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Part of a treatment plan for diabetes will involve learning about diabetes, how to manage it, and how to prevent complications. Your doctor, diabetes educator, or other health care professional will help you learn what you need to know so you are able to manage your diabetes as effectively as possible. Keep in mind that learning about diabetes and its treatment will take time. Involving family members or other people who are significant in your life can also help you manage your diabetes.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
Janis McWilliams, RN, MSN, CDE, BC-ADM, responds: Yes, in type 1 diabetes in particular, the onset of symptoms like frequent urination and extreme thirst can be very sudden. In type 2 diabetes, the symptoms tend to come about more gradually, and sometimes there are no signs at all. People who have symptoms should contact their health care provider immediately for an accurate diagnosis. Keep in mind that these symptoms could signal other problems, too.
Diabetic neuropathy is probably the most common complication of diabetes. Studies suggest that up to 50% of people with diabetes are affected to some degree. Major risk factors of this condition are the level and duration of elevated blood glucose. Neuropathy can lead to sensory loss and damage to the limbs. It is also a major cause of impotence in diabetic men.
Poor vision, limited manual dexterity due to arthritis, tremor, or stroke, or other physical limitations may make monitoring blood glucose levels more difficult for older people. However, special monitors are available. Some have large numerical displays that are easier to read. Some provide audible instructions and results. Some monitors read blood glucose levels through the skin and do not require a blood sample. People can consult a diabetes educator to determine which meter is most appropriate.
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Prediabetes is a condition in which blood glucose levels are higher than normal, but a person does not yet have diabetes. Prediabetes and high blood glucose levels are a risk factor for developing diabetes, heart disease, and other health problems. Other warning signs prediabetes may include increased urination, feeling you need to urinate more often, and/or increased thirst.
Metformin is generally recommended as a first line treatment for type 2 diabetes, as there is good evidence that it decreases mortality.[6] It works by decreasing the liver's production of glucose.[87] Several other groups of drugs, mostly given by mouth, may also decrease blood sugar in type II DM. These include agents that increase insulin release, agents that decrease absorption of sugar from the intestines, and agents that make the body more sensitive to insulin.[87] When insulin is used in type 2 diabetes, a long-acting formulation is usually added initially, while continuing oral medications.[6] Doses of insulin are then increased to effect.[6][88]
Diabetes mellitus results mainly from a deficiency or diminished effectiveness of insulin that is normally produced by the beta cells of the pancreas. It is characterised by high blood sugar, altered sugar and glucose metabolism and this affects blood vessels and causes several organ damage. Causes of diabetes can be classified according to the types of diabetes.
Considering that being overweight is a risk factor for diabetes, it sounds counterintuitive that shedding pounds could be one of the silent symptoms of diabetes. "Weight loss comes from two things," says Dr. Cypess. "One, from the water that you lose [from urinating]. Two, you lose some calories in the urine and you don't absorb all the calories from the sugar in your blood." Once people learn they have diabetes and start controlling their blood sugar, they may even experience some weight gain—but "that's a good thing," says Dr. Cypess, because it means your blood sugar levels are more balanced.
DKA usually follows increasing hyperglycemia and symptoms of osmotic diuresis. Users of insulin pumps, by virtue of absent reservoirs of subcutaneous insulin, may present with ketosis and more normal blood glucose levels. They are more likely to present with nausea, vomiting, and abdominal pain, symptoms similar to food poisoning. DKA may manifest as respiratory distress.
nephrogenic diabetes insipidus a rare form caused by failure of the renal tubules to reabsorb water; there is excessive production of antidiuretic hormone but the tubules fail to respond to it. Characteristics include polyuria, extreme thirst, growth retardation, and developmental delay. The condition does not respond to exogenous vasopressin. It may be inherited as an X-linked trait or be acquired as a result of drug therapy or systemic disease.
Several common medications can impair the body's use of insulin, causing a condition known as secondary diabetes. These medications include treatments for high blood pressure (furosemide, clonidine, and thiazide diuretics), drugs with hormonal activity (oral contraceptives, thyroid hormone, progestins, and glucocorticorids), and the anti-inflammation drug indomethacin. Several drugs that are used to treat mood disorders (such as anxiety and depression) also can impair glucose absorption. These drugs include haloperidol, lithium carbonate, phenothiazines, tricyclic antidepressants, and adrenergic agonists. Other medications that can cause diabetes symptoms include isoniazid, nicotinic acid, cimetidine, and heparin. A 2004 study found that low levels of the essential mineral chromium in the body may be linked to increased risk for diseases associated with insulin resistance.
The definition of a genetic disease is a disorder or condition caused by abnormalities in a person's genome. Some types of genetic inheritance include single inheritance, including cystic fibrosis, sickle cell anemia, Marfan syndrome, and hemochromatosis. Other types of genetic diseases include multifactorial inheritance. Still other types of genetic diseases include chromosome abnormalities (for example, Turner syndrome, and Klinefelter syndrome), and mitochondrial inheritance (for example, epilepsy and dementia).
The classic oral glucose tolerance test measures blood glucose levels five times over a period of three hours. Some physicians simply get a baseline blood sample followed by a sample two hours after drinking the glucose solution. In a person without diabetes, the glucose levels rise and then fall quickly. In someone with diabetes, glucose levels rise higher than normal and fail to come back down as fast.
The relationship between type 2 diabetes and the main modifiable risk factors (excess weight, unhealthy diet, physical inactivity and tobacco use) is similar in all regions of the world. There is growing evidence that the underlying determinants of diabetes are a reflection of the major forces driving social, economic and cultural change: globalization, urbanization, population aging, and the general health policy environment.[74]
Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into the cells in your body for use as energy. If you have type 2 diabetes, cells don't respond normally to insulin; this is called insulin resistance. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can't keep up, and your blood sugar rises, setting the stage for prediabetes and type 2 diabetes. High blood sugar is damaging to the body and can cause other serious health problems, such as heart disease, vision loss, and kidney disease.
