7 Principles for Controlling Diabetes for Life.

These 7 principles, or steps, will help you manage your diabetes and live a long and active life. Every person who has diabetes has different needs. Talk to your health care team about a treatment plan that is best for you. Diabetes affects almost every part of the body and good diabetes care requires a team of health care providers. They include doctors, diabetes educators, nurses, dietitians, pharmacists, mental health workers, eye specialists, foot specialists, dentists, and social workers.

It Is Important to Control Diabetes

Taking good care of diabetes will make you feel better and can lower your chances of getting heart disease, stroke, eye disease that can lead to a loss of vision or even blindness, nerve damage that may cause a loss of feeling or pain in the hands, feet, legs, or other parts of the body and lead to problems such as lower limb amputation or erectile dysfunction, kidney failure, gum disease and loss of teeth, etc.

Principle 1: Learn as Much as You Can About Diabetes

The more you know about diabetes, the better you can work with your health care team to manage your disease and reduce your risk for problems.
Diabetes is always a serious disease. Terms that suggest that diabetes is not serious, such as “a touch of diabetes,” “mild diabetes,” and “sugar’s a little high,” are not correct and should no longer be used.

Many People Who Have Diabetes
Do Not Know It

Principle 2: Get Regular Care for Your Diabetes

If you have diabetes, it is important to

* See your health care team regularly
* Make sure your treatment plan is working. If it is not, ask your health care team to help you change it.

Principle 3: Learn How to Control Your Diabetes

Diabetes affects many parts of the body. To stay healthy, it is important to know how to eat the right foods, how to be physically active, and how to look after yourself.

Principle 4: Take Care of Your Diabetes ABCs

A major goal of treatment is to control the ABCs of diabetes: A1C (blood glucose average), Blood pressure, and Cholesterol. You can do this in many ways.

* Follow a meal plan that was made for you.
* Be active every day.
* Take your medicine as prescribed.
* Before taking any non-prescription medicines, vitamins, or herbal products, ask your pharmacist how they may affect your diabetes or prescription medicines.
* Test your blood glucose on a routine basis.

Principle 5: Monitor Your Diabetes ABCs

To reduce your risk for diabetes problems such as blindness, kidney disease, losing a foot or leg, and early death from heart attack or stroke, you and your health care team need to monitor the diabetes ABCs: A1C, Blood pressure, and Cholesterol. Talk to your health care team about how to reach your target numbers.

Principle 6: Monitor Your Diabetes

Ask your Doctor what to do if your blood glucose is often higher or lower than it should be.

Principle 7: Get Checked for Long-Term Problems and Treat Them

See your health care team regularly to check for problems that diabetes can cause. Regular check-ups help to prevent problems or find them early when they can be treated and managed well. Along with the checks of your A1C, blood pressure, and cholesterol (see Principle 5), here are some tests that you will need:

* Triglycerides (a type of blood fat)
* Dilated eye exam to check for eye problems
* Foot check
* Complete foot exam to check for circulation, loss of feeling, sores, or changes in shape
* Urine test to check for kidney problems
* Dental exams to prevent gum disease and loss of teeth

a WebMD article

Pre-Diabetes :: A Serious Concern

Prediabetes

Also called: Chemical Diabetes, Borderline Diabetes, Impaired Fasting Glucose, Subclinical Diabetes, Impaired Glucose Tolerance, IFG, Latent Diabetes, IGT

A patient is diagnosed as having prediabetes when glucose (blood sugar) is higher than normal but not high enough to be diagnosed as diabetes. At least 43 million Americans have this condition, according to estimates by the government. Prediabetes is almost always present in an individual before type 2 diabetes develops.

Screening for prediabetes is an effective strategy for identifying individuals who are at risk for developing type 2 diabetes. By identifying the individuals with prediabetes, physicians can intervene sooner with a plan of treatment. Changes in lifestyle, such as diet, weight loss and exercise, are usually included in the treatment. These interventions have been successful in delaying or preventing type 2 diabetes.

Detection and treatment of prediabetes also may reduce the risk of heart disease, stroke and other complications. The damage that occurs to organs and body systems from type 2 diabetes, such as diabetic neuropathy and diabetic retinopathy, can actually start during prediabetes. Treatment of prediabetes promotes a healthier lifestyle, which in turn can prevent type 2 diabetes and medical complications.

