Tuesday, 8 December 2015

Diabetes prevention and care

diabetes-prevention-and-care



Diabetes prevention and care


 
The estimate of people with diabetes mellitus (DM) in the year 2014 was 387 million worldwide, with type 2 DM making up about 90% of the cases. This has in turn accounted for the increase in number of deaths, as diabetes is a risk factor for diseases like cardiovascular diseases, doubling a person's risk of death [2].
Diabetes is rapidly emerging as a global health care problem that threatens to become the 7th leading cause of death in the world by the year 2030; the number of people with diabetes worldwide is projected to increase from 171 million in 2000 to 366 million by 2030, as shown in the below graphical map [6].


Millions of Cases of Diabetes in 2000 and Projections for 2030, with Projected Percent Changes
Millions of Cases of Diabetes in 2000 and Projections for 2030, with Projected Percent Changes
Diabetes is a chronic metabolic disorder, where role of insulin in the body is disturbed. In cases where, the insulin is not produced by pancreas in the individuals is termed as Type 1 diabetes, while condition where he insulin produced is not well utilized in the body to bring down blood glucose is termed as Type 2 diabetes. In both cases the blood glucose remains relatively very high than normal levels. Another condition where the blood glucose level is high but not as much to consider them as diabetic levels is called pre-diabetes. These increased blood glucose conditions can however be prevented, delayed or managed by healthy food habits and daily physical exercises [1].
Low GI Medium GI High GI
0-55 56-69 70 or greater

Table: Low glycemic foods with their glycemic values [24, 25]:

Low glycemic foods Estimated Glycemic load(per serving size) Low glycemic foods Estimated Glycemic load(per serving size
Fenugreek 2 Raspberries 3
Quinoa,cooked 18 Blackberries 4
Barley,pearl,cooked 19 Grapes 5
Ragi 23 Cranberries 2
Wild garlic 22 Cherries,sweet,raw 7
Bittermelon 1 Dates 9
Okra,cooked,boiled,drained,with salt 2 Low fat cheese 5
Blueberries 6 Milk(fat free and skim) 9
Strawerries 3 Yogurt,plain,lowfat,12 grams protien per 8 ounce 10

Fenugreek:

Fenugreek (Trigonella foenum-graecum) has a historical use for a variety of health condition. The dried seeds of fenugreek can be powdered and taken orally for health benefits. Fenugreek is studied to have 2 main beneficial components for diabetics: diosgenin and 4-hydroxyisoleucine. In one study, different doses of diosgenin was administered orally to group of diabetic rats and normal healthy rats; the 45th day results showed significant decline in blood glucose level and a significant increase in plasma insulin level. These effects were compared with glibenclamide, a standard oral hypoglycemia drug [4]. In another study, insulin resistant-human liver cells were treated with 4-hydroxyisoleucine resulting in increased glycogen levels in the cells as a result of reversal of insulin resistance [5].
fenugreek

Quinoa:

Quinoa (Chenopodium quinoa Willd) is nutrition packed vegetable seed, often a choice of substitute for whole grain. The nutrients found in quinoa are riboflavin (vitamin B2), quercetin, tocopherols, polyphenols, saponins, phytosterols, minerals, vitamins, anti-oxidants and high fiber content altogether making it a great choice for the diabetics [9]. Quinoa was studied for its potential type-2 diabetes mellitus (T2DM)- hyperglycemia-relevant alpha-glucosidase and alpha-amylase activities, quercetin derivatives and antioxidant activity. These pseudograins proved to be a part effective dietary strategy for managing T2DM as they were rich in quercetin and had the highest antioxidant activity [10].
quinoa

Barley:

Barley (Hordeum vulgare L.) is a multi-nutrient cereal grain, which has a nutlike flavor and an appealing chewy consistency when cooked. It is known not only for its rich content of molybdenum, manganese, dietary fiber, and selenium, but also for its fair amounts of copper, vitamin B1, chromium, phosphorus, magnesium, and niacin. Its role in diabetes management is proved through studies. A particular study proved that the starch digestibility rate is the least in barley compared to its counterpart grains like wheat, rice, oats and corn. This also accounts for the high phenolic content of barley making it an ideal snack to modulate glycemic response [11]. Clinical trials on 56 diabetic patients with 3 months follow-up studies showed decreasing plasma glucose levels and glycosylated hemoglobin (HbA1c) with every consecutive months [12].
barley

Ragi:

