Stand up for your health or turn into sitting duck for diabetes

 Are you sitting in your cubicle? Stand up and move around! Because walking is a healthier option. Sitting, like smoking, has become the bane of our generation. Any office shares some common features: Incessant tapping noise of the keyboard, phones ringing, and the passive act of sitting in chairs. All these are the makings of a sedentary lifestyle.

From the seat of your vehicle to the office chair and then the couch at home, your daily displacement, medical experts say is too insufficient to keep you healthy . They say that if you spend most of the day sitting then you are putting yourself at higher risk of diabetes and other lifestyle diseases.

A study was recently conducted by M V Hospital for Diabetes to assess the effects of prolonged sitting among bank employees and school teachers. The results have confirmed the grim news: those with a family history of diabetes sitting for more than three hours a day were at a threefold risk of developing diabetes than those doing moderate physical activity .

The study had a sample size of 514 subjects (244 bank employees and 270 school teachers); it analysed factors such as body mass index, waist circumference, duration of physical activity , positive family history of diabetes and random blood glucose levels. "The main objective of the study was to define the word sedentary and analyse its role in increasing the risk of diabetes. Secondly , we also analysed the role of family history in it," said chief diabetologist Dr Vijay Viswanathan, who was part of the study .

Doctors concluded that those involved in some physical activity and sat less than three hours had less blood sugar, pressure and cholesterol levels. "Those who sat for less than three hours and had a family history of diabetes were at 16% risk, those in the second group were at 27% risk," said the doctor.

Bank employees are more prone to diabetes than teachers who at least stand or pace around classrooms, revealed the study . "This study applies to any profession similar to a job at the bank that requires being seated for a long period. The energy expenditure is very negligible in these people and all the carbohydrates are converted to fat and get deposited all over," said Dr Viswanathan. He added that such fat build-up, apart from causing insulin resistance, also causes polycystic ovaries in women and fatty liver diseases in men. We can't change our family history but we can find solutions to this sitting syndrome. "Employees should take steps like walking around the office and taking mobility breaks every few hours, while offices should take keen interest on their employees' health," said Dr Viswanathan.

If you cannot spare time for an hour in the gym or go for a run or a walk, then making certain changes in your work place or home could do the trick to keep lifestyle diseases at bay . Pace around the office; desire for a better health gives you the licence to fidget. Stand while talking on the phone, walk up to your colleague instead of emailing or phoning and walk those flights of stairs instead of taking the lift. At home, spare at least 15 minutes a day to perform yoga to stretch all the muscles in the body .

The study was published in the Journal of Diabetes Technology and Therapeutics.

Source: http://timesofindia.indiatimes.com

A vegan diet may help with diabetes nerve pain

A low-fat vegan diet may help people with type 2 diabetes reduce physical pain related to the condition, suggests a small new study.

"This new study gives a ray of hope for a condition where there are no other good treatments," said Dr. Neal Barnard, the study's lead author and president of the Physicians Committee for Responsible Medicine, a non-profit organization that promotes a vegan diet, preventive medicine, and alternatives to animal research.

Read: The diabetes diet debate

Diabetic neuropathy common

Most people with type 2 diabetes will develop peripheral diabetic neuropathy, the researchers write in Nutrition and Diabetes. People with the condition may feel pain, burning and numbness in their body's extremities."For an individual patient, it can be miserable and also depressing because there are no good treatments and it just gets worse and worse," said Barnard, who is also affiliated with the George Washington University School of Medicine in Washington, D.C.

"By setting aside animal products and oily foods, you can become healthier, and your pain can diminish and perhaps even go away," he told Reuters Health in an email.Type 2 is the most common form of diabetes and is often linked to obesity. In type 2 diabetes, the body's cells are insulin resistant which means that insulin isn't properly utilised to regulate glucose levels in the blood.The disease is thought to interfere with the ability of nerves to signal the brain about pain, light touch and temperature. Anti-seizure medications and antidepressants help relieve nerve pain in some patients but may have unpleasant side effects.

Read: High-fibre diet may curb type 2 diabetes risk

How the study was conducted

For the new study, the researchers recruited 35 adults with type 2 diabetes and painful diabetic neuropathy.They randomly assigned 17 participants to follow a low-fat vegan diet and take B12 supplements for 20 weeks, with weekly support classes. The other 18 were instructed to take B12 supplements but maintain their normal diet.

