Carbohydrates, fats and other food groups are broken down into glucose and other components during digestion. Actually the glucose level in our blood varies, depending on the time of the day and the time since our last meal. If this balance is somehow disturbed, it can lead to a host of health issues, the most common being diabetes. There are certain simple lifestyle choices you can make that go a long way in helping your body maintain a normal blood glucose level. Diabetes blood sugar levels chart: what is a normal blood, Keep in mind that the blood glucose level before a meal for a non diabetic person and a person with prediabetes may be very similar. Hyperglycemia – wikipedia, the free encyclopedia, Hyperglycemia, or high blood sugar (also spelled hyperglycaemia or hyperglyc?mia, not to be confused with the opposite disorder, hypoglycemia) is a condition in. Diagnosis of diabetes and prediabetes – national diabetes, Diagnosis of diabetes and prediabetes. Hypertension (high blood pressure) health center – webmd, One of the most dangerous aspects of hypertension is that you may not know that you have it.
Glycohemoglobin (hba1c, a1c) – webmd, Glycohemoglobin is a blood test that measures the amount of sugar (glucose) bound to hemoglobin.
Glycohemoglobin (hba1c, a1c) – webmd, Increase their blood glucose levels have more glycohemoglobin (sugar bound to your a1c level in your target range can lower your normal?
Glycohemoglobin (hba1c, a1c): healthwise medical, People who have diabetes or other conditions that increase their blood glucose levels have more glycohemoglobin than normal. Glycated hemoglobin – wikipedia, the free encyclopedia, Normal levels of glucose produce a normal amount of glycated hemoglobin.
Fasting from dawn to dusk in the holy month of Ramadan for healthy adult Muslims has been ordained and physically sick Muslims are exempt from it. The purpose of this presentation is make some recommendations how one can fast safely in light of research on fasting. Check the sugar level 2 hours after Ifthaar to decide whether  any additional dose of medicines is needed. It is of a major concern that the increased consumption of sugar sweetened beverages has been linked to the development of the dangerous chronic illnesses such as diabetes type 2, hypertension and coronary heart disease. Unlike carbohydrates which have a high fiber content, the sugar sweetened beverages are nutrient poor and are often accompanied by intake of salty fast food as well. Normally during the cold winter months, the levels of HbA1C, the 3 month average of sugar, can be higher due to higher food quantity consumed to combat the cold, the frequent outdoor barbeques and probably excess liquor consumption with the co incident Christmas and New Year festivities.
The finger tips may be cold and so warm them by rubbing them together or wrapping them around a hot mug before pricking the finger for testing. It is difficult to work up a sweat while exercising during this time and one may feel cold after the exercise due to the evaporation. Exercise such as skipping rope, doing the Hula Hoop, aerobics, dancing, yoga, swimming in thermal controlled swimming pools or working out in an indoor gymnasium do wonders. Some blame the cold for exercising outdoors, but then they also blame the summer heat and humidity when that sets in.
Those with neuropathy ( where the nerves of the feet are not working properly) may have difficulty in gauging the heat of water used for bathing. Alcohol may cause a sense of warmth caused by dilatation of blood vessels, but the same may be lost after some time.
Use tissues, frequent washing of hands  using soap and water or sanitizers especially before shaking hands with others help to prevent transmission.
Glycemic index ( GI )of a food is the increase in blood glucose ( above fasting glucose) 2 hours after ingestion of a constant amount of food divided by a reference food( usually glucose). To make this easy to understand, if the GI of a particular food is 72, this means that 72% of the ingested food is converted to glucose within the body after 2 hours of consumption.
Bariatric surgery is known to be the most effective and long lasting treatment for morbid obesity and many related conditions, but now mounting evidence suggests it may be among the most effective treatments for metabolic diseases and conditions including type 2 diabetes, hypertension, high cholesterol, non-alcoholic fatty liver disease and obstructive sleep apnea. People are often reluctant to undergo surgery for fear of pain and the possible scars on their body. Please be informed that this is not useful among those with type 1 diabetes in curing diabetes. Bariatric surgeries help in almost full cessation of medicines for diabetes type 2, blood pressure and cholesterol after the surgery. Please be reminded that not all people who are overweight or obese will benefit from the surgery and so also some not so obese people will benefit from this surgery to help adjust their metabolic dysfunction thereby improving their quality of life. Normally all fat people will carry some risk for surgery as they will have many associated problems. In this, a PVC band is applied to the uppermost part of the stomach to restrict the size of the stomach. This operation utilizes a series of staplers to run across the stomach to restrict the size of the stomach, to convert it into a tubular structure. It is a more complex operation which bypasses the second half of the stomach by connecting the first half of stomach directly to the intestine.
