Diabetes and fasting

image credit to maryvancenc.com

Fasting in patients with Type 2 Diabetes Mellitus (T2DM) depending on personal decisions.

But they should seek advice based on specific guidelines through discussions with health professionals.

T2DM diabetes is most common, but which comprises about 90 percent of diabetes patients around the world.

Senior Consultant Medicine and Endocrinology, Professor Dr. Nor Azmi Kamaruddin said, whether high or low risk patients had complications related to the practice of fasting depends on the level of their disease.

"For example, diabetics who experience severe hipoglesemia or blood sugar is very low making the patient unconscious or requires a third party within three months before Ramadan.

"Or the patients with a history of repeated hipoglesemia categorized as high risk and should not fast during Ramadan," he said. Nor Azmi.

He said studies conducted observations in five countries found that nearly 20 percent of patients with T2DM who are Muslims have the highest hipoglesemia by 45 per cent of Malaysia (24 per cent, UAE (18 per cent, India (13 [percent) and Saudi Arabia (10peratus) .

"It is estimated there are 1.2 million people with diabetes in Malaysia and more than half of them do not realize that they may have diabetes until severe diabetes develop complications such as blindness, kidney disease, nerve disease, cardiovascular disease or stroke.

"In addition, Survey of the Third National Health and Morbidity Survey, conducted in 2006 showed that, naturally significantly higher in urban than rural areas," he said.

Clearly, based on disease prevalence rates, Malaysians should not be nonchalant about monitoring blood sugar levels.

"They should eat moderately at the appropriate time. This is why fasting is quite challenging for people with diabetes who are Muslims.

"Fast foods are generally open with, but this is not recommended for diabetics because it can cause blood sugar levels increased dramatically," he said.

He said, since the drug should be eaten after a meal, patients with diabetes should not fast if they do not pre-dawn meal.

"They will be in the body for some time, causing decreased blood sugar levels if they do not eat. This will result in dizziness, drowsiness, tremors and headaches," he said. Nor Azmi.

He said Hipoglesemia or low blood sugar occurs when blood glucose levels to become too low for the body needs.

"Long intervals between meals with certain diabetes medications are risk factors that cause hipoglesemia.

"It is therefore important blood sugar level checked more frequently during a fast to better public health," he said.

Hipoglesemia he said, must be avoided because it can cause severe medical problems.

"If left untreated, can result in the loss of hipoglesemia aware or seizures that requires emergency treatment," he said.

He added that low blood sugar can occur even if a person to do all they can to manage diabetes.

"The level of low blood sugar is most often caused by certain diabetes, do not eat regularly or the work of more than usual.

"To reduce this risk, follow a regular eating schedule, and schedule of physical activity and regular medication. Discuss with the team of health experts to set a target blood sugar levels," he said. Nor Azmi.



reference Utusan Online

Fatty liver diet

Most cases of fatty liver due to obesity and body shape like an apple shape. credit Utusan

Did you know that the liver function is for storing energy, vitamins and minerals? Liver or liver also produces proteins, and remove waste from the body through urine, perspiration and so forth.

In fact issued by the American Liver Foundation, liver disease attack about one out of 10 Americans. In Malaysia, we find the figure of 20 people suffering from heart related diseases.

To ensure that we are suffering from heart or not, people are advised to undergo screening, and then followed by surveillance, if it can be detected early so treatment can begin earlier.

World Hepatitis Day this month, the President of Malaysian Liver Foundation (YPM), Prof Tan Sri Datuk Seri Dr. Mohd. Ismail Merican advised Malaysians to eat a balanced diet and high fiber.

Eat less fat, calories and be sure to have the ideal body weight.

This is because a healthy lifestyle is the cause of liver disease such as hepatitis and fatty liver.

Hepatitis

According to Dr. Mohd. Ismail, Sabah, Sarawak and Kelantan is a state that had the most number of people with hepatitis that may expose them to liver cancer. Liver cancer also is among the five most common cancer among men in Malaysia.

He said they are part of the 2.5 million people in this country who was diagnosed with the disease are mostly men.

"Based on statistics released by the foundation, Sabah and Sarawak had the highest rate in the country for people with hepatitis B virus and hepatitis A. Kelantan for five to eight per cent of Malaysians are carriers of Hepatitis B.

Dietary and lifestyle factors to be among the main causes of the disease increased among the population in the state, "he said.

The disease affects about 350 million people around the world. According to statistics, men are more people suffering from liver cancer and it may be due less concerned about hygiene and healthy eating is not as women.

The rest, they are found to be suffering due to infectious disease from mother to child, the sharing of drug needles, blood, mostly involving hepatitis B.

Dr. Mohd. Ismail said he seeks to intensify awareness campaigns about the disease can be life threatening in the country and also targeted to schools to enable the detection and treatment should be performed earlier.

