugar levels. He can prescribe some of the many diabetic medications, if necessary. If you are in any doubt whatsoever regarding meal plans for a good diabetic diet or anything else related to your diabetes, you should always seek medical advice. However, the internet has a wealth of articles that you can read to keep yourself well informed about your condition.
Summary:
Exercise, on its own, is not sufficient to help control diabetes, which means that a diabetic diet should also be followed. Much of the advice that a dietician will give regarding a healthy diet applies to both diabetics and non-diabetics alike. The key is moderation in all things.
Christina
Nov
23
To Compare the Role of Glibenclamide and Pioglitazone Drugs in Type 11 Non- Insulin Dependent Diabetes Mellitus Patients
Filed Under Medicine | Comments Off
lalaghulamrasool bhurgri asked:
To compare the role of glibenclamide and pioglitazone drugs in type 11 non- insulin dependent diabetes mellitus patients.
Authors:Raj kumar chohan,Mashori Ghulam Rasool,Bhurgri Ghulam Rasool,Shamim-u-Rehman,DahriGhulam mustafa,Anis-u-rehman.
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 1 DIABETES MELLITUS (IDDM):
Type I diabetes affect children of all ages, both sexes and all athenic groups. type 1 diabetes usually occurs by mechanisms. It is most common metabolic condition in children and adolescents (Bui, 2004). Type1diabetes is characterized by immune mediated destruction of pancreatic b -cells resulting in insulin deficiency. This results in a common biochemical end point of hyperglycaemia and risk of ketoacidosis, but the clinical presentaion varies, widely depending on the rate and degree of b -cells failure (Lambert & Bingley. 2005).
Type II diabetes mellitus (NIDDM):
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
:
Women who develop glucose intolerance in late pregnancy and womens who with previously undiagnosed diabetes.
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 *** 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:
Lacets.
Lancet Hlder(Abbots easy touch TM2 lot 03 Asee).
Glucometer(Medisense) optilim one touch(Abbotts).
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).
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.
TABLE NO:2
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:
Anderson J,Kendall,Perryman.S etal,”Diet and Diabettes” Diabetes 2006,16(3):17-19-
Bui H- Type 1 diabetes in childhood-Medicine 2006,3 ,1-3
Bernhard –Diabetes-type 11 diabetes mellitus Diabetes care 1995,19(100:12-17-
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.
Carren M.Types of Diabetes mellitus-Diabettes 2006 10 (3),07-
David Owerback NJ-Prevalence in diabetes population-Diabetes 1988,02(6):31-32
Dale MM,-Treatment of Diabetes mellitus –pharmacology 20035th edition:287-391.
Heller SR –Hypoglycemic in diabetes Ketoacidosis and hypoglycemic-Medicine 2006:34(03):102-110.
Jawad F Untraveling the mystry of Diabetes’Diabetes 2006;15(3):13-15.
Jacobes D-Insulin-Diabetes 1998;6(3);1160126.
Lambert and Bingliy-basic facts-medicine 2006,34(6):3-7.
Natters M-Ketoacdosis and hyperglycemia-Medicine 2006;34(3):104-106.
Power AC-Epidemiology of type11 diabetes Basic facts of diabetes –Diabetes 2005;1(1)7-9
Scarlet Oral therapy in type 11 diabetes sulfonylureas 1984;16(10);3-9.
Schade DS et al A placebo controlled randomized study of glimepiride in patients of Diabetes mellitus- Diabetes 19998, 38(7);636-641.
Warchman and Forouhi-Epidimology of Diabetes- Diabetes basic facts- Medicine 2006 ;34(2);57-60
Wheeler Gd- Aaccident dicovery led to the noble prize for canadian reseachers,2005,01-02.
WHO Report-Health-Diabetes Mellitus-Defiition and types of Diabetes 2007;1:1-4.
Carolyn
To compare the role of glibenclamide and pioglitazone drugs in type 11 non- insulin dependent diabetes mellitus patients.
Authors:Raj kumar chohan,Mashori Ghulam Rasool,Bhurgri Ghulam Rasool,Shamim-u-Rehman,DahriGhulam mustafa,Anis-u-rehman.