The era of bariatric surgery questioned is over, it is now accepted with nearly over forty lakh patients having undergone this surgery from all over the world. These metabolic surgeries are being done to help control the weight and even get rid of diabetes, hypertension and increased lipids.
The surgery will help reduce the intake of medicines for blood pressure, diabetes and high blood lipids, which will make the patient feel much better than having to take so many medicines. The success of the surgery will depend largely up on the determination of the patient and the ongoing effort by the patient to adhere to the instructions given by the medical and surgical team. This is a condition in which excess body fat is collected and deposited on the body which has an adverse effect on life. The management will need the support of many specialties including even a psychologist opinion.
Ironically, people of today look for shortcuts to everything for example weight reduction surgery, face lift surgeries various plastic surgical techniques to help beat natural aging and also gadgets which can remotely control everything in life from opening the gates, switching on the lights, locking the house and what not. Life has indeed become so fast, we hardly have the time to stop and think of ourselves.  There are so many age defying cosmetics flooding the market these days. Many people with diabetes live to a ripe age by leading a healthy lifestyle and regular check. Glucose intolerance increases and slowing of the glucose absorption occurs with advancing age.
The medicines that were once doing well in controlling sugar levels may not work as effective as age advances.
Complication of the eye, nerve and kidney is directly linked to the level of sugar control.
However, heart diseases stroke, and blood vessel problems are directly linked to the control of blood pressure and cholesterol panel. Most of the time, older adults feel embarrassed to address their fears to their dependents.
HbA1C ( the three month average of sugar ) is not reliable in older adults as red cell span may be reduced with advancing age.
However, the levels of blood sugar and 3 month average are not to be as stringent as for that of a younger person. Increase in urine output may be due to urinary bladder irritation or dysfunction, medications for reducing blood pressure or due to prostate enlargement in males and not always due to high blood sugar levels.
Care of the feet may need heel protection, extra cushioning of wheel chair of bedding and prevention of dry skin is important. Driving at this age may be troublesome due to the reduced vision, reduced judgment and reflexes.
Make sure the older patient above 65 years must have taken a vaccination against pneumonia once and a vaccine against flu yearly. Many of the older adults may be having medicine such as diuretics ( which increase urination), hormones such for post menopause or steroids , and anti depressants which may worsen sugar control. Maintain good oral hygiene, check the feet, the skin folds for fungal rashes and boils which may go unnoticed by the patients. It will be useful if a small handbook can be used for mentioning their concerns as they may forget during the consultation. Maintaining a log book of the sugar readings and a diary of food intake will help to make inferences and plan management. The consultation can take more time than normal making the patient understand what is expected.
For those with eye problems or after laser treatment, it is advised to avoid intense exercises which may further increase the pressure. For those with neuropathy, it is advisable to perform exercises such as walking or cycling.
Walking together in groups or even performing aerobics, Yoga or Tai Chi also help in a better way as combining enjoyment with exercises make this pleasurable and motivated to continue with this. The management of older adults involves avoiding low sugar levels, avoiding weight gain or loss in excess and to maintain well being.
Metformin, gliclazide, Vildagliptin and Sitagliptin are safe to use among the oral medicines.
It is better to have simple treatment plans rather than complex regimes difficult to remember. The patient care given, the patient care giver, the patient care process and the patient care outcome are very important in the management of this elder population.
In todays world,one needs to relax in between to recharge ones mental and physical faculties. You might be needing a letter stating you are carrying the insulin shots, the glucometer kits, syringes and the pump in your carry bag. No matter where you go, wear a medical ID bracelet or necklace that shows you have diabetes.
