Herbal therapy in DM
Many medicinal herbs to lower blood sugar levels, if the note is the taste bitter herbs. Among them:
A. Leaf Cats Whisker
2. Tread leaves Dara
3. brotowali
4. Mahogany seeds
5. Pare the fruit
6. Noni fruit
Pare the fruit to the processing means is made ​​cuisine, taste the bitterness should not be removed. Noni fruit commonly eaten directly or blackmailed made ​​drinks / juice, mixed with honey or other flavorings to eliminate the smell that smell. For the other ingredients generally each boiled with water about 3 cups water to boiling and the amount was reduced to 1 cup, then drink the water.
We recommend that even if traditional medicine is safe and he said no side effects, it is advisable not to overdo it and not all served at once.

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There is concern that a person with Diabetes Mellitus (DM) not be the same foods "good", because these foods can make the patient more chronic conditions. Apparently all revelation is not always true. Diabetes does not mean anti against any kind of food.

According to Dr. Endang Darmoutomo MS, a clinical nutritionists in the seminar entitled "Diabetes, Do So Now!" Siloam hospital, some time ago, although a person suffering from a disease known as "blood sugar" is, yet they continue to consume these foods.

"Because the disease is characterized by increased sugar in the blood, then you need to do is to control blood sugar itself. It is very important to prevent complications caused by increased blood sugar that can lead to decreased quality of life, "he said.

He explained that "good food" can still be consumed as long as there is a balance of nutrition in it. In a sense it must contain carbohydrate foods as much as 50 to 65 percent, 15-20 percent protein and fat between 25-30. That's not the food consumed should also contain fiber, vitamins and minerals.
"In addition, the patient must also make a meal schedule, by the exercise and take medication regularly in order to control insulin so that glucose does not accumulate in the blood," said Endang added.

In terms of diet, consider dose consumption of carbohydrates. According to dr. Ervina Karyadi, MSc., Nutritionists, there are two classes of carbohydrates, which is complex and simple. If you consume complex carbohydrates such as bread, rice, or potatoes, these substances will be decomposed into a single chain of glucose, and then absorbed into the bloodstream. Sugar levels are going up, but with a faster or a lot. If you consume a simple carbohydrate foods, such as jams, jellies, syrups, lemonade, ice cream, blood sugar levels rise quickly into the blood system.
Therefore people with diabetes are encouraged not to consume a simple carbohydrate foods. In contrast, consumption of natural fibrous sources of carbohydrates such as whole wheat bread, biscuits fiber, vegetables, nuts, and fresh fruit (low sugar levels).
Dr. David suggested to people with DM in Indonesia, using the composition of 68% carbohydrate calories, 20% fat calories, and 12% protein calories.
Basically, diabetes diet consists of 3 main meals and 3 meals between (snack) with a distance of 3 hours. For example:
• At 6:30 - eat breakfast.
• At 09:30 - snack or fruit.
• At 12.30 - lunch.
• At 15.30 - a small snack or fruit.
• At 18.30 - dinner.
• At 21:30 - snack or fruit.
Each meal in a number of small to moderate portions so as not to burden the pancreas. Diajurkan fruits, papaya, kedondong, bananas, apples, tomatoes, watermelon is not sweet. Prohibited, sapodilla, mango, citrus, rambutan, durian, grapes.
In carrying out the daily diabetic diet should adhere to dietary guidelines 3J, namely the number of calories, diet schedule, and type of food is allowed and which not.
Determination of nutritional DM patients carried out by BBR (relative weight) by the formula:
                             BB
           BBR = --------------------- x 100%
                      TB - 100 TB

Where: BW = body weight (kg)
              TB = height (cm)
Of course, to measure their own dietary restrictions that do a bit difficult without the help of a nutritionist or a doctor who treated the patient. Because there's more to other criteria that must be considered whether the lack of weight gain, mild or absence of disease, skinny or not the patient, there are complications, etc..

