Home Remedies for Hyperglycemia

Blood Sugar Miracle

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Blood Sugar Miracle Overview

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Hyperglycemia

Hyperglycemia, or high blood sugar, is the result of either too little insulin or of the body's inefficient use of insulin. Indicators of hyperglycemia include frequent urination, thirst, high levels of sugar in the urine, and high blood sugar. Failure to address hyperglycemia results in dehydration and ketoacidosis. Over the long term, hyperglycemia causes heart disease, foot problems, blindness, kidney disease, and nerve damage. For diabetics, frequent blood glucose testing and diet management are critical to preventing hyperglycemia. Regular self-monitoring of blood glucose levels determines the degree of adjustment in insulin and diet. A registered dietician can conduct a nutritional assessment that will reveal nutritional needs critical to preventing and treating chronic complications of diabetes. This assessment, based on personal, cultural, and lifestyle preferences, is the foundation for a diabetic's dietary plan. For meal planning, the diabetic exchange system provides a...

Regional Diet American

It is quite clear that nutritional intake is associated with common health conditions such as obesity, hypertension (high blood pressure), cancer, diabetes (high blood sugar), and cardiovascular disease. People in the United States make daily decisions related to grocery purchases, meal choices, food preparation, and other factors influencing their consumption of food and nutrients, and, thus, likely affecting their health. However, much of the current knowledge and most published works are based on studies or other information that concern the general population. This information is important in influencing dietary patterns, but additional information is needed regarding specific regional and minority populations. Additionally, more detailed information is necessary to determine if there are any differences or similarities between these subpopulations. What follows is a general literature review related to minority groups in the United States.

Recommendation for Tuna

Gestational diabetes is the onset of high blood sugar (or carbohydrate intolerance) that is generally detected around the twenty-eighth week of pregnancy. Because this condition is caused by the placenta putting out large doses of anti-insulin hormones, as soon as the placenta is removed (during the baby's delivery), the condition disappears in almost all cases. Women diagnosed with gestational diabetes have very specific dietary concerns and should work with a qualified nutritionist (registered dietitian) on appropriate meal planning.

To Artificially Sweeten or

People often have to use artificial sweeteners because of a medical condition. For example, sugar substitutes can be great for diabetics, who can't tolerate real sugar because their bodies can't produce the hormone insulin. Insulin delivers the sugar from our blood to our cells, where we utilize it as energy. When your body doesn't have enough insulin, sugar builds up in the blood and doesn't get into the cells. This condition is known as high blood-sugar and can be extremely dangerous for people with diabetes. Because sugar substitutes do not contain any glucose (and therefore do not require insulin), they can be effective sweeteners for people with diabetes.

Relative glycaemic potency and glycaemicglucose equivalents

Health consequences of hyperglycaemia are multiple and most evident in the diabetes mellitus syndrome.28,49,50 Persistently raised blood glucose causes protein glycation throughout the body, leading to cumulative, diffuse damage, emerging as pathology in a number of organ systems. Basal membrane damage is commonly an underlying factor in changes to micro-vessels involving the eyes, kidneys and nerves.51 Intense insulin production in response to diabetic hyper-glycaemia, or to repeated acute glucose loading from large intakes of highly digestible carbohydrate, is thought to contribute to the progression of glucose intolerance, through b-cell toxicity, leading to loss of the capacity of the pancreas to produce insulin.52 Hyperinsulinaemia as a response to elevated blood glucose Post-prandial glycaemia may also lead to a number of acute and sometimes serious disorders, as the body attempts to counter the osmotic effects of high blood sugar levels. The excretion of sugar by the kidneys...

Thiamin Riboflavin and Niacin

Toxicity is not a problem except in the case of niacin. Nicotinic acid, a form of niacin, is often prescribed by physicians to lower elevated blood cholesterol levels. Unfortunately, it has some undesirable side effects. Starting at doses of 100 milligrams, typical symptoms include flushing, tingling, itching, rashes, hives, nausea, diarrhea, and abdominal discomfort. Flushing of the face, neck, and chest lasts for about 20 minutes after a person takes a large dose. More serious side effects of large doses include liver damage and high blood sugar levels.

Diabetes Complications

People with diabetes are at increased risk for serious long-term complications. Hyperglycemia, as measured by fasting plasma glucose concentration or glycosylated hemoglobin (HbA1c), causes structural and functional changes in the retina, nerves, kidneys, and blood vessels. This damage can lead to blindness, numbness, reduced circulation, amputations, kidney disease, and cardiovascular disease. Type 1 diabetes is more likely to lead to kidney failure. About 40 percent of people with type 1 diabetes develop severe kidney disease and kidney failure by the age of fifty. Nevertheless, between 1993 and 1997, more than 100,000 people in the United States were treated for kidney failure caused by type 2 diabetes. Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemia state (HHS) are serious diabetic emergencies and the most frequent cause of mortality. Both DKA and HHS result from an insulin deficiency and an increase in counter-regulatory hormones (a.k.a. hyperglycemia). Hyper-glycemia...