The vegan diet focused on vegetables, fruits, grains and legumes. Overall, most participants on the vegan diet appeared to avoid animal products and about half stuck to low-fat diets throughout the study.

Find out: Are you eating correctly for your diabetes?

Vegan diet assists in weight loss and lower levels of pain

After 20 weeks, those on the vegan diet lost an average of about 15 pounds, compared to about one pound among those in the comparison group.Several other measures of health, including blood pressure, improved among the participants on the vegan diet, compared to the control group.Those on the vegan diet also reported a much greater drop in pain, compared to the control group, the researchers report. A test of the nerves in the foot also suggested that the vegan diet may have slowed or halted nerve function decline, compared to the control group.There was also a suggestion that the overall quality of life of those on the vegan diet improved, compared to the control group. The difference may have been due to chance, however.

Read: Type 2 diabetes and diet

Limitations of the study

Barnard and his team acknowledged larger trials would still be needed to show a vegan diet helped relieve pain related to type 2 diabetes.

Dr. Stuart Weiss, an endocrinologist at NYU Langone Medical Center in New York, said the study was "kind of cool," though the number of participants was small and the length of the study was short."We always talk about diabetes and diabetes control being about diet and exercise, but we end up prescribing a lot of medications and don't really focus that much on diet and exercise because that's not easy," said Weiss, who was not involved in the study.

Weiss told Reuters Health that he typically advised patients to eat less processed and refined foods and not overeat."It might be that eating less of that in a plant-based diet might be helpful (in reducing inflammation), but again it was just 20 weeks and it takes years and years for neuropathy to develop," Weiss said. "We need to see long-term and nobody's going to pay for that."While Weiss said it was exciting that researchers were looking for an alternative to medication, he cautioned that not everyone would go for a vegan diet.

Source: http://www.health24.com

One in three Colchester Type diabetes sufferers “not confident in managing condition” – survey

The figure, published by the charity Diabetes UK, has come as the number of people suffering from the condition nationally has soared to an all-time high of 3.9million, with more than 17,600 living in north east Essex.

The data was gathered by the charity during a Living with Diabetes Day in Colchester, with 105 people with Type 2 being surveyed – it has been released during Diabetes Awareness Week.

Sharon Roberts, Eastern Regional Manager at Diabetes UK, said: “It is extremely worrying that so many people with diabetes do

n’t feel confident at managing their diabetes, as this means huge numbers of people do not have information that could be lifesaving. This makes no sense because the health complications of diabetes are not only devastating but are also extremely costly to treat.

“This Diabetes Week, we are urging the Government and the NHS to do more to ensure people with diabetes get the support and education they need to manage the condition not just at the point of diagnosis but beyond as the educational needs of people already living with the condition can change over time.”

Diabetes is a condition where your body is not producing any or enough insulin to keep you healthy. Type 1 is normally diagnosed in child or young adulthood, whereas Type 2 can happen later in life and has links to lifestyle and obesity.

It is thought that about 90% of diabetes cases are Type 2.

If treated effectively sufferers can reduce day-to-day symptoms and the risk of complications such as kidney failure, heart disease and stroke.

The charity believes greater education is vital to helping people with diabetes managing their condition.

During their recent Living With Diabetes Day in Colchester, 61% said they were confident of managing it, but after, this figure increased to 98%.

A spokesman for the NEEDS diabetes service in north east Essex said: “We recognise that it is vital that people living with diabetes are offered all the information and support they need to confidently and effectively manage their condition.

“This year we have offered 96% of people newly-diagnosed with Type 2 diabetes structured education and guidance to help them manage their own condition and 95% of people newly-diagnosed with Type 1 diabetes. Of 1,607 people offered the courses, 462 (29%) have completed it in full.

“Starting this year an additional offer of important carbohydrate counting courses has been introduced as part of our diabetes education. Further refresher courses and patient education events will also be offered.”

  Source: http://www.eadt.co.uk

No one best diet for diabetes patients, just 'patterns' of healthy eating

What's the best diet for people with diabetes? It's not an easy one-size-fits all, we were told at the scientific sessions of the American Diabetes Association in Boston recently. In fact, many of the experts at this meeting said the answer may not be in one specific diet.Instead they point us to well-studied "patterns" of eating. Evidence is strong, for example, that people with diabetes who follow an eating style based on the Mediterranean and the DASH (Dietary Approaches to Stop Hypertension) dietary patterns can benefit health-wise.

