Diabetes Information

Diabetes Information
Submitted by Thiruvelan on 18 Nov 2010 | Last updated 13 May 2016
Diabetes is a chronic and complex disease, caused by having too much glucose (sugar) in the blood.
This happens when there is low or no insulin production or improper use of insulin.
What is Diabetes? - About Diabetes

Diabetes (diabetes mellitus) is a metabolic
disorder. Metabolism is a chemical process,
occurs in all living cells or organisms, consumed
food is broken down to yield energy and other
substances necessary for life. It, furthermore,
expels the waste let-out by this metabolic
process.
Most of the foods we eat are broken down into
glucose (a form of sugar) and released into the
bloodstream, which is the principal source of
energy for our body. However, presence of insulin
is vital to absorb glucose by our cells. Insulin makes it possible for our cells to take-up glucose.
Insulin is a hormone produces and secretes by the pancreas. Once the blood-glucose level rises after
eating, the pancreas automatically senses the glucose level, and it releases a proportionate quantity of
insulin in the bloodstream. This helps our body cells to consume the glucose present in our
bloodstream, and thus keeps the blood-sugar level at a normal range.
Diabetes is a condition in which the quantity of glucose in the blood is raised called hyperglycemia.
This happens when there is low or no insulin production or improper use of insulin.
Why is Diabetes and Diabetes Mellitus called so?

The term diabetes is from the Greek word diabaineine refers a tubular organ that take-in or expels
water - excessive urine discharges disease.
In 1675, Thomas Willis added mellitus (means honey in Latin) to the word diabetes and called it as
Diabetes Mellitus, which refers to too much of sweet taste urine.
Matthew Dobson in 1776 confirmed that diabetics urine and blood have excess sugar that contributes
to its sweet taste.
History of Diabetes & Diabetics

Obesity & Diabetes - Sushruta (6th century BCE), identified and relates diabetes with obesity and
sedentary lifestyle. In addition, suggests exercise to help cure it.
Ancient diabetes diagnosis Ancient Indians diagnose diabetes by watching whether ants got attracts
towards the urine, and they refer diabetes as sweet urine diseases. In addition, Chinese, Korean, and
Japanese called in the same manner.
Role of the Pancreas in Diabetes In 1889 Joseph von Mering and Oskar Minkowski discovered the
role of the pancreas in diabetes after they found that, a dog whose pancreas cut removed causes
diabetes symptoms and died later.
Insulin produced by Pancreas - In 1910 Sir Edward Albert Sharpey-Schafer confirmed that, a shortage
in chemical produced by the pancreas is behind the cause of diabetes.
World Diabetes Day Banting successfully purified hormone insulin from bovine pancreas and first
effective treatment on 1922. Banting receives the Nobel Prize in 1923 for this remarkable achievement
and honored by celebrating World Diabetes Day on his birthday that is November 14.
Distinction between diabetes types - Sir Harold Percival (Harry) Himsworth, first confirms type 1 and
type 2, and it was in 1936 publications.
Diabetes Information
Diabetes is a condition with a high blood sugar (glucose) level, caused by improper glucose
metabolism. Below are the lists of articles covering diabetes and its treatments, just click blue text to
read more.
Diabetes Symptoms
Diabetes Symptoms - Knowing the symptoms helps early diagnosis, timely treatment and avoids its
complications.
Diabetes Risk Factors

Diabetes Risk factors can increase your diabetes chances. Knowing and lowering it, helps prevent
diabetes.
Diabetes Testing
Diabetes diagnosis test are Fasting Plasma Glucose test, Oral Glucose Tolerance test, Random
plasma glucose test and HbA1C test.
Pre-diabetes
Pre- diabetes can anytime develop into full-fledged diabetes. Can you Prevent Diabetes? Yes, by
simple lifestyle modifications.
Type 2 Diabetes
Type 2 Diabetes Modify your lifestyle to manage healthy BS & A1C range for preventing diabetes
complications.
Type 1 Diabetes
Type 1 Diabetes Learn to eat right, carb counting, insulin dose calculation, and managing hypo &
hyper-glycemia.
Gestational Diabetes in Pregnancy

Gestational Diabetes & Diabetes during pregnancy Learn to manage BS with healthy eating, and
proper treatment for safer delivery.
Diabetes Lifestyle
Diabetes Lifestyle Modify Life in a healthy way by eating right, physically active, losing weight,
exercising, and stop smoking.
Diabetes ABC
Diabetes ABC - A stands for your A1C, B stands for your blood pressure, and C stands for your
blood cholesterol level. Managing all the three is important.
Diabetes Foods
Diabetes food choices should be Smarter and healthier. Low carb eating is preferable than low-fat diet
for effective blood-glucose management.
Diabetes Alternative Medicines

Diabetes Natural Treatment covered here are Herbs, Homeopathy, Yoga, Acupressure & Reflexology.
Prevent Diabetes
Do you have more risk factor towards diabetes? Do not worry, you can prevent diabetes with some
simple changes in your diet and activities.
Cure Diabetes
Is Diabetes Reversible? There is no known cure for diabetes; however, you can be able to manage it
near normal blood-glucose range.
Diabetes complications
Diabetes complications are due to badly managed BS, leads to nerves and organ damage. Learn to
stop diabetes complications.
Diabetes Risk Factors

Submitted by Thiruvelan on 22 Jun 2010 | Last updated 27 November 2013
Diabetes risk factor is a characteristic condition or behavior that increases the chances to develop
diabetes.
Diabetes risk factors

Certain factor that increases the chances of developing diabetes is called diabetes risk factors. Now let
us explore, what are the risk factors of diabetes and how do we prevent it.
Risk factors of Diabetes
Genetic or Hereditary risk factor studies show if mother has diabetes, there is some risk
towards diabetes, if the father has it, there is comparatively increased risk and if both parents have
diabetes, then chance is even more.
No or low physical activity will stop full utilization of the sugar or glucose from carbohydrate
food consumption. This raises the blood glucose-level forcing the pancreas to release excess insulin
leading to too much of glycogen and fat storage. In due course, pancreas loses its ability to balance
this increased insulin requirement end-up with diabetes.
Improper food habits such as eating foods high in carbohydrate leads to blood-glucose rise.
Pancreas work hard to lower it by increasing the insulin secretion. After some time, maybe months to
years the pancreas unable to keep up this increased insulin secretion leads to diabetes.
Obesity or overweight may indicate too much fat storage than the requirement during
starvation. Mostly, this huge storage takes time by prolong surplus consumption of carbohydrate food.
Various studies confirm excess of fat storage might be the risk factor for insulin resistance.
Chronic traffic-related pollution exposure - may contribute to the development of diabetes; a

clinical study shows. This is even prevails among individuals with a healthy lifestyle, nonsmokers, and
physically active.
Stress has shown to have major effects on metabolic activity by causing the release of various
hormones. Importantly, it elevates the blood-glucose level to fulfill fight or flight response. Thus, chronic
stress can lead to diabetes. Reference - Diabetes Care October 1992 vol. 15 10 1413-1422.
Sleep deprivation is associated with an adverse impact on glucose homeostasis. Insulin

sensitivity decreases rapidly and markedly without adequate compensation in beta cell function,
resulting in an elevated risk of diabetes. Additionally, sleep deprivation is associating with a disturbed
regulation of the neuroendocrine control of appetite. Insufficient energy and increased appetite forces
to eat in excess causing obesity and finally diabetes. Reference - PubMed PMID: 18591489.
Age over 40 to 45 years our body organs start losing its normal functioning, including
pancreas. Thus, aging makes it difficult to support increasing insulin requirement and the risk toward
diabetes.
Gestational diabetes during pregnancy indicates an increased risk towards diabetes for
both mother and the child. It is due to both genetic factor and bodys inability.
Previously diagnosed as pre-diabetes are at increased risk for diabetes. Pre-diabetes has
a high blood-glucose level higher than normal but not high enough to diagnose diabetes. You can
reverse pre-diabetes by adapting to diabetes lifestyle changes, otherwise end-up with diabetes in few
months or years.
Ethnic is also playing an important role in diabetes development. Certain country, region,
community, hereditary, food habits, climate and lifestyle have increased risk towards diabetes than
others.
Does diabetes affect only adults (over middle age)?

Diabetes prevalence is rising dramatically all over the world for last two decades, including among
children and teenagers. Screening for diabetes is not only important for the middle-aged people, but it
is also essential for children and adolescents who are at more risk towards diabetes. You and your
family checked blood-glucose levels recently, if not do it immediately?
A study show, lifestyle changes may mitigate genetic effects among diabetics: Chennai (Tamilnadu,
India) based researchers, part of an international study on the gene-environment interplay in diabetes
has exciting data that suggests that lifestyle modifications can override the effect of genes in an Indian
population.
Even though genetics is blamed for the diabetes epidemic, most probably it is due to children learn
habits of eating an unhealthy diet, not exercising from their diabetic parents. This increases the risk
towards diabetes, which has been falsely considered being due to genetic.
Diabetes Causes
Submitted by Thiruvelan on 22 Jun 2010 | Last updated 20 April 2013
Causes of diabetes can be due to any defect in the insulin production, insulin action or both; diabetes
is a disease marked by high levels of blood glucose.
What are the causes of diabetes?

The exact diabetes causes of both types are still unknown, still managed to identify some general
diabetes causes.
Type 2 diabetes causes

In a healthy individual, the pancreas releases insulin to help the body to store and use the glucose
from the food; we eat. Type 2 diabetes causes may be one or more of the following:
Pancreas does not able to produce enough insulin and causes diabetes.
Body does not properly respond to insulin (that is not sensitive to insulin), a condition called
"insulin resistance," which causes diabetes.
Alternatively, both insulin shortage and insulin resistance causes diabetes.\
Type 1 diabetes causes

Some genes may be behind the type 1 diabetes causes, but mostly the following trigger it:
Autoimmune disorder - our body immune system mistakenly attacks and destroys the insulinproducing cells of the pancreas and losing its ability to produce insulin that leads to diabetes.
Pancreas beta cells damaged by cystic fibrosis or pancreatic surgery can cause high blood
glucose called diabetes.
Video on diabetes causes
Gestational diabetes causes

Gestational diabetes is metabolic disorder happens during the later stages of pregnancy. It is difficult to
pinpoint the gestational diabetes causes, but have some clues of its causes.
The fetus provides with necessary nutrition via placenta during pregnancy. Placenta not only supplying
the nutrition to the fetus, but also releases some hormones like cortisol and estrogen. These hormones
are essential for the health and growth of the fetus. Unfortunately, these hormones block the insulin
receptors of the cells, which cause high level of blood glucose. It usually begins about 20 to 24th
weeks of pregnancy.
Does eating too much sugar develop diabetes?

Diabetes type 1 can develop by unknown factors that trigger the onset. Type 2 develops based on how
many risk factor you have and how severe it is. Taking too much sugar is considering as one of the risk
factor for type 2 diabetes; however, that alone will not develop type 2 diabetes.
Eating sugar, sweets or desserts do not cause diabetes. Unhealthy eating habit is one of the risk factor
for diabetes, but that alone does not cause diabetes, still when combine with other diabetes risk factors
can cause diabetes. If you eat right and exercise regularly, then you can reduce your risk of developing
diabetes type 2.
Diabetes Organs
Submitted by Thiruvelan on 22 Jun 2010 | Last updated 9 August 2012
What are diabetes organs? Pancreas and Liver are considering as diabetes organs, which are
responsible for the glucose metabolism.
Diabetes pancreas, liver & muscle cells

Glucose metabolism involves small intestine, pancreas, liver and muscle cell. If there are, any problem
with any of this diabetes organ leads to defect in glucose metabolism and can developdiabetes.
Diabetes pancreas
The pancreas produces various enzymes that aid in the digestive process, additionally to convert
glucose into energy. The pancreas secretes various enzyme and hormones, which include insulin
requires for the digestion and absorption of food. The glucose utilization in the body is controlling by
the insulin. Your body tissues requires insulin for proper glucose absorption, exception is your brain. If
your pancreas fails to produce or secretes sufficient amount of insulin, leads to elevated blood glucose
level called diabetes mellitus.
Functions of Insulin hormone

Insulin is a hormone, which controls and comments (signals) the whole glucose metabolism process.
When food is digested, glucose (first nutrient released from food, which energies the whole body) is
released in the blood stream. On seeing the high level of glucose in blood, pancreas releases certain
quantity of insulin with respect to the level of glucose in blood to normalize the blood-glucose level.
Insulin as a commenting signal
to muscle cells that inform there is enough glucose available for consumption
it is the commenting signal to liver to stop converting glycogen to glucose and releasing of
glucose in the blood stream.
if there is high level of glucose in blood than the normal requirement, then pancreas releases
high level of insulin with respect to the level of glucose. This high level of insulin is the blood is the
commenting signal to liver to convert available excess glucose in blood to glycogen and store it for
future requirements.
Diabetes and liver

Once after the body cells consume the required glucose, still if the blood-sugar level remains high.
Then liver convert this excess sugar in the blood stream into glycogen and stores it.
For any reason if the blood-glucose level drops below a normal level, mostly when we are in fasting.
Our liver immediately responds to this situation by converting glycogen to glucose and released into
the blood stream for our energy needs.
If the liver releases glucose inappropriately, even when there is enough glucose in blood (and insulin
in blood) may cause diabetes.
Diabetes Muscle cells

If the muscle cells do not consume glucose, even when there are enough glucose and insulin in the
blood, called insulin resistance may cause diabetes.
Many studies confirm that a large quantity of fat storage in and around the abdominal organs affect the
muscle cells sensitivity to the insulin hormone. Therefore, there is low utilization of insulin and thus the
blood-glucose level in the blood stream remains high.
Understanding diabetes organs defect that causes Type 2 diabetes
if the pancreas is not able to release, enough insulin (or needed excess quantity of insulin) may
cause Type 2 diabetes.
if the liver is not sensitive to insulin or/and mistakenly dump glucose into the blood stream even
when enough glucose is already, exist may cause diabetes type 2.
if the muscles cells are not sensitive to insulin (insulin resistance) or/and not properly use
(burn) the available glucose may raise blood-glucose level causing diabetes.
Diabetes pancreas damage and Type 1 diabetes
Most of the cases of Type 1 diabetes is due to autoimmune disorder. Our immune system
mistakenly attacks the pancreas by considering it as an enemy and causing damage to islet cells,
which releases insulin. So there is no or low insulin secretion.
certain viruses may attack pancreas causing damage to islet cells that leads to no or low
insulin secretion causing Type 1 diabetes.
pancreatic disease affects pancreas, leads to diabetes type 1.
Type 1 Diabetes Risk factors

Submitted by Thiruvelan on 11 Sep 2012 | Last updated 7 May 2013
Type 1 diabetes mostly occur among young people, however it can also develops among older
peoples. Type 1 diabetes happens when your pancreas stops producing insulin.
Type-1 diabetes risk factors

Type 1 diabetes mostly starts in childhood when the pancreas stops producing insulin. Insulin is a
hormone your body needs to burn glucose found in food for energy. The risk factors for type 1 diabetes
are:
Genetic (Hereditary) having a family member with diabetes is the major risk factor. A firstdegree family member mother, father, sister, or brother has diagnosed as type-1 diabetes.
Diseases of the pancreas - injury or any pancreatic diseases can affect its ability to produce
insulin and lead to type-1 diabetes.
Infection or illness - a range of rare infections and illnesses can damage the pancreas and
cause type 1 diabetes. That is exposure to certain virus causes autoimmune destruction of the islet
cells. The viruses, which trigger this, are Epstein-Barr virus, coxsackie virus, mumps virus or
cytomegalovirus.
Drinking of nitrates containing water may increase the risk factor.

Omega-3 fatty acids have considered providing certain protection against type-1 diabetes. Therefore,
regular consumption of fish containing omega fatty acid can reduce your risk towards type-1 diabetes.
Is type 1 diabetes a hereditary condition?

If once of the parents with diabetes type 1, in the case of father your chance for type 1 is 6%, in the
case of mother (had diabetes before 25 years) your chance is 4% and 1% chance if mother had
diabetes after her 25 years. Your risk will be double, if your parent was diagnosed around 10 years.
Does a child get diabetes type 1, without any family history?

Research shows that only 10 % of people with type 1 diabetes have a family history with first-degree
relatives, such as a sibling, parent, of offspring. These shows there are other important factors besides
just genes that influence the development of diabetes type 1. There is a misconception, type 1
diabetes is a genetic disease and mostly happens with family history. However, in reality, only 10 %
who have diagnosed with type 1 have a family history of the disease.
Type 2 Diabetes Risk Factors

Type 2 diabetes mostly starts in middle or old age when your body restricts to respond to insulin.Type 2
diabetes risk factors are classifying into two, they are uncontrollable type-2 diabetes risk factors and
controllable type-2 diabetes risk factors.
Risk factors of type 2 diabetes

Type 2 diabetes risk factors are classifying into two categories; they are:
Uncontrollable type-2 diabetes risk factors are factors that are not modifiable with your efforts.
Controllable type-2 diabetes risk factors are factors that are modifiable with your consistent
effort.
Uncontrollable type-2 diabetes risk factors

The risk factors for type 2 diabetes that are not modifiable are:
Genetic (Hereditary) family history of diabetes; family members are having diabetes.
Age - Your age is more than 45 years.
Gestational diabetes - You have had gestational diabetes during your pregnancy and/or given
birth baby, weighing more than nine pounds (4.082 Kgs).
Ethnic Asian, particularly Indian (world's largest diabetes population), Middle East, Oceania
and the Caribbean, African American, Hispanic Americans, and Native Americans, all have high rates
of diabetes.
Pre-diabetes - previously has diagnosed as pre-diabetes or impaired glucose tolerance.
Polycystic ovary syndrome - women with PCOS are at higher risk of type 2 diabetes.
Controllable type-2 diabetes risk factors

Type 2 diabetes risk factors, which are changeable with your consistent effort, are controllable diabetes
risk factors. They are:
Sedentary life style - is with no or low physical activity.
Unhealthy foods - when you regularly eating improper unhealthy foods.
Overweight or obese - You can consider as obese if your BMI is 30 to 39.9 and overweight if
your BMI is 40.0 and above.
High cholesterol level and HDL (or good cholesterol) level lower than 35 mg/dl and/or
triglycerides level more than 250 mg/dl.
High blood pressure - blood pressure is at or above 140/90 mmHg.

If you are having controllable diabetes risk factors, you can avoid having diabetes by lifestyle
modification with your consistent effort.
Everyone over 45 should have their blood glucose checked at least every 2 years. Moreover, be
performed more often if have high diabetes risk factors either controllable or uncontrollable.

If both the parents have diabetes type 2, your risk for diabetes is 45 %. If one of the parents has
diabetes type 2, your risk for diabetes is 14%. If parents and grandparents have diabetes, then you are
likely to develop diabetes at an early age, may be at your 20 to 25 years.
Does overweight or obese eventually develop type 2 diabetes?

Being overweight is a risk factor for diabetes; however, other risk factor combination also plays a role.
Most overweight individuals never develop diabetes type 2; furthermore, many with type 2 diabetes are
at their normal weight.
Sleep deprivation develop or worsen Insulin Resistance

Are you getting enough sleep? You need extra insulin on nights when you have sleep deprivation. A
small study shows a worsening of insulin resistance in people who has sleep deprived. You already
know that there is a role for sleep in learning, memory, and other central nervous system functions. A
prospective epidemiological study show insufficient sleep may increase the risk for metabolic
disturbances, including insulin resistance, obesity, and type 2 diabetes.
The cause of diabetes type 2 is insulin resistance; sleep deprivation may play a role in increasing the
incidence of type 2 diabetes or worsening its control for people who already have it. If you are diabetes
type 1, your insulin requirement may vary with the amount of sleep you get.
Psychological distress can increase your risk for type 2 diabetes.

A study has found people who are consistently under mental or psychological stress are more likely to
develop type 2 diabetes in the future.
A large UK survey found that people with higher levels of psychological distress were 33 percent more
likely to develop the metabolic condition compared to those with low distress levels.
Diabetes Test
Submitted by Thiruvelan on 22 Jun 2010 | Last updated 3 October 2014
Blood test is useful to diabetes diagnosis and monitoring of all diabetes types (pre, type 1, type 2 &
gestational). Diabetes test is easier, faster, and less expensive to perform.
What is diabetes test?

Diabetes test is a simple blood test to diagnose diabetes or to monitor diabetes. Diabetes test is testing
the glucose or sugar level in your plasma or previously blood.
Commonly used diabetes testing
Diabetic testing is testing for glucose or sugar level in blood or plasma, commonly used tests are
fasting plasma glucose test, oral glucose tolerance test, and random plasma glucose test.
1.
Fasting plasma glucose (FPG) test - this test is to measure bloods plasma-glucose after
fasting for at least 8 hours, thus the name fasting plasma glucose test. This test is useful to detect all
types of diabetes.
2.
Oral glucose tolerance test (OGTT) - which measures blood glucose after 8 hours of fasting
and 2 hours after the person drinks a glucose-containing beverage. This test is effective to diagnose all
types of diabetes.
3.
Random plasma glucose test - also called a casual plasma glucose test, because there is no
fasting required or worry about what we have eaten. This test, along with an assessment of symptoms,
is used to diagnose diabetes but not pre-diabetes. However, once random plasma glucose test
confirms diabetes needs to be reconfirming by FPG or OGTT.
4.
Glycated hemoglobin A1C test also called as HbA1C test, this test also do not require
fasting or need to drink anything and can take at any time at your convenience. This test provides the
mean blood glucose level for last 2 to 3 months. Thus help assess, how well or worst your diabetes
treatment is responding.
For many, making few lifestyle changes such as losing some weight, increase in physical activity and
eat healthy can help reverse diabetes or at least help reduce the medicine dosage.
FPG Test
The fasting plasma glucose (FPG) test or fasting blood sugar test, which measure blood sugar or
glucose levels and is useful in diabetes diagnosis. It is a simple, relatively reliable, and inexpensive test
for diabetes diagnosis.
What is fasting blood sugar test?

Fasting triggers a glucagon hormone, when there is no longer enough glucose in blood for energy. The
pancreas produces glucagon hormone, and it instructs the liver to convert stored glycogen to glucose
and release it into the bloodstream for energy requirements.
Once liver releases glucose into the bloodstream, normal body immediately releases insulin to prevent
hyperglycemia (high blood glucose). However, for diabetics, there is no longer enough insulin secretion
or improper use of available insulin, thus fasting blood-glucose level stays high.
Fasting Plasma Glucose Test procedure

For FPG test, you require to have been fasting for at least 12 to 14 hours (must not to eat or drink
anything except water for 12 to 14 hours). Because of this prolong fasting; the test is convenient to
have in the morning.
Blood glucose levels: FPG test can be mention with different measurement units; they are:
milligrams per deciliter (mg/dl), is the unit to measure that shows x milligrams of glucose in the
blood plasma per deciliter of blood, Blood glucose level in mg/dl is the unit used in United States.
millimoles per liter (mmol/L), is the unit of measure that shows 'x' mmol concentration of glucose
in the blood plasma per liter of blood. In most part of the world (except United States) uses this unit for
blood-glucose test results.
Diabetes Blood Glucose Level Signal
Diabetes: Blood glucose level more than126

mg/dl or 7 mmol/L is confirmed as diabetes.
Pre-diabetes: 100 to 126 mg/dl or 5.56 to 7

mmol/L is pre diabetes (impaired fasting
glucose).
Non-diabetic: Glucose level of 70 - 99

mg/dl (3.89 - 5.5 mmol/L) is considered
normal.
Hypoglycemia blood glucose levels

Blood glucose levels lower than 70 mg/dl is considered as hypoglycemia.
Blood glucose levels lower than 3.89 mmol/L is considered as hypoglycemia.
Even if the results are within the normal range, additional testing may be ordered to determine if a
person has additional risk factors for diabetes, such as high body mass index (BMI), or if exhibits other
symptoms of diabetes.
Also if the test result confirms diabetes at the border line level, then doctor may order another test on
another day to reconfirm diabetes.
OGTT
The oral glucose tolerance test measures the bodys ability in glucose metabolism and clearing excess
glucose in a bloodstream.
Oral glucose tolerance test

The oral glucose tolerance test (OGTT), can also be called as glucose tolerance test or sugar tolerance
test. It is used to measures the bodys ability in glucose metabolism and clearing excess glucose in the
bloodstream. The test is useful in the diagnosis of diabetes, gestational diabetes and pre diabetes.
Importance of the OGTT

OGTT is better able to diagnose high blood-glucose after a glucose challenge than the fasting bloodglucose test. Doctor may recommend OGTT, if he/she suspects diabetes in cases where patients
fasting, blood-glucose level is normal, but have other symptoms of diabetes or overweight.
An OGTT is most commonly preferred to check for diabetes that happens during pregnancy
(gestational diabetes).
Oral glucose-tolerance test procedure

OGTT test needs at least 8 to 12 hours of fasting. In addition, another test after the patient drink a
glucose-rich beverage, typically a drink containing 75 grams of carbohydrates (other different levels of
glucose consumption are also possible, but the result may be analyzed accordingly). Blood will be
drawn and tested after one hour and two hours after having a glucose beverage.
What is the Oral glucose tolerance?

Oral glucose tolerance means the body ability to tolerance against the consumption of a certain
amount of glucose. That is how effective the body is in breaks down (metabolizes) blood glucose.
OGTT provides details about how quickly glucose is absorbed into the bloodstream for use by body
cells as energy. The rate of glucose clearance depends on the amount of glucose consumed. After
fasting, the normal blood-glucose rate is 60 to 100 mg/dl.
Normal, pre-diabetes, diabetes OGTT blood glucose level

For 75 grams of glucose consumption; the normal, pre-diabetes, diabetes blood-glucose levels are as
below.
Oral Glucose Tolerance Level Signal
Diabetes: Blood glucose level

above 200 mg/dl (11.1 mmol/l) is
consider as diabetes.
Pre-diabetes: Glucose level of 140 199 mg/dl (7.77 - 11 mmol/l) is

consider as prediabetes (impaired
fasting glucose).
Non-diabetic: Blood glucose level

below139 mg/dl or 7.72 mmol/l is
consider normal.
Oral glucose tolerance test is useful to diagnose diabetes, as well as provides additional information
about the bodys ability to metabolize blood glucose. Higher OGTT values are likely to reflect diet,
lifestyle problems and problems of insulin functioning.
RPG Test
Random plasma glucose test measures plasma or blood-glucose levels. It is performed with a small
blood draw taken at any time of the day no fasting is required or no worry about what you have eaten,
so called as the casual plasma glucose test.
Casual plasma glucose test

It is a general used as a screening test for diabetes when a patient has had food or drink and therefore,
cannot do a fasting plasma glucose test or oral glucose tolerance test.
Interpreting random plasma glucose test

Blood
glucose
level
of under
200
mg/dl
or
11.1
mmol/L is normal.
Blood glucose level of over 200 mg/dl or 11.1 mmol/l is diabetes, if you additionally have diabetes
symptoms.
Doctor recommends a subsequent re-test on a different day. This re-test should be Fasting plasma
glucose test or Oral glucose tolerance test.
Blood Sugar Levels

Submitted by Thiruvelan on 30 Dec 2010 | Last updated 20 April 2013
For proper understanding of diabetic health, you must compare with a normal healthy individual
(person without diabetes).
Blood sugar number means

In order to understand how your blood sugar behaves throughout the day? You need to monitor your
blood sugar at different times. Your doctor can help you finding suitable blood-glucose target range.
Here, we provided general blood-glucose numbers based on the American Diabetes Association
guidelines.
Blood-glucose level influencing factors

Seven factors can influence your blood-glucose level.
Foods you eat,
Exercise you undertake,
How effective you are managing your stress,
Individualized medication you take,
Restful sleep you get,
Illness you have,
Hormonal changes
Self-monitoring of glucose level is the best tool to keep track of these influencing factors. It helps you to
take necessary measures to control your blood-glucose level more effectively.
Fasting blood-glucose number (before breakfast)

This test needs to be performing on an empty stomach, mostly after eight hours of fasting before
breakfast. It shows how effective your long-acting insulin or medication that you take. In general, the
results will be as follows:
FPG blood sugar number is considering normal up to 100 mg/dl (or 5.5 mmol/L).
FPG Levels between 110 and 125 (6.1 to 6.9 mmol/L) are considering impaired fasting glucose
(pre-diabetes). It is slightly higher than normal but not high enough to diagnose as diabetes.
FPG level of 126 mg/dL (7.0 mmol/L) or higher absorbed on two different days are confirmed as
diabetes.
diabetics on treatment should plan to achieve between 90 and 130 mg/dL (5 mmol/L to 7.2
mmol/L).
Pre-meal blood glucose number (before lunch & dinner)

This reading should be carried out before lunch and dinner. It shows how effective your breakfast and
lunch time insulin or medication dosage.
for a normally healthy individual the blood sugar levels are maintained between 82 to 110 mg/dL
(4.4 to 6.1 mmol/L).
for diabetics, the blood sugar number should be managed between 90 and 130 mg/dL (5
mmol/L to 7.2 mmol/L).
Two hours after eating (breakfast or lunch or dinner)

Blood glucose rises to its peak for few hours after you eat (not only for diabetics also for non-diabetics).
for people without diabetes, blood sugar increases modestly after eating and decreases after
two hours of eating.
blood-glucose number measured between 140 to 200 mg/dL (7.8 to 11.1 mmol/L) is considering
as at risk for type 2 diabetes and is referred to as impaired glucose tolerance or pre diabetes.
for diabetes, the initial increase is significant high and the level should remain at least that 180
mg/dL (10 mmol/L).
This reading shows if the insulin/medication you took was enough to cover the carbohydrates that you
ate.
Just before bedtime

A target range for someone with diabetes is 110 to 150 mg/dL (6.1 to 8.4 mmol/L). You should not go
to bed with blood sugar that is too low, because that may put you at risk of having a severe
hypoglycemia (low blood sugar) episode during the night.
Type 1 Diabetes Diagnosis Tests

Submitted by Thiruvelan on 03 Sep 2011 | Last updated 20 December 2011
High level of blood glucose is first test with random blood-glucose test, fasting blood-glucose test
and/or oral glucose tolerance test.
This only helps to diagnose diabetes that is the condition with a high blood glucose/sugar level. After
that how do we differentiate between diabetes type 1 & 2.
Diagnosing Type 1 Diabetes

The type 1 diabetes can be confirming with autoantibody testing; they are:
Islet cell cytoplasmic auto-antibodies
Glutamic acid decarboxylase auto-antibodies
Insulinoma-associated-2 auto-antibodies
Insulin Auto-antibodies
Islet cell cytoplasmic auto-antibodies test

This test helps to measure islet-cell autoantibodies that attack against a variety of islet cell proteins.
This is the most commonly detected among newly diagnosed diabetes type 1, almost detected in about
80% of type 1 diabetes.
Glutamic acid decarboxylase auto antibodies test

This test helps to measure autoantibodies that attack against beta cell proteins (antigen) still it is not
that much specific to beta cells. This is the also most commonly detected among newly diagnosed
diabetes type 1, almost detected in about 75% of type 1 diabetes.
Insulinoma Associated 2 auto antibodies test

This test also measures autoantibodies attacking against beta cell antigens, but it is not specific, still
detects in about 60% of type 1 diabetes.
Insulin Auto-antibodies test

This test measures autoantibody targeting against insulin; this is an antigen considered more specific
to beta cells. Detected among 50% of type 1 diabetes children, it is not commonly detected among
adults.
To confirm the diabetes type, expert suggest a combination of the above-said autoantibody tests for
newly diagnosed diabetes, to distinguish between type 1 and type 2 diabetes.
Normal Blood Glucose Level

Submitted by Thiruvelan on 09 Oct 2013 | Last updated 9 October 2013
What is the normal blood-glucose level? Healthy glucose level is the BS number generally noted
among the young non-diabetic people.
What is the normal blood-glucose level?

The BS numbers recommended by the popular institutions or organizations for healthy, pre-diabetes
and diabetes are generally slightly in a high side. These institutions do so base on an older study,
which predicted those who have diagnosed as pre-diabetes has progressed to diabetes early due to
mental strain. Thus, they push the numbers slightly to a higher range to stop diabetes progression.
However, many health professionals think their patients are intelligent, smarter, and brave enough.
Therefore, the patients are strong to take challenge and considering it as an alarm in preventing
diabetes.
Perfect normal blood-glucose levels noted among most young healthy persons (non-diabetic adults)
are:
Fasting blood-glucose level: 7090 mg/dl (3.895.00 mmol/l)
One hour after a meal: 90125 mg/dl (5.006.94 mmol/l)
Two hours after a meal: 90110 mg/dl (5.006.11 mmol/l)
Five hours after a meal: 7090 mg/dl (3.895.00 mmol/l)

If your blood-glucose levels are more than the above-said range, then you are at increased risk
towards diabetes. Thus, require taking necessary steps to prevent diabetes; otherwise, diabetes may
develop within next few years or decades.
You are not only risked towards diabetes; additionally, even undiagnosed as diabetes for years, your
body develops diabetes complications, read on to know why.
Nerve damage begins even during impaired glucose tolerance:

The spectrum of neuropathy is in diabetes and impaired glucose tolerance Neurology January 14,
2003 vol. 60 no: 1 108-111. The neuropathy associated with IGT is milder than the neuropathy
associated with diabetes. Small nerve fibers are prominently affected and may be the earliest
detectable sign of neuropathy in glucose dysmetabolism. OGTT is appropriate in patients with
idiopathic neuropathy.
Increased prevalence of Impaired Glucose Tolerance is in patients with painful sensory Neuropathy
Diabetes Care August 2001 vol. 24 no: 8 1448-1453. The results suggest IGT may cause or contribute
to small-fiber neuropathy, which is similar in phenotype to the painful-sensory neuropathy commonly

encountered in diabetes. Two-hour OGTT is more sensitive than other measures of glucose handling in
screening these patients?
Cardiovascular disease risk increase even before diagnosed as prediabetes:

Inflammation markers and metabolic characteristics of subjects with one-hour plasma glucose levels,
Diabetes Care November 16, 2009, doi: 10.2337/dc09-134. 1-hour OGTT result over 155 mg/dl (or 8.6
mmol/L) links with markers for cardiovascular disease. "Normal" glucose tolerance as defined by
doctors and researchers means a 2-hour blood sugar reading of under 140 mg/dl on an oral glucose
tolerance test. Thus, it is essential to keep one-hour blood sugar reading after meals under 140 mg/dl.
The reliance of doctors on two-hour glucose-tolerance test results allows people to live for years with
blood sugars high enough to promote complications long before they are diagnosed even pre-diabetes.
Diabetes Diagnosis
Submitted by Thiruvelan on 21 Sep 2013 | Last updated 9 October 2013
Diabetes diagnosis is by blood sugar tests. Diabetes diagnosing tests are Fasting Plasma Glucose
FPG test, Oral Glucose Tolerance OGT test (most emphasized), Random plasma glucose test (not
reliable) and A1C.
Diabetes screening criteria - Who should be diagnosed for diabetes?

A principle or standard by which diabetes screening has suggested this set of standard is diabetesscreening criteria.
Criteria for diabetes diagnosis are:
More than two diabetes risk factors,
Central obesity,
Have had gestational diabetes,
Already diagnosed as pre-diabetes,
Presence of diabetes symptoms,
Have hypertension or high blood pressure,
Have hyperlipidemia or high blood cholesterol.

If you met most of the above-said criteria, then you need to undergo for diabetes screening.
How is diabetes diagnosis?