Carbohydrate requirementsenergy metabolism

Hyperglycemia is a complication of excessive carbohydrate (glucose) provision and must be addressed in reference to the higher percentages of carbohydrate need suggested. Clearly, there is a hyperglycemic effect in the flow phase of burn injury as well as in critically ill patients who may also have a wound. Although short-term hyperglycemia accompanies the stress response to injury, persistent hyperglycemia is a problem that has commonly been associated with poor wound healing and immunity (7). Pediatric burn patients with poor glucose control experienced reduced skin graft take and subsequent mortality. Total caloric intake should be evaluated, as hypercaloric feeding may be associated with hyperglycemia. Further, because carbohydrate is a key substrate in burn wound healing, internal insulin production may be enhanced. Insulin, an anabolic hormone, has positive effects on nitrogen utilization. The use of exogenous insulin has been shown to lead to a decrease in peripheral muscle...

Monitoring and evaluation

At each prenatal visit, eating disorders screening may be conducted (see Table 9.4) along with measurement and documentation of parameters or outcomes related to nutrition interventions and diagnoses. Body weight and rate of weight gain should be tracked and evaluated. Adjustments in energy intake should be based on appropriateness of weight changes. Eating behaviors and dietary intake should be examined at each prenatal visit to assess the adequacy of dietary composition and patterns of intake. Changes in purging and nonpurging behaviors should be noted and addressed. Fingersticks to check hematocrit and glucose may be useful in the monitoring of iron status and hypoglycemia or hyperglycemia. In women with established eating disorders, urinalysis may detect starvation or dehydration as noted by urinary ketones, elevated specific gravity, and alkaline urine. Vital signs will show any change in general health status. Glucose tolerance testing should be conducted in the 24th to 28th...

Carbohydrates energy metabolism and wound healing

Carbohydrates have been shown to impact wound healing in a variety of ways. Historically, carbohydrates have been viewed as an energy source for patients who are recovering from wounds. Differences have been noted in regards to carbohydrate requirements of patients who suffer from acute traumatic wounds (i.e., burns), acute iatrogenic wounds (i.e., incisions), and chronic wounds (i.e., diabetic wounds) (2). Under normal circumstances, the body increases glucose production via the liver and kidneys. This increase in gluconeogenesis is stimulated by a variety of hormones, including glucagons, epinephrine, and norepinephrine. Skin cells are glucose dependent for energy in cutaneous wound healing (3). Although adequate glucose levels are vital for wound healing, excessively high levels (hyperglycemia) have a negative impact on this process.

Other Things of Importance for Stroke Patients

The injured brain does not tolerate excess sugar very well. Several studies of brain-trauma patients have shown that hyperglycemia can actually increase brain injury. In addition, high sugar intake depresses immunity and increases the formation of glycated cell components, which can increase free-radical injury.

Treatment for Diabetes

Factors, diabetes requires lifestyle changes and medication adherence in order to control blood glucose levels. Due to the damage caused by hyperglycemia, diabetic patients also experience a number of complications related to the disease. With good self-management practices, however, individuals with diabetes can live a long and productive life. see also Carbohydrates Exchange System Glycemic Index Hyperglycemia Hypoglycemia Insulin. Yki-Jarvinen, Hannele (1998). Toxicity of Hyperglycemia in Type 2 Diabetes. Diabetes Metabolism Reviews 14 S45-S50.

Gestational Diabetes

Gestational diabetes affects 0.6 percent to 15 percent of pregnant women (35). It implies an increased risk of development of impaired glucose tolerance and diabetes (35). Most develop type 2 diabetes, with an incidence of at least 13.8 percent. The incidence of type 1 diabetes is reported to be 0.7 percent to 6.6 percent over 2-11 years. In a study looking at gestational diabetes, the cumulative risk for diabetes and abnormal glucose tolerance was 13.8 percent and 42.4 percent after 11 years versus 0.0 and 2.8 percent in women without diabetes (35). Independent, predictive factors for diabetes were prior hyperglycemia four abnormal glucose values on the diagnostic OGTT overt diabetes during pregnancy two-hour blood glucose > 11.7 mmol l on the diagnostic OGTT gesta-tional age at diagnosis < 24 weeks and prepregnancy body-mass index (BMI) > 26.4 kg m2 (35). Race is thought to be a risk factor for gestational diabetes (36). Recurrence rates for gestational diabetes have been...

Posttransplantation Diabetes

American recipients than Caucasian recipients), and immunosuppression (39). Transplant recipients with posttransplant diabetes tend to be 0 to 12 years older than those without (39). Non-Caucasian patients had a twofold increased risk of post-transplant diabetes (RR 3.3, 95 percent CI 1.7-7.0) (39). There is an increased incidence of posttransplant diabetes in patients treated with glucocorticoid therapy, cyclosporine, and those treated with high doses of tacrolimus (39, 41). The mean time from transplantation to development of PTDM is 1.2 years (range from one day to 6.2 years), with most cases occurring during the first three months after transplant or after treatment for rejection (41, 42). Significant risk-factor development of PTDM included first-degree family history of type 2 diabetes mellitus, tacrolimus use, and hyperglycemia in the two weeks immediately after transplantation (42). Patients that developed persistent PTDM had later onset disease (mean 1.9 years) compared to...

