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People are falling victim to diabetes at an alarming rate! Diabetes is a condition that means your body cannot control the level of sugar in the blood effectively.

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 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:

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.

working>as>assitant>professor>inmmc>mirpurkhas>sindh

Diabetes cannot be cured, but it can be controlled. Strict control of blood glucose, or blood sugar, as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes.

Learn how to protect yourself from the deadly disease(Diabetes).

Instantly Download the Diabetes Toolkit Now!

{According to the Health Care Association,Cardiovascular disease (CVD) is the leading cause of death among people with diabetes, accounting for at least two out of three diabetes-related deaths. While the statistics are scary, here are some important steps you can take to help prevent this deadly disease.|This kit contains material useful during and after your
diabetes — Tips, Suggestions, and other information
will help you at the time of your diabetes .

i) A Step-By-Step Guide : In this kit you will easily know.
many tricks, along with :

* History of Diabetes
* Diabetes Glossary
* What is Pre-Diabetes and Who is at Risk?
* The Cause of Diabetes
* The Diagnosis and Management of Diabetes
* The Treatment of Diabetes
* Diabetes and Your Emotions
* Possible Diabetes Complications
* How Diabetes is Managed?
* Diabetes Facts
* Diabetes Food and Meal Planning
* Diabetes Nutrition
* Insulin Resistance
* Insulin Pumps
* Lantus Insulin
* Diabetes Cure
* Diabetes Education
* and much much more . . . . . . . . . . . .}

Instantly Download the Diabetes Toolkit Now!

Does having diabetes affect when you will start your first period?

I’m thirteen years old almost fourteen i have had diabetes since i was eight years old. I still haven’t started my period. My mom says its proably because i have diabetes. When you have type 1 you have to take insulin which is a hormone. So she says it can affect all of my other hormones and my growth. But im really wondering is this true?

Answer
I personally don’t know if it’s true or not, I haven’t heard anything about that. But you shouldn’t assume the delay is due to your diabetes. I knew a girl who didn’t start until she was 16, and she didn’t have any medical problems. Some girls just start late.

There are 18.3 million people in the United States, or 6.4% of the population, who have diabetes. Diabetes is a condition that means your body cannot control the level of sugar in the blood effectively.

Diabetes is an insulin-related disease that affects nearly 21 million people in the USA. This grave situation is characterized by the bodys inability to produce enough using the services or insulin. It is the hormone, insulin, which is responsible for hot flashes from glucose into the cells of the body. When blood sugar rises, our health suffers greatly.

According to the National Diabetes Information Clearinghouse (NDIC), about 14.6 million people in the USA are diagnosed with the disease, while nearly 6 million people have not yet been diagnosed. In a 2005 NDIC report, the total results with regard to diabetes patients of all ages, from those of the elderly to experience toddlers May symptoms of diabetes. Typically, type 2 diabetes who suffer are usually diagnosed between the ages of 35 and 50.

The symptoms of diabetes

There are many signs that alert a person that May be suffering from diabetes. Common symptoms of diabetes May occur in bulk or a patient May an exhibition only a few. Whatever the case May, when any of the following diabetes symptoms appear, patients should contact their doctor.

Individuals should be on the lookout for: frequent urination, extreme hunger or thirst, blurred vision, sudden weight loss, numbness or tingling in the hands or feet, fatigue, skin too dry, increased infections and slow healing of wounds. People with type 1 diabetes symptoms include nausea, vomiting and / or abdominal pain.

Different types of diabetes

If you experience symptoms that prove the disease, it will be diagnosed as suffering either type 1 or type 2 diabetes. Type 1 diabetes accounts for 5-10% of diagnosed cases of diabetes where the immune system actually destroys the cells in the body that produce insulin. This type of diabetes May also be regarded as insulin-dependent diabetes or juvenile-onset diabetes. Most people with the disease are diagnosed with type 2 diabetes, which involves the bodys resistance to insulin. Another type of diabetes exists, but only affects 2-5% of pregnant women. It is called gestational diabetes and has the potential to harm the mother and child when they are not treated.

