Causes of Diabetes - What are the Risks Involved

February 20th, 2009
Dr John asked:


The Causes of diabetes are still not fully understood. Neither are medical scientists able to explain why some people develop diabetes and others don’t. Certain factors have, however, been clearly identified which contribute to the development of diabetes.

Is Diabetes Inherited?

Heredity is a major factor. That diabetes can be inherited has been known for centuries. However, the pattern of inheritance is not fully understood. Statistic indicates that those with a family history of the disease have a higher risk of developing diabetes than those without such a background. The risk factor is 25 to 33 percent more.

Children are most likely to develop diabetes if either or both parents are diabetes, or if the expectant mother became diabetic, or if the mother was a confirmed diabetic prior to conception. This may not always be true. It is possible for parents who were, or are diabetic and the other remains free from the disease.

It is, however, essential that the blood sugar level of an expectant mother who is diabetic be maintained within the normal range, so that diabetes is not passed on to her child. It the blood sugar level is kept under control, the infant may not have nay symptoms of inherited diabetes, but a risk factor cannot be ruled out.

One reason why diabetes, especially type-2 diabetes runs in the family is because of the diabetes gene. But even it is caused by genetic factors beyond your control; there is no reason to suffer from it. Diabetes mellitus cannot be cured in full sense of the term, but it can be effectively controlled so that you would not know the difference.

Intensive genetic research is currently underway to identify genes associated with both type-1 and type-2 diabetes. In a study sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases of USA the relatives at risk of type-1 diabetes are being treated with low doses of either insulin or an oral medication to determine if drugs may prevent the disease.

Surveys show that in India diabetes is more prevalent among males than females. In this population, family history of diabetes mellitus was present in 5.5 to 11.6 per cent. Amongst diabetics, 18.3 per cent urban and 6.4 percent of rural population had a direct relative with diabetes. Therefore, genetic predisposition in India is comparable to that observed in other parts of the world.

Diet: A Self inflicted Causes

Diabetes has been described by most medical scientists as a prosperity’ disease, primarily caused by systematic overeating. Not only is eating too much sugar and refined carbohydrates harmful, but proteins and fats, which are transformed into sugar, may also result in diabetes if taken in excess.

Too much food taxes the pancreas and ultimately its normal activity of producing insulin gets paralyzed. It is interesting to note that diabetes is almost unknown in countries where people are poor and cannot afford to overeat.

The incidence of diabetes is directly linked with the consumption of processed foods rich in refined carbohydrates, like biscuits, bread, cakes chocolates, pudding and ice creams. In Britain, during the war when only whole wheat bread was available the incidence of diabetes dropped by 55 percent.

Parents should take great care to develop correct dietary habits in their children. Children should be prevented from becoming addicts to harmful foods like ice cream, cakes, jam, jelly, peppermint, chocolates and other sweets. The amount of food given to children should be such as would allow growth but not obesity. Children should be convinced about the importance of exercise and games and sports should be encouraged. Ideal body weight and a proportionate body is an almost certain guarantee against diabetes.

The Obesity Trigger

Obesity is one of the main causes of diabetes. Studies show that 60 to 85 % of diabetics tend to be overweight. In the United States of America, about 80 percent of type –2 non-insulin dependent diabetics are reported to be overweight. During the Second World War, when there was a decrease in the average weight of the people, the incidence of diabetes came down dramatically. The greater the obesity, the greater is the mortality rate due to complications of diabetes.

Excess fat prevents insulin from working properly. The more fatty tissue in the body, the more resistant the muscle and tissue cells become to body insulin. Insulin allows the sugar in the blood to enter the cells by acting on the receptor sites on the surface of the cells. In obesity, where a person is overweight by 20 percent of the ideal weight or has high uric acid, or some syndromes, receptors are sparse and functionally idle. This is observed in patients developing diabetes around the age of 40 years, and having type-2 non-insulin dependent diabetes. It is estimated that the incidence of diabetes is four times higher in persons of moderate’s obesity and 3 times higher in persons of severe obesity. It has been rightly said; Heredity is like a cannon and obesity pulls and trigger.