About 40% of diabetes sufferers require oral agents for satisfactory blood glucose control, and some 40% need insulin injections. This hormone was isolated by Frederic Banting and Charles Best in 1921 in Canada. It revolutionized the treatment of diabetes and prevention of its complications, transforming Type 1 diabetes from a fatal disease to one in which long-term survival became achievable.
If you are a diabetic and are pregnant you can have a normal, healthy pregnancy, but you need to take extra steps to avoid gaining excess weight and high blood sugars. Lifestyle habits (eating primarily vegetables and lean protein and exercising every day) will prevent problems during pregnancy. If you are a diabetic and become pregnant, monitor your blood sugar levels often. Talk with your doctor about exploring additional health care professionals, for example, a nutritionist, health coach, or naturopathic doctor about a healthy eating plan. If your blood sugar gets out of control you may:
Diabetes mellitus (DM) is best defined as a syndrome characterized by inappropriate fasting or postprandial hyperglycemia, caused by absolute or relative insulin deficiency and its metabolic consequences, which include disturbed metabolism of protein and fat. This syndrome results from a combination of deficiency of insulin secretion and its action. Diabetes mellitus occurs when the normal constant of the product of insulin secretion times insulin sensitivity, a parabolic function termed the "disposition index" (Figure 19-1), is inadequate to prevent hyperglycemia and its clinical consequences of polyuria, polydipsia, and weight loss. At high degrees of insulin sensitivity, small declines in the ability to secrete insulin cause only mild, clinically imperceptible defects in glucose metabolism. However, irrespective of insulin sensitivity, a minimum amount of insulin is necessary for normal metabolism. Thus, near absolute deficiency of insulin must result in severe metabolic disturbance as occurs in type 1 diabetes mellitus (T1DM). By contrast, with decreasing sensitivity to its action, higher amounts of insulin secretion are required for a normal disposition index. At a critical point in the disposition index curve (see Figure 19-1), a further small decrement in insulin sensitivity requires a large increase in insulin secretion; those who can mount these higher rates of insulin secretion retain normal glucose metabolism, whereas those who cannot increase their insulin secretion because of genetic or acquired defects now manifest clinical diabetes as occurs in type 2 diabetes (T2DM).
FIGURE 19-1 ■. This figure shows the hyperbolic relationship of insulin resistance and beta cell function. On the y-axis is beta cell function as reflected in the first-phase insulin response during intravenous (IV) glucose infusion; on the x-axis is insulin sensitivity and its mirror image resistance. In a subject with normal glucose tolerance (NGT) and beta-cell reserve, an increase in insulin resistance results in increased insulin release and normal glucose tolerance. In an individual for whom the capacity to increase insulin release is compromised, increasing insulin resistance with partial or no beta-cell compensation results in progression from normal glucose tolerance, to impaired glucose tolerance (IGT), and finally to diabetes (T2D). Differences between these categories are small at high insulin sensitivity, which may be maintained by weight reduction, exercise, and certain drugs. At a critical degree of insulin resistance, due to obesity or other listed factors, only a further small increment in resistance requires a large increase in insulin output. Those that can increase insulin secretion to this extent retain normal glucose tolerance; those who cannot achieve this degree of insulin secretion (e.g., due to a mild defect in genes regulating insulin synthesis, insulin secretion, insulin action, or an ongoing immune destruction of beta cells) now unmask varying degrees of carbohydrate intolerance. The product of insulin sensitivity (the reciprocal of insulin resistance) and acute insulin response (a measurement beta-cell function) has been called the "disposition index." This index remains constant in an individual with normal beta cell compensation in response to changes in insulin resistance. IGT, impaired glucose tolerance; NGT, normal glucose tolerance; T2D, type 2 diabetes.
Type 1 diabetes mellitus is predominantly a disease of the young, usually developing before 20 years of age. Overall, type I DM makes up approximately 15% of all cases of diabetes. It develops in approximately 1 in 600 children and is one of the most common chronic diseases in children. The incidence is relatively low for children under the age of 5, increases between 5 and 15, and then tapers off.
The prognosis of diabetes is related to the extent to which the condition is kept under control to prevent the development of the complications described in the preceding sections. Some of the more serious complications of diabetes such as kidney failure and cardiovascular disease, can be life-threatening. Acute complications such as diabetic ketoacidosis can also be life-threatening. As mentioned above, aggressive control of blood sugar levels can prevent or delay the onset of complications, and many people with diabetes lead long and full lives.
Insulin is only recommended for individuals for type 2 diabetics when they have not been able to get blood sugars low enough to prevent complications through other means. To avoid insulin, those with this health condition should work very hard to follow a healthy eating plan that includes a lot of vegetables and lean proteins, exercise every day, and keep stress in perspective. They also should take their oral drugs regularly. It can be difficult to follow these recommendations and the help of your doctor, nutritionist, diabetes educator, health coach, or integrative medicine practitioner may be helpful. If you who want to avoid taking medicine, work with health professionals who are knowledgeable about lifestyle medicine, and can help you understand how to fit the changes into your life.
Often people don't experience symptoms of diabetes until their blood sugars are very high. Symptoms of diabetes include: increased thirst, increased urination, increased hunger, extreme fatigues, numbness and tingling in the extremities (hands and feet), cuts and wounds that are slow to heal, and blurred vision. Some people also experience other less common symptoms including weight loss, dry itchy skin, increased yeast infections, erectile dysfunction, and acanthosis nigricans (thick, "velvety" patches found in the folds or creases of skin, such as the neck, that is indicative of insulin resistance).