From Diabetes

When accompanied by regular exercise and proper medication, healthy eating habits can relieve the symptoms of diabetes. Thanks to a balanced diet, filled with a healthy mix of carbohydrates, proteins and fats, good nutrition can be used as a defence against the symptoms associated with diabetes. Acceptable foods include fruits, vegetables, whole grains, poultry, beans, milk 2% and lean meats. The fried foods and very sweet foods should be avoided if diagnosis of diabetes.

Demand for treatment is important

When you think you are exhibiting symptoms of diabetes, an immediate visit to a doctor is required. The reason is that when diabetes is not treated, a host of debilitating health problems follows closely. Since foot problems tend to affect diabetics, there are many concerns in this area, including infection, gangrene and amputation. The eye problems are also common in people with diabetes. When left untreated, blindness May occur. Other health problems associated with diabetes untreated symptoms include heart disease and renal failure. The disease is so serious that it is a major cause of death in the USA.

Want to find out about gestational diabetes symptoms and diabetes facts? Get tips from Diagnosing Diabetes.

Treatment for diabetes varies on a number of factors, including weight, age and any complications you may encounter.

Learn how to protect yourself from the deadly disease(Diabetes).

Instantly Download the Diabetes Toolkit Now!

{According to the Health Care Association,Cardiovascular disease (CVD) is the leading cause of death among people with diabetes, accounting for at least two out of three diabetes-related deaths. While the statistics are scary, here are some important steps you can take to help prevent this deadly disease.|This kit contains material useful during and after your
diabetes — Tips, Suggestions, and other information
will help you at the time of your diabetes .

i) A Step-By-Step Guide : In this kit you will easily know.
many tricks, along with :

* History of Diabetes
* Diabetes Glossary
* What is Pre-Diabetes and Who is at Risk?
* The Cause of Diabetes
* The Diagnosis and Management of Diabetes
* The Treatment of Diabetes
* Diabetes and Your Emotions
* Possible Diabetes Complications
* How Diabetes is Managed?
* Diabetes Facts
* Diabetes Food and Meal Planning
* Diabetes Nutrition
* Insulin Resistance
* Insulin Pumps
* Lantus Insulin
* Diabetes Cure
* Diabetes Education
* and much much more . . . . . . . . . . . .}

Instantly Download the Diabetes Toolkit Now!

What are the odds of having diabetes if nobody in your immediate family is known to have it?

In other words, is it likely to have prediabetes or diabetes if nobody in your family has it?
While I’m at it, is prediabetes/diabetes common in teenagers?

Answer
Type 1 you developes in childhood and you would probably have known by now.

Type 2 developes in obese people, and it does not matter in there is not history. You could still get it, so get tested if you are concerned.

People are falling victim to diabetes at an alarming rate! Diabetes is a condition that means your body cannot control the level of sugar in the blood effectively.

This article will explain what you need to know about Diabetes before you or someone you know are unpleasantly surprised.

Diabetes affects around 16 million Americans and about 800,000 new cases are diagnosed each year.

A diagnosis of diabetes is made if your blood glucose reading is 126 mg/dl or higher. People with Type I Diabetes are subject to episodes in which blood glucose levels are very high (hyperglycemia) and very low (hypoglycemia). There are two primary reasons for Diabetes, 1) A prolonged diet high in carbohydrates and 2) Improper and under nourishment. Today, most people with diabetes are only treating the symptoms and not getting to the root of the problem. The prevalence of diabetes has been steadily increasing world over. Diabetes is a disease in which blood glucose levels are above normal.

Insulin is a hormone secreted by the pancreas that is needed to convert sugar and starches into energy needed for daily activity. Type 1 Diabetes is also called Insulin Dependent Diabetes. Insulin is a very important hormone that is needed to convert sugar, starches and other food into energy-the energy we need for daily life. Diabetes is a disease that develops over time, and your health care provider can help you find out whether you are likely to become a diabetic. Diabetes does not care who you are, if testing is painful or if you are tired. Type 2 diabetes is sometimes referred to as mature onset diabetes.

