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Combination of Thiazide-Type Diuretic and Beta-Blocker may Cause Diabetes

Clinical Question: In patients with hypertension is it safe to combine thiazide-type diuretic and beta-blocker?

 

Bottom Line: Studies suggest that the routine combined use of a thiazide with a beta-blocker should be questioned in the early management of hypertension, particularly in patients who are at increased risk of developing new-onset diabetes.

A Certified Family Physician of the Philippine Academy of Family Physician and continue to complete the requirements for Continuing Medical Education in Family Practice.

In such patients, the increased risk of developing diabetes may exceed the benefit of blood pressure lowering. Reference: J Hypertens. 2005 Oct;23(10):1777-1781

 

Study Design: Retrieve randomized control trials and meta-analysis

 

Synopsis: Recently published trials addressing the pharmacological management of hypertension have reported an increase in new-onset diabetes mellitus when comparing certain older and newer treatment regimens.

 

Thiazide-type diuretics (thiazides) and beta-blockers have been individually implicated, but these drugs are frequently combined, and the magnitude of risk associated with their combined use has not been quantified.

 

So randomized control trials were retrieved that:

(i) featured stepped treatment to manage hypertension;

(ii) compared initial treatment using a thiazide or beta-blocker (older drug) with an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker or calcium antagonist (newer drug);

(iii) assessed cardiovascular outcomes;

(iv) reported new-onset diabetes; and

(v) provided at least 1-year follow-up.

 

A meta-analysis of available trials indicated that patients exposed to treatment regimens combining thiazides and beta-blockers are at greater risk of developing diabetes than regimens avoiding this combination of drugs (risk ratio for alternative therapy 0.81, 95% confidence interval 0.77-0.86). Current data cannot inform reliably about the risks associated with individual older drugs because of similar overall exposures in patients starting on newer and older drugs.

 

Also a member of the Philippine Medical Informatics Society, Philippine Occupational Health and Safety Inc., and Pangasinan Medical Society. Faculty Department of Physiology (Medicine) Lyseum- Northwestern University, Dagupan, Pangasinan, Faculty Medical Informatics Lyseu

 

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Salacia oblonga Indian herb also known as Ponkoranti. It has been used by Indian natives since ancient times to effectively manage Diabetes. This is a effective cure for type 2 diabetes. Reduction in blood sugar levels can be observed within 5 days of usage. It is also a strong weight gain inhibitor and effectively controls weight gain commonly associated with type 2 diabetic patients.

 

The recommended dosage is 1000 mg twice daily.

To purchase this medicine visit www.salaciaoblongacapsules.com write to info@salaciaoblongacapsules.com

LEARN MORE ABOUT THIS HERB ON www.nutrasolutions.com/CDA/ArticleInformation/news...

http://www.newstarget.com/005986.html

http://www.news-medical.net/?id=7685

 

For Salacia Oblonga herb Capsules and Extract Write to Botanika herbalpowders@operamail.com treeseeds@operamail.com treeseeds@rediffmail.com : : : : WWW.SALACIAOBLONGACAPSULES.COM Traditional Indian medicine, herb Salacia oblonga may help treat diabetes Posted By: News-Medical in Medical Study News Published: Tuesday, 8-Feb-2005 Printer Friendly Email to a Friend : : : : Herbs used in traditional Indian medicine to treat diabetes seems to lower blood sugar and insulin levels in a manner similar to prescription drugs, a new study reports. Researchers gave extracts of the herb Salacia oblonga to 39 healthy adults, and the results were promising.

 

The largest dose of the herb extract - 1,000 milligrams - decreased insulin and blood glucose levels by 29 and 23 percent, respectively. : : "These kinds of reductions are similar to what we might see with prescription oral medications for people with diabetes," said Steve Hertzler, a study co-author and an assistant professor of nutrition at Ohio State University. : : Salacia oblonga, which is native to regions of India and Sri Lanka, binds to intestinal enzymes that break down carbohydrates in the body.

