How is type 2 diabetes controlled by exercise and diet quotes,homeopathy treatment for diabetes type 2,food for diabetes patients in urdu youtube - New On 2016

Diabetes is a common disease, yet every individual needs unique care.  The major goal in treating diabetes is to minimize any elevation of blood sugar without causing abnormally low levels of blood sugar.
Copyright © 2012 Rayur, All trademarks are the property of the respective trademark owners. With no way of producing insulin, a type 1 diabetic will starve to death without a constant external supply of insulin.
Diabetes can be managed but not without inhibiting a diabetic’s ability to live a normal life.
Lactic acidosis is a rare, but serious complication that can occur due to metformin accumulation. The onset of lactic acidosis is often subtle, accompanied only by nonspecific symptoms such as malaise, myalgias, respiratory distress, increasing somnolence, and nonspecific abdominal distress.
If acidosis is suspected, sitagliptin and metformin HCl extended-release tablets should be discontinued and the patient hospitalized immediately. Sitagliptin phosphate monohydrate is a white to off-white, crystalline, non-hygroscopic powder. Metformin hydrochloride (N,N-dimethylimidodicarbonimidic diamide hydrochloride) is not chemically or pharmacologically related to any other classes of oral antihyperglycemic agents.
Sitagliptin is a DPP-4 inhibitor, which is believed to exert its actions in patients with type 2 diabetes by slowing the inactivation of incretin hormones. Metformin is an antihyperglycemic agent which improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose.
Placental transfer of sitagliptin administered to pregnant rats was approximately 45% at 2 hours and 80% at 24 hours postdose. Of the total number of subjects (N=3884) in premarketing Phase II and III clinical studies of sitagliptin, 725 patients were 65 years and over, while 61 patients were 75 years and over. Controlled clinical studies of metformin did not include sufficient numbers of elderly patients to determine whether they respond differently from younger patients, although other reported clinical experience has not identified differences in responses between the elderly and young patients. Patients should be educated to promptly report these symptoms to their physician should they occur. There have been postmarketing reports of acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, in patients taking sitagliptin with or without metformin. The risk of metformin accumulation and lactic acidosis increases with the degree of impairment of renal function. There have been postmarketing reports of worsening renal function in patients taking sitagliptin with or without metformin, including acute renal failure, sometimes requiring dialysis.
In controlled clinical trials of metformin of 29 weeks duration, a decrease to subnormal levels of previously normal serum Vitamin B12 levels, without clinical manifestations, was observed in approximately 7% of patients. Certain individuals (those with inadequate Vitamin B12 or calcium intake or absorption) appear to be predisposed to developing subnormal Vitamin B12 levels.
When sitagliptin was used in combination with a sulfonylurea or with insulin, medications known to cause hypoglycemia, the incidence of hypoglycemia was increased over that of placebo used in combination with a sulfonylurea or with insulin [see Adverse Reactions]. Hypoglycemia does not occur in patients receiving metformin alone under usual circumstances of use, but could occur when caloric intake is deficient, when strenuous exercise is not compensated by caloric supplementation, or during concomitant use with other glucose-lowering agents (such as sulfonylureas and insulin) or ethanol.
Concomitant medication(s) that may affect renal function or result in significant hemodynamic change or may interfere with the disposition of metformin, such as cationic drugs that are eliminated by renal tubular secretion [see Drug Interactions], should be used with caution. Intravascular contrast studies with iodinated materials (for example, intravenous urogram, intravenous cholangiography, angiography, and computed tomography (CT) scans with intravascular contrast materials) can lead to acute alteration of renal function and have been associated with lactic acidosis in patients receiving metformin [see Contraindications]. When a patient stabilized on any diabetic regimen is exposed to stress such as fever, trauma, infection, or surgery, a temporary loss of glycemic control may occur. Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Table 1 summarizes the most common (≥5% of patients) adverse reactions reported (regardless of investigator assessment of causality) in a 24-week placebo-controlled factorial study in which sitagliptin and metformin immediate-release were co-administered to patients with type 2 diabetes inadequately controlled on diet and exercise. The incidences of pre-selected gastrointestinal adverse experiences in patients treated with sitagliptin and metformin immediate-release were similar to those reported for patients treated with metformin immediate-release alone.
