Tag Archives: Academy of Nutrition and Dietetics

Eatching & tearing of Eyes (Epiphora)

Definition:

Watery eyes (epiphora) tear persistently or excessively.

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Depending on the cause, watery eyes may clear up on their own. Self-care measures at home can help treat watery eyes, particularly if caused by inflammation or dry eyes.

Causes:
Watery eyes can be due to many factors and conditions.

In infants, persistent watery eyes, often with some matter, are commonly the result of blocked tear ducts. The tear ducts don’t produce tears, but rather carry away tears, similar to how a storm drain carries away rainwater. Tears normally drain into your nose through tiny openings (puncta) in the inner part of the lids near the nose. In babies, the tear duct may not be fully open and functioning for the first several months of life.

In older adults, persistent watery eyes may occur as the aging skin of the eyelids sags away from the eyeball, allowing tears to accumulate and flow out.

Sometimes, excess tear production may cause watery eyes as well.

Allergies or viral infections (conjunctivitis), as well as any kind of inflammation, may cause watery eyes for a few days or so.

There may be some more other cause like due to different medication & other  diseases.

Do your eyes itch after you’ve been near a cat? Do they puff up or run with tears when pollen is in the air? Allergies of the eye affect about 20% of Americans each year, and are on the rise. The same inhaled airborne allergens — pollens, animal dander, dust mite feces, and mold — that trigger allergic rhinitis (the familiar sneezing, runny nose, and congestion) can lead to allergic conjunctivitis (inflammation of the conjunctiva, the lining of the eye). It’s not surprising that people with allergic rhinitis often suffer from allergic conjunctivitis as well.

About 50% of allergic conjunctivitis sufferers, who tend to be young adults, have other allergic diseases or a family history of allergies. About 80% of eye allergies are seasonal; the rest are perennial (year-round). The symptoms are itchy and red eyes, tearing, edema (swelling) of the conjunctiva or eyelid, and a mucous discharge. Although it can be uncomfortable, you can rest assured that it is not a threat to your vision.

Diagnosing allergic conjunctivitis:

Allergic conjunctivitis usually can be confirmed by your doctor based on your symptoms. Testing is not usually needed to diagnose the condition, but skin testing (the same kind that’s done for other allergic reactions) may help identify the allergens causing your symptoms.

If your symptoms don’t quickly respond to treatment, see your doctor in case you have a different condition. Dry eye, in particular, can mimic the symptoms of allergic conjunctivitis.

Treating allergic conjunctivitis:-

Avoidance is your first line of defense. If you are allergic to cats, for example, avoid them (or at least don’t touch your eyes when near one), and wash your hands immediately after touching one. If pollen is your nemesis, keep your windows closed and an air purifier or air conditioner going in pollen season. Also, don’t rub your eyes, because rubbing causes cells in the conjunctiva to release histamine and other inflammatory chemicals, which worsens symptoms. Use artificial tears (available without prescription) frequently for relief and to dilute allergens in the eye.

If your only allergy problem is allergic conjunctivitis, then medicated eye drops would be your first step. You can start with an over-the-counter product, such as ketotifen eye drops (Zaditor, Alaway). The active ingredient is an antihistamine and a mast cell stabilizer, both of which can control the immune system overreaction that leads to your symptoms. Prescription-strength products that have similar actions are also available.

Allergic conjunctivitis can also be treated with over-the-counter oral antihistamines such as loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra), or the prescription antihistamines desloratadine (Clarinex) and levocetirizine (Xyzal). These are especially useful for people that have other allergy symptoms in addition to conjunctivitis.

For allergic conjunctivitis that is very severe and doesn’t improve with other medications, there are prescription eye drops that contain corticosteroids, such as loteprednol etabonate (Alrex, Lotemax) and fluorometholone (Fluor-Op, FML Forte). However, these eye medications should only be used under the guidance of an ophthalmologist.

General  precautions  & Alternative treatment of eatching & tearing eyes:

*Remember to keep their eyes free from dust and other particles that cause a blocking of the tear ducts.

*Wash the face and eyes frequently as this will also help to keep you refreshed. Washing your eyes frequently also removes the impurities from around the area of the tear ducts, keeping them free from blockages.

*You could also keep your eyes moist with the use of some mild eye drops. This will help in reducing the itchiness and the dryness that you experience.

*If you are going outdoors, make sure to wear some protective eye wear that help to keep impurities out of the eyes, thereby avoiding any irritability of the sense organs.

*Rose water is an excellent remedy to soothe dryness or burning sensations that are experienced in the eyes. Washing out the eyes in a capful of rose water will provide instantaneous relief.

*There are occasions where the optical nerve of the eyes and the muscles around the eyes have been strained, leading to dryness and itching, followed by a continuous flow of secretions. In order to relax the eyes and the relevant muscles, place slices of cucumber over the eyelids while you rest your eyes. The cooling effect of the cucumber slices will provide a great deal of relief to your tired eyes.

*On certain occasions, a warm compress, made by dipping a piece of towel into warm water and pressing it gently over the eyes will provide relief from symptoms of itching and continuous flow of tears.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Resources:
Harvard Medical School healthbeat@mail.health.harvard.edu via nf163.n-email.net
http://www.home-remedies-for-you.com/askquestion/83237/causes-of-itchy-eyes-what-could-be-the-root-of-itc.html
http://www.mayoclinic.org/symptoms/watery-eyes/basics/causes/SYM-20050821

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Broccoli

Botanical Name: Brassica oleracea italica
Family: Brassicaceae
Genus: Brassica
Species: B. oleracea
Kingdom: Plantae
Order: Brassicales

Common Names: Broccoli
Broccoli is an edible green plant in the cabbage family whose large flowerhead is eaten as a vegetable…....CLICK &  SEE

The word broccoli comes from the Italian plural of broccolo, which means “the flowering crest of a cabbage”, and is the diminutive form of brocco, meaning “small nail” or “sprout”.  Broccoli is often boiled or steamed but may be eaten .

Habitat: Broccoli is native to Mediterranean Region. It is a result of careful breeding of cultivated leafy cole crops in the northern Mediterranean starting in about the 6th century BC. Since the Roman Empire broccoli has been considered a uniquely valuable food among Italians. Broccoli was brought to England from Antwerp in the mid-18th century by Peter Scheemakers. Broccoli was first introduced to the United States by Italian immigrants, but did not become widely known there until the 1920s.