Epidemiology and predisposing conditions

The immunocompetent subjects developing esophageal infections will have predisposing conditions that weaken defence mechanisms of the esophageal mucosa. Esophageal disorders that cause slowing of peristalsis and stasis of intraluminal content such as achalasia, systemic sclerosis, myopathies, neuropathies and esophageal strictures predispose to infections of the eso-phageal mucosa, usually candidiasis. Infections in the surrounding organs and structures may also involve the esophagus. Other conditions predisposing to esophageal infections are malnutrition and diabetes mellitus. The latter may derange esophageal peristalsis and emptying of intralumi-nal content, and may impair granulocyte function through hyperglycemia. Finally, antimicrobial drugs can alter the normal oropharyngeal flora leading to overgrowth of Candida organisms.

Estimated Healthcare Expenditures Associated With Diabetes

A large portion of the costs of diabetes is associated with its complications (7). The University Group Diabetes Program, the earliest randomized clinical trial of the treatment of hyperglycemia in people with diabetes, failed to show a positive effect of glycemic control on the prevention of the development or progression of microvascular complications (8). However, the Diabetes Control and Complication Trial and the United Kingdom Prospective Diabetes Study clearly showed that strict control of blood glucose could positively affect the progression of diabetic complications (9). It has also been shown that elevated hemoglobin A1c (HbA1c), an indicator of poor glucose control, is associated with increased mortality in diabetic populations (9). The American Diabetes Association recommends a goal for HbA1c of < 7 percent, with the need for intervention when HbA1c is > 8 percent (10).

Design Of Treatment For Type Diabetes Based On Nutrient Interactions

It is perhaps apparent by now that increased lipid availability can impair glucose utilization through many different mechanisms and result in the hyperglycemia of type 2 diabetes. Consequently, there are as many different approaches that can be used to design effective treatment strategies for the disease on the basis of the competition of nutrients as substrates for metabolic reactions. These strategies include limiting the availability of lipids as metabolic fuels inhibition of fatty-acid uptake and oxidation inhibition of gluconeogenesis and uncoupling the energy obtained during fatty-acid oxidation with concomitant manipulation of the fatty-acid Hyperglycemia FIGURE 10.2 Summary of pathways of the glucose-fatty-acid cycle. Increased fatty-acid utilization generates intermediate substrates that impair glucose utilization while enhancing de novo glucose synthesis and storage, resulting in blood-glucose overload or hyperglycemia. As pointed out earlier, fatty-acid oxidation affects...

Fatty Acid Oxidation in Skeletal Muscle

Activity or ability of CPT-1 to transport fatty acyl-CoAs into the mitochondria is believed to be the rate-limiting step of fat oxidation in skeletal muscle.89 Malonyl coenzyme A (malonyl CoA), the product of acetyl coenzyme A carboxylase (ACC), allostericaly binds to and inhibits CPT-1 activity,74 thereby inhibiting transport of fatty acyl-CoAs into the mitochondria. The importance of the malonyl CoA-CPT-1 interaction upon rates of fat oxidation has been demonstrated in response to many stimuli.84,89,90 Transgenic mice that lack the ACC enzyme (no production of malonyl CoA) have increased rates of fat oxidation and reduced rates of fat storage1. In addition, the same ACC knockout mice are resistant to weight gain and maintain normal insulin sensitivity in response to a high-fat diet.1 An in vivo human study demonstrated that hyperglycemia hyperinsulinemia decreases long-chain fatty acid oxidation through increasing muscle malonyl-CoA content, but had no effect upon oxidation of...

Gastrointestinal Peptides

In clinical trials, subcutaneous injection of GLP-1 before each meal in patients with diabetes resulted in improvement in glycemic control without untoward effects (104). Exendin-4, a GLP-1 receptor agonist with longer biological action than GLP-1, also is showing promise in clinical trials (105). Endogenous GLP-1 abundance can be augmented by inhibition of dipeptidyl peptidase-4 (DPP4), the enzyme involved in GLP-1 breakdown. Such a strategy using a novel DPP-4 inhibitor (NVP DPP728) has been reported to improve glycemic control in subjects with diabetes (106). Thus, GLP-1 appears to be an intestinal satiety factor with diverse metabolic effects favorable for control of hyperglycemia. Not surprisingly, there are current

Vitamins and Minerals

While there's nothing wrong with taking a daily multivitamin, megadoses aren't a good idea because their long-term safety remains in question. Over the years, various supplements have been recommended for an assortment of ailments. B-vitamins, for instance, were used to treat diabetic neuropathy, but their beneficial role was never proven and they're not recommended as a therapeutic option. Although chromium piccolinate was reported to have a good effect on blood-sugar control, it was never conclusively demonstrated. One antioxidant, alphalipoic acid, is a prescription drug in Germany that has been used to treat diabetic neuropathy. Although studies are underway in the United States, results will not be available for years.

