Antipsychotic Meds Related To Diabetes And Weight Gain

Psychosis in children is often treated with medications that calm and tranquilize the mind (tranquilizers and neuroleptics). But little did we know that they could cause weight gain and diabetes. So should the children stop receiving their antipsychotic medications?


For children and adolescents, the symptoms such as delusions, hallucinations, anxiety, fear, tension, and disturbances of mind can be hard to manage. Many children who have pediatric-onset schizophrenia, and attention deficit hyperactivity disorder (ADHD), do not respond to stimulant medications, in such cases too, antipsychotic drugs play a significant role.


The study, published in the journal JAMA Psychiatry said that children on these medications were at increased risk of obesity and diabetes as they tend to increase fat deposition in the body and reduce body’s sensitivity to insulin.


The study included 144 young children of age group 6 to 18 years who were treated with antipsychotics — either aripiprazole, olanzapine or risperidone for disruptive disorders. Of all the three medicines, olanzapine produced largest weight gain due to increased body fat deposits. The number of children who were considered obese after 12 weeks of treatment rose to 46.5 percent.


Ginger E. Nicol, Associate Professor at the Washington University in US, said, “if we do treat children with antipsychotics, we have to be diligent in monitoring body weight as well as blood sugar, cholesterol, and triglyceride levels and then be prepared to change course if we see adverse medication effects that could increase long-term risk for diabetes, cardiovascular disease, and other conditions,”.


John W. Newcomer, Lead Investigator, Psychiatrist & Professor, Florida Atlantic University, US, added, “It is a challenge for clinicians because we know that antipsychotic medications can produce rapid improvements in disruptive behavioral symptoms in children, but not without serious health consequences.”


Further Newcomer added, “We believe it is time to really hit the brakes on the common first-line use of these medications in children with non-psychotic behavior disorders and to implement more consistent frontline use of behavioral treatment options that are available and effective,”


It is a great challenge indeed to manage both psychosis, their complications and the side effects of the medications together.  Both obesity and diabetes are major lifestyle diseases faced by millions around the globe.



Dash diet

For a person with diabetes and hypertension, food habits should comply with dash diet.

Dash diet is not a diet that guarantees weight loss or disease reversal. Rather it helps to keep the condition in control.

  1. Limit sodium, sugary food, red meat.
  2. Cut back on food rich in cholesterol, transfat and saturated fat. Choose low fat diary products.
  3. Enjoy fruits and vegetables; fish and nuts.
  4. Choose whole grains food over processed food.

Another diet, “Dash sodium diet” specifies to limit sodium intake 1500mg or 2-3 teaspoons.

Start slow. Reduce the salt intake to 2500mg daily. Allow your body to get used to the low salt. And then reduce to 1500mg per day salt.

The DASH diet suggests getting:

Grains: 7-8 daily servings

Vegetables: 4-5 daily servings

Fruits: 4-5 daily servings

Low-fat or fat-free dairy products: 2-3 daily servings

Meat, poultry, and fish: 2 or less daily servings

Nuts, seeds, and dry beans: 4-5 servings per week

Fats and oils: 2-3 daily servings

Sweets: try to limit to less than 5 servings per week

Hypoglycaemia – First aid tips for a diabetic

Hypoglycaemia is a medical emergency that a diabetic experiences at least once in their lifetime. A diabetic controls blood sugar with a combination of diet, exercise and medicines with/without insulin. Unnaturally high or low sugar increases the risk for complications, that are immediate and severe.

Hypoglycaemia – dangerously low blood sugar level – below 70 mg/dl or below 4.0 mmol/l:

Hypoglycaemia may ensue after exertion or even during rest. Losing consciousness is common in many cases. Call for emergency when the symptoms are severe or the patient is unconscious. Do not provide insulin to treat hypoglycaemia.

Patient in mild hypoglycaemia may experience trembling, palpitations, tingling, sweating, nausea, hunger or anxiety. Dizziness, headache, drowsiness, problem in vision, speaking or concentrating, and confusion are advanced symptoms. When these symptoms are mild to moderate, the person can act immediately. In severe cases, person if conscious may need assistance or lose consciousness.