Description:
Broccoli is an herbaceous annual or biennial plant grown for its edible flower heads which are used as a vegetable. The broccoli plant has a thick green stalk, or stem, which gives rise to thick, leathery, oblong leaves which are gray-blue to green in color. The plant produces large branching green flower heads covered with numerous white or yellow flowers. Broccoli can be annual or biennial depending on the variety and can grow to 1 m (3.3 ft) in height. Broccoli may also be referred to as sprouting broccoli and likely originates from the Mediterranean although the exact location has not been determined……..CLICK  & SEE THE PICTURES

Varieties:
Broccoli plants in a nursery:
There are three commonly grown types of broccoli. The most familiar is Calabrese broccoli, often referred to simply as “broccoli”, named after Calabria in Italy. It has large (10 to 20 cm) green heads and thick stalks. It is a cool season annual crop. Sprouting broccoli has a larger number of heads with many thin stalks. Purple cauliflower is a type of broccoli sold in southern Italy, Spain, and the United Kingdom. It has a head shaped like cauliflower, but consisting of tiny flower buds. It sometimes, but not always, has a purple cast to the tips of the flower buds.

Other cultivar groups of Brassica oleracea include cabbage (Capitata Group), cauliflower and Romanesco broccoli (Botrytis Group), kale and collard greens (Acephala Group), kohlrabi (Gongylodes Group), Brussels sprouts (Gemmifera Group), and kai-lan (Alboglabra Group). Rapini, sometimes called “broccoli raab” among other names, forms similar but smaller heads, and is actually a type of turnip (Brassica rapa). Broccolini or “Tenderstem broccoli” is a cross between broccoli and Chinese broccoli. Beneforté is a variety of broccoli containing 2-3 times more glucoraphanin that was produced by crossing broccoli with a wild Brassica variety, Brassica oleracea var villosa.

Cultivation:
Succeeds in full sun in a well-drained fertile preferably alkaline soil. Tolerates a pH in the range 4.3 to 8.3. Prefers a heavy soil. Succeeds in any reasonable soil. Succeeds in maritime gardens. Some forms are very cold-hardy, tolerating temperatures down to about -17°c. Broccoli is closely related to the cauliflowers (C. oleracea botrytis) and is often grown for its edible young flowering stems which, by careful selection of varieties, can be available almost all year round from early summer right round to late spring. There are many named varieties and these can be classified into three main groups:- Calabrese, which matures in summer and autumn, is the least cold-hardy form. It produces green, or sometimes purple, flowering heads. Some forms will produce a number of side shoots once the main head has been harvested, though other forms seem unable to do this. Romanesco matures in late summer and the autumn. It has numerous yellowish-green conical groups of buds arranged in spirals. Given a little protection from the cold, it is possible to produce a crop throughout the winter. Unlike the other types of broccoli, romanesco seems unable to produce side shoots once the main head has been harvested. Sprouting broccoli is the most cold-hardy group. It does not form a central head like the other two groups but instead produces a mass of side shoots from early spring until early summer. The more you harvest these shoots, especially if you do so before the flowers open, then the more shoots the plant produces. A good companion for celery and other aromatic plants since these seem to reduce insect predations. Grows badly with potatoes, beet and onions. Grows well with potatoes, beet and onions according to another report.

Propagation:
Seed – sow sprouting broccoli in a seedbed outdoors in March to May. Plant out in June. Do not let the seedlings get overcrowded or they will soon become leggy and will not make such good plants. If your seedlings do get leggy, it is possible to plant them rather deeper into the soil – the buried stems will soon form roots and the plant will be better supported. Romanesco and calabrese are often sown in situ in the spring.

Edible Uses :
Edible Parts: Flowers; Leaves.
Edible Uses:

Young flowering stems and leaves – raw or cooked. The shoots of sprouting broccoli are harvested when about 10cm long, and before the flowers open, the shoots look somewhat like a small white or purple cauliflower and have a delicious flavour. They are considered to be a gourmet vegetable. When picking the stems, make sure that you leave behind a section of the stem with leaves on it, since the plants will often produce new side shoots from the leaf axils. Calabrese and Romanesco plants produce a central inflorescence rather like a small cauliflower, which are sometimes followed by a number of smaller flowering shoots. They usually come into bearing in the late summer or autumn and are very productive if they are regularly harvested. Sprouting broccoli plants come into production in late winter to early spring and can be very heavy bearing over a period of two months or more so long as all the flowering stems are harvested before coming into flower.
Nutrition:
Broccoli is high in vitamin C and dietary fiber. It also contains multiple nutrients with potent anti-cancer properties, such as diindolylmethane (DIM) and small amounts of selenium. A single serving provides more than 30 mg of vitamin C and a half-cup provides 52 mg of vitamin C. DIM is a potent modulator of the innate immune response system with anti-viral, anti-bacterial and anti-cancer activity. Broccoli also contains the compound glucoraphanin, which can be processed into an anti-cancer compound sulforaphane, though the anti-cancer benefits of broccoli are greatly reduced if the vegetable is boiled. Broccoli is also an excellent source of indole-3-carbinol, a chemical which boosts DNA repair in cells and appears to block the growth of cancer cells.Sulforaphane, another compound in broccoli has been shown to stop over-rapid aging.

Boiling broccoli reduces the levels of suspected anti-carcinogenic compounds, such as sulforaphane, with losses of 20–30% after five minutes, 40–50% after ten minutes, and 77% after thirty minutes. However, other preparation methods such as steaming, microwaving, and stir frying had no significant effect on the compounds.

Broccoli has the highest levels of carotenoids in the brassica family.[20] It is particularly rich in lutein and also provides a modest amount of beta-carotene
Meditional Uses:
*Broccoli can provide us with some special cholesterol-lowering benefits if we cook it by steaming. The fiber-related components in broccoli do a better job of binding together with bile acids in our digestive tract when they’ve been steamed. When this binding process takes place, it’s easier for bile acids to be excreted, and the result is a lowering of your cholesterol levels.

*Raw broccoli still has cholesterol-lowering ability—just not as much.

*Broccoli has a strong, positive impact on our body’s detoxification system, and researchers have recently identified one of the key reasons for this detox benefit. Glucoraphanin, gluconasturtiian, and glucobrassicin are 3 glucosinolate phytonutrients found in a special combination in broccoli. This dynamic trio is able to support all steps in body’s detox process, including activation, neutralization, and elimination of unwanted contaminants. Isothiocyanates (ITCs) are the detox-regulating molecules made from broccoli’s glucosinolates, and they help control the detox process at a genetic level.

*Broccoli may help us solve our vitamin D deficiency epidemic. When large supplemental doses of vitamin D are needed to offset deficiency, ample supplies of vitamin K and vitamin A help keep our vitamin D metabolism in balance. Broccoli has an unusually strong combination of both vitamin A (in the form of beta-carotene) and vitamin K. For people faced with the need to rebuild vitamin D stores through vitamin D supplements, broccoli may be an ideal food to include in the diet.

*Broccoli is a particularly rich source of a flavonoid called kaempferol. Recent research has shown the ability of kaempferol to lessen the impact of allergy-related substances on our body. This kaempferol connection helps to explain the unique anti-inflammatory benefits of broccoli, and it should also open the door to future research on the benefits of broccoli for a hypoallergenic diet.