Other studies have focused, not on sugar overall but specifically on sodas and other sugar-sweetened beverages. Many have found no significant relationship, apart from sugar's extra calories that lead to weight gain. For example, the Women's Health Study,8 the Atherosclerosis Risk in Communities Study,9 the Black Women's Health Study,10 and the Multi-Ethnic Study of Atherosclerosis found no significant associations between sugar consumption and diabetes risk after adjustment for measures of body weight. Some studies have had mixed results, exonerating sucrose, but indicting glucose and fructose.12,13 And some studies have shown associations between sugar-sweetened beverages and diabetes that persist after adjustment for body weight.14,15
The blood glucose levels may jump after people eat foods they did not realize were high in carbohydrates. Emotional stress, an infection, and many drugs tend to increase blood glucose levels. Blood glucose levels increase in many people in the early morning hours because of the normal release of hormones (growth hormone and cortisol), a reaction called the dawn phenomenon. Blood glucose may shoot too high if the body releases certain hormones in response to low blood glucose levels (Somogyi effect). Exercise may cause the levels of glucose in the blood to fall low.
Longer-term, the goals of treatment are to prolong life, reduce symptoms, and prevent diabetes-related complications such as blindness, kidney failure, and amputation of limbs. These goals are accomplished through education, insulin use, meal planning and weight control, exercise, foot care, and careful self-testing of blood glucose levels. Self-testing of blood glucose is accomplished through regular use of a blood glucose monitor (pictured, right). This machine can quickly and easily measure the level of blood glucose based by analysing the level from a small drop of blood that is usually obtained from the tip of a finger. You will also require regular tests for glycated haemoglobin (HbA1c). This measures your overall control over several months.
The most common complication of treating high blood glucose levels is low blood glucose levels (hypoglycemia). The risk is greatest for older people who are frail, who are sick enough to require frequent hospital admissions, or who are taking several drugs. Of all available drugs to treat diabetes, long-acting sulfonylurea drugs are most likely to cause low blood glucose levels in older people. When they take these drugs, they are also more likely to have serious symptoms, such as fainting and falling, and to have difficulty thinking or using parts of the body due to low blood glucose levels.
Insulin is the hormone responsible for reducing blood sugar. In order for insulin to work, our tissues have to be sensitive to its action; otherwise, tissues become resistant and insulin struggles to clear out sugar from the blood. As insulin resistance sets in, the first organ to stop responding to insulin is the liver, followed by the muscles and eventually fat. How does insulin resistance begin? The root of the problem is our diet.
The 1989 "St. Vincent Declaration"[117][118] was the result of international efforts to improve the care accorded to those with diabetes. Doing so is important not only in terms of quality of life and life expectancy but also economically – expenses due to diabetes have been shown to be a major drain on health – and productivity-related resources for healthcare systems and governments.
Can you "exercise your way" out of this problem? Sometimes you can; however, the key is exercising properly. For younger patients, it is best to exercise briefly and intensely. Within the first 20 minutes of intense exercise, your body burns its sugar stores, which are hanging out in liver and muscle again. After that, you start burning fat. Although this sounds good; and to some extent it is, if you spend hours running or exercising excessively, you train your body to burn fat efficiently, which subsequently lead to also training your body to store fat efficiently.
According to the National Institutes of Health, the reported rate of gestational diabetes is between 2% to 10% of pregnancies. Gestational diabetes usually resolves itself after pregnancy. Having gestational diabetes does, however, put mothers at risk for developing type 2 diabetes later in life. Up to 10% of women with gestational diabetes develop type 2 diabetes. It can occur anywhere from a few weeks after delivery to months or years later.
Type 2 diabetes primarily occurs as a result of obesity and lack of exercise.[1] Some people are more genetically at risk than others.[6] Type 2 diabetes makes up about 90% of cases of diabetes, with the other 10% due primarily to diabetes mellitus type 1 and gestational diabetes.[1] In diabetes mellitus type 1 there is a lower total level of insulin to control blood glucose, due to an autoimmune induced loss of insulin-producing beta cells in the pancreas.[12][13] Diagnosis of diabetes is by blood tests such as fasting plasma glucose, oral glucose tolerance test, or glycated hemoglobin (A1C).[3]
Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly.[2] As the disease progresses, a lack of insulin may also develop.[12] This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes".[2] The most common cause is excessive body weight and insufficient exercise.[2]
Don't be alarmed: This is not diabetic retinopathy, where the blood vessels in the back of the eye are getting destroyed, says Dr. Cypess. In the early stages of diabetes, the eye lens is not focusing well because glucose builds up in the eye, which temporarily changes its shape. "You're not going blind from diabetes," Dr. Cypess says he assures patients. "In about six to eight weeks after your blood sugars are stabilized, you're not going to feel it anymore; the eye will adjust." Here are more surprising facts you never knew about diabetes.
Scientists have done studies of twins to help estimate how important genes are in determining one's risk of developing diabetes. Identical twins have identical genes and thus the same genetic risk for a disease. Research has found that if one identical twin has type 1 diabetes, the chance that the other twin will get the disease is roughly 40 or 50 percent. For type 2 diabetes, that risk goes up to about 80 or 90 percent. This might suggest that genes play a bigger role in type 2 than in type 1, but that isn't necessarily so. Type 2 is far more common in the general population than type 1, which means that regardless of genetics both twins are more likely to develop type 2 diabetes.
Creatinine is a chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Creatinine has been found to be a fairly reliable indicator of kidney function. As the kidneys become impaired the creatinine level in the blood will rise. Normal levels of creatinine in the blood vary from gender and age of the individual.
Elevated homocysteine levels in the blood called hyperhomocysteinemia, is a sign that the body isn't producing enough of the amino acid homocysteine. is a rare and serious condition that may be inherited (genetic). People with homocystinuria die at an early age. Symptoms of hyperhomocysteinemia include developmental delays, osteoporosis, blood clots, heart attack, heart disease, stroke, and visual abnormalities.
Get to Know Your Medications: If you have diabetes, it is important to know and understand what your medications do. This can help to keep blood sugars controlled and prevent low and high blood sugars. Certain medicines need to be taken with food, or they will cause your blood sugar will drop. There are so many diabetes medications out there. Being your own advocate can help you. Make sure to tell your doctor if your medications are too expensive or if they are causing any side effects. If your medication regimen is not working for you, odds are your doctor can find a new medicine that might work better.
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More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There's no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy.