But wait. Aren't these ways of eating designed to prevent heart disease and stroke? Yes, they are, said Lawrence Appel, MD, of Johns Hopkins Medical Institutions. But diabetes is closely linked to heart disease. So when we eat to keep our hearts ticking, we also help control diabetes.What do healthful diet patterns for diabetes have in common? They emphasise vegetables, fruits, beans, nuts, seeds, and whole grains. They include fish, low-fat dairy foods and vegetable oils like olive oil. And they put less emphasis on meats and high-fat dairy foods.

These types of food choices provide a healthful balance of nutrients; and they also have been shown to reduce inflammatory processes in the body which scientists say are linked to chronic diseases like diabetes and heart disease. Fish, vegetables, nuts and whole grains are especially rich in anti-inflammatory substances, say researchers.And, yes, it is still important for people with diabetes to control their intake of carbohydrates (sugars and starches in food). "But I don't believe carbohydrates are the devil," said Appel.

He pointed out that many of the beneficial foods in diabetes-friendly eating patterns contain carbohydrates. They just don't go overboard with foods excessively high in sugar or refined starches. And what's interesting, reported registered dietitian nutritionist and certified diabetes educator Marion Franz, is that, after following any type of diet, most people tend to settle back into eating patterns that are not extremely high or extremely low in carbohydrates.

How to translate all this great research into real life is the biggest challenge, these researchers acknowledged. It all comes down to the choices we make from day to day, meal to meal. Like choosing fruit over hash browns; or a veggie omelette more often than biscuits and gravy. We can eat a fish meal a couple of times a week. And salad more often than fries.Diabetes is a serious and complex disease, and we still don't have all the answers, these experts report. But from what I observed, researchers are hitting it from all directions. Stay tuned.Barbara Quinn is a US-based registered dietitian and certified diabetes educator.

Source: http://www.stuff.co.nz

An old-line diabetes drug may have new uses against diseases of aging

Just over a year ago, Catherine Price decided to start taking one of the cheapest, safest, oldest, most widely prescribed drugs for Type 2 diabetes. So much metformin is taken in the United States — some 72 million prescriptions were written for it in 2013 — that a recent study found higher trace levels of it (presumably from the urine of people taking it) in Lake Michigan than of any other drug, including caffeine.

But Price, a science and medical reporter in Oakland, Calif., doesn’t have Type 2 diabetes. She has Type 1, the far less common form of the disease, which requires lifelong treatment with insulin, to compensate for her body’s failure to produce enough of the hormone. However, she had read studies indicating that metformin combined with insulin might help Type 1 diabetics, too. Moreover, the drug was being studied in clinical trials as a way to lower the risk of cancer, heart disease and dementia — not just for diabetics, but for everyone.

For Price, there was yet another possible benefit — as a treatment for polycystic ovary syndrome, an endocrine disorder that doctors thought might explain the difficulty she and her husband had had conceiving.

Sure enough, a month and a half after she had started taking metformin pills and even as she was enjoying the benefits of better blood-sugar control, Price became pregnant, eventually giving birth to a girl.

“I’m still taking metformin along with my insulin,” said Price, 36, who was diagnosed with Type 1 diabetes 14 years ago. “I remember eating Mexican food one night, which can be a potential disaster for people with diabetes because of the carbs, but I noticed I needed only two-thirds to a half of the insulin I normally needed.”

Synthesized in the 1920s, metformin was first approved for treatment of Type 2 diabetes in the United Kingdom in 1958. It took until 1995 to get approval in the United States after a potentially fatal disorder linked to a similar drug was found to be rarely if ever associated with metformin.

Unlike insulin shots, which help Type 1 diabetics break down sugar and starches in the blood, metformin lowers blood-sugar levels primarily by squelching the liver’s tendency to release stored-up sugar into the bloodstream. Keeping that extra sugar (actually a form of sugar called glucose) out of the blood helps to maintain normal blood-sugar levels, thereby preventing such long-term complications as blindness, kidney failure and lower-limb amputation.

About 29 million people in the United States have diabetes, according to the Centers for Disease Control and Prevention. More than 90 percent of them have Type 2, in which their bodies slowly fail to respond to normal levels of insulin, forcing their pancreas to produce so much that it’s eventually exhausted. The estimated 2.5 million with Type 1, in contrast, lose their ability to produce insulin, usually within a matter of months, due to an autoimmune attack by the body on itself.