Older people often tend to gain weight, and the same time, many of them develop and mild form of diabetes because who are over weight can often improve their blood sugar simply by losing weight. In some cases, it is all that is required to bring blood sugar back into the normal range. Even small weight loss can have beneficial effects, reducing blood sugar levels, or allowing medicines to work better. However, sudden gain in weight may cause diabetes to return. It is therefore important for older people to keep their weight down to normal. Among those detected to be diabetic, almost one third are overweight.

Virus Infections

Pancreatic infections with Coxsackie’s B virus can result in beta cell damage, development of autoantibodies and, consequently, type-1 insulin dependent diabetes mellitus. Some of these can be diagnosed by a viral antibody test and islet cell antibody test. Screening for antibodies can indicate potentially juvenile diabetes in a family on the basis of auto-immunity.

The Lifestyle Risk

A sedentary lifestyle, resulting from lack of physical work and exercise, plays an improvement role in the development of diabetes. The less active a person, the greater the risk of developing diabetes. Modern conveniences have made work easier. Physical activity and exercise helps control weight, uses up a lot of glucose (sugar) present in the blood as energy and makes cells more sensitive to insulin. Consequently, the workload on the pancreas is reduced.

Exercise also adds to the muscles mass. Normally, between 70 percent to 90 percent of the blood sugar is absorbed into the muscles. A reduction in muscle mass-either due to age of physical inactivity—reduces the storage space for blood sugar, and it remains in the blood stream.

Smoking: An Important Risk Factor

Smoking is another important risk factor. Among men who smoke, the risk of developing diabetes is doubled. In women who smoke 25 or more cigarettes a day, the risk of developing diabetes is increased by 40 percent. Smoking also reduces retinal blood flow and increases the risk of developing retinopathy. It also decreases insulin absorption and limits joints mobility. Smoking, in combination with diabetes, greatly enhances the likelihood of premature mortality. It also depends upon the number of cigarettes a day a person smokes and the number of years he has been smoking.

Age

A risk of type-2 diabetes increases, as one grows older, especially above the age of 45 years. Part of the reason is that is people grow older, they tend to become less physically active, lose muscle mass and gain weight. With life styles becoming more sedentary, there has been an increase of diabetes among people in there 30s and 40s.

Stress and Tension

Stress can be emotional or physical, such as a surgery or a serious infection, an accident or an emotional shock. Another very urban trait, the high stress lifestyle, not just amongst the young unwardly mobile, but increasingly in all walks of life, is a relatively new phenomenon in India. Since there is a known connection between stress and diabetes mellitus, those who are under stress and/or lead an irregular lifestyle, need to take adequate precautions and make necessary lifestyle adjustments.

Pancreatic insufficiency caused by stress, can lead to diabetes. Grief, worry and anxiety resulting from examinations, death of a close relative, loss of a joy, business failure and strained marital relationship, all a deep influence on the metabolism and may cause sugar to appear in the urine.

Organic Disorders

Diabetes may be associated with some grave organic disorders like cancer, tuberculosis and cerebral diseases. Diabetes may also be caused by a variety of other factors. These include certain metabolic and genetic disorders, inadequate secretion of insulin by the pancreas, malfunctioning of other endocrine glands like thyroid, pituitary and adrenal, excessive consumption of alcohol and the use of the certain drugs.

Race

Although the reasons are unclear, people of certain races are more likely to develop diabetes than others.



The DelRe Protocols

Age and Diabetes Risk

February 17th, 2009
Juliet Cohen asked:


Diabetes is a disease in which the body does not produce or properly use insulin. Diabetes means a disease where people have too much sugar in their blood. The three main types of diabetes are type 1 diabetes , type 2 diabetes and gestational diabetes. Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body’s system for fighting infection (the immune system) turns against a part of the body. Symptoms of type 1 diabetes usually develop over a short period, although beta cell destruction can begin years earlier. Symptoms include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue. The most common form of diabetes is type 2 diabetes. About 90 to 95 percent of people with diabetes have type 2. This form of diabetes is associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and ethnicity. About 80 percent of people with type 2 diabetes are overweight. The symptoms of type 2 diabetes develop gradually. Symptoms may include fatigue or nausea, frequent urination, unusual thirst, weight loss, blurred vision, frequent infections, and slow healing of wounds or sores.

