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Hyperinsulinism Treatment In Adults

Hyperinsulinemia: Symptoms, Treatments, And Diet

Hyperinsulinemia: Symptoms, Treatments, And Diet

The typical cause of hyperinsulinemia is insulin resistance . Insulin resistance is what happens when your body doesnt respond correctly to insulin. This incorrect response causes your body to need the pancreas to produce more insulin. As your pancreas makes more insulin, your body continues to resist and respond incorrectly to the higher levels of insulin. Your pancreas will continually need to make more to compensate. Eventually, your pancreas wont be able to keep up with the amount of insulin your body needs to keep your blood sugar at a healthy level. Insulin resistance can eventually lead to type 2 diabetes . Less common causes of this condition are insulinoma and nesidioblastosis. Insulinoma is a rare tumor of the pancreas cells that produce insulin. Nesidioblastosis is when the pancreas produces too many cells that make insulin. Hyperinsulinemia may also develop after having gastric bypass surgery. The theory is that the cells have become too large and active for the body, but the body has changed significantly after the bypass. Doctors arent fully sure why this happens. Hyperinsulinemia is usually diagnosed through a blood test taken when youre fasting. It may also be diagnosed when your doctor is checking for other conditions like diabetes. Treatment for hyperinsulinemia begins by treating whatever is causing it. This is particularly true if your condition is caused by insulinoma or nesidioblastosis. Your treatment may also include a combination of medication, lifestyle changes, and possibly surgery. These lifestyle changes include diet and exercise. The medications used to treat this condition are the same or similar to the medications used to treat diabetes. However, medication should be used only if diet and exercise arent enough to control the condition. S Continue reading >>

Hyperinsulinemic Hypoglycemia

Hyperinsulinemic Hypoglycemia

David R. Langdon MD, ... Mark A. Sperling MD, in Pediatric Endocrinology (Fourth Edition) , 2014 Hyperinsulinemic hypoglycemia occurs in many infants and young children with type 1 (hepatorenal) tyrosinemia due to deficient fumarylacetoacetate hydrolase activity (OMIM ID: 276700).151 Problems may include acute liver failure, cirrhosis, hepatomegaly, glomerulosclerosis, renal Fanconi syndrome with rickets, and acute crises with painful neuropathy. Most expanded newborn screening programs detect tyrosinemia. Plasma amino acid screening reveals markedly elevated tyrosine, and urine organic acid screening contains increased succinylacetone. Current treatment options include liver transplant or NTBC [2-(2-Nitro-4-Trifluoromethylbenzoyl)-1,3-Cyclohexanedione]. The mechanism of excessive insulin secretion is not known, but beta cell hyperplasia has been seen in the pancreas. Some infants have been born with macrosomia and cardiac hypertrophy suggestive of fetal insulin excess. Hypoglycemia can be severe enough to threaten the brain, but it responds to diazoxide and improves with age.152 Evelien F. Gevers, ... Mehul T. Dattani, in Endocrinology: Adult and Pediatric (Seventh Edition) , 2016 Hyperinsulinemic hypoglycemia is the major cause of persistent and recurrent hypoglycemia in neonates and infants. It is due to unregulated secretion of insulin, and it can be transient or permanent. Transient forms lasting for days are associated with maternal diabetes mellitus, maternal sulfonylurea treatment, and glucose infusions during labor. Transient HI due to IUGR, perinatal asphyxia, and Beckwith-Wiedemann syndrome can last for days to months and may require diazoxide treatment. Permanent hyperinsulinism can histologically be divided into focal and diffuse forms that are inherited i Continue reading >>

Congenital Hyperinsulinism International | Congenital Hyperinsulism International

Congenital Hyperinsulinism International | Congenital Hyperinsulism International