Many people with diabetes, particularly those who use insulin, should have a medical ID with them at all times. In the event of a severe hypoglycemic episode, a car accident, or other emergency, the medical ID can provide critical information about the person’s health status, such as the fact that they have diabetes, whether or not they use insulin, whether they have any allergies, etc.
The second rule of travel for a person with diabetes: pack at least twice as much medication and blood-testing supplies as you think you need.
If you take insulin, wait until you see your food coming down the aisle before you take your shot.
When you travel with insulin, give some thought to where you’ll be storing your supplies. In general, you should stick with the exact brand and formulation of insulin that you have been prescribed by your doctor.

However, if you run out while you are on the road, and your regular brand is unavailable, you may substitute another brand’s equivalent formulation (for example, NovoLog for Humalog, Humulin R for Novolin R).
If you need to use these insulin preparations, you must buy new syringes to match the new insulin to avoid a mistake in your insulin dose.
If you take insulin shots and will be crossing time zones, talk to your doctor or diabetes educator before your trip.
To keep track of shots and meals through changing time zones, keep a watch on the home time zone until the morning after arrival.
Keep the home time in the watch for half a day after arriving so that you take the shots of insulin at the normal time as back home.
If one injects insulin while in flight, those traveling frequently suggest you be careful not to inject air into the insulin bottle.
No matter what kind of diabetes you have, it’s smart to watch what you eat and drink when traveling.
Those planning on visiting a beach, must remember to carry some cool fluids and keep the medicines cool. The effects of alcohol can be blunted while in water and so many may consume more to get the “kick”.
For those on an insulin pump, have the pump disconnected while taking off or landing as the pressure changes can sometimes deliver more insulin than needed. Sometimes despite the intense effort and hard work put in, the weight loss is not as expected . The progression from initial weight loss to a weight-loss plateau follows a typical pattern. Homeostasis: the use of negative feedback loops to maintain body temperature and chemical composition relatively constant despite wide variations in food intake and environmental stress. Why do alert and active animals store mainly fats, while sedentary plants store mainly carbohydrates? What are the principal "food" stores in the human body, and how are these used to protect the cerebral energy supply? Note: neurotransmitter release from synaptic vesicles can be very fast, where there is a premium on speed. This seems so obvious that it is superfluous to mention it, except for the numerous misleading claims about regulatory systems that are actually close to equilibrium.
Subcutaneous fat: the major fat depots are immediately beneath the skin, and packed around the viscera in the abdominal cavity. Great vessels above the heart: in healthy people about 70% of the blood normally resides within the veins, and red cells (erythrocytes) account for 40%-50% of the blood volume. Cardiac muscle: has the highest metabolic rate in the human body, and achieves the highest arteriovenous oxygen extractions. Colon: (large intestine) is mainly responsible for the resorption of water from the faeces.
Liver: is the major effector organ for the regulation of blood glucose and the processing of ingested food. It is more efficient to concentrate major metabolic activities in a small number of tissues. Use the mouse to point at the tissues illustrated on the right, to review details of their metabolic activities under different physiological conditions. Liver (L-type) and muscle (M-type) PFK subunits form mixed tetramers, but the genes are on separate chromosomes and their relative importance varies in different tissues.
In addition to the allosteric regulation by 5'AMP and citrate, PFK is strongly activated by fructose-2,6-bisphosphate which is produced by a second enzyme called phosphofructokinase-2 (PFK2). PFK2 is known as "tandem enzyme" because it also possesses fructose-2,6-bisphosphatase activity. The residual expression of FBPase in non-gluconeogenic tissues such as skeletal muscle suggests that some FBPase activity is important for normal PFK regulation. Insulin increases PFK gene expression in the longer term and PFK activity is depressed in type 1 diabetics.
If the amount is too high (Hyperglycemia), or even too low (Hypoglycemia), our body stops functioning properly.
So, the glucose level is lowest in the morning, when we wake up, and continues to be low till we have the first meal of the day. This also happens when we consume alcohol – there is a huge surge of glucose in the body which later falls drastically. Other problems could include memory loss, heart disease, infertility and even coma (in case of extreme hypoglycemia).
When you eat bread with simple carbohydrates, it dumps a huge load of glucose in your blood which the body finds difficult to regulate.
People who have one grapefruit every day (ideally split up between two meals) tend to lose weight and have a normal blood sugar level. But make sure that each of these meals are about half of what your regular meals are today.