Action calls:

Mild-moderate hypoglycaemia in conscious person: If the person is conscious and can manage on his own, give 15g glucose (15g glucose tablets or 3tsp sugar dissolved in water, 1tbsp honey, 175ml regular soft drink). Ideally, patients achieve normalcy in 20 minutes. So retest glucose levels in 15 minutes, if the levels remain lower than 70 mg/dl or <4.0 mmol/l repeat another 15g glucose and consult doctor soon.

Severe hypoglycaemia in conscious person: When the person needs assistance in consciousness or is unconscious, the condition is severe. In conscious person, give 20g glucose (20g glucose tablets or 20g glucose dissolved in water). Ideally, patients achieve normalcy in 20 minutes. So retest glucose levels in 15 minutes, if the levels remain lower than 70 mg/dl or <4.0 mmol/l repeat another 15g glucose and consult doctor soon.

Severe hypoglycaemia in unconscious person: Call for emergency, do not provide anything to drink. In order to handle the emergency in high risk individuals, caretakers may be trained to use hypoglycaemia emergency kits.

Hypoglycaemia of any severity should be reported to doctor as early as possible for close monitoring with changes in dose of medicine / insulin, if need be.

Extreme physical exertion, travelling, meal skipping or over usage of insulin increase the risk of hypoglycaemia. Track all the day-to-day things and stay safe. Check your glucose levels frequently on an unusually tiring or difficult days. Remember, monitor and prevent!




Vegetables for healthy sugar levels

If you believe vegetables are carbohydrates, we agree. But if you are counting the starchy ones – potatoes, dried peas or dried beans – as vegetables, we beg to disagree!

Vegetables are main part of the diabetic meal plan. American diabetes association recommends 2-3 servings of vegetables (and 2-3 servings fruits) each day. One serving of vegetables equals to either one cup raw vegetables | tossed salad or half cup cooked vegetables.[1]

Green leaves and crucifers are low-carb vegetables  that are known to fight diabetes and diabetes-related inflammation, free radicals and toxins.

Deep purple, red and orange vegetables: Anthrocyanins in brinjal, purple cabbage, and tomatoes help in healing, fighting infections and keep normal insulin levels. Additionally, lycophene in tomatoes are found to lower blood sugar, cholesterol and work against oxidative stress and cancer.[2] They are low calorie vegetables that provide little glucose to the blood.

Spinach and other green leaves: They are rich in folates, beta-carotene, iron, vitamins A, B6, D, K and C. Lutein in green leaves help against eye problems. You may choose fenugreek for similar benefits. They are blood sugar neutral and can be enjoyed as much as you want.

Green vegetables: Choose the darkest greens while shopping, whether it is bitter gourd, cucumber, asparagus, capsicum lady finger or green leaves. Diabetics are prone to problems related to vision and glaucoma. Control your blood pressure to keep your eyes healthy.

Crucifers: Broccoli and cabbage that are green are a perfect choice that you should know about. These vegetables contain sulphurophane that fights inflammation, oxidation and elements causing heart problems and cancer.[3]

Sweet potatoes: Anthocyanins in sweet potatoes have shown to reduce %HbA1c, major marker of diabetes by 0.3 to 0.6%. These red-orange tubers come with anti-inflammatory and antioxidant properties.[4]

A few cooking tips for controlled blood sugar:

  • Love cinnamon and cloves – Spice up your vegetables with more of cinnamon and cloves.
  • Turmeric, walnuts and flax seeds along with fruits and vegetables are a good diabetic defense.
  • Forget polished rice and its products – Replace polished rice and wheat with healthier brown rice or millets.



[2] Aydin, Muhsin, and Sefa Celik. “Effects of lycopene on plasma glucose, insulin levels, oxidative stress, and body weights of streptozotocin-induced diabetic rats.” Turkish Journal of Medical Sciences 42.Sup. 2 (2012): 1406-1413.

[3] Wang, Yonggang, et al. “Sulforaphane attenuation of type 2 diabetes-induced aortic damage was associated with the upregulation of Nrf2 expression and function.” Oxidative medicine and cellular longevity 2014 (2014).

[4] Ooi, Cheow Peng, and Seng Cheong Loke. “Sweet potato for type 2 diabetes mellitus.” The Cochrane Library (2013).

Is walking enough exercise for type 2 diabetics?

Your trainer must have told you to look for step count everyday. With so many activity tracker apps and wearable, ppl these days are more active and want to count distance, calories burnt and all.