With the combination of sitagliptin and metformin immediate-release, no clinically meaningful changes in vital signs or in electrocardiogram parameters (including the QTc interval) were observed. The most common adverse experience in sitagliptin monotherapy reported regardless of investigator assessment of causality in ?5% of patients and more commonly than in patients given placebo was nasopharyngitis.
In a 24-week clinical trial in which extended-release metformin or placebo was added to glyburide therapy, the most common (>5% and greater than placebo) adverse reactions in the combined treatment group were hypoglycemia (13.7% vs.
During controlled clinical trials in healthy subjects, single doses of up to 800 mg sitagliptin were administered. Overdose of metformin hydrochloride has occurred, including ingestion of amounts greater than 50 grams. The mean volume of distribution at steady state following a single 100-mg intravenous dose of sitagliptin to healthy subjects is approximately 198 liters. Approximately 79% of sitagliptin is excreted unchanged in the urine with metabolism being a minor pathway of elimination.
Following a [14C]sitagliptin oral dose, approximately 16% of the radioactivity was excreted as metabolites of sitagliptin.
Intravenous single-dose studies in normal subjects demonstrate that metformin is excreted unchanged in the urine and does not undergo hepatic metabolism (no metabolites have been identified in humans) or biliary excretion. Following administration of an oral [14C]sitagliptin dose to healthy subjects, approximately 100% of the administered radioactivity was eliminated in feces (13%) or urine (87%) within one week of dosing. Elimination of sitagliptin occurs primarily via renal excretion and involves active tubular secretion.
Renal clearance is approximately 3.5 times greater than creatinine clearance, which indicates that tubular secretion is the major route of metformin elimination. An approximately 2-fold increase in the plasma AUC of sitagliptin was observed in patients with moderate renal impairment, and an approximately 4-fold increase was observed in patients with severe renal impairment including patients with end-stage renal disease (ESRD) on hemodialysis, as compared to normal healthy control subjects.
In patients with decreased renal function (based on measured creatinine clearance), the plasma and blood half-life of metformin is prolonged and the renal clearance is decreased in proportion to the decrease in creatinine clearance. In patients with moderate hepatic impairment (Child-Pugh score 7 to 9), mean AUC and Cmax of sitagliptin increased approximately 21% and 13%, respectively, compared to healthy matched controls following administration of a single 100-mg dose of sitagliptin. There is no clinical experience in patients with severe hepatic impairment (Child-Pugh score >9). No pharmacokinetic studies of metformin have been conducted in patients with hepatic impairment. Gender had no clinically meaningful effect on the pharmacokinetics of sitagliptin based on a composite analysis of Phase I pharmacokinetic data and on a population pharmacokinetic analysis of Phase I and Phase II data. Metformin pharmacokinetic parameters did not differ significantly between normal subjects and patients with type 2 diabetes when analyzed according to gender. When the effects of age on renal function are taken into account, age alone did not have a clinically meaningful impact on the pharmacokinetics of sitagliptin based on a population pharmacokinetic analysis. Limited data from controlled pharmacokinetic studies of metformin in healthy elderly subjects suggest that total plasma clearance of metformin is decreased, the half life is prolonged, and Cmax is increased, compared to healthy young subjects. Race had no clinically meaningful effect on the pharmacokinetics of sitagliptin based on a composite analysis of available pharmacokinetic data, including subjects of white, Hispanic, black, Asian, and other racial groups. Body mass index had no clinically meaningful effect on the pharmacokinetics of sitagliptin based on a composite analysis of Phase I pharmacokinetic data and on a population pharmacokinetic analysis of Phase I and Phase II data. Diabetic-ShockAlarmingly low level of blood sugar leads to Diabetic Shock or Insulin shock. Diabetic-CareDiabetic Care involves- regular exercise, foot care, controlled diet, avoidance of alcohol and cigarette, and regular monitoring of blood glucose level.