Today, the range of ailments being targeted by metformin, a prescription drug sold under such names as Glucophage, Glumetza, Fortamet and Riomet, all share one characteristic: They are diseases related to aging.

“Metformin actually lowers the rate of cell turnover,” said Michael Pollak, who has been studying metformin’s effects on pancreatic cancer as chairman of oncology at McGill University in Montreal. “It makes cells divide less quickly. The rate-of-living theory defines aging as the number of cell divisions you undergo since you were a fertilized egg. If the theory is true, then people who age more gracefully have a slower rate of cell division. The question is whether the rate-of-living theory is operational in mammals.”

Pollak says that none of the most exciting possible benefits for the drug have yet been proved in randomized clinical trials of non-diabetics. For now, the evidence suggesting benefits is limited to large studies of diabetics that have found, on average that those who take metformin tend to have lower rates of cancer, heart disease and dementia, and to live longer overall than those who take other drugs for diabetes. Those effects have also been seen in animal studies. But such evidence often does not pan out in human studies.

At a medical meeting in May, Pollak reported disappointing results from his first randomized, placebo-controlled trial of metformin for people with pancreatic cancer. “It yielded no benefit,” he said. “Plain old metformin given in the same dose as we do for Type 2 diabetes doesn’t seem to be a breakthrough for cancer, at least for pancreatic cancer.”

Many other metformin clinical trials are underway for breast, colorectal, endometrial and other cancers.

For heart disease, the benefit of metformin over most other drugs for Type 2 diabetics has been seen repeatedly in clinical trials. For people without diabetes, only one study has been published, finding no apparent effect after 18 months. As with cancer, however, other studies are underway.

For dementia, which people with Type 2 diabetes have double the risk of developing compared with non-diabetics, metformin has been found in a number of studies to cut that risk substantially.

“There’s been a lot of excitement about metformin and dementia,” said Rachel Whitmer, an epidemiologist at Kaiser Permanente in California.

In 2013, Whitmer presented the results of a study of about 15,000 people newly prescribed a medication for Type 2 diabetes: By the end of the five-year study, those who received metformin had a 40 percent lower risk of having developed dementia than those prescribed sulfonylureas, another common type of diabetes drug.

But, Whitmer notes, “I don’t think the story is complete. There needs to be more work in this area with all drugs for diabetes.”

For Type 1 diabetes, researchers at the University of Colorado Denver School of Medicine published a study in May in which they added either a low dose of metformin or placebo pills to the insulin regimen of 74 adolescents. Those who received metformin lost weight — generally a benefit for those with diabetes — and needed less insulin after six months. Those who received the placebo needed more insulin than at the beginning of the study and saw their blood pressure rise. The one goal the study did not achieve was better blood-sugar control.

“There is some benefit, but it wasn’t the full benefit we hoped for,” said Helen Nickerson, senior scientific program manager at JDRF, formerly known as the Juvenile Diabetes Research Foundation, which partly funded the study. Even so, she said, she is hearing from doctors that growing numbers of them are prescribing metformin along with insulin to patients with Type 1 diabetes.

No one would suggest that a person with Type 1 diabetes stop taking their insulin. Doing so would be life-threatening. For those with Type 1, metformin is being tested only as an add-on to insulin.

JDRF, meanwhile, is funding a clinical trial to see if metformin will reduce the risk of heart disease in people with Type 1, and it is funding a trial in Britain to see if the drug will prevent children from developing Type 1 in the first place.

Terry Wilkin, a professor of endocrinology and metabolism at the University of Exeter, is leading the prevention trial. He theorizes that the risk of developing Type 1 rises when excess demand for insulin is placed on the pancreas in children who are even slightly overweight. His study will give low daily doses of metformin to children who are at high risk of developing Type 1.

“If we can even slightly lower their average blood sugar with metformin,” Wilkin said, “I believe we can have a big benefit on their risk of developing Type 1.”

Despite all these potential benefits of metformin — and despite a recommendation from the American Diabetes Association that it be tried before any other drug for newly diagnosed Type 2 diabetics — a recent study found that only about half of all such people get metformin as their first prescribed medication. The study does not explain why that might be. Among the possibilities, experts say, are that newer drugs are being pushed heavily in direct-to-patient advertising and that some patients are turned off by the common though mild side effect of metformin — stomach upset and diarrhea — which can usually be avoided by starting on a low dose.