 

These enzymes, called alpha-glucosidases, turn carbohydrates into glucose, the sugar that circulates throughout the body. If the enzyme binds to the herbal extract rather than to a carbohydrate, then less glucose gets into the blood stream, resulting in lowered blood glucose and insulin levels. : : "Lowering blood glucose levels lowers the risk of disease-related complications in people with diabetes," Hertzler said. "Also, poor compliance with diabetes medications often hinders the effectiveness of these drugs.

 

These blood samples were used to determine insulin and blood glucose concentrations. The biggest changes in blood glucose and insulin levels usually happen within the first two hours after eating. : : The beverage that contained the highest concentration of the herbal extract - 1,000 milligrams - provided the most dramatic reduction in insulin and blood glucose levels. Insulin levels were 29 percent lower, while blood glucose levels were 23 percent lower as compared to the control drink, which contained no herbal extract. : : As Salacia oblonga can cause intestinal gas, the researchers had the study participants collect breath hydrogen samples hourly for eight hours after drinking the test beverage. The participants collected their breath in small plastic tubes.

 

The researchers then analyzed these breath samples for hydrogen and methane content - the level of either substance in the breath corresponds to the level contained in the colon. : : The subjects also rated the frequency and intensity of nausea, abdominal cramping and distention and gas for two days after consuming each test meal. : : While the test beverages containing Salacia oblonga caused an increase in breath hydrogen excretion, reports of gastrointestinal discomfort were minimal, Hertzler said. : : Right now he and his colleagues are trying to figure out what dose of the herb is most effective, and when it should be taken relative to a meal. : : "We want to know how long it takes for the herb to bind to the enzymes that break down carbohydrates," Hertzler said.

 

"The participants in this study took the herb with their meal, but maybe taking it before eating would be even more effective." : : The researchers also want to study the effects of Salacia oblonga in people with diabetes. : : "A lot of studies show that lowering blood sugar levels reduces the risk for all kinds of diabetes-related complications, such as kidney disease and nerve and eye damage," Hertzler said. "We want to see if this herb has this kind of effect." : : Salacia oblonga is still relatively difficult to find in the United States, Hertzler said, although there are manufacturers that sell the herb through the Internet. : : This study was supported by the Ross Products Division of Abbott Laboratories in Columbus. : :

 

Hertzler is continuing to conduct Salacia oblonga studies with the Ross Products Division of Abbott Laboratories. He has no links to the company beyond this affiliation. : : Hertzler conducted the work with former Ohio State colleague Patricia Heacock, who is now at Rutgers, the State University of New Jersey; Jennifer Williams, a clinical scientist with Ross Products Division, Abbott Laboratories; and Bryan Wolf, a former research scientists with Ross Products Division

 

we are exporters and ,anufacters of herbal and traditiona ayurverdic medicnes for diabetes

 

Diebetes supply

Salacia oblonga Indian herb also known as Ponkoranti. It has been used by Indian natives since ancient times to effectively manage Diabetes. This is a effective cure for type 2 diabetes. Reduction in blood sugar levels can be observed within 5 days of usage. It is also a strong weight gain inhibitor and effectively controls weight gain commonly associated with type 2 diabetic patients.

 

It may be easier to get someone to take an herb with food or in a beverage, as opposed to a pill." : : The study appears in a recent issue of the Journal of the American Dietetic Association. : : Thirty-nine healthy adults participated in four separate meal tolerance tests. These meals, which were given in beverage form, were spaced three to 14 days apart. Each participant fasted for at least 10 hours before consuming the test beverage. : : Participants were asked to drink about two cups' worth of the chilled beverage, which contained zero, 500, 700 or 1,000 milligrams of Salacia oblonga extract. Afterward, the researchers used the finger-prick method to draw blood samples from each person every 15 to 30 minutes for three hours.