A proper diet and exercise are the foundations of diabetic care,[23] with a greater amount of exercise yielding better results.[80] Exercise improves blood sugar control, decreases body fat content and decreases blood lipid levels, and these effects are evident even without weight loss.[81] Aerobic exercise leads to a decrease in HbA1c and improved insulin sensitivity.[82] Resistance training is also useful and the combination of both types of exercise may be most effective.[82]
One particular type of sugar that has attracted a lot of negative attention is high-fructose corn syrup (HFCS) — and for good reason, as multiple studies suggest HFCS can influence diabetes risk. Some research in people who are overweight and obese, for example, suggests regularly consuming drinks sweetened with either fructose, a byproduct of HFCS, or glucose can lead to weight gain, and drinks with fructose in particular may reduce insulin sensitivity and spike blood sugar levels.
Diabetes mellitus is a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas, or by the ineffectiveness of the insulin produced. Such a deficiency results in increased concentrations of glucose in the blood, which in turn damage many of the body's systems, in particular the blood vessels and nerves.
Considering that being overweight is a risk factor for diabetes, it sounds counterintuitive that shedding pounds could be one of the silent symptoms of diabetes. "Weight loss comes from two things," says Dr. Cypess. "One, from the water that you lose [from urinating]. Two, you lose some calories in the urine and you don't absorb all the calories from the sugar in your blood." Once people learn they have diabetes and start controlling their blood sugar, they may even experience some weight gain—but "that's a good thing," says Dr. Cypess, because it means your blood sugar levels are more balanced.
Healthy lifestyle choices can help you prevent type 2 diabetes. Even if you have diabetes in your family, diet and exercise can help you prevent the disease. If you've already received a diagnosis of diabetes, you can use healthy lifestyle choices to help prevent complications. And if you have prediabetes, lifestyle changes can slow or halt the progression from prediabetes to diabetes.
WELL-CONTROLLED DIABETES MELLITUS: Daily blood sugar abstracted from the records of a patient whose DM is well controlled (hemoglobin A1c=6.4). The average capillary blood glucose level is 104 mg/dL, and the standard deviation is 19. Sixty-five percent of the readings are between 90 and 140 mg/dL; the lowest blood sugar is 67 mg/dL (on April 15) and the highest is about 190 (on March 21).
Excess glucose in the blood can damage small blood vessels in the nerves causing a tingling sensation or pain in the fingers, toes and limbs. Nerves that lie outside of the central nervous system may also be damaged, which is referred to as peripheral neuropathy. If nerves of the gastrointestinal tract are affected, this may cause vomiting, constipation and diarrhea.
Jump up ^ O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX, Anderson JL, Jacobs AK, Halperin JL, Albert NM, Brindis RG, Creager MA, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Kushner FG, Ohman EM, Stevenson WG, Yancy CW (January 2013). "2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. 127 (4): e362–425. doi:10.1161/CIR.0b013e3182742cf6. PMID 23247304.
Jump up ^ Piwernetz K, Home PD, Snorgaard O, Antsiferov M, Staehr-Johansen K, Krans M (May 1993). "Monitoring the targets of the St Vincent Declaration and the implementation of quality management in diabetes care: the DIABCARE initiative. The DIABCARE Monitoring Group of the St Vincent Declaration Steering Committee". Diabetic Medicine. 10 (4): 371–7. doi:10.1111/j.1464-5491.1993.tb00083.x. PMID 8508624.
Diabetes also can cause heart disease and stroke, as well as other long-term complications, including eye problems, kidney disease, nerve damage, and gum disease. While these problems don't usually show up in kids or teens who've had type 2 diabetes for only a few years, they can affect them in adulthood, particularly if their diabetes isn't well controlled.
In general, women live longer than men do because they have a lower risk of heart disease, but when women develop diabetes, their risk for heart disease skyrockets, and death by heart failure is more likely in women than in men. Another study also found that in people with diabetes, heart attacks are more often fatal for women than they are for men. Other examples of how diabetes affects women differently than men are:


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Objective: Heme oxygenase (HO-1) is an enzyme that possess anti-oxidant, anti-inflammatory and cytoprotective functions. In case of various harmful stimuli such as oxidative stress, HO-1 is induced as an compatible and helpful response. The purpose of the current study was assessing the impacts of equal doses (50 mg/kg body weight) of sulforaphane, curcumin and quercetin on the expression levels of HO-1 gene. Method:4 groups of ICR male white mice (25–30 g) were formed: group I included the treatment with sulforaphane(n=6), group II included the treatment with quercetin (n=6), group III included the treatment with curcumin (n=6), and group IV was the control (vehicle) group (n=6). The chemicals were applied intraperitoneally at a dose of 50 mg/kg body weight for 14 days. A vehicle (DMSO, tween 20 and normal saline in the ratio of 0.05:0.1:0.85) was similarly applied to the control group. At the 15th day, the animals were killed and their livers were isolated. The total RNA was obtained, the reverse was transcribed and the quantitative real?time PCR was used to assess HO-1 expression. In order to assure the specificity of the amplification, Agarose gel electrophoresis was also conducted. Results: The administration of Sulforaphane caused an increase of 4.6-fold HO-1 proceeded by the treatment with sulforaphane comparing to the control (P<0.05). The treatment with curcumin caused a 3.3-fold induction of HO-1 comparing with the control (P<0.05). The treatment with quercetin led to a 3.0-fold induction of HO-1 comparing with the control (P<0.05). Conclusion: Applying the dose of 50mg/kg body weight, Sulforaphane had the highest influence on inducing of HO-1 in the livers of mice, proceeded by curcumin and quercetin.[PDF] |
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|Picture: Desmond Maringwa, president of the Footballers Union of Zimbabwe, (left) and Edward Sadomba shake hands outside the Court of Arbitration for Sport in Lausanne, Switzerland. Courtesy of Fifpro.com
Libyan Football Club AL Ahli has been ordered to compensate former player and Zimbabwe international, Edward Sadomba after the Court of Arbitration for Sport found the club guilty of failing to honour a contract termination agreement with the player.