The author of the study, Niteesh Choudhry, an associate professor of medicine at Harvard Medical School, also found that newly diagnosed Type 2 diabetics who start on metformin are the least likely to need an additional diabetes drug later.

“It’s clear that physicians and patients are not always choosing to start on metformin,” he said. “There are legitimate reasons to put patients on one drug rather than another. But the guidelines do recommend metformin first.”

For patients with Type 2 whose doctor started them on a drug other than metformin, he said, “I certainly would encourage people to talk with their doctor. That’s always a good thing.”

Hurley is a New Jersey-based science journalist who writes frequently on diabetes and health.

Source: http://www.washingtonpost.com

The carbohydrate metaboliser

 Ancient Wisdom, Modern Science

GYMNEMA (Gymnema sylvestre) is also known by various names such as gurmar, periploca of the woods, and meshashringi (ram’s horn). It has been used since ancient times to treat many health conditions. It is a climbing plant that grows in the tropical forests of central and southern India. The woody meshashringi plant also grows in parts of Africa. 


The leaves of this long, slender plant have been used for more than 2,000 years in India to treat diabetes. On account of its property of abolishing the taste of sugar, it was given the Indian names of gurmar and madhunashini, meaning “sugar destroying”. Extracts of meshashringi are sold in Japan for the control of obesity.

In the past, powdered meshashringi root was used to treat snake bites, constipation, stomach complaints, water retention, and liver disease. However, meshashringi is best known in Ayurveda as a treatment for adult-onset diabetes, a condition once described as “honey urine”.



Meshashringi today

Extracts of this plant are widely used in Australian, Japanese, Vietnamese and Indian folk medicine. Meshashringi preparations have a profound action on the modulation of taste, particularly suppressing sweet taste sensations. It is used in the treatment of diabetes mellitus. Anti-allergic, antiviral, lipid lowering and other effects are also reported1.



Meshashringi and diabetes



 Thousands of years ago, type 2 diabetes was treated with meshashringi. The plant’s sugar-destroying property was released when a person chewed on one or two leaves. Meshashringi was said to “paralyse” a person’s tongue to sweet and bitter tastes. This taste-blocking reaction lasted for several hours. 

Meshashringi blocked sugar in the digestive system, resulting in a decrease in blood sugar. This is known as a hypoglycemic effect. This action has been studied since the late 1930s.

Meshashringi has also been used in folk medicine as a remedy for allergies, urinary tract inflections, anaemia, hyperactivity, digestion, cholesterol, and weight control. Most of those treatments did not prove to be effective. Meshashringi lowers cholesterol slightly, but not enough to be regarded as a significant remedy.

Recent studies

 Recent studies have demonstrated the efficacy of this herb in diabetes. Persaud et al. found that meshashringi helped control blood sugar levels by stimulating insulin release from the beta cells in the islets of langerhans2. 

Another study by Bhaskaran et al. found that the same meshashringi preparation (400 mg/day) produced similar results for non insulin-dependent diabetics. Fasting blood glucose, glycosylated haemoglobin and glycosylated plasma protein were significantly reduced compared to baseline values after 18-20 months of treatment. 

By the end of the treatment period, cholesterol, triglycerides, phospholipids and free fatty acid levels were also significantly reduced compared to baseline values. 

Meshashringi has also been used to treat drug-induced hyperglycemia. Gholap et al. studied the effects of meshashringi in the regulation of serum cortisol and glucose concentrations. Meshashringi was found to exhibit hypoglycaemic activity without altering the serum cortisol concentration. It is possible that the hypoglycaemic effects of meshashringi are mediated through their cortisol inhibiting potency4.

Previous clinical trials have recorded the benefits of meshashringi in diabetic patients. A controlled study on insulin-dependent diabetics found that a water-soluble meshashringi extract (400 mg/day) reduced insulin requirements (by about 50%). 

Over the duration of treatment, meshashringi lowered fasting mean blood glucose (by about 35%), glycosylated haemoglobin and glycosylated plasma protein levels from baseline values. Cholesterol was significantly reduced and brought to near normal levels. Triglycerides, free fatty acids and serum amylase were also lowered. The treatment period ranged from six to 30 months. 

The significant decrease in glycosylated haemoglobin occurred after six to eight months of treatment, but remained significantly higher than normal values. None of these reductions was observed in control patients on insulin therapy alone who were studied over a period of 10 to 12 months. 