However many Muslims with mild to moderate Diabetes, Hypertension and other medical conditions do want to fast. A glass of water melon juice, butter milk or tender coconut water will be a good option to break the fast.
If the sugar levels are either too low or too high, it is wise to seek medical advice immediately.
High levels of fructose corn syrup promote insulin resistance as well as fatty liver which can lead on to diabetes type 2. Adequate and generous application of moisturising creams, and sunscreen if going to winter sports such as skiing or snow surfing or those just trekking in the snow laden mountains are very important.
It is wise to have a Flu vaccine taken once a year rather than have to take multiple courses of antibiotics and medications to combat the infection.
Try to aim for low GI food combined with medium or high GI food rather than have more of high GI food. A thorough medical check up is normally done which will include blood tests, chest X ray, spirometry to check the lung function, a detailed heart check up , a check up by the anesthetist ( doctor who puts you to sleep during the surgery) and the dietitian.
The great advantage of this operation is that it does not require frequent adjustments like the gastric band does. Although this is a technically challenging operation compared to the sleeve gastrectomy, it is more useful in obese patients who are also diabetic, hypertensive, and have cholesterol and triglyceride problems. As far as the sleeve gastrectomy is concerned, the major side effects are in the immediate post operative period, when the surgeon worries about a possible leak.
With this background, it is best to use it judiciously to make patients lose weight, take control over their diabetes, hypertension, and live healthy long lives. But, it needs the person to be motivated for the rest of life to keep the beneficial effects of the procedure. However, some are lucky not to have diabetes until their middle years, but become diabetic after 65 years or more.
There is a decline in lean body mass, there may be an increase in body fat due to increasing insulin resistance.
This is one reason why doctors prescribe medicines for cholesterol even when the levels are normal. The floor in most of the places has a smooth surface and planting the feet is quite a hazard. The annual eye, heart check and foot check may have to be done more frequently if there are minor problems. It will be worthwhile to have the blood and urine samples drawn early and they can have a light snack while waiting for their turn. The letter should explain what you need to do for your diabetes, such as take diabetes pills or insulin shots. It will be cumbersome to hunt for a doctor and schedule an appointment in the middle of enjoyment.
Emergency medical personnel are trained to look for a medical ID when they are caring for someone who can’t speak for themselves. Pack all of them in your carry-on bag so that your medication is always with you (checked luggage can get lost). Insulin does not need to be refrigerated, but insulin stored in very hot or very cold temperatures may lose strength. Changes in formulation (for example, from rapid-acting Humalog to to short-acting Humulin R) require medical supervision. This means one ml of that insulin could have either 40 units or 80 units or 100 units or 500 units.
If you use U-100 syringes for U-40 or U-80 insulin, you will take much less insulin than your correct dose.
Remember that these can have a lot of calories and carbohydrates.Try to have plain coffee with low fat milk rather than the fancy Cuppa Mocha, Starbucks or Latte which can pack quite a lot of calories. Those who wish to have their blood sugar checked by pricking must remember to wash their hands well before doing so.
During the reconnection, remember that small air bubbles must be removed or else less insulin will be delivered. One also tends to notice that a plateau has been hit after a period of time when the weight remains stationary. They all compare the current situation (or 'output') "C" with some 'desired' reference value "R" in order to generate an error signal "E". It is mobilised by adrenalin and glucagon, signalling via calcium ions and 3'5' cyclic AMP, but the total reserve is only sufficient for a few hours use. Hydroxybutyrate is an "honorary" ketone, because it is chemically related to acetoacetate, but it is in fact a secondary alcohol. It is only possible to regulate reactions that would otherwise proceed spontaneously with a large negative ΔG. Fat cells arise from the fibroblast lineage, and consist of a central lipid droplet, surounded by a thin skin of active cytoplasm.
Red cells have neither nucleus nor mitochondria, and their metabolism is restricted to a sluggish anaerobic glycolysis producing lactate and ATP. It is capable of limited amino acid metabolism and during fasting it releases mainly alanine and glutamine for further processing by the liver and the small intestine. Soluble compounds are delivered to the liver via the portal vein, while dietary fats are handled by the lymphatic drainage and delivered as chylomicrons into the left subclavian vein. Resistant polysaccharides that escape digestion in the ileum are fermented by the colonic bacteria mainly to form butyrate, which can be absorbed and processed by the liver. It is also responsible for the synthesis of numerous blood proteins, cholesterol and VLDL, ketone bodies, ureogenesis and the formation of bile.