Diabetes is not contagious. People cannot “catch” it from each other. About 3 to 8 percent of pregnant women in the United States develop gestational diabetes. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles. There are 20.8 million children in the United States, or 7% of the population, who have diabetes. While an estimated 14.6 million have been diagnosed with diabetes, unfortunately, 6.2 million people (or nearly one-third) are unaware that they have the disease. Diabetes mellitus is a disease where people have too much glucose (a kind of sugar) in the blood. Glucose level in the blood is controlled by several hormones. Hormones are chemicals in your body that send messages from cells to other cells. Insulin is a hormone made by the pancreas. Diabetes is likely to be underreported as the underlying cause of death on death certificates. About 65 percent of deaths among those with diabetes are attributed to heart disease and stroke.

Obesity is the single most important risk factor for type 2 diabetes. Between 80% and 90% of people with diabetes are overweight–that means they weigh at least 20% more than the ideal body weight for their height and build. More than 40 percent of people with diabetes have abnormal levels of cholesterol and similar fatty substances that circulate in the blood. These abnormalities appear to be associated with an increased risk of cardiovascular disease among persons with diabetes. Nearly 40 percent of the women who have diabetes during their pregnancy go on to develop type 2 diabetes later, usually within five to ten years of giving birth. Diabetes prevalence in the United States is likely to increase for several reasons. First, a large segment of the population is aging. Education is important for both types of diabetes. Diabetics must learn about diet. Diabetics must also be careful about exercise. Exercise is important to stay healthy. High Cholesterol or other fats in the blood and Impaired glucose tolerance or impaired fasting glucose can precede the development of type 2 diabetes.

Diabetes Treatment Tips

1. Medicines, diet, and exercise to control blood sugar and prevent symptoms and complications.

2. Type 1 diabetes mellitus is treated with insulin, exercise, and a healthy diet.

3. Type 2 diabetes mellitus is first treated with weight reduction, a healthy diet and regular exercise.

4. Gestational diabetes is treated with insulin and changes in diet.

5. Alcohol use Try to have no more than 7 alcoholic drinks in a week and never more than 2-3 in an evening.

6. Smoking: If you have diabetes, and you smoke cigarettes or use any other form of tobacco, you are raising your risks markedly for nearly all of the complications of diabetes.

7. Diet: A healthy diet is key to controlling blood sugar levels and preventing diabetes complications.

8. Drink extra fluids that do not contain sugar before, during, and after exercise.



Weight Loss Cure

Diabetes - Symptoms, Test and Control

February 3rd, 2009
Jyoti asked:


What is Diabetes?

Diabetes is a defect in the body’s ability to convert glucose to energy. It is caused due to insufficient production of glucose by the pancreas. In diabetes patients, the production of glucose is impaired.

What are the symptoms of Diabetes?

Patients with Type-1 diabetes usually develop symptoms over a short period of time, and the condition is often diagnosed in an emergency setting.

Symptoms of type 1 diabetes:



Increased thirst

Fatigue

Nausea

Increased urination

Weight loss in spite of increased appetite

Vomiting



However, because Type-2 diabetes develops slowly, some people with high blood sugar experience no symptoms at all.

Symptoms of type 2 diabetes:



Increased thirst

Impotence in men

Increased appetite

Increased urination

Blurred vision

Fatigue

Slow-healing infections



How to diagnose diabetes?

The diagnosis of diabetes is made by a simple blood test measuring blood glucose level. Usually blood glucose level tests are repeated on a subsequent day to confirm the diagnosis. Your health care team may also request that you have a glucose tolerance test. If two hours after taking the glucose drink your glucose level is 200 or above, you will be diagnosed as having diabetes.

