Monitoring blood glucose levels at home is part of the diabetes treatment that is advocated by physicians all over the world today in addition to the diabetes diet. Most physicians recommend that patients acquire a blood glucose monitor or a glucose meter and learn how to take a glucose test and glucose reading on a daily basis.

However, physicians caution that the accuracy of the glucose reading taken at home depends on the capabilities of the glucose meter and the way the glucose test is taken. So it is very important that the person using the blood glucose monitor reads the manual supplied with the glucose meter and follows the instructions faithfully. The test must be performed using the proper techniques and the meter should be properly calibrated.

Home glucose meters are considered to be accurate if their reading falls within a 20% + or ? variance to the Lab analyzed blood sample. This is because the Lab tests are done on the plasma extracts of the blood sample and home glucose tests are done on whole blood samples. However, modern blood glucose monitors take care of the variance and calibrate their glucose reading to match with Lab readings up to 5% level of accuracy.

If the glucose readings are significantly low, look for signs of hypoglycemia or abnormal low level of sugar in the blood. The symptoms include lethargy, confusion, inattention, shakiness or coordination problems. Immediately give the patient something sweet to eat like honey. This is emergency diabetic treatment. Later check on the diabetes diet prescribed by the physician and discuss with him on what has gone wrong in the diabetes treatment.

If none of these problems of hypoglycemia are evident, then the test procedure may need to be checked for accuracy:-

• Check if the sample was large enough to cover the strip’s test area completely.
• Check whether the strip has been handled and stored as instructed.

Some strips are sensitive in the sampling area and should not be touched while handling. The strips should be taken out from the box and the foil only a few seconds before using. If the strips are to be taken in a car, all effort should be made to ensure that they are not exposed to high temperatures or humidity. Check the expiry date on the strip. Use the strip with the prescribed meter only and ensure that the code from the strip container matches the number coded into the machine.

You could get incorrect readings for the following reasons:-

• The glucose meter is dirty
• The meter had been dropped on the floor or from a height and damaged.
• The glucose meter is stored in high temperature conditions.
• The solutions that come with the blood glucose monitor could have expired.

Despite all precautions and faithful adherence to the instructions contained in the manual, if your meter continues to give you an erroneous reading, call the manufacturer.

Monitoring blood glucose levels at home is not very difficult but it must be remembered that glucose meters become less reliable over time and must be checked thoroughly before use. The new models of blood glucose monitors are easier to use and more foolproof. The test strips require only a small drop of blood and are corrected to plasma values. The results are easier to understand and compare with the results from the lab. Built-in memory for storing results and faster test times make these meters very attractive.

Patients using glucose meters to record the glucose reading as part of their daily diabetes management should learn how to maintain the results of the tests and how to record them:-

• Glucose test and glucose readings must be set down on paper along with the time and date and details of the dose of medication taken.
• Details of food intake, exercise and difficulties with the illness should also be recorded.
• Stress should also be recorded whenever applicable.

This method helps the health care professional identify daily patterns and make necessary medication adjustments to the diabetes treatment and diabetes diet.

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Gymnema Sylvestre
Gymnema is a plant used medicinally in India and Southeast Asia for treatment of “sweet urine” or what we refer to in the West as diabetes or hyperglycemia. In ancient Indian texts, gymnema is referred to as gurmar, which means “sugar killer” in Sanskrit. Gymnema leaves, whether extracted or infused into a tea, suppress glucose absorption and reduce the sensation of sweetness in foods – effects which may deliver important health benefits for individuals who want to reduce blood sugar levels or body weight.
The botanical name of Gymnema is Gymnema Sylvestre. It is also known as Gurmar, Gurmabooti, Ram’s Horn, Periploca of the woods and Meshasringi.
It is known as Periploca of the woods in English and Meshasringi – meaning ram’s horn – in Sanskrit. The leaves, when chewed, effectively block sweet tastes in the mouth which explains the Hindi name Gurmar meaning “sugar destroyer”.
A member of the milkweed family Gymnema Sylvestre is a woody climbing plant that grows in the tropical forests of central and southern India, Deccan peninsula, Assam, and some parts of Africa whose leaves are used in herbal medicine preparations.

