DIET FOR SMOKERS AND EX-SMOKERS

As a dietitian, the three most common questions which smokers ask me about diet and smoking, are: (1) Can a diet compensate for health damage caused by smoking? (2) What should I eat if I smoke? (3) If I quit, what type of diet is best to prevent weight gain?

(1) CAN A DIET COMPENSATE FOR SMOKING?

No diet or eating-plan, no matter how nutritious, can neutralise the health damage caused by the 850+ chemicals in tobacco smoke - many of which are carcinogenic. On average, if you smoke 20 cigarettes a day, you double your risk of a heart-attack and are five times more likely to suffer a stroke than a non-smoker. At 40 cigarettes a day, you are five times more likely to suffer from sudden cardiac death. Smoking is also the leading cause of lung cancer.

Thus before we even start to examine an appropriate type of diet for smokers, my overriding advice is: quit smoking today!

(2) WHAT SHOULD I EAT IF I SMOKE?

For anyone who smokes, daily diet nutrition is critical. The damage doneto the body's cardiovascular and respiratory functions requires a constant need for extra nutrients. Even if you smoke 5 cigarettes a day, you have increased nutritional needs due to your increased risk of hypertension, atherosclerosis, emphysema and numerous cancers. As stated, a healthy diet will not prevent these health conditions, but it may delay their development.

INCREASED NEED FOR ANTIOXIDANTS

Tobacco smoke leads to increased levels of free radicals - cancer-causing agents - in the body and a corresponding need for protective antioxidants that can neutralise them. The main antioxidant vitamins are vitamin C and vitamin E (which works best in combination with the mineral selenium). Phytochemicals such as bioflavonoids and carotenoids (eg. beta-carotene) are also rich in antioxidants.

HOW TO INCREASE YOUR ANTIOXIDANT INTAKE

Use the following suggestions are a guide to minimum dietary requirements.

- Eat 3-5 daily servings of deep green, dark red, orange of yellow vegetables.

- Eat 3-5 daily servings of red, yellow, orange or green fruits.

- Switch from coffee to tea, ideally green tea.

- Each day, take 2 tsp of wheatgerm oil (rich in vitamin E) and 6 Brazil nuts (selenium).

[Note: a serving is approx 1 medium fruit, or 1/2 cup chopped]

SPECIAL NEED FOR INCREASED VITAMIN C

One cigarette is estimated to rob the body of 25mg of vitamin C. Thus all smokers have a greatly increased need for this antioxidant-rich vitamin simply to maintain minimum levels. In practice, this need can only be met by taking supplements. As a general guide, I suggest you take 1 gram of vitamin C supplements per day. Choose a "timed-release" brand that includes a minimum of 100mg bioflavonoids.

BEST DIETARY SOURCES OF VITAMIN C

Fruits, such as: blackcurrants, papaya, guava, cantaloupe, elderberries, kiwi fruit, mango, oranges, strawberries.

Fruit Juices, such as: cranberry, grapefruit, lemon, orange.

Vegetables, such as: red peppers, green peppers, broccoli, Brussels sprouts, cauliflower, kale, tomatoes.

PROTECTIVE CAROTENOIDS

Carotenoids are pigments found in plants. All carotenoids are antioxidants, the most common example being beta-carotene. It is found in green plants (eg. spinach), as well as orange and yellow plants, such as carrots, sweet potato and melons. Clinical trials indicate that when consumed in foods - not supplements - betacarotene reduces certain precancerous symptoms.

[Warning: for reasons which are still unclear, beta-carotene supplements actually increase the risk of disease (eg. lung cancer). Thus your intake of beta-carotene should come exclusively from food.]

HOW TO INCREASE YOUR INTAKE OF CAROTENOIDS

Use the following suggestions are a guide to minimum dietary requirements.

Eat 4 daily servings of deep green, yellow or red vegetables, including: carrots, sweetcorn, pumpkin, spinach, sweet potato.

Eat 4oz tomatoes daily, either in sauce or chopped.

Eat 3 daily servings of colored fruit, including: melon, oranges, strawberries, mango, cherries.

PROTECTIVE BRASSICAS

According to research evidence, cigarette smokers who eat more brassicas have less incidence of cancers (eg. breast, colorectal, lung, pancreatic, prostate and stomach). As all these cancers are initiated by free radicals, it follows that brassicas may help to prevent other problems initiated by free radical damage and accelerated by smoking, such as: cataracts, emphysema, asthma and age spots.

Brassicas include: broccoli, Brussels sprouts, cabbage (all types), cauliflower, cress, horseradish, kale, kohlrabi, mustard, radish, swede, turnip, watercress.

GARLIC AND ONIONS

Garlic is a good source of unique antioxidants and contains anti-bacterial and anti-viral properties. Its anti-tumor properties are well documented. Onions, a member of the same vegetable family, have similar properties to garlic.

MORE DIETARY TIPS FOR SMOKERS

Reduce the total fat in your diet. At the same time, minimize your intake of saturated fat and trans-fatty acids. Eat regular servings of omega-3-rich oily fish (eg. salmon, mackerel, sardines).

Eat healthy carbohydrates. Avoid refined white flour carbs, choose only whole grains such as, oats, brown rice, wholewheat pasta. In addition, choose foods rich in soluble fiber (eg. apples, oat bran).

Eat healthy low-fat protein such as fish, lean chicken/turkey, or egg-whites. Include small amounts of lean red meat in your diet, along with regular servings of soy foods (eg. soybeans) and other vegetable protein.

Reduce sodium in your daily diet. Check food labels and choose low-sodium or sodium-free foods. Also avoid adding salt when cooking or eating.As a dietitian, the three most common questions which smokers ask me about diet and smoking, are: (1) Can a diet compensate for health damage caused by smoking? (2) What should I eat if I smoke? (3) If I quit, what type of diet is best to prevent weight gain?

(1) CAN A DIET COMPENSATE FOR SMOKING?

No diet or eating-plan, no matter how nutritious, can neutralise the health damage caused by the 850+ chemicals in tobacco smoke - many of which are carcinogenic. On average, if you smoke 20 cigarettes a day, you double your risk of a heart-attack and are five times more likely to suffer a stroke than a non-smoker. At 40 cigarettes a day, you are five times more likely to suffer from sudden cardiac death. Smoking is also the leading cause of lung cancer.

Thus before we even start to examine an appropriate type of diet for smokers, my overriding advice is: quit smoking today!

(2) WHAT SHOULD I EAT IF I SMOKE?

For anyone who smokes, daily diet nutrition is critical. The damage doneto the body's cardiovascular and respiratory functions requires a constant need for extra nutrients. Even if you smoke 5 cigarettes a day, you have increased nutritional needs due to your increased risk of hypertension, atherosclerosis, emphysema and numerous cancers. As stated, a healthy diet will not prevent these health conditions, but it may delay their development.

INCREASED NEED FOR ANTIOXIDANTS

Tobacco smoke leads to increased levels of free radicals - cancer-causing agents - in the body and a corresponding need for protective antioxidants that can neutralise them. The main antioxidant vitamins are vitamin C and vitamin E (which works best in combination with the mineral selenium). Phytochemicals such as bioflavonoids and carotenoids (eg. beta-carotene) are also rich in antioxidants.

HOW TO INCREASE YOUR ANTIOXIDANT INTAKE

Use the following suggestions are a guide to minimum dietary requirements.

- Eat 3-5 daily servings of deep green, dark red, orange of yellow vegetables.

- Eat 3-5 daily servings of red, yellow, orange or green fruits.

- Switch from coffee to tea, ideally green tea.

- Each day, take 2 tsp of wheatgerm oil (rich in vitamin E) and 6 Brazil nuts (selenium).

[Note: a serving is approx 1 medium fruit, or 1/2 cup chopped]

SPECIAL NEED FOR INCREASED VITAMIN C

One cigarette is estimated to rob the body of 25mg of vitamin C. Thus all smokers have a greatly increased need for this antioxidant-rich vitamin simply to maintain minimum levels. In practice, this need can only be met by taking supplements. As a general guide, I suggest you take 1 gram of vitamin C supplements per day. Choose a "timed-release" brand that includes a minimum of 100mg bioflavonoids.

BEST DIETARY SOURCES OF VITAMIN C

Fruits, such as: blackcurrants, papaya, guava, cantaloupe, elderberries, kiwi fruit, mango, oranges, strawberries.

Fruit Juices, such as: cranberry, grapefruit, lemon, orange.

Vegetables, such as: red peppers, green peppers, broccoli, Brussels sprouts, cauliflower, kale, tomatoes.

PROTECTIVE CAROTENOIDS

Carotenoids are pigments found in plants. All carotenoids are antioxidants, the most common example being beta-carotene. It is found in green plants (eg. spinach), as well as orange and yellow plants, such as carrots, sweet potato and melons. Clinical trials indicate that when consumed in foods - not supplements - betacarotene reduces certain precancerous symptoms.

[Warning: for reasons which are still unclear, beta-carotene supplements actually increase the risk of disease (eg. lung cancer). Thus your intake of beta-carotene should come exclusively from food.]

HOW TO INCREASE YOUR INTAKE OF CAROTENOIDS

Use the following suggestions are a guide to minimum dietary requirements.

Eat 4 daily servings of deep green, yellow or red vegetables, including: carrots, sweetcorn, pumpkin, spinach, sweet potato.

Eat 4oz tomatoes daily, either in sauce or chopped.

Eat 3 daily servings of colored fruit, including: melon, oranges, strawberries, mango, cherries.

PROTECTIVE BRASSICAS

According to research evidence, cigarette smokers who eat more brassicas have less incidence of cancers (eg. breast, colorectal, lung, pancreatic, prostate and stomach). As all these cancers are initiated by free radicals, it follows that brassicas may help to prevent other problems initiated by free radical damage and accelerated by smoking, such as: cataracts, emphysema, asthma and age spots.