HypoglycemiaHypoglycemia is the indication of decline in the blood sugar level below normal. Complications-of-diabetesComplications-of-diabetes include- Hypoglycemia, Hyperglycemia, Diabetic, Cardiomyopathy, Diabetic Nephropathy, Diabetic Neuropathy, Diabetic Retinopathy.
Diabetes MellitusAn imbalance in the blood glucose level may indicate low blood sugar or high blood sugar. Diabetes-and-DepressionDiabetes leads to Depression and sometimes even more complications. Causes-of-DiabetesVarious Causes of Diabetes can be-genetic, obesity, abnormal functioning of pancreas and liver, unhealthy Food and lifestyle and certain infections. Diabetic-DietDiabetic-Diet should incorporate plenty of greens and vegetables, no-sugar,colocasia,rice or potato and chicken, mutton should be consumed sparingly. Tingling in hands and feet, Sudden weight loss, Always hungry, Always thirsty, Wounds take time to heal, Blurry Vision. Prevent-DiabetesDiabetes can be successfully prevented by leading healthy lifestyle, less intake of sugar and avoiding alcohol consumption and cigarette smoking. Risk-factors-for-diabetesModifiable Risk Factors Of Diabetes-Lifestyle, Eating Habits, Existing Health Problems. Is-Diabetes-HereditaryPeople with diabetes heredity have higher chances of getting this metabolic disorder. Diabetes MellitusWhen the blood sugar is either below or above the normal level then it may lead to a disorder called diabetes mellitus. Nephrogenic-Diabetes-InsipidusNephrogenic Diabetes Insipidus is caused by insufficient amount of antidiuretic hormone in the body.
Generally, people tend to associate diabetes as having high blood glucose level in the blood that circulates the body.  But do we really know if this increased amount of blood glucose level in blood is due to the high carbohydrates or sugar consumption we take daily?  Or is it really due to the communal norms that obese people tend to have more glucose deposits in their body?
Genetic Vulnerability:  Study shows heredity plays a vital role in the development of type 1 diabetes. Type 2 diabetes develops when the pancreas does not produce enough amount of insulin to compensate for the glucose ingested into the body. Obesity: Obesity coupled with physical inability is a significant among the causes of diabetes Type 2. Insulin Resistance:  As long as the pancreas, through its beta cells, function normally by producing enough insulin, blood glucose level will remain normal. India has more diabetics than any other country in the world, according to the International Diabetes Foundation. Diabetes is a disease in which your blood glucose, or sugar, levels are higher than the normal levels. Type 1 diabetes occurs when the body's own immune system destroys the insulin-producing cells of the pancreas (called beta cells). Insulin's main role is to help move certain nutrients -- especially sugar -- into the cells of the body's tissues. In people with type 1 diabetes, sugar isn't moved into the cells because insulin is not available. Dehydration The build up of sugar in the blood can cause an increase in urination (to try to clear the sugar from the body). Weight loss The loss of sugar in the urine means a loss of calories which provide energy and therefore many people with high sugars lose weight.
Diabetic ketoacidosis Without insulin and because the cells are starved of energy, the body breaks down fat cells. Unlike people with type 1 diabetes, the bodies of people with type 2 diabetes make insulin.
Damage to the body Over time, the high glucose levels in the blood can damage the nerves and small blood vessels of the eyes, kidneys, and heart and lead to atherosclerosis, or hardening of the arteries that can cause heart attack and stroke. Dehydration The buildup of sugar in the blood can cause an increase in urination, causing dehydration. As well as taking your medicines or insulin, there are a few key steps you can take to prevent or delay the health complications associated with diabetes. Maintain a healthy weight - This will help control your blood glucose level, as well as your blood pressure and cholesterol.
Eat a healthy - balanced diet that's low in fat, salt and sugar - This doesn't mean you can never eat biscuits or cakes again, but try to eat sugary and fatty foods in moderation. Get active for 30 minutes a day - five times a week - This helps you stay at a healthy weight and maintain good general health. Check your feet every day - The nerve damage that can occur in diabetes most commonly affects feet.