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 1 DIABETES MELLITUS (IDDM):
Type I diabetes affect children of all ages, both sexes and all athenic groups. type 1 diabetes usually occurs by mechanisms. It is most common metabolic condition in children and adolescents (Bui, 2004). Type1diabetes is characterized by immune mediated destruction of pancreatic b -cells resulting in insulin deficiency. This results in a common biochemical end point of hyperglycaemia and risk of ketoacidosis, but the clinical presentaion varies, widely depending on the rate and degree of b -cells failure (Lambert & Bingley. 2005).
Type II diabetes mellitus (NIDDM):
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
:
Women who develop glucose intolerance in late pregnancy and womens who with previously undiagnosed diabetes.
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 *** 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:
Lacets.
Lancet Hlder(Abbots easy touch TM2 lot 03 Asee).
Glucometer(Medisense) optilim one touch(Abbotts).
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).
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.
TABLE NO:2
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:
Anderson J,Kendall,Perryman.S etal,”Diet and Diabettes” Diabetes 2006,16(3):17-19-
Bui H- Type 1 diabetes in childhood-Medicine 2006,3 ,1-3
Bernhard –Diabetes-type 11 diabetes mellitus Diabetes care 1995,19(100:12-17-
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.
Carren M.Types of Diabetes mellitus-Diabettes 2006 10 (3),07-
David Owerback NJ-Prevalence in diabetes population-Diabetes 1988,02(6):31-32
Dale MM,-Treatment of Diabetes mellitus –pharmacology 20035th edition:287-391.
Heller SR –Hypoglycemic in diabetes Ketoacidosis and hypoglycemic-Medicine 2006:34(03):102-110.
Jawad F Untraveling the mystry of Diabetes’Diabetes 2006;15(3):13-15.
Jacobes D-Insulin-Diabetes 1998;6(3);1160126.
Lambert and Bingliy-basic facts-medicine 2006,34(6):3-7.
Natters M-Ketoacdosis and hyperglycemia-Medicine 2006;34(3):104-106.
Power AC-Epidemiology of type11 diabetes Basic facts of diabetes –Diabetes 2005;1(1)7-9
Scarlet Oral therapy in type 11 diabetes sulfonylureas 1984;16(10);3-9.
Schade DS et al A placebo controlled randomized study of glimepiride in patients of Diabetes mellitus- Diabetes 19998, 38(7);636-641.
Warchman and Forouhi-Epidimology of Diabetes- Diabetes basic facts- Medicine 2006 ;34(2);57-60
Wheeler Gd- Aaccident dicovery led to the noble prize for canadian reseachers,2005,01-02.
WHO Report-Health-Diabetes Mellitus-Defiition and types of Diabetes 2007;1:1-4.
Carolyn
Nov
19
Treat Diabetes (sweet Disease) With Homoeopathy
Filed Under Diseases And Conditions | Comments Off
Prof.Dr.A.K.Gupta,MD(Hom.) asked:
How to Deal with Diabetes Mellitus – (Sweet Disease) - Homoeopathic Approach
According to recent survey reports about 5% of the total world population is suffering from Diabetes Mellitus. The incidence rate is also reasonably high in India. Currently about 20% of Indian Population is at High risk to develop Diabetes Mellitus in future i.e. they are having abnormal glucose Tolerance test. Studies have revealed that diabetic women suffer more than men. A male who is diabetic has double the chances of a heart failure. In case of women it grows to almost 5 times and it is 8 times more if the patient is a young female.
Diabetes is associated with long term complications that affect almost every major part of the body. It contributes to Blindness, Heart Disease, Stroke, Kidney Failure, Amputations, and Nerve Damage. Uncontrolled diabetes can complicate pregnancy.
What is Diabetes?
Diabetes is a metabolic disorder where the human body either does not produce or properly use insulin, a hormone that is required to convert Sugar , Starches and other food into Energy .The human body has to maintain the Blood Glucose level within a very narrow range, which is done with insulin and glucagons. Diabetes is defined as abnormally High sugar level in blood and presence of sugar in urine due to lack or decreased proportion of Insulin in human body. The Normal Blood Sugar levels should not exceed more than 100 mg% in Fasting state and 140 mg% , 2 hours after food in take which is called PP ( Post Perandial).
