Monday, June 20, 2011

Diabetes vs. supplements, when to say yes to them


Coming back to nature campaign has became widely accepted, and somehow supplements serves better than taking a medication, to most patients with chronic disease supplements can hold hope to them much than going to admit they have this specific disease. No matter what is the supplement you think to take or wish to take, remember to always ask your pharmacist or physician.

Recent studies report that 35% to 48% of patients with diabetes use some form of complementary and alternative medical therapy. Moreover, >800 plants have been traditionally used for the treatment of diabetes. Despite this widespread use, only few were supported by rigorous clinical evidence.

While Googling the answer to such questions, to actually see the percentage of people agreeing to use them or those who had them worked for them, only small number people actually had either given a slight improve or they thought they did, most herbals I found to be used are:

Cinnamon:

Well to most shocking, cinnamon can lower blood glucose level, but not always and CANNOT be used as medication, it has no effect on HA1C, which is the primary thing to be lowered.
It is not approved to be used for type one diabetes mellitus. It shouldn’t be used regularly in all cases for lowering diabetis, but for sure you can take it for H. Pvlori one powdered spoon per cup of juice.

Gymnemre sylvestre


it has been used as a natural treatment for diabetes for nearly two millennia. While it is still being studied, and the effects of the herb are not entirely known, the herb has been shown to reduce blood sugar levels when used for an extended period of time. Additionally, Gymnema reduces the taste of sugar when it is placed in the mouth, thus some use it to fight sugar cravings this effect lasts up to about 2 hours. Gymnema cannot be used in place of any medication taking.
Gymnema sylvestre, is a plant considered to be with potent antidiabetic effects and, hence, widely used in folk, ayurvedic and homeopathic systems in medicine. The authors were unable to find previous reports associating G sylvestre to liver injury. Herein, the authors report a case of DILI in a patient who was treated with G sylvestre for diabetes mellitus and review the literature to suggest possible mechanisms that led to this acute condition. [Pubmed] [Department of Internal Medicine E, Soroka University Medical Center, Beer Sheva, Israel. arthur.shiyovich@gmail.com]

Aloe vera

Most studies are done regarding its effect on injuries and diabetic foot, as per its hypoglycemic effect it had shown to lower it but not in controlled manner nor in an obvious way, no studies has showed its effect on daily bases nor on HA1C effect, should be taken with cushion when the patient is receiving other diabetic medications.
Aloe latex should not be taken internally if you are taking the following drugs: digoxin (Lanoxin), diuretics, steroids, drugs for irregular heartbeat, and drugs that cause potassium loss.

Banaba
Lagerstroemia speciosa


“Is there a Banaba cure for diabetes?” is the highlighted sign for it, which in fact has not gone any clinical trial nor any study! in 1999 a study was done in Japan which had showed a weight gain, and also a lowered BG levels in mices, these researchers found that the Banaba herbs extract suppressed hemoglobin A1C, this plant is supposed to have an insulin like effect by increasing glucose uptake.

Ginseng


Did you know that there is original ginseng and like ginseng?
It is contraindicated for high blood pressure people, and some Dr’s believe Ginseng shouldn’t be taken by diabetics since it has a bad effect on sugar levels. Ginseng significantly decreased insulin resistance and fasting blood glucose (FBG) in T2DM patients, However, Ginseng had no effect on indices of glucose regulation following acute or chronic ingestion in healthy volunteers. Its active compounds with antihyperglycemic effects included ginsenosides, polypeptide, and polysaccharides. Ginseng might exert a antihyperglycemic effect by promoting insulin secretion, protecting pancreatic islets, stimulating glucose uptake, and enhancing insulin sensitivity. Future studies require identifying the component(s) of Ginseng. Ginseng had no significant side effects. However, chronic overdosed administration of Ginseng may suffer from gastrointestinal, mental, cardiovascular, and hormone disorders. Children and pregnant women should be cautious of using this herb. [Pubmed] [Traditional Chinese Medicines in Treatment of Patients with Type 2 Diabetes Mellitus Weidong Xie,1 Yunan Zhao,2 and Yaou Zhang]