History
Indian physicians first used Gymnema to treat diabetes almost 2,000 years ago. The primary application was for adult-onset diabetes, a condition for a condition once described as “honey urine and is continued to be recommended today in India. The leaves were also used for stomach ailments, constipation, water retention, and liver disease.
In the 1920s, preliminary scientific studies found some evidence that Gymnema leaves can reduce blood sugar levels, but nothing much came of this observation for decades. Today, Gymnema has become increasingly popular in the United States as a supportive treatment for diabetes.
Active constituents:
Plant constituents include two resins (one soluble in alcohol), gymnemic acids, tartaric acid, gurmarin, calcium oxalate, glucose, saponins, stigmasterol, quercitol, and the amino acid derivatives betaine, choline and trimethylamine. Gymnema Sylvestre is a stomachic, diuretic, refrigerant, astringent, and tonic. It has been found to increase urine output and reduce hyperglycemia in both animal and human studies.

Usage Gymnema sylvestre
Blood Sugar
The main focus of gymnema research is blood sugar regulation and glucose metabolism. It has been used in India for treatment of diabetes for about 2000 years. Today in India it is being used to treat primarily type II diabetes and type I as well. The herb has shown to reduce blood sugar, glycosylated haemoglobin and glycosylated plasma proteins when used for 18-20 months [1]. The effect is gradual rather than immediate with conventional drugs. The active components responsible for lowering glucose are the gymnemic acids.

Weight Loss
Gymnema could also reduce and alter the taste of sugar, and it does just that. By placing the herb on your tongue or drinking the tea, the perception of sugar or aspartame is reduced or eliminated completely. That may come in handy if you want to deter a binge on chocolate cheesecake. Some articles state that this is not true so I tried it myself by breaking open a capsule and placing a small amount in my mouth. It did indeed eliminate the perception of sugar. The effect lasted for about 15 minutes as I sampled other foods and drinks. Sweet Relief gum is available which contains gymnema.

Unproven Uses
Gymnema has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially serious and even life-threatening. You should consult a health care provider before using Gymnema for any unproven use.

>> Aphrodisiac
>> Cardiovascular disease
>> Cholesterol reduction
>> Constipation
>> Cough
>> Digestive stimulant
>> Diuretic
>> Gout
>> High blood pressure Laxative
>> Liver disease
>> Liver protection
>> Malaria
>> Obesity
>> Rheumatic arthritis
>> Snakebite antidote
>> Stomach disorders
>> Uterine stimulant

General Interaction
Gymnema may alter the dosage needed for other drugs commonly used to treat diabetes, including glipizide, metformin, and insulin resulting in hypoglycemia.

Cautions
Gymnema has safely been used for decades in various countries. Careful long-term studies on its safety have not been done so far, however.
Consult your doctor about your desire to supplement your diabetes regimen with Gymnema.

Ailments Dosage

Diabetes: 150 mg twice a day
Warnings: Gymnema should not be taken in place of insulin. It could potentially lower blood sugar too much, resulting in a hypoglycemic reaction. If you have been diagnosed with diabetes and wish to use Gymnema consult your physician first. It should not be used as a substitute, only a supplement to your current therapy.

Allergies
People allergic to plants in the Asclepiadaceae (milkweed) family should avoid Gymnema.
Side Effects: Gymnema may lower blood sugar levels. Caution is advised if you are also taking prescription drugs that may lower blood sugar levels. Patients taking oral drugs for diabetes or using insulin should be monitored closely by their health care provider while using Gymnema. Dosing adjustments may be necessary. Gymnema may alter the ability to taste sweet foods.
Pregnancy and Breast-Feeding: Gymnema cannot be recommended during pregnancy or breast-feeding because of a lack of information on safety and effectiveness.
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Herbs and Nutrition Supplement Research