There is no rule saying a “N” km walk is great for a diabetic. Instead, we say add few extra steps each time you reach your goal. Your muscles will be benefited in this graded fashion. For example, if you walk 2 km today, in next 15 days you must add another 1 km to your goal.

Walking is good indeed. It’s a full body energiser. Brisk walking is considered as a moderate intensity workout.

Adults should cover minimum 150 minutes of moderate intensity workout per week. So instead of counting distance, look for increase in your breathing and heart rate while you walk. Walk as long as you can, as brisk as you can while still be able to maintain a steady breath and talk.

Trainers safely suggest walking for everyone irrespective of the diabetes status to avoid injuries in:

  • Patients with joint or bone problems.
  • Patients with heart or kidney problems.
  • Patients in recovery from recent surgery, trauma or major injuries affecting movement, heart or general health.
  • Elderly

However, walking is just halfway there. For a fit and energetic person, diabetes can be improved by a more effective activity plan. The activity plan includes minimum 150 mins moderate aerobic activity + 2 days or more strength training.

Brisk Walking burns lesser calories than moderate-to-high intensity exercises such as jogging, stair climbing and cycling do. Moreover, walking involves only simple muscle movement. So even if you walk for an hour or 2, you hardly burn a few calories. Rather use it as an ice breaker.

You need more –

So, walk 10 mins as a warm up, jog 10 mins and then cool down for next 10 mins with slow walk. If you are already doing this, add more minutes to your jog. Choose jog or any kind of aerobic activity instead – run, cycle, swim, dance.
In my previous blog post “Diabesity, a twin axe”, I did mention the benefits of lean muscles. So, focus on some strength training also. Pick anything from yoga and calisthenics to muscle gaining exercises for improved sugar control. Choose what you will enjoy and practically stick to plan.
If you are exercise/gym fresher, ensure do’s and don’ts from your doctor and learn from an expert/trainer.

Gym workouts are demanding, so rest days are equally important. However, if u choose to do yoga it’s a therapy and you can do it everyday.

Either ways, focus more on your core and chest, this way you will activate the sleeping digestive system, along with the muscles. Also work on legs, back, hips and shoulder muscles.

This way, pancreas become more active and release insulin. Also, active muscles will benefit from insulin and pull in more glucose.

Better insulin release in pancreas + better insulin response in liver and muscle = better blood glucose profile.

With both aerobic and strength workouts you maintain lean muscles, reduce weight, reduce stress and eat well. All of these 4 factors are interrelated and are related to metabolism, and thus to diabetes. So, take control of them and stay on doctor prescribed meds, if any.

Why log your exercise?

It takes a while, but you can enjoy a better quality of life.

  • Log and update the entry in a diary or app of your choice each time you work out.
  • If you miss a planned routine, take a note of it along with reasons. It is okay to not push yourself when tired or sick.
  • Make note of unusual symptoms or unexplained sensations such as dizziness, fainting-spells. They need immediate medical attention.
  • Make a note of time gap between medicine/insulin or meal/snack and exercise. This is important in preventing hypoglycemic event.
  • If your doctor has recommended glucose checks before and after exercise, do that without fail.
  • What do you like the best – the running track, dance floor, cricket pitch or a calm morning garden. Note it and get the most out of it.

Soon you will find patterns as to what time and what exercise is best for you. Then stick to that routine and improve on the weak areas.

Diabesity, a twin axe

Yes, that’s what is usually called as diabesity. In India, 85% of diabetics are obese/overweight. And 30% of obese/overweight are diabetic. So, you do the math, one has 3 in 10 chances of being diabetic if they are obese or have high thin fat.

Fat can be either visible (overall or belly fat) or invisible (thin or visceral fat).

Either ways, either lack of exercise, long sitting hours, sedentary lifestyle, alcohol, family history affect how our body breaks food, forms energy, uses or stores it. Thus, causing obesity and diabetes in lieu.

What can you do?

Lean muscle. That’s is what is the need of the hour. Focus on eating and working out to utilise the best of your muscles. More active the muscles are the more glucose they take in.

More glucose needy the muscles are means more responsive to insulin they are. This way, even little insulin can fuel the game. Also, lesser is the glucose converted to fat and stored away.

More muscles mean better insulin utilisation, improved sensitivity, ideal weight and better lipid profile.

This way your liver, pancreas and kidneys know how to manage and throw the glucose from food you eat. So if you eat guilt free, manage the mischief well.