How can I control diabetes?



Gather all the information about diabetes, its symptoms and causes

Check your blood glucose level regularly

If find any symptom of diabetes, visit your health care team for diagnosis of diabetes

Ask your health care team about how to check blood glucose level at home

Stop smoking

Exercise daily

Follow a healthy meal plan

Check your vision at regular intervals, If found blurred visit your health care team

Check your feet regularly for checking the occurrence of diabetes

If you are diabetic, monitor you diabetes regularly

Follow instructions of health care team strictly

Avoid sweet ingredients, use sugar free food



Can diabetes be cured?

As yet, there is no treatment for either type of diabetes, although there are many ways of keeping diabetes in control. Studies have shown that good control of blood glucose (blood sugar) is the key to avoid diabetic complications later.

What are the treatment options to cure diabetes?

Diabetes is incurable. The only option is to prevent ourselves from diabetes or to keep diabetes under control.

Is diabetes a hereditary disease?

You are at higher risk of Type 2 diabetes if you have a parent, brother or sister with diabetes.

Complications of Diabetes

If you have diabetes, you are much more likely to have a risk of stroke, heart disease, or a heart attack. In fact, 2 out of 3 people with diabetes die from stroke or heart disease. There are three conditions that make people with diabetes vulnerable to foot problems. These are vascular disease and foot deformities. About 30 percent of patients with Type 1 diabetes and 10 to 40 percent of those with Type 2 diabetes eventually will suffer from kidney failure. Diabetes also may cause damage to nerves in your body.



Diabetes

To Compare the Role of Glibenclamide and Pioglitazone Drugs in Type 11 Non- Insulin Dependent Diabetes Mellitus Patients

January 7th, 2009
lalaghulamrasool bhurgri asked:




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

Authors:Raj kumar chohan,Mashori Ghulam Rasool,Bhurgri Ghulam Rasool,Shamim-u-Rehman,DahriGhulam mustafa,Anis-u-rehman.



Introduction:-



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

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

(Heller, 2003).



TYPES OF DIABETE MELLITUS

TYPE 1 DIABETES MELLITUS (IDDM):

Type I diabetes affect children of all ages, both sexes and all athenic groups. type 1 diabetes usually occurs by mechanisms. It is most common metabolic condition in children and adolescents (Bui, 2004). Type1diabetes is characterized by immune mediated destruction of pancreatic b -cells resulting in insulin deficiency. This results in a common biochemical end point of hyperglycaemia and risk of ketoacidosis, but the clinical presentaion varies, widely depending on the rate and degree of b -cells failure (Lambert & Bingley. 2005).

Type II diabetes mellitus (NIDDM):



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



GESTATIONAL DIABETUS MELLITUS

:

Women who develop glucose intolerance in late pregnancy and womens who with previously undiagnosed diabetes.





SECONDARY DIABETUS MELLITUS:



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

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

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

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

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

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

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



PREVALACES& IINCIDENCE

:


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

Rank Country

2000 Individuals country with diabetes (milloins)

Country

2030 Individuals with diabtes (Million)

India

31.7

India

79.47

China

20.8

China

42.3

USA

17.7

USA

30.3

Indonesia

8.4

Indonesia

21.3

Japan

6.8

Pakistan

13.9

Pakistan

5.2

Brazil

11.3

Russian federation

4.6

Bangladesh

11.1

Brazil

4.6

Japan

8.9

Italy

4.3

Philippines

7.8

Bangladesh

3.2

Egypt

6.7

(Wareham& FOROUHI 2OO6)



DRUG TREATMENT OF DIABETIES MELLITUS

:


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

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

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

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



RESEARCH DESIGN AND MATERIAL AND METHODS:



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

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



INCLUSION CRITERIA

:




Newly diagnose patients of non Insulin Dependent Diabtes Mellitus.

Diagnsed patients of diabetes also including having no any history medication.

Having either *** of age between 30 to 60 years.