CLICK & READ  THE LATEST RESEARCH
Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider.

Resources:
https://en.wikipedia.org/wiki/Brassica_oleracea
http://www.pfaf.org/user/Plant.aspx?LatinName=Brassica+oleracea+italica
http://www.whfoods.com/genpage.php?tname=foodspice&dbid=9
https://www.plantvillage.com/topics/broccoli/infos

Cauliflower

Botanical Name: Brassica oleracea botrytis
Family: Brassicaceae
Genus: Brassica
Species: B. oleracea
Kingdom: Plantae
Order: Brassicales

Common Name: Cauliflower (The name comes from Latin caulis (cabbage) and flower)

Habitat: Cauliflower is grown allover the world. It is cultivated form of B. oleracea.

Description:     Cauliflower an annual /biennial plant that reproduces by seed, growing to 0.8 m (2ft 7in).    It is not frost tender. It is in flower from May to August, and the seeds ripen from Jul to September in Colder countries but in tropical countries it is an winter vegitable. Typically, only the head (the white curd) is eaten. The cauliflower head is composed of a white inflorescence meristem. Cauliflower heads resemble those in broccoli, which differs in having flower buds. Brassica oleracea also includes broccoli, brussels sprouts, cabbage, collard greens, and kale, though they are of different cultivar groups.The flowers are hermaphrodite (have both male and female organs) and are pollinated by Bees.The plant is self-fertile.

CLICK &  SEE THE PICTURES….………....Cauliflower Plant..……Cauliflower…...Cauliflower seeds

Classification and identification:…….Major groups:…….There are four major groups of cauliflower.

*Italian: Diverse in appearance, and biennial and annual in type, this group includes white, Romanesco, various brown, green, purple, and yellow cultivars. This type is the ancestral form from which the others were derived.

*Northern European annuals: Used in Europe and North America for summer and fall harvest, it was developed in Germany in the 18th century, and includes the old cultivars Erfurt and Snowball.

*Northwest European biennial: Used in Europe for winter and early spring harvest, this was developed in France in the 19th century, and includes the old cultivars Angers and Roscoff.

*Asian: A tropical cauliflower used in China and India, it was developed in India during the 19th century from the now-abandoned Cornish type,and includes old varieties Early Benaras and Early Patna.

Varieties: There are hundreds of historic and current commercial varieties used around the world. A comprehensive list of about 80 North American varieties is maintained at North Carolina State University.

Colours: ....White……..White cauliflower is the most common color of cauliflower.

Orange:....Orange cauliflower (B. oleracea L. var. botrytis) contains 25% more vitamin A than white varieties. This trait came from a natural mutant found in a cauliflower field in Canada. Cultivars include ‘Cheddar’ and ‘Orange Bouquet’.

Green:.…..Green cauliflower, of the B. oleracea botrytis group, is sometimes called broccoflower. It is available in the normal curd shape and with a fractal spiral curd called Romanesco broccoli. Both have been commercially available in the U.S. and Europe since the early 1990s. Green-curded varieties include ‘Alverda’, ‘Green Goddess’ and ‘Vorda’. Romanesco varieties include ‘Minaret’ and ‘Veronica’.

Purple:…….The purple color in this cauliflower is caused by the presence of the antioxidant group anthocyanins, which can also be found in red cabbage and red wine. Varieties include ‘Graffiti’ and ‘Purple Cape’.
In Great Britain and southern Italy, a broccoli with tiny flower buds is sold as a vegetable under the name “purple cauliflower”; it is not the same as standard cauliflower with a purple curd.
Cultivation :
Succeeds in full sun in a well-drained moisture-retentive fertile soil with plenty of lime. Cauliflowers, especially the winter and spring maturing types, should not be given a soil that is too rich in nitrogen since this can encourage soft, sappy growth that is more susceptible to winter cold damage. Prefers a heavy soil]. Requires a warm sunny position. Prefers a pH in the range 6 to 7, though it tolerates a pH in the range 4.3 to 8.3. Succeeds in maritime gardens. Lack of moisture in the growing season can cause the plant to produce small or deformed curds. Summer varieties are not very cold hardy and will be damaged by light frosts, winter cauliflower plants are more hardy and will tolerate temperatures down to about -6°c, though the curds are more sensitive and can suffer damage at about -2°c. This damage can often be prevented by bending over the leaves so that they cover the curd. Cauliflowers are widely grown for their edible immature flower heads (or curd). There are many named varieties and, by careful selection, it is possible to provide a year round supply. The summer and autumn maturing cultivars are annuals, they need to produce a certain number of leaves before curd development will be initiated. The optimum temperature for this is around 17°c, but at temperatures above 20°c the curds will either be of poor quality or not be produced at all. Winter and spring maturing forms are biennial and need exposure to temperatures below 10°c before they will produce curds and once again, this will not happen unless the plant has reached a certain size. Grows well with celery and other aromatic plants since these seem to deter insect predations. Grows badly with beet, tomatoes, onions and strawberries.

Propagation :
Seed – sow in a seedbed outdoors in April to June depending on the cultivar. Plant out into their permanent position when the plants are 5 – 10cm tall. Seed of some cultivars can be sown in late winter in a greenhouse in order to obtain a harvest in early summer. Do not let the seedlings get overcrowded or they will soon become leggy and will not make such good plants. If your seedlings do get leggy, it is possible to plant them rather deeper into the soil – the buried stems will soon form roots and the plant will be better supported.

Edible Uses: 
Edible Parts: Flowers; Leaves.
Edible Uses:

Immature flowering head – raw or cooked. A mild cabbage-like flavour, they make an excellent cooked vegetable and are also very acceptable in salads. By careful selection of cultivars, it is possible to produce flowering heads all year round. Leaves – cooked. A mild cabbage flavour, they make a good cooked vegetable. Do not over-harvest them, however, since this would adversely affect the production of the flowering head .

Medicinal Uses:
Protection against certain cancers. Naturally occurring chemicals (indoles, isothiocyanates, glucosinolates, dithiolethiones, and phenols) in cauliflower, Brussels sprouts, broccoli, cabbage, and other cruciferous vegetables appear to reduce the risk of some cancers, perhaps by preventing the formation of carcinogens in your body or by blocking cancer-causing substances from reaching or reacting with sensitive body tissues or by inhibiting the transformation of healthy cells to malignant ones.

All cruciferous vegetables contain sulforaphane, a member of a family of chemicals known as isothiocyanates. In experiments with laboratory rats, sulforaphane appears to increase the body’s production of phase-2 enzymes, naturally occurring substances that inactivate and help eliminate carcinogens. At the Johns Hopkins University in Baltimore, Maryland, 69 percent of the rats injected with a chemical known to cause mammary cancer developed tumors vs. only 26 percent of the rats given the carcinogenic chemical plus sulforaphane.