The authors suggested that meshashringi enhanced endogenous insulin production, possibly by pancreatic regeneration, as levels of C-peptide, a by-product of the conversion of pro-insulin to insulin, were apparently raised (in comparison to both the insulin alone group and normal subjects)5. 

To unravel the possible mechanism of glucose lowering activity, the effects of 10 different plant extracts in the regulation of blood glucose were evaluated in male mice. While the extracts of Inula racemosa, Boerhaavia diffusa and Ocimum sanctum decreased the serum concentration of both cortisol and glucose, Aegle marmelos, Azadirachta indica and Meshashringi sylvestre extracts could exhibit hypoglycaemic activity without altering the serum cortisol concentration. 

It appears that the hypoglycaemic effects of the former three plant extracts are mediated through their cortisol inhibiting potency, whereas the mechanism for other plant extracts could be different. 

Lipid peroxidation was not enhanced by any of the plant extracts (some were in fact, anti-peroxidative in nature). As I. racemosa, B. diffusa and O. sanctum exhibited anti-peroxidative, hypoglycaemic and cortisol lowering activities, it is suggested that these three plant extracts may potentially regulate corticosteroid induced (stress induced) diabetes mellitus.

A weight loss remedy?

Although meshashringi won’t make sugary foods taste bad, the sugar destroyer is said to curb the desire for sweets. Due to this sugar-blocking property, meshashringi has been marketed as a weight-loss remedy. 

People could take meshashringi to help fight the desire for sweet treats. As a weight-loss remedy, gymnema has not been studied extensively, and some in the medical community are dubious about its effectiveness. Instead, the sugar destroyer is acknowledged as a potential treatment for diabetes.

Luo et al. studied the anti-obesity effects of meshashringi on overweight rats and found that meshashringi promoted weight loss by its ability to reduce hyperlipidemia (increase in serum lipids), which did not rebound upon withdrawal of treatment. 

With its efficient carbohydrate metabolising action, meshashringi has emerged not only as an effective sugar metaboliser, but also a hope for diabetic and overweight patients. 

References:

1. Porchezhian E, Dobriyal RM. An overview on the advances of Gymnema sylvestre: chemistry, pharmacology and patents. Pharmazie. 2003 Jan;58(1):5-12.

2. Persaud SJ, Al-Majed H, Raman A, Jones PM. Gymnema sylvestre stimulates insulin release in vitro by increased membrane permeability. J Endocrinol. 1999 Nov;163(2):207-12.

3. Baskaran K, Kizar Ahamath B, Radha Shanmugasundaram K, et al Antidiabetic effect of a leaf extract from Gymnema sylvestre in non-insulin-dependent diabetes mellitus patients. J Ethnopharmacol. 1990 Oct;30(3):295-300.

4. Gholap S, Kar A. Hypoglycaemic effects of some plant extracts are possibly mediated through inhibition in corticosteroid concentration. Pharmazie. 2004 Nov;59(11):876-8.

5. Shanmugasundaram ER, Rajeswari G, Baskaran K, et al. Use of Gymnema sylvestre leaf extract in the control of blood glucose in insulin-dependent diabetes mellitus. J Ethnopharmacol. 1990 Oct;30(3):281-94.

6. Luo H, Kashiwagi A, Shibahara T, Yamada K. Decreased bodyweight without rebound and regulated lipoprotein metabolism by gymnemate in genetic multifactor syndrome animal. Mol Cell Biochem. 2006 May 12. 



Source: http://www.thestar.com.my

Medicinal Plants Capture Eye Balls

BENGALURU: Herbal and medicinal plants have become the centre of attraction at the Krishi Mela 2014 which started at the University of Agricultural Sciences here on Wednesady. A number of people and small-time farmers thronged the stalls which have over 200 varieties of such plants.

Dr M Vasundhara, Head of the Department of Medicinal Plants and Horticulture in the university told Express: “The plants like Insulin (Costusignaeus), Amruthaballi and Madhunashini are in great demand as people want to control diabetes by using them.”

The university has cultivated these plants on its land.

“Fifty farmers from Brahmavar will be trained (in medicinal plant cultivation) in December first week. Farmers who don’t have a wide cultivation area can grow these plants and get reasonable profit,” In-Charge Vice-Chancellor of the university Dr D P Kumar said.

Among these plants, Brahmi (Centella asiatica) enhances memory  power while Cemaruba and Lakshmi Taroo are good for preventing cancer. Patta Choor prevents stone formation in kidneys. Mint is a good mouth fresher. Some other plants are good for display, Dr Vasundhara said.

