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Archive for the ‘Diabetes’ Category

Metaglip (Glipizide, Metformin)

Friday, November 6th, 2009

You should test your blood or urine whenever you are worried about your diabetes. Do not sit there worrying. Find out what is happening to your blood glucose so that you can do something about it. Experiment by testing after an unusual day, a different meal, a family upset, or a new hobby. See how your moods, your work, your meals and your activities affect your diabetes. Write the results of your tests down so that you can refer back to them. Many manufacturers provide free diaries in which to do this.
When we study diabetics in research projects we may make a twenty-four hour glucose profile. This means that we take a tiny sample of blood every hour from a little plastic tube in a vein and plot the blood glucose level on a graph. A glucose profile is shown in the diagram. Notice the peaks after every meal and the low levels at night.
Blood testing every hour is not necessary in day-to-day life and would give you very sore fingers! Most people test the glucose in their blood or urine before each main meal – before breakfast, before lunch, before the evening meal – and also before going to bed. If you test after meals you will have higher results but these should still, ideally, be below 8 mmol/1 or 140 mg/dl. Some people test only once a day, but at a different time each day – before breakfast on Monday, before lunch on Tuesday, before the evening meal on Wednesday and so on. It is important to build up a picture of what is happening throughout the day. Discuss the timing of your tests with your doctor.
I thought the idea was to make life easier! It is. You will soon become skilled at testing your blood or urine and it will only take a few minutes. The time spent and the momentary discomfort of finger pricks is well repaid by the peace of mind you gain from knowing what is going on. Why keep yourself in the dark?
Finding out what is happening
• The first step in taking command of your diabetes is to learn how to measure your blood glucose level and to continue to keep a close eye on it.
• The most direct way of doing this is to do finger prick blood glucose tests.
• Urine tests can also be helpful, provided you understand their limitations.
• When you have found out what is happening to your blood glucose level you can use the knowledge to get the very best out of your treatment and to adjust it to suit what you want to do each day.

Glyset (Miglitol)

Friday, November 6th, 2009

It is a well-known fact that the air-bath tends to soothe the nerves and to relax the whole system, so that most people go to sleep quickly after it. Many skin sufferers who go to bed without airing their skins are asking for trouble, and they generally wake up during the night with the irritation. In a great many cases this can be avoided by the proper use of the air-bath, and this is a much better way than using all kinds of lotions and pain-killing agents. As we have already seen, there is a very close relationship between the nerves and the skin, and anything that will soothe the nervous system will allay the irritation in the skin.
If the skin irritation is localized it may be very useful to apply a cold compress before sleeping, because this will relieve the congestion and enable the patient to get off to sleep. Whenever the skin is hot and irritable the cold compress should be used. It can do no harm, and there is no other measure that will give so much relief to the hot, irritable skin.
One should remember that one spends one-third of one’s life in bed and so it is worth while thinking about it from the standpoint of health and comfort. The bed should be fairly firm, so that it holds the body without giving way too much. A sagging bed may cramp the muscles and the spine. For hygienic reasons no feathers should be used in the pillows or in any of the other parts. The covering clothes should be as light as possible, so that they give warmth without weight. It is wise for the skin sufferer to try to sleep with too little rather than too much covering, because overheating the skin is very disturbing to the sleep.
The covering of the body should be of cotton or silk material; certainly not wool. Some people like to sleep without any covering to the body, and provided that the bed is well-aired every day there is much to be said for this habit. On the other hand, if the skin is actively throwing off the waste products of the system it is a good thing to wear pyjamas which can be changed and washed more easily than the sheets.
Taking the air-bath before retiring will help to relax the body and mind in readiness for sleep, but in any case a few minutes should be spent in “letting go” the limbs and the mind. Taking one’s business and other worries to bed is a great mistake, and if the mind is active it is a good plan to think of pleasant things. Try to remember pleasant holidays that have been spent under peaceful surroundings. Often in this relaxing, contemplative mood the mind will shut off its energy and the individual will be at sleep.
It is important to bear in mind that if one can go to sleep thinking of pleasant things one is far more likely to sleep quietly and to waken more refreshed and in a better frame of mind. The optimistic outlook is essential for the skin sufferer, and the best test for it is a good night’s sleep with dreams that do not cause any anxiety. When going to sleep there is no harm in changing the position of the body so as to relax all the muscles in turn. First lie on the back, then turn over on to the abdomen, then turn on the left side and finally turn on to the right side and then go to sleep.
A final hint: do not try to go to sleep. Sleep is a purely involuntary act, and no one can will it. It is something that is controlled by the body, and whilst we can rest by an act of will we cannot do the same with sleep. It is important, therefore, not to get the idea too much into the conscious mind. Think of relaxing and resting, and sleep, Nature’s soft nurse, will “steep your senses in forgetfulness.”