 

The recommended dosage is 1000 mg twice daily.

To purchase this medicine visit www.salaciaoblongacapsules.com write to info@salaciaoblongacapsules.com

LEARN MORE ABOUT THIS HERB ON www.nutrasolutions.com/CDA/ArticleInformation/news...

http://www.newstarget.com/005986.html

http://www.news-medical.net/?id=7685

 

For Salacia Oblonga herb Capsules and Extract Write to Botanika herbalpowders@operamail.com treeseeds@operamail.com treeseeds@rediffmail.com : : : : WWW.SALACIAOBLONGACAPSULES.COM Traditional Indian medicine, herb Salacia oblonga may help treat diabetes Posted By: News-Medical in Medical Study News Published: Tuesday, 8-Feb-2005 Printer Friendly Email to a Friend : : : : Herbs used in traditional Indian medicine to treat diabetes seems to lower blood sugar and insulin levels in a manner similar to prescription drugs, a new study reports. Researchers gave extracts of the herb Salacia oblonga to 39 healthy adults, and the results were promising. The largest dose of the herb extract - 1,000 milligrams - decreased insulin and blood glucose levels by 29 and 23 percent, respectively. : :

 

"These kinds of reductions are similar to what we might see with prescription oral medications for people with diabetes," said Steve Hertzler, a study co-author and an assistant professor of nutrition at Ohio State University. : : Salacia oblonga, which is native to regions of India and Sri Lanka, binds to intestinal enzymes that break down carbohydrates in the body. These enzymes, called alpha-glucosidases, turn carbohydrates into glucose, the sugar that circulates throughout the body. If the enzyme binds to the herbal extract rather than to a carbohydrate, then less glucose gets into the blood stream, resulting in lowered blood glucose and insulin levels. : : "Lowering blood glucose levels lowers the risk of disease-related complications in people with diabetes,

 

" Hertzler said. "Also, poor compliance with diabetes medications often hinders the effectiveness of these drugs. It may be easier to get someone to take an herb with food or in a beverage, as opposed to a pill." : : The study appears in a recent issue of the Journal of the American Dietetic Association. : : Thirty-nine healthy adults participated in four separate meal tolerance tests. These meals, which were given in beverage form, were spaced three to 14 days apart. Each participant fasted for at least 10 hours before consuming the test beverage. : : Participants were asked to drink about two cups' worth of the chilled beverage, which contained zero, 500, 700 or 1,000 milligrams of Salacia oblonga extract. Afterward, the researchers used the finger-prick method to draw blood samples from each person every 15 to 30 minutes for three hours.

 

These blood samples were used to determine insulin and blood glucose concentrations. The biggest changes in blood glucose and insulin levels usually happen within the first two hours after eating. : : The beverage that contained the highest concentration of the herbal extract - 1,000 milligrams - provided the most dramatic reduction in insulin and blood glucose levels. Insulin levels were 29 percent lower, while blood glucose levels were 23 percent lower as compared to the control drink, which contained no herbal extract. : : As Salacia oblonga can cause intestinal gas, the researchers had the study participants collect breath hydrogen samples hourly for eight hours after drinking the test beverage. The participants collected their breath in small plastic tubes. The researchers then analyzed these breath samples for hydrogen and methane content - the level of either substance in the breath corresponds to the level contained in the colon. : :

 

The subjects also rated the frequency and intensity of nausea, abdominal cramping and distention and gas for two days after consuming each test meal. : : While the test beverages containing Salacia oblonga caused an increase in breath hydrogen excretion, reports of gastrointestinal discomfort were minimal, Hertzler said. : : Right now he and his colleagues are trying to figure out what dose of the herb is most effective, and when it should be taken relative to a meal. : : "We want to know how long it takes for the herb to bind to the enzymes that break down carbohydrates," Hertzler said.