About prediabetes

Prediabetes exists when a person has glucose (blood sugar) levels higher than normal but not high enough to be diagnosed as diabetes. It often, but not always, escalates to type 2 diabetes, which accounts for an estimated 90 to 95 percent of cases of diabetes. In the past, mildly elevated levels of glucose were often ignored. Today, glucose levels slightly above the normal range are a warning sign for an individual to take prompt action to prevent type 2 diabetes. In addition to being a strong risk factor for diabetes, prediabetes increases a person’s risk for heart disease and stroke, the U.S. Centers for Disease Control and Prevention (CDC) warns. Worldwide, there has been a steady increase in the number of people diagnosed with diabetes. Given the facts, scientists are researching ways to identify people at risk for diabetes earlier. Unlike type 1 diabetes, it is believed that that with early identification, type 2 diabetes may be delayed or even prevented. A diagnosis of prediabetes has emerged as a condition for predicting individuals at risk for type 2 diabetes. Prediabetes can be diagnosed by a physician using standard glucose tests. A fasting blood glucose test (FPG) or an oral glucose tolerance test (OGTT) can be used to identify the condition. These tests measure the level of glucose in the blood. If the level of glucose is found to be within a certain elevated range, prediabetes is diagnosed. The range, in milliliters per deciliter of blood, is 100 to 125 mg/dL for a fasting blood glucose test and 140 to 199 mg/dL for an oral glucose challenge test. Even glucose at the high range of normal may be a concern. A recently completed 12-year Israeli study of more than 13,000 troops found that those with fasting glucose of 95 to 99 mg/dL were several times more likely than those with lower glucose to become diabetic. Studies conducted by the U.S. Department of Health and Human Services indicate that individuals with prediabetes will likely develop type 2 diabetes within 10 years unless changes are made to their lifestyle. In addition, women diagnosed with prediabetes are at a high risk of developing gestational diabetes during pregnancy. Treating prediabetes helps prevent the onset to type 2 diabetes and is important for other reasons as well. Research has shown that medical complications linked to diabetes may actually start in the prediabetes stage. The heart, blood vessels, kidneys and eyes may be damaged during the prediabetes stage. Treatment and prevention in the prediabetic state may slow down the damage of vital organs and body systems. Recent research shows that: Almost 8 percent of the (prediabetic) participants in the Diabetes Prevention Program developed early-stage diabetic retinopathy. People with prediabetes are more likely to develop chronic kidney disease than those with normal glucose, mainly because of cardiovascular risk factors such as high blood pressure. Prediabetes increases the risk of heart disease, according to a nine-year study of more than 28,000 patients. The type of nerve damage associated with diabetes (diabetic neuropathy) can be present in people with prediabetes. Prediabetic women have increased risk of urinary incontinence, which can be improved with weight loss. A condition related to prediabetes that also often develops before type 2 diabetes is insulin resistance, an impairment in the body’s ability to use insulin to process glucose for energy. In addition, people with prediabetes may have a cluster of cardiovascular risk factors known as metabolic syndrome. Reviewed By: Gary Pepper, M.D., FACP

Exams & Tests :: When & What

Exams and Tests

People with type 2 diabetes should see a health professional every 3 to 6 months throughout life for tests and exams to monitor the condition and adjust treatment. You also need yearly screening tests for eye problems (diabetic retinopathy) and kidney problems (diabetic nephropathy).

Every 3 to 6 months :: Visit your health professional for:

* A review of your blood sugar levels since your last checkup. Your health professional may evaluate whether your treatment needs to be changed.
* A blood pressure check. Keep your blood pressure below 130/80 mm Hg.6 If you have high blood pressure, ask whether you should monitor your blood pressure at home.
* An examination of your feet for signs of injury, infection, or other foot problems.
* A hemoglobin A1c or similar test (glycosylated hemoglobin, or glycohemoglobin). If your blood sugar levels are stable and your treatment hasn't changed, this test may be done every 6 months.

Every 6 months :: Visit your dentist for an exam to check for gum problems.

Every year :: Visit an ophthalmologist or optometrist for a dilated eye exam (ophthalmoscopy) to look for signs of diabetic retinopathy and glaucoma, which is increasing in people with diabetes. Some health professionals may recommend less frequent eye exams if you have no signs of diabetic retinopathy or glaucoma.

Visit your health professional for:

* A fasting cholesterol (LDL and HDL) and triglyceride test. If your levels are normal, you may be tested every 2 years.
o Keep your LDL cholesterol level less than 100 mg/dL (2.60 mmol/L), your triglyceride level less than 150 mg/dL (1.7 mmol/L), and if possible, men need to keep their HDL cholesterol level more than 40 mg/dL and women more than 50 mg/dL.7
* A thorough examination of your feet, including testing your ability to feel a thin, flexible piece of plastic.
* A urine test for protein, an indicator of kidney damage. Either of the following tests may be done:3
o Microalbuminuria dipstick test, to estimate the amount of protein in a urine sample
o Spot urine test for microalbuminuria, to measure the exact amount of protein in a urine sample

If one of these urine tests shows 30 micrograms or more of protein per milligram (mcg/mg) of creatinine in your urine, you have some amount of kidney damage.

Other possible tests You may also need:

* A blood glucose test. This test may be used to check the accuracy of your blood sugar meter to see whether your home blood sugar tests are reliable. It also may be done if your health professional is adjusting your diabetes medicine.

* An electrocardiogram (ECG or EKG), if you have had a heart attack or have heart disease or high blood pressure. An EKG may be done after a diabetes diagnosis even if you have not had a heart attack, because people with diabetes have a higher-than-average risk of heart disease. The test also provides a baseline against which to compare future tests in case of chest pain.

* An exercise electrocardiogram (treadmill EKG test) before you begin a vigorous exercise program.

* An electromyogram (EMG) and nerve conduction study, if your health professional suspects that you may have diabetic neuropathy.

* An ankle-brachial index (ABI) measurement, which can be used to test for peripheral arterial disease if you are older than 50.

From : WebMD

Drugs for Diabetes :: Unscrupulous Advertisements

Drugs for diabetes: unscrupulous advertisements
Ashok Kumar Das


As diabetes is a chronic disease, it has become common for unethical people to offer instant cures, and even advise patients to stop treatment with time- tested anti- diabetic agents.

Research is going on, both in type I and type II diabetes, to look into various facets of immune modulation, pancreatic transplants, etc. However, though diabetes can be controlled, at present it cannot be cured. Despite this fact, some people claim that diabetes can be cured, which is completely unethical. Many clinicians find patients being swayed by the claims of advertisements of indigenous medicines, and stopping their treatment. Practitioners and councils of these disciplines do not look into such instances and try to stop this practice. The common belief that ayurvedic drugs are harmless can be very dangerous. Many of these preparations contain toxic metals which if not adequately purified can cause grave harm.