Former Dynamos and Maritzburg United forward, Sadomba, signed a contract termination agreement with Al Ahli, in which the club agreed to pay him $450,000, but the club failed.
Sadomba took his case to the Court of Arbitration for Sport (CAS) in Switzerland via the Footballers Union of Zimbabwe which is chaired by former Dynamos defender Desmond Maringwa after his initial complaint to the FIFA Dispute Resolution Chamber (DRC) was rejected.
The Court of Arbitration for Sport (CAS) overturned a decision by FIFA's (DRC) and ordered Libyan football club Al Ahli to compensate Edward Sadomba for failing to honour contract termination agreement.
Sadomba joined AL Ahli in 2013 and played there until 2015 before joining rivals AL Ahly Tripoli after his contract termination with AL Ahli.


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Welcome to Orange Fedora!
Hi! I'm Shannyn, proud owner of Orange Fedora Health and Wellness!
I'm so excited that you're ready to take your health to a whole new level!
To help you navigate the site, check out these tips:
Below, you will find a bit about what Orange Fedora can do for you!
Head over to the "About" page to read a little more about me and how OFHW came to be.
Click on "Programs" to find current offerings.
The "Recipes" page consists of the easiest and quickest healthy options to nourish your body!
The "Journal" is where you'll find me every Sunday (some might call this my blog).
Click "Connect" to send a message, and follow me on Instagram for daily posts!
Keep an eye out for my "Books" page coming soon… along with my first book, to be published at the end of January 2019!
Thanks for visiting - I look forward to getting to know you!


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Brand new: lowest price
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Skorpione by Ann Webb 9783800176489 (Hardback, 2014) Delivery UK delivery is usually within 9 to 11 working days. International delivery varies by country, please see the Wordery store help page for details.
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The Philidor Defense: Early f5 For BlackGM GMBenjaminFinegold 10 min
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Game 10 of the 2018 world chess championship between Magnus Carlsen and Fabiano Caruana was a wild battle, with chances for...11,032 16 Amazing Games
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Fabiano Caruana chose the same opening for game three as he did in game one, and the overall result was the same. The games,...5,098 5 Amazing Games
Topalov's Most Instructive Endgames
Veselin Topalov was the world chess champion for a few years last decade, but his endgames are instructive and relevant today....5,004 29 Endgames
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IM Keaton Kiewra concludes his comprehensive series on the Trompowsky Attack with two of the most amazing wins ever played...10,305 41 Openings
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You've learned the main lines of the Trompowsky Attack by now, but what should you do if your opponent plays a new move? IM...10,991 29 Openings
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What happens when your opponent immediately fights for the center, as early as move two? IM Keaton Kiewra shows you how to...13,720 50 Openings
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If you like a flexible opening without too much theory, the Trompowsky Attack is for you. In this lesson, learn from IM...10,118 12 Openings
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Dive into IM Keaton Kiewra's deep lesson on the Trompowsky Attack in this next lesson, as he discusses a tricky line he's...10,080 16 Openings
Learn The Trompowsky With 3...d5
It's time for your next lesson on the Trompowsky, a creative and flexible opening that is easy to learn. IM Keaton Kiewra...5,417 17 Openings
How To Play The Trompowsky Attack
Do you play the Tromp? IM Keaton Kiewra introduces you to one of his favorite openings, the flexible and powerful Trompowsky...15,619 27 Openings
Chess Openings For Beginners: The PircIM TigerLilov 11 min
When selecting your opening repertoire as a beginner, you have to choose lines you like to play. Watch this introduction...12,274 34 Openings
Games That Changed Chess History: The Shock Of Positional ChessIM Anna_Rudolf 15 min
Wilhelm Steinitz started out as a romantic attacking chess player like many of his peers, but he really transcended his era...12,224 42 Amazing Games
Final Round: How Shankland Won The U.S. Championship
This is it—the final round of the U.S. championship, with the title on the line. Learn from the U.S. champion himself as...7,633 25 Amazing Games
How Shankland Won The U.S. Champs: 'Don't Tear My Head Off!'
Sam Shankland was the surprise winner of the 2018 U.S. chess championship, and now he is here to explain how he did it. Take...4,557 30 Amazing Games
When Computers Go Wrong: Long-Term Attacks
GM Simon Williams concludes his amazing series on chess positions where the almighty computer doesn't have the last word—except...8,768 25 Strategy


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Availability: This item will be released on February 8, 2019. You may order it now and we will ship it to you when it arrives.
Release Date: February 8, 2019Creators: Namco (Production Company)Package Dimensions (in inches): 0.6 x 6.75 x 5.36Package Weight: 26 Hundredths PoundsItem Dimensions (in inches): 6.69 x 5.12 x 0.39Item Weight: 26 Hundredths PoundsAudio Tracks/Subtitles: English (Unknown)
Product Description: All of a sudden, unknown life forms called "Oracle cells" begin their uncontrolled consumption of all life on Earth. Their ravenous appetite "devour" and remarkable adaptability earn them first dread, then awe, and finally the name "Aragami". In the face of an enemy completely immune to conventional weapons, urban civilization collapses, and each day humanity is driven further and further toward extinction. One single ray of hope remains for humanity. Following the development of "God Arcs"-living weapons which incorporate Oracle cells-their wielders, the "God Eaters," appear. In a world ravaged by mad gods, these "God Eaters" fight a desperate war... Create your character, and fight for the survival of human-kind in GOD EATER 3. Select your weapon from a wide range of God Arcs and face brand new Aragamis in dynamic high-speed battles. Explore devastated areas you have never seen in the previous GOD EATER games.
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Exactly Mark! In my experience you can certainly write around 1000 words per hour, even if you are practically new to blogging. I personally think that spinning articles is just a gimmick that doesn't really get results but wastes tons of time. The spinning software certainly makes a lot of money for the creators though! They are the ones who are laughing all the way to the bank!
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For a long time I search around the internet looking for the best and easiest way of creating website content. I then looked into ways of creating lots of backlinks because I thought it was the best way to get ranked at the top of Google. I wasted so much time searching for methods that appeared to make things easy, when in actual fact they didn't.
