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Nateglinide Tips

Dr. Sajeev Kumar 91% (38624 ratings)
C.S.C, D.C.H, M.B.B.S
General Physician, Alappuzha
Diabetes Management in Ramadan

During Ramadan, diabetics who chose to fast should be educated about how to adjust their medications and be prepared to break the fast if necessary.
During the lunar-based month of Ramadan, Muslims abstain from eating, drinking, smoking, or using oral medications from predawn to sunset.
Followers will typically eat just after sunset and again before dawn.
In general, fasting is not recommended for people with diabetes. The practice increases the risk for both hypoglycemia from lack of food and hyperglycemia resulting from cutting back too far on medication in attempts to avoid hypoglycemia. Hyperglycemia can also occur if patients overeat after sundown.
If the period of fasting is longer and the two meals are eaten close together, this can be tricky.
Islamic law does not require fasting when it would create a physical danger.
Fasting is especially risky for those with type 1 diabetes, for pregnant women, and for children. However, patients with well-controlled type 1 diabetes who use insulin pumps can often accomplish fasting by adjusting their basal infusion rates and monitoring their blood glucose levels frequently.
For patients with type 2 diabetes taking medications other than insulin or sulfonylureas, the risk for hypoglycemia is low. However, because of the prohibition against taking oral medication during daylight hours, patients who usually take metformin 3 times daily should take two-thirds of the dose at the sunset meal and one-third at the predawn meal.
Long-acting sulfonylureas should be avoided.
Once-daily sulfonylureas should be taken at the sunset meal.
For patients taking twice-daily sulfonylureas, the usual dose should be taken at the evening meal and half the usual dose before the predawn meal. One can also skip the predawn dose altogether.
The very short-acting insulin secretagogues repaglinide or nateglinide can be taken before each of the meals.
No adjustments are needed for thiazolidinediones, alpha-glucosidase inhibitors, incretin-based therapies, or bromocriptine.
Basal insulin doses should be reduced by about 30% to 40%. Patients who are on either mixed or intermediate-acting insulins should switch to basal insulin.
The usual dose of rapid-acting insulin should be taken before the sunset meal. The predawn dose of rapid-acting insulin can be cut to half or omitted.
Frequent monitoring is the key. Patients should be advised to break their fast if the blood sugar drops below 70 mg/dL. If it rises above 250 mg/dL ? particularly for patients with type 1 diabetes ? they should also break their fast and take insulin.
Patients should be cautioned against overeating after breaking the fast.
Moderation is the trick. Don't overfill an empty stomach.
Patients should be counseled about avoiding dehydration as much as possible.
Also adjust BP medicines during Ramadan
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Hypoglycemia - Signs & Symptoms You Should Not Ignore!

Dr. Rajesh Kesari 88% (31 ratings)
Diploma In Diabetology, MD - Diabetology
Endocrinologist, Delhi
Hypoglycemia - Signs & Symptoms You Should Not Ignore!

Hypoglycemia is the disease of low sugar level in blood. It primarily occurs when the sugar level is below 4 mmol/L (72mg/dL).

What is hypoglycaemia?
It is the decrease in the blood sugar amount to a certain level. If the disease is identified at an early stage, then the treatment can make the person free of the disease quickly. It affects people having diabetes as well as arthritis, increased blood pressure, high cholesterol and many others.

Early signs of the disease

  1. Weakness
  2. Hungry
  3. Blurred vision
  4. Increased heart rate
  5. Increased sweating
  6. Extreme levels of tiredness
  7. Pale face
  8. Bewilderment
  9. Convulsions
  10. Coma in the last stage
  11. Anxiety
  12. Headaches
  13. Problems with sleeping

Who are the people risk of having this disease?
People who take this three medications have a higher risk of having the disease:

Diabetes medications pose a more significant threat to patients of having hypoglycaemia.

Causes of the disease:

  1. Exercise
  2. Delayed meals
  3. Alcohol drinking
  4. High dose of insulin
  5. Tremendous levels of stress
  6. Deficiency of enzymes
  7. Not balanced hormonal levels


  1. At first, the patient must take a blood test to catch up with the levels of blood sugar
  2. Intake of 15-20 kg of carbohydrates is necessary every day. You can get a stabilized carbohydrate content from a bread slice, a banana and a bar made of cereal.
  3. Drink sugar-filled drinks such as Pepsi, etc. Glucose tablets and juice ease the disease rapidly. The patient can also eat sweets in this case. Take a balanced level of sugar content drinks such as 160 ml of cola or lemonade or 200 ml of fruit juice.

Natural treatment through diet:

  1. Liquorice roots: Cut the roots and boil it. Drink the water every day for controlled sugar level.
  2. Apple- It has magnesium and chromium which regulates the sugar level
  3. Wild yam
  4. Tomatoes
  5. Sunflower seeds
  6. Pumpkin seeds
  7. Gentian Root
  8. Barley

If a person is attacked by seizures. It’s not possible to give such medications at that time. At that time a pillow or cushion should be placed below the patients head. The seizure goes away in about 5 min. if holds up more time. The person needs to get admitted to a hospital.

Hypoglycemia doesn’t have its adverse side effects if captured at an early stage. The person gets recovered with the above-stated home medications. Although slow realization of the disease can take the person to the stage of a comma. The disease engulfs body’s maximum energy and few essential body functions also get hampered. But it is treatable with regular natural medications. People having diabetes receives the highest threat of the disease. The sugar levels have to be maintained for proper body working. If the person’s blood sugar level is not right, he/she may have the tendency to get hypoglycaemia and hyperglycemia. Having both this disease is the root of having diabetes. It would make the body weak, and the person will crave for more sugar. It will also weaken the nerve cells and tissues of the brain. Weight will be lost gradually which is a terrible sign. Therefore don’t be late if you are having this above-stated signs go to the doctor and have the proper diagnosis of the disease.

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