Brassicas include: broccoli, Brussels sprouts, cabbage (all types), cauliflower, cress, horseradish, kale, kohlrabi, mustard, radish, swede, turnip, watercress.

GARLIC AND ONIONS

Garlic is a good source of unique antioxidants and contains anti-bacterial and anti-viral properties. Its anti-tumor properties are well documented. Onions, a member of the same vegetable family, have similar properties to garlic.

MORE DIETARY TIPS FOR SMOKERS

Reduce the total fat in your diet. At the same time, minimize your intake of saturated fat and trans-fatty acids. Eat regular servings of omega-3-rich oily fish (eg. salmon, mackerel, sardines).

Eat healthy carbohydrates. Avoid refined white flour carbs, choose only whole grains such as, oats, brown rice, wholewheat pasta. In addition, choose foods rich in soluble fiber (eg. apples, oat bran).

Eat healthy low-fat protein such as fish, lean chicken/turkey, or egg-whites. Include small amounts of lean red meat in your diet, along with regular servings of soy foods (eg. soybeans) and other vegetable protein.

Reduce sodium in your daily diet. Check food labels and choose low-sodium or sodium-free foods. Also avoid adding salt when cooking or eating.

TAKE REGULAR CARDIO-AEROBIC EXERCISE

No cigarette smokers diet-plan is complete without regular physical exercise. Working within your fitness capacity, gradually increase the intensity and duration of your workouts to about 30-45 minutes a day, on most days. For best effects on lung capacity and cardiovascular function, choose aerobic exercise such as: brisk walking, jogging, jumping rope, swimming and most sports.

(3) CAN YOU PREVENT WEIGHT GAIN AFTER YOU QUIT?

Yes, if you take proper physical exercise and eat a healthy calorie-controlled diet, you are unlikely to gain weight. However, in my experience, some weight gain seems to be inevitable.

WHAT IS THE AVERAGE WEIGHT GAIN?

Most smokers gain weight immediately after they quit. Current evidence suggests that the average weight gain for both men and women who quit smoking is about 6-8 pounds. The more you smoke, the higher the risk of weight gain when you quit. This weight gain is due to the decrease in metabolic rate and an increase in appetite experienced when you quit smoking. This weight increase is perfectly normal, and need only be a short term event.

SO WHAT SHOULD I EAT?

There is no single diet which will prevent weight gain once you quit smoking. Your best option is to focus on healthy eating combined with regular vigorous exercise (within your fitness capacity) and let Nature do the rest. As a general guide, follow these suggestions.

First, cut down on caffeine. Nicotine withdrawal makes us jittery and nervous. So it's important to avoid coffee and caffeine-rich soft drinks which may increase this nervous tension.

Second, increase your intake of fresh fruit and vegetables. Studies show that an increased intake of fruit and vegetables can help to minimize weight gain after you quit smoking. Eat them for snacks, add them to meals, eat them as starters and/or desserts. Eat them on car journeys instead of sweets or candy.

Third, eat little and often. Avoid the temptation to linger over your meals. Get into the habit of eating smaller meals at more regular intervals. Aim to eat something, no matter how small, every 2-3 hours. This helps to maintain a regular rate of calorie-burning.

Fourth, take steps to learn more about nutrition and choose nutrient-dense foods whenever possible. (See above for information about antioxidants, and healthy fats, carbs and protein.)

WHAT ELSE CAN I DO TO PREVENT WEIGHT GAIN?

Make physical exercise a top priority in your daily schedule. Ideally join a gym or fitness center and get into shape. Research evidence demonstrates a clear link between exercise and weight control after you quit smoking. Choose both cardio-aerobic and strength-training exercises, as both play an important role in raising metabolic rate.

Also, make sure you get enough sleep. Research evidence shows that lack of sleep may lead to weight gain, as well as an increased craving for cigarettes and food.

TAKE REGULAR CARDIO-AEROBIC EXERCISE

No cigarette smokers diet-plan is complete without regular physical exercise. Working within your fitness capacity, gradually increase the intensity and duration of your workouts to about 30-45 minutes a day, on most days. For best effects on lung capacity and cardiovascular function, choose aerobic exercise such as: brisk walking, jogging, jumping rope, swimming and most sports.

(3) CAN YOU PREVENT WEIGHT GAIN AFTER YOU QUIT?

Yes, if you take proper physical exercise and eat a healthy calorie-controlled diet, you are unlikely to gain weight. However, in my experience, some weight gain seems to be inevitable.

WHAT IS THE AVERAGE WEIGHT GAIN?

Most smokers gain weight immediately after they quit. Current evidence suggests that the average weight gain for both men and women who quit smoking is about 6-8 pounds. The more you smoke, the higher the risk of weight gain when you quit. This weight gain is due to the decrease in metabolic rate and an increase in appetite experienced when you quit smoking. This weight increase is perfectly normal, and need only be a short term event.

SO WHAT SHOULD I EAT?

There is no single diet which will prevent weight gain once you quit smoking. Your best option is to focus on healthy eating combined with regular vigorous exercise (within your fitness capacity) and let Nature do the rest. As a general guide, follow these suggestions.

First, cut down on caffeine. Nicotine withdrawal makes us jittery and nervous. So it's important to avoid coffee and caffeine-rich soft drinks which may increase this nervous tension.

Second, increase your intake of fresh fruit and vegetables. Studies show that an increased intake of fruit and vegetables can help to minimize weight gain after you quit smoking. Eat them for snacks, add them to meals, eat them as starters and/or desserts. Eat them on car journeys instead of sweets or candy.

Third, eat little and often. Avoid the temptation to linger over your meals. Get into the habit of eating smaller meals at more regular intervals. Aim to eat something, no matter how small, every 2-3 hours. This helps to maintain a regular rate of calorie-burning.

Fourth, take steps to learn more about nutrition and choose nutrient-dense foods whenever possible. (See above for information about antioxidants, and healthy fats, carbs and protein.)

WHAT ELSE CAN I DO TO PREVENT WEIGHT GAIN?

Make physical exercise a top priority in your daily schedule. Ideally join a gym or fitness center and get into shape. Research evidence demonstrates a clear link between exercise and weight control after you quit smoking. Choose both cardio-aerobic and strength-training exercises, as both play an important role in raising metabolic rate.

Also, make sure you get enough sleep. Research evidence shows that lack of sleep may lead to weight gain, as well as an increased craving for cigarettes and food.

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DIET FOR SMOKERS AND EX-SMOKERS

As a dietitian, the three most common questions which smokers ask me about diet and smoking, are: (1) Can a diet compensate for health damage caused by smoking? (2) What should I eat if I smoke? (3) If I quit, what type of diet is best to prevent weight gain?

(1) CAN A DIET COMPENSATE FOR SMOKING?

No diet or eating-plan, no matter how nutritious, can neutralise the health damage caused by the 850+ chemicals in tobacco smoke - many of which are carcinogenic. On average, if you smoke 20 cigarettes a day, you double your risk of a heart-attack and are five times more likely to suffer a stroke than a non-smoker. At 40 cigarettes a day, you are five times more likely to suffer from sudden cardiac death. Smoking is also the leading cause of lung cancer.

Thus before we even start to examine an appropriate type of diet for smokers, my overriding advice is: quit smoking today!

(2) WHAT SHOULD I EAT IF I SMOKE?

For anyone who smokes, daily diet nutrition is critical. The damage doneto the body's cardiovascular and respiratory functions requires a constant need for extra nutrients. Even if you smoke 5 cigarettes a day, you have increased nutritional needs due to your increased risk of hypertension, atherosclerosis, emphysema and numerous cancers. As stated, a healthy diet will not prevent these health conditions, but it may delay their development.

INCREASED NEED FOR ANTIOXIDANTS

Tobacco smoke leads to increased levels of free radicals - cancer-causing agents - in the body and a corresponding need for protective antioxidants that can neutralise them. The main antioxidant vitamins are vitamin C and vitamin E (which works best in combination with the mineral selenium). Phytochemicals such as bioflavonoids and carotenoids (eg. beta-carotene) are also rich in antioxidants.

HOW TO INCREASE YOUR ANTIOXIDANT INTAKE

Use the following suggestions are a guide to minimum dietary requirements.

- Eat 3-5 daily servings of deep green, dark red, orange of yellow vegetables.

- Eat 3-5 daily servings of red, yellow, orange or green fruits.

- Switch from coffee to tea, ideally green tea.

- Each day, take 2 tsp of wheatgerm oil (rich in vitamin E) and 6 Brazil nuts (selenium).

[Note: a serving is approx 1 medium fruit, or 1/2 cup chopped]

SPECIAL NEED FOR INCREASED VITAMIN C

One cigarette is estimated to rob the body of 25mg of vitamin C. Thus all smokers have a greatly increased need for this antioxidant-rich vitamin simply to maintain minimum levels. In practice, this need can only be met by taking supplements. As a general guide, I suggest you take 1 gram of vitamin C supplements per day. Choose a "timed-release" brand that includes a minimum of 100mg bioflavonoids.

BEST DIETARY SOURCES OF VITAMIN C

Fruits, such as: blackcurrants, papaya, guava, cantaloupe, elderberries, kiwi fruit, mango, oranges, strawberries.

Fruit Juices, such as: cranberry, grapefruit, lemon, orange.

Vegetables, such as: red peppers, green peppers, broccoli, Brussels sprouts, cauliflower, kale, tomatoes.

PROTECTIVE CAROTENOIDS

Carotenoids are pigments found in plants. All carotenoids are antioxidants, the most common example being beta-carotene. It is found in green plants (eg. spinach), as well as orange and yellow plants, such as carrots, sweet potato and melons. Clinical trials indicate that when consumed in foods - not supplements - betacarotene reduces certain precancerous symptoms.