Blood tests are used to diagnosis diabetes; there are several ways to diagnose diabetes. They are
fasting blood-glucose test, oral glucose tolerance test, and glycated hemoglobin A1C test.
If the test result indicates that a person has diabetes, then should be re-confirming with a second test
on a different day. What is pre-diabetes? The blood glucose is higher than normal but not high enough
to diagnose diabetes. Pre-diabetes puts you at risk for developing type 2 diabetes.
Fasting Plasma Glucose (FPG) is a blood-glucose test after not having anything to eat or
drink (except water - even do not drink a lot of water before the test) a minimum of eight hours before
the test. This test is conveniently carryout in the morning, before breakfast. Confirm diabetes diagnosis
if BS is greater than or equal to 126 mg/dl (7 mmol/L). Diagnose as pre-diabetes if BS is 100 mg/dl to
126 mg/dl (5.56 to 7 mmol/L). Confirm hypoglycemia if BS level is lower than 70 mg/dl (3.89 mmol/L).
Oral glucose tolerance test (OGTT) or glucose challenge test is a blood-glucose test before,
and two hours after you eat a carbohydrate-rich food or drink a special sweet drink. Confirm diabetes if
BS is greater than or equal to 200 mg/dl (11.1 mmol/L). Diagnose as pre-diabetes if BS is 140 mg/dl to
199 mg/dl (7.77 to 11 mmol/L). The oral glucose tolerance test is no longer useful in hypoglycemia
diagnosis because experts say the test can actually trigger hypoglycemic symptoms.
Random plasma glucose test is a blood-glucose test at any time of the day no restrictions.
Confirm diabetes diagnosis if the BS is greater than or equal to 200 mg/dl (11.1 mmol/L).
Glycated hemoglobin test (A1C) is a test done at any time, there is no fast or drink anything,
and it measures the average BS for the past two to three months. Confirm diabetes diagnosis if the
A1C percentage is greater than or equal to 6.5%. Diagnose as pre-diabetes if the A1C is 5.7% to 6.4%.
What test is preferable in early diabetes diagnosis?

Why does most patients diagnosed as diabetes along with complications? You can find answer for this
question from this study. "Impaired fasting glucose or impaired glucose tolerance, what best predicts
future diabetes in Mauritius," was published in Diabetes Care March 1999 vol. 22 no. 3 399-402. It
shows the higher sensitivity of IGT over IFG for predicting progression to type2 diabetes. Screening by
the criteria for IFG alone would identify fewer people who subsequently, progress to type2 diabetes
than would be the oral glucose tolerance test.
Thus, it is preferable to take both IFG & IGT tests for early diagnosis of diabetes. However, most
doctors chose only IFG for diagnosis thus high percentages of people with IGT has missed out from
diagnosis.
BS number once confirms diabetes and next proved wrong, why?

People getting different results between tests may indicate diabetes is trying to get through the system.
Where blood-glucose levels have not risen high enough or not yet stabilizes to be higher level to show
up on every test result.
For many, making few lifestyle changes such as losing some weight, increase in physical activity and
eat healthy can help reverse diabetes or at least delay its onset.
Newly Diagnosed Diabetes

Submitted by Thiruvelan on 09 Apr 2013 | Last updated 9 April 2013
Are you newly diagnosed diabetes? Do not worry, it will not help you, learn about diabetes to make it
bow you otherwise it will make you bow.
Are you diagnosing as diabetes recently?

It is very hard to accept that you have diabetes. However, learning about diabetes is the first step for
every newly diagnosed. This helps you to feel better, life healthier and gets you longer life.
Knowledge is power learn a lot about diabetes and its management. Start your diabetes treatment
along with lifestyle changes such as healthy diet, physical activity, self-monitoring of blood glucose,
and lose weight (if overweight).
Make your diabetes bow you

It is natural that newly diagnosed person has always being challenged by diabetes management
difficulties! Do not bow to it and make it a big obstacle in front of you. Instead, keep a brave heart, be
positive, learn to handle diabetes and make it to bow you.
Do not allow diabetes to control your life; instead change your attitude towards it. Accept it and put a
brave heart, be positive and take control of your diabetes.
You (Diabetic) needs to be smarter.

S Stress management help stops your roller coaster effect and stabilizes your blood-glucose level.
M Measure, Monitor your carbohydrate and manage it in an optimal range.
A A1C test for every four months; fix and achieve your target to avoid diabetes complications.
R Restful sleep helps your diabetes management in an amazing way.
T Treatment for your diabetes is required with a proper insulin and/or medication dosage, exactly at
the same time every day.
E Educate yourself and Exercise regularly for your overall physical & mental health.
R Reward yourself for your D achievements, this helps you motivate further.
What do I do, I am newly diagnosed type 2 diabetes?

Once newly diagnosed as diabetes type 2, it is quite natural to feel scared, depressed or anger. These
feeling only make your diabetes management more complicated.
You need to:
Educate yourself because knowledge is the power; it helps you to gain confidence.
Be smarter in your food choices. Your does not need to avoid sugars instead learn to count carb
and maintain your target range.
Be more active or do physical exercise regularly.
Check your blood glucose periodically.
Discuss with your doctor, whether you can manage your diabetes with lifestyle change and
without medication.
Otherwise, learn different diabetes medication options you are having. How does an oral
diabetes medication work to lower blood-glucose level? Discuss with your doctor for a best medication
& dosage.
Stop smoking, if you are a smoker.
What do I do, I am newly diagnosed type 1 diabetes?

Newly diagnosed as diabetes type 1 may come as a shock, the first question will be why me? No one
wants to admit I had it. Other questions hang before you may be how it going to affects my life. How I
am going to relief from this shock? How I am going to manage my diabetes?
Therefore, you need to:
Educate yourself, because knowledge is the power, especially at the time of diagnosis. Learn as
much as you can about the condition; the effort you put on can directly effluence how well your
diabetes management will be.
Read the stories of other people with type 1 diabetes and learn how they find a way to better
diabetes management.
Learn about blood-glucose extremes; hypoglycemia (low blood glucose) or hyperglycemia (high
blood glucose) and how to avoid these extremes.
Be smarter in your food choices; learn how to do carb counting, know how much you need per
day, and try to get it safely.
Learn how to calculate your insulin dosages: basal (insulin requirement for the entire day) and
bolus (insulin to cover the foods you are going to eat).
Be more active or do physical exercise regularly.
Check your blood glucose regularly.
Finally yet importantly, you should do an A1C test every three to four months.
What is Diabetes ABC?

According to American Diabetes Association (ADA), diabetes-ABC is the key to manage your bloodglucose level better than before and help prevent or delay diabetes complications.
A stands for your A1C (average blood-glucose level) measure it at least two times a year. Fix a
suitable target and try achieving it.
B stands for your blood pressure, periodic blood pressure measurement is must, and you
should aim for a blood pressure level below 130/80 mm Hg.
C stands for your blood cholesterol level, measure your lipid profile every 3 to 6 months and
manage it within target range with proper diet, exercise and medication (if required).
A1C
The A1C test is a blood test that reflects the average blood-glucose level over the last two to three
months. Blood sample to check A1C can be taking at any time of the day, does not require fasting.
History of A1C test

In 1950s, hemoglobin A1c was identified as one of the largest fractions of the minor components of
normal adult hemoglobin. Followed by different discoveries and in 1976, Koenig and colleagues
demonstrated that HbA1c concentration was an indicator of fasting blood-glucose
concentrations.HbA1c concentrations decreased as diabetes control improved with treatment.
What is A1C test?
Hemoglobin is a protein in the red blood cell, which transports oxygen from your lungs to the whole
body. This hemoglobin get glycosylated by glucose called as glycated hemoglobin. The blood-glucose
level decides the volume of glycosylation reaction and the level of glycated hemoglobins. The life of red
blood cell in our body is approximately three months (120 days). Thus, A1C provides the average blood
glucose over three months.
HbA1c is a simple blood test measures the percentage of hemoglobin variant A subtype 1c that has
been attached to the glucose in the blood. To find HbA1c, have to count the percentage of red blood
cells attached to glucose.
This test measures as a percentage of glycated hemoglobin; for example, an A1C of 4.5% does mean
4.5% of the total hemoglobin has glucose attached to it.
Our glucose meter measures blood glucose directly in the blood in mg/dl or mmol/l. For example, blood
glucose of 90 mg/dl means 90 mg of total glucose in the deciliter of blood or blood glucose of 5 mmol/l
means 5 mmols of glucose in a liter of blood.
However, blood-glucose levels in the preceding 30 days can make more effect in the A1C than the 90
to 120 days earlier. That is why A1C level rise or drop quickly within 30 days of stringent or badly
managed diabetes respectively.
If you are having A1C percentage, it looks less meaning, until you convert it into equivalent bloodglucose level help provide more meaning. You can learn more by visiting A1C chart & calculator.
How is the blood sample collected for A1C testing?

HbA1c tests can easily do with a regular finger stick or a blood sample drawn from a vein in your arm
like testing for blood glucose. Blood sample to check A1C can be taking at any time of the day, fasting
not required. Home tests are now available too; they are subject to inaccuracy, if not conducted exactly
as stated in the instructions.
Types of method to measure HbA1C

Four basic types of methods are in use to measure HbA1c; they are:
1.
Immunoassay,
2.
Ion-exchange high-performance liquid chromatography (HPLC),
3.
Boronate affinity HPLC,
4.
Enzymatic assays
Laboratories should be aware of their method limitations with respect to interference from the most
prevalent Hb variants. They can also select new methods that are less likely to have interference. As
with any laboratory test, any result that does not fit the clinical picture should require investigation
further with the clinician.
Ask your doctor if the lab running the test uses a method that has certified by the NGSP. Sadly,
however, not every laboratory or home test kit meets those standards. List of NGSP Certified
Laboratories.
Factors affecting HbA1C

A1C can be increases or decreases by certain factors; they are:
1.
Decrease or increase in erythrocyte (decrease in RBC) can make you A1C to lower or increase
respectively.
2.
Hb Variants - Hemoglobin S trait, which affects about 8% of African Americans, hemoglobin C

trait, which affects approximately 3% of African Americans, and hemoglobin E trait, which affects 10%
to more than 50% of Southeast Asians in California, are all reported to affect some HbA1c assay
methods. Elevated hemoglobin F, which is associated with thalassemia syndromes, also affects some
assay methods.
3.
Hypertriglyceridemia interfered with some assay methods and falsely increasing results.
4.
High bilirubin interferes with some assay methods and falsely increasing results.
5.
Aspirin interfered with some assay methods and falsely increasing results.
6.
Vitamin C & E ingestion interfered with some assay methods and falsely decreasing results.
7.
Chronic alcohol abuse produces false high.
8.
A splenectomy is a surgical procedure that partially or completely removes the spleen, will
falsely raise A1C.
9.
Chronic liver disease has false A1C low.
Causes of decrease in erythrocyte (lower A1C):

1.
Anemia & thalassemia or hemolytic anemia, liver disease
2.
Hemorrhage or bleeding - heavy menstrual periods in women and stomach ulcers,
3.
Hemolysis (RBS destruction) - due to transfusion, blood vessel injury, or other causes,
4.
An erythropoietin deficiency - secondary to kidney diseases, Uremia (BUN > 85 mg/dl), and
Severe nephropathy ( shorten RBC survival)
5.
Bone marrow conditions - include leukemia, multiple myeloma (cancer of the plasma cells in
bone marrow), and lymphoma (blood cancer).
6.
Medical conditions leads to low RBC count include cancer, rheumatoid arthritis, HIV/AIDS.
7.
Nutritional deficiencies such as iron, copper, foliate vitamins B6 and B12 can falsely affect the
result.
8.
Medications - chemotherapy drugs, chloramphenicol, hydantoins, quinidine.
9.
Over hydration
10.
Pregnancy
Causes of an increase in erythrocyte (higher A1C)

1.
Cigarette smoking
2.
Congenital heart disease
3.
Dehydration (due to severe diarrhea)
4.
Kidney tumor (renal cell carcinoma)
5.
Low blood oxygen level (hypoxia)
6.
Pulmonary fibrosis
7.
Polycythemia Vera
8.
Medication: Gentamicin, Methyldopa

Once A1C interferences are recognized; choosing an alternative form of testing, such as glycated
serum protein testing (fructosamine or glycated albumin) can help assess glycaemia better.
Unfortunately, factors affecting the accuracy of HbA1c measurement may not be recognized clinically.
How accurate is A1C test?

The A1C test result accuracy is up to 0.5 percent plus or minus the actual. This means an A1C of 6.0
percent can measure differently as 5.5 to 6.5 percent.
Many people have a question, what does it mean if I have a high A1C and normal blood sugars? Many
others, on the other hand, have a question, what does it means if I have normal A1C and high fasting
glucose? If you are one among them visit A1C glucose level relationship.
You may also be interested in:
What are the benefits of A1C test? You can learn by visiting A1C benefits.
What is a normal A1C target? You can learn by visiting Healthy A1C goal.
How do you convert A1C to estimated average glucose (eAG)? You can easily convert by
visiting A1C to BS chart & calculator.
How do you lower your A1C? You can learn by visiting lower your A1C.
What is the relation between A1C and blood-glucose test? You can learn by visiting A1C
glucose relationship.
A1C Glucose Relationship

Submitted by Thiruvelan on 17 Aug 2012 | Last updated 6 January 2014
Many people may ask what it means if I have a high A1C and normal blood sugars. On the other hand,
some more people may ask what it means if I have healthy A1C and elevated fasting glucose. If you
are one among read on for clarification.
Relation between A1C and blood-glucose test
The A1C test is a blood test that reflects the average blood-glucose level over the last two to three
months. On the other hand, glucose test is to measure the glucose level at that instance. A1C and
glucose level is closely related; however, at many instances, it seems unrelated.
Unknowingly, you may have a lot of blood-glucose highs and lows, thus end up with an unrelated
hba1c as compared with meter reading. You are taking glucose reading only at a certain time during a
day.
What it means if you have high A1C and normal blood sugar? It shows, presently you are in tight diabetes control that your
glucose meter indicates. However, you may be badly managed your diabetes for past weeks or months that has reflected in you
A1C.
What it means if you have normal A1C and high blood sugar? A good A1C means, your diabetes
control was well past one or two months that appeared in you A1C result. However, presently you are
in badly controlled diabetes, shown by your glucose meter.
When might an HbA1c test consider being not accurate? Your HbA1c is conflicting with home
glucose monitoring; for example, the self-monitoring blood-glucose levels have been between 300 to
400s and an HbA1c of 6% the two do not reconcile and there may be a medical condition affecting the
test results. Consult your doctor, he/she may order CBC test (complete blood count) to know the cause
of false A1C result.
Do self-monitoring and HbA1c results not agree? You should consult with your healthcare
professional; confirm whether you are doing the finger-prick glucose measurement correctly and
accurately.
Are both self-monitoring blood-glucose and A1C testing necessary?

A1C test provides an average blood-glucose level for lost three months. Additionally, you need regular
glucose test, because this helps to assess the glucose level at that instant. If it is high (hyperglycemia)
or low (hypoglycemia), you can be able to treat accordingly.
Additionally, if you are self-monitoring your glucose level today and treat accordingly will help to
achieve optimal A1C months later. Both A1C and glucose test are inter-related and thus regular blood
sugar monitoring is necessary to achieve healthy A1C.
If you have A1C percentage, it is meaningless unless it has converted into an equivalent blood-glucose
level, here you can find A1C chart & calculator. If your A1C is in a higher side, do not panic; learn how
to lower your A1C level.
Research studies show improving both blood-glucose levels, and A1C is important for diabetes
patients to avoid both micros and macro-vascular diabetes complications.
A1C and eAG

Submitted by Thiruvelan on 23 Jun 2010 | Last updated 6 January 2014
An estimated average glucose (eAG) is an easy way to understand your A1C percentage result and
help relate it with the glucose meter reading.
What is estimated average glucose (eAG)?
An A1C result is always in percentage, which is difficult

to understand. Estimated average glucose(eAG) helps
translate our A1C % test result into a number in mg/dl
or mmol/l. These numbers can be easily relating with
the daily glucose meter readings.
New study provides a calculation formula to estimate
glucose levels (in mg/dl on mmol/l) from the A1C
results. This helps us to use the same numbers we are
seeing on our daily glucose monitors.
eAG & Average glucose reading on the meter

Most of the blood-glucose monitor in use for daily testing can provide your average of all the readings
past several weeks or months. Mostly, this meter average will not be same as the eAG, learn why?
Your blood-glucose meter only provides the reading at that moment. Even if you are testing ten times
or more, the average is likely to be slightly higher or lower than your eAG. The eAG is an average of
glucose level 24/7 for lost two to three months; thus, it may be more accurate. However, if your reading
deviates more than 15% consistently, then check whether your A1C result is falsely affected.
Two popular estimated Average Glucose (eAG)

There are numerous studies and formulas to convert A1C to blood-glucose level. There are two
popular studies "The Diabetes Control and Complications Trial (DCCT)" & "A1c Derived Average
Glucose is arrived using Continuous Glucose Monitors (ADAG)," which provides two different formulas
for eAG.
Dr. Richard K. Bernstein, the author of the popular book "Diabetes Solution," is the first who
successfully used low-carb diet for his type1 diabetes control (with an A1C of 4.2 to 4.6). He
recommends DCCT's formula to convert A1C to eAG than the formula by ADAG recommended by
ADA.
Every individual is different, thus we provide two A1C charts (eAG); one based on DCCT A1C
chart and another based on ADAG A1C chart. We request you to put your mind and find, which chart
best suits you. However, we trust Dr. Richard K. Bernstein recommendation over American Diabetes
Association (ADA). Additionally, our website visitors have been preferring DCCT over ADAG formula.
A1C Benefits
What are A1C test benefits? A1C test helps best understand diabetes treatment, manage diabetes
better and prevent diabetes complications.
A1C Tests Benefits

In addition to blood-glucose test, A1C test has numerous benefits, which help diabetes individuals to
efficiently achieving their target.
1.
Check self-testing results - A1C tests help, how

correctly you are doing self-monitoring. Even
many errors in your home glucose test became
known and help you to correct it (value for your
money, time and efforts).
2.
Assess diabetes treatment - how well it is going

on, help confirm whether the on-going treatment
regimen is suiting you or need any modification. If
your A1C result is not within the target, then you
may need to change for more effective diabetes
treatment.
3.
Fix healthy choices - A1C not only helps assess your diabetes medication; additionally, help to
assess other lifestyle changes you have just adopted.
4.
Improve diabetes treatment - once you have achieved your target a1c, then you can try for
more stringent targets and improvise your treatment plan to achieve it.
5.
Avoid diabetes complications - achieving good A1C range will stop various diabetes
complications such as nerve damage, eye problems, oral problems, heart attack, sexual dysfunction,
and depression.
6.
Diagnose pre-diabetes & diabetes a1c test can be an useful tool for early diagnosis of prediabetes, and diabetes. Additionally, if your a1c is not in a healthy range, then you can change your
lifestyle to stop its progression towards pre-diabetes and later to diabetes.
A1C test to diagnose pre-diabetes and type-2 diabetes

International organization recommends A1C test as one of the tests to diagnose pre-diabetes and type2 diabetes. A1C test provides mean value of blood-glucose levels of last three months.
The blood-glucose test only provides a glucose

level at that instead based on what you have ate
on past hours, stress level, sleep quality, and any
illness. That may cause a false high or low bloodsugar level.
You know diabetes type 2 develops slowly for
months, during this period your blood-glucose
level may fluctuate largely, and you may miss out the high level. A1C shows the 3-month average, thus
it helps early diagnosis of diabetes.
Still, impaired glucose tolerance and impaired fasting glucose tests are important test for diabetes
diagnosis. Because, a1c has some drawbacks due to anemia or other conditions causing false, low
and high in some individuals.
An A1C percentage is useful in diagnosis of diabetes, the result range and its meaning is; optimal 4.14.6%, sub-optimal 4.7-5.1%, normal 5.2-5.6%, pre-diabetes 5.7-6.4%, diabetes 6.5% & over.
Many studies confirm the importance of A1C test to avoid diabetes

complications.
A1C test is a well-established way to determine your historical glycemic control. A1C has a strong
relationship with the blood-glucose level; increase in glucose level will reflect in an increase in A1C.
The link between A1C levels and the risk towards diabetes complications in diabetes patients (both
type 1 & 2) is established by some of the popular studies, such as:
1.
The Diabetes Control and Complications Trial (DCCT) Study Findings; Intensive blood-glucose
control reduces the risk of eye disease by 76%, kidney disease by 50%, and nerve disease by 60%. In
participants who had some eye damage at the beginning of the study, tight management slowed the
progression of the disease by 54 percent.
2.
The United Kingdom Prospective Diabetes Study (UKPDS) data showed a continuous
relationship between the risks of micro vascular complications and glycemia, such that for every
percentage point decrease in HbAlc (e.g., 9 to 8%), there was a 35% reduction in the risk of
complications.
3.
Epidemiology of Diabetes Interventions and Complications (EDIC) Study Findings: Intensive

blood-glucose control reduces the risk of any cardiovascular disease events by 42%, nonfatal heart
attack, stroke, or death from cardiovascular causes by 57%.
4.
Norfolk cohort of European Prospective Investigation of Cancer and Nutrition (EPIC-Norfolk)

Study shows that those people with a 6% (considered normal) compared to those with a 5%, had a
28% increase in cardiovascular death.
Healthy A1C Goal

What is optimal A1C goal? Healthy non-diabetics HbA1C range is within 4.2-4.6%. Many-experienced
diabetics have been achieving the above range.
Best A1C target/goal

Fit non-diabetic persons glycated hemoglobin percentage
will be within 4.2 to 4.6%. These numbers are only from a
person who is fit, non-obese, active, and on healthy diet.
The A1C result depends upon how well you are maintaining your
blood-glucose level. If you are maintaining your blood sugar
(BS) at an optimal range 70-85mg/dl (3.9-4.7mmol/l) at most of
the time, then your A1C will be near normal range around 4.24.6%.
Dr. Richard K. Bernstein, Author of Diabetes Solution developed
type-1 diabetes in 1946 at the age of 12. He said, "My A1C reading was once 3.9, over the years the
highest was 4.4 but usually the results are 4.1 or 4.2%." At his age of about 80; he has been able to
achieving the optimal A1Crange with type1 diabetes, why it is impossible for you!
However, if you are new to diabetes and diabetes control, then in the beginning, it is difficult to achieve
it. Even, Dr. Richard K. Bernstein faced difficulties to reach his todays number. He put many efforts by
testing, analyzing, modifying, again testing and after years of struggle, he made it. You can also make
it, if you put consistent effort until your target has met.
Strikeout im in impossible; you will get possible

Achieving your A1C target is not impossibility, just strikeout "im" it becomes possible. Noting is
impossible, if you strongly decided to do it.
However, do not fix any target that is difficult to achieve. It may make you disappoint and lose heart to
achieve it again. Instead, aim for an easy target, once you achieved it; you will gain knowledge as well
as confidence to go for the next level.
Step by step, achieve you A1C

As in shooting try to achieve a broader target, once you gained proper aiming slowly to shrink your
focus to a much-specific optimal target.
1.
American Diabetes Association (ADA) suggests people with diabetes to aim for A1C levels of
7% or less. Thus for anyone with diabetes, a starting A1C goal of 7.0 to 6.5% is a good choice, and
your chance of diabetes complications is low. If you are experiencing frequent hypoglycemia, stay in
this range for months, until your body got practicing to this BS level. At the same time, learn what
induce hypoglycemia and strive to stop it.
2.
Once you have gained expertise to stop frequent hypoglycemia, proceed to pre-diabetic range
of 5.7 to 6.4%. Medication alone cannot make any magic; you have to take nutritious diet by cuttingdown your carb intake, and increase in physical activity plus regular exercise.
3.
Once you have adapted to your lifestyle changes without frequently hypoglycemia, you can aim
for an A1C range of 5.2 to 5.6%. Illness can raise your blood sugar level; you should prevent illness
and manage it promptly. Lack of sleep, will affect your blood glucose as well as your dieting habit;
never compromised restful sleep.
4.
At this stage, you have gained mastery in glucose management. You can now try achievingsuboptimal A1C range of 4.7 to 5.1%. To reach this target, you may need further to cut down in
carbohydrate and increase in physical activity. At this range, your chances for the diabetes
complications are almost zero, keep it up!
5.
Learn to manage stress and ovoid fight/flight situations, these fluctuate your blood-glucose
level. The final best optimal A1C range is 4.2 to 4.6%; this is the range of the healthy non-diabetic
range, thumps up! You are a master of diabetes management, share your expertise in diabetes forum
and help other.
Achieving your target, A1C (even just 7.0 to 6.5%) is not an easy job; it requires patience, interest to
learn, ability to analyze, willpower to accept failures, and stick with lifestyle changes. If you have
trouble at any target range, simply stay at that range for some months until your body practicing to the
BS. Once your BS stabilizes, you feel comfortable and gained confidence then you can try reaching
next target range.
Every individual is different, Your Mileage May Varies YMMV, so a healthy A1C for your friend will not
be a normal one for you and vice versa. You need to find the right level for your own body. Does a lot
of testing and finds what works best for you? If you are having any health concern such as
gastroparesis, then it is very difficult to reach the target A1C range.
ACCORD study shows intensive glycemia treatment is dangerous, is it true?

No, because the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study has been targeted
an A1C of less than 6.0% with too much of medication, combination of medication and/or insulin.
Additionally, the ACCORD study advised their patients to take low fat (means high carb) diet for their
blood-glucose control. Too much of the carb, treated with an increased blood insulin level
(Hyperinsulinemia) by Insulin Secretagogues drug or insulin, which is a risk towards hypertension,
Coronary Artery Disease, and cardiovascular disease.
However, following an intensive glycemia treatment with a low-carb diet and increased physical activity
help improve your overall health.
How frequently, I have to test my A1C.

Once diagnosed as diabetes, it is good to have at least four A1C test per annum. If you are more
health concerns, it is up to you to have A1C test even monthly until reached your target by modifying
treatment regimen. Do not forget your A1C decides your risk for diabetes complications.
Once you have reached your target A1C, and it has stabilized at that range then you can reduce taking
A1C test to two to four times yearly.
If your A1C is in a higher side, do not be panic, you can lower it with some effort. You can learn more
by visiting lower A1C level.
A1C Chart & Calculator

A1C chart on this page has A1C to BS conversion chart and calculator using the DCCT formula. To
use this A1C calculator; you have to enter A1C/BS to calculate the BS/A1C equivalent.
Why do you need a hemoglobin A1C chart?

The hemoglobin A1C result is an important value for long-term glucose monitoring; about three months
mean value of glucose level. HbA1C results are in percentage value. This may be confusing for many,
because we are measuring plasma glucose levels in mg/dl or mmol/l using a glucose monitor.
Converting A1C to equivalent blood-glucose level (as shown by the glucometer) can be easier
interpreting the result.
A1C Chart - A1C to Blood-glucose converter

DCCT (The Diabetes Control and Complications Trial) Formula: Below is the a1c chart to show a
relation between A1C and BS equivalent. This A1C chart is based on the DCCT formula, a randomized
clinical trial designed to compare intensive and conventional therapies and their relative effects on the
development and progression of diabetic complications in patients with type 1. Seven-point capillary
blood-glucose profiles (pre-meal, post-meal, and bedtime) obtained in the DCCT were analyzed to
define the relationship between HbA1c and BG. This DCCT formula seems to work a lot better in
people with very high blood sugars.
Mean plasma glucose = (a1c x 35.6)77.3 mg/dl (or) (a1c x 1.98)4.29 mmol/l
Reference: Curt L. Rohlfing, BES, Hsiao-Mei Wiedmeyer, MS, Randie R. Little, Ph.D., Jack D.
England, Alethea Tennill, MS and David E. Goldstein, MD "Defining the Relationship Between Plasma
Glucose and HbA1c, Analysis of glucose profiles and HbA1c in the Diabetes Control and
Complications Trial," Diabetes Care 25:275-278, 2002.
Dr. Richard K. Bernstein, the author of the

popular book "Diabetes Solution," is the first
who successfully used low-carb diet for his
type-1 diabetes control (with an A1C of 4.2
to 4.6). He recommends DCCT's formula to
convert A1C to BS than the formula by
ADAG recommended by ADA. We trust Dr.
Richard K. Bernstein recommendation over
American Diabetes Association (ADA).
Additionally, our website visitors have
preferred DCCT to ADAG formula.
A1C Calculator - DCCT

How do you convert the A1C to average (blood) glucose level? Just enter your HbA1C number in the
box before % mark and press calculate to get average blood-glucose numbers in mg/dl & mmol/L.
Is your A1C high, do not panic?

If your A1C number is in a higher side, do not worry. You can lower your A1C with certain changes in
your lifestyle. First, you should fix your A1C target, see the benefits of A1C, automatically you will be
interested and finally achieve it by learning how to lower A1C?
A1C Chart & Calculator ADAG

Submitted by Thiruvelan on 01 Sep 2013 | Last updated 17 October 2013
A1C chart on this page has A1C to BS conversion chart and calculator using the ADAG formula. To
use this A1C calculator; you have to enter A1C/BS to calculate the BS/A1C equivalent.
ADAG A1C Chart - A1C to Blood-glucose converter

There are numerous studies and formulas to convert A1C to blood-glucose level. Every individual is
different, thus we provide two A1C chart one based on ADAG A1C chart, and another based on
DCCT A1C chart. We request you to put your mind and find, which chart best suits you.
ADAG (A1c Derived Average Glucose is arrived using Continuous Glucose Monitors) Formula: Here is
a diabetes a1c conversion chart to show a relation between A1C and blood-glucose testing results.
This study takes into account type 1, type 2, non-diabetics as well as study carried out in different
locations. Many people with diabetes using this formula, and find it more accurate (well relate with
home glucose reading).
Mean plasma glucose = (a1c x 28.7)46.7 mg/dl (or) (a1c x 1.59)2.59 mmol/l
Reference: David M. Nathan, MD, Judith Kuenen, MD, Rikke Borg, MD, Hui Zheng, PhD, David
Schoenfeld, PhD, Robert J. Heine, MD "Translating the A1c Assay Into Estimated Average Glucose
Values," Diabetes Care 31:1473-1478, 2008.
Many people have a question, what does it

mean if I have a high a1c and normal blood
sugars? Many others, on the other hand,
have a question, what does it means if I
have healthy a1c and raised fasting
glucose? If you are one among them visit
A1C glucose level relationship.
ADAG A1C to Average Blood

glucose conversion Calculator
How do you convert the A1C to average
(blood) glucose level? Just enter your
HbA1C number in the box before % mark
and press calculate to get average bloodglucose numbers in mg/dl or mmol/L.
This A1C calculator is based on the ADAG formula, which is well accepted by both the patients
(diabetics) as well as health care professionals.
Is your A1C high, do not panic?

If your A1C number is in a higher side, do not worry. You can lower your A1C with certain changes in
your lifestyle. First, you should fix your A1C target, see the benefits of A1C, automatically you will be
interested and finally achieve it by learning how to lower A1C?
Does your HbA1C disagree with the blood-glucose reading?

It is quite common; almost every person with diabetes had been complaining about disagreement
between A1C and blood-glucose reading. A1C might appear to be higher or lower as compared with
day-to-day glucose reading. Why your hba1c disagree with BS reading, there are many reasons.
How to lower A1C ?

Submitted by Thiruvelan on 15 Jul 2011 | Last updated 6 January 2014
High A1C numbers mean there are more chances for developing diabetes complications that damage
your heart, kidneys, eyes, and nerves. It may end up in heart attack, stroke, kidney dialysis, blindness,
or amputation.
What should be your A1C number?

Most people with diabetes should aim to have an A1C of below 7. Lower A1C is better if you can
achieve it without any hypoglycemia risk. If you cannot be able to identify your early symptoms of low
blood sugars, then you should aim for higher-end A1C number. Discuss with your health profession to
help you set a right A1C goal for you.
Right A1C number for you is based on your age, ability of identify hypoglycemia, frequency of
hypoglycemia episodes, other health conditions you have, and expected life span.
If your A1C is high, how do you lower A1C?

Firstly, do not get to discourage over your numbers. Trends are more concerning than single test.
Firstly, do not get to discourage over your numbers. Trends are

more concerning than single test.
1.
Find the influencing factors - numerous things can influence

your blood sugars such as mood, new routines, foods, illness
and weather. Try figure out anything you might change recently.
2.
Proper diet healthy diabetes diet is necessary for effective

blood-glucose management. Calculate your daily calorie's requirement, distribute these calories
throughout the day, decide how much carb best for you, learn carbohydrate counting in your meals,
take good carbohydrates, know the glycemic index of carb foods (prefer low glycemic index foods such
as beans, seeds, whole grains, vegetables, fruits, etc.). Try achieving your target by changing your diet,
their combination, timing and/or its frequency.
3.
Low-carb or high-carb diet - If you are on the low-carb diet, then you could spikes late from
protein or fat, which you may miss in home testing. Low-carb diet will reduce your metabolic rate, which
is important to maintain burning rate of glucose in muscle tissue and so forth. With a sufficient burn
rate, you can be able to consume excessive blood glucose and makes it easier to handle bloodglucose level. Therefore, restricting carbs is fine making it 100g of carbs per day not 30g.
4.
Breakfast - When you do not have breakfast on time, you may notice a blood sugar spike.
Whether taking your breakfast in time could stop it? If your answer is yes, you can lower your A1C by
taking your breakfast in time all days without skipping.
5.
Foods to lower A1C - Certain things can naturally lower your A1C; they are onions, garlic, red
wine, and fish.
6.
Physical activity works like a natural medicine - it can lower insulin resistance and moves
the blood sugar better into the muscles. Burning more sugars can help lower blood glucose and
A1C. Diabetes exercise makes you physically as well as mentally feels better and stresses free. This
peaceful state helps lower blood-glucose spikes.
7.
Losing weight - can help reduce insulin resistance or increase insulin sensitivity thus drops
blood-sugar level and A1C. Many studies have confirmed that losing weight can help your insulin or
medicines to work better, need lesser medication, improves blood-glucose levels,lower A1C, reduce
the risk for diabetes complication, high cholesterol, hypertension, etc. Even just 5 to 10% weight loss
will make a huge health benefit.
8.
Be stress free to lower A1C - stress, depression, anger, anxiety, panic, illness can raise your
glucose level and A1C. Stress put you on fight or flee response mode; your number becomes crazy
and would not be able to stabilize. Many studies confirm that negative mind affects your number even if
you are perfect in other things. Put maximum efforts to bring back your positive mind this will make a
huge benefit not only attaining optimal A1C, and improved overall wellness. So keep yourself-cool by
involving yourself in music, dancing, aerobics, yoga, meditation, etc.
9.
Start from beginning - Like math, if there is any mistake instead of try correcting, start from the
basics. Completely start again with determining your basal and bolus rates. Most important is the basal
rate as having this set right is important to avoid both highs & lows and is the foundation on which the
bolus dosing works.
10.
Change treatment - Sometimes changing the insulin-treatment dosage timing can make a
huge difference. Some can be able to stop BS spikes after eating simply by shifting insulin to 15
minutes before eating. Try achieving your target A1C by modifying your diabetes medication or insulin dose, type, timing, and/or frequency.
11.
A1C error - Ultimately, A1C is a lab test prone to inaccuracies; biological factors can play a
part, so this test may not be as accurate for some people as others.
12.
Write stuff down & analyze - use Excel or something that works for you, even hand-drawn is
ok. This allows analyze, look back and help decide the best strategy. Do BG testing in mealtime, 2 &
four-hour post-meal, waking and retiring? You do not need to do this all the time, only when things
seem "out of control." You can use web-charting software calledDiasend.
13.
Thyroid problems - Have you had your thyroid checked lately? A slightly low level may cause
hikes in BG along with a little weight gain.
Your Life is and will be better if you are managing your A1C is within 7%.
BS testing devices
Submitted by Thiruvelan on 22 Sep 2013 | Last updated 22 August 2014
Blood glucose or sugar level is the important parameter to measure for proper diabetes management,
regardless of the type of diabetes you belong.
What is blood-glucose test means?

Glucose is a sugar, an important energy source for our body. A healthy individual's body can regulate
the amount of glucose in blood and maintain an equilibrium called glucose homeostasis. However, in
the case of diabetes, the glucose homeostasis gets disturbed. Thus, they need special diets and
medications to control the blood glucose from rising or falling. Diabetics are required monitoring their
blood-glucose level called BG or BS test.
As a diabetic, you should take the blood test to monitor your blood glucose (sugar) levels. This is a
quantitative test to measure the amount of glucose present in your blood. The test results are useful to
understand:
How different diets and exercise can affect your blood-glucose levels,
Help treated the blood-sugar level highs & lows in time,
Know how effective the diabetes treatment is.
Moreover, learn to adjust the treatment (drug dosage, timing, etc.).
How often should you take BS test?