Starlix (Nateglinide)

Friday, November 6th, 2009

The problem is that our bodies are not machines. A car owner can calculate the number of miles his car goes per gallon and knows how much the fuel tank holds – so he knows how much fuel he needs and how often. But there are so many variables in the working of the human body that a simplistic view of food as a fuel may lead to a false sense of security.
For example, if John needs 50 grams of carbohydrate to work all afternoon, he could eat his 50 g of carbohydrate in various ways – 20 g as new potatoes, 20 g as bread and 10 g as an apple. But if he eats the potato as crisps and the apple as apple juice, the same 50 g of carbohydrate will produce a different rise in his blood glucose after the meal because these foods will be digested differently. It is possible to calculate the amount each carbohydrate containing food will elevate the blood glucose concentration as compared with an equivalent amount of carbohydrate as glucose itself. This produces the glycaemic index. For example, the glycaemic index of new potatoes is 70 but the glycaemic index of potato crisps is 51.
What are the practical implications? If there is such a variable blood glucose response to carbohydrate foods there seems little point in weighing out precise carbohydrate portions for every meal. However, for people taking insulin, it is helpful to have some idea of how much carbohydrate a meal contains as this is one factor which determines how much insulin you inject. It is also helpful for all of us to know approximately what is on our plates in terms of total energy (calories), carbohydrate, fat and protein. Start looking at the back of food packets and the labels on tins – most now provide this information. One piece of useful information is that 1 g of fat provides twice the number of calories (9 cals/g) as 1 g of carbohydrate (3.8 cals/g) or 1 g of protein (4.0 cals/g). Most foods contain water which adds to the weight but not the energy content.
John has a plateful of food containing about 500 calories. Of this 55 per cent (275 cals) should be starchy carbohydrate, 30 per cent (150 cals) should be fat and 15 per cent (75 cals) should be protein. John could eat this as 75 g carbohydrate, 17 g fat and 16 g protein. This is approximately equivalent to 290 g boiled potato (it contains a lot of water) with 100 g lean ham (it contains some water). Lettuce, tomatoes and onion rings, all of which can be regarded as calorie-free could be added, with 20 g salad cream and two apples for dessert.
There is absolutely no need to do such complex dietary calculations yourself – as discussed above this is not appropriate – but this example shows you how tiny your helpings of fatty foods should be in comparison with carbohydrate foods. Essentially your plate should contain four helpings (by weight) of dry carbohydrate food, one helping of fat and one helping of protein.
If your foods have water in them (like vegetables or meat) you can eat more of them than of drier foods. Because protein foods often contain fat you will find there is very little of your fat allowance left over for dressings or spreading on your bread. Some carbohydrate foods also contain fat (potato crisps). This can make them very high in calories (potato crisps contain 559 cals per 100 g, boiled old potatoes 80 cals per 100 g) but may also use up most of your fat allowance (100 g crisps contain 37 g fat).
Special diabetic foods have no place in your diet. They contain fructose or sorbitol and neither has been shown to be of definite benefit in the management of diabetes. You are better eating small amounts of natural foods as part of your diet.