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    16 views41 pages

    Diabetis Millets

    Uploaded by

    Om Shrivastava

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    © All Rights Reserved
    Download as PDF or read online from Scribd
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    of 41
    Tae eae Aiur tT a aR by PU ne aorea er Parte nuke CR ences) , Foreword ’ peor =< “The traditional smal cede known as miles have been in the nation since time immemorial These miracle healthy grains have been tinder down fill since fw decades de to emergence of commercial crops and non availability and difflelty in pose harvest technologies. However, the National Agriculttial Innovation Project of Indian Council of Agricultural Reseach generously funded to probe into valve addition and popularization of miles during 2008 for the period of 4 year Under theable guidance of Dr. Rana K-Naik, the Dean of Home Science and Principal Investigtorof the project, enormous and ‘caningful research oriented activities have been planned and exceed. The potentiality of miles, especially im maintaining goad health and its possible role in maintaining diabecesmellcus sed hyperlipidema have been proved sn human volunteers in collaboration with Dr. MV. Jali, Director, KLES. Prabhakar Kore Hospital and Medical Research Centre, Belgaum. The ‘compositional component of fort and tle millet especialy the complee carbohydrates and dietary fiber have revealed its sortanee in health maintenance and disease management ‘Te hookle prepared bythe scientists serves as 3 ssl tool for popularization of millets for maintaining health and preventing diseae risk factors. {personaly appreciate the efforts of scientists in bringing ths Book on role of potential grains in Aiahetes management. The information i useftl fr everyone and leo for heath workers - doctors, disticans, mtsing staff, ‘educatonistandalsostudents of medicineand nutiion, Paraisd De-L Keishna Naik , From the Authors “TX Since lt 25 years, the department of Food Sconce and nuttin hs bee evolved in indepth reach onthe poten Pee ica areata comes eee Se ete eee tee eae smovintsn the mallee grins: The ole of ck components Sete et ener eee prevention an management of oncommmnicble dieses The ther nutridonal companions of lls areon pa with poplar Seer Under the fumes) aieance of Naconal Agricul Inperaion Projet of Indi Concl of Apter Revnrch fee eet ees eet eee under taken in collaboration with Dr. MV. Jal, KLES Prabhakar Kore Hoopialand Medial Research Cente, Beli ere eek oneal comimesliz andthe efficiency of his post wr teed a KLES. Pabst Kore Hopi and Medical Research Cente, Bcgnum. The mille in general and fbrcted ml foo for Alnbsics inpartealar have been rowed ore hood cone tncbloodipidaberern1Onnd 196i longterm tad. “This the bosklecon mille inthe management of diabetes hasbeen specily brought out for the ae of corona eee eee ee ee eee Rama K.N: Hemalatha 8. Meghana D. R. Geeta Kapaleshwar MY. Kamatar lan introduction to Millets Reviving the Lost Grains forthe Future: The Mighty Milets INutraceutical Properties and Benefits of Millets [Cultivation of Miles understanding Diabetes Mellitus |Complications Due to Diabetes Management of Diabetes Role of Food in the Management of Diabetes Recommended Exercise for Diabeties Medication for Diabetes Management Monitoring and Tests for Diabetes |Gestational Diabetes |Special Care of Other Parts of Body by Diabet |Coping With Diabetes to Stay Healthy biter Recipes [Appendix 28 2 “4 35 0 2 4“ 0 5 “7 Management of Diabetes - Made Easy with Millets Rama K. Naik Hemalatha S. ‘Meghana)D))Re ws MYaKamatary National Agricultural Innovation Project, ICAR, New Delhi College of Rural Home Science University of Agricultural Sciences, Dharwad ‘Management of Diabetes’ - Made Easy with Millets First print : 2014 500 Number of copie Number of pages: 73+4 Rama K. Naik Hemalatha 8. Printed at Shri Bhavani Offset Printers, Hubli Millets are smallseeded grasses whose grains are used as food oF ‘eed by humans and animals. The crops are hardy and grow wellin dry ones a