As twin weasely’s enjoyed, “Mischief managed” Hehe.. I am a Harry Potter fan.

Please comment on how you stay fit. Even a 10 minutes walk is a good exercise…

Understand your blood sugar tests and reports

There are various tests available to measure blood sugar levels, screen for diabetes, monitor glucose levels and help your doctor decide the treatment options suitable for you at each stage.

Taking charge over your blood sugar levels requires knowledge about blood sugar and what results actually mean to you.1

What are the various tests available?

Haemoglobin A1c test (haemoglobin A1c, HbA1c or glycohaemoglobin test)

HbA1c test is a useful longer term gauge of blood sugar levels that your doctor would prescribe to screen and diagnose diabetes. It gives an overall picture of your average blood sugar levels for the past 2 to 3 months. It measures the percentage of your haemoglobin (a protein in red blood cells that carries oxygen) that is coated with sugar. If your blood sugar levels are consistently on the higher range, HbA1c values are also high, indicating the risk for complications or events of diabetes. The advantage of this test is that there are no restrictions such as fasting or drinking anything prior to the test.2,3

Fasting blood glucose

This test depicts your blood sugar levels on an empty stomach over a fasting period of 8 hours or more. This test is usually done first thing in the morning, before breakfast. However, if you have normal fasting blood sugar, but with risk factors for diabetes or symptoms of diabetes, your doctor may recommend glucose tolerance test prior to the confirmation of the diabetes.2,4

Glucose tolerance test

Breakdown of sugar and its utilisation by the body cells are essential to maintain the normal blood sugar levels. Glucose tolerance test is performed to know the way your body breaks down the sugar after a meal. This 2-hour test requires fasting for 8 hours before the test. Blood sugar levels are measured after 2 hours of drinking a syrupy glucose solution or a sweet drink given at the doctor’s office.2,4

What do the report values mean?

The values of the reports should be in the normal reference range. If the values are a little above the reference range, you are at a risk for developing diabetes but not diagnosed with diabetes.

Here is a simple illustration that depicts values to ease your understanding of your report.2




OGTT<7.8 mmol/l


HbA1c 5.7-6.5%

FPG 5.6-7.0 mmol/l

OGTT 7.8-11.1 mmol/l


HbA1c >6.5%

FPG >7.0 mmol/l

OTGTT >11.1 mmol/l

Based on these values, your doctor will recommend a treatment plan to bring down your blood sugar levels to the reference range.


  1. Blood sugar testing: Why, when and how [Internet]. 2014 [cited 2016 Oct 18]. Available from:
  2. Diagnosing Diabetes and Learning About Prediabetes [Internet]. 2014 [cited 2016 Oct 18]. Available from:
  3. Mayoclinic. A1c test [Internet]. 2014 [cited 2016 Oct 18]. Available from:
  4. Diabetes: Tests and diagnosis [Internet]. 2014 [cited 2016 Oct 18]. Available from:

A monitoring system that reads your blood sugars, blood pressure and heart rate

Recently, a patient had a question about having so many monitoring devices at home. Her curiosity was that, “Isn’t there a single device that can take care of my blood sugar and blood pressure.

I was happy that I had an answer for her. I said gleefully, “Yes there is, Fora D20.” As a diabetes health professional, I always stress on the importance of regular glucose monitoring and actions to follow. If anything can make diabetes easy to manage, that is a bliss. So, here is a brief information about this unique monitor that tracks both blood pressure and blood sugar.

Fora D20 monitoring system:

2 in 1 BP and blood sugar monitor

This device comes with a monitor that reads –

Blood sugars:

Blood sugars from test strips loaded with a small droplet of blood sample.

The device accurately detects blood sugars as high as 600mg/dl (33.3mmol/L) using a very small sample of blood.

It works on GOD enzyme response at hematocrit range of 20 to 60%.

A quick reaction time of 7 seconds and your results are flashed on the device.

Ketones warning:

Monitor shows warning sign for ketones when your sugars exceeds or equals 240mg/dl (13.3mol/L).

Blood pressure:

Blood pressure from the cuff perfecting worn on left arm while seated.

This is an arm type digital BP monitor.

It accurately (±3mmHg or 2% of the reading value) measures blood pressure in mmHg or kPa.

Heart rate:

Heart rate from the cuff perfectly worn on left arm while seated.

The monitor reads heart rate at an accuracy of ±4% of the reading value.