It is shown here in the relaxed position when the abdominal contents have compressed and emptied the lungs. It is protected from infection and environmental stress by the blood:brain barrier, which also prevents the access of large particles such as chylomicrons, VLDL and free fatty acids bound to serum albumin.
This arrangement has been selected in all species, including humans, because specialisation permits higher local substrate concentrations and more rapid catalysis. First of all, write down what you think will happen, then review your answers from the screen.
This was one of the first allosteric enzymes to be discovered and it is a major control point for the glycolytic pathway. The remainder of this discussion applies mainly to liver cells, where the gluconeogenic pathway may be in operation, via fructose-1,6-bisphosphatase (FBPase). Conversely, fructose-1,6-bisphosphatase is inhibited by fructose-2,6-bisphosphate, which consequently sets the switch in favour of glycolysis, and blocks gluconeogenesis. The ratio between the two antagonostic enzyme activities is controlled by adrenalin and glucagon via adenyl cyclase, 3'5' cyclic AMP and protein kinase A. Newsholme has suggested that a low level of futile cycling may be important for effective regulation at low glycolytic fluxes, and allows the pathway to be controlled with much smaller excursions in the concentrations of the allosteric effectors. Fructose bisphosphatase and PFK are reciprocally regulated, and corticosteroids antagonise the insulin effects, although the detailed molecular mechanisms have yet to be elucidated.
When the blood glucose level rises, the Pancreas produces Insulin which facilitates the breakdown of glucose bringing the level down. This ensures a steady flow of sugar into your blood and helps in maintaining a normal blood glucose level. Stress relief activities can go a long way in ensuring that the body becomes more capable of maintaining normal blood glucose level. Out here in the Middle East, Coca Cola and Mountain Dew are considered like the national drinks and no party is complete without a similar beverage. Lack of adequate physical activity and excess sleeping hours cuddled up under the warm blankets add more insult. Try to take hot beverages and easily digestible food such as soups, oats, porridge, steamed food and some fruits. Whatever be the diet chosen, the dietary management has to be combined with physical activity for maximum benefit. Normally the patient , after medical check up, will be admitted the night before the surgery and be discharged the day after the surgery after performing an X ray to check for leaks ( you will made to drink a medicine and then X ray will be taken). When the patient takes more than a little food, he feels full rapidly and if he eats more he feels like vomiting.
Also it is quite easy to perform in experienced hands, and the time taken for surgery is also not much.
However the major issue with gastric bypass is the need to take calcium, iron and vitamin B12 supplements as the nutrients are not absorbed sufficiently following this operation. This happens only in a tiny proportion of patients, that too those who are very fat, in the region of around 200 kg. These can cost quite a lot, but can be tried to contain those who are extremely obese and or dependent on just too many medicines for their metabolic control. The patients will have to be on a lifelong supplement of vitamins and some on iron as well. In a study around 7% of the older adults were diagnosed as having diabetes by noting high fasting sugar, whereas 6% were diagnosed based on their post meal sugar levels. If you plan to travel by car or bike or to be out in the elements, take steps to protect your insulin.
You must enjoy the vacation and so even if you wish to have all these, go for a stroll after the meals or these beverages. The extreme heat can sometimes damage the insulin in the infusion tubing which can work less effectively. This is the dangerous time when one may give up out of frustration and all the weight lost will be regained in no time. In part this is because when calories from food are reduced, the body gets needed energy by releasing its stores of glycogen, a type of carbohydrate found in the muscles and liver.
Adipocytes provide the major energy store in humans, but muscle proteins are also degraded when food intake is inadequate. In practice food withdrawal may not be complete, and reduced physical activity lowers the fasting energy requirements. If a process has almost reached equilibrium regulation will make no difference to the outcome.
In the fed state adipocytes respond strongly to circulating insulin with enhanced glucose uptake, associated with rapid glycolysis and the synthesis of triglyceride, thereby helping to stabilise the blood glucose concentration.