rained crops, under marginal conditions of sol ely and ‘moisture ina shore growing season. Millets are one ofthe oldes foods known to humans and possibly the frst cereal grain to be used for domestic purposes. They were thought co be cultivated way back 10 thousand years in Asia, Millets found along with the asumnmies een the pyramidsofEsypearea proof to indicate itscultiation since ages, Millet are clasified based on the site of the grains, large and smal miles. Sorghum and Maize are grouped under large and Finger rill (Elucine coracana), Foxtal millet (Setaia italic), Lil millet (Panicum sumatrense ,Proso millet(Panicum muliaceum), Kodo millet (Paspalum serobiculatum) , Pear millet (Pennisetum glaueum) and Barryard millet (Echinochloa esculenta) belong to small millet category. Miles are highly nutetious, donot possess gluten, last allergic and also possess many nutraceutial components, So, these can Ia righly called "Mighty millet”, Looking at the immense national ‘and nucraceutical benefits the Government of India has ow advised allsates including Karnataka. t include mallets in the mid day meal programme Foxtail millet Foxtail millet isbeliwed to have its origin in South East Asia and ‘has the longest history of cultivation amiong the mille, In China ichas ‘been cultivated since seth millennim BC. Other names for foxt miller include Ielian mille, German millet, Chinese mille, and Hungarian millet. Iris present being cultivated in Japan, China, India ‘and Eastern Burope, Tn India this crop i being culated in Andhra Pradesh, Karnataka, and Tamil Nadu. In South Karnataka st i cultivated as mixed crop along with finger millet and other crops while in Norch Karnataka foxall is being cultivated both as mised and sole oval drupe ocean le cee des. wri hgh tabs f ery dena 4 Pe-dlabeten Tis isa condton where nthe Mood cose foods such fied or unk sone of levels are raised but not high enough to be diagnosed as. Se eoalet oem dais dlskeces, thos eed at Inpalned luce Tolerance OT, People with IOT ore at rk of dewoping abet and al Sires incre kof cadionselt dese, Conse aes t work place Fe ese aie eo Totals e tena fice ete dies Medications Consumption of medications like steroids have found to reduce theactivtyofinsulin, ‘Symptoms of diabetes: High blood agar levels can cause several symptoms sich a5 ‘© Bxces thirst and hunger "New bom baby with diabetes + Bryson + Fatigue Causes: Frequent urination Th tg he it om, Sel ist + Weigh los ‘Straps dna and tis adlvrdet, Genet preopostion may aoa SDs snd Seal oe be one of the causes. Obesity or overweight and middle aged ioe Decrepeed asain, population ae more prone to ths donde, Higher fr deporions in 4 Itching around the genital organs ‘hebody may ado imprimencin the insulin act. Hire alo_postble delay ‘Urbanization Aliabeses without any sympeoms fora long Several research studies have reported that rural co urban peril a rnigration has lead to fou and lifestyle changes resulting in higher {incidences of diabetes 1° Diabetes is diagnosed with the following tests: 1, Blood test: ‘Fasting blood ghicose level diaeresis diagnosed iit is higher than 100 mg/L (normal rangeis60-100mg/A). ‘+ Random (nos fasting) blood glucose lve! when blood glucose levelismore than 40me/dt 1+ Oral glucose tolerance rst- diabetes is diagnosed ifthe glucose level ishigher han 120mg/L- How the testis performed A person should be under fasting state (without any food oF rink) for 12 hours, For the tet, the person is asked ta drink aliquid ‘containing 75¢ of glucote. Blood will be drawn priot to ingestion of slucose and again afer every 30 minutes afer taking glucose solution for Z hoursand blood lucose eves are estimated ‘Why the testis performed Glucose is the sugar the body uses for energy. Patients with untreated diabetes have high blood glucose lewls. Ghose tolerance tests are one of the tool ted to diagnose diabetes, Above normal blood glucose levels can be ued to disgnone type 2 abetes or high blood glucose during pregnancy (gestational diabetes) ‘The orl giscor tolerance teste weed to screen pregnant women for gestational