If you are newly diagnosed diabetes, you may need to take BG test more often to learn how your body
is responding to your diet, exercise and medication. Once you are familiar with them, then you can limit
the testing to suit you the most. Generally, people with diabetes type 1 have to test their BS three or
more times a day. On the other hand, type-2 diabetes is less frequently testing their BS levels, may be
one or more times a day.
Blood-glucose monitoring devices

You can choose a suitable blood-glucose monitor as per your requirement or test your BS at lab. Selfblood glucose monitoring is the preferred method by many diabetics.
Devices that are in use for BS monitoring are:

1.
Blood-glucose meter - support diabetics to keep track of their

glucose levels, wherever and whenever they want. The results
are required making appropriate medical and lifestyle choices; it
helps avoid hyperglycemia and hypoglycemia episodes.
2.
Continuous Glucose Monitor is a new generation of the

blood-glucose monitoring system? It promises to change the way patients, and their care providers
manage diabetes. It delivers blood-glucose readings every few minutes for 24/7. Many patients with
type-1 diabetes, who is at risk towards non-symptomatic hypoglycemia, can use it to treat
hypoglycemia in time before it turns dangerous.
3.
Ketone Testing Strips - Presence of ketones in the urine is an indication that the body start
metabolizes fat. Both diabetics and persons on low-carbohydrate diets may test their urine for ketones
daily.
Diabetes Meter
Submitted by Thiruvelan on 22 Jun 2010 | Last updated 22 September 2013
Blood-glucose monitors help diabetics to keep track of their glucose levels wherever and whenever
they want. The results allow them to make appropriate medical and lifestyle choices, also it is helpful to
avoid hyperglycemia and hypoglycemia episodes.
Glucose monitor overview

Glucose monitor is useful to measure the blood-glucose level, which in-turn helps better diabetes
management. Monitoring of the blood-sugar level allow them to make appropriate medical and lifestyle
choices, also it is helpful to avoid hyperglycemia and hypoglycemia episodes.
Other names for glucose monitor are blood-glucose monitor, glucometer, glucose meters, glucose
monitors, diabetes monitor, diabetic meter, blood-glucose monitoring system, home glucose monitor.
The most common way to check glucose levels involves pricking a

fingertip with an automatic lancet (lancing device - Lancet is a small
instrument for pricking the skin with a quick-action fine needle.) to
obtain a blood sample and placed on a disposable test strip then
using a glucose meter to measure the blood samples glucose level.
How do you choose a Glucose monitor?

Important features to consider when selecting glucose meter: choose a meter,
Which is conveniently smaller, lightweight, and easy to carry with you?
That requires a smaller blood sample means less painful.
Testing speed - gives the result within seconds,
Option to store test results such as date and time of the test. This helps to keep the record for
doctors review.
Other important features you can look for are no coding, high and low blood-glucose level
warning, etc.
Meter & Test strips cost
Glucose Monitor usage procedure

The following is the general instructions for usage of a glucose meter:
First, set out your glucometer, a test strip, a lancet and alcohol prep pad.
Wash your hands to prevent infection. Decide where you are going to obtain the blood from,
usually a finger. Some of the newer monitors let you use your forearm or another less sensitive place.
Turn on the glucose meter and place a test strip in the machine when the machine is ready. If
coding is required, then enter it. Watch the indicator for placing the blood to the strip.
Make sure your hand is dry and wipe the area you have selected with alcohol pad and wait until
the alcohol evaporates.
Pierce your fingertip on the soft, fleshy pad and obtain a drop of blood. Place the drop of blood
on or at the side of the strip.
The glucose monitor will take a few moments to calculate the blood-sugar reading.
You may use the alcohol pad to blot the site where you drew the blood if it is still bleeding.
Glucose meters and the strips, both have instructions for use, read carefully these instructions for
proper use and accurate reading.
Glucose monitor - Cleaning & maintenance

Every monitors need to be taken care of in order to function properly. Some need more cleaning and
maintenance than others do and this may be another factor to consider in choosing a monitor. Be sure
to follow the manufacturers instructions regarding proper care of your monitor. This is important
because a monitor may provide inaccurate readings if it is dirty, old, or stored at extreme temperatures.
Non-coded & Plasma glucose monitors

Confirm the glucose monitor is non-coded (now a days all the monitors available are non-coded still
confirm) and confirm the readings are in plasma glucose (some glucose monitor gives blood-glucose
value instead of plasma glucose).
Glucose levels in plasma (one of the components of blood) are generally 10%15% higher than
glucose measurements in whole blood (and even more after eating).
Continuous Glucose Monitor

A new generation of the blood-glucose monitoring system, known as continuous glucose monitors,
promises to change the way patients and their care providers manage diabetes.
What is a Continous glucose monitor?

Unlike traditional monitors that provide one-time snapshots of blood-glucose level, continuous glucose
monitors deliver readings every few minutes around the clock. This enables the patients and their
doctors to measure the trends, chart ups & downs, and identify problems and adjust insulin, meal, or
exercise regimens.
In addition, the monitors have safety

alarms, which alert for hypoglycemia
(dangerously low glucose level) and to
hyperglycemia (dangerously high glucose
levels).
Continous glucose monitor's
glucose sensor
Continuous glucose monitors have a tiny flexible catheter, similar to the catheters used with an insulin
pump, is inserted into subcutaneously (under the skin). The catheter houses the glucose sensor,
which measures changes in glucose levels in the interstitial fluid (the tiny layer of fluid under the skin),
and sends the information either to a beeper-sized box or to a compatible insulin pump, which stores
the results. Three or four days worth of blood-glucose readings can be stored at a time.
Because it sometimes takes a while for the glucose level in the interstitial fluid to match the glucose
level in your blood, you should double-check your results with a finger stick reading before treating for
a high or a low glucose level that shows up on your continuous glucose monitor. Talk with your doctor
about the availability of these products, whether it makes sense for you.
Ketone Testing Strips

Presence of ketones in the urine is an indication of the body start metabolizes fat. Both diabetics and
persons on low-carbohydrate diets may test their urine for ketones daily.
Ketone test overview

Normally, no ketones are available in the urine. In low carbohydrate metabolism situations, ketones
appear in the urine in large amounts before serum ketones are elevated. The reagent detects as little
as 5-10 mg/dl acetoacetic (ketones) in urine.
Ketone testing procedure

Ketone urine-testing strips have a small absorptive pad; it contains
a chemical reagent that changes color (usually within 15-20
seconds) in the presence of ketones in the urine. The ketone-strips
change to varying shades of pink and purple. The ketone-strips'
container has a scale on the label, with illustrative blocks of color to
help you identify the shade of your ketone-testing strip.
Ketone test strips handling procedure

The chemical reagent on the ketone test strip is very sensitive to moisture, including moisture in the air,
so be sure to keep the lid of the container tightly closed at all times. In addition, keep your hands dry
when using the strip. Once you open the container seal, ketone strips have a shelf life of only six
months for a reliable result.
Ketone test strips usage procedure:
It is best to collect first morning urine sample in a clean, dry container.
Confirm that your hand is dry.
Take out one reagent strip from the bottle and immediately close container tightly, to minimize
exposure to moisture.
Immerse the tip of the reagent strip in the urine sample and then takeout immediately to avoid
dissolving of reagent in the strip.
Run the edges of the strip against the rim to avoid urine spills.
Wait for some seconds (15 20 seconds) for the reaction to carry over and color change to take
place.
Compare the color change of the reagent strip to that of the color chart provided in the
container.
Diabetes Type
Diabetes mellitus is a heterogeneous group of disorders characterized by high blood-glucose levels.

This abnormal rise in glucose levels in the blood due to either insulin deficiency or to resistance of the
bodys cells to the action of insulin. The World Health Organization (WHO) defines four major types of
diabetes.
Classification of Diabetes mellitus

It is classified based on the cause or mode of treatments;
1.
Insulin-dependent diabetes mellitus (IDDM) - need insulin shots to maintain the blood-glucose
level,
2.
Non-insulin-dependent diabetes mellitus (NIDDM) - insulin shots are not must to normalize the
glucose level,
3.
Gestational diabetes mellitus (GDM) - diabetes develops during pregnancy and mostly
disappears after delivery,
4.
secondary to other conditions (e.g. pancreatic disease, Hormonal disease, Drug or chemical
exposure, Insulin receptor abnormalities, certain genetic syndromes).
Diagnosis of diabetes is by the presence of the classic signs & symptoms and unequivocally elevated
blood-glucose levels, by fasting plasma glucose (FPG) 140 mg/dl, or by venous plasma glucose 200
mg/dl at 2 hours after a 75-g oral glucose challenge.
Video on type of diabetes
There are two major types of diabetes

Diabetes is broadly classified into two major types.
Type 1 diabetes or insulin-dependent diabetes mellitus (IDDM) or juvenile diabetes, the

pancreas is failed to produce hormone insulin. Resulting in high blood-glucose level and so, the
patients need insulin shots.
Type 2 diabetes or non-insulin-dependent diabetes mellitus (NIDDM) or insulin resistance, the

pancreas produces insulin, but insufficient quantity or body become insensitive to insulin and need
excess insulin (insulin resistance). Type 2 diabetes is very common, particularly along elderly people.
Subdivisions in Type 2 diabetes
pre-diabetes - blood glucose is higher than normal but not high enough to diagnose as diabetes.
That is borderline diabetes can be reversed with proper food and physical activities.
gestational diabetes - develops during pregnancy due to hormonal changes that occur naturally
during pregnancy.
Other Types of Diabetes

Submitted by Thiruvelan on 19 Jan 2011 | Last updated 21 September 2013
Other not so common types of diabetes are LADA (Late Autoimmune Diabetes in Adults)
andMODY (Maturity onset diabetes of the young).
Other Types of Diabetes
Latent Autoimmune Diabetes in Adults (LADA)
Maturity Onset Diabetes of the Young (MODY)
What is LADA?
Latent Autoimmune Diabetes in Adults (LADA) is a slowly developing form of type 1 diabetes also
called as type 1.5 that is diagnosed among adulthood. Similar to normal type 1 diabetes, the
autoimmune process of LADA destroys cells in the pancreas. Nevertheless, slowly and eventually they
need insulin treatment.
LADA is different from diabetes type 2 still people with LADA are frequently misdiagnosed because
both diabetes occurs in adulthood with similar symptoms. Over time, this misdiagnosis can lead to
uncontrolled blood sugar levels, which can develop serious life-threatening diabetic complications.
How does a doctor distinguish between Type 2 and Type 1.5 (LADA)?
Diagnose LADA based on two blood tests currently in use to detect LADA:
GAD Antibody test - Attacking the beta cells of the pancreas by inflammatory cells, produces an
enzyme GAD (Glutamic Acid Decarboxylase), so this is a marker for the diagnosis ofLADA in adults.
C-Peptide test - C-Peptide (an amino acid) produced by the pancreas proportional to the
amounts of insulin in produce. A low level of C-peptide in the blood indicated that the pancreas is not
producing enough insulin and can suggest LADA in a type 2 patients.
What is MODY?
Most commonly MODY (also called as genetic diabetes) behaves like a very mild form of type 1
diabetes, with continued partial insulin secretion with normal insulin sensitivity. It is not diabetes type 2
in a young person, as might incorrectly be inferred from the name.
MODY is a diabetes type with six basic sub classifications depending upon the gene that is responsible
for its onset. Only some 1 to 2% of type 1 has this variety of diabetes but mostly goes
unrecognized. MODY is an autosomal predominant inherited disease, means born with a single (auto)
gene that can be come from either parent. If a parent has MODY, then their children have a 50% more
chances of developing MODY.
MODY is dominantly inherited; a monogenic defect of insulin secretion that may occur at any age, and
it no longer includes any forms of diabetes type 2.
MODY is not exclusively among adolescents, and the research knowledge shows it can also be
diagnosed up to an age 55.
Prediabetes
Pre-diabetes is a condition in which blood-glucose levels are marginally higher than normal but not
high enough for the diagnosis of diabetes.
Still, there is positive news if you have pre-diabetes you can reduce your risk of getting diabetes. With
modest weight loss and moderate physical activity, you can prevent altogether and return to normal
glucose levels or slow down the development of type 2 diabetes.
What is Prediabetes?
Impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) or borderline diabetes are the other
names for prediabetes.
If pre-diabetes, then there are more chances to

develop type 2 diabetes. Being overweight and
physically inactive contributes to pre-diabetes.
Sometimes pre-diabetes can be reverse with
weight loss that comes from healthy eating and
more physical activity.
Most people with pre-diabetes do not have any
symptoms. Diabetes blood test is the one and
only way to diagnose pre-diabetes. If you are
over 45 years and over weight, particularly large waist size, then you are at risk of developing pre
diabetes and even diabetes. Therefore, it is necessary to get blood tested at least once in every year.
Prediabetes Diagnosis
Pre-diabetes diagnosis is by blood sugar tests, if your number is higher than most young-healthy
people has, then you are diagnosing as prediabetes. Prediabetes also called as borderline diabetes
and impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), depending on which test has
used to detect it.
Are you required screening for pre-diabetes?

Based on the diabetes risk factors, certain standard is set for pre-diabetes screening criteria.
Criteria for prediabetes screening are:
More than two diabetes risk factors,
Central obesity,
Have had gestational diabetes,
Have had a poly-ovarian cyst,
Already have a blood-glucose higher end of the normal range,
Presence of diabetes symptoms,
Have high blood pressure,
Have high blood cholesterol.

If you met most of the above-said criteria, then you require undergoing for pre-diabetes screening.
How is pre-diabetes diagnosed?

Blood tests are used to diagnosis pre-diabetes. They are fasting blood-glucose test, oral glucose
tolerance test, and glycated hemoglobin A1C test.
What is the pre-diabetes number? The blood-glucose range is higher than normal but not high
enough to diagnose as diabetes.
Fasting Plasma Glucose (FPG) is a blood-glucose test taken after not having anything to eat
or drink (except water - even do not drink a lot of water before the test) a minimum of eight hours
before the test. This test is conveniently carryout in the morning, before breakfast. Confirm prediabetes if BS is 100 mg/dl to 126 mg/dl (or 5.56 to 7 mmol/L) also known as impaired fasting glucose.
Oral glucose tolerance test (OGTT) or glucose challenge test is a blood-glucose test before,
one-hour and two hours after you eat a carbohydrate-rich food or drink a special sweet drink. Confirm
pre-diabetes if BS is 140 mg/dl to 199 mg/dl (or 7.77 to 11 mmol/L) also known as impaired glucose
tolerance.
Glycated hemoglobin test (A1C) is a test done at any time, there is no fast or drink anything,
and it measures the average BS for the past two to three months. Confirm pre-diabetes if the A1C is
5.7% to 6.4%.
What is Impaired Fasting Glucose (IFG) & Impaired Glucose Tolerance (IGT)?
Both IFG & IGT are insulin-resistance. People with IFG along have hepatic insulin resistance and
optimal muscle insulin sensitivity. People with IGT alone have been normal to slightly reduced hepatic
insulin sensitivity and moderate to severe muscle insulin resistance. People with both IFG & IGT
possess both muscle and hepatic insulin resistance; they have about double the chances to develop
diabetes than people with just one of them.
What test is preferable in early pre-diabetes diagnosis?

A study "Impaired fasting glucose or impaired glucose tolerance, what best predicts future diabetes in
Mauritius," was published in Diabetes Care March 1999 vol. 22 no. 3 399-402. It shows the higher
sensitivity of IGT over IFG for predicting progression to type2 diabetes. Screening by the criteria for
IFG alone would identify fewer people who subsequently, progress to type2 diabetes than would be the
oral glucose tolerance test.
Numerous studies show both IFG & IGT has been associated with a modest increased risk towards
CVD, with IGT being a slightly stronger risk predictor. Intensive lifestyle chances can help delay or
prevent diabetes and risk factors for CVD.
Thus, it is always preferable to take both IFG & IGT (is particularly important) in the same day or
alternate day to predict pre-diabetes in the early stage.
Is it possible, to reset the clock or altered the rate of progression of

diabetes?
A study shows the natural history of both IFG and IGT is variable; with 25% progressing to diabetes,
50% remaining in their abnormal glycemic state, and 25% reverting to NGT (normal glucose tolerance)
over an observational period of 3 to 5 years. Individuals who are older, overweight, and have other
diabetes risk factors are more likely to progress. Moreover, low insulin secretion and severe insulin
resistance identify individuals more likely to progress to diabetes.
The lifestyle modification studies were associated with any untoward effects. Instead, they are having
other health-related benefits. Lifestyle modification therapy with modest weight loss (510% of body
weight) and moderate-intensity physical activity (about 30 minutes daily) is the treatment of choice for
people with IFG/IGT. Metformin was the first drug shown to be effective; however, it is just about the
half of that of lifestyle modification.
It is possible; you will be one in this 25% reverting to NGT group, best of luck!
Change your lifestyle, when your numbers are in unhealthy range.

The popular institutions set ranges for healthy, pre-diabetes and diabetes based on the old study that
say one who has knowingly diagnosed as pre-diabetes progress to diabetes early due to mental strain.
The ranges have shifted to the higher end for this reason. However, prolong unhealthy blood glucose
level can lead to diabetes complications even if not progress to diabetes.
However, many health professionals think their patients are intelligent, smarter, and brave enough.
Therefore, the patients are stronger to take challenge and considering it as an alarm in preventing
diabetes.
The actual unhealthy blood-glucose numbers are as below:
Fasting blood-glucose level over 90 mg/dl (or 5.00 mmol/l)
One hour after meal level over 125 mg/dl (or 6.94 mmol/l)
Two hours after meal level over 110 mg/dl (or 6.11 mmol/l)
Five hours after meal level over 90 mg/dl (or 5.00 mmol/l)
If your blood-glucose number is in the unhealthy range, then take this alarm towards prediabetes &
diabetes. Take necessary steps to prevent its progression as well as stop diabetes complications.
The early intervention help delays the onset of diabetes. Additionally, preserving beta-cell function, and
delay the likelihood of micro vascular, and cardiovascular complications.
Preventing type 2 diabetes
Submitted by Thiruvelan on 09 Apr 2013 | Last updated 22 August 2014
How do you prevent diabetes type 2? Most of the cases of diabetes type 2 can be preventable by
simple healthy lifestyle changes. Common let us explore the possibilities.
How do you prevent diabetes type 2?

You can able to prevent the onset of diabetes type 2, if you are having pre-diabetes or high risk towards
diabetes.
Research shows those who have diagnosed as pre-diabetes; out of them 1 in 10 may have to develop
diabetes within the next year. However, a large study Diabetes Prevention Program has given as an
encouraging result. The risk of developing diabetes in next three years can improve up to 60
percentages, with proper diet and exercise.
You can prevent diabetes by:
Achieve and maintain a weight loss of 7 % with proper diet and regular exercise. Reduce fat to
less than 25 % of your total calorie intake can help you to lose weight. If your weight has not reduced,
then reduce your calorie intake.
Maintain regular exercise at least 150 minutes a week with moderate intensity exercises such as
walking or cycling.
Additionally, a diabetes medication metformin (for prediabetes) can reduce your risk of getting
diabetes by up to 31 %.
This result shows those who have just diagnosed as pre-diabetes or those who are at increased risk for
diabetes can avoid diabetes by up to 60 % with consistent effort in diet and exercise.
Some experts believe your risk towards heart disease's increases when you are pre-diabetes and
moving towards diabetes. If it is correct, then you must take the necessary steps to avoid diabetes as
well as heart diseases.
Weight loss and diabetes risk

Studies show that individuals who are at risk of developing diabetes type 2 can lower their risk by
losing their weight by five to seven percentages through healthy diet and regular exercise. A study
shows that 5 to 7 % weight loss can lower the chances of having diabetes by up to 60 %.
Food Pyramid
The food pyramid has been considered to provide effective diabetes control and blood-glucose
management. Now food pyramid is considered as an outdated method that is only suitable for healthy
individual (non-diabetic) not for diabetes.
Because for diabetics, carbohydrate plays a major role in blood-glucose level, so it should not consume
freely. "Food pyramid information is intended for non-diabetic who wants to avoid diabetes. Still
diabetic can continue reading the food pyramid for general information, and in the following pages diabetics diet and carb count can guide you correct diet planning.
Food Pyramid | Food Triangle

Healthy food triangle or pyramid: This depicts what to eat few and what to eat more. The top of the
pyramid is of a low area, similarly fat & sweet should eat fewer. Next bigger area contains milk, meat
and other proteins, thus it can eat moderately. Finally, the largest area is the base of the triangle it
contains grains, nuts and other starches; it can be eaten most.
Eat less Fats and Sweets
Eat moderately Milk, Meat and Meat substitute
Eat morel Fruits, Vegetables, grains, nuts and other starch foods
Vegetables, fruits, grains, nuts and other starch foods

Starches are bread, grains, cereal, pasta, and starchy vegetables like corn and potatoes. They provide
carbohydrate, vitamins, minerals, and fiber. Whole grain starches are healthier because they have
more vitamins, minerals, and fiber. Eat some starches at each meal. Eating starches is healthy for
everyone except diabetics.
Examples for starch foods include whole-grain bread, pasta, corn, pretzels, potatoes, rice, crackers,
cereal, tortillas, beans, yams, lentils.
Vegetables provide vitamins, minerals, and fiber. They are low in carbohydrate.
Examples for vegetables include lettuce, broccoli, vegetable juice, spinach, peppers, carrots, (green)
beans, tomatoes, celery, chilies, greens, cabbage.
Fruits
provide
carbohydrate,
vitamins,
minerals,
and
fiber.
Examples for fruits include apples, fruit juice, strawberries, dried fruit, grapefruit, bananas, raisins,
oranges, watermelon, peaches, mango, guava, papaya, berries, and canned fruits.
Milk, Meat & Meat Substitutes and other proteins

Milk provides carbohydrate, protein, calcium, vitamins, and minerals. Eat fat-free or low-fat milk, yogurt
with low calories sweetener.
The meat and meat substitutes group includes meat, poultry, eggs, cheese, fish, and tofu. Eat small
amounts of some of these foods each day. Meat and meat substitutes provide protein, vitamins, and
minerals.
Examples of meat and meat substitutes include chicken, beef, fish, canned tuna or other fish, eggs,
peanut butter, tofu, cottage cheese, cheese, pork, lamb, turkey.
Fats and Sweets

Limit the amount of fats and sweets you eat, they are not as nutritious as other foods. Fats have many
calories, and sweets can be high in carbohydrate. Some contain saturated fats, Trans fats, and
cholesterol that increase your risk of heart disease. Limiting these foods will help you lose weight and
keep your blood-glucose and blood fats under control.
Examples of fats include salad dressing, oil, cream cheese, butter, margarine, mayonnaise, avocado,
olives, and bacon.
Examples of sweets include cake, ice cream, pie, syrup, cookies, and doughnuts.
Alcoholic Drinks
Alcoholic drinks have calories but no nutrients. If you have alcoholic drinks on an
empty stomach, they can make your blood-glucose level go too low. It also can raise
your blood fats. If you want to have alcoholic drinks, talk with your doctor or diabetes
teacher about how much to have.
Measuring Your Food
To make sure your food servings are of the right size, you can use.
measuring cups
measuring spoons
a food weighing scale

In addition, the Nutrition Facts label on food packages tells you how much of that, food is in one
serving.
Type 2 diabetes | NIDDM

Type 2 diabetes is a condition when the pancreas does not produce enough insulin, or the body cells
do not able to use the insulin properly. If you are a type-2 diabetic, glucose builds up in your blood
instead of using for energy.
What is type 2 diabetes?

It is the most common form of diabetes; people can develop type-2 diabetes at any age even during
childhood. This form of diabetes usually begins with insulin resistance, a condition in which fat, muscle,
and liver cells do not respond to the insulin properly. At first, the pancreas keeps up with the added
demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in
response to glucose level in blood.
Overweight and inactive lifestyle increases the chances of developing type 2 diabetes. Type 2
diabetes formerly called as adult-onset diabetes (because previously most of the cases were adults.
Now, type 2 diabetes is increasingly being diagnosed among children and adolescents), non insulindependent diabetes or NIDDM (do not need insulin for treatment), insulin resistance(body resistance to
insulin).
People who are obese or overweight are most likely to develop insulin resistance, because many
studies confirm that fat interferes with the body's ability to use insulin. Type 2 diabetes usually occurs
gradually; it may take many years.
Research found type 2 diabetes is a cellular metabolism problem.

A study confirms that changes in cellular metabolism play a major role in the development of type 2
diabetes.
Diabetes type 2 is a chronic condition with high level of glucose in the blood stream. Beta cells in the
pancreas continually monitor glucose level in the bloodstream. When it senses any rise in blood
glucose, normally after a meal, beta cells release insulin to keep glucose levels from getting too high.
However, in the case of type 2 diabetes, beta cells fail in this important function. As a result, bloodglucose levels rise, causing diabetes.
Obesity has long been considered as a risk factor for type 2 diabetes, due to a lot of fat in the system.
When beta cells are exposing to high levels of fat can lead to breakdown of their glucose transport
mechanism.
In a healthy individual, beta cells take enough glucose; however, in type 2 diabetics the amount of
glucose transported have dropped below a certain point. Therefore, the cells do not properly sense the
glucose level and thus low insulin secretion leads to high blood glucose level.
Approximately, 10 percent of type 2 diabetes has Autoantibodies!

If you are, the one diagnosed as type 2 diabetes, and later told to have, type 1 diabetes or LADA. You
are not alone, a European study, published in Medscape Medical News; nearly 10 percent of patients
with adult-onset diabetes were found to have associated with autoantibodies.
Many of those with autoimmune diabetes did not require insulin during diagnosis, although they are
young and lean structure. About 90 percent of the patients with positive antibodies had GADA, and
they require insulin very shortly. The authors advising everyone to undergo GAD antibodies test for
people with type 2 diabetes who is not responding to the treatment or for thinner people who have
diagnosed as having diabetes type 2.
Type 2 diabetes statistics
Among youth ages younger than 10 years, the rate of new cases was 0.4 per 100,000 fortype 2
diabetes.
Among youth ages 10 years or older, the rate of new cases was 8.5 per 100,000 for type 2
diabetes.
Type 2 diabetes is the most common form, affecting 90 to 95 percent of all adults who has
diabetes.
Type 2 diabetes Symptoms

Learn, what are the three major type 2 diabetes symptoms? What are the common type 2
diabetessymptoms? How and why type 1 diabetes symptoms are developing.
Type 2 diabetes causes and risk factors

Type 2 diabetes causes can be due to any defect in the insulin production, insulin action or both;
diabetes is a disease marked by high levels of blood glucose. Type 2 diabetes risk factors some
factors can increases the chances for diabetes known as diabetes risk factors. Why certain factors are
diabetes risk? How do you overcome it?
Type 2 diabetes diagnosis

Blood test is useful to diagnose the high blood glucose level in case of type 2 diabetes diagnoses. The
commonly used diagnosing test for blood glucose level is the Random plasma glucose test, Fasting
plasma glucose (FPG) test, and Oral glucose tolerance test (OGTT).
Type 2 diabetes Treatment

Diabetes type-2 treatment is necessary to maintain the blood glucose level, using a type 2 diabetes
medications or insulin treatment to improve the efficiency of type 2 diabetes treatment. Diabetes
medicines and insulin alone cannot make wonders, so you need to follow a suitable type 2 diabetes
management with correct diet, physical activity and blood glucose monitoring. Similar to proper diet
certain diabetes type 2 alternative medicine treatment can help improve the diabetes treatment; few
alternative treatments are herbs, homeopathy, yoga, acupressure and reflexology.
Type 2 diabetes alternative treatment

Natural diabetes type-2 alternative treatment is not a cure for diabetes, but it can help manage type-2
diabetes better. Learn how to choose correct diabetes herbs, diabetes homeopathic remedy and how
to do diabetes yoga, diabetes healing acupressure, and diabetes massage reflexology.
Type 2 diabetes complications

Type 2 diabetes complications may develop, because of badly managed blood-glucose level. Some of
the common type 2 diabetes complications are heart attack, stroke, blindness, kidney disease, loss of
a toe (or foot), and erectile dysfunction. Following proper type 2 diabetesmanagement can help to
prevent diabetes type 2 complications.
Type 2 Diabetes Risk Factors

Type 2 diabetes mostly starts in middle or old age when your body restricts to respond to insulin. Type
2 diabetes risk factors are classifying into two, they are uncontrollable type-2 diabetes risk factors and
controllable type-2 diabetes risk factors.
Risk factors of type 2 diabetes

Type 2 diabetes risk factors are classifying into two categories; they are:
Uncontrollable type-2 diabetes risk factors are factors that are not modifiable with your efforts.
Controllable type-2 diabetes risk factors are factors that are modifiable with your consistent
effort.
Uncontrollable type-2 diabetes risk factors

The risk factors for type 2 diabetes that are not modifiable are:
Genetic (Hereditary) family history of diabetes; family members are having diabetes.
Age - Your age is more than 45 years.
Gestational diabetes - You have had gestational diabetes during your pregnancy and/or given
birth baby, weighing more than nine pounds (4.082 Kgs).
Ethnic Asian, particularly Indian (world's largest diabetes population), Middle East, Oceania
and the Caribbean, African American, Hispanic Americans, and Native Americans, all have high rates
of diabetes.
Pre-diabetes - previously has diagnosed as pre-diabetes or impaired glucose tolerance.
Polycystic ovary syndrome - women with PCOS are at higher risk of type 2 diabetes.
Controllable type-2 diabetes risk factors

Type 2 diabetes risk factors, which are changeable with your consistent effort, are controllable diabetes
risk factors. They are:
Sedentary life style - is with no or low physical activity.
Unhealthy foods - when you regularly eating improper unhealthy foods.
Overweight or obese - You can consider as obese if your BMI is 30 to 39.9 and overweight if
your BMI is 40.0 and above.
High cholesterol level and HDL (or good cholesterol) level lower than 35 mg/dl and/or
triglycerides level more than 250 mg/dl.
High blood pressure - blood pressure is at or above 140/90 mmHg.

If you are having controllable diabetes risk factors, you can avoid having diabetes by lifestyle
modification with your consistent effort.
Everyone over 45 should have their blood glucose checked at least every 2 years. Moreover, be
performed more often if have high diabetes risk factors either controllable or uncontrollable.

If both the parents have diabetes type 2, your risk for diabetes is 45 %. If one of the parents has
diabetes type 2, your risk for diabetes is 14%. If parents and grandparents have diabetes, then you are
likely to develop diabetes at an early age, may be at your 20 to 25 years.
Does overweight or obese eventually develop type 2 diabetes?

Being overweight is a risk factor for diabetes; however, other risk factor combination also plays a role.
Most overweight individuals never develop diabetes type 2; furthermore, many with type 2 diabetes are
at their normal weight.
Sleep deprivation develop or worsen Insulin Resistance

Are you getting enough sleep? You need extra insulin on nights when you have sleep deprivation. A
small study shows a worsening of insulin resistance in people who has sleep deprived. You already
know that there is a role for sleep in learning, memory, and other central nervous system functions. A
prospective epidemiological study show insufficient sleep may increase the risk for metabolic
disturbances, including insulin resistance, obesity, and type 2 diabetes.
The cause of diabetes type 2 is insulin resistance; sleep deprivation may play a role in increasing the
incidence of type 2 diabetes or worsening its control for people who already have it. If you are diabetes
type 1, your insulin requirement may vary with the amount of sleep you get.
Psychological distress can increase your risk for type 2 diabetes.

A study has found people who are consistently under mental or psychological stress are more likely to
develop type 2 diabetes in the future.
A large UK survey found that people with higher levels of psychological distress were 33 percent more
likely to develop the metabolic condition compared to those with low distress levels.
Diabetes Symptoms
Submitted by Thiruvelan on 22 Jun 2010 | Last updated 12 December 2013
Type 2 diabetic symptoms mostly go undiagnosed, because many of the symptoms seem harmless.
However, if you know the symptoms of diabetes, then it helps early diagnosis, timely treatment and to
avoid diabetes complications.
Most of the symptoms of diabetes are common among all diabetes types such as diabetes type 1,
diabetes type 2, pre-diabetes, gestational diabetes, etc. Still there are some specific symptoms for a
specific diabetes types.
Symptoms of type 2 diabetes

Below are the some common type 2 diabetes symptoms:
Frequent urination,
Frequent thirst,
Lack of energy and feeling tired,
Usual too much hungry,
Blurred eye vision,
Dry and itchy skin,
Losing sense or tingling in feet,
Sore heals slowly,
There is unusual sudden weight loss or gain.
In type-2 diabetes, the symptoms start occurring more gradually. In some individuals, there are no
symptoms at all, and so it often goes undiagnosed. Many type 2 diabetes patients unknowingly have
this condition and consult doctor with symptoms of diabetes complications, such as tingling in the feet
(neuropathy) or vision loss (retinopathy). That is why diabetes screening is important for people
at diabetes risk factor.
Video on diabetes mellitus symptoms
Pre-diabetes symptoms
Symptoms of pre-diabetes are the same, as the diabetes symptoms, most notably lesser and some do
not have any symptoms. Therefore, it is advisable to have diabetes testing regularly, if you are having a
high diabetes risk factor.
Interested to know, why diabetes symptoms are developing.

What is glucose homeostasis? Human homeostasis means a stable condition throughout the body.
The body is carrying out various complex interactions to keep a proper healthy range. Maintaining
blood glucose within the normal range is glucose homeostasis. If there is, any disturbance to this
glucose homeostasis will lead to various bodily symptoms.
Why are diabetics, pee often and in large quantities? - If the blood-sugar level get elevated
and your body cells are unable to consume it. Then, these high-sugar level remains, until the kidney
flush out this extra sugar in blood as urine (pee). Therefore, people with diabetes urinate frequently
and/or in large quantities, urine often contains sugar, and other minerals (such as sodium, chloride,
potassium, and bicarbonate).
Why diabetics are having severe frequent Thirst? - The human body needs water to keep
enough blood and other fluids. However, frequent urination leads to depletion of liquid called
dehydration leads to shortage in saliva causing dry mouth and throat. Dehydration increases the
osmotic blood pressure and lower blood volume. This makes the kidney to release of rennin
angiotensin this stimulates the hypothalamus to signal thirst. Thus, diabetics have frequent thirst and
need to drink often.
Why Lack of Energy & Feeling Tired? - Inadequate insulin secretion or insulin resistance
prevents the body to consume the available blood glucose. Additionally, kidney flushes out excess
sugar and minerals (such as sodium, chloride, potassium, and bicarbonate) from the body meant for
energy that gone unutilized. This lack of glucose absorption, removal of vital minerals and dehydration
leads to lack of energy thus diabetics feel tired.
Why diabetics are having too much hungry? - In almost 40% of people, the thirst mechanism
is so weak that often mistaken for hunger. In addition, when you feel tired, your body signals for energy
as hunger. This causes you feel hunger.
Why diabetics are having blurred vision? Those who unknowing having diabetes are often
happy to note that they do not need glasses anymore to see distance objects (mostly people with
myopia or Shortsightedness). This is because, increase or decrease in blood-sugar level makes the
eye lens and (or) corneal tissue to swell or shrink respectively, results in varying vision. Others may
find their vision turns blur; with respect to how high the blood-sugar level is. With proper treatment if the
blood-sugar level returns to normal, blurred vision (or sometime clear vision) disappears.
Why diabetics are having dry and itchy skin? - Dehydration and inadequate supply of
nutrients to the skin makes it, lose its lust and shine. Furthermore, the dehydrated skin result is dull,
flaky, rough, and dry skin. Which makes the skin itchy?
Why diabetics are losing sense or tingling in their feet? - Numbness or tingling sensation
among healthy individuals when they sit in a position for extended time. This is due to short supply in
blood circulation to these areas. Similarly, diabetics with high blood sugar levels are generally short
supply of nutrients to the extremities causing numbness or tingling sensation over the feet.
Why are diabetics, Sores heals slowly? - Healing takes longer due to low nutrient supply. In
addition, the immune system does not work efficiently in case of high blood sugar, because of the
interactions between various hormones and enzymes. Thus, diabetics sore takes longer to heal.
Why is diabetic loss or gain weight? - Some lose weight because of low consumption of the
blood glucose due to inadequate insulin. Some with diabetes gain weight because of frequent hunger,
continuous dumping of food items and unnecessary fat storage. Thus, diabetics have sudden weight
loss or weight gain.
Reactive Hypoglycemia
Reactive hypoglycemia or postprandial hypoglycemia is a recurrent episode of hypoglycemia within

four hours of having a high-carbohydrate meal in people with or without diabetes. It may be due to
excess insulin release triggered by a carbohydrate meal after digestion and absorptions of glucose.
What is reactive hypoglycemia?