Type II diabetes, in the past, was relegated to the adult population. This form of diabetes is mainly found in children. Smoking is another important risk factor. Among men who smoke, the risk of developing diabetes is doubled. Of the many types of Diabetes, type 1 diabetes, type 2 diabetes, gestational. diabetes and pre-diabetes are the most common. Before the discovery of insulin, type 1 diabetes was fatal. Doing the right things to take care of diabetes can also help to take care of your heart as well. Most Type 2 diabetics don’t have symptoms because the onset. Typically, this type of diabetes will occur during the last three months of the pregnancy , but may potentially occur before that time.

Of the many types of Diabetes, type 1 diabetes, type 2 diabetes, gestational. Diabetes and pre-diabetes are the most common.

Twenty to fifty percent may develop Type 2 diabetes later in life. Children of mothers with gestational diabetes are more at risk for obesity and developing diabetes as teens or adults. It is quite possible to live and eat quite nicely with diabetes if you stick to your plan. The most important thing about dieting with diabetes is that you never lose sight of how crucial it is to do so. Through losing weight, getting the right amount of exercise and controlling your diet, you can manage. Juvenile Onset diabetes is another major form of diabetes that affects many children. The challenge with pre-diabetes is the fact that the condition doesn’t like to reveal itself with noticeable symptoms.

The experience teaches that a mere elimination of symptoms is short-lived, as the underlying causes will soon give birth to new symptoms. Diagnosed with type 2 Diabetes. One of the main causes is overweight. There are a number of causes which give rise to diabetes.

Recently more children are being diagnosed with Type 2 Diabetes. The aim with the treatment of both types of Diabetes is to have blood glucose levels, blood pressure and cholesterol levels as near to average as is possible.

You can prevent or at the very least delay onset of type II diabetes with proper nutrition and exercise.

The thought of getting a disease such as diabetes can be worrisome, it helps to be aware of what diabetes symptoms are and be able to recognize them early enough to get the help you will need to get the disease under control.

For people who are heavily dependent on medicines, exercise cannot replace drugs but it does contribute to normalizing the glucose metabolism.

There have been reports of women diabetics who experienced a decline in sexual activities due to the lack of sensation.

And most diabetics develop heart disease. Research has repeatedly shown that regular physical activity helps reduce the likelihood of having a heart attack or a stroke, aids in weight loss, and improves mood.

It is a very serious disorder, sometimes fatal and is the leading cause of death in Western society because of its damage to the cardiovascular system.

With exercise, weight loss and a healthy diet, pre-diabetic people can and have managed to bring down their glucose levels and have escaped the threat of an insulin-dependent life.

The cause of diabetes is somewhat a mystery, although both family history and environmental factors such as obesity and lack of exercise appear to play roles.

Ketoacidosis is most often seen in Type I diabetics, individuals whose pancreas does not produce enough insulin to allow their cells to take in glucose for metabolism (also the most common form of childhood diabetes).

It should come as no surprise that one of the major causes for the increase in diabetes is due to the obesity problem.

If proper treatment and medication is not administered, at times aggressively, it can lead to fatal complications .

In our days diabetes becomes a big problem even when patients are given insulin and stay on strict diets.

Doctors have always asked themselves why some people develop diabetes and some not, and so, by studying, they have discovered that there are some factors that interfere with the installation of diabetes.

As many studies have shown that an increase in UCP2 function has an important role in pathogenesis of diabetes, this genipin with its inhibitor action on UCP2, represents a solution for improving beta cell function in type 2 diabetes.

Alexis Kenne is a graduate in mathematiques, and wellness expert
To know more about his work visit:
http://www.extend-yourlife.com
http://www.goodhealthguaranteed.com

Treatment for diabetes varies on a number of factors, including weight, age and any complications you may encounter.

Learn how to protect yourself from the deadly disease(Diabetes).