diabetes between 24 and 28 weeks of pregnancy le may also be used in cases where the disease i suspected, despite normal fasting blood pace level Normal results Normal blood values fora 754 orl glucose tolerance test used to check for ype diabetes: © Fasting: 60-100 me/dL- Tour: less than 200 mg/l + Thou: les than 140 mg/dL. Berween 140 - 200 mp/al is considered Impaired glucose tolerance Gometimes called “prediahete’). This group i at increased risk for developing labetes Greater than 200 mg/dL is asign of diahetes melts » 2.Urinetest Urine analsis may be used to look for high blood sugae However, urine tetalone doesnot diagnose diabetes. The thresbold of Kidney fr glucose is 180mg/aL filtrate. Hence this tests mot accurate fortesting the control or diagnosing diabetes 3.Ketone testing Ketone esting i aso sometimes used. The ketone testis done sing urinesamplear blood sample. Ketone testing mayhedone: + When theblood sugar ishigher than 240 m/l. + Duringanillnes such s pneumonia, heartattack orstoke ‘+ When nausea orvomiting occurs During pregnancy Screening for diabetes s recommended for: + Overweight children who have other tsk actos for diabetes, startingat age IDand repeated every 2 years © Overweight adults (BMI greaterthan 25) + Adulte shove 45 yeas tepeated every year Monitoring blood glucose love! near normals very J cstenial for preventing: complictions. In perons with SPY diabetes, high or very less blood glicose levels results in ZO several complications Hypoglycemia Hypoglycemia is « condition cha occurs when blood sugar {vcore i to lene Blood niga below 60 m/l considered low Blood agarator low this eetcan be dangers Hypoglycemia occurs whens 1 Body's sugar (glucose) is used up too quickly due eo severe physical activites «+ Food fas not been consumed afer drug/insulin trestment Insulin is hormone cha reduces Blood sugar. eis produced by the panereas in esponse to neressed gluco levels in he blood “The most common causes of law blood sugar in people with iabetesare: «Taking doslin or diabetes medicine st regula ime «+ Taking too much or high potency inulin by mistake ‘+ Not eating adequate food during meals or snacks after taking insulincemedicine «Skipping meals «Delaying meals «Exercising more or ata different time than usual «Drinking aleohal Symproms Common symptoms experienced by diabetics during byposficacmiaare, © General weakness {Double vison or bioreyvsigp Fast or pounding heartbeat Feeling cranky oF acting aggresive Feeling nervous Headache Hunger Shivering or trembling Sleeping trouble Sweating Tingling or numbness of the skin Tiredness Unclear thinking Iris also possible without any above mentioned symptoms, = diabetic can suddenly undergo following staves due to low blood slucosc level + Faint + Have a seizure + Go into a coma 2, Diabetic ketoacidosis Itisa problem that occarsin people with diabetes Ieoccurs when the body cannot us sugar (glucose) a fuel source Because there sno ‘or not adequate insulin, Ft is weed as fuel instead, Byproducte of fat breakdown, called ketones, buildup in the blood and reveal following symptoms. Deep, rapid breathing Dryskin and mouth Flushed face Fruity smelling breath Nausea and vomiting Stomach pain TF untreated, ketoacidosis can lead to severe illness or death Improved therapy for young people with diabetes as decreased the leah rate fom this condition. However, i remains a big rk inthe ‘lderyand in people who fall inca @ coma when treatment has been Selayed 3. Other complications Delayed wound healing is often observed in people with ‘uncontrolled dbetes, Tubercoss, infections of skin, urinary tact andlegcan occur frequent. Long term complications of diabetes among uncontrolled. subjects 1, High blood pressure Blood pressure the fore of blood pushing agnins the walls of the arteries as the heart pumps blood. If this pressure rises and stays Ingh overtime, sean damage the boy in many ways. Blood presse is measured as sstolic and diastalic pressures and is indicated by two ppumbers. Ey 130/HOmmHle. The fast numer 130 indiates sscolic pressure and the second diastolic pressure,"Systlic" refers to blood pressure when the heartbeats while pumping blood. "Diastolic" refers tablood prestre when the heart tat rex etcen beats, The mma is millimeters of mercury-the unis used to measure blood pressure Desirable blood pressures 120/80 mmHg Any blood pressure reading that consistently stays at 140/90 mm or higher is considered high blood pressure. Untreated diabetes may make it harder t contol blood pressure and cholestrol. This can lead to heart attack, stroke and other related problems. Iecan become harder for blood te flow to thelegrand fet, leading to neuropathy. 