 

"The participants in this study took the herb with their meal, but maybe taking it before eating would be even more effective." : : The researchers also want to study the effects of Salacia oblonga in people with diabetes. : : "A lot of studies show that lowering blood sugar levels reduces the risk for all kinds of diabetes-related complications, such as kidney disease and nerve and eye damage," Hertzler said. "We want to see if this herb has this kind of effect." : : Salacia oblonga is still relatively difficult to find in the United States, Hertzler said, although there are manufacturers that sell the herb through the Internet. : :

 

This study was supported by the Ross Products Division of Abbott Laboratories in Columbus. : : Hertzler is continuing to conduct Salacia oblonga studies with the Ross Products Division of Abbott Laboratories. He has no links to the company beyond this affiliation. : : Hertzler conducted the work with former Ohio State colleague Patricia Heacock, who is now at Rutgers, the State University of New Jersey; Jennifer Williams, a clinical scientist with Ross Products Division, Abbott Laboratories; and Bryan Wolf, a former research scientists with Ross Products Division

 

we are exporters and manufacters of traditional herbal and ayurvedic medicine for diabetes

Hypoglycemia (Low Blood Sugar), Diabetes Testing and Driving Your Car

Because hypoglycemia can effect your driving performance (even modestly low blood sugar can do this), if you are at all prone to hypoglycemia, I personally would strongly recommend you check out your blood sugar level each time you are about to drive.

Prior to you putting the key in the ignition, test your blood sugar. There are some great glucometers out there, like the Accu-Check Compact with the Accu-Check Multi-clix lancet pen.

 

The Accu-Check Compact has a 17 strip drum inside so you don't have to take any extra strips with you. The Accu-Check Multi-clix lancet pen has a drum that automatically holds 6 lancets within the pen to use quickly and easily. Again, you won't have to bring any lancets separately with you. If your blood sugar is low, treat yourself to some juice or hard candy and don't drive until your blood sugar is back to normal. Usually 80 mg/dl and higher you should feel better. Then try and eat a small meal, like a low fat cheese and/or turkey sandwich.

 

Usually in 15 minutes taking 15-20 grams of Carbohydrate (CHO) will usually bring up your blood sugar to normal range. You can have a 4-6 ounce glass of juice, glucose tablets or 2-3 pieces of hard candy. Don't overdo it because your blood sugar will then go sky high. If it doesn't return within normal limits in 15 minutes, repeat the 15-20 grams of CHO and then check your blood sugar in 15 minutes.

 

Usually if your blood sugar is above 80 mg/dl, you should feel fine but sometimes going above 100 mg/dl, you'll feel better. You should always follow with a small meal that contains CHO, protein that contains a small amount of fat. Always make sure you have something to eat right within reach in the car (not in the trunk!). I tell my father to put 2-3 peppermint candy right in his pocket and have a supply of hard candy or peppermint candy always stashed in his car.

 

There is also gestational diabetes, which occurs during pregnancy due to specific hormonal changes in the body of the expectant mother. Diabetes is often accompanied by obesity and high cholesterol and is a disease that often runs in families, so if one of your family members has it, you have a higher risk of developing diabetes too. Lack of activity, a diet rich in fats and processed products and obesity significantly increase your risk for diabetes.

 

It is best if you eat 6-8 small meals a day. This would include a CHO, protein food that contains a little fat included. Example would be a cheese sandwich that contains either 1 or 2 slices of bread, a cheese that is low fat or turkey low in fat but not fat free. The protein and fat does help to stablize your blood sugar over a period of time instead of a quick spike in your blood sugar and a quick drop in blood sugar like juice would do.

 

During your trip if you need to take an insulin injection or an oral blood sugar medication, then make sure you eat as prescibed with your medication, otherwise your blood sugar can go low. I will be writing about how insulin and certain oral blood sugar medications can make your sugar go low. Not all insulin, esp. Lantus, or oral diabetic medications make your blood sugar low.

