Blood glucose control and diabetic management

ü               A low-GI food will release glucose more slowly and steadily. A high-GI food causes a more rapid rise in blood glucose levels and is suitable for energy recovery after endurance exercise or for a person experiencing hypoglycemia.

ü               It's also possible to lower the GI of a meal with a few teaspoons of vinegar and the addition of fresh fruits and vegetables

^ü               Jamun Sirka is a vinegar produced from the Jamun (or rose apple) fruit in India. It is considered to be medicinally valuable for stomach, spleen and diabetic ailments.

ü                When you eat a low-G.I. food, such as oatmeal, it will break down more slowly and deliver the glucose into the bloodstream at a slower but steady rate.

ü           Although it is not recommended to use fructose as a sweetener, fruit should not be avoided because of its fructose content. Benefits may be obtained by consumption of dietary fibre in conjunction with carbohydrate; as Francis (1987) points out, evidence suggests that carbohydrate consumed with dietary fibre will have a less major impact on glycemic rise than the same amount of carbohydrate consumed alone.

ü          Prior to hypoglycemic agents, diabetics used vinegar teas to control their symptoms. Small amounts of vinegar (approximately 20 ml or two tablespoons of domestic vinegar) added to food, or taken along with a meal, have been shown by a number of medical trials to reduce the glycemic index of carbohydrate food for people with and without diabetes. This also has been expressed as lower glycemic index ratings in the region of 30%.

ü              The American Diabetes Association explains: "saturated fat raises blood cholesterol. High blood cholesterol is a risk factor for heart disease. People with diabetes have more frequent heart disease.

ü                Research has shown the Maitake mushroom (Grifola frondosa) has a hypoglycemic effect, and may be beneficial for the management of diabetes. The reason Maitake lowers blood sugar is because the mushroom naturally acts as an alpha glucosidase inhibitor. Other mushrooms like Reishi, Agaricus blazei, Agrocybe cylindracea and Cordyceps have been noted to lower blood sugar levels to a certain extent, although the mechanism is currently unknown.

ü              Exercise decreases insulin requirements as exercise increases glucose uptake by body cells whose glucose uptake is controlled by insulin, and vice versa

ü               Weight reduction and exercise improve tissue sensitivity to insulin and allow its proper use by target tissues.

ü                  Tooth decay and cavities are some of the first oral problems that individuals with diabetes are at risk for. Increased blood sugar levels translate into greater sugars and acids that attack the teeth and lead to gum diseases.

ü             Diabetic people tend to experience more severe periodontitis because diabetes lowers the ability to resist infection and also slows healing.

ü           To prevent further diabetic complications as well as serious oral problems, diabetic persons must keep their blood sugar levels under control and have a proper oral hygiene. A study in the Journal of Periodontology found that poorly controlled type 2 diabetic patients are more likely to develop periodontal disease than well-controlled diabetics are. At the same time, diabetic patients are recommended to have regular checkups with a dental care provider at least once in three to four months. Diabetics who receive good dental care and have good insulin control typically have a better chance at avoiding gum disease to help prevent tooth loss

ü                  HbA1c test

A useful test that has usually been done in a laboratory is the measurement of blood HbA1c levels. This is the ratio of glycosylated hemoglobin in relation to the total hemoglobin. Persistent raised plasma glucose levels cause the proportion of these molecules to go up. This is a test that measures the average amount of diabetic control over a period originally thought to be about 3 months (the average red blood cell lifetime), but more recently thought to be more strongly weighted to the most recent 2 to 4 weeks. In the non-diabetic, the HbA1C level ranges from 4.0-6.0%; patients with diabetes mellitus who manage to keep their HbA1C level below 6.5% are considered to have good glycemic control. The HbA1c test is not appropriate if there has been changes to diet or treatment within shorter time periods than 6 weeks or there is disturbance of red cell aging (e.g. recent bleeding or hemolytic anemia) or a hemoglobinopathy (e.g. sickle cell disease). In such cases the alternative Fructosamine test is used to indicate average control in the preceding 2 to 3 weeks.

ü                  Other non-invasive methods like radio waves, ultrasound and energy waves are also being tested for checking blood sugars

ü              Small, portable insulin infusion pumps are available from several manufacturers. They allow a continuous infusion of small amounts of insulin to be delivered through the skin around the clock, plus the ability to give bolus doses when a person eats or has elevated blood glucose levels. This is very similar to how the pancreas works, but these pumps lack a continuous "feed-back" mechanism. Thus, the user is still at risk of giving too much or too little insulin unless blood glucose measurements are made.

ü                 There are several insulin application mechanisms under experimental development as of 2004, including a capsule that passes to the liver and delivers insulin into the bloodstream.

ü       There are indications that intensive efforts to normalize blood glucose levels may worsen cardiovascular and cause diabetic mortality

ü          Recently it has been suggested that a type of gastric bypass surgery may normalize blood glucose levels in 80-100% of severely obese patients with diabetes.