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Halki Diabetes Remedy Summary


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Author: Eric Whitefield and Amanda Feerson
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The Big Diabetes Lie Summary

Contents: Ebook
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Treat Type 2 Diabetes Naturally Summary

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Diabetic women should be closely monitored to make sure their blood sugar levels are normal or near normal. If the maternal blood sugar rises too high, the increased sugar crossing into the placenta can result in a large, overdeveloped baby with defects or blood sugar level abnormalities. Having a large baby can also result in injuries during birth and increase the need for cesarean delivery or other assistance during delivery, such as forceps or vacuum delivery. Women who are diabetic may also suffer from a greater loss of some nutrients. It is important to maintain tight control of blood sugar before and during pregnancy. Gestational diabetes is a form of diabetes that begins during pregnancy. It usually disappears after the birth of the baby. Gestational diabetes is indicated by a high amount of sugar in the pregnant woman's blood. It is a relatively common problem, affecting 2 to 4 percent of all pregnant women. You are more likely to develop gestational diabetes if you have had...

How Is Epilepsy Diagnosed

Doctors often take blood samples for testing, particularly when they are examining a child. These blood samples are often screened for metabolic or genetic disorders that may be associated with the seizures. They also may be used to check for underlying problems such as infections, lead poisoning, anemia, and diabetes that may be causing or triggering the seizures.

Examination And Investigations

The patient received valproate for 2 months, and he seemed to improve during that time. Meanwhile, his diabetes worsened, blood glucose levels fluctuating between 0.5 and 3.5 g l were noted and insulin was started. He continued to have both hypoglycemic episodes as well as marked hyperglycemic episodes. The amnestic episode was thought to be caused by transient hypoglycemia at that time, which could not be confirmed later with concomitant measurements.

General Physical Examination

A complete physical examination should be conducted during the evaluation of patients with possible epilepsy. The examination can give clues to the presence of heart or any other systemic disease that could be implicated either in the generation of acute seizures or in secondary brain injury leading to chronic epilepsy. A detailed discussion of these entities is beyond the scope of this text, and only a few entities will be highlighted. The general appearance of the patient can suggest a state of dehydration or show diffuse edema, suggesting the presence of electrolyte abnormalities. This is important in poorer regions of the globe, where malnutrition can lead to severe electrolyte imbalance. A history of diabetes mel-litus should prompt a search for additional signs of dehydration that can accompany severe hyperglycemia. Arrhythmias, valvular disorders, or cardiac failure can all be sources of cardiac emboli that can lead to brain infarcts. Infarcts can occur without clinical...

Vocabulary Builder

Glucose D-glucose, a monosaccharide (hexose), C6H12O6, also known as dextrose (q.v.), found in certain foodstuffs, especially fruits, and in the normal blood of all animals. It is the end product of carbohydrate metabolism and is the chief source of energy for living organisms, its utilization being controlled by insulin. Excess glucose is converted to glycogen and stored in the liver and muscles for use as needed and, beyond that, is converted to fat and stored as adipose tissue. Glucose appears in the urine in diabetes mellitus. eu

Recurrent Amnestic Episodes In A 62Year Old Diabetic Patient

In December 1996, after a recent diagnosis of type 2 diabetes, a 62-year-old right-handed man began to experience episodes resembling 'transient global amnesia', lasting 15 minutes to 1 hour. The episodes started on waking, with the loss of ability to plan his activities, followed by his asking a series of questions about what he had done the previous day, accompanied by a feeling of perplexity. Otherwise his behaviour seemed normal. There were no automatisms or other motor signs. He was not able to recall any details of the amnesic episode. The patient received valproate for 2 months, and he seemed to improve during that time. Meanwhile, his diabetes worsened, blood glucose levels fluctuating between 0.5 g l and 3.5 g l were noted, and insulin was started. He continued to have both hypoglycaemic episodes as well as marked hyperglycaemic episodes. The amnestic episode was thought to be caused by transient hypoglycaemia at the time, which could not be confirmed later with concomitant...