In 1997, Johns Hopkins researchers discovered that broccoli seeds and three-day-old broccoli sprouts contain a compound converted to sulforaphane when the seed and sprout cells are crushed. Five grams of three-day-old broccoli sprouts contain as much sulforaphane as 150 grams of mature broccoli. The sulforaphane levels in other cruciferous vegetables have not yet been calculated………....Click & see : 
Other Uses :…….Fungicide……..An extract of the seeds inactivates the bacteria that causes black rot.

Known Hazards:
Enlarged thyroid gland (goiter). Cruciferous vegetables, including cauliflower, contain goitrin, thiocyanate, and isothiocyanate. These chemicals, known collectively as goitrogens, inhibit the formation of thyroid hormones and cause the thyroid to enlarge in an attempt to produce more. Goitrogens are not hazardous for healthy people who eat moderate amounts of cruciferous vegetables, but they may pose problems for people who have a thyroid condition or are taking thyroid medication.

Intestinal gas. Bacteria that live naturally in the gut degrade the indigestible carbohydrates (food fiber) in cauliflower, producing intestinal gas that some people find distressing.

Food/Drug Interactions: Anticoagulants. Cauliflower contains vitamin K, the blood-clotting vitamin produced naturally by bacteria in our intestines. Additional intake of vitamin K may reduce the effectiveness of anticoagulants (warfarin, Coumadin, Panwarfin), requiring larger-than-normal doses to produce the same effect.

False-positive test for occult blood in the stool. The active ingredient in the guiac slide test for hidden blood in feces is alphaguaiaconic acid, a chemical that turns blue in the presence of blood. Cauliflower contains peroxidase, a natural chemical that also turns alphaguaiaconic acid blue and may produce a positive test in people who do not actually have blood in the stool.

Disclaimer : The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplement, it is always advisable to consult with your own health care provider.

Resources:
https://en.wikipedia.org/wiki/Brassica_oleracea
https://en.wikipedia.org/wiki/Cauliflower
http://www.vietnamese-recipes.com/articles/medical-uses-benefits-cauliflower.php
http://www.pfaf.org/user/Plant.aspx?LatinName=Brassica+oleracea+botrytis

Glycaemic Index

Definition:
The glycemic index or glycaemic index (GI) is a number associated with a particular type of food that indicates the food’s effect on a person’s blood glucose (also called blood sugar) level. The number typically ranges between 50 and 100, where 100 represents the standard, an equivalent amount of pure glucose.

The GI represents the total rise in a person’s blood sugar level following consumption of the food; it may or may not represent the rapidity of the rise in blood sugar. The steepness of the rise can be influenced by a number of other factors, such as the quantity of fat eaten with the food. The GI is useful for understanding how the body breaks down carbohydrates  and only takes into account the available carbohydrate (total carbohydrate minus fiber) in a food. Although the food may contain fats and other components that contribute to the total rise in blood sugar, these effects are not reflected in the GI.

The glycemic index is usually applied in the context of the quantity of the food and the amount of carbohydrate in the food that is actually consumed. A related measure, the glycemic load (GL), factors this in by multiplying the glycemic index of the food in question by the carbohydrate content of the actual serving. Watermelon has a high glycemic index, but a low glycemic load for the quantity typically consumed. Fructose, by contrast, has a low glycemic index, but can have a high glycemic load if a large quantity is consumed.

GI tables are available that list many types of foods and their GIs. Some tables also include the serving size and the glycemic load of the food per serving.

A practical limitation of the glycemic index is that it does not measure insulin production due to rises in blood sugar. As a result, two foods could have the same glycemic index, but produce different amounts of insulin. Likewise, two foods could have the same glycemic load, but cause different insulin responses. Furthermore, both the glycemic index and glycemic load measurements are defined by the carbohydrate content of food. For example when eating steak, which has no carbohydrate content but provides a high protein intake, up to 50% of that protein can be converted to glucose when there is little to no carbohydrate consumed with it.  But because it contains no carbohydrate itself, steak cannot have a glycemic index. For some food comparisons, the “insulin index” may be more useful.

CLICK & SEE
Glycemic index charts often give only one value per food, but variations are possible due to variety, ripeness (riper fruits contain more sugars increasing GI), cooking methods (the more cooked, or over cooked, a food the more its cellular structure is broken with a tendency for it to digest quickly and raise GI more), processing (e.g., flour has a higher GI than the whole grain from which it is ground as grinding breaks the grain’s protective layers) and the length of storage. Potatoes are a notable example, ranging from moderate to very high GI even within the same variety.

The glycemic response is different from one person to another, and also in the same person from day to day, depending on blood glucose levels, insulin resistance, and other factors.

Most of the values on the glycemic index do not show the impact on glucose levels after two hours. Some people with diabetes may have elevated levels after four hours.

Why  GI is so Important?
Over the past 15 years, low-GI diets have been associated with decreased risk of cardiovascular disease, type 2 diabetes, metabolic syndrome, stroke, depression, chronic kidney disease, formation of gall stones, neural tube defects, formation of uterine fibroids, and cancers of the breast, colon, prostate, and pancreas. Taking advantage of these potential health benefits can be as simple as sticking with whole, natural foods that are either low or very low in their GI value.

Determination of GI of a food:
Foods with carbohydrates that break down quickly during digestion and release glucose rapidly into the bloodstream tend to have a high GI; foods with carbohydrates that break down more slowly, releasing glucose more gradually into the bloodstream, tend to have a low GI. The concept was developed by Dr. David J. Jenkins and colleagues  in 1980–1981 at the University of Toronto in their research to find out which foods were best for people with diabetes. A lower glycemic index suggests slower rates of digestion and absorption of the foods’ carbohydrates and may also indicate greater extraction from the liver and periphery of the products of carbohydrate digestion. A lower glycemic response usually equates to a lower insulin demand but not always, and may improve long-term blood glucose control   and blood lipids. The insulin index is also useful for providing a direct measure of the insulin response to a food.

The glycemic index of a food is defined as the incremental area under the two-hour blood glucose response curve (AUC) following a 12-hour fast and ingestion of a food with a certain quantity of available carbohydrate (usually 50 g). The AUC of the test food is divided by the AUC of the standard (either glucose or white bread, giving two different definitions) and multiplied by 100. The average GI value is calculated from data collected in 10 human subjects. Both the standard and test food must contain an equal amount of available carbohydrate. The result gives a relative ranking for each tested food.

The current validated methods use glucose as the reference food, giving it a glycemic index value of 100 by definition. This has the advantages of being universal and producing maximum GI values of approximately 100. White bread can also be used as a reference food, giving a different set of GI values (if white bread = 100, then glucose ? 140). For people whose staple carbohydrate source is white bread, this has the advantage of conveying directly whether replacement of the dietary staple with a different food would result in faster or slower blood glucose response. A disadvantage with this system is that the reference food is not well-defined.