Types of Diabetes
Type I : This occur in young people, usually before the age of 20 years. Insulin is essential for its treatment.
Type II : It may occur at any age group but usually diagnosed after the age of 40 years. Oral hypoglycemic agents are the choice of treatment. Insulin is required only occasionally for the treatment of Type II diabetes.
Gestational Diabetes : It is detected during pregnancy. Treatment is usually not required. Blood sugar levels come down to the Normal after delivery of the baby.
DIABETES (Type - I) Also known as Insulin Dependent Diabetes Mellitus (IDDM ).
Diabetes mellitus is a syndrome ( group/set of symptoms) characterized by increased level of sugar (glucose) in the blood due to deficiency or inactivity of hormone “Insulin” that is absolutely necessary to monitor glucose metabolism of body. It occurs when Pancreas no longer produces any or very little Insulin. The immune system attacks the insulin producing Beta Cells in the pancreas and destroy them. Insulin is needed in the body to use sugar for producing energy. Approximately 10% of people with diabeteshave Type-I diabetes. Someone with IDDM needs daily injections of Insulin.
Diabetes is a worldwide disease and if not attended properly leads to serious complications.
IDDM (Insulin Dependent Diabetes Mellitus) or Type 1 diabetes is result of decreased production of hormone ‘”Insulin” by the pancreas (the organ that synthesizes insulin). Various factors including viral infections, stress, certain foods are known to trigger or aggravate the condition. But the root cause is disturbance of immune system where the defense mechanism of own body starts attacking the organs of own body and tissues. Some genetic factors and inborn errors are at the basis of this alteration in the immunity. Type I Diabetes is a constitutional disorder as it is an offshoot of constitutional defects (genetic factors, altered immunity) having an impact on the entire constitution of an individual. Hence it calls for an in-depth constitutional approach for its management.
DIABETES (Type II) or NIDDM ( Non Insulin Dependent Diabetes Mellitus)
The remaining 90% are Non Insulin dependent Diabetes Mellitus (NIDDM) or Type II Diabetes .It occurs when the Pancreas does not produce enough insulin or when the body does not use the insulin though it is produced effectively. It is more frequently observed in individuals who are obese. These are the individuals who have normal or less than normal production of insulin, but more importantly some body mechanism poses obstacle to the action of Insulin. The risk factors for this disorder include age, lifestyle (overeating with inactivity), pregnancy etc. But the most important factor is genetic defect that make one prone to this condition. Diabetes is a constitutional disorder as it is an offshoot of constitutional defect (genetic factors) having an impact on entire constitution of an individual. Hence it calls for an in-depth constitutional approach for its management.
GESTATIONALL DIABETES
It is a temporary condition which occurs during pregnancy. It affects 0.5% of pregnant women, with 40% of those cases developing into Type-II Diabetes later in life times. Treatment is usually not required. Blood sugar levels come down to the Normal after delivery of the baby.
SYMPTOMS OF DIABETES
In both types of Diabetes , Signs and Symptoms are more likely to be similar as the Blood Sugar is High, either due to less or no production of Insulin, or Insulin resistance.
Diabetes can also be asymptomatic, however, the common symptoms are Increased Thirst, Appetite, Increased Urination, Sudden Loss of Weight or Increase in Weight, Easy Fatigability, Pruritis (Itching) - usually around ******* Organs, Numbness of Limbs, Non Haling of Cuts and Wounds, Frequently Changing Vision Power, Recurrent Skin Infections ( Fungal and Pyogenic). Few people are diagnosed only at the time of routine screening test before tooth extraction, operations or before starting the L.I.C. policies. Therefore people suffering with the above mentioned symptoms must go for blood sugar Testing.
Diabetes Type-I
In type-I the pancreas stops producing insulin due to an autoimmune response or possibly, a viral attack on the pancreas. In the absence of insulin body cells do not get the required glucose for producing ATP( Adenosin Triphosphate) units, which results in primary symptoms in the form of nausea and vomiting. In later stages, which lead to breaking down the muscle tissue and fat for producing energy causing fast weight loss.
Diabetes Type - II
- Increased Fatigue :- Unexplainable weakness, due to inefficiency of the cell in the metabolizing Glucose the reserve fat of the body is metabolized to gain energy.