After eating, if your blood sugar goes up at one hour and then drops below 70 mg/dl (3.9 mmol/L) at
the two hour, this condition called reactive hypoglycemia. The blood sugar rises up after food; your
body releases insulin to being back the blood-glucose level. Due to insulin resistance, glucose level
stays high; your body reacting to this by rapidly releases a huge dose of insulin. This excess insulin
dose ends up with low blood sugar.
Reactive hypoglycemia may sometime due to insulin

resistance. Usually in insulin resistant, the insulin does
not recognize as usual, so the pancreas does not shut
off. This leads to blood-glucose crash. Normally working
pancreas would immediately release glucagon, which
signals the liver to dump glucose into the blood stream.
However, in case of reactive hypo, your pancreas does
not do so leading to low blood sugar.
Reactive hypoglycemia may be an early-warning sign for diabetes. However, this may take many years
or even decade until it becomes apparent. Although, you do not progress to diabetes, insulin resistant
forcing your body to secrete too much of insulin driving your blood sugar low. Excess level of insulin in
blood may be a precursor to heart disease.
Reactive hypoglycemia symptoms

Symptoms of reactive hypoglycemia can vary from one person to another. Thus, the rate and
magnitude of drop in blood-glucose concentration decide the development of symptoms.
Some of the common food induced reactive hypoglycemia symptoms are: hunger, weakness, trouble
concentrating, sleepiness, sweating, lightheadedness, anxiety, shakiness and confusion.
Reactive hypoglycemia causes

The exact cause of reactive hypoglycemia is still not clear; however, there are several assumptions to
explain why it can happen.
Exaggerated insulin response due to insulin resistance, body cells are not properly reacting to
insulin. Thus, pancreas gets confused and releasing excess insulin to clear blood glucose leading to
very low blood-glucose level.
Exaggerated insulin response due to increased glucagon-like-peptide 1 - is a strong antihyperglycemic hormone, stimulates insulin secretion while suppressing glucagon secretion.
Renal glycosuria is a defect in sodium-dependent glucose co-transporters causing more

glucose to send out as urine.
Glucagon is a hormone causing the opposite effect of insulin; it raises blood-glucose levels if
low. Defects in glucagon hormone response may not be able to stop hypoglycemia.
Sensitivity to epinephrine, a hormone releases in the body during stressful situation.
Gastric surgeries may pass food too quickly through the digestive system leading to
hypoglycemia.
Hypothyroidism may effect on blood sugar levels.

Helicobacter pyloric infection induced gastritis - some reports show H. pylori may contribute to
the occurrence of reactive hypoglycemia.
Reactive hypoglycemia treatment

Below are the common simple treatments to relieve reactive hypoglycemia:
Low-carbohydrate diet is the first treatment option for reactive hypoglycemia.
Limit or even avoid sugar or any other high-carbohydrate high glycemic food intake.
Exercising regularly can increase sugar consumption, which decrease excessive insulin release
and thus stop hypoglycemia.
Choose to eat a variety of foods such as meat, poultry, fish, whole-grains, fruits, vegetables,
and dairy products.
Prefer foods that are fiber rich, which help stop dumping of glucose into the blood stream thus
chances of reactive hypoglycemia, can minimize.
Choose high-fiber foods.
T2D BS Test
Submitted by Thiruvelan on 22 Oct 2013 | Last updated 22 August 2014
The type-2 diabetes control is in your hands and literally, at your fingertips. Test, analyze, modify, and
test again until reaching your target BS.
Home Self-Monitoring Blood Glucose in Type 2 Diabetes

You should check your fasting that is before eating anything to check the liver. Moreover, two hours
after start eating your meal to check how well your body responding
to food.
Keep a written log for what you eat and your BS tests result. Your
meter can keep the reading in its memory. These readings are no
meaning unless you relate with what food influencing how much BS.
Write down what food, how much and match it to the BS respond it
makes. This helps you to find enemy foods (makes higher BS
spikes) and replacing it with friendly foods (makes lowest BS
spikes).
Next, find out when your BS peak spike happens after eating. Start
testing at 1, 1.5, 2, and 3-hours after eating (do these for all three meals). Learn at which time your
highest spike occurs. This is the time your will do postprandial testing in the future. There is a peck at
30 minutes after eating that is no importance because studies confirm that will not increase diabetes
complications.
My A1C is below 6.5%, why should I SMBG?

Most type-2 diabetes (even their healthcare providers) on seeing their A1C of less than 6.5% might be
a normal blood sugar number. Thus, they may think why should spend money, time and effort of BS
testing. However, the truth is the A1C is the average glucose of 24 hours a day, for about three months
past. An average may contain both highs and lows; it is common to have an A1C of less than 6.5%
with blood sugar highs at 200s and lows at 50s. You may shock to hear still this may be the truth.
Why, when, how and what is blood sugar testing?

Blood sugar testing is important to manage your diabetes and stop its complications. For type-2
diabetes, BS testing is not emphasized, thus they are more likely to get early diabetes complications
than type-1 diabetes. A study shows people with type1 diabetes develop the diabetes complications
after 15 years, whereas people with type2 diabetes may develop diabetes complications after 10 years.
Why you need to test BS?

Blood sugar testing or self-monitoring blood glucose can help you how well your diabetes treatment is
going on, learn how your diet and exercise influencing your blood sugar levels, discover how an illness
& stress can disturb your BS, know how your medication maintains your BS, and identifies and
prevents hyper & hypoglycemia.
Why I should take both fasting and postprandial blood sugar?

When type2 diabetics have a raised fasting blood sugar, does not mean anything about the diet for the
day or night before, why? Because the carbohydrate is the nutrient in your food that takes around five
hours (maximum) to raise your blood-sugar level. After that, the sugar level in blood starts dropping,
your brain signaling the pancreas to release the glucagon hormone. This hormone will signal the liver
to convert stored glycogen to glucose and releases into the blood stream. Thus, the blood-sugar level
after five hours since you last had food is the indication of your livers glucose mechanism. The fasting
blood sugar only indicates your livers glucose mechanism and does not show anything about your
bodys response to the food you ate.
To know how your body handles the food (particularly carbohydrate); you should test your blood sugar
after one or two hours after start taking your meal. After ingesting food, your blood sugar rises for
about two hours and then returns to normal within next two hours.
Thus, you should check your fasting that is before eating anything and two hours after start eating your
meal.
When do you do BS testing?

Test your BS at the different times, such as fasting, one hour after each meal, two hours after each
meal, and at bedtime. This makes eight tests per day; fasting, three meals two tests each (1 & 2-hours
after food) equals six tests, and at bedtime. These tests help you to learn:
1.
How long after a meal, the blood-glucose is rising to its peak.
2.
How fast it is returning to normal.
3.
You will see how carb foods such as bread, potato, pasta, etc. raise your BS reading.
4.
How certain low carb foods (such as food rich in fat, protein and whole grains) is producing the
least rise in your BS.
How often BS tests you, need to do?

Leading diabetes institutions does not recommend SMBG for type2 diabetes, if you are on lifestyle
diabetes control or on medications. Only those on insulin treatment can test twice daily.
However; diabetes type 2 requires to test their blood sugar two or more times, when newly diagnosed,
changing medication, ingesting new-food, unstable BS, high blood sugar levels (fasting >130mg/dl,
postprandial >180mg/dl), acute illness, pregnancy, on insulin therapy, acute illness, hypoglycemia risk,
and if job warrants (such as pilots, critical jobs, etc.).
If your A1C is within your target range (A1C of less than 7%), you do A1C test twice a year. If it is not in
your target range, you do A1C test four times a year.
If you are not affording to test BS frequently, (four times a day, testing roughly requires $120 a month
for test strips), then you can do block testing, means testing four or more times a day only one day per
week. Record what you eat, how active you are, what & when you have medication, quality of sleep,
stress level. Etc.
If your type2 diabetes is in control, you do not need to test more frequently and could test once a
week. If your diabetes control is not as expected and try improving it, then you should test more often
as needed.
Reasons for elevated fasting blood sugar: inadequate sleep, any form of pain, illness or infection,
skipping your regular exercise, missed your medication previous night, too much of stress and/or right
before a menstrual period.
Reasons for elevated postprandial blood sugar: eat too much, ingesting wrong food (more carbs or
sugar), forget to take medication (or need medication change), any form of pain, illness or infection,
before a menstrual period, taking steroids (such as prednisone/cortisone), skipping exercise earlier in
the day, and/or stressed out.
Low blood sugar BS testing

Blood sugar under 70mg/dL is considering as hypoglycemia and needs treatment by ingesting a quick
source of a carb like three to four glucose tabs, half cup juice, half regular soda (six ounces), eight
ounces nonfat milk, etc. Waited for ten minutes, retest and makes sure it is over 80. If BS is remained
below 80, then repeat the treatment and retest in 15 minutes until BS rises over 80.
Type 2 diabetes should not tighten their control, if they are frequently experiencing hypoglycemia or
occasionally non-symptomatic hypoglycemia.
Diabetes Care
Carefully manage your diabetes with proper food, physically active, monitor glucose level, have
medicines, control pressure-cholesterol, quit smoking and regular doctor visit.
Is it possible to manage diabetes without medication?

Yes, many with type 2 diabetes can manage their diabetes without medication. How is it possible to
manage your diabetes without medication? You can manage your diabetes (only type 2, not type 1)
without medication and with certain lifestyle changes.
Food you eat can affect your blood-glucose level. Therefore, you need to take a healthy food
with low to moderate amount of carbohydrate. Break up your 2 to 3 big meals into 4 to 5 smaller meals;
it can reduce blood-glucose spikes.
Physical activity or regular exercise can help burn excess glucose in your blood stream, as well
as reduce your insulin resistance (if you have).
Losing weight helps increase your insulin sensitivity, which has a direct relationship with your
blood-glucose control.
Enough sleep can repair your body and nourishes the entire system, additionally supports the
management of your blood-sugar level.
Stress is detrimental to your physical as well as mental health; proper stress management helps
you to attain your target blood-glucose level.
Diabetes Management
1.
Food - What you eat directly influences your bloodglucose levels. Follow the food pyramid for effective
diabetes control or management. Take food at the
same time also the same volume and never skip
your food or even snack.
2.
Physically active try to make your busy in your

daily life routine or spent some time for physical
exercises such as walking, swimming, exercising
and playing. It produces positive results in bloodglucose control as well as a drop in medicine (pills or
insulin) requirements.
3.
Lose weight if you are obese or overweight, try to reduce weight by following food pyramid
and increasing physical activity or exercising. Losing weight has a direct positive impact in your bloodglucose control.
4.
Monitor glucose level closely monitor your blood-glucose, check your blood-glucose using
home glucose monitor, and make a record. If you maintain your blood-glucose near normal, then you
can avoid many diabetic complications.
5.
A1C test Have A1C test at least two times a year. If you are very much concerned about your
health, it is better to have A1C test for every three months. If you are able to maintain your bloodglucose near normal most of the time, then your A1C level will be at the best range.
6.
Medicine Have your medicine or insulin in the same time every day without skipping or
delaying. Learn to adjust your medicines with respect to your daily activity change of any rare diet
change.
7.
Scheduled exams Go for regular yearly exam for eye, kidney, heart, nerves, and teeth. If you
have, any symptoms of diabetes complication immediately consult your doctor.
8.
Vaccination high blood-glucose can weaken your immune system, which makes routine
vaccination is important for diabetics. Ask your doctor for details.
9.
Foot care Give a special importance to your foot. Wash your foot in lukewarm water, dry it
gently, and moisturize it. Regularly check foot for any blisters, cuts, sores, redness or swelling, if found
any consult your doctor immediately for treatment.
10.
Blood pressure, Cholesterol if you are hypertension and or cholesterol keep it in control with
medication to avoid or postponed diabetes complications such as heart disease, stroke, and kidney
disease.
11.
Aspirin - Aspirin interferes with your blood's ability to clot. Taking a daily aspirin can reduce your
risk of heart attack and stroke a major concern when you have diabetes.
12.
Do not smoke if you are a smoker plan to quit. Smoking increases your risk of various
diabetes complications, including heart attack, stroke, nerve-damage, and kidney disease.
13.
Alcohol if you are a drinker, do so only in moderation and always with a meal.
14.
Stress stress causes hormonal imbalance and prevents insulin to work normally, end up with
a high blood-glucose control. So take the stress seriously and try to calm yourself or practice
meditation.
Diabetes Weight Loss

Every diabetes losing weight can help get off insulin and other medications. Learn how diabetes safely
loses their weight.
Weight loss and diabetes management

Weight loss helps overweight or obese diabetics to manage your blood-glucose levels better and
additionally help to reduce your need for diabetes medication. You should consult with your doctor for a
weight-loss plan with diet and exercise combination; he/she may change your medication or dosage to
suit your requirement. Obesity or overweight is determining by your bodys BMI (body mass index). A
person with a BMI of equal or more than 25 is considering as overweight and 30 or more is considering
as obese.
Various studies confirm that if someone with diabetes loses 5% to 10% of their weight, they will
significantly reduce their blood glucose level.
Even losing 10 or 15 pounds (4.5kg to 6.8kg) has numerous health benefits:
Lower blood glucose level
Normalizes blood pressure
Improves cholesterol levels

Make your hips, knees, ankles, and feet more flexible and stress free. Additionally, you will feel more
energetic, easy get around and convenient breathing.
Weight loss to stop diabetes

National Institutes of Health study found that a weight loss by a combination of diet and exercise limits
the risk of developing diabetes by up to 58%. The study involved people who were overweight with an
average body mass index of 34, who have slightly high blood sugar levels, which is not high enough to
diagnose as diabetes.
Diabetes weight-loss plan

Here are the eight points for diabetes to lose weight:
Limit and maintain an optimal level of carbohydrate intake. Calculate your carbohydrate
requirement based on your body weight, height, gender and age.
Limit your fat intake to a safer range.
Eat foods rich in fibers, which help your digestive system, and you feel fullness.
Take healthy diets rich in fruits, vegetables, grains, cereals, spices, etc.
Be physically active and or do exercise regularly, just 30 to 60 minutes of physical activity per
day for most of the days in a week.
Get enough sleep; because numerous studies show sleeplessness make you obese.
Drink plenty of water, which helps to wash your system and help safely lose weight.
Finally do not try to lose weight suddenly; it is not safe and good for your health. Try to lose
weight in steps for safer weight loss.
Before you starting a weight-loss plan, you should consult with a doctor about your health needs and
the best suitable options for safer weight loss. Additionally, regular blood-glucose monitoring is
important, because you may need medication or dosage change once you start losing weight.
Diabetes Smoking
Smoking harms everyone and every body organ. In diabetes, smoking can affect diabetes
management and multiply the risk of diabetes complications.
Smoking spoils your diabetes management

Numerous researchers show that people with diabetes who smoke have elevated blood-glucose levels;
smoking makes their blood-glucose level management difficult to control and putting them at greater
risk towards developing diabetes complications such as heart disease and stroke. Those who
additionally have high blood pressure are even riskier for diabetes complications.
If you are a smoker, please stop smoking it is not only good for you; it is also beneficial for this
environment and those around you.
How smoking can increase your diabetes complications?

High blood-glucose level in blood can increase the chances of building arterial fatty-deposits, this in
turn reduce normal circulation. Long term of diabetes and badly managed diabetes can already
damage the heart. Smoking alone can increase the chances of increased fatty deposits in the artery
walls and vastly affects the blood circulation by hardening the arteries. Thus, smoking can multiply your
risk towards heart attack, stroke and other diabetes complications.
Why diabetes should stop smoking?

Smoking is a health hazard; smoking increases your risk towards diabetes complications. Smoking is
bad for everyone, however, for diabetics; smoking can be even more damaging and dangerous.
Studies confirmed that smoking is an independent diabetes risk factor, and among diabetes, it can
increase your risk of diabetes complications.
Diabetes complications include heart disease, stroke, kidney problems, sexual dysfunction and
circulation problems. Smoking is already proving to increase the risk of further complicating these
things.
Smoking makes your diabetes management difficult; blood-glucose levels become unstable, because
smoking causes glucose levels to peak. Diabetics who smoke have a risk to develop high blood
pressure and cholesterol levels, which eventually increases the risk of having heart attack and stroke.
If you are a non-smoker that is great, you are not only helping you and those around you, be proud
about it. Make a plan never to start in the future. If you are a smoker, it is not too late immediately you
have to challenge yourself to quit smoking.
Ways to quit smoking cigarettes

You need to quit smoking; there is no better time than today. Of course, quit smoking is the hardest
things you ever do. There is a physical and psychological addiction your body has with the nicotine.
Nicotine withdrawal symptoms are headaches, anxiety, irritability and strong cravings for sugar and
salt. The physical nicotine withdrawal symptoms usually subside in three days, and psychological
cravings can take up to six months to subside.
There are many products available in the market that supports to quit smoking by reducing the
withdrawal symptoms as well as improve to make you remain smoke-free. Some of these options are:
Nicotine replacement therapy (NRT) is one of the most popular smoking-cessation treatments. It
is available as gum, patches, lozenges and nasal sprays on the market. Using this product consistently
can have more than doubles the chances of successfully quitting.
Medications that help quit smoking are Zyban (Wellbutrin) and Chantix; it works by reducing the
urge to smoke. Zyban (Wellbutrin) is a mild anti-depressant whose side effects have found to help
people quit smoking. Chantix is a new drug specifically developed to help people quit smoking by
blocking nicotine from reaching the receptors in your brain.
Benefits of quit smoking

Some of the benefits you will begin to notice immediately once start to quit smoking:
In about 20 minutes - your heart rate and blood pressure drop to normal.
In about 12 hours - the carbon monoxide level in your blood normalizes.
In two weeks to nine months there is an improvement in circulation, lung functionality,

coughing and shortness of breath.
In about one year - the excess risk of coronary heart disease is half of that of smokers.
In about five years - the Stroke risk is reducing to that of a nonsmoker.
In about 10 years - the lung cancer risk is about half that of smokers. The risk of cancer of the
mouth, throat, esophagus, bladder, cervix, and pancreas also decreased.
In about 15 years - the risk of coronary heart disease is that of a nonsmoker.
Diabetes Alcohol
Can diabetics drink alcohol? Limit if have a health problem that alcohol can make worse, such as nerve
damage or hypertension, otherwise no problem.
Can people with diabetes drink alcohol?

Before deciding to drink alcohol, ask yourself three basic questions:
Is diabetes under your control?

Do you have health problems that alcohol can make worse, such as diabetic nerve damage or
high blood pressure?
Do you know how drinking alcohol can affect your diabetes?
When you drink alcohol, it moves quickly into the bloodstream without metabolizing in your stomach.
After five minutes of drinking, there is enough measurable alcohol in your bloodstream. Alcohol is
metabolizing by the liver, and normally it takes approximately two hours to metabolize one drink.
Alcohol drinking can cause your blood glucose to drop. Alcohol stimulates your appetite, which lead
you to overeat and thus affects your diabetes control. If your blood glucose is well under control, then
an occasional moderate amount of alcohol drinking may be ok with before, during or soon after a meal.
Effect of Alcohol in People with Diabetes

The effect of alcohol on your blood-glucose levels depends upon various factors such as alcohol type,
quantity you consume, your diabetes-type, medication or insulin-type you are taking, your blood
pressure, and your blood cholesterol.
Alcohol has a significant number of calories and may cause weight gain, thus you may like to limit its
intake.
Drinking alcohol can lead to nerve damage in your arms and legs, diabetes eye problems, high blood
pressure and high blood cholesterol (specifically high level of triglycerides). Alcohol can lead to organ
damage such as the liver, heart, pancreas and skin. Diabetes itself is more susceptible to organ
damage and thus chooses to reduce your alcohol intake.
Even low quantity alcohol drinking can damage nerve cells; already diabetes itself leads to nerve
damage thus a diabetes individual who drinks alcohol has increased chances of nerve damage leads
to pain, numbness, tingling or burning sensation.
Tips for diabetics, who prefer to drink alcohol

If you decide to consume alcohol, following are some useful tips:
Check your blood glucose before, during, and after you have alcohol. Alcohol can drop your
blood glucose from 15 minutes to about 12 hours.
Only drink in moderation and should not have it in an empty stomach.
Avoid excessive uncontrolled drinking or continuous drinking, and never substitute alcohol for
your meals. All of this can increase the risk of hypoglycemia.
Check your blood glucose before bedtime; if it is below 100 mg/dl, have a snack to avoid
hypoglycemia in the midnight.
Each alcohol type will affect blood-glucose levels differently based upon the carbohydrate
content it has. Beer can push glucose levels up if you have more than a single pint. Wines tend to have
less carbohydrate than beer thus less effect on glucose levels. Spirits such as whiskey, vodka, rum and
gin, have no significant carbs. Therefore, has no effect on glucose levels. However, if you have them in
a mixer, this will need to take into account.
If you are on diabetes medications, then you need to practice caution. The action of insulin and
some diabetes medications such as sulfonylureas and meglitinides (Prandin) can lower blood glucose
by making more insulin. Thus, require to adjust the dose to prevent hypoglycemia.
The symptoms of too much alcohol and hypoglycemia looks similar, i.e. sleepiness, dizziness,
and disorientation. Thus, learn to distinguish between hypoglycemia and alcoholic effect.
Caution during alcohol drinking
Never drink if your blood-glucose level is low or experiencing hypoglycemia symptoms.
Drinking alcohol in high quantities regularly can cause an increase in blood pressure and weight
gain, thus do not do so.
Avoid drinking frequent large quantities of alcohol; it can aggravate neuropathy by increasing
pain and numbness.
Each person will have a different reaction to alcoholic drinks, thus it is worth carryout blood tests to
know how your body responding to it.
Type2Diabetes Treatment
Submitted by Thiruvelan on 22 Oct 2013 | Last updated 22 August 2014
Before going over the details of type2 diabetes treatment, let us first see how most doctors prescribe
their type2 diabetes patient, and why it is not effective as expected.
How does newly diagnose type2 diabetes treated?

If you are newly diagnosed type2 diabetes, generally depressed and scared to death and consult your
doctor with total trust. Most doctors put you on a low fat (means high carb) reduced-calorie diet, and
prescribes some diabetes medication to lower blood-glucose level. They suggest an appointment after
one month for rechecking.
After a month, you have to retest your A1C; in most of the cases, it will be at the same value as one
month before. This may be due to depression, anxiety and high carb diet. On seeing the result, the
doctor modifies the prescription by increasing the

medication dose.
You will start taking this huge dose of diabetes
medicines; your blood-glucose start falling. This is new
for your body, because your body has practiced to high
blood sugar for a prolong time. This falling BS makes you
feel fatigue and signaling hunger. You try compensating
by eating more food (high carb diet). The blood sugar
comes back to high level; you feel better and this cycle repeats.
On your next doctors visit, your A1C is the same or higher than earlier. Your doctor sees the result as
a treatment failure and your doctor raises the dose and/or adds another diabetes medication.
You left the doctors office with an added overdose of medication and the above-said cycle repeats;
lowering BS, feeling tired, eating more carbs, raising blood sugar and feeling better.
For the next visit, the A1C result is the same or higher, and your doctor increases your medication
further or put you on insulin injection. You will start developing diabetes complications and feel waste.
Actually, this is the way most type2 diabetes is treated and forced to early death.
What is the right way of type2 diabetes treatment?

If you are newly diagnosed type2 diabetes, generally depressed and scared to death and consult your
doctor with total trust.
Few doctors ask you some question, including
diet habits and put you on a low carb reduced
calorie diet without prescribing any diabetes
medication (stick with him; he/she is a best
doctor). Additionally, your doctor instructs; it is
common to feel tired if your blood-glucose level
drops from high do not overeat to compensate.
They suggest an appointment after one month for
rechecking.
In the next appointment, you visit your doctor with a good A1C result. Your doctor congratulates you for
your number. Additionally, he may suggest you to do some regular exercise and increased physical
activity. Your doctor suggests an appointment after two to three months for rechecking.
At the next doctors visit, mostly your A1C result will be in the non-diabetic range. Not only, your BS in
a normal range; you do feel more energetic, getting restful sleep, mentally more alert, and always brisk.
Your doctor appreciates you for your effort and asks you to keep it up.
Unfortunately, if your A1C number is not good enough, then your doctor may prescribe a minimum
dose of diabetes medication (mostly insulin sensitizer such as metformin). Your doctor asks you to take
medication along with your low-carb diet and regular exercise.
If your numbers are in the non-diabetes range, this does not mean your type2 diabetes is gone. You
have well balanced between your carb intolerance with diet, exercise and/or medication. Thus, it is
important to stick with your treatment; it should be your lifetime commitment. If you go back to your old
style of eating (high carb), your high blood sugar will return.
Stages of type2 diabetes treatment

Levels of type2 diabetes treatments are:
1.
Diet with appropriate weight loss (about 80 % type2 diabetics are overweight; thus, weight loss
should be an important treatment.) Most of the patients BS normalizes with diet alone.
2.
Diet plus exercise (helps lower insulin resistance as well as induce excess glucose consumption
in other ways that does not require insulin.) some patient requires an exercise to normalize their BS
number.
3.
Diet plus exercise plus an oral insulin-sensitizing or insulin-mimetic agent very few patients
require a low dosage of medication to normalize their BS.
4.
Diet plus exercise plus insulin injections with or without an oral agent sadly after years of oraldrug use, few patients may require insulin treatment.
Only few doctors follow this style of treatment, because most of the patients are not co-operative
enough and not stick with their low-carb diet and/or exercise. Thus on the safer side doctors straight
away prescribe medication to control your blood-glucose level. Whatever the reason, it is not advisable
to go for drug treatment instead of trying with diet and exercise.
Type2Diabetes Diet
Submitted by Thiruvelan on 22 Oct 2013 | Last updated 28 November 2013
Most newly diagnosed diabetes will have a common question, what, how much, when to eat to
normalize their blood glucose (sugar). At the same time, there is ever continuing debate (& studies)
over the low carb versus low-fat diet for diabetes type 2.
Why does diabetes require a specific diet?

Everyone with diabetes wants to prevent the blood-glucose spikes/drops, get enough calories with
nutrient-rich foods, managing weight (with or without weight loss), prevent hypoglycemia, achieving
A1C, avoid diabetes complications and stop shortening their lifespan.
For this, diabetic should individualize their diet to fulfill their taste buds, eating habit and budget without
spiking the blood-glucose level. You can achieve this by lowering your total carbohydrate intake.
What are the diets to choose for

diabetes?
Most probably, your doctor has been telling to cut
down intake of fat, protein, salt and add a lot of
complex carbohydrate. The publications
circulated among diabetic patients are also
insisting the same. Leading diabetes
organizations even though, acknowledging the
carbs could be bad for diabetes!
Why their message is so diluted as well as confusing?

If the goal of T2D treatment is to lower BS then, why you have to eat foods that raise it? Start lowering
carbs that raise your BS. Several low-carb diet advocates have been arguing it is closer to the
ancestral diet before the advent of agriculture. Thus, humans are genetically adapted to this diet.
Some of the common diabetes diet plans are:
1.
Mediterranean diet - includes abundance of locally grown plant-derived foods (such as fruits,
vegetables, whole grains, beans, nuts, seeds, and healthy fats), minimally processed, eggs, red meet,
and dairy products. It is a modern nutritional recommendation inspired by the traditional dietary
patterns.
2.
Vegetarian and vegan - The vegan diets are devoid of all flesh foods and animal-derived
products such as dairy products. The vegetarian diets are without any flesh foods but including egg
and/or dairy products. Features of a vegetarian diet may reduce the risk of chronic disease by higher
intakes of fruits, vegetables, whole grains, nuts, and phytochemicals.
3.
Low-fat diet means high carb, the daily calorie from fat is 30% or lower, carb 50%, and
protein 20%. This diet has been followed/prescribed guidelines for weight control and diabetes control
by various leading diabetes organizations. Instead of supporting, it only worsens your diabetes
treatment by spiking BS after eating.
4.
Low-carbohydrate diet is considering as a diet for people with diabetes; the daily calories from
carbohydrate are anything less than 45%. You can achieve low carb by eating foods higher in protein
(such as meat, poultry, fish, eggs, cheese, nuts, and seeds), fats (such as oils, butter, olives, avocado),
and low-carb vegetables (such as salad greens, cucumbers, broccoli, summer squash). Avoid pasta,
rice, potato, and bread.
How do you choose a suitable diabetes diet?

Here are some points to help you for better decision making:
1.
Know your body weight category such as obese, overweight, optimal weight or
underweight. Use BMI calculator, to know your weight category. If you are more than normal weight,
losing weight help achieving BS target. Use weight loss calculator to know how much calories to cut for
achieving a weight loss of 0.5 kg (1 pound) per week. Normal-weight individuals should know their
calorie's requirement; use the daily calorie's calculator.
2.
You are vegetarian or non-vegetarian vegetarian can choose vegetarian or vegan diet. Still,
you need to cut down your carb a little to bring back your blood glucose to normal. For nonvegetarians, there are numerous options to choose.
3.
What diet you were on before you diagnosed? - Diabetes diet you are going to choose
should match your eating habit. This will be convenient to follow, fulfill your taste buds, easy available,
within your budget and your body has been practiced to it.
4.
Other conditions you are having such as high cholesterol, hypertension, kidney problems,
digestion disorders, food allergies, etc. If you are having high-cholesterol, studies show lowcarbohydrate diets causes the triglyceride levels to fall, raise HDL cholesterol levels and nothing to
LDL. Therefore, this is a good thing for you to choose a low-carb diet. If you are hypertension (high
blood pressure), limit your sodium salt intake and try replacing it with potassium. If you are having
kidney problems, you should be conscious about your protein intake; consult your healthcare team for
optimal level of protein. If you are having digestive disorder or any food allergies, try identifying the
problematic food and avoid it. Additionally, consult Gastroenterologists - and get prompt treatment.
There is no fit for all suggestions for diabetes diet. However, simply saying you should cut down your
carb intake to counteract carbohydrate intolerance. You do so (cut-down carb) whenever you
experience carbohydrate intolerance to normalize blood sugar.
Additionally, you need to try, test, and modify to betterment your diabetes diet.
We all are different, what works for me may not work for you and vice-versa. Some people naturally
lean towards veggie style eating, another set of people lean towards more protein diets, and some
others lean towards fat diet. Whatever it is, you should cut down carbohydrate, and added carb should
be good one such as whole grain, fiber and nutrient rich.
Why you need to cut down carbohydrate intake?

Each of us reacting differently to carbohydrate; however, as we age, often develop carbohydrate
intolerance and greater blood-sugar response to carbohydrate. Carbohydrate intolerance persists for
years, even if the BS levels stay in the normal range.
Pancreatic beta cells produce insulin, and it stimulates
body cells to uptake glucose from the blood. Over time,
the body develops resistance to insulin and needs extra
insulin to stimulate body cells to uptake glucose and this
further increase the insulin resistance. Additionally,
increased level in insulin in blood is the risk factor for
triglycerides rise & low HDL cholesterol level in blood,
raised uric acid in gout, high plasminogen-activatorinhibitor-activity (risk towards clotting), and increased risk
towards heart attack and stroke.
If a person cannot properly metabolize carb, then it is
quite apparent to cut down the intake of carbohydrates.
Benefits of low-carb diet in diabetes type2 management

The very low-carb diet (carb< 20 grams/day) can lower:
1.
Hemoglobin A1C by -1.5% (17% reduction),
2.
Fasting glucose by 11.2%,
3.
Fasting insulin by 29%,
4.
Cravings for sweets are slowly vanish or lowered.
5.
Diabetes medications were lower or eliminate all together in almost 95% of type2 diabetes.
What are the other benefits of low-carb diet?

Some of the most common low carb benefits are as below:
1.
Can be able to lose weight (by 10%), even without restricting daily calorie's requirement.
2.
You may feel more energetic than usual.
3.
Help improves the triglyceride's level in blood (lower by 32%).
4.
It reduces total cholesterol (by 2.3%), total cholesterol to HDL ratio (by 8.9%) and triglyceride to
HDL ratio (by 34.6%).
5.
Increase in HDL (good) cholesterol level.
6.
There is notable improvement in insulin sensitivity.
7.
Help decreases your blood pressure (systolic BP by 11.5% & diastolic BP by 9.6%).
8.
There is notable improvement in emotional, mental and psychological states.
9.
There is appreciable reduction of insulin level in the blood (by 29%).
10.
Some with digestion problems also find improvement in digestion and other gastrointestinal
symptoms such as heartburn, fullness, etc.
T2D Exercise
Submitted by Thiruvelan on 22 Oct 2013 | Last updated 28 November 2013
Type2 diabetic doing exercise of any form and amount will get amazing improvement in their bloodglucose level, physical and mental well being. Additionally, lower your blood pressure and cholesterol
levels.
Type 2 diabetes exercise

Physical activity is defining as any bodily movements produced by skeletal muscles resulting in energy
expenditure. It comprises four dimensions:
1.
Mode or type of physical exercise such as aerobic versus anaerobic activity, resistance or
strength training, balance and stability training,
2.
Frequency of exercise, that is the number of sessions per day or per week,
3.
Duration of activity in minutes or hours per day or week,
4.
Intensity of exercise is indicating in rate of energy expenditure measured as oxygen

consumption, heart rate, and respiratory exchange ratio.
In addition, there are four domains of physical activities; they are occupational, domestic,
transportation, and leisure time.
Aerobic exercise is an endurance activity or cardio activity in which the larger muscles move in a
rhythmic manner for a sustained period. It causes your heart to beat faster than usual, increases
cardiorespiratory fitness. Some moderate-intensity aerobics are walking briskly (3 miles/hour or faster,
but not race-walking), water-aerobics, bicycling slower than 10 miles per hour, tennis (doubles),
ballroom dancing, and general gardening. Some vigorous-intensity cardio activities are race-walking,
jogging, or running, swimming laps, tennis (singles), aerobic dancing, bicycling 10 miles/ hour or faster,
jumping rope, gardening (continuous digging or hoeing, with heart rate increases), and hiking uphill or
with a backpack.
Muscle-strengthening exercise causes the muscles to work/hold against a force or weight; it is
important to put all the major body muscle groups to work such as the legs, hips, back, abdomen,
chest, shoulders, and arms. Muscle Strengthening activities include exercise using exercise bands,
weight machines, weight lifting, calisthenic exercises (putting body weight for resistance to movement,
such as climbing a tree or doing push-ups), gardening (digging & lifting), yoga, and tai chi exercises.
Bone-strengthening exercises put force on the bones promoting bone strength such as weightbearing or weight-loading activity. This force is generally producing by influencing the ground, such as
jumping jacks, running, brisk walking, and weight-lifting exercises. These activities can also be aerobic
and muscle strengthening.
What will happen, when you are doing exercise?

When you are exercising, your body uses two sources of fuel, glucose and free fatty acids (from fat) to
generate energy. Moderate exercise requires up to 20 times more energy than usual.
1.
During the first 15 minutes of exercise, most of the glucose for energy comes from either the
blood stream or the muscle glycogen.
2.
After 15 minutes of exercise, the fuel starts to come from the livers glycogen storage.
3.
After 30 minutes of exercise, the body begins to get more of its energy from the free fatty acids.
As a result, exercise can deplete sugar levels and glycogen stores. The body will replace these
glycogen stores; it takes 4-24 hours with more intense activity. During rebuilding of glycogen stores,
your blood-glucose level is maintaining low in some it may cause hypoglycemia.
There are two well-defined pathways stimulate glucose uptake by muscle; they are:
1.
At rest and postprandial, its uptake by muscle is insulin dependent and serves primarily to
replenish muscle glycogen stores.
2.
During exercise, muscle-contractions increase BG uptake even when insulin-mediated uptake is

impaired in type2 diabetes.
Muscular BG uptake remains elevated post exercise by
both contraction-mediated pathway and insulin-mediated
uptake. Thus, even if the insulin-stimulated BG uptake is
impaired in type2 diabetes, exercise induced muscularcontraction stimulates BG uptake is not impaired by
insulin resistance, which help lower glucose level. A
combination of aerobic and resistance training may be
more effective for BG management than either type of
exercise alone. The BG lowering effect persists for at
least 24-48 hours after exercise.
What can you do to be physically active?