Adjunct, not substitute
Many of the so- called cures are either plant- or metal- based. These agents have some blood sugar lowering properties. However, they cannot control blood sugar. The common belief that a ‘nature cure‘ is more physiological and less harmful is not always true especially in the case of diabetes. These agents, if taken in the proper form and in proper doses can help reduce the doses of either insulin or other oral hypoglycemic agents. Insulin is vital for the sustenance of life. It is almost criminal to claim that type I diabetes patients can live without insulin, or that any other agent can be a proper alternative to insulin. Many patients have lost their lives due to the unethical promotion of these home remedies. Manufacturers purport to back their tall claims with the recommendations of reputed doctors. However, investigations reveal that such statements are quoted in part and out of context.

Importance of control
The fundamental principle of diabetes management is to achieve adequate blood sugar control. Various trials have conclusively proved that strict control of diabetes can be very beneficial for the patient. Complications like gangrene can be reduced by 40 per cent to 60 per cent, simply by controlling blood sugar strictly. This cost- effective treatment needs to be popularised amongst patients as well as doctors. Regular self- monitoring of blood sugar levels is the cornerstone of blood sugar control. This can be done by any patient and at any level of health care. Effective patient education on the importance of blood sugar control will drastically reduce the money spent on treatment of complications. Many manufacturers of “wonder drugs” advocate less stringent blood sugar control. This can cause grave harm to the patient and set in complications like retinopathy and nephropathy.

Early detection, adequate blood sugar control and prompt recognition and treatment of complications remain key elements in tackling diabetes, from the point of view of individual patients as well as public health. However, awareness of these aspects in society and the medical profession is low. One important factor which contributes significantly to the current problem is the unequal distribution and availability of doctors in the country. Diabetes is a disease of both urban and rural areas, but rural diabetics are forced to depend on unqualified or untrained practitioners for the diagnosis and treatment. The large — and increasing — number of diabetic patients may be viewed by unscrupulous people as a golden opportunity to make a quick buck at the expense of vulnerable people.

Need to communicate
Another factor responsible for the prevalent situation is doctors’ apathy and lack of will to spend time with diabetics. Diabetes is a chronic disease linked to lifestyle which includes diet. Doctors must establish proper communication with patients. Besides drugs, other aspects of the treatment such as diet control, stress management and exercise can be implemented only if the patient is motivated and is involved in the treatment. This requires lot of effort on the doctor’s part.

In today’s commercialised practice, doctors don’t spend this time, as a result of which patients go for “wonder cures” for want of adequate scientific information. Quackery in diabetology is emerging as a major factor with serious public health implications, given the large numbers of diabetics expected in the future. There is a desperate need to provide doctors and paramedics with proper training, and to develop cadres of health workers trained in the basic management of diabetes.

In conclusion, there are many misconceptions about diabetes and its treatment, and they have not been dispelled by the medical profession. There is an urgent need for a patient education movement to prevent unethical treatments in diabetes. Diabetes is a relentless disease. Its advance can only be controlled, not stopped. The medical profession has an ethical duty to keep abreast of all new developments which could benefit their patients, and work with their patients to reduce the serious effects of the disease.

India has successfully tackled health care challenges like small pox. However, as a slow killer, diabetes is in a different league and needs a different strategy. At the same time, drugs and doctors cannot control the public health problems of diabetes. We require a cadre of health- care workers to educate patients in diet control, stress management, lifestyle changes and other non- medical aspects of treatment. Doctors, paramedics and other health care workers must be trained in scientific methods of diabetes management with cost- effective technology which is applicable to our country. Only this can prevent unethical exploitation of patients.

---

Ashok Kumar Das, Dean, JIPMER, Pondicherry

Diabetes & OMEGA~3

Author: Donald Rudin, MD, Clara Felix

DIABETES AND OMEGA-3

Although it was known in ancient times, diabetes has been an increasingly common problem in this century. It is now among the leading causes of death from noninfectious disease in the United States.

Two hormones produced by the pancreas--insulin and glucagon--cooperate to keep blood sugar, called glucose, at the correct level. When glucose levels are too high, the pancreas sends out insulin to force glucose from the bloodstream into the body's cells. If glucose levels are too low, glucagon sends glucose into the bloodstream for additional energy.

Diabetes occurs in two forms. The most serious form--called juvenile or Type 1 diabetes--usually strikes in childhood. It may arise from an attack by the immune system on either the insulin-producing cells of the pancreas or on the insulin receptors within the tissues. In juvenile diabetes, an essential fatty acid deficiency can cause the immune system to turn against the body instead of defending it.

The more common form--called adult-onset or Type 2 diabetes--usually appears later in life. In people who are predisposed by heredity to this form of diabetes, a diet high in sugar and fiberless carbohydrates can eventually stress the insulin production mechanism. Hypoglycemia, or low blood sugar, may represent an early phase of diabetes, in which a hair-trigger response from the overworked pancreas sends out too much insulin. Eventually, the body stops responding to the pancreas's signals, and blood levels of both insulin and sugar go up.

As we've seen, all hormones, including insulin and glucagon, exert their control over the cells by stimulating production of local regulatory chemicals called prostaglandins. In turn, the prostaglandins pass the message of the hormones to the individual cells. The prostaglandins are made from essential fatty acids. Therefore, a deficiency of essential fatty acids, or of the vitamins or minerals they need to be effective, interferes with prostaglandin production. This can intensify adult-onset diabetes even though adequate insulin is produced.