Polycystic Ovary Syndrome And Infertility

Women with epilepsy have higher rates of PCOS than the general population 52 , which is a frequent cause of infertility. The current definition of PCOS is the presence of two of the following three factors (i) polycystic ovaries (ii) oligo- anovulation and or (iii) clinical or biochemical evidence of hyperandrogenism 56 . Other frequently present features of PCOS include an elevated LH FSH ratio and insulin resistance with or without obesity 57, 58 . The contribution of valproate to the occurrence of PCOS in women with epilepsy remains unclear, especially since the cause of PCOS itself is mysterious. It is clear that valproate also causes several of the primary features of PCOS. Valproate causes increased androgen levels 59-62 and probably cystic ovaries 57, 60 in women with epilepsy. The association between valproate and anovulation has not been consistently found 59, 62, 63 but, when present, could contribute to difficulty conceiving. The association of valproate with PCOS is...

Migraine and Other Headache

Serum PRL measured between migraine attacks is normal in men and women (54). Endocrine challenge studies of migraineurs have shown that I-deprenyl, which increases the availability of endogenous dopamine, produces greater decrease in serum PRL in migraineurs than in normal subjects, implying increased dopamine receptor sensitivity in migraine. Simultaneous administration of TRH, luteinizing hormone releasing hormone, and insulin also produces greater PRL release for migraineurs than for normal controls, suggesting serotonergic hyperactivity in migraine (55). The effects of acute migraine attacks have not been studied.

Models Of Primary And Shared Care For Epilepsy

The primary care needs of patients with epilepsy have been well stated in a UK epilepsy needs document.274 These include the suggestion of a structured annual review, as has now become common with other chronic diseases, such as asthma and diabetes. Suggested tasks for primary care are listed in the document. Implementation of such management in primary care would be facilitated by the deployment of specialist epilepsy nurses, who can liaise between primary care and hospital care, and promote a shared care model.272

Monitoring Patients May Be More Important Than Their Laboratory

The patient's past medical history was significant for diabetes mellitus, mild congestive heart failure following three-vessel coronary artery bypass graft surgery 4 years previously, chronic obstructive pulmonary disease, depression, rheumatoid arthritis and colostomy for resected colon cancer. Medications included phenytoin as above, insulin (Humulin 70 30) 20 units subcutaneously in the morning and 10 units in the evening, clopidogrel 75 mg day, amitriptyline 25 mg day at bedtime and sertraline 100 mg day in two divided doses. Her only known allergy was to penicillin. She had a previous history of smoking, no history of alcohol or drug abuse and a strong family history of diabetes and coronary artery disease in middle age.

Entitled to Respect A National Survey of Teens Attitudes and Behaviors About Epilepsy and Acceptance Executive Summary

Summary Entitled to Respect A National Survey of Teens' Attitudes and Behaviors About Epilepsy and Acceptance Executive Summary summarizes the results of a survey of teens' attitudes and behaviors about epilepsy. The survey consisted of a questionnaire that was distributed to teens throughout the United States by 20 affiliates of the Epilepsy Foundation from March through July 2001 in schools selected by the affiliates. The questionnaire asked about respondents' (1) demographics (2) awareness of epilepsy (3) knowledge of epilepsy (4) perceived stigmas associated with epilepsy and (5) awareness of muscular dystrophy, human immunodeficiency virus infection acquired immunodeficiency syndrome, arthritis, diabetes, breast cancer, and Parkinson's Disease. Results are based on 19,441 usable questionnaires. Thirty-six percent of the respondents felt that kids with epilepsy are likely to get picked on or bullied more than other kids. Only 25 percent felt this is unlikely to happen. Thirty-one...

Other Conditions Which May Benefit From Aed Treatment

Neuropathic pain is common and occurs in many diseases such as diabetes, paraneoplastic disorders, multiple sclerosis, systemic vasculitides, human immunodeficiency virus (HIV) and as a result of chemotherapy-associated neuropathy. Several of these conditions are also associated with seizures. Gabapentin and pregabalin both appear to be very effective for neuropathic pain 97, 98 . There is also evidence that oxcarbazepine and lamotrigine are effective 99, 100 . In addition, topiramate, levetiracetam and zonisamide are used, although there is less evidence supporting their effectiveness 101-103 .