Separately Dr.Megah Imeyati Senduk Sp. RM, medical rehabilitation consultant explained that the most important in maintaining blood sugar rise is to perform regular exercise. A pretty good one is aerobic. Then why should exercise, as the biggest cause of death in people with diabetes are affected by stroke, peripheral vascular disease and myocardial infarction. "With the exercise of all these diseases can be tackled. In addition to the sport we can also maintain fitness as an effective prevention of these diseases as well as create increased insulin sensitivity, "said Megah.
Regular exercise is recommended for patients with DM. Dr. Sadoso Sumosardjuno, sports health expert, suggested that exercising six days a week in the portion is. Kind of like walking or aerobic exercise at least 20-45 minutes / day.
Controlled pulse of approximately 60% exceeds the maximum pulse rate - normal (not exceeding 85% of the maximum pulse rate). Between 60% - 80% of the maximum pulse rate training zone is called. Maximum pulse rate is 220 minus age (in years).
But do not forget to warm up and cooling down (gradually reduce the intensity of exercise). One to three hours before exercising to eat in moderation. If prolonged heavy exercise, it is recommended to eat a snack every 30 minutes. Also drink plenty of water (cold or not).
"Before you start exercising to know the physical condition and disease status is uncertain," said dr. David. Do not choose a sport like tennis or a sudden stop badminton. Should not exercise in air-conditioned or too hot. If you use insulin injections, blood sugar levels should be monitored in person before, during, and after exercise. If blood sugar levels over 250 mg%, sports postponed.

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If you’re one of 23.6 million Americans diagnosed with Type 2 diabetes, you’ve probably been told by your doctor to “change your diet” to help get your blood sugar level under control. But as you know, changing your diet involves more than just watching what you eat and counting calories. To be successful and make a meaningful impact on your health, changing your diet also involves changing your behavior.
And that’s probably more difficult. If you are diabetic or are serving meals to diabetics in your role as dietary manager—here are some tips to help make losing weight and keeping it off that much easier.

Make Better Food Choices
First, changing your diet doesn’t mean adopting a difficult, complex calorie counting program. It just means being smart. Making better food choices is key. Eating fruits and vegetables over cookies and cake for dessert will automatically reduce caloric intake. Lean cuts of chicken or fish and 1 percent or nonfat-milk both have fewer calories and fat than red meat and 2 percent milk. Drinking water over soda to quench your thirst is better because water cleanses your system without introducing processed sugars into your body. Don’t like drinking water? Try making the flavor more enjoyable by squeezing a lemon, lime, or orange slice into your glass. Green or black tea also has many healthful ingredients and is great hot or cold.

Watch How Much You Eat
Second, watch how much you eat. Obviously, the more you eat the more calories you consume. So when choosing a snack, choose something that is self-limiting…like one apple or one banana instead of eating a box of crackers. It’s easy to keep eating when you’re eating directly from a box or bag but when the apple is gone, it’s gone. Eating “single-servings” of food can make a big difference in helping those with Type 2 diabetes maintain better portion control in their everyday diet. Also, eating in front of the TV tends to inhibit the body’s feelings of being full and distract people from paying attention to the amount of food they are consuming. Instead, try to limit meal times to the kitchen or dining room table and replace the TV with some relaxing background music.

Regularly Check Your Blood Sugar
Third, be vigilant and regularly check your blood sugar. Your blood sugar level directly correlates to the foods you eat—what kinds and how much. And everyone is different. So by testing yourself regularly after meals, you will have a better idea of how your body responds to various foods. Be sure to talk with your doctor or healthcare professional about what your blood sugar levels should be and things that you can do to help maintain a healthy blood sugar level throughout the day. Generally, normal glucose levels range between 70 and 150mg. Blood sugar levels are generally lower before meals, but after meals, they rise depending on several factors including diet. When the blood sugar level reaches above 150, it signals hyperglycemia, or high blood sugar. Conversely, a low level below 70 is called hypoglycemia. Unstable, unhealthy blood sugar levels can be a serious or even fatal condition, so it is extremely important to always keep blood sugar at a healthy level, if you have Type 2 diabetes.