In addition to hepatitis, YPM also stressed the danger of fatty liver is often associated with liver disease such as hepatitis.

What is fatty liver? The disease is caused by obesity and diabetes, but teenagers as young as 15 years are also at risk for heart disease as a result of both these problems.

Dr. Mohd. Ismail explained, also known as fatty liver NFLD (Non-Alcoholics fatty liver disease).

It is a condition in which a large amount of saturated fat membranes accumulate in liver cells through the process of steatosis.

Fatty liver is divided into two main groups, the normal fatty liver (steatosis), and fatty liver associated with inflammation (steatohepatitis).

PuncaSecara basis, the disease arises due to alcohol consumption, especially in Western countries. However, the situation is changing.

Today, cases of fatty liver in the absence of alcohol (NAFLD) is increasing. Changes in liver enzymes in an imbalance of abnormal metabolism leads to fatty liver problem.

Without specific symptoms, the disease usually affected those aged 40 years and above other people with obesity or diabetes. Most patients do not realize it. Because the disease is associated with metabolic syndrome (diabetes, extreme pressure and obesity), regular screening can not detect the presence of fat in the liver.

Add Dr. Mohd. Ismail, progress steatohepatitis can cause liver fibrosis, cirrhosis and liver cancer. As a result, it increases the risk of death for sufferers. Fibrosis or cirrhosis in the liver faced by between 15 to 50 percent of patients with non-alcoholic fatty liver steatohepatitis (NASH).

Rapid weight reduction is also invited to the existence of fatty liver. Thus, those who want to lose weight are urged to do it in stages.

"If you are suffering from obesity, chances are you have a problem of fatty liver is high," he said.

Diagnosis and treatment of ultra-sound test, followed by biopsy of the liver can detect the presence of fat.

Dr. Mohd. Ismail stressed that only by leading a healthy lifestyle and proper eating helps prevent the spread of the disease.

Although fatty liver is not a chronic disease, but this condition should be treated. Treatment depends on the cause. For example, if the patient is an individual who is a lot of drinking, he must reduce the land acquisition.

If the patient is an individual who is obese, she should be eating and weight control.

Worry about the effect of contraceptive pills

Worry about the effect of contraceptive pills

SALAM doctor. I'm happily married and has one child aged 2 years 8 months. I have been taking birth control pills 28 seed then switch to 21 seeds. At the beginning of last year, I stopped taking the pills. My problem now, I do not come from the period January 2011 until now. Make knowledge a doctor, I would like to have another child.

* FK, NSW.

ANSWER:

In medical terms, it's called post aAmenorrhea pill. It occurs when a woman does not come haidnya after stop taking birth control pill. Although it does not always happen, but this occurs significantly, at 0.2 to 3.0 percent. This means that in 1,000 women who practice birth control pill, a total of 2-30 people will experience this problem. Do you worry that the problem experienced is quite common.

When women take the birth control pill, estrogen and progesterone levels in the body is at relatively high levels. In turn causes the pituitary gland in the brain can not function normally. In women with normal menstrual cycle, the pituitary gland releases the hormone stimulator follicles (follicle stimulating hormone, FSH) and hormone Peluteinan (LUTEINIZING hormone-LH), which will stimulate the ovaries (egg plants) produce follicles containing the ova (female seeds).

This growing follicle releases the hormone estrogen. When these follicles mature and rupture, it releases an ovum. At this time (usually in the middle of the menstrual cycle or the 14th day of the menstrual cycle) is called ovulation and progesterone produced. When women practice birth control pills containing the hormones estrogen and progesterone, both of these hormones will be in the body at high altitudes. The increase in this hormone will give a negative response when the pituitary gland feels that enough estrogen and progesterone in the body. So the pituitary gland does not produce hormones FSH and LH indirectly, prevent ovulation. This will prevent the egg is released and the woman will become pregnant.

Often women practice birth control pills for long periods of time between one to two years while waiting for a newborn baby grow up. Since taking too long, the effect of the negative reaction in the pituitary gland will continue to be felt even if she does not take birth control pill again. This will prevent ovulation and menstruation.

Diagnosis and treatment of cases, doctors will give a diagnosis based on patient history who have taken birth control pill. Ultrasound scan examination (ultrasound) will show the ovaries with no growing follicles. In other words there is no blood kelihatan.Pemeriksaan follicles showed that the level of hormones FSH, LH and estrogen are at a very low level.

Typically, doctors do not give any medication for this problem. If the situation continues to occur for six months, then the doctor will provide medicines that contain the hormone progesterone for about five days to bring about menstruation. These drugs act very quickly, usually bleeding to occur after several days due progesterone pills.

However, should you know that the bleeding would be meaningless if there is no production of ova from the ovary. This is because the progesterone pill does not encourage the development of follicles in the ovary.

So fertile drug (clomiphene citrate) is supplied to encourage the development of a follicle for ovulation. It is best you consult a doctor for treatment.