[Warning: for reasons which are still unclear, beta-carotene supplements actually increase the risk of disease (eg. lung cancer). Thus your intake of beta-carotene should come exclusively from food.]

HOW TO INCREASE YOUR INTAKE OF CAROTENOIDS

Use the following suggestions are a guide to minimum dietary requirements.

Eat 4 daily servings of deep green, yellow or red vegetables, including: carrots, sweetcorn, pumpkin, spinach, sweet potato.

Eat 4oz tomatoes daily, either in sauce or chopped.

Eat 3 daily servings of colored fruit, including: melon, oranges, strawberries, mango, cherries.

PROTECTIVE BRASSICAS

According to research evidence, cigarette smokers who eat more brassicas have less incidence of cancers (eg. breast, colorectal, lung, pancreatic, prostate and stomach). As all these cancers are initiated by free radicals, it follows that brassicas may help to prevent other problems initiated by free radical damage and accelerated by smoking, such as: cataracts, emphysema, asthma and age spots.

Brassicas include: broccoli, Brussels sprouts, cabbage (all types), cauliflower, cress, horseradish, kale, kohlrabi, mustard, radish, swede, turnip, watercress.

GARLIC AND ONIONS

Garlic is a good source of unique antioxidants and contains anti-bacterial and anti-viral properties. Its anti-tumor properties are well documented. Onions, a member of the same vegetable family, have similar properties to garlic.

MORE DIETARY TIPS FOR SMOKERS

Reduce the total fat in your diet. At the same time, minimize your intake of saturated fat and trans-fatty acids. Eat regular servings of omega-3-rich oily fish (eg. salmon, mackerel, sardines).

Eat healthy carbohydrates. Avoid refined white flour carbs, choose only whole grains such as, oats, brown rice, wholewheat pasta. In addition, choose foods rich in soluble fiber (eg. apples, oat bran).

Eat healthy low-fat protein such as fish, lean chicken/turkey, or egg-whites. Include small amounts of lean red meat in your diet, along with regular servings of soy foods (eg. soybeans) and other vegetable protein.

Reduce sodium in your daily diet. Check food labels and choose low-sodium or sodium-free foods. Also avoid adding salt when cooking or eating.As a dietitian, the three most common questions which smokers ask me about diet and smoking, are: (1) Can a diet compensate for health damage caused by smoking? (2) What should I eat if I smoke? (3) If I quit, what type of diet is best to prevent weight gain?

(1) CAN A DIET COMPENSATE FOR SMOKING?

No diet or eating-plan, no matter how nutritious, can neutralise the health damage caused by the 850+ chemicals in tobacco smoke - many of which are carcinogenic. On average, if you smoke 20 cigarettes a day, you double your risk of a heart-attack and are five times more likely to suffer a stroke than a non-smoker. At 40 cigarettes a day, you are five times more likely to suffer from sudden cardiac death. Smoking is also the leading cause of lung cancer.

Thus before we even start to examine an appropriate type of diet for smokers, my overriding advice is: quit smoking today!

(2) WHAT SHOULD I EAT IF I SMOKE?

For anyone who smokes, daily diet nutrition is critical. The damage doneto the body's cardiovascular and respiratory functions requires a constant need for extra nutrients. Even if you smoke 5 cigarettes a day, you have increased nutritional needs due to your increased risk of hypertension, atherosclerosis, emphysema and numerous cancers. As stated, a healthy diet will not prevent these health conditions, but it may delay their development.

INCREASED NEED FOR ANTIOXIDANTS

Tobacco smoke leads to increased levels of free radicals - cancer-causing agents - in the body and a corresponding need for protective antioxidants that can neutralise them. The main antioxidant vitamins are vitamin C and vitamin E (which works best in combination with the mineral selenium). Phytochemicals such as bioflavonoids and carotenoids (eg. beta-carotene) are also rich in antioxidants.

HOW TO INCREASE YOUR ANTIOXIDANT INTAKE

Use the following suggestions are a guide to minimum dietary requirements.

- Eat 3-5 daily servings of deep green, dark red, orange of yellow vegetables.

- Eat 3-5 daily servings of red, yellow, orange or green fruits.

- Switch from coffee to tea, ideally green tea.

- Each day, take 2 tsp of wheatgerm oil (rich in vitamin E) and 6 Brazil nuts (selenium).

[Note: a serving is approx 1 medium fruit, or 1/2 cup chopped]

SPECIAL NEED FOR INCREASED VITAMIN C

One cigarette is estimated to rob the body of 25mg of vitamin C. Thus all smokers have a greatly increased need for this antioxidant-rich vitamin simply to maintain minimum levels. In practice, this need can only be met by taking supplements. As a general guide, I suggest you take 1 gram of vitamin C supplements per day. Choose a "timed-release" brand that includes a minimum of 100mg bioflavonoids.

BEST DIETARY SOURCES OF VITAMIN C

Fruits, such as: blackcurrants, papaya, guava, cantaloupe, elderberries, kiwi fruit, mango, oranges, strawberries.

Fruit Juices, such as: cranberry, grapefruit, lemon, orange.

Vegetables, such as: red peppers, green peppers, broccoli, Brussels sprouts, cauliflower, kale, tomatoes.

PROTECTIVE CAROTENOIDS

Carotenoids are pigments found in plants. All carotenoids are antioxidants, the most common example being beta-carotene. It is found in green plants (eg. spinach), as well as orange and yellow plants, such as carrots, sweet potato and melons. Clinical trials indicate that when consumed in foods - not supplements - betacarotene reduces certain precancerous symptoms.

[Warning: for reasons which are still unclear, beta-carotene supplements actually increase the risk of disease (eg. lung cancer). Thus your intake of beta-carotene should come exclusively from food.]

HOW TO INCREASE YOUR INTAKE OF CAROTENOIDS

Use the following suggestions are a guide to minimum dietary requirements.

Eat 4 daily servings of deep green, yellow or red vegetables, including: carrots, sweetcorn, pumpkin, spinach, sweet potato.

Eat 4oz tomatoes daily, either in sauce or chopped.

Eat 3 daily servings of colored fruit, including: melon, oranges, strawberries, mango, cherries.

PROTECTIVE BRASSICAS

According to research evidence, cigarette smokers who eat more brassicas have less incidence of cancers (eg. breast, colorectal, lung, pancreatic, prostate and stomach). As all these cancers are initiated by free radicals, it follows that brassicas may help to prevent other problems initiated by free radical damage and accelerated by smoking, such as: cataracts, emphysema, asthma and age spots.

Brassicas include: broccoli, Brussels sprouts, cabbage (all types), cauliflower, cress, horseradish, kale, kohlrabi, mustard, radish, swede, turnip, watercress.

GARLIC AND ONIONS

Garlic is a good source of unique antioxidants and contains anti-bacterial and anti-viral properties. Its anti-tumor properties are well documented. Onions, a member of the same vegetable family, have similar properties to garlic.

MORE DIETARY TIPS FOR SMOKERS

Reduce the total fat in your diet. At the same time, minimize your intake of saturated fat and trans-fatty acids. Eat regular servings of omega-3-rich oily fish (eg. salmon, mackerel, sardines).

Eat healthy carbohydrates. Avoid refined white flour carbs, choose only whole grains such as, oats, brown rice, wholewheat pasta. In addition, choose foods rich in soluble fiber (eg. apples, oat bran).

Eat healthy low-fat protein such as fish, lean chicken/turkey, or egg-whites. Include small amounts of lean red meat in your diet, along with regular servings of soy foods (eg. soybeans) and other vegetable protein.

Reduce sodium in your daily diet. Check food labels and choose low-sodium or sodium-free foods. Also avoid adding salt when cooking or eating.

TAKE REGULAR CARDIO-AEROBIC EXERCISE

No cigarette smokers diet-plan is complete without regular physical exercise. Working within your fitness capacity, gradually increase the intensity and duration of your workouts to about 30-45 minutes a day, on most days. For best effects on lung capacity and cardiovascular function, choose aerobic exercise such as: brisk walking, jogging, jumping rope, swimming and most sports.

(3) CAN YOU PREVENT WEIGHT GAIN AFTER YOU QUIT?

Yes, if you take proper physical exercise and eat a healthy calorie-controlled diet, you are unlikely to gain weight. However, in my experience, some weight gain seems to be inevitable.

WHAT IS THE AVERAGE WEIGHT GAIN?

Most smokers gain weight immediately after they quit. Current evidence suggests that the average weight gain for both men and women who quit smoking is about 6-8 pounds. The more you smoke, the higher the risk of weight gain when you quit. This weight gain is due to the decrease in metabolic rate and an increase in appetite experienced when you quit smoking. This weight increase is perfectly normal, and need only be a short term event.

SO WHAT SHOULD I EAT?

There is no single diet which will prevent weight gain once you quit smoking. Your best option is to focus on healthy eating combined with regular vigorous exercise (within your fitness capacity) and let Nature do the rest. As a general guide, follow these suggestions.

First, cut down on caffeine. Nicotine withdrawal makes us jittery and nervous. So it's important to avoid coffee and caffeine-rich soft drinks which may increase this nervous tension.

Second, increase your intake of fresh fruit and vegetables. Studies show that an increased intake of fruit and vegetables can help to minimize weight gain after you quit smoking. Eat them for snacks, add them to meals, eat them as starters and/or desserts. Eat them on car journeys instead of sweets or candy.

Third, eat little and often. Avoid the temptation to linger over your meals. Get into the habit of eating smaller meals at more regular intervals. Aim to eat something, no matter how small, every 2-3 hours. This helps to maintain a regular rate of calorie-burning.