Classification:
GI values can be interpreted intuitively as percentages on an absolute scale and are commonly interpreted as follows:

Low GI…..(55 or less fructose;) …….Examples:beans (white, black, pink, kidney, lentil, soy, almond, peanut, walnut, chickpea); small seeds (sunflower, flax, pumpkin, poppy, sesame, hemp); most whole intact grains (durum/spelt/kamut wheat, millet, oat, rye, rice, barley); most vegetables, most sweet fruits (peaches, strawberries, mangos); tagatose; mushrooms; chilis.

Medium GI…..(56–69 Examples: white sugar or sucrose, not intact whole wheat or enriched wheat, pita bread, basmati rice, unpeeled boiled potato, grape juice, raisins, prunes, pumpernickel bread, cranberry juice,[10] regular ice cream, banana.

High GI….….(70 and above) Examples: glucose (dextrose, grape sugar), high fructose corn syrup, white bread (only wheat endosperm), most white rice (only rice endosperm), corn flakes, extruded breakfast cereals, maltose, maltodextrins, sweet potato , white potato , pretzels, bagels.

A low-GI food will release glucose more slowly and steadily, which leads to more suitable postprandial (after meal) blood glucose readings. A high-GI food causes a more rapid rise in blood glucose levels and is suitable for energy recovery after exercise or for a person experiencing hypoglycemia.

The glycemic effect of foods depends on a number of factors, such as the type of starch (amylose versus amylopectin), physical entrapment of the starch molecules within the food, fat and protein content of the food and organic acids or their salts in the meal — adding vinegar, for example, will lower the GI. The presence of fat or soluble dietary fiber can slow the gastric emptying rate, thus lowering the GI. In general, coarse, grainy breads with higher amounts of fiber have a lower GI value than white breads.  However, most breads made with 100% whole wheat or wholemeal flour have a GI not very different from endosperm only (white) bread.  Many brown breads are treated with enzymes to soften the crust, which makes the starch more accessible (high GI).

While adding fat or protein will lower the glycemic response to a meal, the relative differences remain. That is, with or without additions, there is still a higher blood glucose curve after a high-GI bread than after a low-GI bread such as pumpernickel.

Fruits and vegetables tend to have a low glycemic index. The glycemic index can be applied only to foods where the test relies on subjects consuming an amount of food containing 50 g of available carbohydrate.[citation needed] But many fruits and vegetables (not potatoes, sweet potatoes, corn) contain less than 50 g of available carbohydrate per typical serving. Carrots were originally and incorrectly reported as having a high GI.  Alcoholic beverages have been reported to have low GI values; however, beer was initially reported to have a moderate GI due to the presence of maltose. This has been refuted by brewing industry professionals, who say that all maltose sugar is consumed in the brewing process and that packaged beer has little to no maltose present. Recent studies have shown that the consumption of an alcoholic drink prior to a meal reduces the GI of the meal by approximately 15%.  Moderate alcohol consumption more than 12 hours prior to a test does not affect the GI.

Many modern diets rely on the glycemic index, including the South Beach Diet, Transitions by Market America and NutriSystem Nourish Diet. However, others have pointed out that foods generally considered to be unhealthy can have a low glycemic index, for instance, chocolate cake (GI 38), ice cream (37), or pure fructose (19), whereas foods like potatoes and rice have GIs around 100 but are commonly eaten in some countries with low rates of diabetes.

The GI Symbol Program is an independent worldwide GI certification program that helps consumers identify low-GI foods and drinks. The symbol is only on foods or beverages that have had their GI values tested according to standard and meet the GI Foundation’s certification criteria as a healthy choice within their food group, so they are also lower in kilojoules, fat and/or salt.

Weight control:
Recent animal research provides compelling evidence that high-GI carbohydrate is associated with increased risk of obesity. In one study,  male rats were split into high- and low-GI groups over 18 weeks while mean body weight was maintained. Rats fed the high-GI diet were 71% fatter and had 8% less lean body mass than the low-GI group. Postmeal glycemia and insulin levels were significantly higher, and plasma triglycerides were threefold greater in the high-GI-fed rats. Furthermore, pancreatic islet cells suffered “severely disorganized architecture and extensive fibrosis.” However, the GI of these diets was not experimentally determined. In a well controlled feeding study no improvement in weight loss was observed with a low glycemic index diet over calorie restriction.  Because high-amylose cornstarch (the major component of the assumed low-GI diet) contains large amounts of resistant starch, which is not digested and absorbed as glucose, the lower glycemic response and possibly the beneficial effects can be attributed to lower energy density and fermentation products of the resistant starch, rather than the GI.

In humans, a 2012 study shows that, after weight loss, the energy expenditure is higher on a low-glycemic index diet than on a low-fat diet (but lower than on the Atkins diet).

 Prevention of Diseases:
Several lines of recent [1999] scientific evidence have shown that individuals who followed a low-GI diet over many years were at a significantly lower risk for developing both type 2 diabetes, coronary heart disease, and age-related macular degeneration than others.  High blood glucose levels or repeated glycemic “spikes” following a meal may promote these diseases by increasing systemic glycative stress, other oxidative stress to the vasculature, and also by the direct increase in insulin levels.  The glycative stress sets up a vicious cycle of systemic protein glycation, compromised protein editing capacity involving the ubiquitin proteolytic pathway and autophagic pathways, leading to enhanced accumulation of glycated and other obsolete proteins.

In the past, postprandial hyperglycemia has been considered a risk factor associated mainly with diabetes. However, more recent evidence shows that it also presents an increased risk for atherosclerosis in the non-diabetic population   and that high GI diets,  high blood-sugar levels more generally,  and diabetes  are related to kidney disease as well.

Conversely, there are areas such as Peru and Asia where people eat high-glycemic index foods such as potatoes and high-GI rice without a high level of obesity or diabetes.  The high consumption of legumes in South America and fresh fruit and vegetables in Asia likely lowers the glycemic effect in these individuals. The mixing of high- and low-GI carbohydrates produces moderate GI values.

A study from the University of Sydney in Australia suggests that having a breakfast of white bread and sugar-rich cereals, over time, may make a person susceptible to diabetes, heart disease, and even cancer.

A study published in the American Journal of Clinical Nutrition found that age-related adult macular degeneration (AMD), which leads to blindness, is 42% higher among people with a high-GI diet, and concluded that eating a lower-GI diet would eliminate 20% of AMD cases.

The American Diabetes Association supports glycemic index but warns that the total amount of carbohydrate in the food is still the strongest and most important indicator, and that everyone should make their own custom method that works best for them.

The International Life Sciences Institute concluded in 2011 that because there are many different ways of lowering glycemic response, not all of which have the same effects on health, “It is becoming evident that modifying the glycemic response of the diet should not be seen as a stand-alone strategy but rather as an element of an overall balanced diet and lifestyle.”