The essential fatty acids also affect the ability of the body's cells to respond to insulin. In a 1993 study, Australian researchers learned that insulin resistance is related to what kinds of fatty acids make up the cell membranes. The more Omega-3 and Omega-6 fatty acids there are in the cell membranes of adult diabetics, the more their tissues respond to insulin.

Some diabetics seem to be blocked from converting short-chain Omega-6 linoleic acid into the longer-chain acids needed for both cell membranes and prostaglandins. Noted researcher David Horrobin and others are using supplements which contain an Omega-6 oil called gamma linolenic acid (GLA), to bypass the blocked processes. Damage to nerves, a big problem for many diabetic persons, has been halted or even reversed by GLA supplements.

Degeneration of the eye's retina--the projection screen on which light that passes through the eye is thrown--is a common cause of blindness in severe cases of diabetes. An Omega-3 oil called DHA is the most abundant polyunsaturated fat in the retina, an oil that is normally made by the body from the basic Omega-3 oil, ALA. However, the high blood-sugar levels seen in diabetes block the conversion of ALA into DHA. The block may be partly overcome by eating foods, mainly fatty fish, that contain ample amounts of ready-made DHA.

As we've seen in the case of cancer, studies now indicate that dietary fiber can help to prevent diabetes or to affect its course by reducing insulin requirements. I think Omega-3 supplements can do the same thing. A fiber deficiency, coupled with an Omega-3 deficiency, magnifies all the blood sugar problems seen in diabetes. Normally, fiber acts as a buffer in the digestive tract by slowing the release of sugar into the bloodstream.

THE DISEASE-REDUCING POTENTIAL OF OMEGA-3

Since I began to study Omega-3 deficiencies in the early 1980s, research in this field has seen an exponential surge. Between 1985 and 1993, close to 5,000 medical studies on Omega-3 fatty acids emerged worldwide. If anything, the pace has quickened since then, as more and more optimistic reports on Omega-3 benefits in terms of heart disease and other ailments are confirmed.

The original focus of these studies was on the cardiovascular system, but it soon expanded to include studies on cancer, arthritis, psoriasis, and various inflammatory and immune disorders, including kidney disease. Though the emphasis remains on heart disease--the major killer in industrialized countries such as the United States--it is becoming evident that many of these conditions are a result of modernization, and that balancing the essential fatty acids in our diet will rid us of some of the diseases that plague our modern world.

Get The Most From Your Next Doctor's Visit

People with diabetes need a lot of information. To get the right information, you must share many details about your health with your Doctor.

Talk openly about:

• Symptoms
• Any problems you’ve had, including stressful events
• Any changes in your life, including any illnesses since your last appointment
• Why you need help controlling your blood sugar
• Any medicines you have heard about and would like to know if they are right for you
• How you think your medicines are working

Learn about your condition. Take part in treatment decisions. Ask questions.
Remember: There’s no such thing as a dumb question.

This check list can help you recall issues to discuss with your doctor. You can list more details below each item:

* I have severe or frequent low blood sugar(s).
* My blood sugars are higher than my target numbers.
* I’ve noticed a change in my vision, had a sore that was slow to heal, or had other problems that might mean a complication.
* I’m not sure how to take my medicine (list all medicines you’re taking).
* I have high or low blood sugar that I can’t explain.
* I’m not sure how to tell if my medicine is working.
* I’ve had some problems following my Diabetes Action Plan.
* I feel worried and/or depressed about my diabetes.
* I’ve made these changes to my eating and physical activity program.
* Other changes, concerns, or questions.

I am taking these medicines (include any new prescriptions your doctor gives you today):
* Name
* Dose
* When to take it
* If I miss a dose
* Possible side effects

When you’re at your doctor’s office:
* Bring your blood sugar records and go over them at each visit.
* Be honest about your lifestyle and habits, like exercise and meal planning.
* Discuss any prescription medicines, over-the-counter drugs, herbal treatments, or supplements that you take.
* Make a list of questions before your visit.

A L A :: Alpha Lipoic Acid

Alpha Lipoic Acid

Author: Allen S. Josephs, M.D., Jefferson Medical College, Board Certified in Internal Medicine & Board Certified in Neurology, Section Chief, Neurology, St. Barnabas Hospital, Livingston, NJ

A little known but extremely powerful antioxidant nutrient is available in supplemental form called alpha lipoic acid. It is a vitamin-like substance that contains sulfur. Alpha lipoic acid (ALA) plays an extremely important role in energy production within the cell. What makes alpha lipoic acid so effective as an anti-oxidant is that it works on both water and fat soluble free radicals which are the cause of oxidation.

For those of you who think that alpha lipoic acid (ALA) is a nutrient that has not been well researched, think again. A recent Medline search indicated 1,378 articles in the medical literature on alpha lipoic acid. Alpha lipoic acid appears to be a wonder nutrient. It seems to work particularly well in diabetic patients.

Experimental studies show that it has a potential renal protective effect. In a study out of Germany published last year, diabetic patients treated with 600 mg of ALA daily had stabilization in urinary albumin concentration over an 18 month follow-up whereas patients in the control group had an increase in urinary albumin excretion. In animal studies the renal protective effects of ALA were not attributable to improved glycemic control alone but also likely related to its antioxidant activity. Alpha lipoic acid increases glucose uptake in the cells and appears to reduce symptoms of diabetic complications including cataract formation, vascular damage and even polyneuropathy (nerve damage).