Fourth, take steps to learn more about nutrition and choose nutrient-dense foods whenever possible. (See above for information about antioxidants, and healthy fats, carbs and protein.)

WHAT ELSE CAN I DO TO PREVENT WEIGHT GAIN?

Make physical exercise a top priority in your daily schedule. Ideally join a gym or fitness center and get into shape. Research evidence demonstrates a clear link between exercise and weight control after you quit smoking. Choose both cardio-aerobic and strength-training exercises, as both play an important role in raising metabolic rate.

Also, make sure you get enough sleep. Research evidence shows that lack of sleep may lead to weight gain, as well as an increased craving for cigarettes and food.

TAKE REGULAR CARDIO-AEROBIC EXERCISE

No cigarette smokers diet-plan is complete without regular physical exercise. Working within your fitness capacity, gradually increase the intensity and duration of your workouts to about 30-45 minutes a day, on most days. For best effects on lung capacity and cardiovascular function, choose aerobic exercise such as: brisk walking, jogging, jumping rope, swimming and most sports.

(3) CAN YOU PREVENT WEIGHT GAIN AFTER YOU QUIT?

Yes, if you take proper physical exercise and eat a healthy calorie-controlled diet, you are unlikely to gain weight. However, in my experience, some weight gain seems to be inevitable.

WHAT IS THE AVERAGE WEIGHT GAIN?

Most smokers gain weight immediately after they quit. Current evidence suggests that the average weight gain for both men and women who quit smoking is about 6-8 pounds. The more you smoke, the higher the risk of weight gain when you quit. This weight gain is due to the decrease in metabolic rate and an increase in appetite experienced when you quit smoking. This weight increase is perfectly normal, and need only be a short term event.

SO WHAT SHOULD I EAT?

There is no single diet which will prevent weight gain once you quit smoking. Your best option is to focus on healthy eating combined with regular vigorous exercise (within your fitness capacity) and let Nature do the rest. As a general guide, follow these suggestions.

First, cut down on caffeine. Nicotine withdrawal makes us jittery and nervous. So it's important to avoid coffee and caffeine-rich soft drinks which may increase this nervous tension.

Second, increase your intake of fresh fruit and vegetables. Studies show that an increased intake of fruit and vegetables can help to minimize weight gain after you quit smoking. Eat them for snacks, add them to meals, eat them as starters and/or desserts. Eat them on car journeys instead of sweets or candy.

Third, eat little and often. Avoid the temptation to linger over your meals. Get into the habit of eating smaller meals at more regular intervals. Aim to eat something, no matter how small, every 2-3 hours. This helps to maintain a regular rate of calorie-burning.

Fourth, take steps to learn more about nutrition and choose nutrient-dense foods whenever possible. (See above for information about antioxidants, and healthy fats, carbs and protein.)

WHAT ELSE CAN I DO TO PREVENT WEIGHT GAIN?

Make physical exercise a top priority in your daily schedule. Ideally join a gym or fitness center and get into shape. Research evidence demonstrates a clear link between exercise and weight control after you quit smoking. Choose both cardio-aerobic and strength-training exercises, as both play an important role in raising metabolic rate.

Also, make sure you get enough sleep. Research evidence shows that lack of sleep may lead to weight gain, as well as an increased craving for cigarettes and food.

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Sweat Glands - Why We Sweat When We Exercise

I love my daily workouts, I love to shop for exercise equipment, and I have a great time getting sweaty. This is because I know I am doing a good thing for my entire body, my mentality and, my overall quality of life. Nonetheless, showering on a regular basis (which you usually will end up doing after a nice sweaty exercise session) can rob your body of the moisture it needs. As odd as it may sound, excess water and especially sweat will dry out your skin. When you sweat and shower excessively you will need extra moisture inside your body as well as outside your body. Drinking water to replace the water you lose when you sweat. Nonetheless, you loose more than just water when you sweat excessively.

Click Here For A Surefire way To Cure Excessive Sweating

Certain occasions when someone sweats, (such as those mentioned above, one usually has a general idea of why it happens: to cool the body, to respond to the stimuli of the skin or to respond to an infection. Nonetheless, there are other occasions when you will notice sweat. This kind of sweat seems like a kind of unexplained sweat . . . so why does it happen?

Say you have a very important job interview, or perhaps you are nervous about meeting someone, or maybe you just get the sweats sometimes and you are not sure why. Well, there are reasons that your body produces sweat (of course) and all of them are related to each other in some way. Nonetheless, they can manifest in different forms and present for many different reasons. Perspiration is a persons bodys way of indicating that the body needs to be cooled. Sometimes the body needs to be cooled because of temperature rising due to hardworking muscles, or it could be a reaction to rising temperature designed to help indicate and fight off an infections.

Oh, but there are so many more reasons that a bodys temperature may rise one of them is blood pressure. When you are nervous about something, exited, or even under stress you blood pressure can be elevated and your core temperature will rise. Therefore, your body will respond as it is designed to when this happens it will produce sweat to cool the bodys outer temperature as well as your core temperature.

Nonetheless, I believe that the body is confused in this kind of situation rising blood pressure because of some sort of excitement or pressure is normal. However, sweat will do nothing to soothe you as a matter of fact, it will probably make you feel more nervous, self-conscious, and worried about the situation that has your stomach churning in the first place. Too bad.

The sweat gland is a very important part of the skin the largest organ in the body. Most people have about 2.6 million sweat glands distributed over the entire body. The sweat gland app ears as a long, hollow, tube-like cluster of cells. There is a coiled part of the sweat gland that is where the sweat is created. The long portion of the sweat gland connects a sort of duct to the pore in the skin. The sympathetic nervous system connect directly to the sweat glands, the sympathetic nervous system directs the way the glands function. There are actually two different kinds of sweat glands in the body.

The two different types of sweat glands are called the Eccrine glands. These are sweat glands that are all over the skin, especially on your palms, the soles of your feet and your forehead. You will notice that your nerves respond to tension often with sweat in these areas in high stress situations.

The other kind of sweat gland in the body is called the Apocrine sweat gland. These glands are virtually confined to the armpits, anal, and genital areas. These seem (from simple experience) to be the sweat glands which expel the most stinky perspiration . As a matter of fact, the pores that leak perspiration from the Apocrine sweat glands are most likely to be found around the hair follicles.

The hair surrounding Apocrine sweat glands in the body will absorb the sweat secreted and thus the stench is most likely to remain than sweat that presents from the Eccrine glands. The Apocrine glands produce the sweat that is most likely to stain your clothing. Nonetheless, the Apocrine sweat glands are smaller, they are active from birth, and they produce a cleaner sweat. In other words: the sweat from Apocrine sweat glands is absolutely free of proteins and fatty acids.

You will notice sweat the most at certain times as opposed to others, this is because of the stimuli upon the Of course, once youve finished a workout routine you know your body is likely to be drenched. We know that when we are running a fever we sweat. But do we know exactly why? Sweat glands produce sweat in response to the sympathetic nervous syste m (which controls the bodys production of sweat) to different kinds of stimuli. Read more about how these glands produce sweat in more of my articles!

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Is There Cure for Abdominal Aortic Aneurysm?

Abdominal aortic aneurysm (AAA) is the enlargement of the large blood vessel that supplies blood to the abdomen, pelvis and legs. Anybody can acquire this disease, even babies, but there are determining factors for adult individuals.

People who smoke, those suffering from high blood pressure, obesity, and emphysema have greater chances of acquiring the sickness. An individual will never know if he has acquired the disease because it hardly shows any symptoms and it develops gradually. You won't feel the blood vessel tear but without your knowledge blood is already leaking along the vessel's wall which is a dangerous thing.

It is only through a life line screening that one can determine if he is at risk of this type of aneurysm that is why preventive screenings are highly advisable especially to male smokers between the ages of 65 and 75.

Through ultrasonography an individual will be able to determine the seriousness of his AAA and contact his physician right away to inquire about the recommended treatment for it. Surgery is often the last resort of those individuals with very serious AAA but if yours only measures three to four centimeters doctors would usually recommend continuous assessment through rescanning.

Once you start feeling constant abdominal pain which extends to the groin, legs and buttocks then you could be experiencing severe AAA which requires immediate attention. According to medical studies, less than 40% of patients with severe AAA make it through a surgery successfully.

Prevention of Abdominal Aortic Aneurysm

To avoid acquiring AAA, doctors advise everybody to maintain a healthy diet, not to smoke or to quit smoking (if you're into the habit), and to take your medications for high blood pressure or diabetes religiously. Stress is a also a major culprit of AAA so try to get as much sleep as you can and do not take everything in your life too seriously.

Exercise is also one sure-fire way to avoid the attack of AAA and other types of aneurysms for that matter.

Apart from healthy eating habits and a healthy lifestyle, medical practitioners and healthcare experts say undergoing regular preventive screenings will keep this type of sickness at bay. You'll find that hospitals and health care centers offer AAA screenings as part of their life line screening packages.

It is better to prevent serious health conditions such as AAA rather than wait for it to reach the stage wherein you cannot do anything anymore but accept your fate that it ushers in. Grave AAA conditions would usually require an individual's aorta to be replaced but surgery will not necessarily guarantee a person can go back to living a normal life.

If not treated properly, an abdominal aortic aneurysm can lead to various health complications such as infections in different parts of the body and tremendous bleeding which can lead to death. Take advantage of the preventive screening packages which a nearby hospital offers or you can go online and look up a website that specializes in senior care, as this will definitely offer you the best services at prices so affordable.