At least three muscle fibre types are recognised in clinical practice, whose proportions vary in different muscles. During fasting the ileum helps to convert glutamine released from skeletal muscle into blood glucose. There is a further advantage where most tissues are resting most of the time, because the available cardiac output, and hepatic support services (for example, lactate re-cycling) can be focussed towards "mission critical" activities which receive the lion's share of the available blood supply. When the level goes lower than normal, Glucagon, also secreted by the Pancreas, induces the liver to release stored glucose bringing the level back to normal. No: People who have a glass of wine every day have less chance of having abnormal blood sugar level. Not only will you be maintaining your blood sugar at a normal level, but you will be on your way to living a healthier life as well.
In some countries warm fireplaces keep the rooms warm, but beware the carbon monoxide accumulation. The common three operations done for obesity all over the world are Gastric Banding, Sleeve Gastrectomy , Mini bypass and Gastric Bypass. Even in such patients, in the last year or two special devices have been introduced to support the stapler line and prevent leak.
Using the bottle of insulin and syringe may be clumsy at times and can give erroneous dosing which can be quite a headache.
The letter should also list any allergies you have or any foods or medications to which you are sensitive. If your meal is delayed or an order is mixed up, you won’t be stuck with an empty stomach. One may also need to adjust the insulin dosages when going on trekking or climbing mountains when abroad. Usually those with weight issues refrain from socializing, swimming and partying for fear of being ridiculed in public. Most amino acids [except for leucine and lysine] are glycogenic: their carbon skeletons can be converted (at least partially) into glucose via Krebs cycle intemediates. Human beings have evolved to withstand a bad winter in a primitive hunter-gatherer society. Consider a large hydro-electric scheme: do we put the sluice gates in the in the concrete dam, or in the middle of the lake, or downstream on the way out to the sea?
The preferred substrates are free fatty acids and ketones, but heart muscle can also use triglycerides, lactate and even glucose if insulin is present.
Type 1 fibres are rich in mitochondria and myoglobin and have an aerobic fat- or ketone-based metabolism. This helps to ensure a stable energy supply and to control the conversion of carbohydrates into Krebs cycle intermediates and fats, as explained in detail below. PFK and FBPase catalyse a potential futile cycle, and appropriate regulatory mechanisms are required.
This enables adrenalin and glucagon to switch on gluconeogenesis in liver tissue and stablise the blood glucose concentration.
Walking can not only keep your blood sugar levels normal but also increase HDL cholesterol (good cholesterol). Remember that excess red meat consumption can lead to high cholesterol levels in some races. It is advisable to see which food increases the sugar levels by checking the sugar levels after each food ( this is painful, but this can help to decide which food suits a person). This is largely due to reduced stress levels, natural unprocessed food, more of physical activity and less dependent on automated gadgets or electronic gadgets. This leads them to become introverts and they take to eating for comfort which further worsens their predicament.
In biological systems the reference values are often encoded genetically, in the binding constants of proteins for their allosteric effectors. Fatty acids cannot be be converted into glucose, but triglyceride droplets contain 6% by weight glycerol, which the liver converts into sugar phosphates.
In the fasting state adipocytes respond to circulating glucagon and adrenalin (and to noradrenalin released from local nerves) with rapid lipolysis catalysed by hormone-sensitive lipase followed by the release of free fatty acids and glycerol into the blood.
They are fatigue resistant, have a slow twitch speed and are recruited first during physical activity. The temperature can get quite low at night and it is natural people may eat more to raise their body temperature. Receptors, ion-channels, second messengers and enzyme cascades provide the essential amplification for hormonal feedback loops. Type 2A fibres have a similar aerobic metabolism, but they are fast twitch, fatigue-resistant fibres which can use either fats or glucose. They will issue a vaccination card as well which you may have to produce at the port of entry. Most of these people are fed up of being told about diet and exercise and look for short cuts. They give the edge to athletic performance and are recruited in addition to the type 1 fibres when more effort is demanded.
Type 2B fibres are fast contracting anaerobic fibres that are only recruited when a maximum effort is required. Generally, fried food, less of salt, less of junk food, less of starch are the necessary steps.

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