Keep your appointments with your diabetes care team - Regular check-ups once every three months are an important part of managing your diabetes.
Gestational diabetes is a condition characterised by high blood sugar (glucose) levels that is first recognised during pregnancy. Monitoring your diet is highly vital as the food you eat directly affects your blood sugar levels and weight. Low-fat milk products like curd, paneer and egg whites, lean chicken and fish are great protein sources which can prove helpful in diabetes management. If you are a vegetarian, whole pulses and dals can provide little protein and good amounts of fibre. Sugar, jam, syrups, honey, sweets, chocolates, fruit juices, ice creams, cold drinks, glucose drinks, cakes and pastries, sweet biscuits, puddings and protein powder with sugar. Bread, chapatis, oat porridge, cornflakes (No sugar), Cheese, butter, Noodles or spaghetti, macroni, Thick soups, Milk & milk products, Chicken, lean meat, fish.
People with diabetes are encouraged to exercise regularly for better blood sugar control and to reduce the risk of cardiovascular diseases. Exercise is the common term used to describe any bodily activity that enhances or maintains physical fitness and overall health and wellness. As well as strengthening the cardiovascular system and the body's muscles, many people exercise to keep fit, lose or maintain a healthy weight, sharpen their athletic skills, or purely for enjoyment. Furthermore, exercise is free, can be carried out anywhere at anytime and has an immediate effect on your health. Aerobic activity at moderate intensity basically means exercising at a level that raises your heart rate and makes you sweat. Cutting the grass, cleaning your home and other daily chores such as shopping don't count towards your 150 minutes of weekly exercise as advances in technology have made these activities far less demanding on the body than for previous generations, who were active naturally more active through work and manual labour. There are some exercise precautions which people with diabetes must take, however, when done safely, exercise is a valuable aid to optimal health. Exercise precautions are designed to help people with diabetes avoid problems which can result from unwise exercise choices. Always carry a fast-acting carbohydrate food such as glucose tablets when exercising in the event blood sugar drops too low and hypoglycemia symptoms develop during exercise. Wear a form of ID, which identifies you as having diabetes, particularly if you are exercising alone so that others may help you appropriately in the event something unexpected happens. Yoga offers the benefits of exercise to help control blood sugar and improve poor circulation, which is the cause of most complications of diabetes. Regular yoga practice can help reduce the level of sugar in the blood, along with lowering blood pressure, keeping a weight check, reducing the symptoms and slowing the rate of progression of diabetes, as well as lessening the severity of further complications.
The practice of yoga is also proven to reduce weight as well as control increasing weight, which is particularly important to keep diabetes in check.Sun Salutation and Kapal Bhati pranayama are one of the best ways to weight loss. Other yoga postures that are helpful in diabetes include Vajrasana (kneeling pose), Shoulder Stand, Plow Pose, Lying-Down Body Twist, Bow Posture, Two-Legged Forward Bend, and Sitting Half-Spinal Twist. A few minutes of regular meditation practice also acts as an excellent stress-buster for the mind and body. According to IDF Atlas data, globally more than 371 million people are found to be living with diabetes.
The India situation is grim what with sedentary lifestyle prevailing across key metros and big cities aggravating the situation. The emergence of diabetes is turning out to be globally debilitating: new estimates released by the International Diabetes Federation (IDF) show that 187 million are still to be diagnosed. In order to make India diabetes free, the Government of India has initiated a National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in 100 selected districts in 21 States. This effort, however, has yet to show any major changes in the spread of the disease in the country.
Given the imperative lifestyle change to mitigate the disease, it is important to ensure that a balance is maintained at all costs. As regards the choice of food intake, the diet most often recommended is high in dietary fiber, especially soluble fiber, but low in fat (especially saturated fat). Insulin is also important in type 2 diabetes when blood glucose levels cannot be controlled by diet, weight loss, exercise, and oral medications. A diet for those with diabetes should also help achieve and maintain a normal body weight as well as prevent heart and vascular disease, which are frequent complications of diabetes. A diabetic’s body can no longer produce insulin, a hormone necessary for processing glucose.