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Abdominal Aortic Aneurysm Information

An aneurysm is when a blood vessel becomes abnormally large or balloons outward. The abdominal aorta is a large blood vessel that supplies blood to your abdomen, the pelvis, and legs. Normal diameter of the infrarenal aorta is 2 cm. It is caused by a degenerative process of the aortic wall. It is most commonly located infrarenally (90%), other possible locations are suprarenal and pararenal. The aneurysm can extend to include one or both of the iliac arteries. An aortic aneurysm may also occur in the thorax. Risk factors for developing an aortic aneurysm include high blood pressure ,smoking ,high cholesterol ,obesity ,emphysema ,genetic factors and male gender. An abdominal aortic aneurysm can develop in anyone. AAA is uncommon in individuals of African, African American and asian.

It is most frequently seen in males over 60 with one or more risk factors. The larger the aneurysm, the more likely it is to rupture. Other risk factors include hypertension and male sex. In the US, the incidence of AAA is 2-4% in the adult population. Most common symptoms abdominal aortic aneurysm are pain in abdomen, groin, back, legs or buttocks , nausea and vomiting , swelling or bulging in one area of abdomen , abnormal stiffness in abdominal muscles and clammy skin. The treatment options for asymptomatic AAA are immediate repair, surveillance with a view to eventual repair, and conservative. Conservative treatment is indicated in patients where repair carries a high risk of mortality and also in patients where repair is unlikely to improve life expectancy.
Aneurysms that cause symptoms usually require surgery to prevent complications. There are two approaches to surgery. First is traditional (open) repair- traditional (open) repair is a large cut in abdomen. The abnormal vessel is supplant with a graft made of synthetic material, such as Dacron. Exercise, eat well, and avoid tobacco to reduce the risk of developing aneurysms. Get regular physical exams. If you have any risk factors, insist upon a screening abdominal aortic ultrasound. Endovascular stent grafting can be done without making a large cut in your abdomen, so you may get well faster. Exercise, eat well, and avoid tobacco to reduce the risk of developing aneurysms. Get regular physical exams and avoid smoking first. Control your blood pressure and cholesterol.

Abdominal Aortic Aneurysm Treatment and Prevention Tips

1. Avoid smoking.

2. Eating a well-balanced.

3. Do exercising regularly.

4. Control your blood pressure and Cholesterol.

5. Surgery is recommended for patients with aneurysms.

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The signs & symptoms of rheumatoid arthritis

Unlike osteoarthritis, which results from wear and tear on your joints, rheumatoid arthritis is an inflammatory condition. The exact cause of rheumatoid arthritis is unknown, but it's believed to be the body's immune system attacking the tissue that lines your joints (synovium).

Rheumatoid arthritis is two to three times more common in women than in men and generally strikes between the ages of 20 and 50. But rheumatoid arthritis can also affect young children and adults older than age 50.

There's no cure for rheumatoid arthritis. But with proper treatment, a strategy for joint protection and changes in lifestyle, you can live a long, productive life with this condition.
Signs and symptoms

The signs and symptoms of rheumatoid arthritis may come and go over time. They include:

* Pain and swelling in your joints, especially in the smaller joints of your hands and feet
* Generalized aching or stiffness of the joints and mu scles, especially after sleep or after periods of rest
* Loss of motion of the affected joints
* Loss of strength in muscles attached to the affected joints
* Fatigue, which can be severe during a flare-up
* Low-grade fever
* Deformity of your joints over time
* General sense of not feeling well (malaise)

Rheumatoid arthritis usually causes problems in several joints at the same time. Early in rheumatoid arthritis, the joints in your wrists, hands, feet and knees are the ones most often affected. As the disease progresses, your shoulders, elbows, hips, jaw and neck can become involved. It generally affects both sides of your body at the same time. The knuckles of both hands are one example.

Small lumps, called rheumatoid nodules, may form under your skin at pressure points and can occur at your elbows, hands, feet and Achilles tendons. Rheumatoid nodules may also occur elsewhere, including the back of your scalp, over your knee or even in your lungs. These nodules can range in size from as small as a pea to as large as a walnut. Usually these lumps aren't painful.

In contrast to osteoarthritis, which affects only your bones and joints, rheumatoid arthritis can cause inflammation of tear glands, salivary glands, the linings of your heart and lungs, your lungs themselves and, in rare cases, your blood vessels.

Although rheumatoid arthritis is often a chronic disease, it tends to vary in severity and may even come and go. Periods of increased disease activity called flare-ups or flares alternate with periods of relative remission, during which the swelling, pain, difficulty sleeping, and weakness fade or disappear.

Swelling or deformity may limit the flexibility of your joints. But even if you have a severe form of rheumatoid arthritis, you'll probably retain flexibility in many joints.
Illustration comparing rheumatoid arthritis and osteoarthritis
Osteoarthritis, the most common form of arthritis, involves the wearing away of the cartilage that caps the bones in your joints. With rheumatoid arthritis, the synovial membrane that protects and lubricates joints becomes inflamed, causing pain and swelling. Joint erosion may follow.
More On This Topic

* Osteoarthritis

Causes

As with other forms of arthritis, rheumatoid arthritis involves inflammation of the joints. A membrane called the synovium lines each of your movable joints. When you have rheumatoid arthritis, white blood cells whose usual job is to attack unwanted invaders, such as bacteria and viruses move from your bloodstream into your synovium. Here, these blood cells appear to play an important role in causing the synovial membrane to become inflamed (synovitis).

This inflammation results in the release of proteins that, over months or years, cause thickening of the synovium. These proteins can also damage c artilage, bone, tendons and ligaments. Gradually, the joint loses its shape and alignment. Eventually, it may be destroyed.

Some researchers suspect that rheumatoid arthritis is triggered by an infection possibly a virus or bacterium in people with an inherited susceptibility. Although the disease itself is not inherited, certain genes that create an increased susceptibility are. People who have inherited these genes won't necessarily develop rheumatoid arthritis. But they may have more of a tendency to do so than others. The severity of their disease may also depend on the genes inherited. Some researchers also believe that hormones may be involved in the development of rheumatoid arthritis.
Illustration showing inflammation of rheumatoid arthritis

Rheumatoid arthritis typically strikes joints, causing pain, swelling and deformity. As your synovial membranes become inflamed and thickened, fluid builds up and joints erode and degrade.
Risk f actors

The exact causes of rheumatoid arthritis are unclear, but these factors may increase your risk:

* Getting older, because incidence of rheumatoid arthritis increases with age. However, incidence begins to decline in women over the age of 80.
* Being female.
* Being exposed to an infection, possibly a virus or bacterium, that may trigger rheumatoid arthritis in those with an inherited susceptibility.
* Inheriting specific genes that may make you more susceptible to rheumatoid arthritis.
* Smoking cigarettes over a long period of time.

When to seek medical advice

See your doctor if you have persistent discomfort and swelling in multiple joints on both sides of your body. Your doctor can work with you to develop a pain management and treatment plan. Also seek medical advice if you experience side effects from your arthritis medications. Side effects may include nausea, abdominal discomfort, black or tarry sto ols, changes in bowel habits, constipation and drowsiness.
Screening and diagnosis

If you have signs and symptoms of rheumatoid arthritis, your doctor will likely conduct a physical examination and request laboratory tests to determine if you have this form of arthritis. These tests may include:

*

Blood tests. A blood test that measures your erythrocyte sedimentation rate (ESR or sed rate) can indicate the presence of an inflammatory process in your body. People with rheumatoid arthritis tend to have elevated ESRs. The ESRs in those with osteoarthritis tend to be normal.

Another blood test looks for an antibody called rheumatoid factor. Most people with rheumatoid arthritis eventually have this abnormal antibody, although it may be absent early in the disease. It's also possible to have the rheumatoid factor in your blood and not have rheumatoid arthritis.
* Imaging. Doctors may take X-rays of your joints to differentiate between osteoarthritis and rheumatoid arthritis. A sequence of X-rays obtained over time can show the progression of arthritis.

Complications

Rheumatoid arthritis causes stiffness and pain and may also cause fatigue. It can lead to difficulty with everyday tasks, such as turning a doorknob or holding a pen. Dealing with the pain and the unpredictability of rheumatoid arthritis can also cause symptoms of depression.

Rheumatoid arthritis may also increase your risk of developing osteoporosis, especially if you take corticosteroids. Some researchers believe that rheumatoid arthritis can increase your risk of heart disease. This may be because the inflammation that rheumatoid arthritis causes can also affect your arteries and heart muscle tissue.
In the past, people with rheumatoid arthritis may have ended up confined to a wheelchair because damage to joints made it difficult or impossible to walk. That's not as likely today because of better treatments and self-care methods.
More On This Topic

* Osteoporosis

Treatment

Treatments for arthritis have improved in recent years. Most treatments involve medications. But in some cases, surgical procedures may be necessary.