This hybrid monitor works very similar to the monitors that are already available to check blood sugars and BP.

Data transfer:

Data can be easily ported to your mobile or computer through –

  • Internet
  • USB or 4-pin via RS232 output

The device is handy, compact and light (0.75 pounds without batteries). Go for manufacturer made “Instructional Video and user manuals” for detailed clarity on how this device can make your life easier.

What are your comments on this device?  Spread and share… Not all of us know about this monitoring system…


How to overcome diabetes by yoga?

Diabetes, Sugar or Diabetes Mellitus is caused by the increase in the amount of sugar in the body. The pancreas makes insulin, but when the pancreas does not function properly, enough insulin is not formed, which increases the amount of glucose and sugar in our blood, and the person becomes the victim of diabetes or diabetes.

Yoga has goodness for all. Diabetes is no exception. A couple of asanas and pranayamas in your daily life is a healthy hack towards normal sugars. Studies warrant the suitability of yoga for diabetics with or without heart, kidney and other co-morbid conditions.

Here are a few yoga recommendations for you:

Asanas or poses:


In Dhanurasan, our body becomes like a bow, with the maximum pressure on muscles in the stomach, chest and waist. Pancreas become healthier and the extra layers of fat is reduced. Also, dhanaurasan is very beneficial in relieving physical and mental stress. This yoga pose or asana can be performed by women even in periods.


In Halasan, your body’s posture becomes similar to the Hal, a farming tool. Halasan offers great benefits in thyroid, sterility, insomnia and diabetes. By doing this, you energise your endocrine system and regulate hormone release and achieve greater weight loss flexibility. Both are major tenets of diabetes management.


Setu means the dam or the bridge. During this asana, our body’s posture becomes like a dam and hence this pose is named as Setubandhasan. Blood pressure control starts with bridging. Setubandhasan is the most effective yoga for people who have asthma, headache or sinus or thyroid problem. By doing this, the swelling in your lungs and wind pipe ends and your pancreas becomes more active.

Surya namaskar

Surya namaskar is a yog vinyas with 12 sun salutations. Each of these salutations focus from tip to toe. Thus surya namaskar is a comprehensive form of yoga exercise. Also, the vinyas includes poses and counter poses taking care of balance, focus and breath – quintessential tenets of yoga. Surya namaskar is vinyas or cycle of pranamasan, hastauttanasan, padahastasan, ashwa sanchalanasan, parvatasan, ashtang namaskar, and bhujangasan. All these asanas focus on strengthening and healthifying the core. Something a diabetic really needs…

Benefits of surya namaskar varies with the flow you choose –

  • If you prefer to quickly pass through the poses, it offers a aerobic power yoga for muscles from head to toe. Slow, steady and deep breathing will help you endure the entire 108 reps. This way you reduce body weight and belly fat.
  • If you otherwise choose to perform surya namaskar as stretches pausing at each pose for 3 to 4 breath counts, you improve muscle and joint movement, flexibility and agility. This way you strengthen your body from the core.

Either way, surya namaskar, brings harmony between and relieves blocks from many parts of body. It aligns the nervous system with heart, liver, muscles, lungs, kidneys and digestive system bringing together warmth, calm, purity and balance to the body.


Pranayam is the breathing exercise, a quintessential part of Yoga. Studies show the varied benefits of pranayama on entire body. It’s stress relief, breathing, heart and diabetes benefits lead the healthy outcomes reported so far.


We all know that diabetes in India is largely related to belly fat, overweight or obesity. Bhastrika is one such pranayam that focuses on forceful breathing using stomach muscles. Bhastrika pranayam not only helps in reducing the belly fat but also focuses on improved digestion. This is achieved by improved connection between organs producing digestive juices and insulin. Thereby relieving metabolism and digestive system related problems such as diabetes, weight gain, gastritis, constipation, etc.

Heart and lung patients are warned to do this exercise in slowly under supervision only.

Anulom vilom:

Also known as nadi shodhana, Anulom vilom tones your breathing, nervous system, and digestive system. It is beneficial in preventing and managing diabetes by detoxing, balancing metabolism, reducing stress, and reducing blood pressure. Practice it regularly on empty stomach for improved results.