Signs of Hypoglycemia:

 

**Cold sweat, faintness, dizziness

**Headache

**Pounding of heart, trembling, nervousness

**blurred vision

**hunger

**Irritability

*Personality Change

**Not able to awaken

 

Now you can also have problems driving if your blood sugar is over 200 mg/dl. My father got in an accident because his blood sugar was over 200, he was becoming confused and at the same time had a Urinary Tract Infection. The police officer told me that a diabetic's license can be revoked if an accident is caused by diabetes. I don't know if that is true but why risk losing your license altogether if this is the case.

 

If you were going to be driving for any sort of extended time, every so often find an appropriate place to pull across and retest your blood. When it comes to driving: if in doubt, check out your blood sugar & eat!

 

Fern Kuhn, RN Specializing in Diabetes

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Brief Overview Of Diabetes And Diet

Diabetes has been around for centuries. There are presently sixteen millions diabetics in America, but eight million do not know that they have the disease. Today, diabetes is in third place as the cause of mortality, behind cardiovascular diseases and cancer.

 

Diabetes is caused by a disruption in insulin production in the body. Insulin is a hormone produced by the pancreas when the level of blood sugar, glucose, increases - after a meal, most commonly. With the help of insulin, glucose moves from the blood into the cells. The cellular components turn the glucose into energy. When glucose does not enter cells, it stays in the blood and is filtered by kidneys which later eliminate it from the bloodstream.

 

Diabetes is a chronic disease that occurs when insulin in the body does not work as it should. Main symptoms of diabetes include excessive thirst, excessive urination, excessive appetite, fatigue, blurred vision, frequent and slow-healing infections including bladder, vaginal and skin. In men, diabetes may be accompanied by such symptoms as erectile dysfunction.

 

In order to timely recognize diabetes, everyone should be familiar with the different types of diabetes as well as with main symptoms of diabetes. Type 1 diabetes is a life-threatening condition which is less common. Those suffering with this type of diabetes need complete insulin replacement because the body does not make sufficient amounts of this essential hormone. The most common type of diabetes is type 2 diabetes, or non-insulin-dependent diabetes mellitus. 90% of all diabetes cases in the US are diagnosed as Type 2.

 

Diabetes can be prevented and controlled by amending your diet. When we eat a product that is rich in sugar, the pancreas starts to produce more insulin to turn the sugar into energy. Saturated fat is transformed by the liver into sugar, which triggers the same response of pancreas - more insulin, more energy. When the body doesn't use this energy, it stores it as fat in the liver, on the stomach and hips. The more sugar and fat we eat, the more "storage space" our body requires.

 

However, when you switch to eating vegetables, cereals and other fiber-rich products cooked or seasoned with olive or grape seed oil, the pancreas does not need to produce any extra insulin. As a result, fat is not deposited in the body and the blood sugar levels remain stable. By avoiding sweet and fat-rich foods, blood sugar levels remains balanced which can delay the onset of diabetes and for those already diagnosed as diabetic can help them manage the condition.

 

Kathryn writes articles on a number of different topics. For more information on Diabetes please visit http://www.understandingdiabetes.info and for additional articles on Diabetes http://www.understandingdiabetes.info/understandingdiabetes-articles/

 

More on Diabetic Related Topics

 

Adult Onset Diabetes - Vanadyl sulfate is a form of the vanadium, a trace mineral. In Europe, vanadium is often used as a natural treatment for diabetes. Vanadium has been found in human studies to imitate the effects of insulin in our bodies.

Artificial Sweeteners - While it's very easy to test for diabetes symptom , a simple blood glucose test is the determining factor, diabetes may not be easily recognized at first since so many of its symptoms are also common complaints for people who do not have diabetes.

Blood Glucose Level - Diabetes is a condition featuring unusually high levels of glucose in the bloodstream. Insulin, produced by the pancreas, is used by the body to lower blood glucose levels. If someone's pancreas doesn't generate enough insulin, their body will develop diabetes.