Instantly Download the Diabetes Toolkit Now!

{According to the Health Care Association,Cardiovascular disease (CVD) is the leading cause of death among people with diabetes, accounting for at least two out of three diabetes-related deaths. While the statistics are scary, here are some important steps you can take to help prevent this deadly disease.|This kit contains material useful during and after your
diabetes — Tips, Suggestions, and other information
will help you at the time of your diabetes .

i) A Step-By-Step Guide : In this kit you will easily know.
many tricks, along with :

* History of Diabetes
* Diabetes Glossary
* What is Pre-Diabetes and Who is at Risk?
* The Cause of Diabetes
* The Diagnosis and Management of Diabetes
* The Treatment of Diabetes
* Diabetes and Your Emotions
* Possible Diabetes Complications
* How Diabetes is Managed?
* Diabetes Facts
* Diabetes Food and Meal Planning
* Diabetes Nutrition
* Insulin Resistance
* Insulin Pumps
* Lantus Insulin
* Diabetes Cure
* Diabetes Education
* and much much more . . . . . . . . . . . .}

Instantly Download the Diabetes Toolkit Now!

How high are my risks for getting diabetes?

My sister has type 1 diabetes, and she told me that I have a good chance of getting it too because our great grandfather and his mother had diabetes. A lot of other people in my family have it, on my mom’s side. What are my chances of getting Type 1 diabetes?

Answer
In both the types of diabetes, signs and symptoms are more likely to be similar as the blood sugar is high, either due to less production of insulin, or no production or insulin resistance. In any of the case if there is inadequate glucose in the cells, it can be identified through certain signs and symptoms. These symptoms are quickly relieved once the Diabetes is treated and also reduce the chances of developing serious health problems.

Diabetes Type 1:

In type 1, the pancreas stop producing insulin, due to autuimmune response or possibly viral attack on pancreas. In absence of insulin, body cells does not get glucose for producing ATP (Adenosin Triphosphate) units which results into primary symptom in the form of nausea and vomiting. In latter stage which leads to ketoacidosis in which body starts breaking down muscle tissue and fat for energy, there is consequently fast weight loss. Dehydration is also usually observed due to electrolyte disturbance. In advance stages even coma and death, are being witnessed.

Diabetes Type 2:

Increased fatigue : Due to inefficiency of cell to metabolise glucose, reserve fat of body is metabolised to gain energy. When fat is broken down in the body, it uses more energy as compared to glucose, hence body goes in negative calorie effect, which results in fatigue.

Polydipsia : As the concentration of glucose increases in the blood, brain receives signal for diluting it and in its counteraction we feel thirsty.

Polyuria: Increase in urine production is the result seen when excess of glucose is present in body. Body tries to get rid of the extra sugar in the blood by excreting it through the urine. This can also lead to dehydration because excreting the sugar which carries a large amount of water out of the body along with it.

Polyphegia : The hormone insulin is also responsible for stimulating hunger. In order to cope up with high sugar levels in blood, body produces insulin which leads to increased hunger.

Weight flactuation : Factors like loss of water (polyuria), glucosuria , metabolism of body fat and protein may lead to loss of weight. Few cases may show weight gain due to increased appetite.

Blurry vision : Hyperosmolar hyperglycemia nonketotic syndrome is the condition when body fluid is pulled out of tissues including lenses of eye, which affects the ability of lenses to focus resulting in blurry vision.

Irritability : It is one of the sign of high blood sugar because of the inefficient supply of glucose to brain and other body organs, which makes us feel tired and uneasy.

Infections : Certain signals from the body is given whenever there is fluctuation of blood sugar (due to suppression of immune system) by frequent infections of fungal or bacterial like skin infection or UTI (urinary tract infection).

Poor wound healing : High blood sugar resists the flourishing of WBC, (white blood cell) which are responsible for body immune system. When these cells do not function accordingly, wound healing is not at good pace. Secondly, long standing diabetes leads to thickening of blood vessels which may affect proper circulation of blood in different body parts.