Diseasespecific Guidelines

The physiological advantage of an emphasis on plant foods may also stem from the influence of these foods on blood sugar control, where there is renewed interest in the role of foods with a lower glycemic index. Whole foods and foods rich in unrefined starch and fiber produce a more blunted postprandial blood sugar response and effectively control hunger than those based on highly refined carbohydrate foods.

Scientific Studies Coming to Terms

A factor such as age, gender, or food choices in a study that differs among the people being studied. An independent variable is the one being studied a dependent variable, perhaps lower blood sugar level or LDL cholesterol level, happens as a result of the treatment.

Coronary Heart Disease in Vegetarian South Asians

South Asian migrants from the Indian subcontinent (Bangladesh, India, and Pakistan) have higher mortality from CHD than other ethnic groups living in the new host country.84 Reliable population-based CHD mortality data are not available from South Asia, but mortality is probably low in rural areas and high in urban areas.84 Many South Asians are vegetarians, which might suggest that this type of vegetarian diet does not reduce the risk for CHD. However, South Asians differ from other ethnic groups, both in many aspects of lifestyle and also genetically, and a case-control study of risk factors for CHD (specifically acute myocardial infarction) in Bangalore, India, did observe a 45 reduction in risk in vegetarians, which was partly explained by their lower blood glucose concentration and lower waist to hip ratio.85

Foundations for practical nutritional information

Table 7.2 Developing nutritional data sets related to health end-points associated with elevated blood glucose A food company that had not kept abreast of nutritional knowledge recently formulated a new 'diabetic muesli bar', replacing all sucrose sources with dextrins, in the belief that 'sugar' replacement would improve blood glucose control. However, such wisdom was obsolete, because sucrose, being half fructose, induces a much lower blood glucose response than dextrins, which are rapidly digested glucose polymers. The new 'diabetic' bar had a greater glycaemic impact than the unmodified version.

Nuts Seeds And Oils

The polyphenolics in olive oil inhibit LDL oxidation by scavenging free radicals and chelating free metal ions.149 The polyphenolics also enhance the synthesis of prostacyclin, PGI2, and thus inhibit platelet aggregation. These phenolic compounds are antioxidants that reduce eicosanoid production by leukocytes, so as to modulate inflammation and protect the cell against cancer-forming substances. Olive oil also contains up to 150 ppm of the antioxidant vitamin E, which can also inhibit platelet aggregation. Polyphenolics have also been shown to lower blood glucose levels.151

Study of Glucose Transporters by Use of Transgenic and Knock Out Mice

The b cells of the pancreas first sense, then respond to, elevated blood glucose levels by secreting insulin. The glucose transporter in their cell membranes is GLUT 2 circumstantial evidence suggests that it may be involved in the glucose-sensing mechanism. However, studies in transgenic mice created to express a transforming ras protein in the b cells showed that these animals respond normally to a glucose load, even though their b cells do not express GLUT 2 ( 26). It is thus difficult to consider GLUT 2 part of the sensing apparatus.

Carbohydrate Reserves

The amount of glycogen stored in the liver amounts to approximately 100 g. This quantity may change periodically depending on the amount of glycogen that is broken down for the supply of blood glucose in periods of fasting and the amount of glucose that is supplied to the liver after food intake. Accordingly, liver glycogen reserves increase after meals but diminish in between, especially during the night, when the liver constantly delivers glucose into the bloodstream to maintain a normal blood glucose level (89-91, 135, 158). A constant blood glucose level, within a narrow physiological range, is important because blood glucose is the primary energy source for the nervous system.

Stroke Prevention and Treatment

This component is found naturally in the body, and is quickly converted to dehydrolipoic acid. In this form it is a very powerful and versatile antioxidant and iron chelator, and has been shown to increase mitochondrial energy production. In my neurosurgical experience I have found it to be very protective of the injured brain. In large doses, 600 mg or more, it can lower blood sugar. I suggest 200 mg a day in two divided doses.

Sugar Protein Reactions in Diabetes and Aging

The Maillard Amadori reactions of sugars with amino acids and proteins lead to a cascade of reactions. Products of these reactions are referred to as advanced glycation end products. These reaction end products have been observed in collagen-rich tissues in vivo and in vitro, and they are associated with stiffening of artery walls, lung tissue, and joints and with other aging symptoms. Considerable evidence links hyperglycemia with increased formation of these end products these products accumulate in the blood vessel wall proteins and may contribute to vascular complications of diabetes. Glycation of lens proteins increases somewhat with aging, but it is accelerated in diabetes. Incubation of lens proteins with glucose or glucose 6-phosphate in vitro results in changes in the lens proteins that mimic most of those observed with age- and cataract-related changes in the lens. Drug-induced inhibition of the reactions leading to these end products in diabetic animals prevented various...