To make matters worse, insulin must only be injected at the right time, when glucose levels are high. In type 1 diabetes, as well as in progressed cases of type 2, it’s essential that a diabetic accurately manage their glucose level as accurately as possible by checking their glucose level frequently by pricking themselves and using a glucose meter. The MiniMed Paradigm REAL-Time System, released in 2006, was the first system to integrate an insulin pump with a continuous glucose monitoring device, thus eliminating the need for diabetics to monitor their own glucose level. The risk increases with conditions such as sepsis, dehydration, excess alcohol intake, hepatic impairment, renal impairment, and acute congestive heart failure. Initial combination therapy or maintenance of combination therapy should be individualized and left to the discretion of the health care provider.
Patients with inadequate glycemic control on this dose of metformin can be titrated gradually, to reduce gastrointestinal side effects associated with metformin, up to the maximum recommended daily dose. Any change in therapy of type 2 diabetes should be undertaken with care and appropriate monitoring as changes in glycemic control can occur. Concentrations of the active intact hormones are increased by sitagliptin, thereby increasing and prolonging the action of these hormones. Its pharmacologic mechanisms of action are different from other classes of oral antihyperglycemic agents. The following data are based on findings in studies performed with sitagliptin or metformin individually. Placental transfer of sitagliptin administered to pregnant rabbits was approximately 66% at 2 hours and 30% at 24 hours.
However, because animal reproduction studies are not always predictive of human response, metformin hydrochloride should not be used during pregnancy unless clearly needed.
In studies performed with the individual components, both sitagliptin and metformin are secreted in the milk of lactating rats. Care should be taken in dose selection and should be based on careful and regular monitoring of renal function. No overall differences in safety or effectiveness were observed between subjects 65 years and over and younger subjects. Lactic acidosis may also occur in association with a number of pathophysiologic conditions, including diabetes mellitus, and whenever there is significant tissue hypoperfusion and hypoxemia. Such decrease, possibly due to interference with B12 absorption from the B12-intrinsic factor complex, is, however, very rarely associated with anemia and appears to be rapidly reversible with discontinuation of metformin or Vitamin B12 supplementation.
In these patients, routine serum Vitamin B12 measurements at two- to three-year intervals may be useful. Evaluation should include serum electrolytes and ketones, blood glucose and, if indicated, blood pH, lactate, pyruvate, and metformin levels.
Elderly, debilitated, or malnourished patients, and those with adrenal or pituitary insufficiency or alcohol intoxication are particularly susceptible to hypoglycemic effects. These reactions include anaphylaxis, angioedema, and exfoliative skin conditions including Stevens-Johnson syndrome.
When the combination of sitagliptin and metformin immediate-release was co-administered with a sulfonylurea or with insulin, the percentage of patients reporting at least one adverse reaction of hypoglycemia was higher than that observed with placebo and metformin immediate-release co-administered with a sulfonylurea or with insulin (Table 3).
Because these reactions are reported voluntarily from a population of uncertain size, it is generally not possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Maximal mean increases in QTc of 8.0 msec were observed in one study at a dose of 800 mg sitagliptin, a mean effect that is not considered clinically important.
In clinical studies, approximately 13.5% of the dose was removed over a 3- to 4-hour hemodialysis session.
Hypoglycemia was reported in approximately 10% of cases, but no causal association with metformin hydrochloride has been established.
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs, and isoniazid.
The median Tmax value for sitagliptin and metformin at steady state is approximately 3 and 8 hours postdose, respectively.
The mean Cmax was decreased by 17%, although the median Tmax was unchanged relative to the fasted state.
Co-administration of a high-fat meal with sitagliptin had no effect on the pharmacokinetics of sitagliptin.