A systematic review of few human trials examined the potential of low GI diet to improve pregnancy outcomes. Potential benefits were still seen despite no ground breaking findings in maternal glycemia or pregnancy outcomes. In this regard, more women under low GI diet achieved the target treatment goal for the postprandial glycemic level and reduced their need for insulin treatment. A low GI diet may also provide greater benefits to overweight and obese women. Interestingly, intervention at an early stage of pregnancy has shown a tendency to lower birth weight and birth centile in infants born to women with GDM.

Other factors:
The number of grams of carbohydrate can have a bigger impact than glycemic index on blood sugar levels, depending on quantities. Consuming fewer calories, losing weight, and carbohydrate counting can be better for lowering the blood sugar level. Carbohydrates impact glucose levels most profoundly,  and two foods with the same carbohydrate content are, in general, comparable in their effects on blood sugar.  A food with a low glycemic index may have a high carbohydrate content or vice versa; this can be accounted for with the glycemic load (GL). Consuming carbohydrates with a low glycemic index and calculating carbohydrate intake would produce the most stable blood sugar levels.

Criticism and alternatives:
The glycemic index does not take into account other factors besides glycemic response, such as insulin response, which is measured by the insulin index and can be more appropriate in representing the effects from some food contents other than carbohydrates. In particular, since it is based on the area under the curve of the glucose response over time from ingesting a subject food, the shape of the curve has no bearing on the corresponding GI value. The glucose response can rise to a high level and fall quickly, or rise less high but remain there for a longer time, and have the same area under the curve. For subjects with type 1 diabetes who do not have an insulin response, the rate of appearance of glucose after ingestion represents the absorption of the food itself. This glycemic response has been modeled, where the model parameters for the food enable prediction of the continuous effect of the food over time on glucose values, and not merely the ultimate effect that the GI represents.

Although the glycemic index provides some insights into the relative diabetic risk within specific food groups, it contains many counter-intuitive ratings. These include suggestions that bread generally has a higher glycemic ranking than sugar and that some potatoes are more glycemic than glucose. More significantly, studies such as that by Bazzano et al.  demonstrate a significant beneficial diabetic effect for fruit compared to a substantial detrimental impact for fruit juice despite these having similar “low GI” ratings.

From blood glucose curves presented by Brand-Miller et al.  the main distinguishing feature between average fruit and fruit juice blood glucose curves is the maximum slope of the leading edge of 4.38 mmol·L-1·h-1 for fruit and 6.71 mmol·L-1·h-1 for fruit juice. This raises the concept that the rate of increase in blood glucose may be a significant determinant particularly when comparing liquids to solids which release carbohydrates over time and therefore have an inherently greater area under the blood glucose curve.

If you were to restrict yourself to eating only low GI foods, your diet is likely to be unbalanced and may be high in fat and calories, leading to weight gain and increasing your risk of heart disease. It is important not to focus exclusively on GI and to think about the balance of your meals, which should be low in fat, salt and sugar and contain plenty of fruit and vegetables.

There are books that give a long list of GI values for many different foods. This kind of list does have its limitations. The GI value relates to the food eaten on its own and in practice we usually eat foods in combination as meals. Bread, for example is usually eaten with butter or margarine, and potatoes could be eaten with meat and vegetables.

An additional problem is that GI compares the glycaemic effect of an amount of food containing 50g of carbohydrate but in real life we eat different amounts of food containing different amounts of carbohydrate.

Note: The amount of carbohydrate you eat has a bigger effect on blood glucose levels than GI alone.

How to have lower GI?
*Choose basmati or easy cook rice, pasta or noodles.
*Switch baked or mashed potato for sweet potato or boiled new potatoes.
*Instead of white and wholemeal bread, choose granary, pumpernickel or rye bread.
*Swap frozen microwaveable French fries for pasta or noodles.
*Try porridge, natural muesli or wholegrain breakfast cereals.
*You can maximise the benefit of GI by switching to a low GI option food with each meal or snack

Resources:
http://en.wikipedia.org/wiki/Glycemic_index
https://www.diabetes.org.uk/Guide-to-diabetes/Managing-your-diabetes/Glycaemic-Index-GI/
http://www.whfoods.com/genpage.php?tname=faq&dbid=32

Hypoglycemia

Definition:
Hypoglycemia is the clinical syndrome that results from low blood sugar. The symptoms of hypoglycemia can vary from person to person, as can the severity. Classically, hypoglycemia is diagnosed by a low blood sugar with symptoms that resolve when the sugar level returns to the normal range….CLICK & SEE

Risk Factor:
While patients who do not have any metabolic problems can complain of symptoms suggestive of low blood sugar, true hypoglycemia usually occurs in patients being treated for diabetes (type 1 and type 2). Patients with pre-diabetes who have insulin resistance can also have low sugars on occasion if their high circulating insulin levels are further challenged by a prolonged period of fasting. There are other rare causes for hypoglycemia, such as insulin producing tumors (insulinomas) and certain medications. These uncommon causes of hypoglycemia will not be discussed in this article, which will primarily focus on the hypoglycemia occurring with diabetes mellitus and its treatment.

Despite our advances in the treatment of diabetes, hypoglycemic episodes are often the limiting factor in achieving optimal blood sugar control. In large scale studies looking at tight control in both type 1 and type 2 diabetes, low blood sugars occurred more often in the patients who were managed most intensively. This is important for patients and physicians to recognize, especially as the goal for treating patients with diabetes become tighter blood sugar control.

Low Blood sugar is Also Bad:
The body needs fuel to work. One of its major fuel sources is sugars, which the body gets from what is consumed as either simple sugar or complex carbohydrates. For emergency situations (like prolonged fasting), the body stores a stash of sugar in the liver as glycogen. If this store is needed, the body goes through a biochemical process called gluco-neo-genesis (meaning to “make new sugar”) and converts these stores of glycogen to sugar. This backup process emphasizes that the fuel source of sugar is important (important enough for human beings to have developed an evolutionary system of storage to avoid a sugar drought).

Of all the organs in the body, the brain depends on sugar (which we are now going to refer to as glucose) almost exclusively. Rarely, if absolutely necessary, the brain will use ketones as a fuel source, but this is not preferred. The brain cannot make its own glucose and is 100% dependent on the rest of the body for its supply. If for some reason, the glucose level in the blood falls (or if the brain’s requirements increase and demands are not met) there can be effects on the function of the brain.

Our Body’s Natural Protection
:
When the circulating level of blood glucose falls, the brain actually senses the drop. The brain then sends out messages that trigger a series of events, including changes in hormone and nervous system responses that are aimed at increasing blood glucose levels. Insulin secretion decreases and hormones that promote higher blood glucose levels, such as glucagon, cortisol, growth hormone and epinephrine, all increase. As mentioned above, there is a store in the liver of glycogen that can be converted to glucose rapidly.