Physical activity is something simple everyone can do. It does not mean to run a marathon or spend
the whole day at a gym. Look for simple ways to include physically exercise into your daily activity.
Ten simple tips to help you to be active:
1.
Start your physical activity slowly and gradually increase your endurance. Make your exercise
plan a lifetime commitment and continue doing.
2.
Choose an activity you love such as swimming or cycling. This increases your chances of
continue doing.
3.
Convert your exercise therapy into a social time, look for community group or get your family or
friends to joining the exercise activity. It will be more joyful and healthy.
4.
Try walking, whenever and wherever possible.
5.
Take the stairs instead of the elevator.
6.
Play with your kids will be relaxing and healthy for both.
7.
Plan a jolly trip by walk or cycle.
8.
Doing regular gardening work increases your activity.
9.
Take your pet for waling.
10.
Wash your car, clean your house, this can save money and help maintain cleanliness.
"Doing something is better than nothing," Thus start with a thirty minutes of physical activity on most
days throughout the week.
Exercise tips
1.
Wear comfortable shoes and practice proper foot care.
2.
Drink enough water before, during, and after exercise to prevent dehydration.
3.
Avoid exercising, when your diabetes medication is at its peak action.
4.
Avoid consuming alcohol prior or immediately after exercise.
5.
Avoid hot tubs, saunas and steam rooms immediately after exercise.
Benefits of Physical Activity in diabetes management

Regular exercise and increased physical activity are the most important things you can do to improve
health. Some of the benefits are:
1.
Glycemic control - improves the glucose level by 10%, fasting BS by 7%, and A1C by 1.0
1.5%. Patient doing exercise can reduce their dose of diabetes medication up to 72%.
2.
Insulin sensitivity - physical training mobilizes visceral-adipose tissue, which increase insulin
sensitivity by about 46%, improve your body's ability to use insulin. A change in visceral abdominal fat
was associated with the improvement in insulin sensitivity.
3.
Hypertension - normalizes blood pressure in case of hyperinsulinemia also in others.

Additionally, improves blood circulation.
4.
Prevent cardiovascular diseases - by reducing hyperglycemia, hyperinsulinemia,

hypertension, LDL (bad) cholesterol and raise HDL (good) cholesterol.
5.
Weight management - It promotes excess fat burning and helps control weight. This can
decrease in body-fat results in improved insulin sensitivity.
6.
Avoid diabetes complications - It can protect against the CHD, stroke, hypertension, obesity,
non-insulin-dependent diabetes mellitus, osteoporosis, colon cancer, and depression.
7.
Increases energy level and thus balance fatigue caused by diabetes.
Physical exercise helps blood-glucose management, reverse insulin resistance (improve insulin
sensitivity), stop diabetes progression (slows down pancreas beta cell death) and prevents diabetes
complications. Thus, regular exercising (both aerobic and muscle strengthening) is necessary therapy
for diabetes control.
Other benefits of physical activities

1.
It reduces stress, promotes relaxation and relieves tension and anxiety.
2.
It improves quality of life,
3.
Improved cardiorespiratory and muscular fitness
4.
Key in determining energy expenditure; help energy balance and weight control.
5.
Reduce blood-clotting tendency where arteries have narrowed.
6.
It increases arterial elasticity.
7.
Help improves mental health, mood and cognitive function by changing the brain chemistry.
8.
Strengthen your bones and muscles; improve bone and functional health.
9.
In older adults, helps maintain full functioning and independence among the elderly.
10.
In disabled, it improves the ability to do daily activities and prevent falls.
11.
Increase your chances of living longer.
12.
It can improve sleep quality and quantity.
Be careful, when exercising

Physical exercise surely provides you with numerous health benefits, still as a diabetic, you should be
extra careful for certain instances; they are:
1.
Hypoglycemia: Low blood glucose is a blood-glucose level anything below 70 mg/dl. If you are
not using insulin or insulin secretagogues, then your chance of hypoglycemia due to physical activity is
rare. Type2 diabetes using insulin and insulin secretagogues are required supplementing with
carbohydrate as needed to prevent hypoglycemia during and after exercise.
2.
Hyperglycemia: Do not exercise if your blood sugar is over 250 mg/dl, and you have ketones.
If your blood sugar is over 400 even without ketones, type-2 does not do exercise. In case of type1
diabetes with blood sugars of 300 or more, test within 5 to 10 minutes after start exercising. If your
blood sugar is dropping, you may continue exercising or else stop exercising.
3.
Medication dosage adjustments to prevent exercise-induced hypoglycemia may require, if

you are on insulin, insulin secretagogues, beta-blocker (hypertension medication), diuretics, and/or
statins (cholesterol medication).
Physical activity for people with chronic medical conditions

For most chronic conditions, physical exercise provides therapeutic benefits and is considering as a
treatment.
Peripheral neuropathy without acute ulceration individuals can do moderate weight-bearing

exercise. Moderate walking does not increase foot ulcers or re-ulceration. Physical activity can help
stop the progression of peripheral neuropathy; in some cases, it even reversed it.
Retinopathy individuals with uncontrolled proliferated-retinopathy should avoid activities

increases intraocular pressure and hemorrhage risk.
Nephropathy and micro albuminuria person can do exercise to improve physical function.
Quality of life improves in case of individuals with kidney disease undergoing dialysis sessions.
Vascular disease such as cardiovascular disease (CVD) is not an absolute contraindication to

exercise. Those with angina classified as moderate or high risk should likely begin the exercise in a
supervised cardiac rehabilitation program. Physical activity is advisable for anyone with peripheral
artery disease (PAD).
Osteoarthritis is a common among older adults; strong scientific evidence shows both
aerobic and muscle-strengthening exercise provides therapeutic benefits. Study shows, safe
exercising reduces pain, make physically functional, better quality of life, and improve mental health in
patients with osteoarthritis.
Tight Diabetes Control

Submitted by Thiruvelan on 10 Apr 2013 | Last updated 22 October 2013
Tight control means getting as close to or within a normal (non-diabetic) blood-glucose range as you
safely can be without frequent hypoglycemia.
What Does Tight T2D Control Mean?

Tight diabetes control is worthwhile in almost every case; it requires the test, analyze, modify and
again; repeat until you reach your target. You require to lowering carb in your diet, physically more
active, stick to regular exercising, manage stress effectively, get adequate sleep, quit smoking, limit
alcohol consumption, and medication/insulin (only if necessary).
For tight T2D control, what will be the best

blood sugar (BS) range?
BS target1: American Diabetes Association suggested
the below said target: Fasting blood sugar number 70
mg/dl to 130 mg/dl and the postprandial blood sugar
number less than 180 mg/dl.
BS target2: Once you have accomplished the abovesuggested target, try achieving closer BS numbers:
Fasting BS under 110 mg/dl (or 6-mmol/l), postprandial
BS one hour after meals under 140 mg/dl (or 8-mmol/l) and two hours after meals under 120 mg/dl
(6.5-mmol/l).
Why would be diabetic assume they would always be higher than nondiabetic?
You cannot cure diabetes; however, it is quite possible to manage it close to a normal range, even
within the non-diabetic range. Many experience diabetic just achieving it even if most newly diagnosed
never know it. It is your good practice, knowledge, and motivation can take you to best non-diabetes
range, thus do not under estimate you. Keeping your BS close to normal, helps you feel better and stop
(or reverse) your diabetes complications.
BS target3: Once you have achieved the above-suggested target, and then try to maintain your BS in
the non-diabetic range: fasting BS under 100 mg/dl (5.5-mmol/l), postprandial BS one hour after meals
under 126 mg/dl (7-mmol/l), and two hours after meals under 100 mg/dl (5.5-mmol/l).
BS target4: You can even try achieving a blood-glucose range that is totally free from any diabetes
complications. Such a best BS number is fasting within 7090 mg/dl (or 3.89 to 5.00-mmol/l), one-hour
after a meal within 90125 mg/dl (or 5.00 to 6.94-mmol/l), and two-hours after a meal within 90110
mg/dl (or 5.00 to 6.11-mmol/l).
Does the tight diabetes control worthy?

Close control of diabetes will reduce your risk of diabetes complications, the United Kingdom
Prospective Diabetes Study confirms this, and it was the largest study of diabetes type2 patients. This
test result shows the benefits of tight control; you can be able to lower your A1C even up to 6.2%. For
every 1% drop in A1C, you can expect:
1.
There is a significant reduction in nerve damage.
2.
Your eye damage risk in the next 10 year can reduce by 35%.
3.
Your kidney damage risk in the next 10 years can reduce by 35%.
4.
Your heart-attack risk in the next 10 year can reduce by 18%.
5.
Your chances of dying within 10 years can reduce by 7%.

There are amazing benefits in tight diabetes control; however, it can increase your risk of hypoglycemia
episodes. If you are not able to prevent hypoglycemia episodes, then close diabetes control is not for
you. Elderly and those who have had a heart attack or stroke can stop trying tight diabetes control;
instead of benefits, it only harms them.
ACCORD (Action to Control Cardiovascular Risk in Diabetes) and ADVANCE (Action in Diabetes and
Vascular disease: preterAx and diamicroN mr Controlled Evaluation) those studies did not show
stringent control is harmful; instead, control by a combination & over dosage of oral medication and/or
insulin treatment may not be good for diabetic health. Additionally, these studies have carried out by
advising the diabetes patients to have an extremely low-fat (means high carb) diet. Which experienced
diabetes patient and some smarter health care professionals have been opposing? If you decide to be
in tight control your diabetes with diet (lowering carb), exercise (more active life with regular aerobic
and resistance training) and without or low dosage of medication/insulin, it is surely beneficial to you
without any form of harm.
A1C target: American Diabetes Association (ADA) suggests people with diabetes to aim for A1C levels
of 7% or less, equivalent to 150 mg/dl average blood sugar. Once you have achieved this target, next
you should try for pre-diabetes A1C range of 5.7 to 6.5%. After achieving this pre-diabetes range, you
can even try for non-diabetes A1C range of below 5.7. You can try shifting your target up to nondiabetic range only if you are not experiencing frequent hypoglycemia episodes. If you are newly
diagnosed t2d, then it is possible to reset the clock and stop any further damage to your pancreatic
beta cells.
Experienced people in various diabetes communities, who are achieving an A1C of less than 6%,
invariably those happy people report that their great results are from their efforts in making changes to
their diet (low-carb diet), post-meal testing, and increasing exercise. Additionally, those people do not
seem to be encountering any of the problems warned about in ACCORD and ADVANCE. Thus, it is the
time to keep aiming for a blood-glucose level and A1C of a healthy non-diabetic range (if possible
without medication/insulin).
Type 2 medication
Body makes insulin but may be insufficiently (impaired insulin secretion) or insulin resistance (impaired
biological response to insulin in the tissue). Insulin resistance and lack of insulin secretion are
considering being the cause of type 2 diabetes.
Is it possible to manage diabetes without medication?

During diagnosis, if you are asymptomatic with A1C level of less than 7% or fasting blood glucose less
than 130mg/dl or 7.22mmol/l, you can manage your diabetes without medication, however, with
lifestyle changes (diet and exercise) and by losing some weight.
Diet, exercise and weight reduction should be the cornerstone of diabetes management. You can
manage your diabetes by losing some weight, increased physical activity (or regular exercise) and with
proper diet. Losing 10 or 15 pounds or 4.5 to 6.8 Kg can sometimes help you reach your target. Always
check with your doctor before you stop taking your diabetes pills or start your treatment by lifestyle
change alone (without medication).
Classes of Diabetes Drugs

Different diabetes pills available in the market that work differently in lowering blood-glucose levels.
Oral medication for diabetes are come under the following categories:
Insulin Sensitizers are working to lower your blood glucose level by increasing insulin
sensitivity of your muscle, fat and liver. Some of the insulin sensitizers
are Biguanides,Thiazolidinediones (TZDs) or glitazones
Insulin Secretagogues (insulin secreting medications) are diabetes drugs that work by making
the pancreas to release (or secrete) more insulin to help lower your blood glucose level. Some insulin
secretagogues are Sulfonylureas, Meglitinides or glinides, GLP-1 agonists, DPP-4 inhibitors
Starch blockers - are working to lower blood glucose level by delaying digestion and
absorption of carbohydrates. Starch blocker class of medication is Alpha-glucosidase inhibitors.
Glucose re-absorption inhibitors - are working by blocking the re-absorbtion of glucose and
allow it to excrete, thus lower the blood glucose level. Glucose re-absorption inhibitor class of diabetes
drug is SGLT2 inhibitors.
Other drug is Amylin analog.
How is a diabetes oral medication works?

Diabetes medication helps to control your blood-glucose level in people whose body still produces
insulin (in case of type 2 diabetes). Several kinds of diabetes medication are available in the market,
which works differently such as:
It stimulates your body to increase insulin secretion by the pancreas.
It makes your liver to limit or stop producing & dumping glucose into the blood stream.
It makes your body cells to better utilizing the glucose in the blood stream.
It inhibits your small intestine from absorbing glucose in the food.

At the beginning, your doctor may try one and two medications or its combination to assess, which one
best suitable for your body system. Be in a close coordination with your doctor to get an individualized
diabetes treatment.
When do you need diabetes medication?

You need diabetes medication treatment along with lifestyle changes, when your A1C is more than 7%
or FBG level more than 130 mg/dl or 7.223 mmol/l.
Derive maximum benefits from your diabetes medications

Your daily routine such as eating habits, physical activities and other health conditions can have an
influence over your medication effectiveness. Your medication works best when it is combining with
proper meal planning, consistent regular exercise, getting enough sleep, and effective stress
management. You should take the diabetes medication at the same time every day, if you are a
forgetful person like me, then you can set reminder on your phone to alert you. Store themedication as
directed by your doctor or as instructed by the manufacturer. Closely monitor your medicines
effectiveness and any side effects it produces; discuss with your doctor regarding this so that he may
change the medication or dosage that best suits you.
What should be your diabetes target?

Every diabetes type 2 should try to achieve a target:
A1C of less than 7.0 % (4 to 6 % non-diabetic normal range),
Pre-prandial glucose level of 90 to 130 mg/dl or 5 to 7.223 mmol/l,
Postprandial glucose level of less than 180 mg/dl or 10 mmol/l, and
Bedtime glucose level 110 to 150 mg/dl or 6.111 to 8.334 mmol/l.
Is it possible to adjust diabetes medication to cover whatever ate?

No, the diabetes medication works as intended, and you cannot adjust it with respect to the food you
ate. However, if you are in insulin treatment, then it is possible for you to learn and adjust the dosage
with respect to the food intake and the physical activity you had. Still it is not advisable for you to eat
you want, and take extra drugs to normalize your blood-glucose levels.
Choose Diabetes Medication

Submitted by Thiruvelan on 05 Mar 2013 | Last updated 6 May 2013
Initiation of your diabetes medication therapy is always based on your fasting blood-glucose level
FBG), postprandial blood-glucose level (PPG) and A1C percentage.
The contribution of FPG to A1C is dominating in patients with poorly managed blood glucose. The
contribution of FPG is about 70% in patents whose A1C is near by 10.2%. As the blood-glucose level
improves, PPG contribution dominates to about 70% when the A1C values close by 7.3%. Postprandial
hyperglycemia is also one of the earliest abnormalities of glucose homeostasis associated with type 2
diabetes and is markedly exaggerated with fasting hyperglycemia.
In one study, PPG monitoring has been shown to improve outcomes is gestational diabetes. However,
it appears that FPG is somewhat better than PPG in predicting HbA1c, especially in diabetes type 2.
Two major group of diabetes drugs

There are two major groups of oral hypoglycemic drugs: sulphonylureas (SUs) and biguanides(BGs).
SU act by stimulating insulin release from the beta cells and by promoting its action through extra
pancreatic mechanisms. BG exerts their action by decreasing gluconeogenesis and by increasing the
peripheral utilization of glucose.
If possible, choose sulfonylureas as an initial therapy in non-obese patients since they are cheaper as
compared to the newer agents. Choose metformin as an initial agent for obese patients (i.e., those
more than 120 % of their ideal body weight) or as an add-on therapy in patients who is not able to
control with sulfonylurea. Alpha-glucosidase inhibitor may be an alternative to sulfonylurea or as addon therapy to metformin in patients with uncontrolled blood glucose or significant renal dysfunction.
Over the past decade, a major interest in postprandial glucose (PPG) has emerged, because of new
medications specifically targeting PPG. These include insulin analogs (lispro and aspart), insulin
secretagogues (repaglinide and nateglinide), alpha-glucosidase inhibitors (miglitol and acarbose), and
injectable amylin analogs and glucagon-like peptide receptor agonists.
Appropriate targeting of plasma glucose may help to reduce expenses and limit unnecessary testing
and may help achieve glucose goals faster. Targeting fasting plasma glucose is more beneficial,
when A1C results are very high. Whereas targeting postprandial glucose is more effective when A1C
results are lower.
Oral Hyperglycemic Agents glucose lowering strength
Agent
Avg. FBG
Avg. PPG
Avg. A1C
reduction
(%)
reduction (%)
reduction (%)
Sulfonylureas
25 to 40
20
2.0
-glucosidase
inhibitors
10 to 20
40 to 45
0.5 to 1.5
Metformin
20 to 40
25
1.5 to 2.0
Steps in choosing correct diabetes medication
During diagnosis if your A1C level is less than 7% or fasting blood glucose less than 130mg/dl
or 7.223 mmol/l, you can manage your diabetes without medication and with lifestyle changes (diet and
exercise).
If your A1C level is 7% or fasting blood-glucose level of 130mg/dl or 7.223 mmol/l, you should
start your diabetes treatment with a mono-therapy (single medication). Preferably, Biguanides
(Metformin) or Sulphonylureas is considering as a first-line diabetes mono-therapy.
If the mono-therapy failed to produce the result; that is your FBG stays in more than 130 mg/dl
or 7.223 mmol/l (after 6 weeks of treatment) or A1C more than 7% (after 12 weeks), consider dualtherapy with the combination of two different classes of diabetes drug. Preferable choices are
Metformin + Sulphonylurea, alternatively Sulphonylurea +Thiazolidinediones.
If the dual-therapy failed to produce the result; that is your FBG stays in more than 130 mg/dl or
7.223 mmol/l (after 6 weeks of treatment) or A1C more than 7% (after 12 weeks), consider tripletherapy with the combination of three different classes of diabetes drug. Preferable choices are
Metformin + Sulphonylurea + Thiazolidinediones, alternatively Metformin + Thiazolidinediones
+ DPP4 or Metformin + Sulphonylurea + GLP1 or Metformin + Thiazolidinediones + GLP1 or Metformin
+ Sulphonylurea + basal insulin.
During diagnosis, if your A1C level is more than 9%, start dual-therapy with the combination of
two different classes of diabetes drug. Preferable choices are Metformin + Sulphonylurea, alternatively
Sulphonylurea + Thiazolidinediones.
If the dual-therapy failed to produce the result; that is your FBG stays in more than 130 mg/dl or
7.223 mmol/l (after 6 weeks of treatment) or A1C more than 7% (after 12 weeks), consider tripletherapy with the combination of three different classes of diabetes drug. Preferable choices are
Metformin + Sulphonylurea + Thiazolidinediones, alternatively Metformin + Thiazolidinediones + DPP4

or Metformin + Sulphonylurea + GLP1 or Metformin + Thiazolidinediones + GLP1 or Metformin +
Sulphonylurea + basal insulin.
During diagnosis, if your A1C level is more than 10 with severe symptoms, start metformin and
insulin therapy. Reach your target value by increasing the dosage of both medications. Continue oral
medication; additionally take intermediate or long acting insulin before bedtime with an initial dose of
0.2 U/kg or 0.9 U/Lb. Monitor FPG and accordingly adjust insulin by 2 to 4 units after at least 3 days.
FPG target should be 72 mg/dl to 144 mg/dl (or 4 to 8 mmol/L) based on your health condition.
Never exchange your diabetes medicines with others

Each diabetes medication has different mechanism of action. Your doctor prescribes your medicines
based on a complete understanding of your condition. Henceforth, exchange doctors if you must but
never exchange your medicines.
Sulfonylurea | Glipizide
Submitted by Thiruvelan on 23 Jun 2010 | Last updated 5 March 2013
Sulfonylurea diabetes medication helps the body to make more insulin; this excess insulin helps to
lower the blood-glucose level when needed, especially after food time.
Sulphonylureas is also calling as Insulin Secretagogues; it stimulates insulin secretion. It can lower
your blood-glucose levels by increasing insulin secretion from the pancreatic beta cells. Liver
metabolizes Sulfonylurea and cleared by the kidney; use it cautiously in patients with hepatic or renal
impairment.
Sulfonylureas mechanism of action

Sulfonylureas bind with an ATP-dependent K+ channel on the cell membrane of pancreatic beta cells.
It inhibits hyperpolarizing out flux of potassium causing electric potential over the membrane to become
more positive. This depolarization opens voltage-gated Ca2+ channels. The rise in intracellular calcium
leads to increased fusion of insulin granulae with the cell membrane, and therefore, increased
secretion of (pro) insulin.
Sulfonylureas also sensitize beta cells to glucose; they limit glucose production in the liver, decrease
breakdown and release of fatty acids by adipose tissue (lipolysis) and decrease clearance of insulin by
the liver.
Sulphonylurea diabetes medications
Generic name: Chlorpropamide (Brand name: Diabinese) this is the only first-generation
sulphonylureas available in the market. It has more side effects than other sulfonylureas, and its use is
no longer recommendable.
Generic name: Glipizide (Brand name: Glucotrol, Glucotrol XL, Minidiab),
Generic name: Glyburide or glibenclamide (Brand name: Diabeta, Glynase and Micronase in
the United States and Daonil, Semi-Daonil and Euglucon in the United Kingdom, Delmide in India,
DiaBeta, Euglucon in Canada.)
Generic name: Glimepiride (Brand name: Amaryl, GLIMPID, GLIMY)
Generic name: Gliclazide (Brand name: Glizid, Glyloc and Reclide in India; Diamicron,
Diamicron MR in Canada and Australia; Diamicron MR in Philippines. Many generic equivalents are
also available, e.g. Glubitor-OD, Clizid.
Available only in a generic form: Tolazamide, Tolbutamide
Sulphonylurea dosage
Chlorpropamide start with a minimum dose of 125 mg every morning, maximum dose 500 mg
every morning, duration very long. It is no longer recommendable because of its extremely long halflife.
Glibenclamide or glyburide begin with a minimum dose of 2.5 mg every morning, maximum
dose 10 mg twice daily, duration long.
Gliclazide treat with a minimum dose of 40 mg every morning, maximum dose 160 mg twice
daily, duration medium. Extended release form has a minimum dose of 30 mg every morning,
maximum dose 120 mg every morning, duration long.
Glipizide (Minidiab) start with a minimum dose of 2.5 mg every morning, maximum dose 10
mg twice daily, duration medium.
Glimepiride (Amaryl) begin with a minimum dose of 1 mg every morning, maximum dose 6
mg every morning, duration long.
There is an apparent lower risk of hypoglycemia with glimepiride and gliclazide MR.
What you can expect for Sulphonylureas?

Sulfonylurea as a mono-therapy can reduce HbA1c levels by 1 to 2%, fasting plasma glucose(FPG) by
60 to 70 mg/dl (or 3.333 mmol/l to 3.889 mmol/l) or up to 25%. You can use sulfonylureas as a monotherapy or in combination with most other oral diabetes drugs and insulin; however, do not use it in
combination with glinides or of two SUs.
Who can benefit from Sulphonylureas?

Patients who respond best to treatment with sulfonylureas include those who are diagnosed before 40
years of age, duration of disease less than five years before initiation of drug therapy and a fasting
blood-glucose level of below 300 mg/dL (16.7 mmol/l).
Possible side effects of Sulfonylurea

Some of the common side effects of Sulfonylurea are low blood-glucose (or hypoglycemia), upset
stomach, skin rash, and Weight gain.
Who should avoid using Sulphonylurea?

Avoid Sulfonylurea, if you are allergic to sulfa drugs, pregnant (or planning to get), or breast-feeding.
It increases insulin secretion and therefore, increases hypoglycemia risk. The risk is higher in
renal impairment, liver cirrhosis and in the elderly.
It increases appetite and thus promotes a weight gain.
They are contraindicating in patients known to be allergic to sulpha drugs.
NSAIDs, anti-thyroid drugs, sulpha drugs, anticoagulants and beta-blockers can increase the
risk of hypoglycemia.
Meglitinide | Repaglinide | Prandin

Meglitinide (Repaglinide) diabetes drug helps the body to make more insulin right after meals, thus
blood-glucose rise is limited after eating.
Glinides are non-sulphonylureas members of a new pharmacologic class of rapid-acting insulinsecretion agents. You can combine this with metformin, TZDs or alpha-glucosidase inhibitors.
Meglitinide mechanism of action

Non-Sulphonylureas agent Glinides action is similar to sulfonylureas to facilitate glycemic control;
however, they have a much shorter metabolic half-life. It stimulates a rapid but short-lived release of
insulin from pancreatic beta-cells that lasts for one to two hours. You need to take this drug along with
every meal.
When taken with meals, it lower postprandial glucose level and decreases hypoglycemia risk during
late postprandial phase, because of less insulin secretion several hours after the meal. Glinides target
postprandial blood-glucose levels rather than fasting blood-glucose levels.
Meglitinides diabetes medications
Generic name: Repaglinide (Brand name: Prandin in the USA; Gluconorm in Canada; Q-Repa,
Regan, Repide, Restrict in India; NovoNorm in other countries)
Generic name: Nateglinide (Brand name: Starlix in Canada, United Kingdom, United States,
Philippines and other countries; Glinate, Nds in India; Nateglinide Watson, Nateglinide in United
States).
Meglitinides dosage
Repaglinide start with a minimum dose of 0.5 mg with meals, maximum dose 4mg with
meals (not exceeding 16mg daily).
Nateglinide begin with a minimum dose of 60 mg with meals, maximum dose 120mg with
meals (not exceeding 360mg daily).
What you can expect for Meglitinide?

As a mono-therapy, a short-term study shows repaglinide and nateglinide lower fasting blood
glucose (FPG) by 31 mg/dl or 1.722 mmol/l and 13 mg/dl or 0.722 mmol/l respectively and hemoglobin
A1C by 0.6% and 0.4% respectively. Longer studies with repaglinide demonstrate a decrease in
hemoglobin A1C of 1.4 to 1.8%. You can use glinides as mono-therapy and in combination with most
other oral diabetes drugs and insulin.
Who can benefit from Meglitinide?

It is a suitable option for patients with severe sulfa allergy who are not candidates for sulfonylurea
therapy. Additionally, meglitinides are a less hypoglycemic effect as compared to sulfonylurea.
Who should avoid using Meglitinide?

This drug is metabolizing by the liver, cleared by the kidney, and should use with caution in patients
with hepatic or renal impairment. However, repaglinide class of drug is only minimally clear by the
kidney and can therefore use safely in patients with renal impairment. It should be titrated cautiously in
elderly patients and in those with renal or hepatic dysfunction.
Avoid Repaglinide / Prandin, if you are pregnant (or planning to get), breastfeeding, or having liver
disease.
Biguanide | Metformin
Biguanide diabetes medication lowers the amount of glucose made by the liver; thus, blood-glucose
levels cannot go too high helps to treat insulin resistance.
Biguanides lower your blood-glucose level by attenuating your liver glucose production, boost glucose
update by improving insulin sensitivity. You may lose some weight when you start taking metformin,
which further helps your diabetes control.
Metformin can additionally improve blood cholesterol levels, which are often a problem among type 2
diabetes. Metformin is primarily used in the obese not responding to dietary therapy. Metformin can
increase insulin sensitivity and reduce insulin requirements. Additionally, biguanides can lower fasting
levels of insulin in plasma.
Metformin is suitable for a mono-therapy and in combination with sulfonylureas and other
secretagogues, thiazolidinediones, and insulin. The combination of glyburide and metformin is more
effective than either glyburide or metformin alone.
Metformin mechanism of action

Biguanides mode of working to lower your blood-glucose level is by reducing gluconeogenesis in the
liver (limiting your liver to make too much glucose). In addition to attenuation of hepatic glucose
production, metformin improves insulin sensitivity, boost peripheral glucose uptake, and limit glucose
absorption from the gastrointestinal tract.
Biguanides diabetes medications
Generic name: Metformin (Brand name: Glucophage, glucophage XP (long-acting form),

Glumetza, Fortamet, Riomet -liquid form)
Metformin dosage
Start with Metformin 500 mg tablet daily increasing it to 500 mg twice daily (after one week) and up to
three times a day (after another one week), to minimize gastrointestinal side effects. You can further
reduce the side effects by taking it along with food. Usual dose is 500 mg three times a day, maximum
dose 1.0g twice daily.
Metformin retards 850 mg tablet is a slow-release formulation. The usual dose is twice daily, maximum
dose of 1700 mg every morning or 850 mg every night.
Side effects of Metformin

Adverse effects of metformin include gastrointestinal distress such as abdominal pain, nausea, and
diarrhea. These effects occur in up to 50% of patients; however, you can minimize this frequency with
slow titration of therapy and food consumption. The more serious side effect is lactic acidosis; low pH
in body tissues and blood.
Sometimes you will need to stop taking this type of diabetes medicine for a short time so you can avoid
developing lactic acidosis. If you have severe vomiting, diarrhea, or a fever, or if you cannot keep fluids
down, call your doctor right away. You should also talk with your doctor well ahead of time about
stopping this type of medicine if
youll be having special x-rays that require an injection of dye
youll be having surgery
your doctor will tell you when it is safe to start taking your medicine again.
What you can expect for Metformin?

Metformin can lower your HbA1c levels by 1 to 2% and fasting plasma glucose (FPG) by 60 to 70
mg/dl or 3.333 to 3.889 mmol/l or up to 20%. Mono-therapy with metformin is associated with weight
loss (or no weight gain) and much less hypoglycemia than sulfonylurea therapy. Metformin other nonglycemic benefits decrease low-density lipoprotein cholesterol (LDL-C) levels, andtriglyceride levels.
Similarly, adding repaglinide to metformin therapy produces more fasting plasma glucose lowering.
Who can benefit from Metformin?

Metformin can be effective for overweight/obese individuals; you may lose some weight when you start
taking metformin, which in turn help your blood-glucose control. Additionally, metformin improves your
blood cholesterol level, thus helps to lower your cholesterol level if you arehyperlipidemia.
Metformin is considering as a therapy of pre-diabetes to prevent diabetes, and it may prevent cancer.
Who should avoid using Metformin?

Avoid Metformin, when you are having advanced liver or kidney disease, drink excessive amounts of
alcoholic beverages, pregnant (or planning to get,) or breastfeeding.
It should not use in patients with impaired renal function (serum creatinine more than 130 mol/l or
creatinine clearance less than 60 mL/min), elderly people (above 70 years), patients with congestive
heart failure, hepatic dysfunction, metabolic acidosis, dehydration, alcoholism, or increased risk for
lactic acidosis. If a patient, who takes metformin and has had a partial gastrostomy, and terminal ileal
disease may develop vitamin B12 deficiency. Patients receiving oral anticoagulant drug and metformin
may require a higher dosage of warfarin to achieve a therapeutic antithrombotic effect. Patients taking
metformin should monitor hemoglobin, hematocrit, red blood cell indexes and renal function at least
annually. Due to lactic acidosis, discontinue metformin treatment during surgery, severe infection and
illness.
Thiazolidinedione
Actos, Avandia (Thiazolidinedione) diabetes medicines help the body to utilize the insulin properly; thus
blood-glucose level stay on target and body cells get the energy they needed.
Thiazolidinedione increases insulin-stimulated glucose uptake in skeletal muscle cells. In addition to
lowering glycemia, these agents modestly reduce blood pressure, increases high-density lipoprotein
cholesterol (HDL), decreases triglyceride, enhance fibrinolysis, and improve endothelial function.
Thiazolidinediones is suitable as a mono-therapy and in combination with metformin, sulfonylureas,
and insulin. Additionally, combining two sensitizers from different drug classes (pioglitazone and
metformin or rosiglitazone and metformin) produces an additive effect. They can combine with another
class of drugs (sulphonylureas or metformin) to improve glucose control.
Thiazolidinediones mechanism of action

Thiazolidinediones acts primarily by improving insulin sensitivity in muscle and adipose tissue and
inhibit hepatic gluconeogenesis. They act on the peroxisome proliferator-activated receptor-gamma
(PPAR-) which regulates the transcription of insulin responsive genes and fatty acid metabolism.
Improvement in glycemic control may be apparent after six weeks of treatment and maximal effect up
to six months.
Thiazolidinediones diabetes medications
Generic name: Pioglitazone (Brand names: Actos in Australia, United Kingdom, Philippines,
United States, Canada; Diabetone, Glitaz, Glitter, Glucozone, Insulact, Piotaz, Piouno, Piozar,
Piozone, PPAR, Prialta, Pyoglit, Zolid, Zypi in Philippines; Diavista, Glito, Glizone, G-Tase, K-Pio, Lita,
Path, Pepar, P-Glitz, Pioglar, Pioglaz, Pioglit, Pionorm, Pio-Q, Piostar, Piosys, Piotrol, Pioz, Piozed,
Piozone, Pizorad, Pozitiv, Radizone, Zipio in India; Apo-Pioglitazone, CO Pioglitazone, GenPioglitazone, Pioglitazone Hydrochloride Accord, PMS-Pioglitazone, ratio-Pioglitazone, Sandoz
Pioglitazone in Canada; Pioglitazone Consilient in United Kingdom)
Generic name: Rosiglitazone (Brand names: Avandia in Australia, Canada, United States,
United Kingdom, and other countries)
Thiazolidinedione dosage
Rosiglitazone minimum dose is 4 mg once daily and maximum dose is 4 mg twice
daily.Pioglitazone minimum dose is 15 mg once daily and maximum dose is 45 mg once daily.
Rosiglitazone and Metformin fixed combination minimum dose 2 mg Rosiglitazone and 500 mg
Metformin, maximum dose 4 mg Rosiglitazone and 500 mg Metformin.
Side effects of TZDs

The most common side effect of all thiazolidinediones is water retention, leading to edema, a problem
in less than 5% of individuals. Significant water retention may lead to a decompensation of potentially,
previously unrecognized heart failure.
Studies have shown that there is an increased risk of coronary heart disease and heart attackswith
rosiglitazone. However, pioglitazone has shown significant protection from both micro and macrovascular cardiovascular events and plaque formation.
What you can expect from Thiazolidinediones?

Thiazolidinediones decrease fasting plasma glucose (FPG) by 35 to 40 mg/dl or 1.94 to 2.22 mmol/l
and lower hemoglobin A1C by 0.5 to 1.5%, the same degree as metformin and sulfonylureas, and to a
greater degree than alpha-glucosidase inhibitors.
When used as a mono-therapy, both rosiglitazone and pioglitazone have not been associated
withhypoglycemia, 1 to 4 kgs (2lb 3.274oz to 8ld 13.096oz) weight gain. Additionally, it raises HDL;
however, it may also slightly raise LDL cholesterol with minimal effect on triglycerideconcentrations. It
may cause increases in plasma volume that result in edema and small decreases in hemoglobin and
hematocrit. The clearance of this drug is decreasing in patients with moderate to severe liver disease;
thus, carryout liver function tests every two months for the first year, thereafter periodically.
Who can benefit from Thiazolidinediones?