In a study published in the Journal Diabetic Medicine from 1999, those patients treated with 600 mg. of ALA, three times daily for 3 weeks had improvement of diabetic symptoms from polyneuropathy. In another study using 600 to 1,800 mg of ALA daily those individuals treated were found to have improvement of insulin sensitivity. In animal studies it has been found to reduce oxidative DNA damage within heart cells.

More recent experimental studies have shown that ALA can actually reverse the damage in aging cells of the brain. This was a study published in the prestigious journal Proceedings of the National Academy of Science from February of this year. In the study, aging rats were treated with either acetyl-L carnitine or ALA. Both of these nutrients improved performance in memory tasks by lowering oxidative damage and improving mitochondrial function. Electron microscopic studies of the brains of these animals indicated these nutrients reversed age associated mitochondrial structural decay.

Most studies have used 600-1,800 mg per day of alpha lipoic acid for optimal benefits in people with specific health concerns. If you are healthy and want to promote optimal health, a dose of 30 - 300 mg per day may be sufficient. Beware of products that contain 500 mcg (1/2 mg)-10 mg; these doses are probably too little to provide any benefit.

Nature's Diabetes Defence

Nature's Diabetes Defence

Author: Sarah Altshul
Source: Natural Cures, Prevention Guide, October-December 2006

First focus on nutrition, advises David Heber, MD, PHD, professor and director, UCLA Center for Human Nutrition. Once you have gotten yourself on a healthy eating and exercise program, you can consider adding herbs as fine tuning, says Heber.

Taken regularly over time, certain herbs can help lower blood sugar, others improve cardiovascular health by lowering cholesterol and strengthening blood vessels, which are two crucial elements for people with type 2 diabetes.

Finally, herbs that contain powerful antioxidants can help reduce inflammation, which may lead to the development of type 2 diabetes and is also implicated in heart disease, kidney problems, and other life threatening conditions.

Discuss taking herbs with your doctor amd make sure to monitor your blood sugar levels regularly, when you factor herbs into your new active lifestyle and smart eating plan, you strengthen organ systems weakened by type 2 diabetes - and you just might be able to avoid taking blood sugar-lowering drugs. Here are some that show promise.

Cinnamon

This familiar spice not only reduces blood sugar, but also lowers cholesterol and triglycerides, and best of all, cinnamon is delicious sprinkled on oatmeal and other whole grain breakfast cereals. In a study conducted by the USDA's Beltsville Human Nutrition Research Center in Maryland, 30 women and men with type 2 diabetes dusted cinnamon on food. Their blood sugar dropped by 18 to 29%, total cholesterol by 7 to 27%, and their triglycerides plummeted 23 to 30% in just 40 days. "Effects of this magnitude could help prevent or alleviate diabetes-and its complications," says Richard Anderson, PhD, of the USDA's Human Nutrition Research Center. "I took about 1/2 teaspoon a day and after 3 months, my cholesterol dropped by 60 mg/dl."

Fennugreek

Fennugreek (Trigonella foenum-graecum) is a staple Ayurvedic medicine and is a spice found in curry blends. Its seeds, rich in fiber and protein, were used in ancient Chinese medicine to help people recover from illness. In studies, a fenugreek compound, called 4-hydroxy-isoleucine, stimulated pancreatic insulin production in rats, and fenugreek seed reduced fasting blood sugar levels. In other studies, people with diabetes who were given the herb handled glucose better in glucose tolerance tests. Finally, researchers found that people with type 2 diabetes who took fenugreek had reduced blood sugar levels after eating.

Gymnema

In Ayurveda, India's traditional medical system, gymnema (Gymnema sylvestre) is a widely used treatment for diabetes and obesity. Its Hindi name "gurmar" means "destroyer of sugar." The herb contains a compound called gymnenin, which lessens your ability to taste sweets, and also diminishes appetite for up to 90 minutes. Two long-term studies showed that the herb reduced fasting blood glucose in people with type 1 and type 2 diabetes.

Using Herbs Safely

Monitor blood sugar frequently. Discuss your plan with your doctor and don't use herbs if you are pregnant or nursing, unless an herbal practitioner recommends otherwise. Give it time to work - most herbs take at least 6 to 8 weeks to show full results.

Diabetics Can Count On Chromium

Author: Jack Challem
Source: Better Nutrition, September 2007

Chromium, an essential dietary mineral, plays a central role in how the body uses insulin to burn sugars, carbs, fats, and proteins for energy. Because of this insulin-enhancing role, chromium can be especially helpful in controlling, and sometimes reversing, some of the symptoms of prediabetes and type 2 (adult-onset) diabetes. Chromium supplements, which are commonly sold as chromium picolinate, chromium polynicotinate (niacin-bound chromium), chromium glycinate, and chromium amino acid chelate, may reduce appetite and contribute to weight loss. The mineral can sometimes help in treating depression, particularly atypical depression, which often manifests as depression accompanied by excessive hunger, weight gain, unexplained exhaustion, and/or too much sleep, according to psychiatrist Malcolm Noell McLeod, MD, author of Lifting Depression: The Chromium Connection, who has done extensive research on the link between chromium and depression.

HOW IT WORKS: Chromium is essential for the normal activity of insulin, the key hormone involved in burning food for energy. Symptoms of chromium deficiency, including elevated blood glucose, insulin, total cholesterol, and triglyceride, can resemble those of prediabetes and syndrome X. This doesn't mean that a lack of chromium alone causes diabetes, but low chromium intake likely contributes to diabetes.