Congenital Hyperinsulinism International (CHI) has developed a patient-reported registry called the HI Global Registry with its partners to improve the understanding of HI, and advance research for better treatments and patient care. Click on either of the images below to learn more. Congenital Hyperinsulinism International (CHI) is a charitable organization dedicated to improving the lives of children, adults, and families living with congenital hyperinsulism. Advocate on behalf of children and adults with congenital hyperinsulinism. Create and provide educational resources about congenital hyperinsulinism to patients, families, medical professionals, school personnel, and any other interested parties. Support research and development of medical knowledge and medical devices to better understand and treat congenital hyperinsulinism. Support children, adults, and their families living with congenital hyperinsulinism. Increase awareness of congenital hyperinsulinism, especially among medical personnel, in order to improve timely diagnosis. View the Be My Sugar Gallery to learn about hyperinsulinism and the children and families who live with it. Click the image above to view our Be My Sugar campaign leading up to the 2016 Rare Disease Day! Watch our video to learn about hyperinsulinism and the children and families who live with it. The video emphasizes the importance of early diagnosis, research, and support for hyperinsulinism families. New! CHI What is Congenital Hyperinsulinism Posters Available for download and printing on our new CHI Posters page ; available in English, Spanish, French, German, Italian, Portuguese, and Catalan. Congenital Hyperinsulinism International (CHI) held its annual Sugar Soire, hosted by Conan OBrien, on November 19, 2017 at the Pool and t Continue reading >>

Congenital Hyperinsulinism

Congenital Hyperinsulinism

General Discussion Congenital hyperinsulinism (HI) is the most frequent cause of severe, persistent hypoglycemia in newborn babies, infants, and children. In most countries it occurs in approximately 1/25,000 to 1/50,000 births. About 60% of babies with HI are diagnosed during the first month of life. An additional 30% will be diagnosed later in the first year and the remainder after that. With early treatment and aggressive prevention of hypoglycemia, brain damage can be prevented. However, brain damage can occur in children with HI if the condition is not recognized or if treatment is ineffective in the prevention of hypoglycemia. Insulin is the most important hormone for controlling the concentration of glucose in the blood. As food is eaten, blood glucose rises and the pancreas secretes insulin to keep blood glucose in the normal range. Insulin acts by driving glucose into the cells of the body. This action of insulin maintains blood glucose levels and stores glucose as glycogen in the liver. Once feeding is completed and glucose levels fall, insulin secretion is turned off, allowing the stores of glucose in glycogen to be released into the bloodstream to keep blood glucose normal. In addition, with the switching off of insulin secretion, protein and fat stores become accessible and can be used instead of glucose as sources of fuel. In this manner, whether one eats or is fasting blood glucose levels remain in the normal range and the body has access to energy at all times. This close regulation of blood glucose and insulin secretion does not occur normally in people who have HI. The beta cells in the pancreas, which are responsible for insulin secretion, are blind to the blood glucose level and secrete insulin regardless of the blood glucose concentration. As a resu Continue reading >>

Hyperinsulinism

Hyperinsulinism

Hyperinsulinism refers to an above normal level of insulin in the blood of a person or animal. Normal insulin secretion and blood levels are closely related to the level of glucose in the blood, so that a given level of insulin can be normal for one blood glucose level but low or high for another. Hyperinsulinism can be associated with several types of medical problems, which can be roughly divided into two broad and largely non-overlapping categories: those tending toward reduced sensitivity to insulin and high blood glucose levels (hyperglycemia), and those tending toward excessive insulin secretion and low glucose levels (hypoglycemia). Symptoms[edit] Hyperinsulinism due to reduced insulin sensitivity is usually asymptomatic.[1] In contrast, hyperinsulinemic hypoglycemia can produce any of the entire range of hypoglycemic symptoms, from shakiness and weakness, to seizures or coma.[2] Diagnosis[edit] Types[edit] Hyperinsulinism due to diminished sensitivity, associated with diabetes risk[edit] Although many factors influence insulin secretion, the most important control is the amount of glucose moving from the blood into the beta cells of the pancreas. In healthy people, even small rises in blood glucose result in increased insulin secretion. As long as the pancreatic beta cells are able to sense the glucose level and produce insulin, the amount of insulin secreted is usually the amount required to maintain a fasting blood glucose between 70 and 100 mg/dL (3.9-5.6 mmol/L) and a non-fasting glucose level below 140 mg/dL (<7.8 mmol/L). When liver cells and other cells that remove glucose from the blood become less sensitive (more resistant) to the insulin, the pancreas increases secretion and the level of insulin in the blood rises. This increased secretion can compensa Continue reading >>

The Treatment Of Hyperinsulinemic Hypoglycaemia In Adults: An Update.

The Treatment Of Hyperinsulinemic Hypoglycaemia In Adults: An Update.