Bitter melon

Bitter melon lowered fasting and postprandial serum glucose levels in T2DM patients. Although bitter melon might have antihyperglycemic effects, data were not sufficient to recommend its use in the absence of careful supervision and monitoring. Major active compounds in this plant contained cucurbitane triterpenoids polypeptide-p, charantin, and vicine. Bitter melon exerted a antihyperglycemic effect by inhibition of protein tyrosine phosphatase 1B (PTP1B), activation of AMPK, increase of glucose transporter type 4 (GLUT4) expression, promotion of the recovery of beta cells, and insulin-mimicking action. However, adverse effects of bitter melon included hypoglycemic coma and convulsions in children and headaches. Bitter melon might have additive effects when taken with other glucose-lowering agents. Despite this, no serious adverse effects were reported in all the clinical trials. There were no documentations of death from any cause, morbidity, (health-related) quality of life, and costs.
[Pubmed] [Traditional Chinese Medicines in Treatment of Patients with Type 2 Diabetes Mellitus Weidong Xie,1 Yunan Zhao,2 and Yaou Zhang]

Fenugreek

Fenugreek improved blood glucose control and insulin resistance in diabetic patients. The findings of 18 cases of patients showed that FBG, triglycerides, and very low-density lipoprotein cholesterol (VLDL-C) decreased significantly after taking fenugreek seed soaked in hot water. Combined therapy of total saponins of Fenugreek with sulfonylureas hypoglycemic drug lowered the blood glucose level and ameliorated clinical symptoms in 46 cases of T2DM compared with 23 cases of controls. Active components of Fenugreek included trigonelline, nicotinic acid, GII, diosgenin, 4-hydroxyisoleucine, total saponins, Fenugreek oil, and soluble dietary fibre fraction. Its antihyperglycemic mechanisms were associated with potentiating insulin secretion, increasing insulin sensitivity, and inhibiting intestinal carbohydrate digestion and absorption. Fenugreek was relatively safe and also had no genotoxicity. However, we should be cautious of its use combined with aspirin in case of the risk of bleeding.
Milk thistle
Silymarin Marianum

This plant is called “liver helper plant” it protects the liver and widely used for alcoholic people, it has effect on CYP450  and so it has many drug interactions.
The researchers gave the patients tablets to take three times a day with meals.Half of the patients got tablets containing an extract made from milk thistle seeds. The others got placebo tablets containing no milk thistle or other medicine.Patients didn't know which tablets contained the milk thistle seed extract.
At the study's start, the patients had similar blood sugar levels and blood sugar control.

But after taking the tablets for four months, the milk thistle group showed better blood sugar control and cholesterol and triglyceride levels. The key might be compounds in milk thistle that are collectively called silymarin, the researchers say."We don't know the exact mechanism of action for this effect, but this work shows that silymarin could play an important role in treating type 2 diabetes," Huseini says in the news release.

[pubmed]  [Milk Thistle May Help Treat Diabetes Iranian Study Shows Improved Blood Sugar Control; Researchers Call for More Studies]



Supplements:
Alpha Lipoic Acid
What is ALA?
Alpha lipoic acid is a fatty acid found naturally inside every cell in the body. It's needed by the body to produce the energy for our body's normal functions. Alpha lipoic acid converts glucose (blood sugar) into energy. Alpha lipoic acid is also an antioxidant, a substance that neutralizes potentially harmful chemicals called free radicals. What makes alpha lipoic acid unique is that it functions in water and fat, unlike the more common antioxidants vitamins C and E, and it appears to be able to recycle antioxidants such as vitamin C and glutathione after they have been used up. 
Alpha lipoic acid is made by the body and can be found in very small amounts in foods such as spinach, broccoli, peas, Brewer's yeast, brussel sprouts, rice bran, and organ meats. Alpha lipoic acid supplements are available in capsule form at health food stores, some drugstores, and online. For maximum absorption, the supplements should be taken on an empty stomach.

In a Japanese controlled study on rats regarding the effect of ALA, they have found no effect of it neither on blood glucose levels nor on weight. [Yakgaku Zasshi] [pubmed],

Interaction:
  Animal studies indicate that alpha lipoic acid may alter thyroid hormone levels, so it could theoretically have the same effect in humans. People taking thyroid medications such as levothyroxine should be monitored by their healthcare provider.

Omega-3
Fish oil
Dietary advice, including modification of dietary fat quality, is the basis of treatment of diabetes, but there is some uncertainty about the optimal amount of polyunsaturated fatty acids of the n-6 (omega-6) and n-3 (omega-3) series.
Blood glucose concentrations at fasting and during the day were lower with the n-6 than with the n-3 diet (P = 0.009 and P = 0.029, respectively), and the area under the insulin curve during the day was significantly higher (P = 0.03) with the n-6 diet. Both diets showed similar effects on insulin sensitivity and plasminogen activator inhibitor 1 concentrations. The reductions in VLDLs and serum apolipoprotein B concentrations were more pronounced after the n-3 diet.
The risk related to the moderately higher blood glucose concentrations with the n-3-enriched diet may be counteracted by positive effects with regard to lipoprotein concentrations. An increase in long-chain n-3 fatty acids from fatty fish, and of n-6 fatty acids from linoleic acid, may be recommended for patients with type 2 diabetes.