Rehydration Solutions

The addition of electrolytes, in small quantities as lost by the whole body sweat, will influence neither gastric emptying nor absorption (153,154). The CHO fraction will contribute to the maintenance of a normal blood glucose level and will lead to a sparing of the endogenous CHO reserves (49, 75,

Interactions with other nutrients and drugs

Biloba, garlic, and saw palmetto add to the effects of agents that may also affect blood pressure, such as eucalyptol, eucalyptus oil, flaxseed flaxseed oil, garlic, ginger, and ginkgo, among others and enhance lower blood sugar properties of aloe vera, American ginseng, bilberry, bitter melon, maitake mushroom, marshmallow, milk thistle, Panax ginseng, rosemary, shark cartilage, and Siberian ginseng, among others.38 Omega-3 fatty acids can increase LDL cholesterol concentrations and may work against the potential LDL-lowering properties of agents like barley, garlic, guggul, psyllium, soy, or sweet almond.38

Nutrition And Diabetes Mellitus

Diabetes is a disease in which there is insufficient or ineffective insulin, a hormone that helps regulate the blood sugar level. When the blood sugar rises, such as after eating a meal, the pancreas releases insulin. The insulin facilitates the entry of glucose into body cells, to be used for energy. If there is no insulin or if the insulin is not working, sugar cannot enter the cells. Thus, high blood sugar levels (called hyperglycemia) result, and sugar spills into the urine.

The Effect Of A Vegetarian Diet On Performance

Nineteen long-term (mean of 46 years) vegetarian and 12 non-vegetarian, healthy, physically active elderly women (mean age of 71 years) were compared on a variety of hematological, anthropometric, and metabolic factors.30 Although the vegetarian subjects had significantly lower blood glucose and cholesterol levels, no differences between groups were found for submaximal and maximal cardiorespiratory and electrocardio-graphic parameters measured during graded treadmill testing. The authors

Complications Associated with Preexisting Diabetes

Congenital malformations and spontaneous abortions are associated with maternal hyperglycemia in the first 12 weeks of gestation. The central nervous system, heart, lungs, gastrointestinal tract, kidneys, urinary tract, skeleton, and placenta are all vulnerable to adverse effects (Table 10.1) 21-23 . The frequency and severity of complications decrease if maternal normoglycemia is maintained throughout pregnancy. Macrosomia is the most common complication associated with diabetes and pregnancy, estimated at 20-45 , depending on the population 24, 25 . The definition of macrosomia varies and ranges from 4,000 to 4,500 g 26 . Macrosomia is thought to occur if maternal glycemic levels are elevated in the third trimester. Pedersen hypothesized that maternal hyperglycemia leads to fetal hyperglycemia, which stimulates the fetal pancreas to produce excessive insulin and results in excess growth 27 . Macrosomic infants have disproportional large fetal trunks in relation to their head size,...

General Dietary Influences

Folk beliefs and remedies have also been passed down through generations, and they can still be observed today. The majority of African-American beliefs surrounding food concern the medicinal uses of various foods. For example, yellow root tea is believed to cure illness and lower blood sugar. The bitter yellow root contains the antihistamine berberine and may cause mild low blood pressure. One of the most popular folk beliefs is that excess blood will travel to the head when one eats large amounts of pork, thereby causing hypertension. However, it is not the fresh pork that should be blamed for this rise in blood pressure, but the salt-cured pork products that are commonly eaten. Today, folk beliefs and remedies are most often held in high regard and practiced by the elder and more traditional members of the population.

Early Detection

Early detection of diabetes is important. The longer the body is exposed to high blood sugar levels, the greater the damage to the nervous and circulatory systems and to the blood vessels in the eyes, kidneys, heart, and feet. The early years of diabetes offer an opportunity. If you have diabetes, that's when you can do the most to prevent or reduce its long-term consequences and so live a longer life with fewer health problems. How would you know if you have it These are common symptoms frequent urination, unusual thirst, extreme hunger, unusual weight loss, extreme fatigue, and irritability. In addition, those with type 2 diabetes also may experience frequent infections cuts and bruises that heal slowly blurred vision numb or tingling hands or feet or recurring skin, gum, or bladder infections. Some people with type 2 diabetes have no outward signs associated with high blood sugar levels. Keeping tabs on your blood sugar level is the way to really know.

Niacin B

This B-vitamin is also involved in energy-producing reactions in the cells that convert food to energy. In addition, niacin helps maintain healthy skin, nerves, and your digestive system. In some instances, you can use large doses of niacin as a cholesterol-lowering medication. However, you should only do this under the supervision of your doctor. Megadoses can cause hot flashes, itching, ulcers, high blood sugar, and liver damage.

Previous page 121

Although the subjects studied were often normal non-diabetic individuals, the findings are likely to apply to individuals with diabetes. Hence, chocolate products should not be blamed for high blood sugar levels, nor should they be recommended for the treatment of clinical hypoglycemia (low blood sugar) in insulin-dependent diabetes. Chocolate products are usually very energy-dense foods and should therefore play a small but nonetheless pleasurable and guilt-free role (e.g. one daily 'indulgence') in the diet of people with type 2 diabetes. Active individuals with type 1 diabetes can afford to include more generous amounts of chocolate as long as blood glucose and lipid control remain within desirable levels.