Diagnosed patients who were Non Insulin Depedent Diabetes Mellitus who were treated with Pioglitazone.

Diagnosed patients who were Non Imsulin Depedent Mellitus, who were treated with drug Glibenclamide.





EXCLUSION CRIRERIA

:




Patients suffering from blood pressure.

Patients suffering from liver disease.

Patients suffering from cardiac disease.

Pregnancies and lactating women.

Patient suffering from renal disorders.

Patients having serious complications.





MATERIAL:





Lacets.

Lancet Hlder(Abbots easy touch TM2 lot 03 Asee).

Glucometer(Medisense) optilim one touch(Abbotts).

Blood glucose nest trpis (IVD for Invitro diagnostic use (Abbott Labortries,Medisense UK Ltd,Abigngdon,Ox14ITR,Masde in UK). Stored between minimum 30?, (4°-30° C) and Maximum 40°C (39°-86°F).

Weight Machine Model No 1101 Lot No.312. TANTIATA.





DRUGS



Tab:Daonil 5 mg (Aventis Pharma)

Drug category:Sulphonylurea.

Generic Name: Glibenclamide.

MFGLIC:No.000007 RegistrationNO.000220

MFG Date:0-06

EXP Date:7-10

Lot NO:B230

Tab:piozer (Hilton Pharm) PvtLTd.

Tab:Poizer 15mg

Drug category:Thaiazolinedione.

Generic Name:Pioglitazone Hydrochloride.

MFG LIC: O.000136 Registration No.03270

MFG Date:3-06

EXP Date:3-o9

Lot No:6287

Tab: Poizer (Hilton Pharma)pvt ltd.

PARAMETERS:

Fasting Blood Sugar (FBS).

Random Blood Sugar (RBS).

Weight.

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



RESULTS:





Table 1



Weight and Blood Sugar level observed on baseline day 0

In group1 and group11

 

Group 1

Group 11

 

Pioglitazone n=27

Glibenclamide n=33

Weight

63.37

+ 2.25

¯

62.7

+ 15.56

¯

Fasting Blood Sugar

172.7

+ 13.32

¯

188.42

+ 12.o5

¯

Random Blood Sugar

285.11

+ 15 .532

¯

284.18

+ 17.07

¯

All Values are expressed in Means± SEM.

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



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

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

blood sugar 285.11±15.32



Group:11

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


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

TABLE: 2

Peroidic Observation In All Parameters Group1

Goup1(Pioglitazon) n=27

 

P-value

 

Day-0

Day-45

Day-90

Day-0to45

Day-45-90

Weight

63.37

±2.25

63.63

±2.26

63.63

±2.23

>0.05

(NS)

>0.05

(NS)

Fasting blood sugar

172.7

±13.32

165.04

±8.98

153.37

±7.59

>0.05

(NS)

0.05

(NS)

Randomblood sugar

285.11

±15.32

279.78

±13.63

255.56

±12.65

>0.05

(NS)

>0.05

(NS)

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









TABLE NO:2



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

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

TABLE NO3

Peroidic Observation in All Parameters Group11

 

Group 11 (Glibenclamide)

N=33

P-value

 

Day-0

Day-45

Day-90

Day-0 to 45

Day-45 to 90

Weight

62.7

±1.56

65.64

±2.10

64.55

±1.92

>0.05(NS)

0.05(NS0

Fasting blood sugar

188.42

±12.05

168.45

±10.99

140.06

±5.68

>0.05(NS)

>0.05(S)

Random blood sugar

284.18

±17.03

220.12

±13.39

170.94

±5.80

<0.005 (MS)

0.002(MS0

(s) significant, (MS) moderate significant

All values are expressed in Mean±SEM.



Table No3:



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



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



DISCUSSION:



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

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

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

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

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



CONCLUSION:



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



REFERNCES:





Anderson J,Kendall,Perryman.S etal,”Diet and Diabettes” Diabetes 2006,16(3):17-19-

Bui H- Type 1 diabetes in childhood-Medicine 2006,3 ,1-3

Bernhard –Diabetes-type 11 diabetes mellitus Diabetes care 1995,19(100:12-17-

Clark CM-Oral therapyin type11 diabetes-pharmacological properties and clinical use of current use of currently available agents-Diabetes spectrum 1998,11(4):211-221.