When people eat a lot of sugars and sugar-like carbs, their blood sugar levels quickly rise. In response, the body secretes insulin to lower bood sugar. However, after many years of this "blood sugar-insulin roller coaster" cells become resistant or unresponsive to the action of insulin. This situation leads to still more insulin secretion in an effort to compensate - and ultimately to insulin resistance, the cornerstone of prediabetes and type 2 diabetes. Less insulin in bettter - and chromuim maximizes insulin function.

HEALTH BENEFITS: Supplemental chromium has many important benefits. Here's an overview:

Blood glucose and insulin. Chromium supplements can have a dramatic effect on blood sugar and insulin levels. In one study, people taking 300 mcg daily of niacin-bound chromium had significant decreases in fasting blood sugar and modest reductions in triglycerides and glycated hemoglobin (which reflect blood sugar levels over six weeks) after three months.

Weight control. Stable blood sugar often translates to fewer hunger jags, which in turn leads to eating less and losing weight. In one study, 28 overweight women took 200 mcg of niacin-bound chromium three times daily for two months, as part of a program of moderate dieting and exercise. The women lost significant amounts of fat, but preserved their fat- and sugar-burning muscle tissue.

Depression. Researchers at the University of North Carolina, Chapel Hill, School of Medicine found that supplements of chromium picolinate could relieve depression. It appeared most effective in dosages of 200-400 mcg in people who were overweight or had a history of overeating (again, associated with atypical depression). Many of the patients also began losing weight after taking chromium and were able to stop taking antidepressant drugs. Researchers believe chromium may increase serotonin.

BACKGROUND CHECK: The body's chromium reserves decrease with age. That's because large amounts of chromium are released to help metabolize sugars and refined carbs, but such foods provide little if any chromium to replenish the loss.

GLEANINGS: Marketplace competition between chromium polynicotinate (niacin-bound chromium) and chromium picolinate products is intense. Is one better than the other? According to Harry Preuss, MD, of Georgetown University in Washington both forms appear to be therapeutically equivalent. However, Preuss, one of the top chromium researchers, favors the polynicotinate form.

HEADS UP: You might remember that chromium was implicated as an industrial toxin in the movie Erin Brockovich. Hexavalent chromium is an industrial compound, which has a different chemical structure (six chemical bonds) from that of trivalent chromium (three chemical bonds). All supplements use trivalent, or nutritional, chromium.

GTF (glucose tolerance facctor) chromium was the term originally used to describe the chromium-containing molecule involved in regulating blood sugar and insulin. The structure of this molecule has never been identified. Nonetheless, chromium is essential for normal glucose tolerance and chromium deficiency can result in diabetes-like symptoms.

WHAT SHOULD YOU TAKE: Most chromium supplements provide 200 mcg per capsule and some contain 400 or 500 mcg. If you take insulin, Glucophage, or any other drug for regulating blood sugar, chromium may reduce your medication requirements over several weeks.

India is Leading in Diabetes

Saturday, January 19, 2008 22:46 IST

90 per cent of the cases are type-2 diabetes, less than 10 per cent of type-1

India is the leading country for diabetes with 31.7 million cases in 2000 and the number is expected to rise to 79.4 million by 2030, followed by China with 20.8 million, and the US is third with 17.7 million, according to a study by the World Health Organisation (WHO).

Says Dr Neal Barnard of the WHO, in 2000, 171 million people had diabetes worldwide but it was expected to rise to 366 million by 2030. About 90 per cent of the cases are type-2 diabetes (related to lifestyle) and less than 10 per cent of the cases are type-1 diabetes (genetic).

In type-2 diabetes, the body continues to make insulin but the cells of the body resist its action. In the latter, the body no longer makes insulin and is treated with insulin injections. Diet changes can make a drastic difference, sometimes eliminating the need for medication in both type-1 as well as type-2 cases.

Dr Barnard attributes this condition to ‘westernisation of diet’ which has played a major role in this epidemic. “Instead of exporting meat diets to India, America would do better to ‘Easternise’ its own diet and if Americans learn to eat dal, rice and palak they would be slimmer and healthier.” He says Indians should stick to the wholesome thali.

He advocates a plant-based diet which reduces blood sugar, cuts cholesterol and reduces body weight rather than a diet with meat, fish, poultry, milk products or eggs, sugar and oils.

“If strong action is not taken against diabetes prevalence, it will double in the next three decades,” warned Dr Barnard.

healthline@dnaindia.net

Diabetes :: The Indian Scenario

We Indians are more prone for diabetes than almost any other population in the world !

Since very long, we believed that diabetes and heart disease are exclusive to the affluent societies. So, Indian health care policies emphasized prevention of infectious diseases only.

But as the living conditions improved in India, we are increasingly following western dietary habits unsuited for our environs, adopting sedentary life style, and exposed to psycho-social stress. This has resulted in an unprecedented rise of diabetes to epidemic proportions during last few decades in our country.

The only national study till to date on diabetes completed in 1989, was coordinated by Prof. M.M.S. Ahuja of the All India Institute of Medical Sciences, and Dr. P.V. Rao who is presently at the Nizam's Institute of Medical Sciences. About 2% of the 12,000 people surveyed in Indian villages were found to be diabetic, and more alarming observation was that half of them did not know that they had diabetes. This infers that there are at least 20 million diabetics in India, which is the highest ever reported number from anywhere in the world.

Further, Indians tend to be diabetic at a relatively young age of 45 years which is about 10 years earlier than in West. The life expectancy in a diabetic is just about 8 years after the onset of the disease, as they succumb to kidney as well as heart disease more often than others. This is indeed very alarming !.