2. Changesin the blood lipid profile ‘Uncontrolled diabetes leads to an increase in blood cholesterol level. Cholesterol isa wany substance that our body needs for normal function. Our body actully can make al he cholesterol needs, but wwe end up getting additional cholesterol frm the ania origi fouls ‘weeat. Normally in diabetics, che levels ofcholesterol and erigiyceries ste higher chan the normal ange. There are many types of cholesterol, ‘Theonestalked aboutmostare {Total choleserl all he choesterols combined ‘© High densi lipoprotein (HDL) cholesterol -often called “goad” choleerol ‘© Low density lipoprotein (LDL) cholesterol often called “bad” cholesterol ‘The main function of HDL isto help soak up excess cholesterol from the walls of blood vesels and cary itt the liver, where it breaks down and i removed from the body inthe bile. Studies ofboth men and women have shown that the higher the HDL, the lower is he rik ofcoronary artery disease Pa LDL carries cholesterol to various tes throughout the hod Too much LDL, commonly called "bad cholesterol” is linked «0 cardiovasculaediease, lower the LDL lower the risk for heart disease or evoke Why are some cholesterol “good” and some “bad”? High-density lipoprotein or HDL cholesterol is “good” becauseit ‘an be taken to liver t be excreted. Lowdensity lipoprotein or LDL ‘cholesterol ic “bad” because it stick to blood vescle snd use up in theartercs, increasing the risk of hearcarackand stroke 3. Diabetic retinopathy Diabetic retinopathy is caused by damage to blood vessels ofthe ‘etinathatoccurswith longterm diabetes ‘The retina isthe layer of tisue a che bac of the inner eye. It ‘barges light and images that enter the eye sco nerve signals that are sent tothe brain, Retinopathy i also more likely to occur earlier and tore severe diabetes has been pootlycontrlled. ‘There are two types, or stages of diabetic retinopathy: + Non proliferative develops + Proliferative is the more advanced and severe form of the isease ‘Generally diaberes for more than 30 yeats wil show signs of diabetic retinopathy. ‘Symptoms Symptoms of dishetic retinopathy include ‘Blurred vision and vision los overtime + Hosters 1 Shadows or mising area of vision + Trouble seing at night Many people with early diabetic retinopathy have no symptoms before major bleeding occurs in che eye. This ie why everyone with dlsbete should have reglareye examinations. 2s 4. Diabetic nephropathy Diabetic nephropathy is kidney damage chat occurs in people with diabetes. Bach kidney is made of thousands of small unis called replirons. These structures filer blood and help remove wastes fom the body, In people with diabetes, the nephrons thicken and slowy become scarred over time, The kidneys begin to leak and protein (albumin) pasts into the urine. Though the exact case is unknown, poor control of blood sigar thought to lead to kidney damage. The problem sapyravatedifthe person has high blood presure. However, smpleurine ret mactoafbuminures can detec early kidney damage 5. Diabetic neuropathy Diabetic neuropathy is damage to nerves inthe body that occurs duc to high blood sugat levels, Nerve injures ate caused by decreased blood flow and high blood sugar levels. They are more lkelyto develop ‘blood agar levels ae not well onttlled. Smptome often develop slowly over several years. They can vary depending on the nerves that sreatfcted “Tingling or burning n the arm and logs may bean cal sign of nerve damage, These eling often satin roesand fet. Nerve damage may