There are 18.3 million people in the United States, or 6.4% of the population, who have diabetes. Diabetes mellitus is a medical disorder characterized by varying or persistent hyperglycemia (high blood sugar levels) resulting from the defective secretion or action of the hormone insulin.

Bhupesh Chandra Semwal 1* Sonia Singh1, Dr. Kalyani Divakar2

Introduction-Diabetes mellitus often referred to simply as diabetes. Diabetes is a syndrome characterized by disordered metabolism and abnormally high blood sugar, hyperglycemia resulting from insufficient levels of the hormone insulin. The world health organization recognizes three main forms of diabetes mellitus type1 type2 and gestational diabetes. Gestational diabetes occurring during pregnancy. Which have different causes and population distributions. While, ultimately, all forms are due to the beta cells of the pancreas being unable to produce sufficient insulin to prevent hyperglycemia, the causes are different. All types have been treatable since insulin became medically available in 1921. Type 1 diabetes, in which insulin is not secreted by the pancreas, is directly treatable only with injected insulin, although dietary and other lifestyle adjustments are part of management. Type 2 may be managed with a combination of dietary treatment, tablets and injections and, frequently, insulin supplementation. While insulin was originally produced from natural sources such as porcine pancreas, most insulin used today is produced through genetic engineering, either as a direct copy of human insulin, or human insulin with modified molecules that provide different onset and duration of action. Insulin can also be delivered continuously by a specialized pump which subcutaneously provides insulin through a changeable catheter1.

Classification of diabetes-
Type one diabetes mellitus
Type two diabetes mellitus
Gestational diabetes mellitus2
Signs and symptoms-

Frequent urination, Excessive thirst, Extreme hunger, unusual weight loss, Increased fatigue, Irritability, Blurry vision 3

Top Risk Factors for Type 2 Diabetes

Obesity

An excessively high body weight increases diabetes risk. The Body Mass Index ( BMI) is a simple, widely accepted means of assessing body weight in relation to health for most people aged 20 to 65 (Exceptions include people who are very muscular, athletes, pregnant or nursing.) A BMI greater than 27 indicates a risk for developing type 2 diabetes and other health problems which include cardiovascular disease, and premature death.

Apple-shaped figure

Individuals who carry most of their weight in the trunk of their bodies (i.e., above the hips) tend to have a higher risk of diabetes than those of similar weight with a pear-shaped body (excess fat carried mainly in the hips and thighs). A waist measurement of more than 100 cm (39.5 inches) in men and 95 cm (37.5 inches) in women suggests an increased risk.

Sedentary lifestyle

Being overweight – another risk factor for Type 2 – can be prevented by regular physical activity. A second, independent benefit of regular physical activity is improved blood sugar control in persons who already have type 2 diabetes.

Unhealthy Eating Habits

Ninety% of people who have been diagnosed with type 2 diabetes are overweight. Unhealthy eating contributes largely to obesity. Too much fat, not enough fiber, and too many simple carbohydrates all contribute to a diagnosis of diabetes. Eating right is can turn the diagnosis around and reverse or prevent Type 2.

Increased Age

            It’s a sad but true fact. Age increases the risk of type 2 diabetes.  The older we get, the greater our risk of type 2 diabetes. Even if an elderly person is thin, they still may be predisposed to getting diabetes. Scientists theorize that the pancreas ages right along with us, and doesn’t pump insulin as efficiently as it did when we were younger. Also, as our cells age, they become more resistant to insulin as well.

 High Blood Pressure and High Cholesterol

            High BP and high cholesterol are the hallmark risk factors for many diseases and conditions, including type 2 diabetes. More than 40 percent of people with diabetes have abnormal levels of cholesterol and similar fatty substances that circulate in the blood. These abnormalities appear to be associated with an increased risk of cardiovascular disease among persons with diabetes.

Family History and Genetics

            It appears that people who have family members who have been diagnosed with type 2 diabetes are at a greater risk for developing it themselves. African Americans, Hispanic-Americans and Native Americans all have a higher than normal rate of type 2 diabetes.