In addition to the biochemical processes that occur, the body starts to consciously alert the affected person that is needs food by causing the signs and symptoms of hypoglycemia discussed below.

Signs and symptoms:
Hypoglycemic symptoms and manifestations can be divided into those produced by the counterregulatory hormones (epinephrine/adrenaline and glucagon) triggered by the falling glucose, and the neuroglycopenic effects produced by the reduced brain sugar.

Adrenergic manifestations

*Shakiness, anxiety, nervousness, tremor

*Palpitations, tachycardia

*Sweating, feeling of warmth

*Pallor, coldness, clamminess

*Dilated pupils (mydriasis)

Feeling of numbness “pins and needles” (parasthaesia) in the fingers

Glucagon manifestations:

*Hunger, borborygmus

*Nausea, vomiting, abdominal discomfort

*Headache

Neuroglycopenic manifestations:

*Abnormal mentation, impaired judgement

*Nonspecific dysphoria, anxiety, moodiness, depression, crying

*Negativism, irritability, belligerence, combativeness, rage

*Personality change, emotional lability

*Fatigue, weakness, apathy, lethargy, daydreaming, sleep

*Confusion, amnesia, dizziness, delirium

*Staring, “glassy” look, blurred vision, double vision

*Automatic behavior, also known as automatism

*Difficulty speaking, slurred speech

*Ataxia, incoordination, sometimes mistaken for “drunkenness”

*Focal or general motor deficit, paralysis, hemiparesis

*Paresthesia, headache

*Stupor, coma, abnormal breathing

*Generalized or focal seizures

Not all of the above manifestations occur in every case of hypoglycemia. There is no consistent order to the appearance of the symptoms, if symptoms even occur. Specific manifestations may vary by age and by severity of the hypoglycemia. In young children, vomiting can sometimes accompany morning hypoglycemia with ketosis. In older children and adults, moderately severe hypoglycemia can resemble mania, mental illness, drug intoxication, or drunkenness. In the elderly, hypoglycemia can produce focal stroke-like effects or a hard-to-define malaise. The symptoms of a single person may be similar from episode to episode, but are not necessarily so and may be influenced by the speed at which glucose levels are dropping, and previous incidence.

In newborns, hypoglycemia can produce irritability, jitters, myoclonic jerks, cyanosis, respiratory distress, apneic episodes, sweating, hypothermia, somnolence, hypotonia, refusal to feed, and seizures or “spells”. Hypoglycemia can resemble asphyxia, hypocalcemia, sepsis, or heart failure.

In both young and old patients, the brain may habituate to low glucose levels, with a reduction of noticeable symptoms despite neuroglycopenic impairment. In insulin-dependent diabetic patients this phenomenon is termed hypoglycemia unawareness and is a significant clinical problem when improved glycemic control is attempted. Another aspect of this phenomenon occurs in type I glycogenosis, when chronic hypoglycemia before diagnosis may be better tolerated than acute hypoglycemia after treatment is underway.

Nearly always, hypoglycemia severe enough to cause seizures or unconsciousness can be reversed without obvious harm to the brain. Cases of death or permanent neurological damage occurring with a single episode have usually involved prolonged, untreated unconsciousness, interference with breathing, severe concurrent disease, or some other type of vulnerability. Nevertheless, brain damage or death has occasionally resulted from severe hypoglycemia.

Causes:-
Hundreds of conditions can cause hypoglycemia. Common causes by age are listed below. While many aspects of the medical history and physical examination may be informative, the two best guides to the cause of unexplained hypoglycemia are usually

1.The circumstances

2.A critical sample of blood obtained at the time of hypoglycemia, before it is reversed.

There are several ways to classify hypoglycemia. The following is a list of the more common causes and factors which may contribute to hypoglycemia grouped by age, followed by some causes that are relatively age-independent. See causes of hypoglycemia for a more complete list grouped by etiology.

Hypoglycemia in newborn infants:-

Hypoglycemia is a common problem in critically ill or extremely low birthweight infants. If not due to maternal hyperglycemia, in most cases it is multifactorial, transient and easily supported. In a minority of cases hypoglycemia turns out to be due to significant hyperinsulinism, hypopituitarism or an inborn error of metabolism and presents more of a management challenge.

*Transient neonatal hypoglycemia

*Prematurity, intrauterine growth retardation, perinatal asphyxia

*Maternal hyperglycemia due to diabetes or iatrogenic glucose administration

*Sepsis

*Prolonged fasting (e.g., due to inadequate breast milk or condition interfering with feeding)

*Congenital hypopituitarism

*Congenital hyperinsulinism, several types, both transient and persistent

*Inborn errors of carbohydrate metabolism such as glycogen storage disease

Hypoglycemia in young children:-

Single episodes of hypoglycemia may occur due to gastroenteritis or fasting, but recurrent episodes nearly always indicate either an inborn error of metabolism, congenital hypopituitarism, or congenital hyperinsulinism. A list of common causes:

*Prolonged fasting

*Diarrheal illness in young children, especially rotavirus gastroenteritis

*Idiopathic ketotic hypoglycemia

*Isolated growth hormone deficiency, hypopituitarism

*Insulin excess

*Hyperinsulinism due to several congenital disorders of insulin secretion

*Insulin injected for type 1 diabetes

*Hyperinsulin Hyperammonia syndrome (HIHA)due toGlutamate dehydrogenase 1gene.Can cause mental retardation and epilepsy in severe cases.

*Gastric dumping syndrome (after gastrointestinal surgery)

*Other congenital metabolic diseases; some of the common include

*Maple syrup urine disease and other organic acidurias

*Type 1 glycogen storage disease

*Type III glycogen storage disease. Can cause less severe hypoglycemia than type I

*Disorders of fatty acid oxidation

*Medium chain acylCoA dehydrogenase deficiency (MCAD)

*Familial Leucine sensitive hypoglycemia

*Accidental ingestions

*Sulfonylureas, propranolol and others

*Ethanol (mouthwash, “leftover morning-after-the-party drinks”)

Hypoglycemia in older children and young adults:-

By far, the most common cause of severe hypoglycemia in this age range is insulin injected for type 1 diabetes. Circumstances should provide clues fairly quickly for the new diseases causing severe hypoglycemia. All of the congenital metabolic defects, congenital forms of hyperinsulinism, and congenital hypopituitarism are likely to have already been diagnosed or are unlikely to start causing new hypoglycemia at this age. Body mass is large enough to make starvation hypoglycemia and idiopathic ketotic hypoglycemia quite uncommon. Recurrent mild hypoglycemia may fit a reactive hypoglycemia pattern, but this is also the peak age for idiopathic postprandial syndrome, and recurrent “spells” in this age group can be traced to orthostatic hypotension or hyperventilation as often as demonstrable hypoglycemia.