Medications
Medications for rheumatoid arthritis can relieve its symptoms and slow or halt its progression. They include:

* Nonsteroidal anti-inflammatory drugs (NSAIDs). This group of medications, which includes aspirin, helps relieve both pain and inflammation if you take the drugs regularly. NSAIDs that are available over-the-counter include aspirin, ibuprofen (Advil, Motrin, others) and naproxen sodium (Aleve). These are available at higher dosages, and other NSAIDs are available by prescription such as ketoprofen, naproxen (Anaprox, Naprosyn), tolmetin (Tolectin), diclofenac (Voltaren), nabumetone (Relafen) and indomethacin (Indocin). Taking NSAIDs can lead to side effects such as indigestion and stomach bleeding. Other potential side effects may include damage to the liver and kidneys, ringing in your ears (tinnitus), fluid retention and high blood pressure. NSAIDs, except aspirin, may also increase your risk of cardiovascular events such as heart attack or stroke.
* COX-2 inhibitors. This class of NSAIDs may be less damaging to your stomach. Like other NSAIDs, COX-2 inhibitors such as celecoxib (Celebrex) suppress an enzyme called cyclooxygenase (COX) that's active in joint inflammation. Other types of NSAIDs work against two versions of the COX enzyme that are present in your body: COX-1 and COX-2. However, there's evidence that by suppressing COX-1, NSAIDs may cause stomach and other problems because COX-1 is the enzyme that protects your stomach lining. Unlike other NSAIDs, COX-2 inhibitors suppress only COX-2, the enzyme involved in inflammation. Side effects may include fluid retention and causing or exacerbating high blood pressure. Furthermore, this class of drugs has been linked to an increased risk of heart attack and stroke.
* Corticosteroids. These medications, such as prednisone and methylprednisolone (Medrol), reduce inflammation and pain, and slow joint damage. In the short term, corticosteroids can make you feel dramatically better. But when used for many months or years, they may become less effective and cause serious side effects. Side effects may include easy bruising, thinning of bones, cataracts, weight gain, a round face and diabetes. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication.
* Disease-modifying antirheumatic drugs (DMARDs). Physicians prescribe DMARDs to limit the amount of joint damage that occurs in rheumatoid arthritis. Taking these drugs at early stages in the development of rheumatoid arthritis is especially important in the effort to slow the disease and save the joints and other tissues from permanent damage. Because many of these drugs act slowly it may take weeks to months before you notice any benefit DMARDs typically are used with an NSAID or a corticosteroid. While the NSAID or corticosteroid handles your immediate symptoms and limits inflammation, the DMARD goes to work on the disease itself. Some commonly used DMARDs include hydroxychloroquine (Plaquenil), the gold compound auranofin (Ridaura), sulfasalazine (Azulfidine), minocycline (Dynacin, Minocin) and methotrexate (Rheumatrex). Other forms of DMARDs include immunosuppressants and tumor necrosis factor (TNF) blockers.
* Immunosuppressants. These medications act to tame your immune system, which is out of control in rheumatoid arthritis. In addition, some of these drugs attack and eliminate cel ls that are associated with the disease. Some of the commonly used immunosuppressants include leflunomide (Arava), azathioprine (Imuran), cyclosporine (Neoral, Sandimmune) and cyclophosphamide (Cytoxan). These medications can have potentially serious side effects such as increased susceptibility to infection.
* TNF blockers. These are a class of DMARDs known as biologic response modifiers. TNF is a cytokine, or cell protein, that acts as an inflammatory agent in rheumatoid arthritis. TNF blockers, or anti-TNF medications, target or block this cytokine and can help reduce pain, morning stiffness and tender or swollen joints usually within one or two weeks after treatment begins. There is evidence that TNF blockers may halt progression of disease. These medications often are taken with methotrexate. TNF blockers approved for treatment of rheumatoid arthritis are etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira). Potential side effects include injection s ite irritation (adalimumab and etanercept), worsening congestive heart failure (infliximab), blood disorders, lymphoma, demyelinating diseases, and increased risk of infection. If you have an active infection, don't take these medications.
* Interleukin-1 receptor antagonist (IL-1Ra). IL-1Ra is another type of biologic response modifier and is a recombinant form of the naturally occurring interleukin-1 receptor antagonist (IL-1Ra). Interleukin-1 (IL-1) is a cell protein that promotes inflammation and occurs in excess amounts in people who have rheumatoid arthritis or other types of inflammatory arthritis. If IL-1 is prevented from binding to its receptor, the inflammatory response decreases. The first IL-1Ra that has been approved by the Food and Drug Administration for use in people with moderate to severe rheumatoid arthritis who haven't responded adequately to conventional DMARD therapy is anakinra (Kineret). It may be used alone or in combination with methotrexate. Anakinra is given as a daily self-administered injection under the skin. Some potential side effects include injection site reactions, decreased white blood cell counts, headache and an increase in upper respiratory infections. There may be a slightly higher rate of respiratory infections in people who have asthma or chronic obstructive pulmonary disease. If you have an active infection, don't use anakinra.
* Abatacept (Orencia). Abatacept, a type of costimulation modulator approved in late 2005, reduces the inflammation and joint damage caused by rheumatoid arthritis by inactivating T cells a type of white blood cell. People who haven't been helped by TNF blockers might consider abatacept, which is administered monthly through a vein in your arm (intravenously). Side effects may include headache, nausea and mild infections, such as upper respiratory tract infections. Serious infections, such as pneumonia, can occur.
* Rituximab (Rituxan). Rituximab reduces the nu mber of B cells in your body. B cells are involved in inflammation. Though originally approved for use in people with non-Hodgkin's lymphoma, rituximab was approved for rheumatoid arthritis in early 2006. People who haven't found relief using TNF blockers might consider using rituximab, which is usually given along with methotrexate. Rituximab is administered as an infusion into a vein in your arm. Side effects include flu-like signs and symptoms, such as fever, chills and nausea. Some people experience extreme reactions to the infusion, such as difficulty breathing and heart problems.
* Antidepressant drugs. Some people with arthritis also experience symptoms of depression. The most common antidepressants used for arthritis pain and nonrestorative sleep are amitriptyline, nortriptyline (Aventyl, Pamelor) and trazodone (Desyrel).

Surgical or other procedures
Although a combination of medication and self-care is the first course of action for rheumatoid a rthritis, other methods are available for severe cases:

* Prosorba column. This blood-filtering technique removes certain antibodies that contribute to pain and inflammation in your joints and muscles and is usually performed once a week for 12 weeks as an outpatient procedure. Some of the side effects include fatigue and a brief increase in joint pain and swelling for the first few days after the treatment. The Prosorba column treatment isn't recommended if you're taking angiotensin-converting enzyme (ACE) inhibitors or if you have heart problems, high blood pressure or blood-clotting problems.
* Joint replacement surgery. For many people with rheumatoid arthritis, medicines and therapies can't prevent joint destruction. When joints are severely damaged, joint replacement surgery can often help restore joint function, reduce pain or correct a deformity. You may need to have an entire joint replaced with a metal or plastic prosthesis. Surgery may also involve tightening tendons that are too loose, loosening tendons that are too tight, fusing bones to reduce pain or removing part of a diseased bone to improve mobility. Your doctor may also remove the inflamed joint lining (synovectomy).

More On This Topic

* Steroid use: Balancing the risks and benefits
* Are COX-2 drugs safe for you? An interview with a Mayo Clinic specialist
* Knee replacement: Surgery can relieve pain

Self-care

Treating rheumatoid arthritis typically involves using a combination of medical treatments and self-care strategies. The following self-care procedures are important elements for managing the disease:

*

Exercise regularly. Different types of exercise achieve different goals. Check with your doctor or physical therapist first and then begin a regular exercise program for your specific needs. If you can walk, walking is a good starter exercise. If you can't walk, try a stationary b icycle with little or no resistance or do hand or arm exercises. A chair exercise program may be helpful. Aquatic exercise is another option, and many health clubs with pools offer such classes.

It's good to move each joint in its full range of motion every day. As you move, maintain a slow, steady rhythm. Don't jerk or bounce. Also, remember to breathe. Holding your breath can temporarily deprive your muscles of oxygen and tire them. It's also important to maintain good posture while you exercise. Avoid exercising tender, injured or severely inflamed joints. If you feel new joint pain, stop. New pain that lasts more than two hours after you exercise probably means you've overdone it. If pain persists for more than a few days, call your doctor.
* Control your weight. Excess weight puts added stress on joints in your back, hips, knees and feet the places where arthritis pain is commonly felt. Excess weight can also make joint surgery more difficult and risky.
* Eat a healthy diet. A healthy diet emphasizing fruit, vegetables and whole grains can help you control your weight and maintain your overall health, allowing you to deal better with your arthritis. However, there's no special diet that can be used to treat arthritis. It hasn't been proved that eating any particular food will make your joint pain or inflammation better or worse.
* Apply heat. Heat will help ease your pain, relax tense, painful muscles and increase the regional flow of blood. One of the easiest and most effective ways to apply heat is to take a hot shower or bath for 15 minutes. Other options include using a hot pack, an electric heat pad set on its lowest setting or a radiant heat lamp with a 250-watt reflector heat bulb to warm specific muscles and joints. If your skin has poor sensation or if you have poor circulation, don't use heat treatment.
* Apply cold for occasional flare-ups. Cold may dull the sensation of pain. Cold also has a numb ing effect and decreases muscle spasms. Don't use cold treatments if you have poor circulation or numbness. Techniques may include using cold packs, soaking the affected joints in cold water and ice massage.
* Practice relaxation techniques. Hypnosis, guided imagery, deep breathing and muscle relaxation can all be used to control pain.
* Take your medications as recommended. By taking medications regularly instead of waiting for pain to build, you will lessen the overall intensity of your discomfort.

Coping skills

The degree to which rheumatoid arthritis affects your daily activities depends in part on how well you cope with the disease. Physical and occupational therapists can help you devise strategies to cope with specific limitations you may experience as the result of weakness or pain. Here are some general suggestions to help you cope:

* Keep a positive attitude. With your doctor, make a plan for managing your arthritis. This will help you feel in charge of your disease. Studies show that people who take control of their treatment and actively manage their arthritis experience less pain and make fewer visits to the doctor.
* Use assistive devices. A painful knee may need a brace for support. You might also want to use a cane to take some of the stress off the joint as you walk. Use the cane in the hand opposite the affected joint. If your hands are affected, various helpful tools and gadgets are available to help you maintain an active lifestyle. Contact your pharmacy or doctor for information on ordering items that may help you the most.
* Know your limits. Rest when you're tired. Arthritis can make you prone to fatigue and muscle weakness. A rest or short nap that doesn't interfere with nighttime sleep may help.
* Avoid grasping actions that strain your finger joints. Instead of using a clutch purse, for example, select one with a shoulder strap. Use hot water to loosen a jar lid and pressure from your palm to open it, or use a jar opener. Don't twist or use your joints forcefully.
* Spread the weight of an object over several joints. For instance, use both hands to lift a heavy pan.
* Take a break. Periodically relax and stretch.
* Maintain good posture. Poor posture causes uneven weight distribution and may strain ligaments and muscles. The easiest way to improve your posture is by walking. Some people find that swimming also helps improve their posture.
* Use your strongest muscles and favor large joints. Don't push open a heavy glass door. Lean into it. To pick up an object, bend your knees and squat while keeping your back straight.

