Galih Gumelar Helath & Therapy - The body has a very good mechanism to notify us if there is an abnormality. It is important to know the symptoms of type 2 diabetes mellitus at an early stage because the earlier the treatment is going to get better results and the less likely the occurrence of complications. Here are some signs - signs / symptoms of diabetes - diabetes we should be cautious.

* Unusual tiredness
The patient will feel weak even though his body was not doing any activities that are not too heavy. So, if you always feel tired and sleepy even before you do not stay up, it helps you see a doctor immediately.
* Losing weight drastically.
If you eat too much food your body will become fat. Excess fat in the body will cause the body to insulin resistance increases. In people who have diabetes, although he ate his food in excess is not to be fat and even take care of it because the muscles are not getting enough energy to grow.
* Disturbance of vision.
High sugar levels in the blood will draw out the liquid in the cell, this will cause the cells become wrinkled. This situation also occurs in the eye lens, so the lens becomes damaged and the patient will experience vision problems. This vision problems would improve if diabetes mellitus successfully handled properly. If not handled, these vision problems can worsen and cause blindness.
* Often when wounds become infected and very difficult to heal.
This situation can occur because the bacteria thrive because of high levels of sugar in the blood. In addition, mushrooms are also really enjoyed growing up in high blood levels glukosanya.

Thus some of the main symptoms that you notice on diabetes - diabetes. Signs - another sign that can be observed among others:

* Frequent urination. Usually waking at night to urinate.
* Itching - itching excessive. This itching usually occurs in About a genitals.
* Easy to hungry and thirsty beyond the habit
* Often good tingling in the feet or other parts
* Lust sex decreases (Melepasmu ...)
* Easy sleepy. This is basically a part of the fatigue.
* For pregnant women may be indicated with the baby weight more than 4 kg.

If you have diabetes and your offspring showed symptoms - even mild symptoms. Immediately take action to do a lot of exercise and consume alternative herbal medicine that has no side effects.

Pengobatan Ustadz Galih Gumelar - Sebagai penyakit serebrovaskuler (pembuluh darah otak), stroke ditandai dengan kematian jaringan otak (infark serebr

Galih Gumelar Health& Therapi - As serebrovaskuler disease (blood vessels of the brain), stroke is marked by the death of brain tissue (cerebral infarction) occur because of reduced blood flow and oxygen to the brain with various risk factors.

Have two types of stroke; ischemic stroke, blood flow to the brain stops because atherosclerosis (cholesterol buildup in blood vessel walls) or a blood clot that has clogged the blood vessels to the brain. In hemorragik stroke, broken blood vessels that block normal blood flow and blood seeped into an area in the brain and damage it.

Because a stroke can be about any part of the brain, the symptoms were diverse, ranging from mild to severe and even some who until death.

Mild form of stroke known as brain attack first glance (Transient ischemic Attack / TIA). Symptoms sometimes just a sense of weakness on one side of the face, or perhaps a sense of tingling in the arms or legs. Some are complaining about noise from the function of speech.

Mild stroke symptoms will usually return to normal in a quick time, less than an hour. Symptoms of a more severe stroke will generally lead to a more typical symptoms, like paralysis.

In general, symptoms of stroke include:
1. Weakness or paralysis of limbs that are supplied
2. Difficulty swallowing
3. Difficulty speaking
4. Disturbance hold urine
5. Loss of consciousness
6. Headache

Some conditions are at risk for stroke

1. Several different factors increase the risk of stroke, including: high blood pressure (hypertension) which are not controlled. This damage artery walls.
2. Diet. High dietary salt content is associated with high blood pressure, while the diet of many fatty and sweet foods is associated with coarsening the surface and narrowing the arteries.
3. Onset diabetes (Diabetes). Those who have diabetes menghidap more likely to experience high blood pressure and atherosclerosis, and by the greater risk of experiencing a stroke.
4. Atrial fibrillation. Type degupan irregular heart was raising the risk of blood clot formation in the heart, which then may be left behind and taken the blood flow to the brain.
5. Smoking. This has a negative effect on the arteries and causes blood pressure higher.
6. Alcohol drinking, drinking habits, alcohol will boost blood pressure and may cause blood vessels in the brain burst.

Red Onion and Adventurous Fiber Foods - To Lower Blood Sugar levels

Galih Gumelar Health & Therapi - DIABETES mellitus (DM) is often called the laity "diabetes", is a disorder that has the characteristics of high blood sugar levels. With diabetes means "flowed on" because the sufferer is always drinking and in large quantities, then keep the form of urine flow urine alias. While mellitus means "sweet", because urine contains glucose, aka sufferer's blood sugar that taste sweet.

IN essence, Council of Ministers due to the hormone insulin that people with inadequate or ineffective, so can not work normally. In fact, the normal person, insulin has a major role regulate blood sugar levels; approximately 60-120 mg / dl in the fasting state, and below 140 mg / dl at two hours after eating.

