15 September, 2014

SUCRALOSE - SWEET LIFE?

People with Diabetes can have sweets?

How to overcome craving?

What is the safest alternative to table sugar?




Well these are some interesting questions based on which countless amounts have been spent for research. The outcome – Many different types of alternatives were introduced. Some came with side effects and some came with a bitter after taste. As of now the most commonly used alternative is SUCRALOSE. Sucralose is 300 to 1000 times sweeter than our normal table sugar (sucrose). This sucralose was developed when scientists were actually trying to develop a sugar based insecticide. At that point the sweetness of sucralose was identified by chance. The scientist misheard the term “test” as “taste” and tasted it. He found the compound exceptionally sweet. Scientists Tate & Lyle patented it in 1976. Slowly the use of sucralose spread over countries and continents. Now sucralose is used in more than 80 countries all over the world. How our simple table sugar becomes sucralose? It goes through processing (Simple word to explain selective chlorination of sucrose, which substitutes three of the hydroxyl groups with chlorine. This chlorination is achieved by selective protection of the primary alcohol groups followed by acetylation and then deprotection of the primary alcohol groups.The partially acetylated sugar is then chlorinated with a chlorinating agent such as phosphorus oxychloride, followed by removal of the acetyl groups to give sucralose)

Sucralose safe?

Well.... anything in excess is definitely harmful. Even water in excess can kill you.
Sucralose is safe. Maximum dose is 9mg per Kg body weight per day.

Moral of the story –

You can have a sweet life with diabetes

But,

Measure before you eat!


Sweet life!

01 September, 2014

MAGGOTS BACK WITH A BANG!



Maggots! Maggots Maggots!!!  Ewww  ahhh ish.... 

But can you imagine that before advent of Life saving antibiotics these maggots had saved many lives and limbs!

Yes ! Exactly!

Maggots were used for treatment of sloughing wounds and deep seated infections.

Maggot therapy in olden days was a result of observation by army surgeons that the maggot infested wounds heal faster compared to non infested wounds.

William Baer was the first one to use Maggots in treatment of wounds and also showed that maggots can help the wound to heal faster.

This method became so popular that many hospitals developed their own insectaries to stock their own insect free maggots for treatment.

Many doctors were happy with this bio-debridement. 

The problems faced that time were Difficulty in getting insect free maggots, Cost & Difficulty in constructing a dressing to house these maggots around the wound.

Slowly maggots disappeared from the scene with advent of “Life- Saving Antibiotics”

Now Maggots are ready to make a comeback!

Why?

Because the Bacteria are becoming more and more resistant to antibiotics. Even before the drug reaches the stage of mass production resistant strains emerge. It is not uncommon for any Doctor to see reports carry these Dangerous terms – MRSA, ESBL, MBL, MDR strains, Pan – Drug Resistant Strains.

Literally we are running out of antibiotics. The small single celled invisible creatures are winning!

Maggot therapy is essentially a controlled therapeutic maggot infestation on a live host). It is controlled by selecting a safe strain and made germ free by using disinfectants. These maggots are introduced in special dressings that prevent them from leaving the wound.

Maggots are applied to the wound at a dose of 5–10 larvae per square centimetre of wound surface area and are left within their dressing for 48–72 h. The basic action comprises of Debridement, Disinfection, Stimulation of healing and Biofilm inhibition and eradication.
Medicinal maggots are like microsurgeons and are precise in their debridement. It is no wonder that they have found their way into the hearts and wounds of so many.
Despite our low cultural esteem for maggots, more and more clinicians and patients are turning to medicinal maggots for assistance with their wound healing. For most, the drawbacks of maggot therapy pale in comparison to the remarkable efficacy in treating even the most recalcitrant wounds.
Modern dressing materials have simplified the maggot therapy procedure and minimized the risk of escape. The establishment of laboratories throughout the world, along with access to overnight courier service in many regions, has made medicinal maggots readily available to millions of people.

20 August, 2014

DIABETES ! DIABETES !! DIABETES!!!

Happy to announce the launch of our new website

www.diabetes.vpweb.in

This website has given me more flexibility to add pages on many more topics concerning community health.
This website has been designed to update general public about various health issues. 
The recent update was on the Ebola Outbreak, Inhaled Insulin ...
I cordially invite all my Friends, Wellwishers and everybody who is interested in health to visit this website..
As a Doctor i feel this website has given me an opportunity to talk on various health related topics and also to get feedback on a regular basis from you folks! 
I Hope that this website will slowly evolve into a very useful website to serve the common man.

Finally
Thanks to vistaprint for providing the website space and making my dream come true..

14 August, 2014

LATEST TREND - SEND OUT EXCESS SUGAR IN URINE!

New member of the squad against Diabetes!

Canagliflozin 

Canagliflozin is a newest member in treatment of Type 2 Diabetes. This drug can be used as adjuvant to Diet & Exercise.

Canagliflozin inhibits Sodium Glucose Transport protein Sub type 2. This protein is responsible for reabsoption of sugar in the kidneys.


By stopping the activity of Sodium Glucose Transport Protein -2 (SGLT-2) will result in loss of glucose in urine. Canagliflozin can help lose about 80-120mg/dl sugar. Additional benefits are better control of Hypertension due to osmotic diuresis and weight loss. 

Half life of Canagliflozin is upto 12hours, Hence a twice daily dosage is preferred.

Canagliflozin comes in  the strengths of 50mg and 150mg

A recent welcome addition is introduction of Invokamet (Canagliflozin + Metformin)

The available combinations are 

Canagliflozin 50 mg + Metformin 500mg
Canagliglozin 50mg + Metformin 1000mg
Canagliflozin 150 mg + Metformin 500mg
Canagliglozin 150mg + Metformin 1000mg

Since most of our patients require twice daily metformin this combination will help give better sugar control. 1 Tablet with advantage of two drugs. 
This drug may help patients attain a better control of blood sugars.
Chances of hypoglycemia are relatively less

This Drug cannot be used in patients with Renal failure, Hypotension and Type 1 Diabetes!

Some patients ( ~5%) may experience the side effects like Female genital mycotic infections, Urinary tract infections and increased urination.

My previous write up about Canagliflozin - CLICK HERE!

This drug being marketed by Johnson & Johnson is expected to come to India soon.

More in news from Johnson & Johnson - JNJ

Dr.Riyaz Sheriff
R.S. Clinic


02 August, 2014

STEP IN TIME


 Tamarind Rice - July issue

Knowledge needs to be shared.

Here is one other way to do it.

My article published in Tamarind rice online magazine.

In this article STEP IN TIME i have given an introduction to exercise in Diabetes

You can read the article in July 2014 issue - CLICK HERE

Best part is............... Its FREE!!

Thank you Tamarind rice!

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