1. J Endocrinol Invest. 2017 Jan;40(1):9-20. doi: 10.1007/s40618-016-0536-3. Epub2016 Sep 13. The treatment of hyperinsulinemic hypoglycaemia in adults: an update. Davi MV(1), Pia A(2), Guarnotta V(3), Pizza G(4), Colao A(4), Faggiano A(5); NIKEGroup. Collaborators: Albertelli M, Arvat E, Baldelli R, Berruti A, Bianchi A, Bodei L, Botti G, Corcione F, Delle Fave G, De Marinis L, De Rosa G, Di Sarno A, Dicitore A, Fazio N, Fanciulli G, Ferolla P, Ferone D, Filice A, Gallo M, Giordano C,Giuffrida D, Lania A, Lastoria S, Logoluso F, Loli P, Malandrino P, Manzoni M,Marchetti M, Martini C, Messina E, Modica R, Motta C, Papotti M, Partelli S,Persico G, Piovesan A, Pontecorvi A, Ramundo V, Razzore P, Rota F, Scavuzzo F,Sciammarella C, Vitale G, Chiara Zatelli M. (1)Section of Endocrinology, Medicina Generale e Malattie Aterotrombotiche e Degenerative, Department of Medicine, University of Verona, Piazzale LA Scuro, Policlinico G.B. Rossi, 37134, Verona, Italy. [email protected] (2)Internal Medicine I, Department of Clinical and Biological Sciences, University of Turin, San Luigi Hospital, Orbassano, Italy. (3)Section of Endocrinology, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Palermo, Italy. (4)Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy. (5)Thyroid and Parathyroid Surgery Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy. BACKGROUND: Treatment of hyperinsulinemic hypoglycaemia (HH) is challenging dueto the rarity of this condition and the difficulty of differential diagnosis. Theaim of this article is to give an overview of the recent literature on themanagement of adult HH.METHODS Continue reading >>

Hyperinsulinemia: Is It Diabetes?

Hyperinsulinemia: Is It Diabetes?

Is hyperinsulinemia a form of diabetes? Answers from M. Regina Castro, M.D. Hyperinsulinemia (hi-pur-in-suh-lih-NEE-me-uh) means the amount of insulin in your blood is higher than what's considered normal. Alone, it isn't diabetes. But hyperinsulinemia is often associated with type 2 diabetes. Insulin is a hormone that's normally produced by your pancreas, which helps regulate blood sugar. Hyperinsulinemia is a sign of an underlying problem. Hyperinsulinemia is most often caused by insulin resistance — a condition in which your body doesn't respond well to the effects of insulin. Your pancreas tries to compensate by making more insulin. Insulin resistance may eventually lead to the development of type 2 diabetes. This happens when your pancreas is no longer able to compensate by secreting the large amounts of insulin required to keep the blood sugar normal. Rarely, hyperinsulinemia is caused by: A rare tumor of the insulin-producing cells of the pancreas (insulinoma) Excessive numbers or growth of insulin-producing cells in the pancreas (nesidioblastosis) Hyperinsulinemia usually causes no signs or symptoms, except in people with insulinomas in whom hyperinsulemia can cause low blood sugar (hypoglycemia). Treatment of hyperinsulinemia is directed at the underlying problem. Continue reading >>