Six metabolites were detected at trace levels and are not expected to contribute to the plasma DPP-4 inhibitory activity of sitagliptin. Sitagliptin is a substrate for human organic anion transporter-3 (hOAT-3), which may be involved in the renal elimination of sitagliptin. Following oral administration, approximately 90% of the absorbed drug is eliminated via the renal route within the first 24 hours, with a plasma elimination half-life of approximately 6.2 hours. Similarly, in controlled clinical studies in patients with type 2 diabetes, the antihyperglycemic effect of metformin was comparable in males and females. Elderly subjects (65 to 80 years) had approximately 19% higher plasma concentrations of sitagliptin compared to younger subjects. From these data, it appears that the change in metformin pharmacokinetics with aging is primarily accounted for by a change in renal function. In controlled clinical studies of metformin in patients with type 2 diabetes, the antihyperglycemic effect was comparable in whites (n=249), blacks (n=51), and Hispanics (n=24). When container is subdivided, dispense into a USP tightly closed, moisture-resistant container.
This condition primarily starts in the extremities (lower and upper) that is arms and legs.
In this case pancreas is able to produce insulin, however, it is not sufficient enough to stabilize the glucose level in the blood. People with too much body fats result in insulin resistance as well as other potentially complicated diseases. The problem arises when insulin production is not enough to level up for our sugar consumption.  Body tissues such as muscle and fats, as well as liver cells may dysfunction in response to insulin content that will lead to overwork of the pancreas. Their only aim is to share their opinion on the concerned topic, and help the reader understand it better.
Your doctor will help you figure out what levels are right for your child, since targets change as kids get older.
And when your child enters puberty, his hormones could cause problems with blood sugars changing wildly. The Art and Science of Diabetes Self-Management Education Desk Reference, 2nd Ed., American Association of Diabetes Educators, 2011. The disease affects more than 50 million Indians - 7.1% of the nation's adults - and kills about 1 million Indians a year. This happens because either the pancreas does not produce enough insulin, or because cells do not respond to the insulin that is produced.
But for unknown reasons, in people with type 1 diabetes, the immune system attacks various cells in the body.
Normally that signals the beta cells in the pancreas to lower the amount of insulin secreted so that you don't develop low blood sugar levels.
When sugar builds up in the blood instead of going into cells, the body's cells starve for nutrients and other systems in the body must provide energy for many important bodily functions.
When the kidneys lose the glucose through the urine, a large amount of water is also lost, causing dehydration. Products of this fat breakdown include acidic chemicals called ketones that can be used for energy. Over time, the high sugar levels in the blood may damage the nerves and small blood vessels of the eyes, kidneys, and heart and predispose a person to atherosclerosis (hardening) of the large arteries that can cause heart attack and stroke.


But either their pancreas does not make enough insulin or the body cannot use the insulin well enough. When a person with type 2 diabetes becomes very ill or severely dehydrated and is not able to drink enough fluids to make up for the fluid losses, they may develop this life-threatening complication.
With proper monitoring and partnering with your health care team you can even prevent the many complications caused by diabetes. It doesn't have to be the gym: there are plenty of other ways to keep active, such as playing with your kids, gardening, or any activity that gently raises your heart rate. Also, avoid processed foods like cakes, biscuits, ready-to-eat foods as they are loaded with fats.
The reason for this is that muscles which are working use more glucose than those that are resting. Sedentary behavior, such as sitting or lying down for long periods, increases your risk of weight gain and obesity, which in turn, may also up your risk of chronic diseases such as heart disease and diabetes. Yoga postures and yogic breathing exercises also exert therapeutic effects on organs and glands and strengthen the pancreas and its functions. It increases the secretion of glucagon hormones in the body, responsible for increasing blood glucose levels. Yoga asanas, such as the Corpse Pose, Bridge Pose, Child Pose, and Yoga Nidra are all helpful in controlling hypertension.
Interestingly, while stress is the major cause of diabetes, the condition in turn results in patients getting highly stressed about it, which further aggravates the problem.