[pubmed] [Fatty fish in the diet of patients with type 2 diabetes: comparison of the metabolic effects of foods rich in n-3 and n-6 fatty acids. Karlström BE, Järvi AE, Byberg L, Berglund LG, Vessby BO.]


The role of omega-3 (n-3) fatty acids (FAs) in the development of type 2 diabetes is uncertain, especially with regard to any differential influence of α-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA).
Increased intakes of total omega-3 FAs were inversely associated with diabetes incidence [hazard ratio (HR) for the fifth compared with the first quintile: 0.78; 95% CI: 0.65, 0.94; P for trend = 0.02]. Omega-3 FAs from marine sources were not associated with diabetes risk, whereas nonmarine omega-3 FA intake was strongly associated (HR for the fifth compared with the first quintile: 0.79; 95% CI: 0.67, 0.93; P for trend = 0.004). Omega-6 and omega-6:omega-3 ratio were not associated with incidence of type 2 diabetes.
Consumption of nonmarine sources (ALA) of omega-3 FAs is associated with a decreased risk of type 2 diabetes in Chinese Singaporeans.

[pubmed] [Omega-3 fatty acids and incident type 2 diabetes: the Singapore Chinese Health Study. Brostow DP, Odegaard AO, Koh WP, Duval S, Gross MD, Yuan JM, Pereira MA.]


Majd Olimat

Saturday, June 11, 2011

Does University teach ethics or books?

Does University teach ethics or books?

Later last week, I went volunteering with autistic kids to play in Jungle Bungle, the most organizers and frequent coming people are either pharmacy or medicine students, and I heard the most shocking things, and worstly I saw the most discussing acts I never thought my generation would do it.

They youth of Jordan, the up to come generation, the future Dr.’s pharmacists, were unable to death with kids, coz simply they are discussed to deal with special needy kids, it’s the most shocking to hear, if they are autistic kids, clean, wearing neat clothes and they all come from good families, that God gave them this problem for a reason, and most of them sat on chairs saying it’s the most boring thing, and hating this volunteering. I am not saying that it is as easy as when its orphanage volunteering, but if you wanted to have fun you would, I took of my boots and entered the play area running after them, it was nice and a remembering to childish times. Those who actually ran with the kids and played with them were the happiest and enjoyed their times.


Many of these medicine students, spend their time discussing how they study for the exams, many had actually confessed they didn’t attend any lectures of some subjects, and was mad about getting C+ or a B, due to no taking attendance in the lectures, and also, they didn’t use BOOKS, but only studied students notes, as what seems the Dr.’s are well aware of this issue and they avoid getting things out of these papers, so everyone can pass. Where is the seek and find method? How can they make their mind to think? If it’s all from papers? And all to be with a name and have money!


I am not saying anything, but at least for my faculty we do have some marks for research to be done, so there is Dr’s to push us to go and look for answers, most my exams are think what’s the answer, and mostly to choose the best from all the right! It’s lacked among medicine students. Somehow I think all medical field students should take a course named Communication Skills; since most are discussed to deal with people, or have this thing called “I’m a Dr/Pharmacist” forgetting they are health care providers, forgetting they cannot live or have work without.
 


I don’t know if it’s a right or wrong way to have a parallel application to university fields, if we gave a chair to those with money study, and haven’t treated their Ego problem during university times, would they be able to work properly? Build properly? I’m not being against it nor pointing only to them, but also wondering if the university/community can accept those after their graduation? Or they just wish to get married and stay at home? “to raise the brides standards” or just to go work with his dad? Or their dad opens a project for himself under his son/daughter sertificat?


If most students finished school, and entered with their aim to look for love, place to hang out in, or to have the name Dr, or to wear the white lab-coat, and among the money spent over Shisha, Nescafe or cigarettes, cannot they provide us with a course to change our behavioral? If they answered community work! I’d say 10 hours are not enough, back in school we did 120hour per year, and it mad most of us leaders, but the shock was when at university rare chances to appear in, rare events, and if there is one believe me there would be an exam on the day after!

We do need a change, and actually I don’t think I’ll take my future children to some Dr who was at university a smoker, play boy, or even passed all years by C+ avg! nor I would go to a Dr who would wear gloves to see a pimple on someone’s face! Why don’t the current Dr’s make sure to pass the good ethics of their job? To pass the good skills we should have, if they graduated stubborn and with praid they will remain so! And we can say no longer good Dr’s at this area…