There are two categories of the most common DM, ie diabetes type 1 and type 2 diabetes. Diabetes type 1, DM diidap by 5-10 percent of patients, usually occurs in children or young adults. While type 2 diabetes, DM diidap by 90-95 per cent of all people with diabetes, increase in number, especially in minority populations.

Diabetes is found in all populations and age groups, but the increase in the number of patients in the elderly group (elderly) and people were black, Hispanic, Native American, and Asian people.

The Congressionally-Established Diabetes Research Working Group (1999) reported that although deaths due to diseases of cancer, stroke, and cardiovascular disease tend to decrease since 1988, mortality due to diabetes increased by about 30 percent. The average life expectancy of people with diabetes on average 15 years shorter than those who did not suffer.

In Indonesia, especially in the urban community, diabetes, a disease classified as prominent today.

Waspadji research in 1982 found that 1.7 percent of patients have diabetes in Jakarta, and in 1992 climbed to 5.7 percent. Epidemiological studies in Depok in 2001, cooperation Perkeni (Association endocrinologist Indonesia) and the Ministry of Health, the number of people with diabetes have 6.2 percent. (Kompas, 5 November 2001). Most diabetes cases found in Indonesia in Manado which reached 6.1 percent. (Kompas, May 29, 2002).

Based on 1998 WHO records, the number of diabetics in Indonesia ranked the 6th largest in the world after India, China, Russia, Japan, and Brazil. The number of diabetics in Indonesia is expected to increase to 12 million people in the year 2025. The increase of 250 percent of 5 million people in 1995 took place with increasing elderly population and changing life styles, ranging from the types of food consumed to reduced physical activity.

Over the centuries, more than 400 plants successfully identified as a "drug" diabetes. In Europe, Asia, and the Middle East, raw onion has long become a favorite choice of food to control blood sugar. In Puerto Rico, Cuba, and Santo Domingo, pariah been widely used as a "medicine" for traditional diabetes.

Recent studies show that consumption of foods high in fiber, particularly soluble fiber, may improve control of blood sugar in type 2 diabetes. The study was conducted by Dr. Manisha Chandalia and colleagues from Medicine Section and the Center for Human Nutrition, University of Texas Southwestern Medical Center, Dallas, United States.

Efficacy of tolbutamide in the red onion

Shallots have long occupied an honored place in medicine as "medicine" of diabetes. Modern research shows, red onions have a "power" lowering blood sugar, and power have on levels found in food.

Indian researchers who make gifts of red onion, both in the form of onion juice and "round" alias is still intact, for 25-200 grams of the subjects studied, found that more and more onion given, the greater the blood sugar decreases. There was no difference between raw red onion and red onion that has been boiled.

According to the theory of the research team, red onion affect sugar metabolism in the liver, or the release of insulin metabolism, and / or prevent the destruction of insulin. "Agent" who may have the ability of hypoglycemia, lower blood sugar levels, it is active allyl propyl disulfide and allicin. Experimental and clinical evidence suggests that allyl propyl disulfide lower blood sugar by increasing the "lifetime" (lifespan) of insulin.

In fact, already since the year 1923 scientists detect the presence of depressor blood sugar in the onion, and in the 1960s, researchers managed to isolate compounds of onion antidiabetes which works similarly to the general antidiabetes pharmaceutical drugs, known as tolbutamide, which is often used to reduces blood sugar levels. How it works is that tolbutamide stimulates insulin synthesis and expenses. In guinea pigs, onion extract showed, 77 percent as effective as standard dose of tolbutamide.

Other research results show, red onion have the effect of lowering blood sugar and fat. Therefore, it is recommended to add the red onion into every meal. Shallots can be used after a meal in the amount of free.

Soluble fiber in natural foods

High levels of blood sugar is a major problem in diabetes. Research shows that the fiber has a strong effect on blood sugar control.

In the study conducted Chandalia et al, 13 with type 2 diabetes were asked to follow two diets, each for six weeks. The first diet is a diet that contains moderate amounts of fiber (total fiber, 24 g; 8 g fiber, 16 g of soluble and insoluble fiber), as recommended American Diabetes Association. Meanwhile, the second diet is high fiber diet (50 g total fiber, each 25 g fiber, soluble and insoluble fiber) containing the full composition of natural food fiber.

Both diets, prepared in the kitchen of research, containing macro nutrients and energy are the same (see Table). Chandalia et al then compared the effects of these two diets to control blood sugar and blood fat levels.

The result? Patient-diabetics who consume 50 g total fiber per day, equal to 7 to 8 servings of fruits and vegetables, high fiber diet aliases have blood sugar levels lower and more stable than-diabetic patients who consumed moderate fiber diet. High-fiber diet also lowered blood total cholesterol level of about 7 percent.