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Diabetes Diet Guidelines

A healthy diet is important to manage diabetes. It helps keep your blood sugar at a healthy level and helps prevent heart disease. A diet for diabetes does not mean that you have to eat special foods. You can eat what your family eats, including sweets once in a while. But you do have to pay attention to how often you eat and how much you eat of certain foods.
Managing the amount of carbohydrate you eat is an important part of a healthy diet for diabetes. Carbohydrate is found in sugar and sweets, grains, fruit, starchy vegetables, and milk and yogurt.
You may want to work with a dietitian or a certified diabetes educator (CDE) to help you plan meals and snacks. A dietitian or CDE can also help you lose weight if that is one of your goals. How can you care for yourself at home?
• Learn which foods have carbohydrate.
• Bread, cereal, pasta, and rice have 15 grams of carbohydrate in a serving. A serving is 1 slice of bread (1 ounce), 1/2 cup of cooked cereal, or 1/3 cup of cooked pasta or rice.
• Fruits have 15 grams of carbohydrate in a serving. A serving is 1 small fresh fruit, such as an apple, banana, or orange; 1/2 cup of chopped, cooked, or canned fruit; 1/2 cup of fruit juice; 1 cup of melon or raspberries; or 2 tablespoons of dried fruit.
• Milk and no-sugar-added yogurt have 12 grams of carbohydrate in a serving. A serving is 1 cup of milk or 1 cup of no-sugar-added yogurt.
• Starchy vegetables have 15 grams of carbohydrate in a serving. A serving is 1/2 cup of mashed potatoes, sweet potato, or squash; 1/2 of a small baked potato; 1/2 cup of cooked dry beans; or 1/2 cup cooked corn or green peas.
• Learn how much carbohydrate to eat each day. A dietitian or CDE can teach you how to keep track of the amount of carbohydrate you eat. This is called carbohydrate counting.
• Try to eat about the same amount of carbohydrate at each meal. Your dietitian or CDE can tell you how much carbohydrate to eat at each meal and snack. Do not "save up" your daily allowance of carbohydrate to eat at one meal.
• If you are not sure how to count carbohydrate grams, use the Plate Method to plan meals. It is a good, quick way to make sure that you have a balanced meal. It also helps you spread carbohydrate throughout the day. You divide your plate by types of foods. Put vegetables on half the plate, meat or other protein food on one-quarter of the plate, and a grain or starchy vegetable (such as brown rice or a potato) in the final quarter of the plate. To this you can add a small piece of fruit and 1 cup of milk or yogurt, depending on how much carbohydrate you are supposed to eat at a meal.
• Limit saturated fat, such as the fat from meat and dairy products. Choose lean cuts of meat and nonfat or low-fat dairy products. Use olive or canola oil instead of butter or shortening when cooking. This is a healthy choice because people who have diabetes are at higher-than-average risk of heart disease.
• Do not skip meals. Your blood sugar may drop too low if you skip meals and take certain diabetes pills or insulin.
• Work with your doctor or other clinician to write up a sick-day plan for what to do on days when you are sick. Your blood sugar can go up or down depending on your illness and whether you can keep food down. Call your doctor or other clinician when you are sick, to see if you need to adjust your pills or insulin.
• Check with your doctor or other clinician before you drink alcohol. Alcohol can cause your blood sugar to drop too low. Alcohol can also cause a bad reaction if you take certain diabetes pills.
Follow-up care is a key part of your treatment and safety. As a partner in your health care, you can do things like keep all scheduled visits, be sure you know the results of all tests and labs ordered as part of your care, and keep an up-to-date personal list of the medicines you are taking. Know how to contact us between visits, and call your doctor or other clinician if you have signs that you are having problems. 

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Keys to success for controlling your blood sugar
1. Eat three meals a day, no more than six hours apart.
2. Try to eat at regular times (even on days when you have dialysis). If you can’t eat a meal, make sure you have suitable snacks available.
3. Avoid simple sugars and sweets such as sugar, regular pop (soda, soft drinks), sweet desserts, candies, jam, and honey. Try using sugar substitutes in your recipes.
4. Do some physical activity each day.
5. Use your glucose meter as directed by your doctor or diabetes team to monitor how your diet and medications affect your blood glucose level throughout the day.
6. Maintain your blood sugar in the range recommended by your doctor and/or diabetes team.

• With CKD, you are at increased risk of low blood sugar. The doctor who takes care of your diabetes may need to decrease your insulin (or other hypoglycemic agent) on a regular basis. 
• You should report repeated low blood sugar reactions to your doctor.
• If you are on dialysis, controlling your blood sugar can help to decrease thirst and control fluid intake. With a kidney transplant and anti-rejection medications, you may need higher doses of insulin (or other hypoglycemic agent). Your doctor will help you adjust these medications.