Rewriting your article by hand is the classic approach that is slowly dissolving, however, many people still prefer so. Write manually and then rephrasing to ensure the finest quality is the safest way but it can often hours, days or weeks to finish a writing task that can otherwise take only a little time. And that's why there also exist people who like to save the trouble and their time, so they look for an article rewriter or article spinner to do the job.
ArticleRewriterTool.org is a free, programmed article rewriter that can efficiently rewrite human-readable text into a new and different version of a readable text. Content is the King; you must have heard; it is at least as important as SEO. An uninterrupted flow of fresh and human-readable content is the key to success for your blog or website as it helps to achieve search engine optimization. The use of article spinner or paraphrasing tool is not just limited to search engine optimization; you can use it to serve any purpose that requires the creation of fresh and unique content.
A few years ago we were wondering - is there a good paraphrasing website with an automatic paraphrasing tool online? We searched the Internet for a good sentence rephraser, and altought we found many, none of it could rephrase paragraphs correctly. Decision was made - create the best English paraphrasing tool to rewrite my or your text. Only our "paraphrase maker" has a built-in reword generator which will help rephrase any text automatically and accordingly. Paraphrase Online is free tool that can be used for automatic text processing: our paraphrasing tool (or article rewriter, article spinner, text rewriter etc.) is an online tool that automaticaly rewrites any provided content into an unique one by changing and mixing specific words and phrases with suitable synonyms. Our article rewriter is an advanced automated paraphrasing tool that allows instant online paraphrasing of any article into a unique content. Rewriting of content can help you greatly in avoiding the penalties you may suffer due to plagiarism. This free paraphrase tool does not require any registration or sign up, all you need is to enter any human readable written content, and you will get human readable rewritten content in the results. The primary goal of this software is to help compose fresh content completely for free and in no time. Mastering an online article rewriter tool can prove quite tricky. When paraphrasing or rewriting any text or paragraph, many writers and students tend to get hold of the technology that enables them to rewriter any written piece of content into a fresh piece, yet keeping the original meaning of the text same. This approach is usually used to simplify a piece of writing, minimize the use of quotes or target an alternative audience. When article spinner tool is used correctly, paraphrasing turns out to be much more concise than the original text, covering all the main points while preventing the risk of plagiarism. Whether you are a student or writer, you can use this free article rewriter online to rewrite any text to save time and get a different version. If your life revolves around writing, perhaps this is what you do for a living then this free article spinner tool is the answer to all your problems. It is the best academic and most SEO friendly paraphrasing tool that enables you to get a rewritten article with great flexibility. This competent instant article spinner helps you make a better attractive and comprehensive article in seconds. You can use tool to get rid of plagiarism or speed up your SEO performance. This is the definitive and complete rephrasing tool for rewrite and reword any of your sentences!
Aaron has just closed out a very profitable 5-figure promo for one of my products, and I've had the pleasure of also promoting him. Now what I'll say about Aaron is, he puts 110% in absolutely everything that he does. If you have an opportunity to jump on one of his launches or promote one of his products or just work with him, I highly recommend that you do so.
The word is out ... there are potentially unlimited opportunities for making money online! But, at the same time, there is a lot of competition for these potentially lucrative opportunities. Not to worry, though. With the help of Article Rewriter Tool, the game has now changed -- in your favor. Before you might have been limited by your time or energy to market your website to major search engines, but now the results of your hard work can be multiplied by this free content rewriting service.
Anyone may carry out this, all you need is a new computer system and the capability to chain a phrase together. You can create original content articles and submit them to post directories and obtain compensated. You have to apply to these websites and may or may not really get switched down. If you should occur to obtain switched down after that just maintain plugging away until you discover somebody to "employ" you.
There are many people who still prefer rewriting their articles by hand. They are used to write sentence after sentence and rephrase their content to ensure the quality of writing. Although it is the safest approach but it can take hours or days to complete a task. On the other hand, there also exist people who are either too lazy to rewrite their content or they understand the importance of time and hence, they look for an article spinner tool or paraphrasing tool.
Before WordAi even starts spinning, it reads the entire article to understand both "generally" what the article is about and the "specifics" as to what exactly happens in the article. This allows WordAi to create complicated paragraph and document level spins based on its deep understanding of the article. Because no other machine has this level of deep understanding, it makes your content look human written. It is even able to correctly write high quality titles by identifying what the article is talking about.
Spin Rewriter 9 is probably the best product in the market… I get great EPCs promoting it and, what is most important to me is that my clients actually love the product. Very low cancellation rates & practically no refund rates. All around it's a fantastic product — if it fits your business at all, then you definitely have to get on board & promote it!
Here's what this amazing ebook reveals in an easy-to-understand format: Link Building Basics, What is Link building, Importance of Backlinks, Search Engine Optimization Basics You Need To Know, 10 Ways To Build Backlinks, The Difference Between 3 Category of Techniques, White hat SEO, Black hat SEO, Gray hat SEO, How To Avoid Being Slapped By Google Updates, Creative Link Building Techniques, Untapped Backlink Sources… and more!
Using Spinbot you can instantly spin (or rewrite) a chunk of textual content up to 10,000 characters in length (or about 1000 words), which is much longer than an average website or freely-distributed article. With a single click you can turn your old blog post or website article into a completely new one, thereby doubling the payoff you get in return for the time and energy you have already invested into creating quality website content. Spinbot is lightning fast as well as free, so there is potentially no limit to the amount of free web content that you can create using this tool.
WordAI automatically rewrites entire paragraphs and sentences – this functionality is offered by most content spinners nowadays, but not many are good at it. WordAI tries to understand in the best possible way, not just the words in the sentence, but the entire meaning of the sentence as well as its connection to subsequent sentences in the paragraph.