cause one to lose feling in arms and legs because of which sensation upon stepping on to sharp objet, feling of hot or cold will note felt Damage to nerves in heart and blood vessels may cause ight beaded when he stands, has «fast heart rat, will note able to notice the chest pain thac warns of hear disease and heart attack. Other symptoms of nerve damage inclade sexual problems. Men may have problems with erections. Women may have trouble with vaginal dryness or orgasm, Bladder problems and sweating even when the temperatures are cool 6. Infertility Diabetes if uncontrolled may in frequent infections of the genial organ leadingeo infertiing. 7. Other complications Uncontrolled dabeces maylead to damage in che Blood vesel co stomach, intestine, uteri and anyother organ and can eause damage to that part. Due to impaled blood supply, imumunity to diseases may bbe reduced: Due to nerve damage feeling in fet may be lost, A cut, 2 Dlisterora sore may noche fl. Foot injures ike these can cause lests and infections, Serious cases may even lead to amputation. Damage to the blood vessels ean also mea that feet donot get enough blood and ‘oxygen. Itisharder forthe woundstobeal. Seroke diovascular disorders Kidney problems "Nerve Problems Diahetesisa lifelong disorder which cannotbe cured, but normal levels of blood sugar has to be managed to preventcomplications. Five thumb rules tobe followed for management of diabetes to lead ahealthy lifer 1, Diets Management of dies as importantas medicine. Medicine ieineffective if dierent managed proper 2. Exerciser Regular exercise is very important. Exercte helps insulin secretion anduptake by cel, 3. Medicines To manage diabetes the prescribed medicines have to be taken regularly and for those dependent on insulin regular insulin eneeded 4. Check ups Diabetes need regolar check up of the blood lipid profileonce in 3 months and blood glucose level once in a week, ‘The blood pressure and body weight need eegular check upy is advised to check these parameters regularly and not when the Ssymproms are severe Bload fucose can be monitored athome by usingglucometer. 5, Eueations Knowledge on diabetes isa must (or everyone for proper management. Hence, diabetics should have knowledge about the diet wo be followed, exercise, medicines and the complications that arise due to improper management of any of these. Food playea maoemoesn the management of diabetes The meal plan for dabeus should be normal fom the family poe However, {Quanty ie decided conaderng the weight, height age, Phsel ay nd nate of dabeter, The energy ruirments should Be dided ‘seween beaks lunch and dinner equally and sweet cishes bated on el Occastonal consumption sugar, jagery and honey should be aveid ‘ofsweets may beallowed after suitable modifications Foods to be consumed liberally by diabeties ‘Green leafy vegetables like, fenugreek, spinach, Amaranthus, — drumitick leaves and. alike can be onaumed liberally, Coloured vegetables lke carro, beetroot, tomato should also be included. Green leaiy vegetables and che coloured vegetables are ich sources of Trinerals, varing, antioxidants Sauting them in very ite oil enhances the bioavailability of antioxidant components presentin themlikeyeopeneand latin. Foods to be avoided by diabetics Sugar, sees, honey, jaggery sweetened sofe drinks should be seridly avoided. Roots and tubers like potato, Deeroot and sweet potatoes should he consumed sparingly. Frost ike mango, banana, rapes seetaphal and sapota need tobe restricted the blood pressure [Sigh food rch in sodium (meat, organ meat, green leafy vegetables, nillcand mile products) includingsaleshould beresticted. Fred fonds should he avoided and th fat shoul be limite to 2 ‘teaspoons (10g) day. Fats have hoon clasfid bssed om the fatty aid chain Length they possess and saturation of hydrogen bonds a5 Saturated, mono unsaturated fatty acids (MUFA) and poly unsarurated fauryacids (PUFA). The usage of fay acdsin ratio of Te: 1 of saturated, [MUBA and PUFA ie the moet advised, Research carried ut tthe Departmens of Food Science and Nuwiion, Univesity