How precise mechanisms high-fiber diet can improve blood sugar control, is not clear. However, it is thought to be caused by a type of soluble fiber gum and pectin that can slow gastric emptying, and even slow down or reduce the absorption of blood sugar.

Chandalia et al study also showed that the intake (intake) high soluble fiber may be achieved by eating natural foods which are full of fiber. High-fiber diet and little side effects were well received by the patient. Therefore, to increase consumption of fiber, the people with diabetes are encouraged to eat natural foods full of fiber compared with fiber preparations or supplements.

Laden foods fiber used for high-fiber diet in the study Chandalia and friends is a dish of fruit cocktail, fresh oranges, fresh pineapple, fresh papaya, peaches (peaches) fresh cherries, fresh tomatoes, corn, zucchini, green beans, whole-wheat bread, and oatmeal (oatmeal and oat bran). Fruit, especially citrus and pineapple, green beans, and oatmeal is a source of soluble fiber is good.

Stroke Risk Level in Patients with Hypertension

The influence of hypertension on Organs

Galih Gumelar Helath & Therapi - Hypertension can cause damage to various target organs such as brain, heart, kidney, aorta, perifir blood vessels, and retina. Some are cross-sectional studies show that the target organ damage more closely associated with blood pressure measured during ambulatory 24-hour or Blood Preasure (ABP) than blood pressure while in the clinic.

In normal people, blood pressure followed the circadian pattern, which decreased blood pressure at night and has increased in the morning. Similarly, the majority of hypertension, which also follows the normal circadian pattern (dippers). However, hypertension in non-dippers did not decrease blood pressure at night. Incidence of cardiovascular disease and stroke occur more frequently in people with hypertension non-dippers than dippers hypertension. Target organ damage more closely related to severe patients with high blood pressure at night (non-dippers) than patients with blood pressure normally decreases at night (dippers) 7. For example, studies of Verdecchia and colleagues in a prospective cohort terhadap1100 hypertension, reported mortality rates average higher, both in non-dippers and reverse dippers Dipper instead. Yamamoto research results prove that high blood pressure on ambulatory measurement (ABP), particularly high blood pressure at night and a decrease in blood pressure is less at night, will cause adverse effects (increasing the extent of the lesion) in the quiet of ischemic lesions (silent ischemic lesions), and stroke in patients with symptomatic myocardial lakuner9.

In the meantime, the results of Chaturvedi and colleagues proved that ischemic stroke is more common in the morning (between 06.00 to 12.00). According to Chaturvedi, there are some acceptable explanation why the ischemic stroke occurred in the morning:

Circadian pattern of blood pressure. The pattern of blood pressure rise in the morning (the highest increase occurred in the mid-morning until noon). Increased blood pressure causes increased intraplaque hemorrhage, which will aggravate the stenosis of blood vessels having atherosclerosis.
Increased platelet aggregation occurred in the morning.
Blood viscosity peak in the morning.
TPA activity (endogenous tissue plasminogen activator) is very low in the morning. This will change the balance between thrombosis and fibrinolysis that thrombosis become more dominant.
Role of Hypertension in Stroke Pathogenesis

Normal people have a system of autoregulation of cerebral arteries. If the systemic blood pressure increases, cerebral vessels become vasospasme (voasokonstriksi). Conversely, when the systemic blood pressure decreases, the cerebral vessels will be vasodilatation. Thus, blood flow to the brain remains constant. Despite a decline in systemic blood pressure by 50 mmHg, autoregulation of cerebral arteries is still able to maintain blood flow to the brain remained normal. Limits on systemic blood pressure which can still be addressed by autoregulation was 200 mm Hg for systolic and 110-120 mm Hg for diastolic pressure.

When systemic blood pressure increases, cerebral vessels to constrict. Depending on the degree of constriction of the blood pressure increase. If the blood pressure rise high enough for months or years, will cause the muscle layer hialinisasi on cerebral vessels. As a result, the lumen diameter of blood vessels will become permanent. This is dangerous because of cerebral vessels can not constrict dilated or freely to cope with fluctuations of systemic blood pressure. When a decline in systemic blood pressure perfusion pressure to the brain tissue is not adequate. This will result in cerebral ischemia. Conversely, when there is an increase in systemic blood pressure perfusion pressure in the capillary walls are high. As a result, there hiperemia, edema, and possible bleeding on otak13.

In chronic hypertension can occur mikroaneurisma in diameter and 1 mm. Is known as Mikroaneurisma aneurysm of Charcot-Bouchard and mainly occurs in arteria lentikulostriata. On systemic blood pressure spikes, as people angry or pushing, aneurysms can rupture. Chronic hypertension is one of the causes of endothelial dysfunction of blood vessels.