Ragi, aslo called finger millet (Eleusine coracana L.) is a deep red cereal and are tiny grain like appearance. It has been extensively studied for its nutrition and role in maintain good health is the last few years. It is found to be a good source of thiamine, iron, calcium, rich in dietary fiber, low in fat content, hence it is food of low glycemic index gaining advantage of bring anti-diabetic. A study trial on 6 non-insulin dependent diabetes mellitus (NIDDM) subjects consuming finger millet based diets showed significant lower plasma glucose levels accounting to the higher fiber content of finger millet compared to rice and wheat [13]. The carbohydrates present in finger millet are slowly digested and absorbed into the system and hence, regular consumption of finger millet is known to reduce the risk of diabetes mellitus [14].
ragy

Wild garlic:

Wild garlic (Tulbaghia violacea) is an herbaceous plant with garlic-like odor, mainly grown in South African countries. It is well known as an ornamental plant, its bulbs and leaves being the edible parts for therapeutic purposes. Study on effects of aqueous extract of T. violacea on Chang liver cells showed significant increased glucose uptake activity [15]. Another study on diabetic rat models showed treatment by methanolic extracts of the wild garlic resulted in significant decrease in fasting blood glucose levels, improved glucose tolerance and significant increase in plasma insulin and liver glycogen content compared to non treated diabetic group of rats [16].
wild-garlic

Bitter melon:

Bitter gourd (Momordica charantia) or Balsam pear is an edible fruit pod, mainly a part of Asian foods. As the name goes it is very bitter in taste and found to have health beneficial roles. Studied for its potential in diabetes management, it contains insulin activators like momordicine II and 3-hydroxycucurbita-5, 24-dien-19-al-7, 23- di-O-β-glucopyranoside; and hypoglycemic agents like charantin, polypeptide-p and vicine [7]. A 4-week, double-blind trial on type 2 diabetes patients showed that a dosage of 2000 mg/day of powdered bitter melon had modest hypoglycemic effects and the results were comparably closer to the effects of the anti-diabetic drug metformin 1000 mg/day [8]. The anti-diabetic effects of bitter melon are seen only at therapeutic doses, while high doses may exert inhibitory effects.
bitter-melon

Okra:

Also commonly known as lady’s finger (Abelmoschus esculentus), is a slender green vegetable with nutritious pods inside them. It is rich in vitamins and minerals, including vitamins A, B, C, E, and K, as well as calcium, iron, magnesium, potassium, and zinc. Okra also contains high levels of mucilaginous fiber. For many years okra has been used as a traditional medicine for diabetes and for the last few years are also studied in labs. Studies have been done mostly on diabetic rats, which when treated with seed powder resulted in decreased blood glucose as okra has the ability inhibit absorption of glucose in the intestines by blocking alpha-glucosidase, an enzyme that helps in carbohydrate digestion [18]. One other study, involving humans in Africa showed that consuming okra as part of a Mediterranean diet, may reduce the risk of blindness in type 2 diabetics [17].
okra

Mixed berries:

Berries like raspberries, strawberries, blackberries and blueberries are natural nutritious source of flavonoids. Darker and riper berries tend to have higher flavonoid value [20]. Refer the table below for a list of berries and the type of flavonoid they possess. A study was done to show the beneficial effect of specific flavonoids on insulin sensitivity. A follow up study on a large group of men and women free of diabetes, cardiovascular disease, and cancer at baseline was carried out using dietary intakes of major flavonoid subclasses. Results proved that higher intakes of anthocyanins were significantly associated with a lower risk of type-2 diabetes [19].
mixed-berries
Berry fruit Flavonid type
Blueberries Quercetin and myricetin
Cranberries Quercetin and myricetin
Black grapes Epicatechin and catechin
Blackberries Epicatechin and catechin
Raspberries Anthocyanidins and cyanidin
Cherries Anthocyanidins and cyanidin
Red Grapes Anthocyanidins and cyanidin
Strawberries Quercetin, Epicatechin and catechin

Dates:

Date palms (Phoenix dactylifera) are oval or cylindrical shaped fruit, and are bright red to bright yellow in color. They are the sweetest and most nutritious of the dry fruits. To an extent they can be considered as the dessert fruit for the diabetics. They are packed with nutrition like calcium, iron, phosphorus, sodium, potassium, magnesium, zinc, thiamin, riboflavin, niacin, folate, vitamin A, K, natural sugars and fiber. A study was carried out among healthy subjects and individuals with type-2 diabetes mellitus to study the effects on postprandial glucose excursions after intake of 5 varieties of dates. The results showed low glycemic indices for the five types of dates in all the participants and consumption of dates by diabetic individuals does not result in significant postprandial glucose excursions compared to the healthy controls [21].
dates