of Agricultural ‘Sciences, Dharwad has shown that lend of diferent pes of oll in ‘very cooking etter than use of single type fol, Groundnut i suitable for vegetarians for prevention of high tighcerides, cholesterol, LDL cholesteral, VLDL cholesealin blood. Fatty acid composition of different cooking oils and fats Fats and oils Tw rn) Coconit ail as | 78 | 20 ‘Groundnut oi 209 | 493 | 299 Mustard oi tor | s60 | 326 Pali oil 463 | 37 | 100 Bice bran oi 21 | 410[)| 352 Safflower ai tar | 167) [as Seasame oi a7 | as [ass Soy el iat | 289 Sunflower ail ot | 250 Butter 34 [280 Ghee 320 Modifications required for non vegetarians Consumption of meats hae ate rich in cholesterol = tom, beef, organ meats ike liver, kidney, brain and egy yolk should he restricted. Lean meats, fish, de skinned chicken can be consumed preferably boiled than fried mo QBeslrlele Fruits suitable for diab Many diabetic are ofthe presumption that fuis should not be ‘consumed. All ft can be constimed in limited quantities when the blood glucose level is managed in the normal range. Papays rust, pomegranate, apple, sweetie, orange, watermelon ean be consumed. advisable to consume fits along with the skin eg apple with skin ‘or sweet lime or orange withthe fiber. Occasionally 5 grapes of balf mango can als be consimed. However, the intake of carbohyerates likeoneros/sicehasro hereduced, L6G co YR Calorie requirements for di eties The calorie requirement for dabetis is dependent on the height and weight of en individual. The ideal weight ofan individual can be ‘computed by using he form, Height (em) = 100 theideal weight would be 16510065 Ke, Ical wight has to be achieved by reducing if fis more and Increased ifit sess. Reduction in weight would sesulin normal blood presureand oad aigarleves dea wel Ex iftheheight is 165. Meal plan for diabs Diabetics should divide the meals four emes ina day- breakfast, lunch, evening snacks and dinner, Fasting and feasting should be avoided, Mealsshould be consumed ata regular time, cn ‘Above dea weight {obese or ver wight) Taaiweiee 3 Teas than el wed (under weiht) ‘The total calories should be 65% from casbohydrates, 15-20% fom proteins and 20-25% fom fats ana oils (boc wise ad nwiible fom the foods). Bach gam of protein and carbohydrates yield 4 Keals fof energy and {3 yelds about 9 Keals. Diabetics should consume ‘alorisin accordance the requirements Food choice for diabetics Diabetics can follow ood exchange list for diferent food groups (Appendic1V).The exchange list grouped in sx food groups, gies the lst food with simi caloyie content. Foods can heselected fom the sroupone ata time ta diversify the intake, Sugar free tablets or artificial sweeteners ‘Suir fee or artificial sweeter can be used in place ‘of sugar for tea, coffee lee, sweets ete. The number of tablets to be used should not exceed 10 tablets/day Pregnant and persons with kidney problems should restrict theuise of rifiilseetenc Alcohol consumption Consumption of alcohol by diabetes is not advisable, Alcohol consumption increases body weight and nerve problems. People wo cannot void alcohol completely should rest consumption to one peg (60ml) per day avoid farther compllctions and red-wine ‘which are rich in ancl oxidants are preferable Alcohol has a hypoglycemic effec, hence drugs for diabetes should be retired when alcohol i consumedin large quantiies. Food rules for diabetics for management of diabetes, Diabetics should adheretothe following suggestions ‘© Riceand whear should be replaced ca larger extent with minor mille like oxtail mile, litle mille, barnyard mille, kode rll proso mille, Consumption of Green leafy vegetables and other vegetables should be high Is advisable to consume vegetables or fits whena diabetic fels angry in berween mealtimes, Fasting is not good for diabetics. Instead of consuming two lange meals che same mal should he split into 34 meals for berter management fblood glucosleves, the mealtime is ging delayed, diabetic should consume wither frit, vegetable, mike or any other food in small ‘qantitesta prevent hypoghcemia, Diabercsshould avoid