In normal circumstances, endothelial show dualistic function. These properties simultaneously express and release vasoconstrictor substances (angiotensin II, endotelin-I, thromboxane A-2, and superoxide radicals) and vasodilator (prostaglandin and nitric oxide). These factors cause and prevent cell proliferation of smooth muscle cells of blood vessels in a balanced way. The balance between these antagonistic systems in an optimal control function of blood vessel walls. As a result of endothelial dysfunction, vasoconstriction occurs, the cell proliferation of smooth muscle cells of blood vessels, platelet aggregation, adhesion lekosit, and increased permeability to macromolecules, such as lipoprotein, fibrinogen, and imunoglobulin14. This condition will accelerate the occurrence of atherosclerosis. Atherosclerosis is an important role for the occurrence of myocardial stroke.

Blood pressure reduction in Stroke Prevention In Primary and Secondary

Primary stroke prevention is intended for individuals at high risk for stroke, namely by controlling the risk factors of stroke. Risk factors of stroke can be treated or controlled and is proven to reduce the occurrence of stroke is well-hypertension, smoking, diabetes, carotid artery stenosis are asymptomatic, Sickle cell disease, hyperlipidemia, and arterial fibrillation. Other risk factors that could potentially be controlled is obesity, less physical activity, alcohol, hiperhomosisteinemia, drug abuse (cocaine, amphetamines, and heroin), nutrition (diet less vegetables and fruits), oral contraceptives, hiperkoagulabilitas, chronic infections Chalmydia pneumoniae, and hormon15 replacement therapy.

Klugel and colleagues reported that uncontrolled hypertension is present in 78% cases of ischemic stroke and 85% in cases of stroke hemoragik16. Uncontrolled hypertension is very strong relation with stroke akut17. Overviews of a prospective randomized 14 shows that the decrease in blood pressure 5 mm Hg to 6 mm Hg can reduce the occurrence of stroke 42% 18. The research results Systolic Hypertension in the Eldery Program (Shep) shows the incidence of stroke decreased 36% with antihypertensive treatment (klortahalidon or atenolol) in elderly patients with isolated systolic hypertension (isolated systolic hypertension) 19. The risk of stroke will increase two times each 7.5 mmHg increase in diastolic pressure. Antihypertensives may lower the risk of stroke 38% 20.

The results of meta-analysis conducted by Gueyffier showed that lowering blood pressure with antihypertensive drugs can reduce the risk of stroke ulang21. While the research results from POGRESS (perindopril Against recurrent Protection Study) showed that treatment with perindopril in stroke patients with hypertension can significantly reduce the occurrence of re sroke (risk reduction = 28%, 95% Cl = 17% to 38%, P <0.0001)> 20-25% of the blood pressure on average. Indications of hypertension therapy in acute stroke:

If the diastolic blood pressure> 140 mmHg on two readings 5-minute intervals, give the IV natriun nitroprusid (very emergency).
If the systolic blood pressure> 230 mmHg and or diastolic blood pressure of l21-140 mm Hg on two readings 20 minutes intervals, giving 20 mg iv labetolol for 1-2 minutes. Labetolol dose may be repeated every 10-20 minutes until a satisfactory reduction in blood. After the initial dose, given every labetolol be 6-8 hours if necessary (emergency).
If the systolic blood pressure 180-230 mmHg or diastolic blood pressure 105-120 mmHg, emergency therapy should be postponed without any evidence of intracerebral hemorrhage or heart failure the left ventricle. If the blood pressure stayed at two times the measurement interval of 60 minutes, then 200-300 mg given 2-3 times daily labetolol. Labetolol alternative treatment is nifedipin oral 10 mg every 6 hours or captopril 6,25-12,5 mg every 8 hours (urgency).
Systolic pressure <180>

Blood pressure in the acute phase should not be lowered more than 20%. Decrease blood tekananan average no more than 25% and arterial blood pressure on average.

If the systolic blood pressure over 230 mmHg or diastolic pressure over 140 mmHg on two measurements of blood pressure hoses 5 minutes, give sodium nitroprusid or nitroglycerin drip.
When the systolic pressure 180-230 mmHg or diastolic pressure of 105-140 mmHg, or arterial blood pressure an average of 130 mmHg on two measurements of blood pressure hoses 20 minutes, give injections or enalapril labetolol.
When the systolic pressure less than 180 mm Hg and diastolic blood pressure less than 105 mmHg, antihypertensive drug treatment delayed.

Hypertension drugs given to stroke patients is a drug that does not affect cerebral blood flow. Dyker and colleagues reported that administration of perindopril effectively lower blood pressure without disturbing the brain's blood flow in patients with ischemic stroke akut31. Meanwhile, Walter and his colleagues reported that administration of perindopril in patients with ischemic stroke who are not acute, with stenosis or occlusion of moderate to severe carotid artery intema, decrease blood pressure without a decrease in cerebral blood flow.