- Polydipsia :- As the concentration of Glucose increases in the blood the brain receives signals for diluting it and in its counteraction patient feels Thirsty.
- Polyuria :- Increased in urine production is due to excess glucose present in the body, which gets rid of the extra sugar in the blood by excreting it through urine. This leads to dehydration because along with sugar a large amount of water is also excreted out of the body.
- Polyphagia:- The hormone insulin is also responsible for stimulating Hunger. In order to cope up with high sugar levels in blood the body produces insulin which leads to increased hunger.
- Weight Fluctuation :- Factors like loss of water (polyuria), glucosuria, metabo;ism of body fat and protein may lead to weight loss.
- Blurry Vision :- Hyperosmolar hyperglycemia nonketotic syndrome is the condition when body fluid is pulled out of tissues including lenses of the eye, which affects its ability to focus resulting in blurry vision.
- Poor Wound Healing :- High blood sugar constrain the flourishing of WBC,(White Blood Cells) which are responsible for the body’s immune system. When these cells do not function properly wounds do not heal properly.
HOMOEOPATHIC APPROACH
Homoeopathy is based on the principle that disease is a total affliction of body. Moreover homoeopathy recognizes importance of root cause such as genetic and inherited factors as a root of any ailment of the body. The homoeopathy medicines prescribed on such strong footings plays a crucial role in management of many deep-rooted, chronic, difficult diseases; one amongst them being Diabetes. Diabetes cannot be cure completely but can effectively controlled. People with diabetes can lead a healthy life if their blood glucose level is under control. The decrease in life span of a diabetic is restored to normal by maintaining good blood glucose control( 90 – 120 mg/dl Fasting and with less than180mg/dl as PP(2 Hrs. after meals).
Homeopathic treatment: When we talk about diseases like diabetes, we talk in terms of management rather than cure. Homoeopathy can be a major player in the management of Diabetes. Timely-administered homoeopathy medicines not only assist in maintaining levels of sugar, protein and fat metabolism, but also helps in preventing further progress and hence complications of the disease. The precipitating factors of diabetes like BP, Obesity etc. can be helped by homoeopathic medication. The complications of Diabetes also can be helped tremendously with homoeopathy. If homoeopathic treatment is opted earlier far less number of case would go to the stage of Amputation etc. Even the cases of Non Healing Diabetic Ulcers have been cured with homoeopathy in our AKGsOVIHAMS Medical Center Clinic.We have been able to help the patients of long standing Diabetes to whom their Antidiabetic medicines stopped affecting anymore and needed the change in group of medication with persistent symptoms and threatening complications , after the proper Constitutiona Homoeopathic medicines ,the same medicines started affecting them once again with no persistence of symptoms and over all relief and comfort in their quality of life. Homoeopathy does help the person in regaining his health.
DIABETES MANAGEMENT
To keep your blood sugar in control through out the day you need diet modification, regular exercise and medicine and change in lifestyle by including yoga, pranayam ,meditation , mental relaxation etc. into your daily schedule.
Lewis
How to Deal with Diabetes Mellitus – (Sweet Disease) - Homoeopathic Approach
According to recent survey reports about 5% of the total world population is suffering from Diabetes Mellitus. The incidence rate is also reasonably high in India. Currently about 20% of Indian Population is at High risk to develop Diabetes Mellitus in future i.e. they are having abnormal glucose Tolerance test. Studies have revealed that diabetic women suffer more than men. A male who is diabetic has double the chances of a heart failure. In case of women it grows to almost 5 times and it is 8 times more if the patient is a young female.
Diabetes is associated with long term complications that affect almost every major part of the body. It contributes to Blindness, Heart Disease, Stroke, Kidney Failure, Amputations, and Nerve Damage. Uncontrolled diabetes can complicate pregnancy.
What is Diabetes?
Diabetes is a metabolic disorder where the human body either does not produce or properly use insulin, a hormone that is required to convert Sugar , Starches and other food into Energy .The human body has to maintain the Blood Glucose level within a very narrow range, which is done with insulin and glucagons. Diabetes is defined as abnormally High sugar level in blood and presence of sugar in urine due to lack or decreased proportion of Insulin in human body. The Normal Blood Sugar levels should not exceed more than 100 mg% in Fasting state and 140 mg% , 2 hours after food in take which is called PP ( Post Perandial).