Pioglitazone demonstrated modest improvement in the composite outcome of all-cause mortality,
nonfatal myocardial infarction, and stroke in patients with type d diabetes. Diabetes Reduction
Assessment with Ramipril and Rosiglitazone Medications (DREAM) trial demonstrate a significant
(62%) reduction in the progression to diabetes mellitus in high-risk patients treated with rosiglitazone.
Who should avoid using Thiazolidinediones

Adverse effects of thiazolidinediones include weight gain, edema, anemia, and peripheral fractures in
women. Weight gain and edema are more common among patients treated with thiazolidinediones and
insulin. The FDA still recommends periodic measurement of hepatic function in patients treated with
TDZs. Patients with congestive heart failure or hepatic impairment should avoid taking this drug.
Alpha Glucosidase
Alpha-glucosidase inhibitors are diabetes medication, which slows down carbohydrate digestionand
limits blood-glucose rise after food, a common problem in diabetics.
Take this medication with your main meals; it decreases postprandial glucose without causing
hypoglycemia. Alpha-glucosidase inhibitors are suitable as mono-therapy or in combination
withsulfonylureas for management of type 2 diabetes. It can have synergistic effects when in use with
other diabetic drugs and may combine well with insulin.
In patients with abnormal renal function, acarbose can safely use. If diabetes is still not well controlled,
insulin is required.
Alpha-glucosidase inhibitors mechanism of action

Alpha-Glucosidase inhibitors work by inhibiting alpha-glucosidase, an enzyme located in the proximal
gut (small-intestinal) epithelium that breaks down disaccharides and carbohydrates that are more
complex. Through this enzyme inhibition, this drug delays intestinal carbohydrate absorption, thus
attenuating postprandial glucose excursions.
Alpha-glucosidase inhibitors diabetes medications
Generic name: Acarbose (Brand name: Glucobay, Prandase in Canada, Philippines, United
Kingdom, India, Australia and other countries; Acarbose Emcure, Acarbose Strides
Arcolab,Acarbose Watson, Acarbose, Precose in United States; Acarex, Asucrose, Diabose, Glucar,
Glucobay, Gludase, K-Carb, Rebose in India)
Generic name: Miglitol (Brand name: Glyset; Diamig, Elitox, Euglitol, Miglit, Mignar, Migtor,
Misobit in India; Glycet in United States)
Alpha-glucosidase inhibitors dosage

Initial dose is 50 mg/day and titrate accordingly, usual dose 50 to 100 mg during main meals and
maximum dose 100 mg three times a day.
Side effects of alpha-glucosidase

Side effects of alpha-glucosidase inhibitors include flatulence (77%), diarrhea (33%), and abdominal
discomfort (21%). Slow titration may attenuate these gastrointestinal adverse effects over time.
What you can expect for Alpha-glucosidase inhibitors?

As a mono-therapy, alpha-glucosidase inhibitors can decrease your fasting plasma glucose (FPG) by
20 to 30 mg/dl or 1.11 to 1.67 mmol/l and hemoglobin A1C by 0.7 to 1%. Additionally, it decreases your
post-prandial glucose by 30 to 70 mg/dl or 1.67 to 3.89 mmol/l. It has a minimal effect on cholesterol
and body weight.
Who can benefit from Alpha-glucosidase inhibitors?

Alpha-glucosidase inhibitors are particularly useful in postprandial hyperglycemia. It effectively reduces
your blood glucose spikes immediately after meals.
Who should avoid using Alpha-glucosidase inhibitors?

Alpha-glucosidase inhibitors are contraindicating in patients with inflammatory bowel disease, partial
intestinal obstruction, a predisposition to intestinal obstruction, colonic ulceration and other
gastrointestinal disorders.
Acarbose may elevate liver function; therefore, monitor hepatic enzymes every 3 months for 1 year,
thereafter periodically. However, miglitol excrete primarily by the kidneys, thus use with caution in
moderate to severe renal failure.
This drug has a link with dose-dependent hepatotoxicity, so monitor liver function tests in patients who
receive high dosages of this medication (more than 50 mg three times daily). Transaminase elevations
are reversible with discontinuation of this drug and are often asymptomatic. Serum transaminase levels
should check every three months for the first-year patients taking the medication and periodically
thereafter. Drugs that are susceptible to binding with other agents (such as cholesterol
medications cholestyramine) should take two to four hours apart from alpha-glucosidase inhibitors to
avoid its interactions. Intestinal absorbents and digestive enzyme preparations should not take with this
medication.
DPP-4 Inhibitor | Januvia

Submitted by Thiruvelan on 23 Jun 2010 | Last updated 11 July 2013
Januvia (DPP-4 inhibitor) lowers blood-glucose by helping body to make more insulin when needed. In
addition, it stops the liver from putting glucose into the blood.
DPP-4 inhibitor or gliptin works by increasing the amount of insulin released by your body and
decreasing the amount of sugar made by your body. Dipeptidyl-peptidase 4 inhibitors preferentially
target post-prandial glucose excursions; however, it also shows to decrease fasting plasma glucose
levels.
Dipeptidyl-Peptidase 4 Inhibitors mechanism of action

DPP-4 inhibitors work by increasing incretin levels (GLP-1 and GIP) this inhibits glucagon release,
which increases insulin secretion, delay gastric emptying, and decreases blood-glucose levels.
Dipeptidyl-Peptidase 4 Inhibitors diabetes medications
Generic Name: Linagliptin (Brand Name: Tradjenta)
Generic Name: Saxagliptin (Brand Name: Onglyza)
Generic Name: Sitagliptin (Brand Name: Januvia)
Generic Name: Alogliptin (Brand Name: Nesina)
DPP-4 inhibitors dosage

The recommended dose is 5 mg once daily, can be taken with or without food.
Side effects of DPP-4 inhibitors

Long-term effects of DPP-4 inhibitors on mortality and morbidity are so far inconclusive, although
adverse effects, including nasopharyngitis (the common cold), headache, nausea, hypersensitivity and
skin reactions, have observed in clinical studies.
What you can expect for DPP-4 inhibitors?

DPP-4 inhibitors can lower your A1C by 0.5 to 1.0%, fasting-plasma glucose level by 11 to 22 mg/dL or
0.611 to 1.222 mmol/l, postprandial glucose level by 24 to 35 mg/dL or 1.333 to 1.944 mmol/l. There is
no change in lipid, no hypoglycemia, no weight gain. A greater reduction in blood-glucose levels is with
a higher baseline A1C level (i.e., A1C 9.0%); while a history of previous, glucose-lowering treatment
generally results in a smaller reduction in blood-glucose levels.
Who can benefit from DPP-4 inhibitors?

While they do not lower glucose largely than existing therapies, they offer many potential advantages.
It has an ability to achieve sustainable reductions in HbA1c with a low risk of hypoglycemia and no
weight gain. It can administer as a once-daily oral dose.
Who should avoid using DPP-4 inhibitors?

Avoid Januvia, if you are pregnant or breast-feeding, having kidney disease, or type 1 with diabetic
ketoacidosis.
DPP4 inhibitor is safer than sulfonylurea when comparing the incidence of hypoglycemia. However, in
combination with other drugs, it has a somewhat higher rate of hypoglycemia. DPP-4 has an
association with the immune system; it thought to inhibit it and might impair the immune system. Thus,
increase the risk of upper respiratory infection (6.3%) and nasopharyngitis (inflammation of the nose
and pharynx in 5.2%).
Primarily, the kidneys break it down and in a small extent by the liver; so the potential for it to interact
with other drugs is relatively low. Thus, DPP-4 inhibitors (only in reduced doses) are safe for treating
patients with moderate and severe renal failure. The most worrying side effects are allergic reaction
causing anaphylaxis, a body wide reaction resulting in low blood pressure, and angioedema, swelling
of the tongue, face, and throat.
SGLT2 inhibitors
Submitted by Thiruvelan on 27 Jul 2013 | Last updated 19 June 2014
SGLT2 inhibitors are a class of diabetes medication prevents the body to reabsorb glucose, increasing
glucose excretions in urine to lower blood-glucose level.
SGLT2 inhibitors
SGLT2 inhibitors are sodium-glucose co-transporter 2 (SGLT2) inhibitors; it blocks the reabsorption of
glucose into body by the kidney and increasing glucose excretions in urine. It is not recommendable for
patients with type 1 diabetes or for the treatment of diabetic ketoacidosis.
SGLT2 inhibitors mechanism of action

SGLT2 is a protein in humans that facilitates glucose reabsorption in the kidney. SGLT2 is responsible
for almost 90% of the glucose reabsorption in the kidney. Inhibiting this transporter leads to the
decrease in blood glucose due to the increase in renal glucose excretion.
The mechanism of action of this new class of drugs also offers further glucose control by allowing
increased insulin sensitivity and uptake of glucose in the muscle cells, decreased gluconeogenesis and
improved first phase insulin release from the beta cells.
Drugs in the SGLT2 inhibitors class
Generic name: Canagliflozin (Brand name: Invokana),
Generic name: Dapagliflozin (Brand name: Farxiga (in US), Forxiga (in EU)),
Generic name: Ipragliflozin (Brand name: Suglat)
SGLT2 inhibitors dosage
Canagliflozin start with a minimum dose of 100 mg once daily for eGFR 45 to < 60
mL/min/1.73 m2, maximum dose of up to 300 mg once daily is allowable for patients with eGFR 60
mL/min/1.73 m2.
Dapagliflozin - start with a minimum dose of 5 mg orally one a day; take in the morning with or
without food. You may increase to 10 mg once a day in patients tolerating 5 mg/day who have an
eGFR 60 mL/min/1.73 m and require additional glycemic control.
Ipragliflozin - The recommended dose is 50 mg once daily, in the morning. If the effects are
insufficient, the dosage may increase to up to 100 mg once a day, while carefully monitoring disease
progress.
SGLT2 can increase the risk of hypoglycemia when combined with insulin or an insulin secretagogue.
What you can expect from SGLT2 inhibitors?

SGLT2 inhibitors as a mono-therapy can reduce HbA1c levels. You can use SGLT2 inhibitors as a
mono-therapy or in combination with most other oral diabetes drugs and insulin.
Possible side effects of SGLT2 inhibitors

SGLT2 inhibitors can increase LDL cholesterol, urinary tract infections, genital mycotic infections, and
associated with increased urination and episodes of hypotension and low blood-glucose (or
hypoglycemia). The same report did show that the drug decreased weight by a 1.9 to 3% as well as
decreased systolic and diastolic blood pressures and raised HDL cholesterol. Some common side
effects are rapid weight loss, tiredness, and dehydration.
Who should avoid using SGLT2 inhibitors?

Avoid SGLT2 inhibitors, if you are
Type 1 diabetes
People with low kidney function
People taking strong diuretic medication
Combination Pills
Diabetes combination medication is in a single pill contain a combination of two classes of diabetes
drugs. There are numerous combinations available in the market that best suitable for your specific
need, additionally it can lower your overall cost as well as strain to taking the multiple tablets.
Metformin is the common drug in all these pills, because it safely lower glucose production in the liver
without any hypoglycemia risk. Additionally, it improves lipid profiles without causing weight gain.
Combination Therapy with Oral Antidiabetic Agents
Combination: Metformin and glipizide (Brand name: Metaglip)
Combination: Rosiglitazone and glimeperide (Brand name: Avandaryl)
Combination: Pioglitazone and metformin (Brand name: ACTOplus Met, ActoPlus Met XR)
Combination: Metformin and glyburide (Brand name: Glucovance)
Combination: Rosiglitazone and metformin (Brand name: Avandamet)
Combination: Pioglitazone and glimepiride (Brand name: duetact)
Combination: Sitagliptin and metformin (Brand name: Janumet, Janumet XR)
Combination: linagliptin and metformin (Brand name: Jentadueto)
Combination: metformin and saxagliptin (Brand name: Kombiglyze XR)
Combination: metformin and repaglinide (Brand name: PrandiMet)
What you can expect from combination diabetes medication?

Combinations of two different classes of drug can provide some improved blood-glucose control, and
improved patients compliance.
Metaglip a combination of metformin and glipizide can decrease FBG by up to by 56.5 mg/dL
or 3.139 mmol/l and A1C by up to 2.15 % on average. People taking glipizide or metformin alone did
not decrease this much.
Avandaryl a combination of rosiglitazone and glimeperide can decrease FBG by up to by 80

mg/dL or 4.445 mmol/l and A1C by up to 2.5 % on average. People taking rosiglitazone
orglimeperide alone did not decrease this much.
ACTOplus Met, ActoPlus Met XR a combination of pioglitazone and metformin can decrease
FBG by up to by 42.8 mg/dL or 2.378 mmol/l and A1C by up to 0.64 % on average. People taking
Pioglitazone or metformin alone did not decrease this much.
Glucovance a combination of metformin and glyburide can decrease FPG by up to 60 mg/dl

or 3.333 mmol/l and hemoglobin A1C by 1.7 to 1.9%. People taking glyburide ormetformin alone did
Avandamet a combination of rosiglitazone and metformin can decrease FBG by up to by 74

mg/dL or 4.111 mmol/l and A1C by up to 2.3 % on average. People taking rosiglitazone or metformin
alone did not decrease this much.
Duetact a combination of pioglitazone and glimepiride can decrease FBG by up to by 56.1

mg/dL or 3.117 mmol/l and A1C by up to 1.67 % on average. People taking pioglitazone or glimepiride
Janumet, Janumet XR a combination of sitagliptin and metformin can decrease FBG by up

to by 64 mg/dL or 3.556 mmol/l and A1C by up to 2.3 % on average. People taking sitagliptin
or metformin alone did not decrease this much.
Jentadueto a combination of linagliptin and metformin can decrease FBG by up to by 72

mg/dL or 4 mmol/l and A1C by up to 2.0 % on average. People taking linagliptin or metforminalone did
Kombiglyze XR a combination of metformin and saxagliptin can decrease FBG by up to by

60 mg/dL or 3.333 mmol/l and A1C by up to 2.5 % on average. People taking metformin or saxagliptin
PrandiMet a combination of metformin and repaglinide can decrease FBG by up to by 56.1

mg/dL or 3.117 mmol/l and A1C by up to 1.67 % on average. People
taking metformin orrepaglinide alone did not decrease this much.
Incretin Byetta
Byetta is only for those with type 2 diabetes who takes metformin, a sulfonylurea, or both. Enhance
insulin secretion in the presence of high blood-glucose.
GLP-1 agonists are a class of drugs for type 2 diabetes treatment. The major advantage of this drug
over older insulin secretagogues (such as sulfonylureas or meglitinides), is it has reduced risk of
causing hypoglycemia.
GLP-1 agonists mechanism of action

The GLP-1 agonist is believed to improve glucose control by;
It increases insulin secretion by the pancreas in response to eating meals; once blood glucose
decreases proportionally insulin production decreases.
It suppresses the pancreatic glucagon release in response to eat, so stops unneeded glucose
dumping in the blood stream.
It slows down gastric emptying, thus minimizes glucose spikes in the bloodstream.
GLP-1 agonists available on the market:
Generic name: exenatide (Brand name: Byetta),
Generic name: liraglutide (Brand name: Victoza).
GLP-1 agonists dosage

GLP-1 agonists should start with 5 mcg administered twice daily within the 60-minute before the two
major meals with a minimum 6 hours apart. It should not administer after a meal. If necessary you can
increase the dose to 10 mcg twice daily after 1 month of therapy, this is to reduce to gastrointestinal
side effects.
Side effects of GLP-1 agonists

The major side effects of GLP-1 agonists are gastrointestinal in nature; acid or sour stomach, belching,
diarrhea, heartburn, indigestion, nausea, and vomiting.
What you can expect for GLP-1 agonists?

In patients with type 2 diabetes, it can lower A1C of up to 1.1% sustained the HbA1c reduction with a
continued use of the medicine over a year. It also reduces fasting blood-glucose level and body weight
(up to 5 pounds). A study shown GLP-1 agonists can help achieve an A1C of less than 7%.
Who can benefit from GLP-1 agonists?

It is beneficial for diabetes type 2, who are overweight; it can reduce weight as well as lower your
blood-glucose level as well as A1C without causing hypoglycemia.
Who should avoid using GLP-1 agonists?

Patients with a history of pancreatitis, consider using other anti-diabetic therapies. If used along
with sulfonylurea may increase your risk of hypoglycemia, try to reduce your dose of sulfonylurea. GLP1 agonists are unsuitable for patients with severe gastrointestinal disease such as gastroparesis. GLP1 agonists should not use in patients without renal impairment.
Type 2 Diabetes Insulin Therapy

Submitted by Thiruvelan on 05 Mar 2013 | Last updated 22 August 2014
Most patients with diabetes type 2 eventually need insulin, due to progressive decline in the production
of insulin by pancreatic beta cells. The question before every type 2 diabetes is when to start
the insulin therapy and what is the appropriate insulin regime?
Anti-diabetic treatment is an evolving field with many new drugs: oral drugs, injectable analogues of
glucagon-like peptide-1 (GLP1) and insulin formations.
Does a diabetes type 2 is really in need of insulin therapy?

Patients with type 2 diabetes on oral diabetes medication may need insulin therapy for a while when
they are sick or have surgery. At these instances, diabetes pills may not work as expected in lowering
your blood-glucose level, thus need insulin therapy.
If triple-therapy (diabetes treatment with three different classes of drugs) of maximum dosage does not
produce a result (i.e., A1C of 7% or FBG of 130 mg/dl or 7.223 mmol/l), then you need to initiate insulin
therapy along with one class of diabetes drug.
Most people with diabetes type 2 are having much fear, as they have advised to go on insulin. Even
though there is numerous oral medications available in the market to treat diabetes type 2, insulin is
the only one capable of not only lowering and even normalizes your blood glucose level.
In adequate management of diabetes for a long time may lead to diabetes complications such asnerve
damage, diabetic eye problems, kidney failure, impotence, heart attack and stroke. Insulin therapy can
prevent all these complications, so why still panic about insulin treatment. Start insulin treatment and
keep yourself away from diabetes complications.
Fear of Needles - Now they are painless.

A person with type 2 diabetes normally has fear of needles. However, there are ultra-thin short needles
are available to inject insulin under your skin. These needles are far less painful (almost painless) than
a lancet (used to prick the skin for the blood test). They are painless to an extent that you may have to
do visually check if you actually have pierced the skin and injected the insulin.
The important thing to make your injection painless is to choose a very thin needles, 30 or 31 gauge,
and use a shortest needle suitable for your body size, maybe 5/16 inch will do.
When should I start the insulin therapy?

At the early stages, patients can be able to manage with diabetes lifestyle modification and oral
diabetes drug or injection of a GLP1 analogue, either alone or in combination. However, most patients
at the later stages need insulin therapy, similar to diabetes type 1 for effective management of bloodglucose and for prevent diabetes complications.
If lifestyle changes along with a combination of diabetes oral medication failed to produce the expected
result; that is A1C of less than 7%, or fasting blood-glucose level of less than 130mg/dl or 7.223
mmol/l.
Here are the three important situations that warrant insulin therapy for type 2 diabetes, they are:
When your blood-glucose is very high over 250 mg/dl (13.89 mmol/l), you need to begin insulin
therapy. Once your diabetes is in control then you might stop insulin and can manage with oral
medication.
If you are elderly, having heart diseases or kidney problems, then insulin therapy is considering
as the safest diabetes treatment.
If cost of treatment is bothering, you can consider changing to insulin therapy, because it is the
least expensive, effective and safest diabetes treatment available.
About one in three individuals with diabetes type 2 requires insulin therapy when their diabetes
age crossed 10 to 15 years.
How do you motivate for insulin therapy?

In 1990's doctors ignored strict blood-glucose control and allowed their diabetes patients with an A1C
of 12 % or higher by putting them in ineffective oral drugs. They put their patient on insulin only when
their blood glucose became so high, which are perfectly not responding to oral medications. Before this
time, diabetes can make enough irreversible damage. This leads to diabetes complications and
numerous patients experiencing vision losses, amputations, kidney failures, heart attacks and strokes.
Most of the patients on insulin, feel better once their blood-glucose levels are under good control. This
is a major motivation for initiating and adhering to insulin therapy. The anticipated reduction of risk for
diabetic complications further enhances the compliance.
Insulin treatment in type 2 diabetes

Including basal insulin to the existing oral glucose-lowering medication can help achieve good glycemic
control in the majority of diabetes type 2; however, few may require a twice-daily dosage. You can
initiate your insulin therapy with either once-daily NPH insulin or a long-acting insulin analog. They
should target fasting plasma glucose less than equal to 100 mg/dl (or 5.6 mmol/l) can safely achieve
an A1C of 7.0%.
For several reasons, NPH insulin is considering as the preferred option. The relative benefit of the
long-acting insulin analogs is limited to a reduction in (nocturnal) hypoglycemia.
The best timing for once-daily basal insulin injection is in the evening as compared with morning.
Combination therapy of insulin with metformin indeed produces a better glycemic control; fewer
episodes of hypoglycemic and fewer weight gains than treatment with insulin alone.
What is the reasonable blood-glucose target?

Patients should try to achieve their best possible blood-glucose control with fewest adverse effects.
Proper diet with a regular mealtime and predictable carbohydrate intake helps to avoid or minimize the
two important insulin side effects (i.e., weight gain and hypoglycemia).
For most A1C of below 7% and FPG of 130 mg/dl or 7.223 mmol/l is considering as a reasonable
target; a less stringent goal may be an A1C of less than 7.5% and FPG of 140 mg/dl or 7.779 mmol/l.
Several factors influence your decision in fixing the target; willingness to follow complex insulin
treatment (basal-bolus therapy), lifestyle factors, how long you have diabetes, other coexisting medical
conditions, hypoglycemia frequency, hypoglycemia awareness, age, life expectancy, and cost factors.
The target should be relaxed in difficult to treat individuals; those with frequent hypoglycemia,
hypoglycemia unawareness, and widely fluctuating in blood-glucose levels in patients with advance
stage of diabetes.
What are the drawbacks of insulin therapy in type 2 diabetes patients?

The two major drawbacks are increased hypoglycemia episodes and weight gain.
Intensive glucose-lowering therapy inevitably leads to an increased hypoglycemia episode.
Hypoglycemia hampers stringent glycemic control and is considering as the restricting factor in
diabetes control. In type 2 diabetes, the frequency of hypoglycemia is generally lower compared to type
1 diabetes. Type 2 diabetes is having protection against hypoglycemia by internally secreted insulin &
glucagon, insulin resistance, higher glycemic thresholds for counter regulatory and symptomatic
responses to hypoglycemia.
The two to four kg weight gain is associating with increased energy intake due to insulin therapy.
Learn how to dose correctly to avoid hypos

Extremely low blood glucose is called as hypoglycemia is always possible with insulin therapy.
However, overtime you can learn to manage or change the insulin dosage with respect to your bloodglucose level, food intake, physical activity you undergo, and the symptoms you are experiencing.
Risk of hypoglycemia is high if you are in alcohol use, smoking, advanced age, intensive therapy, low
body mass index, long diabetes duration, low-carb meals, fasting, delayed meals, vigorous exercise
(without carb to compensate), and medical conditions (such as depression, sleep disorder,
cerebrovascular disorder, liver failure, malnutrition, renal insufficiency, hypothyroidism).
Basal-Bolus Insulin Regimen in T2D

Submitted by Thiruvelan on 05 Mar 2013 | Last updated 10 April 2013
When blood-glucose control is inadequate despite treatment with a maximum dose of oral combination
drug, the next step will be adding basal insulin therapy (once daily of long-acting insulin).
When should type 2 diabetes intensify their insulin therapy?

Normally, there is a progressive decline in beta cells in the case of type 2 diabetes. Thus once-daily
basal insulin treatment may eventually fail to maintain blood-glucose control in a substantial number of
type 2 patients. When you are not able to reach the A1C of 7 % then, treatment needs to intensified.
If you are in once-daily insulin therapy, next you may include a second injection of basal insulin (twicedaily insulin therapy). If you are already in twice-daily insulin treatment, then basal-bolus therapy is
considering as best in achieving greater A1C reduction.
Adding Basal insulin along with Oral Drug

Every individual person is different and his or her insulin requirement too is distinct; YMMV is an
acronym stands for "Your Mileage May Varies." Thus, you should understand that the insulin dose that
works best for you would not work the same way for someone else.
Titrate the insulin regimen is an important to achieve target blood glucose level. This is increasing the
dosage of the insulin by two units every 4 to 7 days until your reach your target, unless hypoglycemia
may become your barrier.
Glargine or detemir (Levemir) insulin is the best choice in the treatment of diabetes type 2. If cost is a
main concern, then NPH, Humulin N, or Novolin N insulin once daily at bedtime or twice daily is a
preferable alternative.
Addition of detemir, glargine or NPH insulin once daily at bedtime along with oral medication resulted in
similar improvement in A1C of about 1.5%. However, detemir & glargine had many advantages
compared to NPH; Chances of hypoglycemia is 50 % lower, and lesser weight gain (detemir 0.7 kg,
NPH 1.6 kgs in 20 weeks treatment).
Type 2 diabetes is progressive condition; over time, patients on once-daily basal insulin often require
multiple daily injections. For patients who take NPH at bedtime can additionally take another dose of
NPH in the morning to manage pre-dinner hyperglycemia.
Adding basal insulin to oral therapy is adequate for most of the patients who are new to insulin. Some
patients may need more, such as the addition of bolus insulin therapy (insulin before meals).
Basal-Bolus Insulin Regimens

Progression of diabetes type 2 may worsen insulin deficiency, and blood-glucose control become
difficult (i.e., impossible to achieve the target). Now patients need to start rapid-acting insulin (regular,
lispro, aspart) before meals (bolus therapy) in addition to once or twice-daily basal insulin therapy.
When do you include bolus regiment to your insulin treatment?

You should consider adding bolus insulin if the dosage of basal insulin has progressively inadequate
glycemic control and frequent hypoglycemia, or if the morning glucose level is within the target range,
but inadequate control of A1C. This indicates there is no benefit in further increasing the basal insulin
dose even if you do so it leads to more hypoglycemia episodes. Now this is the time to consider adding
bolus insulin in your treatment to achieve the target A1C.
A basal-bolus regimen also has cost benefits; for example, a regimen of NPH and regular insulin
(multiple daily injections or premixed) is significantly cheaper than multiple oral hypoglycemic agents.
Insulin dosage in your basal-bolus regiment

A basal-bolus regimen with 50% basal and 50% bolus seemed to provide better glycemic control. In
case if there is variations in glucose levels, inadequate control, or frequent hypoglycemia redistribution
of total insulin dosage to 50% basal and 50% bolus (spread equally before three meals).
Patients with mild stress and hyperglycemia should treat with a low dosage of insulin (0.2 units per kg).
Elderly patients and people with renal or liver failure are at higher hypoglycemia risk, thus start with
lower dosage of insulin. Others can start with a dosage of 0.3 to 0.5 units/kg. Subsequently, titrating
the dosage based on the blood-glucose level. Start the bolus insulin at a low dose; 4 to 6 units and
gradually increase it.
You can add bolus insulin before breakfast if your pre-lunch glucose level is elevated, before lunch if
your dinnertime blood glucose in high, before dinner if your bedtime blood-glucose level is elevated or
a combination of these.
Further adjustments of the insulin dosage should make based on the blood-glucose levels before each
meal and at bedtime. The bolus insulin dosage can be calculated based on the amount of
carbohydrates in each meal, the insulin to the carbohydrate ratio as in the case of diabetes type 1. This
method helps with fewer weight gains due to insulin treatment. You can reduce your bolus dosage if
you expect to do exercise within 2 to 3 hours after the meals.
Simple premixed insulin therapy

Some patients may not be happy injecting them four or five times with the basal-bolus regimen. They
may request for a simpler therapy with three injections of premixed insulin per day, one before each
meal.
Lispro mix (50% lispro and 50 % lispro protamine suspension) taking before each meal can help to
attain A1C of below 7.5% as compared to basal-bolus regimen achieving a goal of A1C less than 7%.
However, hypoglycemic rate is similar for both cases. Thus pre-mixed insulin regimen with the lispro
mix three times a day before each meal, should have a relaxed A1C goal of less than 7.5%.
Biphasic insulin aspart (aspart and protamine aspart mix) given three times a day with each meal is
comparable with the basal-bolus regimen in glycemic control and hypoglycemia episodes.
This simple premixed insulin regimen is a preferable option for selected group of patients who does not
like to adhere with a more complex basal-bolus insulin regimen.
Type 1 diabetes | IDDM

If the bodys insulin production insufficient (or is stopped) production is called as type-1 diabetes
caused by autoimmune disorder, and it needs to be treated with insulin shots.
Type-1 diabetes is also known as Insulin-Dependent Diabetes Mellitus (IDDM), juvenile diabetes,
because it is usually first diagnosed in children, teenagers, and young adults. Now it proves wrong,
that type 1 diabetes does occur even during the adult age. It is also spelled as type-i diabetes, diabetes
one and diabetes 1.
What is Type-1 diabetes (juvenile diabetes)?
Type-1 diabetes is lacked of or no insulin production. Formerly, it was known as "juvenile diabetes,"
because it represents a majority of the cases in children, teenagers, or young adults, but it can also
affect adults.
Type 1 diabetes develops because the body immune system mistakenly destroys the beta cells within
the islet tissue within the pancreas that produce insulin. The rate at which they are destroyed varies
from one to another. Mostly, Infants and children develop type 1 quickly, because the beta cells destroy
rapidly. On the other hand, in the case of adults the type 1 diabetes develops relatively slowly.
Type-1 diabetes is mostly caused by autoimmune disorder. Other less common (very rare) causes of
Type-1 diabetes includes injury to the pancreas from toxins, trauma, or after the surgical removal of the
majority (or all) of the pancreas.
Type-1 diabetes needs insulin shots to maintain the blood-glucose level, because of no insulin
production by the pancreas. Insulin cannot be taking through the mouth, because insulin is a hormone
(protein) that is broken down by the digestive system.
Sometimes after an initial treatment, some peoples has a period from few weeks to few months, when
the pancreas is again start-producing insulin known as "honeymoon period." During this time, a person
may need to take less or no insulin, depending on how much insulin he/she produces. After this
honeymoon period, the person needs to take insulin for the rest of his or her life.
Video on type 1 diabetes
Autoimmune disorder
Our body immune system mistakenly attacks pancreas and damages islet of Langerhans (regions
were insulin is secreted) and thus no or very low insulin secretion leads to high level of glucose in
blood.
Some viruses (mumps, rubella, cytomegalovirus, measles, influenza, encephalitis, polio or EpsteinBarr virus) and the cells in the islets of Langerhans (regions were insulin is secreted) in the pancreas
are of similar structure. Thus if anyone infected by the above-said viruses, then their bodys immune
system mistakenly attacks the islet of Langerhans considering it as virus and damaged it permanently.
As a result, insulin production is stopped leads to type-1 diabetes; it is mostly diagnosing after diabetic
ketoacidosis (DKA) episode.
Type 1 diabetes statistics
Among youth ages younger than 10 years, the rate of new cases was 19.7 per 100,000 each
year for type 1 diabetes.
Among youth ages 10 years or older, the rate of new cases was 18.6 per 100,000 each year
for type 1 diabetes.
Type 1 diabetes Symptoms

Learn, what are the three major type 1 diabetes symptoms? What are the common type 1
diabetessymptoms? How and why type 1 diabetes symptoms are developing. Additional symptoms
specific to type 1 diabetes.
Type 1 diabetes causes and risk factors

Some genes may be behind the type 1 diabetes causes, which are triggered by autoimmune disorder
or pancreas beta cells damaged by cystic fibrosis or pancreatic surgery. Type 1 diabetes risk factors
some factors can increases the chances for type 1 diabetes known as type 1 diabetes risk factors.
Type 1 diabetes diagnosis

Blood test is useful to diagnose high blood glucose level, and to diagnose type-1 diabetes needs
autoantibody testing.
Type 1 diabetes Treatment

Diabetes type 1 insulin treatment is necessary to maintain a blood glucose level; furthermore,
othertype 1 diabetes medicines are available to improve the efficiency of type 1 diabetes treatment.
Insulin alone cannot make wonders, so you need to follow a proper type 1 diabetes managementwith
correct diet, physical activity and self-monitoring of blood glucose (SMBG). Similar to proper diet
certain diabetes type 1 alternative medicine treatment can help improve the treatment efficiency; few
alternative medicines that help the treatment are herbs, homeopathy, yoga, acupressure and
reflexology.
Type 1 diabetes alternative treatment

Natural diabetes type-1 alternative treatment is not a cure, but it can help the management of type-1
diabetes. Learn how to choose correct diabetes herbs, diabetes homeopathic remedy and how to do
diabetes yoga, diabetes healing acupressure, and diabetes massage reflexology.
Type 1 diabetes complications

Type 1 diabetes complications may develop, because of badly managed blood-glucose level. Some of
the common type 1 diabetes complications are heart attack, stroke, blindness, kidney disease, loss of
a toe (or foot), and erectile dysfunction. Following proper type 1 diabetes management can help to
prevent diabetes type 1 complications.
Type 1 Diabetes Symptoms
Submitted by Thiruvelan on 11 Sep 2012 | Last updated 11 September 2012
In type 1 diabetes, the sudden onset of symptoms are frequent urination and extreme thirst, other
symptoms include unexplained weight loss, lethargy, drowsiness, and hunger.
Symptoms of type 1 diabetes
1.
Unusually frequent and high levels of urination
2.
Regular unusual feeling of being very thirsty
3.
Extreme hunger, even after short time after food
4.
All time tiredness
5.
Lowering of muscular bulk and weight loss
6.
Blur vision
7.
Unexpected cramping
8.
Mental irritability or confusion

Mostly symptoms occur after a viral illness and in most cases diagnose of type-1 diabetes are after
diabetic ketoacidosis (DKA).
Type 1 diabetes with diabetes ketoacidosis has the following symptoms:
Nausea or vomiting, inability to keep down fluids
Stomach pain
Deep, rapid breathing
Increased pulse rate, but low strength
Sleepiness
Dry skin and mouth
Flushed face
Fruity breath odor

DKA occurs when blood glucose rises to a dangerously high level due to absence of insulin and the
body unable to get nutrients into the cells. Therefore, the body starts to breaks down fat (and muscles)
for their energy needs, this causes releasing of ketones in the blood and urine. If DKA is untreated in
time can lead to stupor, unconsciousness, and even death.
Some type 1 diabetes has a honeymoon period, which is a brief remission of diabetes symptoms while
the pancreas is still secreting some insulin. The honeymoon phase mostly occurs after starting insulin
treatment; it can extend from a week to even up to a year. However, the absence of diabetes symptoms
should not interpret as diabetes is gone. Slowly pancreas will lose the ability to secrete insulin, and if
untreated the symptoms reappear.
Are you interested to know, how diabetes symptoms are developing.

What is glucose homeostasis? Body maintains blood glucose level within the normal range by a very
complex process called as glucose homeostasis. If there is, any disturbance to this glucose
homeostasis will lead to various bodily symptoms.
Why are diabetics, pee often and in large quantities? - If the blood-sugar level get elevating
continuously then the kidney start flushing out this extra sugar in blood as urine (pee). Urine often
contains sugar, and other minerals (such as sodium, chloride, potassium, and bicarbonate).
Why diabetics are having severe frequent Thirst? - Frequent urination leads to dehydration
causing dry mouth and throat.
Why Lack of Energy & Feeling Tired? - Inadequate insulin secretion prevents the body to
consume the blood glucose. Additionally, kidney flushes out minerals (such as sodium, chloride,
potassium, and bicarbonate) along with excess glucose from the body. Lack of glucose absorption,
removal of vital minerals and dehydration leads to lack of energy.
Why diabetics are having too much hungry? Lack of energy in your body is signaling as
hunger.
Why diabetics are having blurred vision? Increase in blood-sugar level makes the eye lens
and (or) corneal tissue to swell, results in blur vision.
With proper treatment and if the blood-sugar level returns to normal, all diabetes symptoms vanishes.
Type 1 Diabetes Risk factors

Type 1 diabetes mostly occur among young people, however it can also develops among older
peoples. Type 1 diabetes happens when your pancreas stops producing insulin.
Type-1 diabetes risk factors

Type 1 diabetes mostly starts in childhood when the pancreas stops producing insulin. Insulin is a
hormone your body needs to burn glucose found in food for energy. The risk factors for type 1 diabetes
are:
Genetic (Hereditary) having a family member with diabetes is the major risk factor. A firstdegree family member mother, father, sister, or brother has diagnosed as type-1 diabetes.
Diseases of the pancreas - injury or any pancreatic diseases can affect its ability to produce
insulin and lead to type-1 diabetes.
Infection or illness - a range of rare infections and illnesses can damage the pancreas and
cause type 1 diabetes. That is exposure to certain virus causes autoimmune destruction of the islet
cells. The viruses, which trigger this, are Epstein-Barr virus, coxsackie virus, mumps virus or
cytomegalovirus.
Drinking of nitrates containing water may increase the risk factor.