"One thing important in my business as seo provider is to generate unique content for my clients. I used to hire many writers to produce many articles manually costing me lots of time and money. Good thing that I learned about this great piece of software, now I can have many unique articles as I want with just a few clicks.The Spinnerchief team rocks! Highly recommended product"
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Not sure about version 1, but I'm testing version 2 right now and I have to say it's the best auto spinner I've seen bar none. The content is actually extremely readable and probably better than the manual spins a lot of people do out there. However, some of the content doesn't pass copyscape so make sure you play around with the settings. Minor edits should do the trick. I'm on the trial now but seriously thinking of keeping the Turing plan for my Tier 1 content.
This time, WordAI calculates the spin it generated at 97% uniqueness which is basically completely unique. If you look at the text above, again, the first sentence of the quoted content is a bit confusing, but the rest is still good. I would even say that the last sentence came out better than the previous spin, but generally, yes, the above spin looks more like a human wrote it.


text:
Ebo create music that catches attention through dynamic contrast and carefully crafted melodies. Their reputation for intense, lively and exciting live shows can only spread further with the help of the Paper Planes single due for release later this year.
Formed in 2006, Ebo stand out from the current Irish scene.
Musically they embrace a wide range of influences and their original distinct style cannot be confined to one genre.
In the short time the band have been together they have gained a wealth of experience, playing support slots to many of Ireland's high profile acts, such as Pilotlight, The Coronas, Mainline and Subplots (formerly Envelope) in addition to headlining numerous shows in top Dublin venues like Whelan's and The Temple Bar Music Centre.
This year has already seen the band reach the finals of TG4's Battle of the Bands, "Deis Roc", (to be held in late March) and received glowing praise from the 3 judges, with Ebo being singled out by the entire panel as their vote to go forward to the Semi-Final.
Last year saw the group concentrate much of their efforts towards the completion of their eponymously titled debut EP, which is to be launched in Crawdaddy, Dublin, on Friday 28th March 2008.
The four members; Dan Forde, Cathal Mac an Bheatha, Mikey O'Connor and John Singleton, are currently studying at university. Juggling college and band life has proven to be a challenging yet rewarding task.
Ebo create intelligent, diverse music. Their melodic subtlety, explosive dynamic contrast and powerful live performances capture an audience's attention; while lush three-part harmonies provide lasting respite from the cinematic 'soundscape' of their music.
2008 - Ebo EP
3 tracks 'Morning Dew', 'Crazy', 'Paper Planes' played from EP on several radio stations in Dublin: Phantom FM, Near Fm, 2fm and Belfield FM.
Set List
Paper Planes
View From a Bridge
Letters on a Postcard
Dust on my Shoulders
Morning Dew
Adam & Eve


text:
Production Supervisor
Company: Johnson Controls, Inc.
Location: Norman
Posted on: January 15, 2019
Job Description:
What you will do This position is accountable for directing the activities of a work team in meeting daily production schedules in the assembly/fabrication of sub-assemblies, parts, or units of an assigned area while maintaining a high degree of commitment to production goals, efficiency, quality, and safety standards. First shift work hours: 7 am - 3:30 pm How you will do it* Facilitates and directs team members work flow within the assigned department, including distributing work, disseminating information, assigning team members for absences, answering questions, and resolving problems within the work unit.* Controls costs within budget levels, minimizing scrap and rework costs.* Anticipates and reacts to production problems or delays, materials shortages and equipment malfunctions.* Provides technical assistance for equipment malfunctions and expediting repairs.* Works with engineering to effect improvements in cost reduction, work simplification, production scheduling, and man hour planning.* Supervises evaluates and trains the work group. Assists in accident investigation and corrective action.* Promotes safe work environment and assure employees follow all safety policies.* Maintains accurate production and employee records.* Maintains fair and consistent application of all company policies and procedures.* Utilize LEAN tools to measure and improve the departments Key Business Drivers. What we look for Required* High School Diploma or equivalent combined education and experience, Bachelor's Degree preferred.* A minimum of three years first line supervisory experience in a manufacturing environment.* Proficiency in a Windows operating environment, including e-mail and Microsoft Office software. Preferred* Strong interpersonal skills and decision making ability.* Effective and professional communication and organization skills.* Demonstrate full knowledge and understanding of production processes and methods, and strong knowledge of safety requirements and standards.* Basic understanding of materials system.* Ability to train, organize and supervise the efforts of a work group. Johnson Controls is an equal employment opportunity and affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, protected veteran status, status as a qualified individual with a disability, or any other characteristic protected by law. For more information, please view EEO is the Law. If you are an individual with a disability and you require an accommodation during the application process, please visit www.johnsoncontrols.com/tomorrowneedsyou.
Keywords: Johnson Controls, Inc., Norman , Production Supervisor, Professions , Norman, Oklahoma
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text:
Stem cell injection-induced glioneuronal lesion of the cauda equina
Citation Manager Formats
This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Commercial stem cell therapy and "stem cell tourism" refer to the for-profit industry that has recently experienced a rise in popularity due to the regenerative potential of pluripotent stem cells. Without regulatory oversight, there is a growing concern for the future of legitimate research into stem cell therapy due to exaggerated claims of potential benefit, which in turn can contribute to research misconduct and loss of scientific credibility.1 Associated morbidities such as stem cell-induced lesions are often not given adequate consideration. We present a case illustrating the development of a proliferative lesion after stem cell therapy with a unique morphologic pathology, illustrating this medical conundrum.
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received September 13, 2017.
- Accepted in final form January 3, 2018.
- © 2018 American Academy of Neurology
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Senior Living Director Sales/Marketing
Milwaukee, WI
This job is a combination of sales, marketing, and community outreach. A "deal breaking" qualifier is that you MUST have experience with senior living; its idiosyncrasies, regulatory environment, etc.
Direct sales/marketing for one of Milwaukee's long standing and highly regarded senior living communities. Direct marketing and sales efforts for independent living only. This is a lovely facility with beautiful apartments where residents enjoy a wonderful lifestyle, lots of activities and upscale culture.
Reports to Executive Director.
If you love seniors and have a background in sales and/or marketing, this is the job for you! Work culture is team focused and collaborative. Organization has longevity in senior care continuum.