Kapalbhati is an aggressive form of breathing exercise using stomach muscles. Like, bhastrika it has beneficial effects on digestion and metabolism. With more blood and oxygen to brain, brain remains calm yet energetic. Kapalbhati yoga has its effect on entire body. This improves functioning of pancreas as well as entire digestive system. Therefore, it is considered as a treatment for consitpation, acidity, diabetes, weight gain, and kidney problems.

Heart and lung patients are warned to do this exercise in slowly and undeesupervision only.

Blocking prediabetes en-route diabetes

Pre-diabetes is a condition of slightly elevated blood sugar levels that often develops into diabetes within a period of 10 years. A fasting blood glucose level between 100 to 125 mg/dL (5.5 to 6.9 mmol/L) is currently classified as pre-diabetes. With pre-diabetes your HbA1c is within 5.7% to 6.4%, if it reaches/crosses 6.5% its a pretty good sign that you have diabetes.[1]

The rise in blood sugar levels starts when the body begins to develop a problem called “insulin resistance.” Insulin is an important hormone that helps to process blood glucose. You will be able to delay or stop diabetes if you can detect insulin resistance or any other cause for impaired glucose metabolism soomer. Get yourself checked for oral glucose tolerance – you are safe if it falls within 140 mg/dL.

Status Fasting blood sugar Oral glucose tolerance test HbA1c
Measured in In mmol/L In mg/dL In mmol/L In mg/dL %
Normal < 5.5 < 100 < 7.7 < 140 < 5.7
Prediabetes ≥5.5 < 7.0 ≥ 100 < 126 ≥7.7 < 11.0 ≥ 140 < 200 ≥ 5.7 < 6.5
Diabetes ≥ 7.0 ≥ 126 ≥11.0 ≥ 200 ≥ 6.5

People with pre-diabetes face same health risk as diabetics. Pre-diabetes gives 1.5 times greater risk of heart disease and stroke compared while diabetics have 2-4 times increased risk.[2],[3]

Who is at risk of developing pre-diabetes?

You are at risk for prediabetes if you –

  • are in old age – at age 45 years risk begins to rise and after 65 years risk exponentiates.
  • have a birth parent, brother or sister with diabetes
  • had gestational diabetes when pregnant or delivered a baby weighing above 4 kg.
  • overweight or obese (BMI above 25)
  • have high blood pressure
  • have low HDL or good cholesterol
  • have high total cholesterol
  • have history of cardiovascular disease
  • have insulin resistant poly cystic ovary syndrome
  • have dark patches in skin folds – neck, armpits

What are symptoms of pre-diabetes?

Pre-diabetes can either be loud or very silent. Usual diagnoses happen with blood tests irrespective of the symptoms. These symptoms are usually seen in early stages of glucose intolerance and pre-diabetes –

  • Hungrier than usual
  • Thirstier than usual
  • Tired than usual
  • Unexplained weight loss
  • Frequent urination

Steps to stop pre-diabetes from escalating to diabetes[4]

Pre-diabetes is very well managed by some lifestyle changes –

Eat well for normal glucose. Plan your meals, snacks and fluids intake to balance your glucose levels to normalcy.

Get more physical activity. Introduce small one or two 10-15 minute walks daily for a few weeks. Gradually introduce moderate to vigorous exercises to your daily routine.

Ideally 30 minutes exercise a day on 5 days a week works well for pre-diabetic condition. Exercising helps to lower blood glucose levels and decreases body fat. Active muscles use insulin very efficiently.

Lose some kilos. The best way to stay healthy is to reach perfect BMI (<25).

Give up alcohol. Empty calories coming from alcohol is neither good for metabolism nor for liver.

Avoid overcooked and refined starch. Replace white starch with brown ones.

Be safe from hidden sugars from take-away or dining out. Avoid fruit juices and soda thoroughly. Avoid medium-high GI (glycemic index > 56) food and fruits along with meals.

Glycemic Index Chart
Glycemic Index Chart (courtesy:

Do not skip breakfast. Include protein rich, healthy fat, fiber rich sources into your daily diet.

Start small and steady for a long way. The goal is long sighted and you need to be persistent and patient for your readings to reach normal and stay just there!!


[1] Diagnosing Diabetes and Learning About Prediabetes. Accessed from American Diabetes Association on October 2016.

[2] Prevention. International diabetes federation on October 2016.

[3] Pre-Diabetes. Accessed from Palo Alto medical foundation. on October 2016.

[4] Prediabetes. Endocrine Web. Accessed on October 2016 from

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