Omega-3 fatty acids have considered providing certain protection against type-1 diabetes. Therefore,
regular consumption of fish containing omega fatty acid can reduce your risk towards type-1 diabetes.

If once of the parents with diabetes type 1, in the case of father your chance for type 1 is 6%, in the
case of mother (had diabetes before 25 years) your chance is 4% and 1% chance if mother had
diabetes after her 25 years. Your risk will be double, if your parent was diagnosed around 10 years.
Does a child get diabetes type 1, without any family history?

Research shows that only 10 % of people with type 1 diabetes have a family history with first-degree
relatives, such as a sibling, parent, of offspring. These shows there are other important factors besides
just genes that influence the development of diabetes type 1. There is a misconception, type 1
diabetes is a genetic disease and mostly happens with family history. However, in reality, only 10 %
who have diagnosed with type 1 have a family history of the disease.
Diabetes Honeymoon
Submitted by Thiruvelan on 11 Apr 2013 | Last updated 6 May 2013
What is the diabetes honeymoon period? Honeymoon phase is a remission some diabetes type 1
experiences when their pancreas still secretes insulin.
What is a diabetes honeymoon phase?

Literally, "honeymoon" simply means the period just after the wedding when things are at their
sweetest and slowly wanes in few months. However, diabetes honeymoon is not cool and fun, instead it
is hot and boredom.
Diabetes honeymoon phase is the period shortly after the newly onset diabetes type 1 during which
there is a temporary recovery of pancreatic beta cell function and insulin secretion. This is only a
temporary and does not indicate diabetes is recovering, improving, or cured. During this honeymoon
period, your blood-glucose levels may improve to normal or near-normal level.
What happens during the honeymoon phase?

Managing diabetes is a challenge, especially during the onset (newly diagnosed). The honeymoon
phase can make things more frustrating and unpredictable for newly the onset of diabetes type 1.
It is important that you should not stop taking insulin even during the honeymoon phase; this can
rapidly lead to diabetic ketoacidosis. However, you may experience hypoglycemia (low blood-glucose)
when your pancreas is in remission. Thus, your insulin dose needs adjustment to prevent low bloodglucose levels.
This makes tricky to manage the blood-glucose level during this honeymoon period contributing to
hypoglycemia when the pancreas unpredictably producing insulin in addition to administration via
injection.
It is important to remember that this phase will pass and over time, your child (or you) will become
more stable. Treating diabetes really does get easier over time.
How long does the honeymoon period last?

There is no fixed answer for this complicated question. It is very hard to assess how long the diabetes
honeymoon phase may last in people with diabetes type 1. The diabetes honeymoon period can last
for weeks, months or in some rare cases for years.
Self Monitoring of Blood Glucose

Research shows that keeping blood-glucose close to normal reduces diabetes complications. For
better diabetes care, need to maintain the glucose level at target.
Tests for blood-glucose control
Use a glucose monitor to test glucose level at home called self-monitoring of blood-glucose
(SMBG).
The A1C test gives an average blood-glucose level over the last three months. It is the best way
to know your overall diabetes control performance. This test otherwise called as hemoglobin A-1-C or
H-b-A-1-C.
For effective diabetes treatment, you need to use both the A1C and SMBG to get a complete picture of
blood-glucose control.
Who should self-monitor their blood glucose level?

People who may benefit from checking blood glucose include those who are:
Taking insulin,
Pregnant women,
Struggling to control their blood-glucose levels,
Experiencing frequent low levels without usual warning signs, or
Having ketones from high levels
Home Blood-glucose monitoring

(Best Test for Day-to-Day glucose level monitoring)
Monitoring blood-glucose helps to see how food, physical activity, and medicine affect the
glucose levels. The readings can help to manage diabetes day to day or even hour to hour. Keep a
record of the test results and review it at each visit with the health care team.
Learn to test by yourself - Be sure and confirm with your health care team that you are
performing the test in a correct way. Furthermore, know whether the meter gives the results as plasma
or whole blood-glucose.
Below table shows both plasma and whole blood values of blood-glucose goals for most
diabetics. Confirm what is your glucose meter output format is?
Test frequency Blood-glucose test usually done before meals, after meals, and or at bedtime.
Insulin users need to test more often than non-insulins. Ask your health care team for test frequency.
Home blood-glucose monitoring is for day-to-day diabetic care, still need the A1C test for longterm diabetes care.
The A1C Test

(Best test for Long-Term blood-glucose monitoring)
A1C test is a simple test that gives an average blood-glucose level over the last three months.
You can take the blood sample to check A1C at any time.
A1C test is the best test to judge effectiveness of the diabetes treatments.
For most people with diabetes, the good A1C goal is less than 7.
You should test A1C at least twice a year. Get the test more often (once in three months) if the
blood-glucose stays too high or if your treatment plan changes.
Criteria for individualizing your target blood-glucose range

Individualize your target blood-glucose range based on the five important factors, they are:
How long you are having diabetes.
What is your life expectancy?
Other conditions you have, such as blood pressure, cholesterol, etc.
Do you have any cardiovascular condition?
Do you have asymptomatic low blood-glucose level?
The generalized diabetes target glucose level
Pre-prandial plasma glucose (before a meal) is 70130 mg/dl (3.89 to 7.23 mmol/l),
Postprandial plasma glucose (after a meal) is less than 180 mg/dl (10 mmol/l),
At bedtime is 100 to 140 mg/dl (5.56 to 7.78 mmol/l)
A1C is of less than 7%.
When do you need change in treatment?

If your pre-meal blood-glucose is consistently
Below 70 mg/dl (3.89 mmol/l) or
Above 140 mg/dl (7.78 mmol/l)

Alternatively, your bedtime range is steadily
Lower than 100 mg/dl (5.56 mmol/l) or
Higher than 160 mg/dl (8.89 mmol/l),

Then you properly need to modify your treatment regimen, consult your doctor. However, more
stringent target may be appropriate for some individuals with increased risks. Blood-glucose goals may
be different for children, adult, or other who is at greater risk for hypoglycemia.
Benefits of self-monitoring blood glucose
You can learn which foods are best for your blood-glucose control as well as which foods are
most harmful to your diabetes control.
You can know what physical activity, and the duration of the activity is right for you, so that you
can avoid activities that have ill effects on your health.
You can identify your blood-glucose levels rise or fall at any particular time, helps to decide
when to do exercise or take snakes.
Once your master how your blood glucose is influencing by different factors then naturally your
anxiety lowered regarding the blood-glucose level, thus chances are more for efficient control.
SMBG provides useful information for you and your doctor, how well your treatment is producing
results.
The important aspect of diabetes management is blood glucose tracking. Managing your blood
glucose level at or near normal range can help prevent or delay serious diabetes complications such as
nerve damage, eye problems, kidney disease, heart attack and stroke.
However, your blood glucose levels may fluctuate through the entire day, thus it is important to track
your HbA1c levels quarterly. HbA1C provides a long-term measure of your blood glucose levels.
In addition to diabetes if you are having other related health conditions such as high blood pressure
and/or high blood cholesterol, then it is important for you to track this condition too.
How frequently should a diabetes type 1 have to test their blood-glucose

level?
Type 1 diabetes should measure their blood-glucose levels every day before meals.
Some individuals are testing their blood glucose once or twice daily, while others do it four or five
times. Testing in the morning, during the wake up (before taking any food) help provides you how much
insulin you need.
How frequently should diabetes type 2 tests their blood-glucose level?

Type 2 diabetes treating with oral medications should measure your blood-glucose level once or twice
a week. It is preferably to test either before meals or after 90 minutes of a meal. However, if you are on
insulin instead of oral medication (or in addition to oral medication), then your blood-glucose
measurement will be more frequent consult your doctor.
Glucose Spikes Drops

Submitted by Thiruvelan on 18 Apr 2013 | Last updated 21 September 2013
What is a diabetes roller coaster? It means blood-glucose spikes or drops. You are not alone, almost
every diabetic person experiencing this.
What is a diabetes roller coaster?

A non-diabetic individual on hearing the word roller coaster, they start to imagine about amusement
park rides, funs, excitement and everything about good times.
However, for diabetes, their lives are stuck on a roller coaster, whether you have fun with it or not. All
diabetics are familiar with the term roller-coaster ride referring spikes and drops of their blood sugar
levels. I am sure every diabetic would come across the feeling of tiredness, because of riding blood
sugar roller coaster.
Why your blood glucose spikes or drops unexpectedly?

Just when you feel relaxed after gaining a good control of your blood-sugar level, you may suddenly
undergo hyper or hypo. You are not alone; it is common among almost every person with diabetes.
Numerous factors can disturb your blood-sugar level.
Some of the common blood glucose distressing factors are:
Smoking,
Stress,
Depression,
Anxiety,
Alcohol consumption,
Diet you ate,
Medication taken for other conditions,
Illness,
Climatic condition
Monitoring blood-glucose level regularly helps you to identify these worrying factors, which helps you to
avoid most of these BS spikes or drops.
Most cases of the blood sugar roller coaster (BS spikes drops) are instrumental by lack of motivation
and emotional energy. To bring back control and to stop diabetes roller coaster, you need to be in:
Positive thinking,
Focusing on your success,
Better management of stress,
Diabetes education (knowledge is power),
Turn your anger useful

Healthy mindsets and keep moving can help normalizing your blood-glucose level and stops BS spikes
and drops.
Observe your body closely and try learning:
Foods that make your blood sugar spikes,
Physical activities that bring a blood sugar drop
How your illness disturbs your diabetes control,
How your mental feeling affects your blood-sugar level.

Be positive and keep a brave heart and mind; this helps to normalize your blood-sugar level without
any fearful rise and fall.
Diabetes Sick or Illness

Take care of yourself when you are sick, it can make your blood-glucose go too high.
Sick day Diabetes Tips

Any kind of illness among a diabetes individual can make their blood-glucose level to fluctuate. During
illness, do not try to stop taking your diabetes pills or insulin even if you cannot eat as normal. Even
your doctor may recommend you to take extra insulin when you are sick.
If you cannot able to eat your regular food, then discuss with your dietician for a better alternative that
is easy for you to eat.
Check your blood-glucose level

every four hours and note down
the reading.
Keep taking your diabetes medicines,

even if you cannot keep food down.
Drink at least one cup of water or other calorie-free, caffeine-free liquid every hour while you are
awake.
If you cannot eat your usual food, try drinking juice or eating crackers, ice pop, or soup,
because you still need calories. In addition, if you cannot eat enough, you increase your risk of low
blood-glucose, also called hypoglycemia.
In people with type 1 diabetes, when blood-glucose is high, the body produces ketones.
Ketones can make you sick. Test your urine or blood for ketones if
your blood-glucose is above 240
you cant keep food or liquids down.
Urgent symptoms - immediately call healthy care provider.
your blood-glucose has been above 240 for longer than a day
you have ketones
you feel sleepier than usual
you have trouble breathing
you cant think clearly
you throw up more than once
youve had diarrhea for more than six hours
Is a person with diabetes are more likely to get cold and other illnesses?
You are not having any extra chances to get cold when compared to people without diabetes. However,
when you get cold or flu, it makes your blood glucose more difficult to control. That is why people with
diabetes are advisable to take flu shots to prevent it.
Diabetes Diets
Smart diet choices, along with regular physical exercise or activity, can help to control the bloodglucose levels, blood cholesterol level and maintain a healthy weight.
Diabetes diets Fats.

Fats are considering as a heavy diet with highest energy content of all diets. Eating too much of fat can
increase body weight and in the long run, it may be difficult to manage the blood-glucose levels.
Still small amounts of healthier fats (unsaturated fats) may improve the health and reduce the risk of
heart diseases. Thus, both the type of fat as well as the amount consumed is important.
Avoid unhealthy fats (Saturated fat, Trans fat & Cholesterol)

Include small quantity of healthy fats (Monounsaturated fat, Polyunsaturated fat & Omega-3
fatty acids)
Saturated fat - Unhealthy diabetes diet

Limit or even avoid saturated fat because it raises LDL cholesterol (consider as a bad cholesterol)
levels in blood.
Some of the sources of saturated fats are animal foods (fatty meat, milk, butter and cheese), Vegetable
fats (palm oil and coconut products such as copha, coconut milk or cream).
How do you reduce saturated fat consumption?
limit fat milk, yoghurt, ice cream, and custard.
limit lean meat and remove any fat off before cooking.
chicken without skin (remove before cooking).
limit butter, lard, cream, sour cream, copha, coconut milk, coconut cream and hard cooking
margarines.
limit cheese usage and try low-fat varieties.
limit or even avoid bakery stuffs - pastries, cakes, puddings, chocolate and cream biscuits.
try avoiding processed and pre-packaged food items.
avoid fried foods such as chips, chicken, and battered fish.
Unhealthy diabetes diet Trans-Fat

Trans-fat increases blood-cholesterol level, and it is even worse than saturated fats. Trans fat is
nothing but hydrogenated oil: liquid oil is converting into solid by hydrogenation.
Some of the sources of Trans fat are processed and baked foods (such as chips, crackers, muffins,
cookies and cakes), Stick margarines & Shortening and Some fast food items (read the label for
content).
Unhealthy diabetes diet - Cholesterol

Body can make cholesterol, remaining come from the diet we eat. Therefore, it is wise to avoid
cholesterol rich diets.
Some of the sources of cholesterol are dairy products with fat, Egg yolks, Animal liver and other
organs, Poultry skin and high-fat meats.
Diabetes diets - Healthy fats.
Monounsaturated fat,
Polyunsaturated fat &
Omega-3 fatty acids

Healthy fats are called so because they can lower bad (LDL) cholesterol and helps prevent clogging of
the arteries.
Healthy diabetes diet - Monounsaturated fats

some of the sources of monounsaturated fats are: Canola oil, Olive oil, Peanut butter and oil, Avocado,
Almonds, cashews, pecans, peanuts and Sesame seeds.
Healthy diabetes diet - Polyunsaturated fats

Some of the sources of polyunsaturated fats are: Oils (Corn oil, Cottonseed oil, Safflower oil, Soybean
oil, Sunflower oil), Walnuts, Pumpkin or sunflower seeds, Soft (tub) margarine, Mayonnaise, and Salad
dressings.
Omega-3 fatty acids - Healthy diabetes diet

Some of the sources of omega-3 fatty acids are:
some fish varieties (Albacore tuna, Herring, Mackerel, Rainbow trout, Sardines and Salmon),
some plant foods (Tofu and other soybean products, Walnuts, Flaxseed & flaxseed oil and Canola
oil).
Diabetes diets Protein.

Protein provides some important nutrients for good health. Most of the protein foods cannot directly
affect the blood-glucose levels. Protein foods include lean meat, skinless poultry, seafood, eggs,
unsalted nuts, and soy products (tofu and legumes - dried beans and lentils). However, legumes can
also have carbohydrates and so can affect the blood-glucose levels.
Protein and diabetes management

Protein-rich foods are meat, cheese and certain nuts. Approximately, about 40 to 50 percent proteins
you consume are converting into glucose and enter the blood stream in about 3 to 4 hours. Thus, you
should consume carbohydrate along with protein; protein additionally helps to slow down absorption of
carbohydrate. Your bedtime snacks should always contain protein. This helps to keep your bloodglucose level from dropping low during midnight. However, eating too much of protein food can harm
your kidneys.
Diabetes diets Carbohydrate.

Carbohydrates are the best and fast energy source for the body. It is easy to digest and breaks down to
form glucose in the bloodstream. Carbohydrates are not an essential nutrient for humans: the body can
make all its energy from proteins and fats. However, the brain and neurons cannot burn fat and needs
glucose for energy.
Amount of carbohydrate consumed will affect how the blood-glucose levels rise after a meal. Large a
serve can make a huge glucose level rise. Most of the foods contain carbohydrates, which the body
breaks down and digested into simple sugar that is the major source of energy for the body.
Types of Carbohydrates
There are two major types of carbohydrates in foods; they are simple (monosaccharide and
disaccharides) and complex carbohydrates (oligosaccharides and polysaccharides).
Diabetes Exercise
Diabetes exercise - increase exercise in your daily activity lower your blood-glucose level, and you feel
pleasant physical and mental well being.
Diabetes exercise - Physical Activity

Exercise plays an important part in treating and preventing diabetes. When you care for your diabetes
with physical activity, diet management, and proper medication, you will feel difference. In addition, it
reduces your risk for problems with your kidneys, eyes, nerves, feet & legs and teeth. You will also
lower your risk for a heart attack or a stroke.
Is it possible to treat diabetes with exercise therapy alone?

Exercise alone can be a form of therapy for diabetes, when your blood-glucose level is below 200
mg/dl. Provided there are no complications like retinopathy, neuropathy, nephropathy, CVD or any other
additional health conditions such as high blood pressure, or high cholesterol.
Tips before starting regular exercise

Trim your nails, cut your toenails properly to avoid nail growth damaging the skin in the toe
edges.
During exercise, wear properly fitted footwear (shoes) with cotton or woolen socks (help
absorbs sweat for preventing infection).
If your planned exercise involves your hands, then wear proper protective gloves.
Monitor your blood-glucose level before and after exercising and take necessary correction.
Examine your feet before and after exercise to find any sours in the skin.
During exercising, if you feel any discomforts stop doing and continue doing next day.
Benefits of Diabetes exercise - physical activity
Helps lower your blood-glucose level, measuring your blood glucose level before and after
exercise will be a great motivation for you.
Help lower your blood pressure, bad cholesterol and raise good cholesterol.
Reduces your body fat and improve your bodys ability to use insulin.
It improves your blood circulation, thus there is no more numbness, burning sensation in the
feet.
Lowers your risk for heart disease and stroke.
Keeps your heart and bones strong.
Keeps your joints flexible.
Helps you lose weight.
Better utilization of glucose by the body, it improves your energy level so no more fatigue (gives
more energy).
Reduce your stress levels
Additionally, you feel more brisk and energetic.
It reduces your stress, anxiety, and you feel mentally healthier.
Help you to lose weight, which in turn better diabetes control.
Strengthen your muscles and bones.
Surely, you feel betterment in your entire body.

Before starting your exercise regimen, consult with your doctor for any medication change or dosage.
Be active in your daily life routine
Walk around while you talk on the phone.
Play with the kids; take your dog for a walk.
Clean the house, do gardening, watering plants or rake leaves, washing vehicle.
Take stairs instead of the elevator or lift.
Walk the most instead of using vehicles.
At work, walk over to see your co-worker instead of calling or emailing.
Aerobic exercise for diabetes

Aerobic exercise makes your heart beat faster, and you will also breathe harder, thus you burn high
calories, and your lung expands and energizes the whole body. Doing exercise for 30 minutes a day at
least 5 days a week provides many benefits. You can even split up those 30 minutes into several parts,
example, you can take three brisk 10-minute each.
Start with some warm-up stretch, before you start exercising, and make to cool down after you finished
your exercise. If you are new to exercise, then start slowly with 5 to 10 minutes a day. Add a little more
time each week, aiming for at least 2 to 3 hours per week.
Some aerobic exercises to try:
Brisk walk
climbing stairs
swimming or taking a water-aerobics class
dancing
riding bicycle (outdoors or indoors)
taking an aerobics class
playing (basketball, volleyball, tennis or other sports)
in-line skating, ice skating, or skate boarding
cross-country skiing
Can a diabetic do strength exercise

Doing diabetic exercises with weights, elastic bands, or weight machines three times a week builds
your muscles and bones. It makes you overall healthy, flexible, and balanced. When you have more
muscle and less fat, you will burn more calories because muscle burns more calories, even between
exercise sessions.
Exercise regimen and stay motivated

Plan an exercise regimen is easy; however, the biggest challenge is stayed motivated to your exercise
plan. Plan strategies to overcome the hurdles that may derail and unmotivated you.
Tips to overcome these hurdles and to keep you stay motivated.
Choose funny physical activities that make you happy.
Choose a partner (family member, friend or your pet) who can make you exercise, swimming or
walking joyful.
Set simple and easily achievable goals for both short and long term. Once you achieve your
short-term goal, make you motivated to achieve the long-term goal.
Take advice from a professional physical trainer, join yoga, swimming, skating, or dance class
may help.
Go to your bed early and have plenty of rest on days you exercise. Muscles grow and repair
themselves during your restful deep sleep.
Do not have enough time for physical exercise? Take a walk to talk to your colleague instead of
phone, do crunches and jumping jacks while watching TV, pace while talking on the phone, use steps
instead of an elevator, take your pet for walking, play with your child, do gardening, and wash your car.
Simply take every opportunity to do exercise.
Make a note of all the benefits you enjoy from exercising such as feeling energetic, increased
alertness, physically stronger, mentally more relaxed and so forth. This helps you feel pride, and it
motivates you further.
Important when doing diabetes exercises

Physical activity for some may cause low blood-glucose or hypoglycemia, so please have glucose
tablet or gel with you, if you type 2 diabetes. In addition, if you type 1 diabetes keep a glucagons kit at
your easy reach. Give glucagons as an injection with a syringe and quickly raise blood-glucose.
If you have type 1 diabetes, avoid strenuous exercise when you have ketones in your blood or urine.
Ketones are chemicals your body might make when your blood-glucose level is high, and your insulin
level is low. Large quantity of ketones can make you sick. If you exercise when you have ketones in
your blood or urine, your blood-glucose level may go even higher.
If you have high blood pressure or eye, problems then avoid heavy weight lifting or hard exercise. This
may worsen your problems consult your doctor.
If nerve damage from diabetes has made your feet numb, your doctor may suggest that you try
swimming instead of walking for aerobic exercise.
During exercising, no sweat does mean no-benefit.

Your body sweats to bring back your body temperature, which is heating up during exercising, physical
activity, or hot environment temperature (& humidity). Not everyone sweats at the same rate; each
body behaves distinctly. Thus, you should not validate your exercise based upon the intensity of the
sweat.
The downside of heavy sweating is that you lost body fluid content, so risk of dehydration. Dehydration
is not good; particularly, for people with diabetes this makes your blood-glucose control difficult. Thus,
you need to hydrate yourself with plenty of water.
Exercising tiredness and exercise benefits

When you begin, exercising your body may demand more oxygen than before this may makes you feel
some tiredness at the beginning. As you, continue doing the exercise, your lung's capacity increases to
processes more oxygen. This guaranteed to increase your energy levels, improves your blood
circulation, heart's health, decreases mental stress, improves memory, increases the production of
neurochemicals that repair brain cell, boost decision-making skills, growth of new nerve cells and blood
vessels and help you sleep better (restful sleep).
Does old age diabetes can go for walking?

Aged diabetes individuals avoid doing minimum recommended physical activity due to their health
restrictions, fear of fall down and being injured. However, it is considering as their perceptions and not
a fact.
The American Academy of Family Physicians reports, exercising is safer for most of the adults aged 65
and over. Even individuals with additional health conditions such as heart disease, high blood
pressure, and arthritis can safely do physical activity or exercise after consulting with their doctor and
physiotherapist. Actually, regular exercise such as walking can help improve many of these conditions,
additionally help lower the risk of falling.
Type 1 Medication
Once diagnosed as type 1 diabetes or even though a type 2 diabetes but doctor advised to take insulin
shots, then you have to know this information for effective treatment.
Diabetes type 1 medications treatment

Type 1 diabetes requires lifelong treatment to keep the blood-glucose within target range:
Taking several insulin shots per day or use insulin pump
Regular exercising helps effective utilization of insulin as well as helps lower your risk for heart
and blood vessel disease.
Maintain a healthy body weight helps your diabetes treatment and easy to achieve target bloodglucose levels.
Healthy eating habits by distributes carbohydrate throughout the day, to prevent blood-glucose
spikes.
Monitoring blood-glucose level several times a day and strive to achieve your target.
Stop smoking can help avoid diabetes complications and overall health.
Stop drinking alcohol, if you are at more risk towards hypoglycemia.

Following the diabetes type-1 treatment plan helps you stay healthy, but treating diabetes is not curing
it. Presently, there is no cure for diabetes, so type 1 diabetes will need treatment for the rest of their
lives. However, with proper care, you can look and feel healthy and go on to live long just like normal
people.
If left Untreated, type 1 diabetes is generally leading to coma, often due to ketoacidosis. Ketoacidosis
causes cerebral edema (liquid accumulation in the brain), which is very life threatening. This makes
ketoacidosis the most common cause of death in pediatric diabetes.
Informations on Insulin treatment
What is insulin - hormone a protein maintains our blood-glucose level.
Insulin types - There are many types of insulin available, talk with your health care provider
and choose the best one suitable for your body condition.
Insulin analog commonly available is in the table below. Mostly, you need to use more than
one kind to suit your individual requirement.
Insulin shot regimen - number of insulin shots per day at a particular time; your doctor will
guide you in this regard.
Insulin storage and handling - you should know, how to store and handle insulin safely for
effective treatment.
Ways to take insulin - We have to inject insulin into the muscle layer of the skin; this needs a
syringe or other easy injecting devices of your choice. Talk with a diabetes educator for your best
choice.
Insulin therapy - Now start your therapy individually designed as per you needs.
Tips to help yourself for effective insulin therapy based on experience the diabetic
educators designed simple tips for proper treatment, follow these tips for your wellbeing.
Type 1 diabetes treatment goals

The goal of diabetes 1 treatment is to maintain your blood-glucose level as close to normal as possible
to postpone or prevent diabetes complications. Although there are exceptions, generally blood-glucose
target is
Fasting blood-glucose level of 80 to 120 mg/dL (4.4 to 6.7 mmol/L)
Bedtime blood-glucose level of 100 to 140 mg/dL (5.6 to 7.8 mmol/L)
Blood-glucose level of less than 70 mg/dl (3.9 mmol/L) is considering as hypoglycemia (low
blood glucose).
Oramed requests FDA for Oral Insulin drug

Israel-based Oramed announced that it had sent an application to the Food and Drug Administration
for permission to enter Phase 2 trials of its oral insulin product. The company has been working on
developing a means of delivering insulin orally, which would allow people with diabetes to avoid having
to inject themselves with the hormone.
If the FDA gives the go ahead, Oramed will conduct a 12-month trial at 10 different locations across the
United States. The test will involve 147 diabetes type 2 patients who will divide into three groups: one
receiving placebo and the other two will take the Oramed drug at distinctive dosage levels.
Diabetes products helps diabetics

Submitted by Thiruvelan on 22 Jun 2010 | Last updated 9 July 2013
The battle against diabetes continues amidst persistent research. To date, there is no known cure for
diabetes, however; products are so vast that a diabetic and their family can practically have normalcy
back in their lives.
Diabetes help systems for better diabetes care

Diabetes help should be primarily come from within the family next comes from diabetes help products
such as:
Diabetes meter or glucose meter,
Continuous glucose monitor,
Diabetes pen / Insulin pen,
Diabetes pump / Insulin pump,
Jet injector,
Auto injector
Ketone testing strips

Diabetes products enable diabetics and their loved ones, to feel that they are not alone in fighting this
disease. Help comes at a time most needed, particularly when the world struggles to find a cure for
diabetes. Diabetes help product brings benefits to the community involved in the life of the diabetics.
So how is this help best realize then?

Diabetics should learn about these new products and its
usage and help themselves to fight against diabetes in a
convenient or with less discomfort.
For diabetics, the first thing is to manage the glucose
level in target range. For this we have to check it
regularly, thus we are in need of a convenient blood
glucose monitor.
For maintaining the blood-glucose level in target value, we need insulin shots. For this, we need a
convenient insulin injecting systems such as insulin pen, insulin pump, jet injector or auto injector.
At some times, if the blood-glucose is too high, then there may be a chance for ketoacidosis episode. It
is a dangerous one, need to diagnose early, and corrected it in time. For proper diagnosis, we need to
test ketones in urine; it made simple with ketone testing strips.
Diabetes can fight, handle, and manage effectively with diabetes help products. You can achieve a
healthier lifestyle with these convenient diabetes help systems.
Nutritional Diabetes Supplements

Submitted by Thiruvelan on 14 Mar 2011 | Last updated 22 August 2014
Nutritional supplements help effectively manage diabetes and its complications. Some common
diabetes nutritional supplements can be available here.
Micronutrients Diabetes
Micronutrients are vitamins & minerals that are required in micro quantities by our bodies for specific
proper functioning. These micronutrients mostly function as coenzymes & cofactors for our bodys
metabolic reactions. It supports cellular reactions (such as glucose, lipid, and amino acid metabolism)
which are required for energy and life. Deficiency of these micronutrients can lead to serious health
conditions.
The micro minerals include iron, iodine, manganese, cobalt, chromium, copper, selenium, zinc, and
molybdenum. Micronutrients also include vitamins, which are required as nutrients in micro quantity by
an organism.
Nutritional Diabetes Supplements

Micronutrients are in continuous investigation as prevention & treatment supplement for both diabetes
type 1 and type 2 as well as for common complications of diabetes. Many diabetes institutions are not
in support of nutritional supplementations that include American Diabetes Association. However, many
experience diabetics believe that they benefit with diabetes nutritional supplements and taking the
supplements even many experts suggest against this and mention these supplement produces only
costly urine (means most of this costly supplement only removed through urine).
What can you expect from Diabetes Nutrition Supplements?

Diabetes supplements in some extents can help blood-glucose control in many ways:
They may help effective metabolism of glucose and thus helps to support efficient bloodglucose level.
They may help to improve the bodys sensitivity to insulin (or insulin's effectiveness) and thus
helps support effective blood-glucose level.
They may help faster recovery from wounds, illness, etc.
They may help to prevent/manage neuropathy.
They may help to avoid or to manage diabetes complications.
Some of the popular Diabetes Nutrition Supplements

There are many minerals and vitamins beneficial to diabetes management. The most popular diabetes
nutritional supplements are:
Chromium
Vanadium
Zinc
Calcium
Magnesium
Vitamins B, C, D, E, H
Alpha lipoic acid
Co-enzyme Q10
Brewers Yeast
Minerals are vital for the body structures formation (bones & tissues) and for proper physiological
processes (metabolism & energy production). The above said various minerals and vitamins are
helpful in diabetes management as well as stop or treat its complications.
Diabetes Natural Treatments

Alternative medicine practitioners believe that a natural treatment is possible for diabetes by enlivening
the pancreatic cells, which are responsible for this illness.
What is diabetes natural treatment?

Natural treatment can be considering as a medical system supports your body's ability to heal itself.
Groups of diverse medical systems, not presently considering being a part of conventional medicine is
called traditional or alternative therapy.
Alternative medicine is categorizing into five groups they are:
Biologically based practices are therapies involving substances found in nature having
purported medicinal properties. Examples are herbs and dietary supplements to control diabetes.
Mind-body therapy are practices used the relationship of mind and body to achieve improved
health or treat diabetes. Examples are yoga, tai chi, and meditation.
Manipulation and body-based practices are massaging specific body parts or the whole body.
Examples are chiropractic therapy, osteopathic manipulation, and reflexology massage.
Energy healing - are practices involving energy fields around and inside the human bodies that
are altered by energy-healers for a health benefit. Examples are chakra balancing, Reiki, external qi
gong, and therapeutic touch.
Whole-medical systems are complete medical systems often evolved earlier than conventional
medicine. Examples are Homeopathy, naturopathy, Ayurveda and traditional Chineses medicine.
Biological based practices and mind-body medicines are the most commonly used alternative
therapies.
Complementary medicine is treating an illness by a group (i.e. more than one) of alternative therapies;
one compliments the other for better efficacy. Examples are diabetes management by using herbs,
homeopathy, yoga, acupressure, and reflexology therapy combination.
Integrative medicine is the combination of alternative (or complementary) therapy and modern
medicine. It is ultimately superior to a single model approach of treatment, which provides safer, faster,
and more efficient treatment. For example, diabetes controls using alternative medicine or
complimentary therapy (such as herb, homeopathy, yoga, acupressure, or reflexology) and
conventional treatment (such as oral medication and/or insulin therapy).
Start treating diabetes naturally

Numerous natural treatments are useful in diabetes management. Some are impressive and others
ineffective. An alternative therapy, which is effective for your friend or relative, may be worthless for
you. If you are interested in trying natural diabetes treatment, do so only along with your conventional
medicine (i.e. your regular diabetes medication and/or insulin). Be careful, improper diabetes control
can lead to life-threatening complications.
At the initial stages of natural diabetes treatment, you should be more vigilant on your blood-glucose
level, because it may drops to hypoglycemia. If the glucose level is dropping consistently,
proportionally you should reduce your oral medication or insulin.
Benefits of diabetes alternative treatments

Alternative medicine practitioners claim there are no or only minor side effects in alternative medicine
treatment. It can rejuvenate pancreas to function normally, thus insulin secretion and sensitivity
improve.
Alternative treatment not only helps diabetes treatment; furthermore, helps to avoid or slow down longterm diabetes complications such as nerve damage, eye, kidney, heart diseases, and stroke.
Additionally, it can lower cholesterol level, blood pressure, improve digestion, and detoxify your system.
Diabetes alternative medicine statistics

Clinical Diabetes journal says in the United States alone alternative medicine is frequently in use
among adults. An estimated 34% of diabetes adults are using some type of alternative therapy.
As per a survey conducted by BMC Complementary & Alternative Medicine, shows 64 % of diabetes
alternative medicine users using it to manage diabetes complications and 46 % utilize it solely for their
diabetes control.
A study in the USA published in Diabetes Care 2002 identifies those aged over 65 years as being three
times more likely to use alternative medicine than those aged less than 65 years.
Five best diabetes natural therapies

Here we provide you few diabetes natural treatments proved effective in diabetes treatment. You can
combine them together to improve its effectiveness as complementary or integrative therapy.
Diabetes Herbal - is a natural product trusted to control blood sugar. Additionally, it can nourish
kidney, liver, eye, and hearts organs that may affect by diabetes complications. Visit diabetes
herbal, Gymnema Sylvestre, Salacia Oblonga, Bitter Melon, Cinnamon, Fenugreek,Ginseng and Aloe
vera.
Diabetes homeopathy is a nano-pharmacology, which uses very small doses to treat illness
without any side effects. If you are able to choose a suitable remedy, specifically for you, then it will
produce a magical result. Homeopathy can work by stimulating your bodys defense system. For more
information, you can visit diabetes homeopathy.
Diabetes Yoga - Yoga refers to be the traditional physical and mental disciplines originating in
India can balance body, mind, & spirit. This can help/support the diabetes treatment by activating
glandular systems responsible for the illness. For detailed information, you can visit diabetes yoga.
Acupressure Diabetes Healing - TCM considers diabetes as a depletion thirst disease: Upper,
Middle, and Lower warmer depletion thirst disease. Acupressure is a gentle pressure on the specific
pressure points in the body to improve health. To learn more, you can visit acupressure for diabetes.
Reflexology Diabetes Massage - Our body organs have reflex points on our foot and hands.
Just my manipulating these points by gentle firm massage, you can control diabetes as well as prevent
long-term complications. Visit reflexology massage for diabetes for detailed information.
Natural Herbals for Diabetes

Diabetes mellitus is a metabolic disorder in the endocrine system. Metabolism is the process to make
energy from the food you eat. Mechanical and chemical means in your digestive system break down
the food into nutrients, your body needs.
A metabolic disorder develops when there is any defect in this process. When this disorder develops,
you might have excess of some substances or shortage of others that you need to stay healthy.
Metabolic disorder develops, when the liver or pancreas becomes diseased or does not function
normally. Diabetes is an example.
Herbal treatment for diabetes

Synthetic oral anti-diabetic agents exert their effects by various mechanisms. These chemical agents
have certain drawbacks, such as develop resistance to long-term treatment, adverse effects and lack
of action in large segment of diabetes patients. Approximately, 44% of diabetes patients develop
resistance to sulfonylureas treatment within six years. Additionally, these oral agents are associated
with adverse effects such as bloating, flatulence, diarrhea and abdominal discomfort. Some anti-
diabetic agents can cause toxic effects; thiazolidinedione may cause liver toxicity, and sulfonylureas
may worsen heart disease, cause hypoglycemia and increase the body weight gain.
Alternatively, various plants provide hypoglycemic property and widely used in traditional systems to
prevent or treat diabetes. Several medicinal plants have investigated for their use in diabetes. These
plants may help delay diabetic complications and even corrects the metabolic abnormalities. This video
focuses mainly on natural diabetes herbs used as anti-diabetic medicine in diabetes management.
As per ancient literature, there are more than 800 plants having anti-diabetic properties. The literature
indicates diabetes was well known since prehistoric age. The National Health Interview Survey found
that 22 percent of people with diabetes used some type of herbal therapy.
Herbal diabetes products have been popular all over the world. Certain herbs provide symptomatic
relief and prevent diabetes complications. Some herbs can even help in the regeneration of beta cells
and overcoming resistance.
Some herbs exhibit antioxidant activity and cholesterol-lowering property in addition to the bloodglucose level normalizing effect.
Eight herbs for diabetes management
1.
Ivys gourd - has anti-diabetic effect by mimicking insulin in diabetic patients. The herbal Ivy
gourd possesses anti-inflammatory, anti-oxidant properties, which protects against plague formation
and thus, to some extent; it may prevent heart diseases and strokes. Visit Ivys gourd to learn in detail.
2.
Salacia Oblonga - binds with intestinal enzyme alpha-glycosidase that break down
carbohydrates into glucose in the body. Thus, lesser glucose gets into the blood stream, results in antidiabetic effect. Visit Salacia Oblonga to learn more.
3.
Aloe Vera - has appeared to exhibit insulin secretagogue like anti-diabetic action. Additionally, it
enhances glucose metabolism thus results in blood glucose lowering effect. Visit Aloe Vera to learn in
detail.
4.
Better Melon - possesses anti-diabetic properties. It mimics insulin, increase glucose uptake,
improve glucose tolerance and decrease hepatic glucose production. Additionally, bitter gourd has antihyperlipidemic effect. Visit Better Melon to learn more.
5.
Cinnamon - has anti-diabetic effect by mimicking insulin. It improves insulin mediated glucose
metabolism and enhance insulin signaling. Additionally, cinnamon lowers the blood cholesterol level,
particularly LDL cholesterol. Visit Cinnamon to learn in detail.
6.
Fenugreek - slows down the glucose absorption, and other simple carbohydrates. It appears to
possess insulin secretagogue like anti-diabetic effect. Visit Fenugreek to learn more.
7.
Ginseng - has anti-diabetic property, which mimics insulin and alters hepatic glucose
metabolism. It increases insulin production and reduces cell death in pancreatic beta cells.
Visit Ginseng to learn in detail.
8.
Gymnema Sylvestre - is nicknamed as the sugar destroyer, which increases insulin production
(insulin secretagogue) by regeneration of the pancreas cells. It improves glucose uptake by the cells by
increasing the activity of the glucose utilizing enzymes, and stops adrenaline from stimulating the liver
to dump extra glucose. Visit Gymnema to learn in detail.
Herb Ivy gourd for diabetes

Ivys gourd and other herbs are useful in controlling blood glucose level and nourish pancreas, liver,
kidney, heart, & eye.
What is Ivy gourd?