But rather than being a matter of celebration this development is bound to ring alarm bells all over. An estimated 90 per cent of the cases are of Type 2, caused by insufficient amounts of insulin being available for reduction of blood glucose levels. By the end of the year, 4.8 million people will have died from diabetes related complications. Thirty districts were taken up during 2010-11 and remaining 70 Districts have been added during 2011-12. The food ought to reflect a balance with all the food groups and veggies being the largest part of the meal.
Adequate blood glucose control can be achieved with careful attention to diet, regular exercise, home blood glucose monitoring, and multiple insulin injections throughout the day. If the level is too high, they have to take insulin, and if it’s too low they have to eat something. The class is offered to newly diagnosed patients as well as a refresher course for those who are currently managing their diabetes. Sitagliptin phosphate monohydrate is described chemically as 7-[(3R)-3-amino-1-oxo-4-(2,4,5-trifluorophenyl)butyl]-5,6,7,8-tetrahydro-3-(trifluoromethyl)-1,2,4-triazolo[4,3-a]pyrazine phosphate (1:1) monohydrate.
Metformin hydrochloride is freely soluble in water and is practically insoluble in acetone, ether, and chloroform. Incretin hormones, including glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are released by the intestine throughout the day, and levels are increased in response to a meal. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. There are, however, no adequate and well-controlled studies with sitagliptin in pregnant women. While this and other reported clinical experience have not identified differences in responses between the elderly and younger patients, greater sensitivity of some older individuals cannot be ruled out. Serum electrolytes, ketones, blood glucose, blood pH, lactate levels, and blood metformin levels may be useful. Hypoglycemia may be difficult to recognize in the elderly, and in people who are taking β-adrenergic blocking drugs. Onset of these reactions occurred within the first 3 months after initiation of treatment with sitagliptin, with some reports occurring after the first dose. Lactic acidosis has been reported in approximately 32% of metformin overdose cases [see Warnings and Precautions]. In vitro studies indicated that the primary enzyme responsible for the limited metabolism of sitagliptin was CYP3A4, with contribution from CYP2C8. In blood, the elimination half-life is approximately 17.6 hours, suggesting that the erythrocyte mass may be a compartment of distribution. Good or bad, Right or wrong is solely readers decision and should be taken under the guidance of a medical expert. Test your child's blood sugar several times a day so you'll know what you need to do to adjust it.
Since you or your child might not notice symptoms, testing is the best way to avoid dangerously high and low levels. The amount that is released is proportional to the amount that is required by the size of that particular meal. But the destruction of the beta cells that occurs with type 1 diabetes throws the entire process into disarray. Muscle movement leads to greater sugar uptake by muscle cells and lower blood sugar levels.
You may be advised to lower your medication on days you exercise if your blood sugar levels are well-controlled and usually within target range.
Consistent practice of yoga asanas (body postures), pranayamas (breathing exercises) and a few minutes of daily meditation can help reduce stress in the mind and body. Another excellent technique to combat diabetes is a unique breathing technique, Sudarshan Kriya, designed by Sri SriRavi Shankar. It has also been observed that most diabetics lose self-confidence and end up brooding over their condition.
Sanjiv Bhambani, consultant, Endocrinology at Moolchand Medcity, New Delhi, laments, "Diabetes is the result of our habitual sedentary lifestyle, lack of physical activity, obesity, stress and consumption of diets rich in fat, sugar and calories.
The community based strategies and activities include prevention and control of diabetes at various levels like at sub-centres, Community Health Centre (CHC), district hospital and at various other places through screening of all persons above 30 years of age and all pregnant women, awareness generation on healthy life style and management of non- communicable diseases by establishing cardiac care units at district hospitals and community health centres of 100 selected districts of 21 states in the country. Weight reduction and exercise are important treatments for diabetes as they increase the body’s sensitivity to insulin, thus helping to control blood sugar elevations. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range.
A diabetes diet plan must also be balanced with the intake of insulin and oral diabetes medications. The sessions are taught by a Licensed Registered Nurse who is a Nationally Certified Diabetes Educator.