If You Have Diabetes

The goal for diabetes management is this controlling your blood sugar levels so they stay as near to normal as possible. Like a teeter-totter, blood sugar levels go up (hyperglycemia) and down (hypoglycemia) that's part of dealing with diabetes. Those swings can be dangerous when diet, physical activity, and medication such as insulin aren't balanced properly.

Growth Hormone

Growth hormone is secreted by the anterior pituitary. Its secretion is enhanced by hypoglycemia. It has direct and indirect effects on decreasing glucose uptake in specific tissues such as muscle. Part of this effect may be due to the liberation of fatty acids from adipose tissue, which then inhibit glucose metabolism. If growth hormone is chronically administered, it causes persistent hyperglycemia, which stimulates the insulin secretion. The b cells, however, finally become exhausted, and diabetes ensues.

Role of Inflammation

In molecular and animal studies, hyperinsulinemia and hyperglycemia132,133 have been shown to be independent risk factors of colorectal carcinogenesis. Insulin and IGF-1 receptors are expressed by both normal colorectal epithelial cells and colon cancer tissue.134,135 Therefore, both premalignant and cancerous stages can be affected by IGF-1. In a recent review, Chang and colleagues136 summarize the epidemiologic literature with respect to hyperinsulinemia and hyperglycemia as risk factors for colorectal cancer. According to the authors, epidemiologic findings to date indicate a slightly increased risk of colorectal cancer for patients with diabetes however, there are some inconsistencies across the study results. Possible explanations for these inconsistencies might include inadequate information about patients' diabetic disease and treatment status. A greater attention toward medical history, staging and treatment for hyperinsuline-mia and hyperglycemia might be helpful to further...

Diabetes

Diabetes is a chronic disease caused by inadequate secretion of, or peripheral resistance to, insulin. It is characterized by hyperglycemia and hyperlipidemia. Diabetes, when poorly controlled, causes widespread damage to blood vessels and nerves, which can result in blindness, kidney failure, or heart attack.

Insulin

Insulin release and glucose absorption depend on a number of factors, including the glycemic index of food and the co-ingestion of fat and protein. Consumption of high-glycemic foods causes hyperglycemia which results in the release of too much insulin. On the other hand, low-glycemic foods or the ingestion of fat and protein in a meal provide steady glucose absorption and release of insulin. Exercise lowers blood glucose levels and increases the amount of insulin in the bloodstream, along with improving the body's use of insulin. A balance must exist between the sugar used for energy, the sugar available from food, and the insulin used in lowering blood sugar. Consequently, changes may have to be made to insulin, or food intake, or both, prior to and after exercise. see also Diabetes Mellitus Glycemic Index Hyperglycemia Hypoglycemia. hyperglycemia high level of sugar in the blood

Intake

Excessive quantities of carbohydrates can also have a negative impact in the hospital setting. Even moderate degrees of hyperglycemia may result in an increased incidence of infection and adverse outcomes (42). Persistent hyperglycemia has been associated with poor wound healing and immunity (7). Excessive amounts of glucose have been positively correlated with increased carbon dioxide production and hepatic steatosis in traumatized and septic patients (12,13). Diabetic subjects who suffer from wounds need to be especially careful in regard to the regulation of glucose intake and the maintenance of euglycemia (17).

Glycemic Index

The objectives of diet management in diabetic patients are to reduce hyperglycemia, prevent hypoglycemic episodes, and reduce the risk of complications. For people with diabetes, the glycemic index is a useful tool in planning meals to achieve and maintain glycemic control. Foods with a low glycemic index release sugar gradually into the bloodstream, producing minimal fluctuations in blood glucose. High GI foods, however, are absorbed quickly into the bloodstream causing an escalation in blood glucose levels and increasing the possibility of hyperglycemia. The body compensates for the rise in blood sugar levels with an accompanying increase in insulin, which within a few hours can cause hypoglycemia. As a result, awareness of the glycemic indices of food assists in preventing large variances in blood glucose levels. hyperglycemia high level of sugar in the blood

Introduction

Many children and adolescents with type 2 diabetes are asymptomatic at the time of diagnosis and for long periods of time thereafter. Consequently, the condition is defined by measures of blood glucose that lie above the normal range. With increasing recognition of the long-term risks of mild elevations of blood-glucose concentrations in adults, the definition of diabetes has changed during the past generation. The diagnosis is established if fasting blood-glucose concentrations exceed 125 mg and if postprandial or postdextrose challenge glucose concentrations exceed 200 mg . Isolated fasting hyperglycemia must be confirmed on a subsequent day, while postprandial or postchallenge hyperglycemia must be accompanied by diabetic symptoms, such as polyuria or polydipsia. The transient hyperglycemia caused by acute stress, illness, pancreatitis, or certain medications (e.g., glucocorticoids, thi-azides) must be excluded. Recent studies and clinical experience, however, have clouded the...

