Sunday, August 22, 2010

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Diabetics underestimate the risks (I)

Faced with diabetes, patients are often too lax. Yet only a good control of blood sugar helps prevent serious complications. A European survey reveals that too few patients are aware of the importance of such an approach.

type 2 diabetes takes on a epidemic in Western countries. Given the extent of this scourge, we must prevent the onset of the disease but also its complications when diagnosed. Only regular monitoring of blood glucose can prevent serious consequences: heart disease, eye problems, nervous, renal, amputation.

to avoid serious complications

control blood sugar, diabetes medications and modification of lifestyle (nutrition and physical activity mainly) to control the disease and prevent the occurrence of severe complications. But between theory and practice, there is a gap that worried many experts. Today, type 2 diabetes treated with oral hypoglycemic agents is far from being well controlled in France, 34 to 46% of patients treated with oral antidiabetic agents have a glycated hemoglobin (HbA1c) greater than 8% . A figure well above the recommendation of the High Authority of Health is not to exceed 6.5%. "Measuring the HbA1C2 gives an idea of control of diabetes over the last three months, unlike the glucose which gives an instantaneous measurement of blood sugar in the blood. A quarterly dosing allows to accurately track the control of diabetes, treatment efficacy and disease progression, "said Professor Jean-Francois Gautier Hospital in St Louis.

To better understand the reasons the poor control of diabetes, called Choose Control survey was conducted in five European countries, in partnership with the International Diabetes Federation (IDF) Europe and the French Association of diabetes (AFD) with support from Lilly Laboratories. It gives an image of experience and perception of their disease by diabetics.

Wednesday, August 18, 2010

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Diabetes Surveillance (II)

b) Monitoring the patient

best supervisor of diabetes is the patient himself. Only he can adapt his treatment overnight. The monitoring is based on checks on capillary blood glucose. The research of sugar and acetone in the urine also have an interest because these parameters provide information on the melting of lipids (lipolysis) and thus the risk of ketoacidosis (ketonuria) in case of severe hyperglycemia than 3g / l. Self-monitoring of blood glucose is the preferred method due to recent progress: lancets, strips, electronic readers.

Pens lancing permit, with a very mild pain, getting a drop. Such lancing devices are reimbursed at the rate of health services Interdepartmental (TIPS). The patient pricks his middle, ring and little fingers, preferably at the sides slightly innervated. A sample of the ear lobe is also possible. The blood drop is then deposited on a strip or an electrode. Various electronic readers are available. They can automatically determine the glucose from the color of the tape or after the current produced by the electrode.

Practical realization of self

control of blood glucose before the meal is most important. Control postprandial (after meals) helps regulate insulin administered before meals. The number of daily checks is the number of insulin injections and blood glucose targets.

Adapting insulin doses

The patient must be able, from capillary blood glucose, to change the dose of insulin that is injected. It must analyze the evolution of glucose on a time slot the previous day to determine the dose of insulin to inject same day. It must nevertheless take into account the blood glucose at the time of injection to modulate slightly the intended dose. This education is part of the role of the medical team.

Tuesday, August 10, 2010

Community Reference Letters

LARCH Larix decidua, L.

mélèze d'Europe, ou mélèze commun Larix decidua
Description European larch or larch common (Larix decidua) Larch
Europe, or common larch (Larix decidua) is a tree species of the genus Larix and family Pinaceae.
medicinal plant (tree) with effect hyperhémiant, used for external use in rheumatism, often presents as an ointment or salve.

Parts used
- trunks (which is extracted balm) = larch turpentine

Properties / Effects / Hint:
Effects:
  • Hyperhémiant, antiseptic
Directions: In
external use (recommended use)
  • Rheumatism, problems with the nerves (neuralgia), boils, catarrh in the respiratory system
Side Effects: allergy, possible effects at the central nervous system (CNS) when used in internal use (tablets ,...), the purchase of a drug based larch please read the package insert and consult a specialist.
Contraindication: allergy (hypersensitivity) in larch, bronchial asthma, the purchase of a drug based larch please read the package insert and consult a specialist.
Interaction: no known (in our opinion)

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PURPLE-PURPLE-BIG Malva sylvestris

mauve-grande mauve-Malva sylvestris
Description of the large mauve-purple Malva sylvestris:
The large purple, also known as mallow or purple wood, (Malva sylvestris) is a biennial herb of the family Malvaceae.

Parts used - flowers of mauve and purple leaf

Properties / Effects / Hint:
Effects of purple:
  • Emollient, disinfectant (eg buccal dental)
Indications purple:
  • cough, sore throat, mouth ulcers, bronchitis, hoarseness, laryngitis, whitlow (compressed)
Side effects: none known
Contraindication: None known
Interaction: no known (in our opinion)

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-MATE YERBA MATE Ilex paraguariensis

yerba maté-Ilex paraguariensis)
Description yerba maté (Ilex paraguariensis) Yerba mate
(Ilex paraguariensis), sometimes known as Paraguay tea "," Jesuit tea "or" tea from Brazil, is a South American species of the genus Ilex (like holly) and the family Aquifoliaceae. Its leaves, roasted, powdered and infused in hot water, provide a stimulating drink, mate, effects similar to those of coffee or tea.
The yerba mate is grown mainly in Paraguay, Argentina, Uruguay and southern Brazil. The Guarani are reputed to be the first to have grown, and then the Jesuit missionaries have widespread use in the rest of South America, as far away as Ecuador.
Yet almost threatened species, particularly because of deforestation.