Unlike sulfonylureas, metformin does not produce hypoglycemia in either patients with type 2 diabetes or normal subjects (except in special circumstances [see Warnings and Precautions]) and does not cause hyperinsulinemia. In Phase I multiple-dose studies, there were no dose-related clinical adverse reactions observed with sitagliptin with doses of up to 400 mg per day for periods of up to 28 days. Sitagliptin is also a substrate of p-glycoprotein, which may also be involved in mediating the renal elimination of sitagliptin. When there isn't enough insulin or the insulin is not used as it should be, glucose (sugar) can't get into the body's cells.
It is a critical part of managing your diabetes, because controlling your blood sugar can prevent the complications of diabetes. Additional benefits of exercise include a healthier heart, better weight control and stress management.
It has helped several diabetics across the world reduce blood glucose levels and control their condition from getting worse. This is where meditation can help - restoring their confidence levels so that they gain the strength to fight the condition and live well.
India with 63 million diabetic patients is just next to China (92.3 million) in the race to become the diabetes capital of the world, according to the International Diabetes Federation (IDF) Atlas released on November 14, 2012. Management of type 2 diabetes includes healthy eating, regular exercise, diabetes medication or insulin therapy and blood sugar monitoring.
Consumption of a variety of foods including whole grains, fruits, non-fat dairy products, beans, and lean meats or vegetarian substitutes, poultry and fish is recommended to achieve a healthy diet. A combination of exercises like aerobic exercises, walking or dancing on most days, combined with resistance training, such as weightlifting or yoga twice a week often helps control blood sugar more effectively than either type of exercise alone.
It can be controlled by:monitoring the dietinjecting insulinPeople with Type 1 diabetes have to monitor their blood sugar levels throughout the day. There are also several FREE one-on-one counseling sessions available for those who would like the extra support or are unable to make it to the scheduled class times. The incretins are part of an endogenous system involved in the physiologic regulation of glucose homeostasis. With metformin therapy, insulin secretion remains unchanged while fasting insulin levels and day-long plasma insulin response may actually decrease. Later occurrence of gastrointestinal symptoms could be due to lactic acidosis or other serious disease.
Therefore, hemodialysis may be useful for removal of accumulated drug from patients in whom metformin overdosage is suspected. However, cyclosporine, a p-glycoprotein inhibitor, did not reduce the renal clearance of sitagliptin.
Over time, having too much glucose in your blood can cause serious problems such as damage to your eyes, kidneys, and nerves. Since the body cannot use these sugars without insulin, more sugars piles into the blood stream. When glucose builds up in the blood instead of going into cells, the body's cells are not able to function properly. These steps will help keep your blood sugar level closer to normal, which can delay or prevent complications.
People with diabetes may also benefit from eating small meals throughout the day instead of eating one or two heavy meals. These classes are at no expense to the patient to better serve you and your healthcare needs. When blood glucose concentrations are normal or elevated, GLP-1 and GIP increase insulin synthesis and release from pancreatic beta cells by intracellular signaling pathways involving cyclic AMP. In more than 20,000 patient-years exposure to metformin in clinical trials, there were no reports of lactic acidosis.
There may be associated hypothermia, hypotension, and resistant bradyarrhythmias with more marked acidosis.
GLP-1 also lowers glucagon secretion from pancreatic alpha cells, leading to reduced hepatic glucose production. Lactic acidosis should be suspected in any diabetic patient with metabolic acidosis lacking evidence of ketoacidosis (ketonuria and ketonemia). By increasing and prolonging active incretin levels, sitagliptin increases insulin release and decreases glucagon levels in the circulation in a glucose-dependent manner. Patients with congestive heart failure requiring pharmacologic management, in particular those with unstable or acute congestive heart failure who are at risk of hypoperfusion and hypoxemia, are at increased risk of lactic acidosis. Sitagliptin demonstrates selectivity for DPP-4 and does not inhibit DPP-8 or DPP-9 activity in vitro at concentrations approximating those from therapeutic doses.
The risk of lactic acidosis increases with the degree of renal dysfunction and the patient’s age. In particular, treatment of the elderly should be accompanied by careful monitoring of renal function.




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