suga, honey, aggeryor any sweets Excess consumption of food including cereals will convere co sugarand chen fa, olimitche intake of food. Fats from plant origin do not contain cholesterol; however ceacess consumption wil convert available ft to cholesterol (Ourhody requires just Igvsible oat everyday @ Exercising gull wil help diabetics to maintain good health, serie aids for good Blood circulation and alko insulin production, Exercise along with good nutrition, helps to decrease body, which normalize lucote metabolism. Exercise also helps to lower coronary risfactorslike high blood pressureand high cholesterol Points to be considered while exercising: + Rigorous walking 30-45 minute is one ofthe good exercises for diabetes. I helps in blood circulation, breathing and keepsthemactive + Exercise daly atche same time, start out easyin the beginning snd gradually increae the intensity and duration. Almost 5 fimesaweckis mst + Exercise should not be inegula. Proper foot wear should be worn; they should be comfortable, welling and appropriate forthe chosen exercise 4+ Bxerciseshould notbe done when th blood glucoee levels very high orlow + Food should be comtumed before and after exercise Ifa Giaberic feels exhausted after exercising sugar should be Inaly the blood coe wil be achieved through management of di, ‘ete and weight los obese Dre tre reserbe only when luose kel eee ete sweyen Fore I ithtes which ‘vaedduetelakof natin proton, intinnectonsareprsctbed 4 jo aS: Medications can be of three types Melt et be a hi ete Se ES eS see ee + Medinet Steines simulates the pron of ene ie nine ed Neier iste REE ee ee cilegeesaiee ivan ty sae sardonic lmportasttoremenberwhile taking weicinca «Never take medicines without consulting physician. + Medi soc arson et posto ye woes EN ag Ta a ee pate 5s se ter een ci ent do aie oe Insulin Iain ernone ih pol fy he et of (a ee afer eating food, Insulin is protein in nature. This hormone regulates the carbohydrate and fa metabolism fn the human body. Ielowers the level of glucose in the ‘ood and help hcose to enter the body cells, where it can be used for energy or stored as giycogen for Furure ‘se, In diabetes, the pancreas doesnt make adequate sulin or the body cells ean respond normally #0 the ‘sulin that available. This causes the lucose level in thebloodea tie, Insulin is given vo body by injections. The dosage and typeof insulin is dependent on the persou’s lif se, body weight and blood glucose levels and should be taken as per the physician's advice. ‘Types of nsulin ‘The type of innulin i elasfied hase om how quickly they begin ‘oworkand how long they continue to contea blood sug. + Fast or rapid acting insulin - Food can be consumed immediately after akingthis 1 Slow acting inslin-In this ate fod is consumed after halfan houratinjection + Imermediate act hafadsy 1 Longactinginslin-thiesatisties the day’sinsulin roquitement| ‘© Mixed inslin- This insulin ha tobe taken twice daily before meals ‘Theinvulin arvtyis dependenton the persons physica activ, fod and the body pare where iis injected, Insulin can be injected 2¢ several sites in body Injections are taken substances, unvder the {at layer of che skin. To ensure the complete injection of insulin, the neale has to be placed under the skin for at lest si seconds, Physician's advice is necessary co know the type and quantity of tsi tose and how often co inject. Insulin should nocbe used mare or est than that presered bythe physi. Howto injectinsulin? ‘Insulin comes as a soluson (liquid) and a suspension (liquid with particle that will cere’ on standing) to be injscted subcutaneously (under teak) * insu eis satisfies che insulin ned for Tsun comes in vial pre filed disposnble dosing devices and cartridges. One should know in what typeof container sli comes an what other supplies, such as needles, syringes oF ‘pens willbe needed to inject The name and lester on insulin should he exactlywhat thedactorhasprescibed. ‘© Ifinsulincomesin vials, syringes marked for that ype of insulin re needed to inject. Always the same brand and model of needle and syringe should be used, |» Manufacure's insertions should be read carefully co Lear how co draw insulin into asrigeand ijectthe dose © IF insulin comes i cartridges, suitable insulin pen may be needed 1» TFinslin comes ina disposable dosing device the instructions ‘haccomewith thedevice should becarefully read. 1+ Needles should never be reused. Syringes, cartridges or pens should never be shared. Throw away needles and syringes in @ punceuezesistant container. 