· Prior in sales/marketing within senior continuum a must for this job
· Work with team members to develop annual marketing plan, objectives and strategies.
· Budgeting responsibility.
· Attend and plan community events, conduct sales presentations to groups and individuals.
· Familiarity with and adherence to parameters of Life Care Services standards
Minimum 3 years' experience sales/marketing in senior living community a MUST
Bachelor's degree in sales, marketing or related field highly preferred
Special Skills:
Familiarity with DSPI indicators
Timely and accurate input for C3 leads and C3 LinC in community specific systems
Clear understanding of sales cycles, lead generation, and nature of sales environment
Please DO NOT apply if you haven't sold senior living services
Send resume to email@example.com
Call 262-567-6400 for additional details.
Recruiters for Healthcare (Barquist Zitzke Assoc., LLC) is an RN owned and operated healthcare placement firm. We are dedicated to your career success. Our mission to connect talented healthcare professionals to long term employment relationships. Healthcare is our background and our only focus.
Consistently named to Milwaukee Business Journal list of "Top Executive Search Firms." Please visit our website at www.recruiters4healthcare.com.


text:
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Catering Job Board
Welcome to Catering Job Board
Catering jobs in hotels, restaurants, pubs and bars industry.
Search for UK catering jobs on the on our hospitality recruitment website. These include catering jobs, restaurant jobs, pub jobs, bar jobs, chefs and kitchen jobs.
Waiter/Waitress Night Shifts 40h £7.95 Full-time
Rainbow Casino Dec, 29
Night Team Member Full-time
Premier Inn Durham City Centre Dec, 29
Hospitality Host night shift 40h £7.95 Full-time
Rainbow Casino Dec, 29
Receptionist / Housekeeper Full-time
The Lodge in the Vale Dec, 29
Head Chef Full-time
Exclusive Hotels Dec, 29
Barista - Specialty Coffee Full-time
Caffe & Co. Ltd Dec, 29
General Manager (Patrao) in waiting Full-time
Nandos Dec, 29
Front of House Roles - Soho Farmhouse Full-time
Soho House & Co. Dec, 29
Food and Beverage Assistant Full-time
Auntie Anne's Pretzel Bakery Dec, 28
Commis Chef/Chef de Partie Full-time
Bistro at the Pocket Dec, 28
Chef de Partie Full-time
crafted projects Dec, 28
Chef de Partie (12 hour contract) Full-time
CitySuites Dec, 28
Events & Wedding Planner Full-time
Jamies Catering & Events Dec, 28
Events Manager Full-time
Sheraton Grand Hotel & Spa Dec, 28
Golf Club Chef/Cook Full-time
Royal Aberdeen Golf Club Dec, 28
Venue Set Up Logistics Porter Full-time
Delaware North Companies Dec, 28
Night Cleaner Full-time
Champneys Health Resort Dec, 28
Paid Search (PPC) Analyst Full-time
Forward3D Dec, 28


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If kids are in the picture, you'll definitely want to weigh more heavily those characteristics such as sturdiness (to prevent their accidentally tipping over), durability, and ease of cleaning. Of course, if the bar stools will be used exclusively (or, at least, primarily) by adults, you can afford to safely go with lower backs, more delicate stability, and swivel options.
In addition to the height of the stool another detail to take into consideration is the spacing between them. There should be 26-30" from the center of one stool to the center of the one next to it. This ensures a comfortable seating experience for all the users.
Another type is the counter-height stool which is the one we're more interested in. These stools are smaller than the ones used in bars and restaurants and they're the best for kitchen islands. They measure between 24" and 27" in height. Then there's also the bar-height stool which is the same one you see in bars. These can be used for standard built-in bars and have a height of 28" to 33". The fourth type is the extra tall stool which is somewhere between 33" and 36" tall. In its case the name pretty much speaks for itself.
If you're on the market for some serious glam, don't feel left out of the metal bar stool game. You can get gorgeous stools like these gold and acrylic ones to bring the party to your bar table. They'll make you feel like a star studded actress.
Another good example of simple design that fit in a variety of interior designs is that featured by Stool_One by Magis. Here you can see it displayed in a contemporary setting where it complements a large kitchen island.
Fabric, as opposed to leather, tends to be a little bit more versatile. It comes in many different textures, not to mention the array of colors and patterns. Also, fabric is easier to work with. Fabric-upholstered furniture, in this case bar stools, make a space feel more casual and thus more comfortable and inviting. But their rusticity can be toned down by incorporating various accessories into their design or by pairing them with certain types of furniture or certain colors and materials.


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Sharon M. Nickols-Richardson, PhD, RD, , Mary Dean Coleman, PhD, RD, Joanne J. Volpe, Kathy W. Hosig, PhD, MPH, RD, "Perceived Hunger Is Lower and Weight Loss Is Greater in Overweight Premenopausal Women Consuming a Low-Carbohydrate/High-Protein vs High-Carbohydrate/Low-Fat Diet," The Journal of Pediatrics: Vol 105, Issue 9: 1433–1437; September 2005. http://www.sciencedirect.com/science/article/pii/S000282230501151X.
A ketogenic diet helps control blood sugar levels. It is excellent for managing type 2 diabetes, sometimes even leading to complete reversal of the disease. This has been proven in studies. It makes perfect sense since keto lowers blood-sugar levels, reduces the need of medications and reduces the potentially negative impact of high insulin levels.
Sure, you can take a multivitamin while you're on the diet. That said, you should really only be taking a multivitamin if you struggle to eat a varied diet with plenty of fruits and vegetables. The multivitamin will ensure that you're not missing out on any minerals and vitamins that you're not getting from your diet. Make sure that supplements and vitamins are approved by your doctor before you take them.
"When going out for fast food, I used to get the large-size value meal. Now, I satisfy a craving by ordering just one item: a small order of fries or a six-piece box of chicken nuggets. So far, I've shaved off 16 pounds in seven weeks, and I'm on track to being thinner than my high school self for my 10-year reunion later this year." —Miranda Jarrell, Birmingham, AL