Does Inherent Severity Account For Pharmacoresistance

Period after presentation is an important predictor of seizure intractability.27-29 A recent study confirmed the prognostic implications of high early seizure frequency and also identified several other factors associated with intractability including family history of epilepsy, febrile seizures, traumatic brain injury, recreational drug use and a history of depression.30 These results suggest that neurobiological factors related to the occurrence of frequent seizures are associated with intractability. This observation seems logical If the epilepsy is of a nature that seizures are easy to trigger, the seizures may be more difficult to prevent. AEDs probably do not act as a switch to turn off the possibility of seizure occurrence rather, they make it more difficult to trigger a seizure. That is, they raise the threshold for a seizure-inducing stimulus. In most (but not all) animal models in which seizures are induced by a pharmacological or electrical stimulus, raising the intensity...

Epidemiology And Natural History

IGEs constitute approximately 15-20 of all epilepsies (10). They affect all races equally and may have a slight predilection for women (11). Seizures usually, but not always, have an onset early in life, from childhood to early adulthood. In fact, IGEs are the most frequent group of epilepsies with an adolescent onset (12). IGEs are generally associated with low mortality and favorable response rate to treatment. The morbidity from IGE is primarily a function of how well the condition is treated. As it will be mentioned further in this chapter, the response rate to antiepileptic drugs (AEDs) is good. Additionally, 50 of patients with IGE can outgrow them. A recent intriguing finding is the association between IGE and type 1 diabetes (13).

Funding Epilepsy Care Services

Fiscal resources for funding even basic health services are frequently insufficient to meet the needs of people in the developing world. Regardless, efforts must be made to make public policy makers aware of the burden of this treatable disease. Even the poorest countries may offer lower clinic fees and medications to people with certain chronic conditions (e.g., hypertension, diabetes). Epilepsy should be included among these recognized and subsidized disorders. Incorporating epilepsy care into the primary clinics will best suit those countries or regions with the least resources available, since marginal costs will be least under this system. Optimal health policy planning for epilepsy care requires reviewing the healthcare system's resources and recognizing the population's geographic, social, and financial barriers to accessing these services.

Medically Intractable

McCorry D, Nicolson A, Smith D, Marson A, et al. An association between type 1 diabetes and idiopathic generalized epilepsy. Ann Neurol 2006 59 204-206. Benbadis SR, L ders HO. Generalized epilepsies. Neurology 1996 46 1194-1195. Berkovic SF, Andermann F, Andermann E, et al. Concepts of absence epilepsies discrete syndromes or biological continuum. Neurology 1987 37 993-1000. 16. Janz D. Juvenile myoclonic epilepsy. Cleve Clin J Med 1989 56 (Suppl 1) S23-S33.

Other psychotropic agents

Lithium, which is also proconvulsant, can be used as a mood stabilizer in patients who have recurrent cyclical mood disorders, or recurrent outbursts of affective aggressive behaviours. Caution should be exercised when combining lithium with carbamazepine, as patients occasionally develop a cerebrotoxic syndrome. Monitoring of serum levels of lithium is mandatory, as is observing patients over time for the development of secondary complications of lithium therapy such as hypothyroidism, or diabetes insipidus.

Sexual Dysfunction In Women With Epilepsy

Orgasmic dysfunction in women with epilepsy has also been reported in several studies. Jenson et al. in 1990 studied sexuality in 48 women with epilepsy and compared their results with their own previously reported data on sexuality in persons with diabetes mellitus and healthy controls 85 . Sexual desire did not differ between the three groups however, 19 of the women with epilepsy had orgasmic dysfunction compared with 11 of the diabetes mellitus group and 8 of the controls (P 0.081). None of the women with epilepsy had out-of-range testosterone levels, either free or total, or testosterone-binding globulin levels

Druginduced seizures

Theophylline is a potent convulsant which can result in seizures or status epilepticus, possibly due to the anti-adenosine action. P-blockers and other antiarrhythmic agents have been reported to precipitate seizures, particularly in overdose. Cimetidine, levodopa, insulin, thiazide diuretics, lidocaine, salicylates, chemotherapeutic agents, L-asparaginase and baclofen have been reported to cause seizures. The non-steroidal analgesics also predispose to seizures (for example NSAIDs, tramadol, diamorphine and pethidine).