History of Diabetes in Pregnancy

            Nearly 40 percent of the women who have diabetes during their pregnancy go on to develop type 2 diabetes later, usually within five to ten years of giving birth. Giving birth to a baby that weighs more than nine pounds (4 kg) is another symptom of gestational diabetes.

Impaired Glucose Tolerance

            Impaired glucose tolerance or impaired fasting glucose can precede the development of type 2 diabetes. These conditions are determined through blood tests. While persons affected with these problems do not meet the diagnostic criteria for diabetes, their blood sugar control and reaction to sugar loads are considered to be abnormal. This places them at higher risk, not just for the development of type 2 diabetes (an estimated one in ten progress to type 2 diabetes within five years), but also for cardiovascular disease. For this group, preventive strategies including lifestyle changes and regular screening for diabetes mellitus must be a priority4.

Alternative medicine for treatment of diabetes-

 Ginseng -Although there are several different types of ginseng, most of the promising studies on ginseng and diabetes have used North American ginseng (Panax quinquefolius). Those studies have shown that North American ginseng may improve blood sugar control and glycosylated hemoglobin (a form of hemoglobin in the blood used to monitor blood glucose levels over time) levels.

 Chromium-    Chromium is an essential trace mineral that plays an important role in carbohydrate and fat metabolism and helps body cells properly respond to insulin.

 Magnesium-  Magnesium is a mineral found naturally in foods such as green leafy vegetables, nuts, seeds, and whole grains and in nutritional supplements.Magnesium is needed for more than 300 biochemical reactions. It helps regulate blood sugar levels and is needed for normal muscle and nerve function, heart rhythm, immune function, blood pressure, and for bone health. Some studies suggest that low magnesium levels may worsen blood glucose control in type 2 diabetes. There is also some evidence that magnesium supplementation may help with insulin resistance.

Cinnamon-Cinnamon is a glycosides it improves blood glucose control in people with type 2 diabetes.

 Zinc-   The mineral zinc plays an important role in the production and storage of insulin. There is some research showing that people with type 2 diabetes have suboptimal zinc status due to decreased absorption and increased excretion of zinc. Food sources of zinc include fresh oysters, ginger root, lamb, pecans, split peas, egg yolk, rye, beef liver, lima beans, almonds, walnuts, sardines, chicken, and buckwheat.

 Aloe Vera Gel-Although aloe vera gel is better known as a home remedy for minor burns and other skin conditions, recent animal studies suggest that aloe vera gel may help people with diabetes. A Japanese study evaluated the effect of aloe vera gel on blood sugar. Researchers isolated a number of active phytosterol compounds from the gel that were found to reduce blood glucose and glycosylated hemoglobin levels.

Gymnema- Several preliminary studies suggest that the herb gymnema can lower blood sugar levels in people with type 2 diabetes. Because gymnema may lower blood sugar levels, people taking medications for diabetes or using insulin shouldn’t take gymnema unless they are closely monitored by their health care provider

Vanadium-Vanadium is a trace mineral found naturally in soil and many foods. It is also produced during the burning of petroleum. Vanadium has been found to improve insulin sensitivity and reduce blood sugar in people with type 2 diabetes. It appears to mimic many of the actions of insulin in the body. The use of vanadium for diabetes, particularly without the supervision of a qualified health care practitioner, is not recommended, because the dose needed to affect blood glucose levels can be potentially toxic. The typical amount of vanadium found in the average diet (less than 30 micrograms per day) appears to have little toxicity5.

Neem- The leaves of Neem posses’ anti-diabetic properties. The juices of these leaves are helpful in controlling the blood sugar level in diabetics. Neem is in fact an herbal medicine used for the treatment of various other diseases also such as skin problems, warm infections, ulcer etc.

Sweet potato leaves- The leaves of sweet potato are high value in preventing diabetes, by lowering blood sugar level. It is highly nutritious vegetable. Preparation of sweet potato leaves is used in the tea of diabetic patients.