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The Role Of Aerobics In Fitness

The benefits of aerobic exercise are myriad. They include systemic changes such as reduced cholesterol and blood pressure, improved muscular endurance, reduced body fat, increased metabolism, and others. Aerobic exercises improves the strength of your bones, ligaments and tendons, allows your body to use fats and sugars more efficiently, burns a lot of calories, and plays an important role in reducing the onset and symptoms of aging and illness.

Aerobics are particularly helpful for weight control. It helps to control your weight by using excess calories that otherwise would be stored as fat. The number of calories you eat and use each day regulates your body weight and physical activity will make you use the extra calories.

Aerobics means 'with oxygen' and aerobic exercise is defined as any long duration exercise. Aerobics classes, or aerobic dance, are structured, teacher-led classes designed to work on all the components of fitness.

The benefits of aerobic exercise are myriad. They include systemic changes such as reduced cholesterol and blood pressure, improved muscular endurance, reduced body fat, increased metabolism, and others. Aerobic exercises improves the strength of your bones, ligaments and tendons, allows your body to use fats and sugars more efficiently, burns a lot of calories, and plays an important role in reducing the onset and symptoms of aging and illness.

Aerobics are particularly helpful for weight control. It helps to control your weight by using excess calories that otherwise would be stored as fat. The number of calories you eat and use each day regulates your body weight and physical activity will make you use the extra calories.

Following a regular aerobics program gives you a sense of commitment and control - two positive mental attitudes that help counteract stress. Aerobics also relax tense muscles, thereby relieving your body's stress response.

Medical research has shown that regular aerobic activity increases the body's production of endorphins.

Therefore, by following a regular aerobics program, you can also get a sense of commitment and control. Both these positive mental attitudes help counteract stress. Aerobics also relaxes tense muscles, thereby relieving your body's stress response further.

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To Compare the Role of Glibenclamide and Pioglitazone Drugs in Type 11 Non- Insulin Dependent Diabetes Mellitus Patients

To compare the role of glibenclamide and pioglitazone drugs in type 11 non- insulin dependent diabetes mellitus patients.

Authors:Raj kumar chohan,Mashori Ghulam Rasool,Bhurgri Ghulam Rasool,Shamim-u-Rehman,DahriGhulam mustafa,Anis-u-rehman.

Introduction:-

Diabetes comes from the greek word for SIPHON" which one is the first term and implies for a lot of urine is made .The trm "mellitus" comes from a laton word, "met" which means "honey" and was used because the urine was sweet (Wheeler,2004)

Diabetic ketaocidosis is one of life threatening condition requiring some data hospitalization and treatment. Recognition of this condition is of almost importance, because even small delays can have an impact on survival (Nattrass, 2006). Hypoglycaemia are involved in insulin induced episodes in individuals with diabetes. Probably the major factor prescribing, insulin tre ated patient from achieving the glucose targets needed to prevent diabetic complications. The incidence of hypoglycaemia reflects the inadequancy of current mathods of insulin delievery which lead ot inappropriately high insulin concentration, particularly some persons after eating more foods at night onset of blindness and also a major risk factor heart disease and stroke

(Heller, 2003).

TYPES OF DIABETE MELLITUS

TYPE 1 DIABETES MELLITUS (IDDM):

Type I diabetes affect children of all ages, both sexes and all athenic groups. type 1 diabetes usually occurs by mechanisms. It is most common metabolic condition in children and adolescents (Bui, 2004). Type1diabetes is characterized by immune mediated destruction of pancreatic b -cells resulting in insulin deficiency. This results in a common biochemical end point of hyperglycaemia and risk of ketoacidosis, but the clinical presentaion varies, widely depend ing on the rate and degree of b -cells failure (Lambert & Bingley. 2005).

Type II diabetes mellitus (NIDDM):

Type II diabetes is a complex metabolic disorder associated with, b -cells dysfunction and with varying degree of insulin resistance primary pathogenic factors leading insulin resistance leading to type 2 diabetes and decreased insulin, secretion which arise from abnormalities with in liver, skeletal muscle and pancreatic b -cells (charles & clark, 1996).

GESTATIONAL DIABETUS MELLITUS

:

Women who develop glucose intolerance in late pregnancy and womens who with previously undiagnosed diabetes.

SECONDARY DIABETUS MELLITUS:

Secondary diabetes is due to disease of the pancreatic and endocrime system, genetic disorders, or exposure to chemical agents.

Type I diabetes formerly known as insluin dependent diabetes mellitus (IDDM), is characterized by the destruction of the pancreatic beta cells that produces inslulin

Type I diabetes formerly known as insulin dependent diabetes(IDDM),is characterized by the destruction of pancreatic beta cells that produces insulin.Type-1 diabetes occures most often in children and young adults but it can occures at any age.(Anderson et al 2007).

Type-11 diabetes is not straight uprward. A pancreas that does not produce enough insulin. Liver that release too much glucose,muscle cells that do not readily take in glucose.(Carren 2008)

Many genetic factors are involved in the development of diabetes.Because of new genetic methodology researchers are closers to identifying all of the cadidate gene for both non insulin dependent and insulin dependent diabetes(Bernhard,1995).

Woman who had gestation diabetes are more likely to deve lop Type-11diabetes themselves.Pergnant women with diabetes are another disadvantaged group.They need much more intensive antenatal care and close monitoring of blood sugar,blood pressure and weight.(jawed2006)

Over weight children the progression of child obesity into adulthood is associated with early develop of complications, including IgpG2 diabetes and cardiovascular disease.Type diabetes is the most common clinical form of diabetes accountingforabout 90% of all cases,it is currently undergoing world wide epidemic. Type 11diabetes mellitus is caused by bodys infective use of insulin, it is often results from excess body weight and physical inactivity(WHO 2007).

PREVALACES& IINCIDENCE

:

Diabetes mellitus increases with aging, in 200 the prevalance of diabetes,it was estimated to be 0.19% people<20 years old and 8.6% in people>20 years old.There is considered geographic va riation in the incidence of both type-1 and type-11 diabetes mellitus.Scavandinvian has the highest incidence of type-1 diabetes mellitus e.g in Finland, the incidence is 35/100,000 per year the pacific rim has a much lower rate in japan and china the incidence is 1 to 3/100,00 per year of type-1 diabetes mellitus, Northern Europe and the United States share an intermediate rate (8to17/100,000 per year).The prevalence of type 11 diabeties mellitus is highest in certain pacific island, intermediate in countries such as India and the United States, and relatively low in Russia and China.This variability is likely due to genetic, beharioral and enviromental factors(Power 2005).Diabettes mellitus prevalance also arises among different ethic population within a given countries it is common inall ethnic groups its prevalance increased with age and more than 5% of individuals of more than 65 years of age have diabetes mellitus (David Owerback 1988).The World wide prevalence of diab etes mellitus has risen dramatically over past two decades.The prevalence of type11 diabettes mellitus is expected, type 11 diabetes mellitus is more prevalent among Hispanies Native Americas,African,American,and Asians, pacific Islanders than in non- Hispanic whites,the incidence is essentially equal in woman and men in all populations. Type 11 diabetes is becoming increasingly common because people are living longer,and the prevalence of diabetes increases with age it is also seen more frequently now than before in young people, in association with the rising prevalenceof childhood obesity although type11 diabetes still countries with the estimated nubers of cases of diabetes in 2000and 2030.

Rank Country

2000 Individuals country with diabetes (milloins)

Country

2030 Individuals with diabtes (Million)

India

31.7

India

79.47

China

20.8

China

42.3

USA

17.7

USA

30.3

Indonesia

8.4

Indonesia

21.3

Japan

6.8

Pakistan

13.9

Pakistan

5.2

Brazil

11.3

Russian federation

4.6

Bangladesh

11.1

Brazil

4.6

Japan

8.9

Italy

4.3

Philippines

7.8

Bangladesh

3.2

Egypt

6.7

(Wareham& FOROUHI 2OO6)

DRUG TREATMENT OF DIABETIES MELLITUS

:

Biguanides lower blood glucose, they increase glucose uptake and utilize in skeletal muscle there by reducing insulin resistance, and reduce hepatic glucose production (gluconeogenesis).Lower blood glucose, addionally reduces low denisity and very low denisity lipoproteins (LDL and VLDL) respectively. Metformin has a half life of about 3 hours and is excreted unchanged in the urine.Clinically metformin used in type 2 diabetic who are obese and who fail treatment with diet alone.Adverse effects are produced dose related gastrointestinal disturbances e.g anorexia,diarrhoea,nausea,lactic acidosis rare but potentially fatal toxic effect.(Dale,2003).

Improving insulin sensitivity by activating certain genes involved in fat synthesis and carbohydrate metabolism Rosigilitazone and Piogiltazone are currently approved.Thiazolidinediones. Thiazolidinediones do not cause hypoglycemia when used alone,although they are usually taken in combination with sulfonylurease.

In some incouraging studies, thaiazolidiniones have produced very favorable effects on the heart, including reducing blood pressure and improving triglycerides and cholestrol levels including increasing HDL level,the good cholestrol. They may also block a molecule called 11 Best HSK that may play a significant role in metabolic syndrome,as well as diabetes type11. One study also sugessted that Rosiglitazone may even improve beta cells functions and so help prevent progression of diabetes.Anemia, weight gain, increased risk of fluid buildup, may worson heart failure.Troglitazone,was withdrawn after a few reports of heart failure.Liver failure abd deat h.Current Thiazoldinediones don not appear to pose the same effects on the liver although there have been a few reports of liver injury.

