The addition of the dipeptidyl peptidase 4 (DPP-4) inhibitor vildagliptin to metformin therapy in fasting Muslim patients with Type 2 diabetes reduces the incidence of hypoglycemia compared with the addition of the sulfonylurea gliclazide, research suggests.

“If a person with diabetes chooses to fast during Ramadan, his or her decision needs to be respected and an appropriate care plan needs to be devised,” explain the study authors Devasenan Devendra (Central Middlesex Hospital, London, UK) and co-workers.

To study the impact of Ramadan fasting by Muslims with Type 2 diabetes in the UK, the authors followed 52 patients attending primary care practices in north-west London for an average of 7.5 weeks.

Participants had glycated hemoglobin (HbA1c) greater than 8.5% despite treatment with metformin 2 g daily before Ramadan, and were receiving gliclazide 160 mg twice daily or vildagliptin 50 mg twice daily in addition to metformin.

Hypoglycemic events (defined as blood glucose of less than 3.5 mmol/l with or without symptoms), HbA1c, and weight were recorded 2 weeks before and 10 days after the Ramadan fast.

Patients receiving gliclazide experienced a total of 24 hypoglycemic events, one of which was severe, while those receiving vildagliptin experience a total of two hypoglycemic events, neither of which were severe. Among patients receiving the sulfonylurea, 62% suffered a hypoglycemic event, compared with 8% of those taking vildagliptin.

“Vildagliptin was associated with a reduction in the mean number of hypoglycemic events during Ramadan compared with before Ramadan (when patients were on metformin monotherapy), whereas gliclazide was associated with an increase,” write the authors.

Gliclazide and vildagliptin were associated with similar reductions in HbA1c of 1.23% and 1.26%, respectively. Both agents were associated with a small non-significant increase in weight of 0.38 kg and 0.12 kg, respectively.

The authors acknowledge that this was an observational study of a relatively small number of patients with Type 2 diabetes and highlight the need for larger, prospective studies of the different interventions that may help Muslim patients fast safely during Ramadan.

“Newer antidiabetic agents, such as vildagliptin, may have a role to play in the management of these patients during Ramadan, particularly to reduce their risk of hypoglycemia during the long daytime fasting periods,” they conclude in the International Journal of Clinical Practice.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract

It is important to maintain healthy blood sugar levels.

Hyperglycemia, high blood sugar levels can, over time, damage the blood vessels that supply blood to our vital organs. This, in turn, increases the risk of heart and kidney disease, as well as leading to vision problems and problems with your nervous system. Researchers have linked high blood sugar levels with cancer in women. Hypoglycemia, low blood sugar,? can cause us to feel tired, depressed and lead to food eating disorders.

It’s important to keep our blood sugar level within the parameters of normal, so that it is neither too high nor too low.

Every time we eat, our stomach and intestines transform the food into glucose. Our cells need the glucose for energy. Our pancreas releases insulin to work with the glucose, but when our sugar levels are not at their optimum levels the result is, high blood sugar or low blood sugar levels.

For most of us, it’s easy to raise our blood sugar levels by simply drinking some fruit juice or eating a doughnut. Lowering our blood sugar levels, on the other hand, may be more of a challenge.

One way that we can lower our blood sugar level is to eat smaller meals several times a day.? It’s easier for our system to break down the sugars and send it to our vital organs, if it doesn’t have to work as hard. Eating four to six smaller meals throughout the day, while drinking plenty of water, is easier on the stomach, the intestines, the pancreas and even the digestive enzymes that are working to transform the food into nutrients.

Don’t just sit there, get up and exercise. In order for everything to work properly, our bodies need the stimulation that it can only get through proper amounts of exercise. If you can work out, that is great, but if you can’t or just don’t want to,? taking several short brisk walks a day is better than just sitting around all day.

Instead of grabbing that doughnut, eat an apple. Eating foods high in fiber like, apples, oatmeal, nuts and seeds help to fill us up without adding the extra sugars. But, if you must have that doughnut, include some cheese or a hard boiled egg along with it. Since carbohydrates quickly convert into glucose, adding the protein found in cheese or eggs will slow the the conversion of the carbohydrates to glucose, preventing a marked increase in blood sugar levels.