Another important consideration in this regard is the status of diabetes among migrant Indians living all over the world. There are several millions of Indians living outside India, either as recent migrants to Western countries such as England and United States or as the descendants of the 'coolies' indentured by British to South Africa, Mauritius, Malaya, Fiji and to the Caribbean countries like Trinidad, Guyana and Surinam. It is now well known that diabetes is more common in these migrant Indians than in the local host populations of these countries.

In a recent study concluded in 1992, and sponsored by the World Health Organization, Dr. P.V. Rao has screened populations of Indian origin living in London, Malaysia, and British Guyana for diabetes and heart disease. Diabetes among these migrant Indians was at least four times more than in Indians living in India. One among every 7 migrant Indians above 25 years of age, was diabetic. Furthermore, more Indian women than men were affected with diabetes among immigrants, which was not the case within India. These higher rates for diabetes among migrant Indians, and in specific among women are attributed to the quality rather than quantity of dietary intake, life style and social stress.

Indians eat less, weigh less and work more than Europeans. But why are they more prone for diabetes than Europeans?

'Thrifty Genotype' is the answer. This is a hypothesis on genetic inheritance put forward way back in 1956 by James Neel, a geneticist. Prof. M.M.S. Ahuja has adapted this to the Indian context, and Dr. P.V. Rao has tested this hypothesis over last five years of International research among Indians living within India and abroad.

Indians have lived through several centuries of famine and starvation, and largely survived on sustenance foods. Over generations, there evolved a 'thrifty genotype', which made them resistant to prolonged periods of starvation. We tend to store a part of our energy intake simultaneously while 'burning' it. Apparently that may be the reason for a 'big belly' on a small body frame among Indians.

The findings of the multinational study by Dr. P.V. Rao were that body fat around waist is the culprit to diabetes and heart disease among Indians. Overall body weight was not always high among Indians with 'big bellies'. This meant that total amount of food intake in an Indian was not high though the contents have changed over centuries from vegetable sources to 'fat rich' animal sources. Even the vegetable oils used for cooking such as coconut oil which is widely used in Kerala, Malaysia and Guyana are strongly related the high rise in diabetes rates among the populations screened from these areas.

There is a need for a concerted effort from all concerned to first of all know that we Indians are more prone for diabetes and heart disease. It is also important to understand that dietary restrictions as we follow blindly based on Western literature do not apply to Indian context. It is not how much a diabetic eats, nor the amount of 'sugar' one eats, but what matters is the amount and nature of the 'fat' in food. This warrants an urgent reconsideration of the traditional understanding of diabetic diets - "no rice, no sugar in coffee, no fruits or no potatoes" just doesn't mean anything. "No oils, no fats, no food fads' must be the first dietary advice for a diabetic especially in India."

Measure the waist, and not just the body weight - to know the progress of disease. Caution those prone to avoid paunch, not just obesity. This requires a better understanding among physio-therapists and 'weight-watchers' alike, of the causes for diabetes and heart disease.

Who will be a diabetic? Now it is possible for a reasonable 'guess'. If one is over 45, with a 'big belly' and a family background of diabetes, it is almost certain that he or she is going to be a diabetic. Then it may be possible to stop the disease process even before it appears.

Understanding diabetes, living with diabetes and preventing further complications are the major concerns of the health education programs being developed at the Nizam's Institute of Medical Sciences, Hyderabad.

Prescribing drugs and restricting diets are not the right answer for the emerging important problem of diabetes, but understanding the disease in our context and following specific measures against it are now more than ever urgently required.

updated on March 18, 2002 by Diabetes India by Paturi Vishnupriya Rao

Good News + Diabetes Management Up-Date

Stress, Over-weight, High Blood Pressure, Family History are some of the vital factors that may push you towards diabetes. Millions are at the pre-diabetes stage. For those working at high burn-out rate jobs the health related predictions are frightening and they could be moving towards developing diabetes.

Those with diabetes already have multiple complications to cope with. A stressed life becomes more stressful greatly adding to the severity of the problems that show in multifarious ways.

Diabetes unchecked or unmanaged becomes life threatening. Diabetes rob from life's joys and makes a diabetic vulnerable to many complications. Complications like : blindness, kidney failure, foot amputation, heart attacks, skin diseases, impotency, vascular degeneration, unhealed sores, etc., etc. A person with diabetes is at a higher risk for these types of conditions, but a person who does not control his diabetes is even more likely to develop one of these conditions.

Diabetic complications invade individual, marital, family, social and work-place purpose and impairs the person from giving or achieving the best despite his/her ability and inherent potential.

Here is the GOOD NEWS :

You can prevent most of these problems by keeping your blood glucose (blood sugar) under control, eating healthy, being more physically active, and working with your health care provider to keep your blood pressure and cholesterol under control and getting necessary screening tests.

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The High Price of Diabetes

U.S. Diabetes Costs Top $174 Billion

Study Shows Diabetes Costs Have Risen Nearly One-Third Since 2002

By Todd Zwillich
WebMD Medical News

Reviewed by Louise Chang, MD

Jan. Â 23, 2008 -- Diabetes is costing the country more than $174 billion per year, according to an analysis by the American Diabetes Association (ADA).

The study concludes that direct medical care and treatment for diabetes complications, along with indirect costs like lost productivity, have gone up by nearly a third since 2002.

Most of the medical costs associated with diabetes come from treating complications like eye disease, amputations, and kidney failure, according to the study conducted by the Lewin Group auditing firm. About $27 billion of the $116 billion in direct medical costs in 2007 went to treating diabetes itself.