Parts used-leaves


Properties / Effects / Hint:
Effects of mate (mate benefits):
  • Stimulant, diuretic, slimming: glycogenolytic (burning sugar) and lipolytic or lipo-reducer (burns fat), anti-oxidant, anti-cellulite against cellular aging .
Indications mate:
  • fatigue, excessive weight during a diet supplement, cellulite, ° diabetes (see comment below).
Side Effects: excitement, nervousness
Contraindication: heart problems (due to caffeine content)
Interactions: none known we believe

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BROWN-INDIA-horse-chestnut Aesculus hippocastanum-

Marron d'Inde-Marronnier d'Inde-Aesculus hippocastanum
Description Horse Chestnut-Horse Chestnut-Aesculus hippocastanum:
The horse chestnut (Aesculus hippocastanum L.) is a family tree Sapindaceae. It has many other common names such as horse chestnut, white chestnut, chestnut, sea chestnut chestnut chestnut or false (or chestnut) horse.
His cousins are named North American Pavia. They have leaves more smooth and not serrated, with flowers that remind one of European chestnut.
The chestnut is widespread in public parks and along the avenues in Europe and North America.

Parts used
-peel or seed (semen)

Properties / Effects / Hint:
Effects:
  • increase capillary resistance, phlébotrope
Directions:
  • Relieve Symptoms of venous insufficiency (pain, swelling and heaviness in the legs), edema, varicose veins, hemorrhoids, bruises
Side effects: none known (in our opinion)
Contraindication: None known (at our opinion)
Interaction: no known (in our opinion)

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MACA Lepidium meyenii-

maca-Lepidium meyenii

Description Maca-Lepidium meyenii:

Maca (Lepidium meyenii Walpers) is a plant with a taproot family Brassicaceae. It is cultivated as a food and for its medicinal properties since the Neolithic
in the High Peruvian Andes, at an altitude of 3500-4200 meters above sea level

Parts used
bulb (root tuber )
Properties / Effects / Note: Traditional Use

  • Foster fertility, treat sexual dysfunction, boost the immune system, invigorate the body.
Side effects: none known (in our opinion)
Contraindication: None known (in our opinion)
Interaction: no known (in our opinion)

Sunday, August 1, 2010

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Diabetes Surveillance (I)

It is practiced regularly by the doctor and daily by the patient himself.

a) Medical surveillance

The medical examinations periodically asks us with information on:

- The metabolic control of diabetes;
- The existence of disorders associated with a risk of aggravation of vascular risk;
- L existence, severity and scalability complications degenerative.

monitoring of blood pressure is essential. Any increase in numbers (BP greater than 140/80 for example) means an increased risk of suffering eye and kidney. His finding led the doctor to prescribe lifestyle modifications (such as correcting the weight and the elimination of alcohol) and antihypertensive drugs (angiotensin converting enzyme).

Biomarkers of metabolic control are available:

The glycated hemoglobin (HbA1c) provides information on glycemic control during the last 120 days. It the gold standard. The normal result is less than 6% hemoglobin A1C. In case of insufficient treatment, the result is above 7.5% and up to 12%;

Fructosamine information on glycemic control during the previous two weeks.

The lipid is an integral part of monitoring of diabetes:

- The poorly controlled diabetes promotes hyperlipidemia (cholesterol and triglycerides);
- High cholesterol is a risk factor for vascular whose effects combine with those of hyperglycemia and hypertension to promote the development of cardiovascular disease;
- Any reduction in blood cholesterol results in decreased vascular morbidity and even regression of atherosclerotic plaques;
- Total cholesterol should be less than 2 g / l (especially LDL-cholesterol). If its value is slightly supétieure threshold (between 2 and 2.60 g / l), the atherogenic risk is best assessed by measurement of apolipoprotein B by the determination of HDL-cholesterol. Any hyperlipidemia should be treated with lipid-lowering drugs and through dietary advice.

The search for traces albumin (microalbuminuria) is essential for the detection of the latter indicates a certain risk of progression. Microalbuminuria not only represents the first sign of diabetic nephropathy (kidney disease), but cardiovascular mortality is also greatly increased when proteinuria. Microalbuminuria reflects a urinary excretion of albumin between 20 and 200 mcg / ml. It is then sufficient to strip positiver Albustix but however, a reflection of a pathological glomerular hyperfiltration. This anomaly is reversible with improved glycemic control.

can be summarized as Oversight:

Every 3 months, taking blood pressure, blood glucose, glycated hemoglobin or fructosamine, total cholesterol, triglycerides (apolipoprotein B or HDL-cholesterol), microalbuminuria and urine cultures;

Every year, electrocardiogram, X-ray chest, ophthalmologic examination;
at spaced intervals and as needed, retinal fluorescein angiography, stress ECG, myocardial scintigraphy, Doppler of lower limbs and carotid Doppler, etc..