Imtiyaz Ahmed, an estate owner from Chintamani who had come for the mela, said, “We own 40 acres of land. In that, we will grow herbal and medicinal plants in five-acres to help nearby villagers to take up herbal and medicinal plant cultivation. We want to buy Tulsi and Amruthaballi  plants.”

Dr Vasundhara said, “These plants are being sold at lowers rates. You can get them for Rs 10 or Rs 20. We collected Rs 5,000 by selling these plants on the Mela’s first day on Wednesday.”   The Mela ends on Friday.

‘Krishi Bhagya in a Month’s time’

Agriculture Minister Krishna Byregowda said the government will launch the Krishi Bhagya scheme in a month’s time. As part of the scheme, farmers will be offered `2 lakh financial assistance for building percolation tanks and installing pipes.   C Byregowda award was given to late H T Lingappa Gowda from Sakleshpur. M H Marigowda award was given to G D Manjappa from Shivamogga and Mallappa Gowda from Shringeri.


Source: http://www.newindianexpress.com

Critical Issues in Diabetes: Choosing Newer Drugs for T2D

New Drugs to Meet Glycemic Targets

Charles P. Vega, MD: Welcome to Medscape's Critical Issues in Diabetes. I'm Chuck Vega, clinical professor of family medicine here at the University of California at Irvine, and I am joined by Dr Anne Peters, professor of endocrinology at the University of Southern California, Keck School of Medicine, and she runs the clinical diabetes programs there.

We previously discussed glycemic targets and lipid management, and today we want to discuss how to get patients to goal for glycemic targets. Some new options in antidiabetes medications have come on the market in the past several years, and as a group, they can be effective. They generally avoid hypoglycemia, which is very important. Some can promote weight loss, which is a tremendous goal for many of our patients with diabetes, but they also have some down sides and associated risks. Let's go through them one by one. I want to get your take on how they can be applied clinically. What are best practices in applying these drugs to patients with type 2 diabetes?

The DPP-4 Inhibitors

First, I would like to talk about the dipeptidyl peptidase-4 (DPP-4) inhibitors. An advantage of these drugs is that they are largely well-tolerated. They can be used with dose modifications in patients with renal disease, which is a big plus because that is a problem we run into with metformin, for example. But these drugs are only modestly-to-moderately effective, and that's one drawback of these drugs. They play well with others, but for a patient with a glycated hemoglobin (A1c) of 11%, they're only going to have so much efficacy, with a reduction of 0.5% to 1%. What's your take on the DPP-4 inhibitors as a class?

Anne L. Peters, MD: First, I need to give a shout-out to metformin because metformin is the single best drug we have for treating type 2 diabetes, and it is what we use in combination with everything else. Metformin has to be the baseline. Yet there are patients who can't take metformin, either because of gastrointestinal (GI) side effect or for renal dysfunction. DPP-4 inhibitors are a gentle next class. They are very well-tolerated, taken once daily. You can use a drug such as linagliptin alone without any dose adjustment in patients with any degree of renal dysfunction. I tend to use them if I need a patient's A1c to go from 7.4% down to 6.8%. I use them for small goals—no hypoglycemia, no weight change. But cost is always an issue.

I often see patients who need more A1c reduction, so I tend to use other agents. But I often use the DPP-4 inhibitors in the frail elderly, especially with renal dysfunction. I have patients with type 2 diabetes who came to me with a creatinine of 2 mg/dL, who were on prandial basal insulin, and I get them off the prandial insulin by giving them a DPP-4 inhibitor and keep them on the basal insulin. If I can use it to simplify a regimen, reduce hypoglycemia, and get people to their goal more easily, I'll do it. But I don't use them in everybody. A thousand different combinations are available, but I tend to start with metformin and add in whatever the next therapy is. If somebody is higher than 7.5%; if the patient needs a bigger drop in A1c, I'm going to use a different agent.

The GLP-1 Receptor Agonists

Dr Vega: Speaking of large A1c reductions, with the glucagon-like peptide-1 (GLP-1) agonists, you can see improved A1c efficacy; plus these agents offer the benefits of weight loss—between 1 kg and 4 kg in most studies. There is an issue with adverse events. Cost is a universal issue for all of these newer agents. Like many newer drugs, they can be more expensive. They do offer certain advantages that may make it worth it. What is your opinion?
Source:http://www.medscape.com