Blood Glucose Levels - Bottom Line: Studies suggest that the routine combined use of a thiazide with a beta-blocker should be questioned in the early management of hypertension, particularly in patients who are at increased risk of developing new-onset diabetes.

Blood Glucose Test - While it's very easy to test for diabetes symptom , a simple blood glucose test is the determining factor, diabetes may not be easily recognized at first since so many of its symptoms are also common complaints for people who do not have diabetes.

Blood Pressure Monitor - Remember that when you eat out, you are not taking a break from your diet. Most Americans eat out two times a week, and sometimes more. Since you are likely to eat out with some frequency, don't use eating out as a time to take a break from your diet.

Blood Sugar Level - If you are like me you probably thought diabetes is one of those things you have or don't have; nothing could be further from the truth because diabetes is now the biggest threat to health in the developed world and we are eating ourselves into it because of poor diet.

Diabetic Supplies - "Your cat has feline diabetes." If this is your vet's message after examining your beloved friend, it will come as a shock. Yes, your cat has a serious disease.

Fasting Blood Glucose - "Hurricane Katrina Causes Diabetes" may soon be a real headline. This article will explain what you need to know before you or someone you know are unpleasantly surprised.

Potential Harmful Autoimmune - "Hurricane Katrina Causes Diabetes" may soon be a real headline. This article will explain what you need to know before you or someone you know are unpleasantly surprised.

Protein Diet - Dietary considerations can present a Hobson's choice in diabetes. Even when the intake is nutritious, assimilating it can be another matter. Then there is the problem of progression of diabetic complications if one ends up with excess glucose or fat in the system.

Remedies Herbal Supplements - Diabetes Mellitus is one of the most costly burdensome chronic diseases of our time and is condition that is increasing in epidemic population in the whole world. The complications resulting from the diseases are a significant cause of morbidity and mortality and are associated with failure of various organs such as the eyes, kidneys and nerves.

Saturated Fatty Acids - Prediabetes is a condition in which the blood sugar levels of the body are elevated over a period of time and within a specific range. This condition may be associated with the development of Type 2 diabetes, however ongoing research tends to indicate that there are a lot of strategies that someone with prediabetes can use to prevent or delay the onset of Type 2 diabetes.

Sensitivity Proper Exercise - Diabetes Milletus, a condition in which the body cannot convert food into energy because of a lack of insulin (a hormone produced by the pancreas), or because of an inability to use insulin. Diabetes is a serious condition that may cause complications.

Stimulate Insulin Production - Did you know that a third of all people that have diabetes are not aware that they have diabetes? Symptoms may seem tolerable, and most people just move on and don't pay attention to the bodies warning signals. Know you have diabetes or if you are pre diabetic, is important because you can start improving your life style and making the necessary changes to lessen the effects of diabetes in the future.

Sugar Diabetes - When you have diabetes should you really drink alcohol? That is a questions that many diabetics are asking. You are able to dink alcohol in moderation when you are a diabetic. But it is not good to really mix alcohol with any kind of medication.

Sugar Free Products - In past articles I've talked about how dietary sugars (white flour, corn syrup, table sugar, etc.) alter blood sugar levels, and how the body tries to regulate blood sugar through glycogen storage, insulin secretion and body fat creation.

Type Ii Diabetes - Today, diabetes is taking the nation by storm. As more and more people are faced with this illness, another problem develops - depression! For many families, diabetes means constant medical care and expensive medication. That coupled with the illness and it is easy to see why depression sets in. For this reason, we are also seeing a new group of people with diabetes turning to hypnosis to help.

Unconscious Eating Habits - Special areas in the pancreas gland, the islets of Langerhans, produce a hormone called insulin. This hormone is a protein of small size. Insulin stimulates muscle cells and other body cells to take up glucose from the blood and convert the glucose to glycogen, a kind of starch, and then store the glycogen.

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