Diabetes Mellitus

Diabetes mellitus is a common metabolic disorder resulting from defects in insulin action, insulin production, or both. Insulin, a hormone secreted by the pancreas, helps the body use and store glucose produced during the digestion of food. Characterized by hyperglycemia, symptoms of diabetes include frequent urination, increased thirst, dehydration, weight loss, blurred vision, fatigue, and, occasionally, coma. Uncontrolled hyper-glycemia over time damages the eyes, nerves, blood vessels, kidneys, and heart, causing organ dysfunction and failure. A number of risk factors are attributed to the incidence of diabetes, including family history, age, ethnicity, and social group characteristics, as well as behavioral, lifestyle, psychological, and clinical factors. hyperglycemia high level of sugar in the blood

Chromium Cr

Chromium deficiency can result in glucose intolerance, which is an inability to reduce blood glucose levels properly after a meal and throughout the day. Conversely, little is known about the toxic effects of chromium in larger doses. Some scientists have reported that supplements of as much as 800 micrograms daily are safe, while others question as to whether excessive chromium consumed chronically would build up in body tissues such as bone, and have milder long-term effects. Vanadium appears to be able to affect glucose metabolism in a manner similar to insulin. Promising research with diabetic animals has suggested that vanadium therapy may control high blood glucose levels (hyperglycemia). However, the application to hyperglycemia in humans is still questionable and supplementation cannot be recommended at this time.

Medications

A phenomenon of fat redistribution, or lipodystrophy, is often seen in HIV-infected individuals on ARV therapy, specifically PI, NRTI, or both 79, 80 . This usually occurs as a result of long-term ARV therapy. The syndrome is characterized by loss of subcutaneous fat from the face, arms, and legs and oftentimes deposition of excess fat in the neck, upper back, and the trunk 79 . Additionally, metabolic complications such as insulin resistance, hypertriglyceridemia, low levels of serum low density lipoprotein cholesterol, and hyperglycemia are commonly seen.

What Is Diabetes

For many people, the fine regulation of the level of blood glucose becomes impaired. This results in chronic high blood glucose concentrations medically known as hyperglycemia. The impairment may be due to a decreased ability of the pancreas to produce insulin, which is the case in type 1 diabetes. The lack of insulin allows glucose levels to remain elevated even in a fasting state. Furthermore, after a meal blood glucose levels can climb exceptionally high (see Figure 4.4). For most people diagnosed with diabetes, blood glucose regulation is impaired despite their ability to produce insulin. In fact, many of these individuals produce more insulin than what seems normal, at least initially. This type of diabetes is referred to as type 2 diabetes.

Retinopathy

Retinopathy affects more than 300,000 people in the U.S. (90). It is the leading cause of blindness in people age 20 to 64 years old (13). It accounts for 12 percent of all new cases of blindness, with 12,000 to 24,000 new cases each year in the U.S. (13). The prevalence of diabetic retinopathy is 46 percent higher in non-Hispanic blacks and 84 percent higher in Mexican Americans compared to non-Hispanic Caucasians (93). There is evidence to suggest that retinopathy begins to develop at least seven years before type 2 diabetes is clinically diagnosed (94, 95). The Wisconsin Epidemiologic Study of Diabetic Retinopathy examined the prevalence and incidence of diabetic retinopathy (91). The pathogenesis of retinopathy is thought to begin with hyperglycemia, which leads to increased levels of protein kinase C and aldose reductase activities, nonenzymatic glycosylation, vasoactive substances, growth factors, and free radicals (90, 96). These changes cause functional changes,

Micronutrients CHD

Lowers LDL cholesterol and raises HDLs, thereby reducing risk of heart attack.13 Side effects (flushing) can be minimized by raising the dose gradually and taking the niacin with meals. Should betaken only under medical supervision at doses > 1 g day because of rare but potentially serious side effects, including liver inflammation and hyperglycemia

Type Diabetes

Diabetes mellitus represents a group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The pathogenic processes involved in the development of diabetes range from autoimmune destruction of the pancreatic P cells with consequent insulin deficiency to abnormalities that result in resistance to insulin action (164). There are two main etiopathogenetic categories of diabetes (1) type 1 diabetes, which is caused by deficiency of insulin secretion and rises independently of obesity or the metabolic syndrome (will be covered in Sect. 3), and (2) type 2 diabetes, which is caused by a combination of resistance to insulin action and inadequate compensatory insulin secretion. Type 2 diabetes, or noninsulin-dependent diabetes mellitus, is the most frequent form of diabetes, accounting for 90 of the disease prevalence, with an estimated 150 million affected people worldwide (165,166). Overall, type 2 diabetes is...

Measurement Tools

Blood-sugar control on a day-to-day basis is evaluated by using a glucose monitor. However, it is also recommended that a Hemoglobin A1C (A1C) test be performed at least twice a year in patients who are meeting their blood-sugar goals and every three months in individuals whose blood-sugar levels are not well controlled. The A1C is a simple blood test which shows the average blood glucose level over a three-month period. The following table provides guidelines for blood sugar and A1C goals.