Types of Diabetes
Type I : This occur in young people, usually before the age of 20 years. Insulin is essential for its treatment.
Type II : It may occur at any age group but usually diagnosed after the age of 40 years. Oral hypoglycemic agents are the choice of treatment. Insulin is required only occasionally for the treatment of Type II diabetes.
Gestational Diabetes : It is detected during pregnancy. Treatment is usually not required. Blood sugar levels come down to the Normal after delivery of the baby.
DIABETES (Type - I) Also known as Insulin Dependent Diabetes Mellitus (IDDM ).
Diabetes mellitus is a syndrome ( group/set of symptoms) characterized by increased level of sugar (glucose) in the blood due to deficiency or inactivity of hormone “Insulin” that is absolutely necessary to monitor glucose metabolism of body. It occurs when Pancreas no longer produces any or very little Insulin. The immune system attacks the insulin producing Beta Cells in the pancreas and destroy them. Insulin is needed in the body to use sugar for producing energy. Approximately 10% of people with diabeteshave Type-I diabetes. Someone with IDDM needs daily injections of Insulin.
Diabetes is a worldwide disease and if not attended properly leads to serious complications.
IDDM (Insulin Dependent Diabetes Mellitus) or Type 1 diabetes is result of decreased production of hormone ‘”Insulin” by the pancreas (the organ that synthesizes insulin). Various factors including viral infections, stress, certain foods are known to trigger or aggravate the condition. But the root cause is disturbance of immune system where the defense mechanism of own body starts attacking the organs of own body and tissues. Some genetic factors and inborn errors are at the basis of this alteration in the immunity. Type I Diabetes is a constitutional disorder as it is an offshoot of constitutional defects (genetic factors, altered immunity) having an impact on the entire constitution of an individual. Hence it calls for an in-depth constitutional approach for its management.
DIABETES (Type II) or NIDDM ( Non Insulin Dependent Diabetes Mellitus)
The remaining 90% are Non Insulin dependent Diabetes Mellitus (NIDDM) or Type II Diabetes .It occurs when the Pancreas does not produce enough insulin or when the body does not use the insulin though it is produced effectively. It is more frequently observed in individuals who are obese. These are the individuals who have normal or less than normal production of insulin, but more importantly some body mechanism poses obstacle to the action of Insulin. The risk factors for this disorder include age, lifestyle (overeating with inactivity), pregnancy etc. But the most important factor is genetic defect that make one prone to this condition. Diabetes is a constitutional disorder as it is an offshoot of constitutional defect (genetic factors) having an impact on entire constitution of an individual. Hence it calls for an in-depth constitutional approach for its management.
GESTATIONALL DIABETES
It is a temporary condition which occurs during pregnancy. It affects 0.5% of pregnant women, with 40% of those cases developing into Type-II Diabetes later in life times. Treatment is usually not required. Blood sugar levels come down to the Normal after delivery of the baby.
SYMPTOMS OF DIABETES
In both types of Diabetes , Signs and Symptoms are more likely to be similar as the Blood Sugar is High, either due to less or no production of Insulin, or Insulin resistance.
Diabetes can also be asymptomatic, however, the common symptoms are Increased Thirst, Appetite, Increased Urination, Sudden Loss of Weight or Increase in Weight, Easy Fatigability, Pruritis (Itching) - usually around ******* Organs, Numbness of Limbs, Non Haling of Cuts and Wounds, Frequently Changing Vision Power, Recurrent Skin Infections ( Fungal and Pyogenic). Few people are diagnosed only at the time of routine screening test before tooth extraction, operations or before starting the L.I.C. policies. Therefore people suffering with the above mentioned symptoms must go for blood sugar Testing.
Diabetes Type-I
In type-I the pancreas stops producing insulin due to an autoimmune response or possibly, a viral attack on the pancreas. In the absence of insulin body cells do not get the required glucose for producing ATP( Adenosin Triphosphate) units, which results in primary symptoms in the form of nausea and vomiting. In later stages, which lead to breaking down the muscle tissue and fat for producing energy causing fast weight loss.