Hyperinsulinemic Hypoglycemia

Hyperinsulinemic Hypoglycemia

Hyperinsulinemic hypoglycemia describes the condition and effects of low blood glucose caused by excessive insulin. Hypoglycemia due to excess insulin is the most common type of serious hypoglycemia. It can be due to endogenous or injected insulin. Causes[edit] Hypoglycemia due to endogenous insulin can be congenital or acquired, apparent in the newborn period, or many years later. The hypoglycemia can be severe and life-threatening or a minor, occasional nuisance. By far the most common type of severe but transient hyperinsulinemic hypoglycemia occurs accidentally in persons with type 1 diabetes who take insulin. Hypoglycemia due to endogenous insulin Congenital hyperinsulinism Transient neonatal hyperinsulinism (mechanism not known) Focal hyperinsulinism (KATP channel disorders) Paternal SUR1 mutation with clonal loss of heterozygosity of 11p15 Paternal Kir6.2 mutation with clonal loss of heterozygosity of 11p15 Diffuse hyperinsulinism KATP channel disorders SUR1 mutations Kir6.2 mutations Glucokinase gain-of-function mutations Hyperammonemic hyperinsulinism (glutamate dehydrogenase gain-of-function mutations) Short chain acyl coenzyme A dehydrogenase deficiency Carbohydrate-deficient glycoprotein syndrome (Jaeken's Disease) Beckwith-Wiedemann syndrome(suspected due to hyperinsulinism but pathophysiology uncertain: 11p15 mutation or IGF2 excess) Acquired forms of hyperinsulinism Insulinomas (insulin-secreting tumors) Islet cell adenoma or adenomatosis Islet cell carcinoma Adult nesidioblastosis Autoimmune insulin syndrome Noninsulinoma pancreatogenous hypoglycemia Reactive hypoglycemia (also see idiopathic postprandial syndrome) Gastric dumping syndrome Drug induced hyperinsulinism Sulfonylurea Aspirin Pentamidine Quinine Disopyramide Bordetella pertussis vaccine or i Continue reading >>

Advances In Diagnosis And Treatment Of Hyperinsulinism In Infants And Children

Advances In Diagnosis And Treatment Of Hyperinsulinism In Infants And Children

Advances in Diagnosis and Treatment of Hyperinsulinism in Infants and Children Division of Endocrinology, Childrens Hospital of Philadelphia, Philadelphia, Pennsylvania 19104 Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 87, Issue 11, 1 November 2002, Pages 48574859, Charles A. Stanley; Advances in Diagnosis and Treatment of Hyperinsulinism in Infants and Children, The Journal of Clinical Endocrinology & Metabolism, Volume 87, Issue 11, 1 November 2002, Pages 48574859, In infants and children, as in adults, the most common cause of persistent hypoglycemia is hyperinsulinism. However, unlike adults, hyperinsulinism in children most often represents a congenital disorder rather than an acquired islet adenoma. Many children are unresponsive to medical therapy, and near total pancreatectomy is often required because of intractable hypoglycemia. Uncontrolled hypoglycemia may lead to seizures or permanent brain damage. Developmental delay or retardation has been reported to occur in 2550% of affected children. In recent years, concepts about hyperinsulinism in infancy have evolved rapidly as reflected in the changing nomenclature for the disorder. When originally described by MacQuarrie as idiopathic hypoglycemia of infancy in 1954, insulin was not considered to be the mechanism of hypoglycemia, because insulinomas were known to be rare in infants and children. One of the first applications of the insulin RIA in the 1960s by Berson and Yallow, however, identified insulin as the underlying problem. By 1970, the disorder had become known as nesidioblastosis through studies of pancreatic pathology by Yakovak et al. ( 1 ). This term implied that hyperinsulinism was due to an anomaly in islet development in which there was a Continue reading >>

Hyperinsulinemia

Hyperinsulinemia

Tweet Hyperinsulinemia is often associated with type 2 diabetes, but it isn’t diabetes as such. Hyperinsulinemia means that the amount of insulin in the blood is higher than considered normal amongst non-diabetics. When a person has hyperinsulinemia they have a problem controlling blood sugar, meaning that the pancreas has to secrete larger amounts of insulin to keep blood sugar at a normal level. How is hyperinsulinemia caused? Insulin resistance is the primary cause of hyperinsulinemia, with the pancreas compensating by producing more insulin. Insulin resistance of this type can lead to the development of type 2 diabetes, which occurs when the pancreas cannot secrete the insulin required to maintain normal blood glucose levels. In more rare cases, hyperinsulinemia may be caused by a tumour of the insulin-producing cells of the pancreas (insulinoma). It may also be caused by excessive numbers of insulin-producing cells in the pancreas (nesidioblastosis). What are the risks of having hyperinsulinemia? There are a number of risks involved in having hyperinsulinemia which include: Higher triglyceride levels High uric acid Hardening of the arteries (artherosclerosis) Weight gain Hypertension Type 2 diabetes The sooner hyperinsulinemia is diagnosed, which may be in the form of pre-diabetes or type 2 diabetes, the sooner the risks or extent of the above can be reduced. What are the symptoms of hyperinsulinemia? Although hyperinsulinemia often has little clear indicator, hyperinsulinemia symptoms may include: Weight gain Cravings for sugar Intense hunger Feeling frequently hungry Difficulty concentrating Feeling anxious or panicky Lacking focus or motivation Fatigue How is hyperinsulinemia treated? Medical treatment, in the form of diabetes medication, may help to relieve t Continue reading >>