TSC1 and TSC2 gene products colocalize within tubers (and sometimes within individual dysmorphic cells) of patients with TSC (206). Tissue culture experiments in various cell types show that both hamartin and tuberin interact with the G2 M cyclin-dependent kinase CDK1 (213). It has also been suggested that hamartin and tuberin have separable and presumably distinct functions in mammalian cell cycle regulation (214) that is, hamartin has the ability to modulate cell proliferation independent of the presence of functional tuberin, and binding to hamar-tin is not always essential for tuberin to affect cell proliferation. Tscl and Tsc2, Drosophila homologs of TSC1 and TSC2, function together in vivo to negatively regulate cell size, cell proliferation, and organ size in the insulin signaling pathway (PI3Kinase-Akt PKB-mTOR-S6K-S6) at a position downstream of dAkt (Drosophila Akt) and upstream of dS6k (Drosophila S6 kinase) (215). This has been clearly confirmed in surgically resected TSC...

Morning Sickness

Morning sickness, nausea, occasional vomiting, tiredness, and exhaustion are common to about 70 of pregnant women. It is vital to manage morning sickness during your pregnancy, because vomiting can interfere with anti-epileptic drug intake, absorption, and compliance. Most nausea occurs during the first trimester and goes away during the second trimester. Morning sickness does not always happen in the morning. You can get morning sickness for no apparent reason, and at any time of day. For some women, it might last longer than the early stage of pregnancy. Some women experience morning sickness throughout the entire 9 months. No one understands exactly what causes morning sickness, but many factors are known to contribute to morning sickness, including low blood sugar, low blood pressure, hormonal changes, nutritional deficiencies (vitamin B6 and iron), nutritional excess (spicy, sugary, and refined foods), fatigue, and stress. Ginger has been thoroughly researched, and may be taken...

Systemic sideeffects

Membrane-stabilizing drugs (e.g. phenytoin, carbamaze-pine, lamotrigine) carry a risk of promoting arrhythmia and hypotension, which is increased in the elderly, although the extent of this risk is unknown. Other side-effects in the elderly include the dangers of loss of bone mass due to enzyme-inducing drugs such as phenytoin, carbamazepine or phenobarbital, a particular risk in post-menopausal women. Phenytoin and carbamazepine also pose potential problems and should be used cautiously in individuals with autonomic dysfunction, for instance in diabetes. Carbamazepine has an anticholinergic effect which can precipitate urinary retention.


Recently, one group of workers have found an association between valproate therapy and polycystic ovarian syndrome. This finding has become the subject of considerable marketing focus by other manufacturers, but the findings have not been widely duplicated and other workers have disputed the results the evidence is therefore highly contradictory. Valproate can induce obesity, peripheral insulin resistance, hyperandrogenism and hyperinsulinaemia, and on theoretical grounds these could contribute to the induction of polycystic ovaries.

Metabolic Disorders

Symptomatic hypoglycaemia is a common cause of seizures. Hypoglycaemia is often medication related other causes are sepsis and inborn errors of metabolism. Serum glucose usually needs to be less than 2.2 mmol l for seizures to occur. Refractory nocturnal seizures should raise the possibility of insulinoma. Patients with diabetes who suffer from recurrent episodes of symptomatic hypoglycaemia and seizures require modification of their hypoglycaemic medication rather than anti-convulsant treatment. Phenytoin has been shown to interfere with carbohydrate metabolism, the usual effect being hyperglycaemia 44 however, it has also been reported in association with hypoglycaemia 45, 46 . An alternative AED should be used in patients with diabetes. Non-ketotic hyperglycaemia (NKH) usually occurs in older patients with non-insulin-dependent diabetes. It is associated with significant morbidity and mortality and often causes seizures. It may be precipitated by infection, surgery or other...

Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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