Ivys gourd (Coccinia Cordifolia) is a tropical vine (woody climbing
plant that bears grapes like fruits), nativity extents from Africa to
Asia. Green vegetable Ivys gourd is used for cooking as vegetable,
well-ripped fruits are sweet to eat and can be taken raw.
Coccinia Cordifolia is also called as baby watermelon, little gourd, Calabacita, Calabaza Hiedra,
Coccinia grandis, Coccinia indica, Coccinia ndica, Kovai, Little Gourd, Tela Kucha, Tindola.
Ivy gourd lower blood-sugar level

The mechanism of action of the herbal ivy gourd has appeared to mimic insulin in diabetic patients. It
acts like insulin by correcting the elevated enzymes Gluocose -6-phospahtase, lactase dehydrogenase
and thus control of hyperglycemia in diabetes.
Ivy gourd lower heart diseases & strokes risks

Heart diseases and strokes are causing by blood vessel blockage develops due to inflammation and
oxidation. The herbal Ivy gourd possesses anti-inflammatory, anti-oxidant properties, which protects
against plague formation and thus to some extent it may prevent heart diseases and strokes.
Ivy gourds medicinal uses

Ivy gourd is traditionally in use as a diabetes herbal; research too confirmed it. Additionally, it helps
your blood cholesterol control. Traditionally, Ivy gourd can also in use for various conditions; stem juice
as eye drops to treat cataract. Leaves are useful for treating skin eruptions, gonorrhea, biliary
disorders, anorexia, cough, diabetic wounds, and hepatic disorders.
Ivys gourd has some important pharmacological activities; they are anti-inflammatory, antioxidant, antimutagenic, anti-diabetic, anti-bacterial, anti-protozoal, anti-ulcer, hepato-protective, expectorant, and
analgesics.
Ivy gourd dosage

The appropriate daily dose depends on various factors such as your age, health, and other health
conditions. Consult your alternate medicine practitioner or follow product labels before using it.
Ivy gourd availability

Ivy gourds are available as fresh vegetable, fruit and leaf; extract capsules, leaf powder tablet or
capsules.
Possible side effects of Ivy gourd

It appears to be safe for most of the people, when taken by mouth for short and long terms. Pregnancy
and breast-feeding women are advice to avoid its use. Ivy gourd can decrease blood sugar levels, so it
can interact with diabetes medication and leads to hypoglycemia. Thus, you need to monitor your
blood-sugar level closely to avoid hypoglycemia, also need to change your diabetes medication dose.
Ivy gourds scientific evidence

A study titled Effect of Supplementation of Coccinia cordifolia extracts on Newly Detected Diabetic
Patients is published in Diabetes Care February 2008 vol. 31 no. 2 216-220. The study shows, there
was a significant decrease in the fasting and postprandial blood-glucose-levels of the experimental
group significantly decreased, by 16 and 18%, respectively as well as A1C.
Herb Salacia Oblonga for Diabetes

Salacia oblonga can control blood-glucose, and it has an additional benefit of weight gain inhibition.
What is Salacia Oblonga?

Salacia oblonga is a woody plant native to Sri Lanka and India. The roots and stems of Salacia
oblonga are in use extensively in Ayurveda and Traditional Indian Medicine for different medical
conditions, including diabetes.
Herb Salacia oblonga lower sugar level

Salacia oblonga binds to intestinal enzyme alpha-glucosidases that break
down carbohydrates into glucose in the body. Thus, less glucose gets into
the blood stream, resulting in lower blood-glucose.
Salacia oblonga lower heart diseases & strokes risks

Diabetes has greater incidence of cardiovascular disease than others do. It is due to slow development
of fibrosis, results in increased myocardial stiffness causing ventricular dysfunction and ultimately heart
failure. Salacia oblonga improves interstitial and perivascular fibrosis in the hearts and lower your heart
disease and stroke risks.
Medicinal uses of Salacia oblonga

Traditionally, it is in use for blood-glucose management, effective for type 2 diabetes control and
beneficial for type 1 diabetes. It inhibits weight gain thus controls the weight gain. Additionally, it can
lower serum cholesterol, triglycerides, and increasing HDL cholesterol levels. It is much useful for
those who are obese and having both diabetes and cholesterol. Traditionally, salacia oblonga has been
in use to treat arthritis, diarrhea, fever, gonorrhea, obesity, menstrual problems, and skin diseases.
Salacia oblonga dosage

General recommended dosage for Salacia oblonga is 2.5 to 5.0 grams daily of the whole herb, or a
comparable amount as extract. The root and bark are the part of the plant used.
Salacia oblonga availability

It is available in different easy to take forms; they are a Salacia oblonga root, root powder capsules and
extract capsule.
Bioactive constituents of Salacia oblonga

It contains two potent a-Glucosidase inhibitors: Salicinol and Kotalanol together with several known
phenolic compounds, new sesquiterpenes (salasols A and B) and triterpenes (kotalagenin 16-acetate,
salasones A-E, salaquinones A and B). Furthermore, S. reticulata and its phenolic constituents can
exhibit pancreatic lipase inhibitory and anti-obese effects.
Scientific evidence for the diabetes herb Salacia oblonga

Extract of Salacia oblonga lowers acute glycemic in patients with type 2 diabetes, conducted at Ross
Products Division of Abbott Laboratories, Columbus, OH 43215, USA published in Am J Clin Nutr.
2007 Jul;86(1):124-30. The study result show, the extract of Salacia oblonga lowers acute glycemia
and insulinemia in persons with type 2 diabetes after a high-carbohydrate meal.
Salacia oblonga improves cardiac fibrosis and inhibits postprandial hyperglycemia in obese Zucker
rats, conducted at Herbal Medicines Research and Education Center, Faculty of Pharmacy A15, The
University of Sydney, NSW 2006, Australia published in Life Sci. 2004 Aug 20;75(14):1735-46. This
study shows postprandial hyperglycemia plays an important role in the development of type 2 diabetes
and cardiovascular complications. Salacia oblonga has strong inhibition of alpha-glucosidase activity in
vitro, which suggests contributing to the improvement of postprandial hyperglycemia.
Possible side effects of Salacia oblonga

Salacia oblonga is relatively safe. In human, the side effects are similar to the side effects of alphaglucosidase inhibitors (diabetes medication), gas and cramping. It may interact with your diabetes
medication and causes hypoglycemia, so be vigilant in your blood-glucose monitoring and change your
medication dosage if warrants.
Aloe vera for diabetes control

Aloe Vera gel has pre-packed with magic ingredients of numerous medicinal properties; it can reduce
blood-glucose & glycosylated hemoglobin levels.
Aloe Vera
Aloe Vera is a stem-less or very short-stemmed succulent (having
thick, fleshy, water stored leaves) plant growing to 60 to 100 cm (i.e.
24 to 39 inches) tall. The leaves are thick and fleshy, green, or greygreen; margin of the leaf is serrated (saw toothed) and has small
white teeth.
Aloe Vera nativity is unclear and may be from Africa; Aloe Vera has
been widely grown by the modern gardeners as an ornamental plant.
What is Aloe Vera Juice?

Aloe Vera juice is prepared from the leaves of the aloe plant by just removing the marginal saw-toothed
spikes and the green layer of the leaf. Inside this, you can find a watery gel with yellow sap wash it out.
Because consuming this sap may cause dysentery, but it can help treat constipation.
Crash this clean Aloe Veras jelly to become watery liquid called Aloe Vera juice. It is always best to
take it as a fresh juice, but even commercially available Aloe Vera juices are effective. Consuming this
Aloe Vera juice can help various health conditions, for details looks at the Aloe Vera benefits.
Aloe Vera lower sugar level

The mechanism of action of Aloe Vera to reduce blood-glucose levels is by enhancing glucose
metabolism. Additionally, the glucose lowering effect could be by an antioxidant mechanism; it
attenuates oxidative damage in the brains of streptozotocin (a naturally-occurring chemical that is
particularly toxic to the insulin-producing beta cells of the pancreas) induced mice and reduced
peroxidation levels in the kidneys of streptozotocin-induced diabetic rats.
Aloe Vera lower heart attack and strokes risks

Aloe Vera possesses anti-diabetic, anti-dyslipidemia, anti-inflammatory, and anti-oxidant property,
which may help prevent heart disease and strokes. Numerous studies show aloe has a beneficial effect
in the prevention of atherosclerosis and coronary heart disease.
Medicinal uses of Aloe Vera
Many researches show the aloe gel contains active constitutions that reduce blood glucose and
glycated hemoglobin levels (A1C).
It helps many skin conditions; use internally or externally such as for wounds, burns, rashes,
sores, herpes, fungus, vaginal infections, acne, sunburn, psoriasis, warts, etc.
Taking internally increases immunity; it helps cancer patients by stimulating the development of
non-cancerous cells and white blood cells.
Useful in indigestion, liver problems, urinary tract infections, stomach ulcers, kidney infections,
intestinal worms and many other conditions.
Lowers cholesterol level, oxygenate blood, protect body from stress, and reduce high blood
pressure.
It can nourish the body with minerals, vitamins, enzymes and glycol-nutrients.
Aloe Vera dosage

Normally suggested aloe dosage for the treatment of diabetes is 30 ml, dilute with water and take in the
early morning. Otherwise, take 600 mg tablets 1 to 3 daily.
Aloe Vera availability

Aloe Vera is available as gel, juice, spray-dried powder and as capsule.
How do you take Aloe Vera?

Aloe Vera gel or juice can dilute with water, taste it as per your choice or drink the juice as it is. Spray
dried powder capsules can swallow as supplement.
If you have aloe plant around your location, you can try to consume it as fresh juice every alternate
day.
Bioactive constituents of Aloe Vera

The aloe plant gel contains about 99 to 99.5 % water, with an average pH of 4.5. The balance contains
over 75 different ingredients, including vitamins, minerals, enzymes, sugars, anthraquinones or
phenolic compounds, lignin, saponins, sterols, amino acids and salicylic acid. Vitamins and Minerals
are C, A, E, B vitamins, B-carotene, Zinc, Calcium, Copper, Magnesium, Manganese, and
Phosphorous. It contains at least five different enzymes and likely more. It contains twenty-two amino
acids. Plant sterol is a plant-based compound, potent anti-inflammatory agents. Gibberellin is a growth
factor, which assists in healing. Polysaccharides, including B1-3 and B1-4 Glucomannan known for
their immune stimulating effects, Based on its constituent make up, aloe has a wide array of
applications.
Possible side effects of Aloe Vera

Other than occasional allergic reactions, there is no serious problem in the use of aloe gel, both
internally and externally. If aloe is useful in your diabetes treatment, you should closely monitor your
glucose levels. If possible, you can lower your medication in steps otherwise hypoglycemia may occur.
Aloe Vera scientific evidence in diabetes control

Clinical trial titled Antidiabetic activity of Aloe vera L. juice by I. Yongchaiyudha S, Rungpitarangsi V,
Bunyapraphatsara N, et al published in Phytomedicine 1996; 3:241-243. This clinical trial is on new
cases of diabetes mellitus, results showed significantly greater improvements in blood sugar levels
among those who given aloe over the 2-week treatment period.
Clinical trial titled Antidiabetic activity of Aloe Vera L. juice II by Bunyapraphatsara N, Yongchaiyudha
S, Rungpitarangsi V, et al published in Phytomedicine. 1996; 3:245-248. This trial is in diabetes
patients in combination with glibenclamide and aloe. The result shows, taking glibenclamide and aloe
showed definite improvements in blood sugar levels over 42 days as compared to those taking
glibenclamide and placebo.
Bitter melon for diabetes control

Better melon or gourd can naturally increase the bodys ability to utilize glucose, so it is best suitable
for type 2 diabetes with insulin resistance.
Better Melon (Momordica charantia)

Better melon (Momordica charantia) is a tropical and subtropical vine, widely grown in Asia, Africa, and
the Caribbean for its edible fruit, which is the most bitter of all fruits. The plant bears yellow flowers;
fruits have a distinct warty exterior of oblong shape; a thin fleshy layer is surrounding a central seed
cavity having large flat seeds and pith.
Bitter melon has been in use in traditional medicine systems for a long time
for a variety of ailments, particularly stomach complaints.
Bitter melon lower blood sugar level

Vicine, charantin, and polypeptide-P are present in bitter melon are
responsible for its anti-diabetic properties. Together they increase insulin
secretion, increase glucose uptake, glycogen synthesis in the liver, muscle &
adipose tissue, improve glucose tolerance and decrease hepatic gluconeogenesis.
Bitter melon lower heart diseases and strokes risk

Many experimental findings conclude that bitter gourd exhibits promising anti-diabetic activity. Its antihyperlipidemic effect could represent a protective mechanism against the development of
atherosclerosis, especially in diabetic condition. Therefore, it is very much useful in the management of
diabetes mellitus and other associated complications.
Medicinal uses of Bitter melon
The bitter gourd is specifically in use as a folk medicine for diabetes treatment. It contains a
hypoglycemic or insulin-like principle, consider as 'plant-insulin', which is highly beneficial in lowering
the blood sugar levels.
Being rich in essential vitamins and minerals, such as vitamin A, B1, B2, C and Iron, it prevents
many complications such as hypertension, eye complications and neuritis.
It possesses digestive, carminative, anti-inflammatory, anti-cancer, detoxification and blood

purification properties.
Effective for improve immunity, obesity, lipids, blood sugar and psoriasis. It protects heart, brain,
liver, kidney and other vital organs of your body.
Better melon can alleviate liver problems; antimicrobial activities help heal wounds, improves
energy and stamina, alleviate eye problems, nourish the liver, increase immunity and improve
asthmatic condition.
Bitter melon dosage

The typical dosage of bitter-melon is one small, unripe, raw melon or about 50 to 100 ml of fresh juice,
divided into two or three doses over the course of the day. The only problem is that it tastes extremely
bitter. Noted naturopath Michael Murray suggests that you should simply plug your nose and take a 2ounce shot.
Bitter melon availability

Bitter melon is commercially available as fresh fruits, dehydrated fruits, leaf powder or exacts. In
addition, it is available as capsules for you to take easily.
Bioactive constituents of Bitter melon

Bitter melon has charantin on hydrolysis gives glucose and a sterol; the fruit pulp has Galactouronic.
Fruits contain glycosides, saponins, alkaloids, reducing sugars, resins, phenolic constituents, fixed oil,
and free acids. The leaves of the better gourd have hypoglycemic activity comparable to tolbutamide.
The protein termed as P-insulin extracted from the fruits in a crystalline form.
Bitter melon has twice the calcium of spinach and Potassium of bananas. The plant is rich in Iron and
Zinc. The other minerals are Phosphorus, Sodium and Magnesium. Vitamin C makes up 55% of total
vitamins. The other vitamins are B9, B1, B2, B6, B3, B12, A, E, and K. There are Carbohydrates,
Sugars, Dietary fiber and protein as well.
Possible side effects of Bitter melon

As a widely eaten food in Asia, bitter melon is regard as safe. Other very-rare risk may include
impaired fertility, liver inflammation, and spontaneous abortion.
Bitter melon scientific evidence in diabetes control

A clinical study titled Antidiabetic and adaptogenic properties of Momordica charantia extract by
Srivastava Y, Venkatakrishna-Bhatt H, Verma Y, Venkaiah K, published in Phytother Res 7:285289,
1993.
Another clinical study titled Improvement in glucose tolerance due to Momordica charantia (karela) by
Leatherdale BA, Panesar RK, Singh G, Atkins TW, Bailey CJ, Bignell AH published in Br Med J
282:18231824, 1981.
This two-controlled short-term metabolic trial in patients with type 2 diabetes has reported acute effects
on blood glucose with Momordica charantia fruit juice, as well as subcutaneous vegetable insulin
extracts.
Cinnamon for Diabetes control

Cinnamon for diabetes can control glucose level by nourishing digestive system and effectively support
glucose metabolism. Cinnamon is best suitable for obesity-related diabetes andhyperlipedemia.
What is Cinnamon?
Cinnamon (Cinnamomun zeylanicum) is a spice obtained from the inner bark of the tree of genus
Cinnamomum, which is in use for both sweet and savory foods. Cinnamon trees are native to SouthEast Asia.
Traditionally used for blood sugar & cholesterol control and relieve digestive
problems or improve appetite. Other names of cinnamon are Cassia,
Cassia Cinnamon, Chinese Cinnamon, Rou Gui (Mandarin).
Cinnamon lower blood-sugar level

Cinnamon contains biologically active substances that have demonstrated insulin-mimetic
properties. Cinnamon improves insulin mediated glucose metabolism, enhances insulin signaling in
skeletal muscle and helps glucose to glycogen conversion. Thus, cinnamon is considering as an antidiabetic herb.
Cinnamon lower heart diseases and strokes risks

Cinnamon lowers blood sugar, cholesterol, and blood pressure levels. Cinnamon lowers LDL
cholesterol responsible for the plaque formation. Additionally, cinnamon has antioxidant property, which
helps prevent the LDL cholesterol oxidation, thus prevent inflammation of arteries and further plaque
formation.
Medicinal uses of cinnamon

Cinnamon is now the subject of numerous studies for its ability to support proper glucose metabolism.
Its natural compounds help maintain both healthy blood sugar and cholesterol levels. It remains a
warming circulatory tonic, as well as a digestive aid to soothe upset stomach, gas, bloating and
occasional indigestion.
Studies show cinnamon is useful:
It is suitable for obesity-related diabetes as well as to control hyperlipidemia.
To alleviate indigestion, stomach cramps, intestinal spasms, nausea, flatulence, and it improves
the appetite, and treat diarrhea.
Stop yeast infections, anti-clotting effect on the blood, boosts cognitive function & memory,
prevents nervous tension, helps to treat headache, asthma, excessive menstruation, uterus disorders
and gonorrhea.
It is a great source of manganese, fiber, iron, and calcium.
Reduce leukemia and lymphoma cancer cells.
Cinnamon dosage
The daily dose of cinnamon you need for diabetes control may vary depending on your age, weight
and health status. Only your doctor can recommend the appropriate dosage for you, consult your
doctor before you begin taking cinnamon supplements to control blood-sugar level.
The dosage of ground cinnamon bark is 2 to 6 g daily and cinnamon oil dosage is 0.05 to 0.2 g daily.
Your doctor may adjust your dosage of cinnamon to meet your blood-sugar regulation needs.
Cinnamon availability
Over-the-counter cinnamon supplements are available in various forms; they are powder, oil and
tincture. Cinnamon volatile oil is much more concentrated compared to other forms, and it may cause
temporary oral or skin irritation or burning.
How do you take cinnamon?

The sweet tasty spice cinnamon can be added about 1/4 to 1/2 teaspoon to foods and beverages such
as coffee, tea and breakfast cereal. It increases the tastes of apple and pumpkin dishes, including
puddings and applesauce.
Break cinnamon stick into pieces, boil it with water, cover, and steep for 10 minutes. Dilute it if needed
with hot water and enhance the taste with natural sweetener (Stevia). Otherwise, addcinnamon stick in
any tea while it steeps to add flavor and health benefits.
Bioactive constituents of cinnamon

Terpenoids found in the volatile oil of cinnamon are eugenol and cinnamaldehyde, which are having
various medicinal effects. Cinnamaldehyde possesses potential anti-fungal, anti-bacterial, anti-allergic,
anti-hyperglycemic, and anti-hyperlipidemic properties.
Possible side effects of cinnamon

Widely used food spice, grounded cinnamon bark has considered safe. However, cinnamon's essential
oil is much more concentrated than the powdered cinnamon. High doses of cinnamon oil might
depress the central nervous system. It is advisable that pregnant women should avoid
takingcinnamon oil or excess doses of the bark.
Diabetics may experience low blood sugar (hypoglycemia), so you should be vigilant on your bloodglucose level. It may harm your liver, if you already have a liver problem and taking large quantities.
Cinnamon scientific evidence in diabetes control

A clinical study titled Cinnamon Improves Glucose and Lipids of People With Type 2 diabetes by
Alam Khan, MS, PHD, Mahpara Safdar, MS, Mohammad Muzaffar Ali Khan, MS, PHD, Khan Nawaz
Khattak, MS and Richard A. Anderson, PHD is published in Diabetes Care December 2003 vol. 26 no.
12 3215-3218. The study result shows after 40 days, all three levels of cinnamonreduced the mean
fasting serum glucose (1829%), triglyceride (2330%), LDL cholesterol (727%), and total cholesterol
(1226%) levels. Changes in HDL cholesterol were not significant.
A clinical study titled Effects of a water-soluble cinnamon extract on body composition and features of
the metabolic syndrome in pre-diabetic men and women by Ziegenfuss TN, Hofheins JE, Mendel RW,
Landis J, Anderson RA at Ohio Research Group, Wadsworth Medical Center, Wadsworth, OH
published in J Int Soc Sports Nutr. 2006 Dec 28; 3:45-53. This study result show, the efficacy
of cinnamon extract supplementation on reducing fasting-blood-glucose and systolic-blood-pressure,
and improving body composition with the metabolic syndrome and suggest that this spice can reduce
risk factors associated with diabetes and cardiovascular diseases.
Ginseng for Diabetes Control

Ginseng a magical herb trusted for over 5000 years for its ability to promote vigor, nourish nervous
system, enhances hormonal secretion, lower blood sugar & cholesterol, and increases immunity.
What is Ginseng?
Ginseng is a slow growing perennial plant with fleshy roots of the genus Panax family
Araliaceae.Ginseng is suitable for cooler climates, found in the Northern Hemisphere, in North America
and in eastern Asia (Korea, north China, and eastern Siberia).
Ginseng is one of the most highly regarded medicinal plants
gained the reputation of being able to promote health, general
body vigor and prolong life. Ginseng can also be useful to
treat diabetes and cholesterol.
Ginseng lower sugar level

The hypoglycemic activity of ginseng may be due to the
enhancement of aerobic glycolysis through stimulation of
beta-adrenoceptor and increase of various rate-limiting
enzyme activities related to tri-carboxylic acid cycle. Initial
studies have shown that ginseng increases insulin production
and reduces cell death in pancreatic beta cells. In addition, ginseng can decrease blood-glucose in
type II diabetes patients.
Ginseng lower heart diseases and strokes risks

Ginseng decreases endothelial cell (line the inside of blood vessels) dysfunction; it means disturbance
to these cells lead to a heart attack or stroke. Thus, ginseng can provide protection against heart
attack or stroke. Ginseng possesses blood-thinning property. Therefore, should use blood-thinning
medication under the supervision of your doctor.
Ginseng is considering raising blood pressure in the beginning days of treatment, thus you need to be
extra careful when start taking this herb at least for first few days.
Medicinal uses of Ginseng

The ginseng root has many benefits as listed below.
Lowers blood sugar and cholesterol, thus helps in diabetes and high cholesterol treatment.
Enhance stamina, vitalizes, strengthen, and rejuvenate the entire body. It promotes mental,
physical well-being and enhances immunity against diseases.
Its carminative property prevents or relieves flatulence (gas in the gastrointestinal tract); in
infants, it may help in the treatment of colic.
Its expectorant property promotes or facilitates the secretion or expulsion of phlegm, mucus, or
other matter from the respiratory tract. Its demulcent property soothes or softens especially to relieve
pain in inflamed or irritated mucous membranes.
It stimulates as well as relaxes the nervous system. It promotes the secretion of hormones.
It is in use for the treatment of debility by old age or illness, appetite loss, insomnia, stress, and
shock.
Ginseng dosage
General recommended daily dosage of ginseng is 1 g to 2 g of raw herb, or 200 mg daily of an extract.
Do not suggest ginseng for pregnant women. The length of treatment for ginseng is around three
weeks. Excess dosage can cause headaches, restlessness and raised blood pressure, especially
when taken with caffeine, alcohol, turnips, and spicy foods.
Ginseng availability
Ginseng is available as liquid extracts, solid extracts, powders, capsules, and tablets, and as dried or
cut root for tea. The quality of many ginseng supplements can vary widely, so purchase it from
reputable manufacturers.
How do you take Ginseng?

Boil ginseng root powder with water, steep it for 5 to 10 minutes and separate the extract. If you require
sweetened with stevia, flavor with coriander and have a nice medicated energetic tea. In addition, you
can store it in fridge and have cold tea flavored with natural vanilla instead of coriander.
Bioactive constituents of Ginseng

The dried roots and rhizomes of ginseng contain many important constituents,
includes ginsengsaponins, ginseng oils, phytosterol, carbohydrates/sugars, nitrogenous substances,
amino acids & peptides, organic acids, vitamins & minerals, and certain enzymes. Among
these, ginsengsaponins are the most active constituents.
Possible side effects of Ginseng

Ginseng appears to be nontoxic, both in the short and long-term, according to the results of studies in
animals. There are rare reports of cases of breast tenderness, postmenopausal vaginal bleeding, and
menstrual abnormalities associated with ginseng use. Chineses tradition suggests pregnant or nursing
mothers should not use ginseng. Animal study shows that ginseng use by a pregnant mother may
cause birth defects.
Ginseng scientific evidence in diabetes treatment

A small 2008 study from Nutrition, Metabolism, and Cardiovascular Diseases showed that
Panaxginseng might aid in diabetes management. The study involved 19 people with well-controlled
type 2 diabetes for 12 weeks, members who took Panax ginseng supplements for the same time
experienced greater improvements in blood sugar control.
A clinical study titled Ginseng therapy in non-insulin-dependent diabetic patients by E A Sotaniemi, E
Haapakoski and A Rautio at Department of Internal Medicine, University of Oulu, Finland. This study
shows, Ginseng therapy elevated mood, improve psychophysical performance, reduced fasting-bloodglucose and body weight. The 200-mg dose of ginsengimproved glycated hemoglobin, serum, and
physical activity. Ginseng may be a useful therapeutic adjunct in the management of type 2 diabetes.
Diabetes Reflexology Foot Massage

Reflexology massage is simple to perform without any known side effects, have many benefits not only
in controlling diabetes, also beneficial for overall body system. For diabetic patents, reflexology is very
much helpful in lowering their quantity of medicine taken to control blood-glucose level.
Video on Reflexology
High glucose causes & how the reflexology helps to relieve it?
Causes of high blood-glucose may be due to defect in carbohydrate or glucose metabolism. This
defect may be due to stomach, intestine, liver, pancreas, or muscle cells. These problems can be
resolved by stimulating the respective reflex points of the organs. See the picture below for reflex
points of the different organs.
Reflexology diabetes foot massage

Diabetes may be caused due to some minor defects is the organs such as Pancreas, Liver, Small
intestine, Muscular system and or other glandular systems.
It is always preferred and advisable to start the reflexology treatment with massaging endocrine glands
(all the seven glands); which controls the entire metabolic system. Followed by; massaging the organs
that may cause blood-sugar/glucose rise and organ that may be affecting by the high glucose level in
blood. Massaging the reflex of,
The Endocrine system
Organs involved in the cause of High blood sugar.
The organs that are at risk due to high sugar/glucose level in blood.
Reflexology massage Endocrine system

1.
Pituitary gland
2.
Pineal gland
3.
Thyroid & parathyroid gland
4.
Thymus gland
5.
Adrenal gland
6.
Pancreas gland
7.
Testes (for male) or Ovaries (for women)

Massaging the reflex points of the endocrine glands helps to normalize the sugar/glucose level in
blood. Concentrate much on Pancreas, because this is responsible for insulin secretion.
Reflexology to organs responsible for carbohydrate metabolism

Carbohydrate is the major food constituent in the daily food intake. If the digestion and absorption of
the carbohydrate are properly carried-out, then blood-sugar/glucose level is maintained in a normal
level. The organs that are responsible for carbohydrate digestion, and absorptions are:
Stomach
Small intestine - absorbs glucose after digestion
Liver - Glycogen & Fat storage
Pancreas
Muscle cells - defects will cause insulin resistance

Massaging the reflex points of stomach, small intestine, liver, pancreas, and muscle cells can help to
normalize the carbohydrate metabolism and thus blood-sugar/glucose level is maintained at the normal
level. Provide special attention, if there is any pain, numbness in these reflex points. Because a
different sensation at this area means there may be some defect in these organs. If that particular point
shows any positive change after massaging, then increase the frequency of massage to that location. If
happen otherwise, discard massaging those reflex points.
Reflexology to avoid diabetes complications

Long term of high level of blood-sugar/glucose can cause nerve damage, which can lead to.
Nerves damage
Heart problems
Kidney problems
Eye problems
Sex & urological problems

Massaging the reflex points of these organs can be helpful to avoid any complication due to long term
of diabetes. Thus, Diabetes Reflexology Massage not only controlling the blood-sugar/glucose level,
but also protects organs that may be affecting by long term of diabetes.
Diabetes Complications
Some of the common diabetes complications are heart attack, stroke, blindness, kidney disease, loss
of a toe (or foot), and erectile dysfunction. However, you can be avoiding these complications by strict
diabetes care.
How common are the diabetes complications?

The prevalence of the diabetes complications among diabetes patients are more common; diabetic
neuropathy 60%, CHD 32.3%, Cataract 20%, Retinopathy 15.4%, Peripheral vascular disease 11.5%,
and Cerebrovascular accidents 6.9%.
Diabetes complications
Diabetes complications begin because of blood vessel and nerve damages, causes due to high-level of
glucose in blood (uncontrolled diabetes), prolonged diabetes, high-cholesterol level, and high-pressure.
Nerve damages of the respective organs are the root cause of diabetes complications.
Uncontrolled diabetes can harm the nerves in your

body causing diabetic neuropathy.
Heart disease, stroke, heart attacks are all caused by

blockage of blood vessels causing lack of oxygen in
extreme case breakage of blood vessels may
happen.
Diabetic retinopathy caused due to blood vessel

damage in retina causing lack of blood circulation
thus lack of oxygen to nourish retina and in extreme
cause leakage of blood in the retina.
Diabetic Gastroparesis is a disorder of the stomach

that takes too long to empty its contents, mostly due
to vagus nerve damage.
Diabetes kidney diseases are causes due to a small

blood vessel of kidney is damage due to long run of
high blood-glucose.
Erectile dysfunction or impotence is due to over-all nerve damage, and may be nerves in penis.
Urinary incontinence, over active bladder, bladder problems are all cause by nerve damage due
to prolonged high blood-glucose.
Urinary tract infection is also due to nerve damage, but it is not directly relating with a nerve
cause. Due to Diabetic Gastroparesis, there is a delay in the food emptying, which in-turn starts
bacterial growth, and causes urinary tract infection. Furthermore, due to long term of diabetes, immune
system losses it capacity thereby it is not able to fight the infection.
Depression is more in people with diabetes compared to people without diabetes. Diabetes
depression is associated with poorer diabetes care and blood-glucose level.
Then how to safe guard against diabetes complications, it is simple be strict in your diabetes care and
maintain your blood-sugar level and A1C near normal.

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Diabetes Information

Submitted by Thiruvelan on 18 Nov 2010 | Last updated 13 May 2016

What is Diabetes? - About Diabetes

Why is Diabetes and Diabetes Mellitus called so?

History of Diabetes & Diabetics

Diabetes Risk Factors

Gestational Diabetes in Pregnancy

Diabetes Alternative Medicines

Diabetes Risk Factors

Diabetes risk factors

Risk factors of Diabetes

Chronic traffic-related pollution exposure - may contribute to the development of diabetes; a

Sleep deprivation is associated with an adverse impact on glucose homeostasis. Insulin

Does diabetes affect only adults (over middle age)?

What are the causes of diabetes?

Type 2 diabetes causes

Type 1 diabetes causes

Gestational diabetes causes

Does eating too much sugar develop diabetes?

Diabetes pancreas, liver & muscle cells

Functions of Insulin hormone

Insulin as a commenting signal

Diabetes and liver

Diabetes Muscle cells

Understanding diabetes organs defect that causes Type 2 diabetes

Diabetes pancreas damage and Type 1 diabetes

pancreatic disease affects pancreas, leads to diabetes type 1.

Type 1 Diabetes Risk factors

Type-1 diabetes risk factors

Drinking of nitrates containing water may increase the risk factor.

Is type 1 diabetes a hereditary condition?

Does a child get diabetes type 1, without any family history?

Type 2 Diabetes Risk Factors

Risk factors of type 2 diabetes

Uncontrollable type-2 diabetes risk factors

Age - Your age is more than 45 years.

Pre-diabetes - previously has diagnosed as pre-diabetes or impaired glucose tolerance.

Controllable type-2 diabetes risk factors

Sedentary life style - is with no or low physical activity.

Unhealthy foods - when you regularly eating improper unhealthy foods.

High blood pressure - blood pressure is at or above 140/90 mmHg.

Is type 2 diabetes a hereditary condition?

Does overweight or obese eventually develop type 2 diabetes?

Sleep deprivation develop or worsen Insulin Resistance

Psychological distress can increase your risk for type 2 diabetes.

What is diabetes test?

Commonly used diabetes testing

What is fasting blood sugar test?

Fasting Plasma Glucose Test procedure

Diabetes Blood Glucose Level Signal

Diabetes: Blood glucose level more than126

Pre-diabetes: 100 to 126 mg/dl or 5.56 to 7

Non-diabetic: Glucose level of 70 - 99

Hypoglycemia blood glucose levels

Oral glucose tolerance test

Importance of the OGTT

Oral glucose-tolerance test procedure

What is the Oral glucose tolerance?

Normal, pre-diabetes, diabetes OGTT blood glucose level

Oral Glucose Tolerance Level Signal

Diabetes: Blood glucose level

Pre-diabetes: Glucose level of 140 199 mg/dl (7.77 - 11 mmol/l) is

Non-diabetic: Blood glucose level

Casual plasma glucose test