Diet For Hyperinsulinism

Diet For Hyperinsulinism

Based in Springfield, Mo., Jillian Ball, registered and licensed dietitian, has been writing nutrition-based content since 2004. Ball is a nutrition consultant and diabetes educator, and is certified in childhood and adolescent weight management. She holds a bachelor's degree in dietetics with cum laude honors from Missouri State University. Insulin and syringe.Photo Credit: Creatas Images/Creatas/Getty Images Hyperinsulinism occurs when the body produces too much insulin. According to Genetics Home Reference, this can happen as a result of genetics, called familial hyperinsulinism, or it can occur in response to insulin resistance, which causes the pancreas to overproduce insulin in an effort to maintain normal blood sugar levels. Insulin is a hormone that is released in response to glucose, or sugar, in the blood stream, making diet a major part of treatment. Doctors may not identify hyperinsulinism.Photo Credit: Monkey Business Images/Monkey Business/Getty Images The identification, or diagnosis, of hyperinsulinism often goes undetected by you or your doctor. Explained by the January 2013 "Gene Reveiw," hyperinsulinism does not usually present itself with signs or symptoms until low blood sugar occurs, also known as hypoglycemia. Even then, signs of hypoglycemia are somewhat generic resulting in fatigue, weakness, dizziness or irritability, which can point to a number of conditions. In infants, hyperinsulinism symptoms include poor feeding and seizures. Diet is important to keep healthy.Photo Credit: olgakr/iStock/Getty Images When combating abnormalities in glucose -- sugar -- or insulin regulation in the body, diet intake is always a concern and should be closely monitored. Sugar, especially refined sugars such as white or brown sugar, honey, jellies and syrups, w Continue reading >>

Why Is Hyperinsulinism Symptoms Such A Serious Risk In Adults

Why Is Hyperinsulinism Symptoms Such A Serious Risk In Adults

Basic PLUS Author | 9 Articles Why Is Hyperinsulinism Symptoms Such a Serious Risk in Adults By Jones Elkin | Submitted On July 06, 2011 Hyperinsulinism is a condition that could become a serious health risk very quickly. It is a health risk, that is connected to an increase in the insulin level in the blood stream of an adult. Normal insulin levels in the blood of adults are closely related to their blood glucose level. Therefore, if you are an adult who suffers from hyperinsulinism attacks, it means that your body is presently producing too much insulin. This can result in low blood sugar. Insulin is a hormone that is produced by the pancreas - which is an organ of the body. The amount of insulin that will be produced and secreted by the pancreas, depends largely on the amount of sugar present in the blood stream. The hormone insulin is the key that opens the cells of the body for the acceptance of the blood sugar. When the cells are signaled by the insulin hormone, they open up and accept the sugar from that blood. The blood glucose is then converted to energy fuel to be used by the body. However, if there is too much insulin circulating in the blood stream of an adult, the blood glucose of this adult can drop dangerously low. This is another form of the hyperinsulinism condition known as Hypoglycemia. Hyperinsulinism is a condition that is diagnosed in both diabetics and non-diabetics. It is a serious health problem that often occurs due to a diabetic patient taking too much insulin during their treatment. Medically, it is referred to as insulin shock. The major health risk here is that the patient has taken their insulin therapy treatment but failed to increase their blood sugar or glucose intake. A diabetic individual may also experience a drop in blood glucose o Continue reading >>

Peptide Controls Blood Sugar In People With Congenital Hyperinsulinism, Pilot Study Suggests

Peptide Controls Blood Sugar In People With Congenital Hyperinsulinism, Pilot Study Suggests