*Insulin-induced hypoglycemia

*Insulin injected for type 1 diabetes

*Factitious insulin injection (Munchausen syndrome)

*Insulin-secreting pancreatic tumor

*Reactive hypoglycemia and idiopathic postprandial syndrome

*Addison’s disease

*Sepsis

Hypoglycemia in older adults:-

The incidence of hypoglycemia due to complex drug interactions, especially involving oral hypoglycemic agents and insulin for diabetes rises with age. Though much rarer, the incidence of insulin-producing tumors also rises with advancing age. Most tumors causing hypoglycemia by mechanisms other than insulin excess occur in adults.

*Insulin-induced hypoglycemia

*Insulin injected for diabetes

*Factitious insulin injection (Munchausen syndrome)

*Excessive effects of oral diabetes drugs, beta-blockers, or drug interactions

*Insulin-secreting pancreatic tumor

*Alimentary (rapid jejunal emptying with exaggerated insulin response)

*After gastrectomy dumping syndrome or bowel bypass surgery or resection

*Reactive hypoglycemia and idiopathic postprandial syndrome

*Tumor hypoglycemia, Doege-Potter syndrome

*Acquired adrenal insufficiency

*Acquired hypopituitarism

*Immunopathologic hypoglycemia

Treatment:-
Management of hypoglycemia involves immediately raising the blood sugar to normal, determining the cause, and taking measures to hopefully prevent future episodes.

Reversing acute hypoglycemia:-
The blood glucose can be raised to normal within minutes by taking (or receiving) 10-20 grams of carbohydrate. It can be taken as food or drink if the person is conscious and able to swallow. This amount of carbohydrate is contained in about 3-4 ounces (100-120 ml) of orange, apple, or grape juice although fruit juices contain a higher proportion of fructose which is more slowly metabolized than pure dextrose, alternatively, about 4-5 ounces (120-150 ml) of regular (non-diet) soda may also work, as will about one slice of bread, about 4 crackers, or about 1 serving of most starchy foods. Starch is quickly digested to glucose (unless the person is taking acarbose), but adding fat or protein retards digestion. Symptoms should begin to improve within 5 minutes, though full recovery may take 10-20 minutes. Overfeeding does not speed recovery and if the person has diabetes will simply produce hyperglycemia afterwards.

If a person is suffering such severe effects of hypoglycemia that they cannot (due to combativeness) or should not (due to seizures or unconsciousness) be given anything by mouth, medical personnel such as EMTs and Paramedics, or in-hospital personnel can establish an IV and give intravenous Dextrose, concentrations varying depending on age (Infants are given 2cc/kg Dextrose 10%, Children Dextrose 25%, and Adults Dextrose 50%). Care must be taken in giving these solutions because they can be very necrotic if the IV is infiltrated. If an IV cannot be established, the patient can be given 1 to 2 milligrams of Glucagon in an intramuscular injection. More treatment information can be found in the article diabetic hypoglycemia.

One situation where starch may be less effective than glucose or sucrose is when a person is taking acarbose. Since acarbose and other alpha-glucosidase inhibitors prevents starch and other sugars from being broken down into monosaccharides that can be absorbed by the body, patients taking these medications should consume monosaccharide-containing foods such as glucose tablets, honey, or juice to reverse hypoglycemia.

Prevention:
The most effective means of preventing further episodes of hypoglycemia depends on the cause.

The risk of further episodes of diabetic hypoglycemia can often (but not always) be reduced by lowering the dose of insulin or other medications, or by more meticulous attention to blood sugar balance during unusual hours, higher levels of exercise, or alcohol intake.

Many of the inborn errors of metabolism require avoidance or shortening of fasting intervals, or extra carbohydrates. For the more severe disorders, such as type 1 glycogen storage disease, this may be supplied in the form of cornstarch every few hours or by continuous gastric infusion.

Several treatments are used for hyperinsulinemic hypoglycemia, depending on the exact form and severity. Some forms of congenital hyperinsulinism respond to diazoxide or octreotide. Surgical removal of the overactive part of the pancreas is curative with minimal risk when hyperinsulinism is focal or due to a benign insulin-producing tumor of the pancreas. When congenital hyperinsulinism is diffuse and refractory to medications, near-total pancreatectomy may be the treatment of last resort, but in this condition is less consistently effective and fraught with more complications.

Hypoglycemia due to hormone deficiencies such as hypopituitarism or adrenal insufficiency usually ceases when the appropriate hormone is replaced.

Hypoglycemia due to dumping syndrome and other post-surgical conditions is best dealt with by altering diet. Including fat and protein with carbohydrates may slow digestion and reduce early insulin secretion. Some forms of this respond to treatment with a glucosidase inhibitor, which slows starch digestion.

Reactive hypoglycemia with demonstrably low blood glucose levels is most often a predictable nuisance which can be avoided by consuming fat and protein with carbohydrates, by adding morning or afternoon snacks, and reducing alcohol intake.

Idiopathic postprandial syndrome without demonstrably low glucose levels at the time of symptoms can be more of a management challenge. Many people find improvement by changing eating patterns (smaller meals, avoiding excessive sugar, mixed meals rather than carbohydrates by themselves), reducing intake of stimulants such as caffeine, or by making lifestyle changes to reduce stress.

Herbal medication for Hypoglycemia:-
THE following HERBS as stated below can help to ease low blood sugar with symptoms that include lightheadedness, headache, irritability, depression, anxiety, cravings for sweets, confusion, night sweats, weakness in the legs and arms, swollen feet, insatiable hunger, eye pain, nervous tics, mental disturbances, insomnia, aggressiveness, hair-trigger temper.

Cinnamon bark extract, coral calcium with trace minerals, L-carnitine, bilberry extract, Mexican wild yam, dandelion root, milk thistle extract.

Quik Tip
: Cinnamon bark decreases insulin resistance and improves blood-sugar profiles better than most prescription drugs, USDA studies confirm.

Hypoglycemia as “folk” medicine:-
Hypoglycemia is also a term of contemporary folk medicine which refers to a recurrent state of symptoms of altered mood and subjective cognitive efficiency, sometimes accompanied by adrenergic symptoms, but not necessarily by measured low blood glucose. Symptoms are primarily those of altered mood, behavior, and mental efficiency. This condition is usually treated by dietary changes which range from simple to elaborate. Advising people on management of this condition is a significant “sub-industry” of alternative medicine. More information about this form of “hypoglycemia”, with far more elaborate dietary recommendations, is available on the internet and in health food stores. Most of these websites and books describe a conflation of reactive hypoglycemia and idiopathic postprandial syndrome but do not recognize a distinction. The value of most of their recommendations is – from a scientific perspective – unproved.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.medicinenet.com/hypoglycemia/article.htm
http://en.wikipedia.org/wiki/Hypoglycemia
http://www.herbnews.org/hypoglycemiadone.htm

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