Cornelian cherry:

Cornelian cherry (Cornus mas L.) is a kind of berry it has an acidic flavor and best described as a mixture of cranberry and sour cherry. Well used in making jams and sauces and traditionally used as an anti-diabetic supplement. A study done, evaluated the effects of the fruit extract of this plant on biomarkers of glycemic control in adult patients with type 2 diabetes. The patients were treated with either the fruit extract or placebo capsules. After 6 weeks of intervention, a significant increase in insulin level, and decrease in HgbA1C and triglyceride levels were observed in drug group compared to placebo. This signifies that daily consumption of the fruit improves glycemic control by increasing insulin level in type 2 diabetic adult patients [22].
cornelian-cherry

Low fat yogurt/dairy:

The greater health value of low fat diary product like low-fat milk, cheese and yogurt has been proved with respect to incidences of many health conditions in comparison to whole milk and high fat cheese and yogurt. A case-cohort study within the EPIC-Norfolk Study group was carried out using dairy diet for a week and their relation to the incidence of risk of type-2 diabetes was evaluated. Results showed that low fat diary diet especially low fat yogurt consumption everyday as a part of daily diet decreased the risk of type 2 diabetes developments in prospective analyses, suggesting that the consumption of specific dairy types may be beneficial for the prevention of diabetes [23].
yogurt

References:

  1. Mayo Clinic: Diseases and Conditions-Diabetes
  2. Wikipedia: Diabetes mellitus
  3. world healthiest foods: What is the Glycemic Index?
  4. Canadian journal of diabetes: Modulatory Effects of Diosgenin on Attenuating the Key Enzymes Activities of Carbohydrate Metabolism and Glycogen Content in Streptozotocin-Induced Diabetic Rats
  5. Pub Med: 4-Hydroxyisoleucine improves hepatic insulin resistance by restoring glycogen synthesis in vitro.
  6. PubMed: Global prevalence of diabetes: estimates for the year 2000 and projections for 2030.
  7. APJTD: Antidiabetic effects of Momordica charantia (bitter melon) and its medicinal potency
  8. Journal of Ethnopharmacology: Hypoglycemic effect of bitter melon compared with metformin in newly diagnosed type 2 diabetes patients
  9. PubMed: Evaluation of indigenous grains from the Peruvian Andean region for antidiabetes and antihypertension potential using in vitro methods.
  10. LIFE EXTENSION MAGAZINE: Quinoa A Complete, Gluten-Free Protein
  11. PubMed: Total antioxidant capacity and starch digestibility of muffins baked with rice, wheat, oat, corn and barley flour.
  12. PubMed: Clinical assessment of dietary interventions and lifestyle modifications in Madhumeha (type- 2 Diabetes Mellitus).
  13. PubMed:Effect of consumption of finger millet on hyperglycemia in non-insulin dependent diabetes mellitus (NIDDM) subjects.
  14. PMC:Health benefits of finger millet (Eleusine coracana L.) polyphenols and dietary fiber: a review.
  15. PMC:Antidiabetic and Cytotoxicity Screening of Five Medicinal Plants Used by Traditional African Health Practitioners in the Nelson Mandela Metropole, South Africa
  16. Bio Med Central-The Open Acess Publisher:Antioxidant, antidiabetic and hypolipidemic effects of Tulbaghia violacea Harv. (wild garlic) rhizome methanolic extract in a diabetic rat model
  17. Internalize Medicine:Can Okra Cure Diabetes?
  18. PubMed:First identification of α-glucosidase inhibitors from okra (Abelmoschus esculentus) seeds.
  19. PubMed:Dietary flavonoid intakes and risk of type 2 diabetes in US men and women.
  20. LIVE STRONG.COM:List of Foods With Flavonoids
  21. PMC:Glycemic indices of five varieties of dates in healthy and diabetic subjects
  22. PubMed:Evaluation of the Effects of Cornus mas L. Fruit Extract on Glycemic Control and Insulin Level in Type 2 Diabetic Adult Patients: A Randomized Double-Blind Placebo-Controlled Clinical Trial.
  23. PubMed:Dietary dairy product intake and incident type 2 diabetes: a prospective study using dietary data from a 7-day food diary.
  24. SELFNutritionData:Nutrition Facts





Ref: - http://embryophytes.com/diabetes-prevention-and-care