Follow all of ScienceDaily's latest research news and top science headlines ! Peptide controls blood sugar in people with congenital hyperinsulinism, pilot study suggests A pilot study in adolescents and adults has found that an investigational drug shows promise as the first potential medical treatment for children with the severest type of congenital hyperinsulinism. A pilot study in adolescents and adults has found that an investigational drug shows promise as the first potential medical treatment for children with the severest type of congenital hyperinsulinism, a rare but potentially devastating disease in which gene mutations cause insulin levels to become dangerously high. "There is currently no effective medicine for children with the most common and most severe form of hyperinsulinism," said study leader Diva D. De Leon, M.D., a pediatric endocrinologist at The Children's Hospital of Philadelphia. "Our new research shows that this investigational drug, a peptide called exendin-(9-39), controls blood sugar levels in people, a very promising result." The study appeared August 1 online ahead of print in the journal Diabetes. In congenital hyperinsulinism (HI), mutations disrupt the insulin-secreting beta cells in the pancreas. Uncontrolled, excessive insulin levels thus sharply reduce blood glucose levels, a condition called hypoglycemia. If untreated, hypoglycemia may cause irreversible brain damage or death in children. Congenital HI occurs in an estimated one in 50,000 U.S. children, with a higher incidence among Ashkenazic Jews and certain other groups. The standard treatment for some forms of congenital HI is diazoxide, a drug that controls insulin secretion by opening potassium channels in beta cells. However, this drug does not work in the most common type Continue reading >>

Abcc8-related Hyperinsulinism

Abcc8-related Hyperinsulinism

ABCC8-related hyperinsulinism, also called congenital hyperinsulinism, is an inherited condition in which the pancreas releases inappropriately large quantities of the hormone insulin, leading to low blood sugar (hypoglycemia). When blood sugar drops to dangerously low levels, seizures and permanent brain damage may occur. If untreated, the condition could ultimately be fatal. ABCC8 refers to the name of the gene that causes this disease. Other genes have been identified which also cause hyperinsulinism. The pancreas normally secretes insulin in response to rising blood sugar. In people with ABCC8-related hyperinsulinism, the pancreas secretes insulin even without sugar consumption, thereby removing too much sugar from the blood. Infants with ABCC8-related hyperinsulinism tend to have significantly low blood sugar within the first few days of life. They often require immediate infusions of the sugar glucose to prevent seizures. These newborns are typically born larger than normal and may show difficulty feeding, poor muscle tone, and breathing problems. In some people with ABCC8-related hyperinsulinism, symptoms do not appear until later in childhood. The low blood sugar associated with the condition can also range from mild to severe depending on the individual, and varies even among members of the same family. Early and aggressive treatment is important to avoid permanent brain damage. How common is ABCC8-related Hyperinsulinism? ABCC8-related hyperinsulinism affects roughly 1 in 50,000 Europeans. It is particularly common among people of Finnish and Saudi Arabian descent, where the disease may affect as many as 1 in 2,500. A certain genetic mutation is prevalent in people of Ashkenazi Jewish descent. How is ABCC8-related Hyperinsulinism treated? Treatments for ABCC8 Continue reading >>

Hyperinsulinemia Treatments

Hyperinsulinemia Treatments

Hyperinsulinemia refers to an excess of insulin in the blood and is a condition often associated with type 2 diabetes. Hyperinsulinemia leads to problems regulating the amount of glucose circulating in the blood. This means that insulin-producing cells in the pancreas called the islets of Langerhans have to produce increasing amounts of insulin in order to maintain the blood glucose at a normal level. The pancreas continues to do this until eventually it can no longer produce enough insulin to meet the bodys needs, which leads to a rise in the blood sugar level. Hyperinsulinemia can pose a number of risks, which include the following: There are often no clear indicators of hyperinsulinemia, although the following symptoms may be present: The earlier this condition is diagnosed, the more likely it is that the above problems can be prevented or the extent of them reduced. As hyperinsulinemia is a feature of type 2 diabetes, the approaches to treatment are the same. Experts recommend reducing calorie intake as well as the intake of cholesterol, salt and alcohol. Other recommended lifestyle changes include reducing stress and increasing exercise. At least 30 to 60 minutes of moderate to vigorous exercise three times a week is advised to help individuals lose weight. Even within just a few days of starting a calorie-restricted diet, insulin sensitivity can improve. A diet consisting of whole fresh foods that are high in fiber and have a low glycemic index are recommended. Examples include vegetables, fruits, wholegrains and beans. Carbohydrate intake should be moderately low, at around 45% to 65% of the total daily calorie intake. Saturated fats should be avoided and healthy monounsaturated and omega-3 fats should make up around 25% to 35% of daily calories. Good sources of Continue reading >>

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