Diabetes Type - II
- Increased Fatigue :- Unexplainable weakness, due to inefficiency of the cell in the metabolizing Glucose the reserve fat of the body is metabolized to gain energy.
- Polydipsia :- As the concentration of Glucose increases in the blood the brain receives signals for diluting it and in its counteraction patient feels Thirsty.
- Polyuria :- Increased in urine production is due to excess glucose present in the body, which gets rid of the extra sugar in the blood by excreting it through urine. This leads to dehydration because along with sugar a large amount of water is also excreted out of the body.
- Polyphagia:- The hormone insulin is also responsible for stimulating Hunger. In order to cope up with high sugar levels in blood the body produces insulin which leads to increased hunger.
- Weight Fluctuation :- Factors like loss of water (polyuria), glucosuria, metabo;ism of body fat and protein may lead to weight loss.
- Blurry Vision :- Hyperosmolar hyperglycemia nonketotic syndrome is the condition when body fluid is pulled out of tissues including lenses of the eye, which affects its ability to focus resulting in blurry vision.
- Poor Wound Healing :- High blood sugar constrain the flourishing of WBC,(White Blood Cells) which are responsible for the body’s immune system. When these cells do not function properly wounds do not heal properly.
HOMOEOPATHIC APPROACH
Homoeopathy is based on the principle that disease is a total affliction of body. Moreover homoeopathy recognizes importance of root cause such as genetic and inherited factors as a root of any ailment of the body. The homoeopathy medicines prescribed on such strong footings plays a crucial role in management of many deep-rooted, chronic, difficult diseases; one amongst them being Diabetes. Diabetes cannot be cure completely but can effectively controlled. People with diabetes can lead a healthy life if their blood glucose level is under control. The decrease in life span of a diabetic is restored to normal by maintaining good blood glucose control( 90 – 120 mg/dl Fasting and with less than180mg/dl as PP(2 Hrs. after meals).
Homeopathic treatment: When we talk about diseases like diabetes, we talk in terms of management rather than cure. Homoeopathy can be a major player in the management of Diabetes. Timely-administered homoeopathy medicines not only assist in maintaining levels of sugar, protein and fat metabolism, but also helps in preventing further progress and hence complications of the disease. The precipitating factors of diabetes like BP, Obesity etc. can be helped by homoeopathic medication. The complications of Diabetes also can be helped tremendously with homoeopathy. If homoeopathic treatment is opted earlier far less number of case would go to the stage of Amputation etc. Even the cases of Non Healing Diabetic Ulcers have been cured with homoeopathy in our AKGsOVIHAMS Medical Center Clinic.We have been able to help the patients of long standing Diabetes to whom their Antidiabetic medicines stopped affecting anymore and needed the change in group of medication with persistent symptoms and threatening complications , after the proper Constitutiona Homoeopathic medicines ,the same medicines started affecting them once again with no persistence of symptoms and over all relief and comfort in their quality of life. Homoeopathy does help the person in regaining his health.
DIABETES MANAGEMENT
To keep your blood sugar in control through out the day you need diet modification, regular exercise and medicine and change in lifestyle by including yoga, pranayam ,meditation , mental relaxation etc. into your daily schedule.
Lewis
Nov
16
What is the way to recovery from Diabetes Mellitus?
Filed Under Diabetes | Comments Off
robinchakravorty asked:
My brother has been just detected having Diabetes Mellitus with blood-sugar 281 after fasting and a triglyceride level of 544.I solicit Expert recommendation regarding total recovery from this disease.What foods to be taken,what foods to be avoided,at what intervals food should be taken,what should be the way of life,why a person gets this disease,how it can be avoided altogether?Our maternal grandfather had this and our mother aged 86 years also has it.
Nellie
My brother has been just detected having Diabetes Mellitus with blood-sugar 281 after fasting and a triglyceride level of 544.I solicit Expert recommendation regarding total recovery from this disease.What foods to be taken,what foods to be avoided,at what intervals food should be taken,what should be the way of life,why a person gets this disease,how it can be avoided altogether?Our maternal grandfather had this and our mother aged 86 years also has it.
Nellie