Diet Alcohol

Further lowers nutrient absorption from foods. The liver is particularly vulnerable to alcohol - more than three drinks a day causes inflammation and accumulation of fat in the liver. This impairs liver function, reducing the ability to detoxify chemicals and drugs. Because the liver is important for blood sugar control, alcohol-induced liver damage can produce hypoglycemia, leading to fatigue, irritability, and concentration difficulties. Alcohol increases urinary losses of many minerals, including zinc, calcium, and magne-sium.5 Because of these effects, a diet rich in fresh fruits and vegetables, whole grains, lean meats, and low-fat milk products should be carefully chosen.

Toxicity

Supplements of L-cystine (formed by joining two cysteine molecules) should be avoided because they provide none of the antioxidant effects of cysteine and may increase risk of kidney stones. High doses of cysteine may be converted to cystine and precipitate formation of kidney and bladder stones. Ample vitamin C intake helps prevent conversion of cysteine to cystine and reduces the risk of this side effect. Large doses of supplemental cys-teine may interfere with the action of insulin and thereby worsen blood-sugar control in diabetes diabetics should consult their physician before taking large doses of cysteine. There are no reports of toxicity from gluta-thione supplements.

Body Fat and the GI

As mentioned, the study found the insulin levels of the high GI meal were much higher than the other meals. When insulin rushes in to lower blood sugar after a high GI meal, the effect can be low blood sugar shortly after, thus the body senses the low blood sugar sending out the hunger signal.

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Diabetes is a disorder of carbohydrate metabolism characterised by high blood glucose (sugar) levels. Untreated, the disease produces serious complications including blindness, renal failure, nerve damage and coronary heart disease. Thus one of the main goals in the management of diabetes is to maintain before-meal and after-meal blood glucose levels as close as possible to normal. Other goals include normalising blood lipid levels, blood pressure and weight status. These objectives apply to both types of diabetes, type 1 (insulin-dependent, juvenile onset diabetes) and type 2 (non-insulin-dependent, adult onset diabetes). Historical changes in diets for people with diabetes have been so marked that the reader can be forgiven for being confused. In the past, the prescribed diets were low in carbohydrate (i.e. starch and sugars) because dietary carbohydrate was considered the main factor responsible for high blood glucose levels (1). This had the unintended consequence of increasing...

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Starchy foods are rapidly digested and absorbed, giving high blood glucose responses and correspondingly high GI scores. The foods with a high GI (> 70 on a scale where glucose has a value of 100) include white and wholemeal bread, potatoes, most rices, and the majority of breakfast cereals (12). The starch in these foods has been fully gelatinised during processing and is therefore quickly digested and absorbed in the small intestine to glucose.

Diet and Diabetes

Many people think eating lots of sugar causes diabetes. Wrong. Being overweight and underfit are the bigger culprits. In a study of 3,200 people (average age in the 50s) who were overweight and had elevated blood glucose, both when fasting and after eating meals (a risk factor for diabetes), some of the subjects were given medicine (metformin) to lower their blood glucose. Others were instructed to exercise at least 150 minutes per week (five times a week for 30 minutes) and to lose weight (about 7 percent of their body weight, or about 11 pounds for a 160-pound person). And some were told to make no changes (these people made up the control group).

Protective Factors

The pancreas makes pancreatic juice consisting of enzymes (amylases, lipases, and proteases) and bicarbonate, which helps neutralize acidic secretions produced during digestion. The pancreas delivers the pancreatic juice to the small intestine, in response to a signal of food in the intestine and the release of the hormone secretin. The pancreas also has another function, the secretion of the hormones insulin and glucagon, which helps maintain a steady state of blood sugar in the body (insulin decreases blood glucose concentration, while glucagon increases it).

Glycogen

It is a storage form of glucose in human muscle and liver, roughly comparable to the storage of glucose in plant starches such as potato, rice, grains and banana. Glycogen is synthesized or broken down by different enzymes within the cytoplasm. When synthesized, glucose is phosphorylated to glucose-1-phosphate. Glucose-1-phosphate is converted to uridine diphosphate (UDP) glucose, which is built into glycogen by the action of the enzyme glycogen synthetase. When the amount of glucose is insufficient, glycogen is broken down by action of the enzyme glycogen phosphorylase. Glycogen is mainly synthesized in periods when the amount of glucose present in cells exceeds the amount required for energy production. Glycogen metabolism in the liver regulates the blood glucose level. After meals, glucose and fructose are taken up by the liver, leading to liver glycogen storage. During the night or during fasting, liver glycogen will be broken down to maintain a...

Legumes

A number of studies have shown that legumes, such as beans and lentils, lower blood cholesterol levels, improve blood sugar control, lower triglyceride levels, and lower the risk of heart disease.74-76 While beans are good sources of polyunsaturated fat, folic acid, potassium, copper, and soluble fiber, they also contain a variety of important phytochemicals such as flavonoids, protease inhibitors, saponins, phytates, and phytosterols that have cardio-protective and cancer-preventive properties.3,77,78 The anthocyanin pigments isolated from the bean seed coat of Phaseolus vulgarus, the common bean, exhibit strong antioxidative activity.79 These pigments may provide protection against oxidative damage of cell membrane lipids and cell contents.

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