Eat some cinnamon every day. Cinnamon works to naturally lower blood sugar levels and help balance cholesterol levels. You need to eat about a gram a day, to gain these benefits, but you can add it to your oatmeal, toast and even your coffee. It tastes good and works great.

Finally, make sure you are getting the optimum amount of vitamins and minerals in your daily diet. If you aren’t getting the levels you need in your food, find a good supplement that contain vitamins, minerals, trace minerals and herbal additives. If our bodies aren’t receiving the proper amounts of vitamins and minerals, it may affect the ways we are able to convert the foods we are eating into the right blood sugar levels.

Diabetes happens to be one of the difficult ailments to live with. One has to keep track of his blood sugar so it would not drop too low or rise too high. That condition is termed as Hypoglycemia while the latter is termed as Hyperglycemia. A thousand and one dos and don’t must be strictly followed in order to live a normal life. If you happen to be one who suffers from either of these conditions, you can help others who are suffering from Diabetes and need avenues to belt out their concerns and hang-ups in life. You can create a Diabetes blog and invite others like you to say what’s on their minds.

If you’re not made to be a writer, read through the numerous sites available in the Internet to find either groups or perhaps some new information on how to combat this kind of disease. Keep in mind that you must not tire yourself too much since your sugar levels may plummet. Diabetes is indeed a life-long struggle so arm yourself with proper medications, a balanced diet, and right amounts of exercise to keep you healthy. While doing so, would not it be great to document your ups and downs via a Diabetes Blog? ?

If you happen to browse upon the struggle of a little girl, fears and disillusions on being diagnosed as a Type I diabetic, she posted an entry and mentioned how she gets affected with sweet words in it. Well. Sweet Dreams for her turn into nightmares because every since she was much younger, her parents would often tell her that gumdrops are bad and chocolate eggs hatch inside her stomach. Diabetes has robbed the best part of childhood from the life of this girl. You could help give some calming words to this little girl and at the same time inviting her to your Diabetes Blog. ? There you can tell her you have survived Diabetes and share some sentiments with her. Well, would you just wish that all the sweetest things in life end up tasting sour and salty that after you eat it you become dizzy and just throw-up?

Treating diabetes is hard enough. Don’t make it harder by starving your body of the nutrients it needs to work properly. Research has shown decisive evidence supporting key vitamins for hypoglycemia can dramatically improve your success against this disease.

?

Hypoglycemia is low blood sugar, and it leads to type II diabetes. Diabetes is a medical snowball that can deplete your health rapidly. Left unchecked, diabetes can lead to feet/leg amputations and heart disease. Without going into great detail, you would be wise to protect your health and your heart with preventative measures. Vitamins for hypoglycemia exist, and they are proven to be effective.

?

Research has shown that insulin sensitivity (hypoglycemia) is influenced by many different dietary factors. Proper nutrition plays a vital role in controlling blood glucose levels and insulin function throughout our life.

?

Individuals with poor blood sugar metabolism are more susceptible to free radicals that speed up the aging process and promote chronic illnesses like cancer, stroke, and heart disease. Antioxidants can neutralize these free radicals protecting you from the aging process, but unfortunately, diabetics have low levels of antioxidants. This is a main reason the life expectancy of a diabetic person is reduced. A potent antioxidant is recommended by doctors to help neutralize free radicals, but this is not the only supplementation that is helpful.

?

Diabetics have low blood levels of copper, zinc, selenium and especially chromium. These nutrients are an integral part of the glucose tolerance factor (GTF), that is essential for proper glucose metabolism. Supplementing with these key nutrients at optimum doses can make dramatic improvements in your health. Diabetes is not easy to live with, but a little education goes a long way.

?

Without getting technical and wordy, it is important to give your body what it needs to function properly. There are supplements available that are specifically designed to target the needs and deficiencies of diabetes. Vitamins for hypoglycemia work and they are inexpensive. Improve your quality of life with expert advice from the Superfood-Guru. Life’s Delicious!

It is imperative for diabetics to monitor blood sugar levels per day. This is to help keep glucose and insulin at more manageable concentrations so that the person does not suffer from either hypoglycemia (low blood sugar) or hyperglycemia (too high levels of sugar and glucose in the blood stream.) Daily testing is also a great way of gradually eliminating the dependence on prescription medicines and supplements as the person with diabetes learns how to control his or her blood sugar level on a daily basis through diet only. However, A1C test still need to be conducted on a regular basis. In fact, health care givers often recommend that this medical check be administered at least once every 2 months or so.