Madhuca- The Indian name for Madhuca is Madhua it is also posses’ excellent anti-diabetic properties and it is highly beneficial in treating raised blood sugar levels.

Mango leaves- The leaves of Mango helps in lowering the blood sugar levels in diabetics. The fresh leaves of mango are socked in water for an overnight. Then they are squeezed well in the water before filtering them in the morning6.

 Discussion and Conclusion- Managements of diabetes with the agents devoid of any side effects is still challenge for the medical system. This has lead to increase in the demand for natural products with antihyperglycemic activity having fewer side effects. Metabolic imbalance causing diabetes mellitus is a characteristic of materialistic world. Differences in social structure, psychic stress, obesity, hormonal imbalance and heredity are optimizing the growth of pandemic. Increasing population with diabetes has a huge requirement of effective remediation. The vast variety of medicinal plants, which are used traditionally for their anti-diabetic property. However, careful assessment including sustainability of such herbs, ecological and seasonal variation in activity of phyto-constituents, metal contents of crude herbal anti-diabetic drugs, thorough toxicity study and cost effectiveness is required for their popularity. These efforts may provide treatment for all and justify the role of novel traditional medicinal plants having anti-diabetic potentials.

 

References

http://www.diabetesmellitus-information.com/diabetes_herbs.htm

http://www.umm.edu/ency/article/002072.htm

http://www.diabetes.org/diabetes-symptoms.jsp

http://www.phac-aspc.gc.ca/ccdpc-cpcmc/diabetes-diabete/english/risk/index.html

http://altmedicine.about.com/cs/conditionsatod/a/Diabetes.htm

http://www.diabetesmellitus-information.com/diabetes_treatment.htm

 

Bhupesh Chandra Semwal
Lecture Pharmacology,GLAIPR Mathura

Sonia Singh
Lecture Pharmacognosy,GLAIPR Mathura

Dr.Kalyani Divakar
HOD OF pharmacology Acharya & B.M Reddy College of Pharmacy Bangalore

Diabetes cannot be cured, but it can be controlled. Strict control of blood glucose, or blood sugar, as well as blood pressure and cholesterol is the best defense against the serious complications of diabetes.

Learn how to protect yourself from the deadly disease(Diabetes).

Instantly Download the Diabetes Toolkit Now!

{According to the Health Care Association,Cardiovascular disease (CVD) is the leading cause of death among people with diabetes, accounting for at least two out of three diabetes-related deaths. While the statistics are scary, here are some important steps you can take to help prevent this deadly disease.|This kit contains material useful during and after your
diabetes — Tips, Suggestions, and other information
will help you at the time of your diabetes .

i) A Step-By-Step Guide : In this kit you will easily know.
many tricks, along with :

* History of Diabetes
* Diabetes Glossary
* What is Pre-Diabetes and Who is at Risk?
* The Cause of Diabetes
* The Diagnosis and Management of Diabetes
* The Treatment of Diabetes
* Diabetes and Your Emotions
* Possible Diabetes Complications
* How Diabetes is Managed?
* Diabetes Facts
* Diabetes Food and Meal Planning
* Diabetes Nutrition
* Insulin Resistance
* Insulin Pumps
* Lantus Insulin
* Diabetes Cure
* Diabetes Education
* and much much more . . . . . . . . . . . .}

Instantly Download the Diabetes Toolkit Now!

What are the biggest symptoms of diabetes?

It runs in my family, and I’ve already inherited anemia from my grandma, and hypothyroidism, so I’m pretty much waiting on the diabetes. Symptoms I should watch out for?

Answer
increased urination, increased liquid intake and thirst, irreducible fatigue, rapid or gradual (but still realy noticable) despite the fact that diabetes will make you have a bigger appetite

if you don’t wear glasses – blurred vision is a sign. but if you wear glasses – increasingly blurry vision or worse vision is a big sign (gradually worsening vision is a sign of type 2)

all of this is for type 1 diabetes