1+ Some ypes of insulin must be shaken or rotated co mix before tse. Doctor or pharmacist should be consulted to know ifthe ‘ype of inslin being used should be mixed and how it should be mixed. Read the inetactions avaiable with the insulin package, “+ Toaulin container should be checked before use, The inal should be a cleat, colorless and fluid ae water. If inguin spears clay thickened or colored or ifithassolid pariclesit should nothe sed “+ Anytypeof insulin should not he used after the expiration date printed on the bottle, Doctor shold be consulted to know where one should inject insulin. Insulin ssvaly injected inthe stomach except for 2 inches 5 centimeters around the helly button), apper arm, upper leg or buttocks. Injection of insulin into mules, sary or moles should never bbe done. Esch time a different ste should be used, atleast 1/2 inch {1.25 centimeters) away from the previo injection site but inthe same general area is prefered, Al available sites should he used in the same ageneralarea before switchingtoadifferentara, 1 Insulin can be injected without anybody's help, however dloctorsadvice in his regard isa mus. + Inaulin can be combined with oral medicines. Such ‘combination will reduce the quansityof insulin Points to remember while using insulin injections «Allow the injection to come to normal room temperatite i taken out from the refrigerator. Never use insulin fichas thickened + Fe should be ensured before taking fall dose of insulin injection thaone isnotallrgic toi. ‘lf the blood glacose levels ae low ie in hypoglycemic sae, inulin injection should note taken Howtostore insulin? ‘Insulin vials should be stored under refrigeration conditions (28deqre Cand not freeze. +H ehere is no tefhgerator it as w be stored in a vessel ‘ontsningwaterand storedin cool place ‘© Thevial canbe stored in room temperature (228°C) only when ies used before one month, + Teisalways beter tostarean extaviain the reftigerator. Side effects of insulin medication 1. Gaininbodyweight 2. Lowlovele oflood ghicose Precautions tobe taken by diabetics while travel L 2. 3 Plan the ravelwellinadvance Information on dihetes should beknown, eis advisable to cary more than the preteribed amount of medicines, injection needlesand insulin wals ‘Acca containing information - name, address, blood group, contac phone number of dactor and family should be kept specallywhen tavellingalone Sufficient amount of food shouldbe carried while tovelling “cis advil fone wih companion epecally when he 2» 9, Urine test using uristickss Uristicks are available in medical shop. These sticks ate applied with chemical atone end, which should not be touched with hands, This end ofthe stick shold be dipped inthe freshly voided urine fora second andleftfor 30 minutes orcolout evelopment. The developed colour should be matched with the eolour Proper management of food, medicine ad exercise can conteal codes given on the bottle. The blood glacose levels. However, periodic tts are needed to check the concentetion of glucose in the wine's ‘ood glucoselevel Indicated byt respective colour code, af a sicated by its respective colour codk 1. Blood test: Sugar levels in blood should be 4 [Normal values of blood sugae lipids and blood pressure checked at lense once in to months Under the ‘uprontadioe Thee ante ede g oe Se oe oe hicose levels even at home with the help of a P| Piima Gicese slocometer, stasing ferio fee | sz6 2. HbAIC Tests This rest indicares the average amount of ae es | SOR |) 2200) sarin the blood ovee 3 months. Te shows how well diabetes is fz Paar coteserot —-

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