In patients with dietry failur the choice of a sulfonylurea agent or insulin therapy has been controversial and empric in favour of insulin therapy are the studies, who reported marked improvement post receptor diagnostic after intensive short term therapy in untreated type 2 diabetes mellitus (Scarlett et al,1984) Sulfonylureas further classified into two groups or generations based on their potency,duration,drug interaction,side effects profiles. Sulfonylureas enhance insulin action in cells in culture and stimulate the synthesis of glucose transporters (Jacobes et al 1998).A sulfonylurea drug should normally be the insulin secretagogue of choice, NICE (National Institute for Clinical Excellence) also recommends that a generic ,drug should be perscribed (Scsade et al1998).

RESEARCH DESIGN AND MATERIAL AND METHODS:

This study was conducted in the deprtment of Pharmacololgy and Therapeutics,Basic Medical Science Institute,Jinnah,Postgraduate Medical Centre,karachi under kind supervision od DRr:GhulamRsool Mashori,Associate Professoer and Head OF Department Of Pharmacology and Therapeutics in colloboration with Medical Outpatient Department Unit111 and Filter Clinic, Medical Department, JPMC,Karachi.

Seventy NIDDM (type-II)diabetic patients were initially enrolled in the study from the filter clinic/ out patient department Medical Unit III ,and diabetic clinic.Out of this 60 diabetic patients were associated in whole period of study, remaining 10 patients were dropped due to poor comlpiance or change in residential place.All the patients were divided in two main groups,groupI and in group II these patients were selected in this study according of inclusion and exclusion criteria.

I NCLUSION CRITERIA

:

Newly diagnose patients of non Insulin Dependent Diabtes Mellitus.


Diagnsed patients of diabetes also including having no any history medication.


Having either sex of age between 30 to 60 years.


Diagnosed patients who were Non Insulin Depedent Diabetes Mellitus who were treated with Pioglitazone.


Diagnosed patients who were Non Imsulin Depedent Mellitus, who were treated with drug Glibenclamide.

EXCLUSION CRIRERIA

:

Patients suffering from blood pressure.


Patients suffering from liver disease.


Patients suffering from cardiac disease.


Pregnancies and lactating women.


Patient suffering from renal disorders.


Patients having serious complications.

MATERIAL:

Lacets.


Lancet Hlder(Abbots easy touch TM2 lot 03 Asee).


Glucometer(Medisense) optilim one touch(Abbotts).


Blood glucose nest trpis (IVD for Invitro diagnostic use (Abbott Labortries,Medisense UK Ltd,Abigngdon,Ox14ITR,Masde in UK). Stored between minimum 30?, (4-30 C) and Maximum 40C (39-86F).


Weight Machine Model No 1101 Lot No.312. TANTIATA.

DRUGS

Tab:Daonil 5 mg (Aventis Pharma)

Drug category:Sulphonylurea.

Generic Name: Glibenclamide.

MFGLIC:No.000007 RegistrationNO.000220

MFG Date:0-06

EXP Date:7-10

Lot NO:B230

Tab:piozer (Hilton Pharm) PvtLTd.

Tab:Poizer 15mg

Drug category: Thaiazolinedione.

Generic Name:Pioglitazone Hydrochloride.

MFG LIC: O.000136 Registration No.03270

MFG Date:3-06

EXP Date:3-o9

Lot No:6287

Tab: Poizer (Hilton Pharma)pvt ltd.

PARAMETERS:

Fasting Blood Sugar (FBS).

Random Blood Sugar (RBS).

Weight.

Key words:Diabetes mellitus,Non-insulin diabetes mellitus,Insulin depedent diabetes mellitus, Daonil,poizer,Insulin.

RESULTS:

Table 1

Weight and Blood Sugar level observed on baseline day 0

In group1 and group11

Group 1

Group 11

Pioglitazone n=27

Glibenclamide n=33

Weight

63.37

+ 2.25

62.7

+ 15.56

Fasting Blood Sugar

172.7

+ 13.32

188.42

+ 12.o5

Random Blood Sugar

285.11

+ 15 .532

284.18

+ 17.07

All Values are expressed in Means SEM.

FIGURE-1 weight and blood sugar levels observed on baseline (day-o)

In table No shpwing the weight (KGS) and blood sugar (msg/dl0 levels which is observed on baseline (day-0) in both groups 9group: 1 & group11)

Group: 1 Weight in (Kgs) mean + SEM) IS 63.372.25 Fasting blood sugar 172.713.32,and Random

blood sugar 285.1115.32

Group:11

Weight (KGs0 (mean +SEM)62.71.56 Fasting blood sugar (mg/dl0 188.4212.05, Random blood sugar is 284.1817.03.

Figure 2: showing the weight and blood sugar levels observed in base line (day-0) in group: 1 and group 11 weight in 9kgs) its mean values are 63.37,62.7, Fasting blood sugar in (mg/dl) is 172.71, 188.42 Random blood sugar (mg/dl) is 285.11 &284.18.

TABLE: 2

Peroidic Observation In All Parameters Group1

Goup1(Pioglitazon) n=27

P-value

Day-0

Day-45

Day-90

Day-0to45

Day-45-90

Weight

63.37

2.25

63.63

2.26

63.63

2.23

>0.05

(NS)

>0.05

(NS)

Fasting blood sugar

172.7

13.32

165.04

8.98

153.37

7.59

>0.05

(NS)

0.05

(NS)

Randomblood sugar

285.11

15.32

279.78

13.63

255.56

12.65

>0.05

(NS)

>0.05

(NS)

All values are expressed in MeanSEM .(NS) Non significant.

TABLE NO:2

Showing the periodic observations in all parameters in group 1 (piogiltazone) (n+27) weight P.value (day 0 to day 45)>0.05 (NS). Fasting blood sugar >0.05 (NS) Random blood sugar >0.05 (NS) P.values day 90 weight >0.05 (N.S), FBS>0.05 (N.S) 7RBS >0.05(N.S) NON SIGNIFICANT

FIGURE:2 Showing the periodic observation in all parameters in group 1 on day0 day 45& day-90.Mean values in weight (Kg) is 63.37,63.26,63.63, fbs (mg/dl) 172.7,165.04,153.37,RBS(mg/dl) 285.11,279.78,255.56.

TABLE NO3

Peroidic Observation in All P arameters Group11

Group 11 (Glibenclamide)

N=33

P-value

Day-0

Day-45

Day-90

Day-0 to 45

Day-45 to 90

Weight

62.7

1.56

65.64

2.10

64.55

1.92

>0.05(NS)

0.05(NS0

Fasting blood sugar

188.42

12.05

168.45

10.99

140.06

5.68

>0.05(NS)

>0.05(S)

Random blood sugar

284.18

17.03

220.12

13.39

170.94

5.80

<0.005 (MS)

0.002(MS0

(s) significant, (MS) moderate significant

All values are expressed in MeanSEM.

Table No3:

Showing the periodic observation in all parameter in goup:11, Group:11 containing drug (Glibenclamide),no of patients (n=33).Its P-value on day 0 to day 45 on weight >0.05(NS),FBS>0.05(N.S) RBS<0.005 (MS) <0.01- AND DAY 45 TO DAY 90 WEIGHT >0.05 (NS) FBS (0.05) RBS <0.002(M.S0 moderately significant.

Figure 3:Shwing the periodic observations in all parameters in Group 11 weight 62.7,65.64,64.55,FBS (MG/DL) 188.42,168.45 140.06,RBS(mg/dl) 284.18 220.12, 170.94 (on day-0-day 45 to 90).

DISCUSSION:

In Denmark Beck-Nielsenet al,skillman TG (1981) published studies demonstation that glyburide increased he number of receptors on the monocytes of patients with type 11 diabetes mellitus. Some patients were treated with diet and in cobination of second generation sulfonyureas agents Wie. The numbers of insulin receptors all patients were measured before and after the treatment.Intrvenous glucose test shows the persistent impairent of insulin secretion afterthe starting of drug therapy.However those patient who were on drug Pioglitazone some results were obtained of insulin secretion in the impairment in early drug drug therapy.Clinical observations have suggested that the secon d generation sulfonylureas may exert their effects by potentiating insulin released by other primary stimulators Insulin secreting drug.

According to the study of WilliamC Dukworth et al(1972), aftr the chronic treatment with sulfonylureas it is well documented that plasma insulin levels were decreased in response to oral glucose load. This apparently occures even though glucose tolerance is improved over pre-treatment, levels,present study clearly support that study.

The result og group 11 correlates with the research conducted by Bonnie &Kimmel (2005) produces the same results as FBS reduces from baseline, and at the end of study,with an overall 23.44%,reduction,while with the results showed at the end of study peroid p-value were (p<0,001).

Similarly Michael Alvarsson et al (2003) conducted a similar type of study and the found and overall changes of change of 22.11% in Fbs and 40.88% in Rbs at the end of trial p-value were (p <0.001).

However a study conducted by (Stone &Brown in (2003) didnot match to our results in the parameter of FBS and observer a reduction of 26.22%.

CONCLUSION:

In the light of study discussion it is obiovus the glibenclamide was more effective,tolerable and safer than pioglitzone in a short duration.Diabetes Mellitus is chronic prolong disease for whole life.Poor community can afford it easily,on base of marketing of this drug in pakistan diabetes patients easily go and purchase economically,in fact ,mostly people buy it from pharmacy without drs perscription,because pharmacist and patient both of know about this disease.Just like dispirin as analgesic,it is famous anti-diabetic drug in our states as compared of other anti-diabetic drugs.

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