Carren M.Types of Diabetes mellitus-Diabettes 2006 10 (3),07-

David Owerback NJ-Prevalence in diabetes population-Diabetes 1988,02(6):31-32

Dale MM,-Treatment of Diabetes mellitus –pharmacology 20035th edition:287-391.

Heller SR –Hypoglycemic in diabetes Ketoacidosis and hypoglycemic-Medicine 2006:34(03):102-110.

Jawad F Untraveling the mystry of Diabetes’Diabetes 2006;15(3):13-15.

Jacobes D-Insulin-Diabetes 1998;6(3);1160126.

Lambert and Bingliy-basic facts-medicine 2006,34(6):3-7.

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Scarlet Oral therapy in type 11 diabetes sulfonylureas 1984;16(10);3-9.

Schade DS et al A placebo controlled randomized study of glimepiride in patients of Diabetes mellitus- Diabetes 19998, 38(7);636-641.

Warchman and Forouhi-Epidimology of Diabetes- Diabetes basic facts- Medicine 2006 ;34(2);57-60

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December 18th, 2008
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Learn About Diabetes - Information & Facts

The Diabetes is one of the deadliest diseases in world, one in four people in America have this disease. The diabetes disease touches everybody, kids, young and old. It becomes important for everyone to learn what is Diabetes? The real reason is when body is unable to utilize or accumulate glucose. The Glucose is a form of Sugar. The level of glucose when goes high in bloodstream, it causes blood glucose to rise in individuals body. The Diabetes can be categorized into three stages. The three stages of diabetes are “Pre Diabetes”, “Type 1 Diabetes” and “Type 2 Diabetes”. The diabetes has become so common in people that it is common to find kids, teenagers, young adults diagnosed with Diabetes.

How does Glucose affects body?

It is a disorder in the body that affects the way body utilizes the food for energy. All food contains sugar, the digested food in body is broken into sugar known as Glucose. The glucose is used to produces energy. The individual glucose keeps circulating in blood and enters into body cells, once inside the cell the glucose is used as fuel to developed energy. The Insulin is a hormone, which body uses to push Glucose into body cells, if this process stops working then the blood sugar level rises in body.

 Categories of Diabetes

What is Pre-Diabetes? - This is first stage to being diagnosed as Diabetes, under “Pre-diabetes” category either there is shortage of insulin required for pushing Glucose into body cells or body has become resistant to insulin. The people who get diagnosed with “Pre-Diabetes” are venerable and need precautions and changes in life style to keep out of diabetes diseases. Another pointer is your blood sugar numbers, if your blood sugar readings are above normal and not enough to be classified as diabetes. The “Pre-Diabetes is also known as “Impaired Fasting Glucose” or “Impaired Glucose Tolerance”. The good news is that early sign gives you God sent opportunity to prevent your condition changing from pre-diabetes to type 2 diabetes. There is no medication required in “Pre-Diabetes” condition, with control over food, exercise and changes in lifestyle will help to keep out of diabetes danger.

What is Type 1 Diabetes? - Juvenile-Onset or Insulin-Dependent

In Type 1 Diabetes, a person’s body can’t produce any insulin. This type of diabetes usually occurs in early age but can happen any time is life period. The research is still going on diabetes type one, how it happens. As of now the reasons are that body has little or not enough insulin to use Glucose to make energy.

What is Type 2 Diabetes? - Formerly called adult-onset or non insulin-dependent

In Type 2 Diabetes a person’s body has become resistant to insulin. This type of diabetes happens after 35-40 years of age. This form of diabetes is 90 percent common in people. The reasons for “Type 2 Diabetes” are due to genetic reasons, being overweight, because of lack of exercise are some of the reasons.

 



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Diabetes