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Good news! You can control diabetes.
Diabetes can be managed. You can successfully manage diabetes and avoid the serious health problems it can cause if you follow these steps :
• Ask your doctor how you can learn more about your diabetes to help you feel better today and in the future.
• Know your diabetes “ABCs” .
• Make healthy food choices and be physically active most days. Following this advice will help you keep off extra pounds and will also help keep your blood glucose under control.
• Check your blood glucose as your doctor tells you to.
• If you are taking diabetes medications, take them even if you feel well.
• To avoid problems with your diabetes, see your health care team at least twice a year. Finding and treating any problems early will prevent them from getting worse. Ask how diabetes can affect your eyes, heart, kidneys, nerves, legs, and feet.
• Be actively involved in your diabetes care. Work with your health care team to come up with a plan for making healthy food choices and being active—a plan that you can stick to.

Creating a healthy meal plan.
This recipe booklet is a place to start creating healthy meals. Ask your doctor to refer you to a registered dietitian or a diabetes educator who can help you create a meal plan for you and your family. The dietitian will work with you to come up with a meal plan tailored to your needs. Your meal plan will take into account things like :
• Your blood glucose levels.
• Your weight.
• Medicines you take.
• Other health problems you have.
• How physically active you are.

Making healthy food choices.
• Eat smaller portions. Learn what a serving size is for different foods and how many servings you need in a meal.
• Eat less fat. Choose fewer high-fat foods and use less fat for cooking. You especially want to limit foods that are high in saturated fats or trans fat, such as :

1. Fatty cuts of meat.
2. Whole milk and dairy products made from whole milk.
3. Cakes, candy, cookies, crackers, and pies.
4. Fried foods.
5. Salad dressings.
6. Lard, shortening, stick margarine, and nondairy
7. creamers.

Your Diabetes ABCs.

• A stands for A1C test. This test measures your average blood glucose levels for the past three months. Your doctor should test your A1C at least twice a year. For most people with diabetes, the goal is to have an A1C “score” of less than 7.
• B stands for blood pressure, a measurement of how hard your heart needs to work to keep your blood circulating. For most people with diabetes, the goal is to keep blood pressure below 130/80.
• C stands for cholesterol, a fat found in your blood. There are two kinds of cholesterol: LDL, or “bad” cholesterol, and HDL, or “good” cholesterol. For most people with diabetes, the goal is to keep :

• LDL cholesterol below 100.
• HDL cholesterol above 40 (HDL for men > 40 and for women > 50).

Ask your doctor what you can do to reach your targets for A1C, blood pressure, and cholesterol.

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What is diabetes?
Diabetes means that your blood glucose (blood sugar) is too high. Glucose comes from the food we eat. An organ called the pancreas (PAN-kree-as) makes insulin (IN-suh-lin). Insulin helps glucose get from your blood into your cells. Cells take the glucose and turn it into energy.
When you have diabetes, your body has a problem making or properly using insulin. As a result, glucose builds up in your blood and cannot get into your cells. If the blood glucose stays too high, it can damage your body.
What are the symptoms of diabetes?
Common symptoms of diabetes include :
• Having to urinate often.
• Being very thirsty.
• Feeling very hungry or tired.
• Losing weight without trying.
But many people with diabetes have no symptoms at all.
Why should I be concerned about diabetes?
Diabetes is a very serious disease. Do not be misled by phrases that suggest diabetes is not a serious disease, such as “a touch of sugar,” “borderline diabetes,” or “my blood glucose is a little bit high.”
Diabetes can lead to other serious health problems. When high levels of glucose in the blood are not controlled, they can slowly damage your eyes, heart, kidneys, nerves, and feet.
What are the types of diabetes?
There are three main types of diabetes.
• Type 1 diabetes—In this type of diabetes, the body does not make insulin. People with type 1 diabetes need to take insulin every day.
• Type 2 diabetes—In this type of diabetes, the body does not make enough insulin or use insulin well. Some people with type 2 diabetes have to take diabetes pills, insulin, or both. Type 2 diabetes is the most common form of diabetes.
• Gestational diabetes—This type of diabetes can occur when a woman is pregnant. It raises the risk that both she and her child might develop diabetes later in life.

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