"The cost most likely dramatically underestimates the true cost," says Ann L. Albright, PhD, ADA's president of health care and education.

The $174 billion figure means that nearly one-tenth of the nation's $2 trillion health budget goes to diabetes care.

More than 21 million Americans are thought to have diabetes. Albright says the report's estimates include roughly 6 million who have the disease but are undiagnosed.

Diabetes results when the body either doesn't produce insulin, produces too little of it, or doesn't respond to the insulin it does produce. Without insulin the body can't metabolize sugar. That can damage blood vessels and lead to a host of cardiovascular and other illnesses.

Ed Gregg, chief of diabetes epidemiology at the CDC, says the results are "not that surprising."

While diabetes patients on average have better glucose control than they did a decade ago, the number of people with diabetes continues to rise. Much of the trend is being driven by widespread obesity.

A 2002 study concluded that moderate exercise, dietary changes, and weight loss can help at-risk adults cut their chances of developing the disease by nearly 60%. The diabetes drug metformin was also effective at reducing diabetes incidence in at-risk adults.

A 7% weight loss, or 14 pounds for a 200-pound person, was enough to significantly cut diabetes risk, says Griffin Rogers, MD, chief of the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health. "It's not an enormous number."

Diabetes Overview

DIABETES OVERVIEW

There are three main types of diabetes, type 1, type 2, and gestational diabetes. You may have a health risk factor for type 2 diabetes if you; are overweight, are over 45 years of age, have a family history of diabetes, metabolic syndrome (insulin resistance), high blood pressure, abnormal cholesterol levels, a history of gestational diabetes, polycystic ovary disease, habitually inactive, or have a history of vascular disease (such as stroke).

Understanding diabetes is the first step to managing it. Get information on diabetes causes, risk factors, warning signs, and prevention tips.

What is diabetes?

Diabetes is a disorder of metabolism--the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body. After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

When we eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

What are the types of diabetes?

The three main types of diabetes are

* type 1 diabetes
* type 2 diabetes
* gestational diabetes

Type 1 Diabetes

Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body's system for fighting infection (the immune system) turns against a part of the body. In diabetes, the immune system attacks the insulin-producing beta cells in the pancreas and destroys them. The pancreas then produces little or no insulin. A person who has type 1 diabetes must take insulin daily to live. It develops most often in children and young adults, but can appear at any age.

Symptoms of type 1 diabetes usually develop over a short period, although beta cell destruction can begin years earlier. Symptoms include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue. If not diagnosed and treated with insulin, a person with type 1 diabetes can lapse into a life-threatening diabetic coma, also known as diabetic ketoacidosis.

Type 2 Diabetes

The most common form of diabetes is type 2 diabetes. About 90 to 95 percent of people with diabetes have type 2. This form of diabetes is associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and ethnicity. About 80 percent of people with type 2 diabetes are overweight.

Type 2 diabetes is increasingly being diagnosed in children and adolescents. However, nationally representative data on prevalence of type 2 diabetes in youth are not available. When type 2 diabetes is diagnosed, the pancreas is usually producing enough insulin, but for unknown reasons, the body cannot use the insulin effectively, a condition called insulin resistance. After several years, insulin production decreases. The result is the same as for type 1 diabetes--glucose builds up in the blood and the body cannot make efficient use of its main source of fuel.

The symptoms of type 2 diabetes develop gradually. Their onset is not as sudden as in type 1 diabetes. Symptoms may include fatigue or nausea, frequent urination, unusual thirst, weight loss, blurred vision, frequent infections, and slow healing of wounds or sores. Some people have no symptoms.

Gestational Diabetes

Gestational diabetes develops only during pregnancy. Like type 2 diabetes, it occurs more often in African Americans, American Indians, Hispanic Americans, and among women with a family history of diabetes. Women who have had gestational diabetes have a 20 to 50 percent chance of developing type 2 diabetes within 5 to 10 years.

What are the tests for diagnosing diabetes?

The fasting plasma glucose test is the preferred test for diagnosing type 1 or type 2 diabetes. It is most reliable when done in the morning. However, a diagnosis of diabetes can be made after positive results on any one of three tests, with confirmation from a second positive test on a different day:

* A random (taken any time of day) plasma glucose value of 200 mg/dL or more, along with the presence of diabetes symptoms.
* A plasma glucose value of 126 mg/dL or more after a person has fasted for 8 hours.
* An oral glucose tolerance test (OGTT) plasma glucose value of 200 mg/dL or more in a blood sample taken 2 hours after a person has consumed a drink containing 75 grams of glucose dissolved in water. This test, taken in a laboratory or the doctor's office, measures plasma glucose at timed intervals over a 3-hour period.

Gestational diabetes is diagnosed based on plasma glucose values measured during the OGTT. Glucose levels are normally lower during pregnancy, so the threshold values for diagnosis of diabetes in pregnancy are lower. If a woman has two plasma glucose values meeting or exceeding any of the following numbers, she has gestational diabetes: a fasting plasma glucose level of 95 mg/dL, a 1-hour level of 180 mg/dL, a 2-hour level of 155 mg/dL, or a 3-hour level of 140 mg/dL.

What are the other forms of impaired glucose metabolism (also called pre-diabetes)?

People with pre-diabetes, a state between "normal" and "diabetes," are at risk for developing diabetes, heart attacks, and strokes. However, studies suggest that weight loss and increased physical activity can prevent or delay diabetes, as weight loss and physical activity make the body more sensitive to insulin. There are two forms of pre-diabetes.

From :: Web MD 7:14 PM 25/01/2008