What is A1C test and why is it important?

A1C test is a method of checking a diabetic person’s glucose level for a longer period of time. This test is almost similar to the daily blood test when it comes to procedure. All the patient would really need is to contribute a bit of blood, and submit it for testing. Nonetheless, this check often shows a more concrete “history” of the person’s average blood glucose control. This is primarily used to determine whether or not the diabetic treatment plan of a particular person is working. Adjustments are usually made after each test so as to accommodate the health needs of the diabetic person in question. Simply put, diabetics usually react differently to prescribed diets, medicines and treatments - so monitoring A1C level is usually critical during the early diagnostic and treatment stages.

A1C is known by many terms, like: glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C, HbA1c, and Hb1c. This component of the blood is very reliable when it comes to identifying the average glucose concentration in the plasma, even (and especially) after a lapse of 2 or 3 months.

The A1C test relies on the actual “memory” of the A1C hemoglobin. When the diabetic person has high levels of blood sugar for a particular week, that memory is embedded in the DNA structure of the A1C, particularly in the red blood cells. At the same time, that memory also records levels of blood sugar dipping below normal, or when the glucose remains constant during the treatment period. This memory can be retained for as long as the red blood cells remain alive - and that is approximately 120 days. After that, the cells die and are quickly replaced by other A1C “memory” keeping red blood cells. This is primarily the reason why this important medical check must be conducted within a span of only a couple of months. Every 2 months is most preferably, but allowances can be made for up to 3 months, but no more. This is to ensure that the “memory” that the cells carry do have sufficient history for comparison.

Often, it is the person with Type I diabetes who is required to take the A1C test Diabetic Diets, Diabetic Cooking. However, elderly patients who are diagnosed with Type II diabetes are sometimes recommended to take the same especially when his or her blood sugar level does not stabilize or becomes increasingly erratic as the treatment progresses.

Sufferers of type 2 diabetes at times walk a fine line between hypoglycemia and hyperglycemia simply because their bodies cannot process blood sugars as effectively and efficiently as non-diabetics. However, don’t despair about this because stable blood sugar levels can be achieved although, it must be emphasized, it will still be relatively higher when compared with non-diabetic levels.

Thus, you must consult with your health care provider to determine the target blood glucose range appropriate for you.

1: With the aid of your personal glucose meter, regular blood sugar level testing at times agreed with your health care provider, will help you determine the pattern with which your levels rise and fall. Of course your activities, foods consumed and time of day will make a difference. Don’t forget issues like stress, depression, pain, poor mobility and illness come into play as well.

When you have determined your personal pattern your diabetes management plans will be easier to customize to your needs. In other words, you can then make the necessary changes to your lifestyle to stabilize your blood sugars.

2: Various conditions, like type 2 diabetes, send you warning signals when something is not quite right. You must learn to listen to your “body talk” … your body will always show you but you must be aware of the symptoms of high or low blood sugars. For examples an unquenchable thirst, frequent urination and extreme tiredness are all signs your levels are high. If you are taking insulin and maybe missed a meal, you would have signs of a “hypo” and they could include pale sweaty skin, palpitations, confusion, slurred speech or maybe a headache.

Once you know your signs and symptoms take immediate action, i.e. monitor your blood sugar levels, inject insulin, take glucose tablets, and/or eat food. Don’t wait for your symptoms to go away as your capacity to remedy the situation may fade quickly.

3: Even when you give your type 2 diabetes your full attention, blood sugar levels can be unpredictable. So it is really important for you to know the level you should be aiming for. Most people who have diabetes should aim for:

• an HbA1c of less than 7 per cent
• a pre-meal blood glucose level of 4 to 6mmol/l (72 to 108 mg/dl) or 3.5 to 6mmol/l (63 to 108 mg/dl) if you are not taking insulin or diabetic medications
• a level of 4 to 8 mmol/l (72 to 144 mg/dl) measured two hours following your meal.

Don’t forget to share with your family and friends the steps you would like them to take if you are unable to help yourself. Post your health care provider’s telephone number in conspicuous places so they can contact him when emergency situations occur.

By keeping your blood sugar levels in a healthy range you can slash your risk of developing complications and live a long and healthy life even with type 2 diabetes.