Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles
Fasting Blood Sugar:70 - 100 mg/dl
Google
(8-10 hrs in empty Stomach)
Post Prandial Blood Sugar : 100 - 140 mg/dl
(1 ½ hrs after breakfast / lunch)

How Effective Are the Shots

Depo­Provera is highly effective. Only 1 out of every 300 to 400 women on Depo­Provera will get pregnant.

The Benefits and Risks

Like Norplant implants, Depo­Provera contains no estrogen and is therefore free of estrogen­related side effects. It is, however, associated with its own set of complications: bleeding irregularities, cancer risks, bone mineral density changes, low birth weight babies, tubal pregnancies, drug interaction, and problems reestablishing fertility. Although breastfeeding while taking Depo­Provera poses no problem for the infant, some experts advise women to wait 6 weeks after childbirth before getting a shot.

Bleeding irregularities: You might have irregular periods while using Depo­Provera. Since vaginal bleeding might also be a symptom of a more serious medical problem such as an infection or cancer, see your doctor if the bleeding is severe or persistent.

Cancer: Suspicion that Depo­Provera could cause breast cancer was based on high­dose animal studies later discredited by the FDA. Still, the stigma persisted. To resolve the issue, researchers in several different countries conducted studies involving thousands of women. Some of these studies found no increased risk for breast cancer, while others found a slightly higher risk among women who had taken Depo­Provera within the last 4 years and who were under 35 years of age. In June 1993, a panel of experts convened by the World Health Organization in Geneva, Switzerland, reviewed all the available data, and announced that Depo­Provera does not increase the overall risk of breast cancer. They also found no link between the drug and cervical cancer, the second most common cancer among women. Moreover, the panel stated that Depo­Provera can provide some protection from endometrial cancer.

Bone mineral density changes: During the FDA's evaluation of Depo­Provera, a study of 30 New Zealand women who had been using the drug for at least 5 years raised questions about a possible link with brittle bones. However, experts contend that the study was flawed because it involved too few women, failed to measure the women's prestudy bone density, and didn't consider such life-style factors as smoking.

The drug's suppression of a woman's naturally occurring estrogen could theoretically lead to a reduction in bone density. However, studies of women using Depo­Provera for noncontraceptive purposes have not shown this to be true. Scientists feel the results of the New Zealand study are inconclusive and that further research is needed to settle the issue.

Low birth weight babies: Women who are pregnant at the time of their first shot of Depo­Provera or who accidentally become pregnant a month or two after starting the drug are more likely to deliver babies with low birth weights. Although low-birth-weight babies are twice as likely to die as babies of normal weight, children exposed to Depo­Provera before birth and followed through adolescence show no signs of adverse health effects.

Tubal pregnancies: Tubal pregnancies can occur among Depo­Provera users, but less often than among women using an intrauterine device (IUD) or no birth control at all. If you begin to feel abdominal pain, see a doctor to rule out tubal pregnancy.

Drug interaction: The drug amino-glutethimide (Cytadren) can reduce the effectiveness of Depo­Provera. Cytadren is used to suppress adrenal gland function in patients with Cushing's syndrome and adrenal cancer.

Returning to fertility: Sixteen weeks after your last shot you should be able to conceive, but it could take 1 to 2 years for your periods to fully return to normal. In one study, more than half of the women who wanted to become pregnant conceived after 1 year; by the end of 2 years, 90 percent of women had conceived.

Breastfeeding: There is no evidence that Depo­Provera is harmful to nursing infants. However, the manufacturer takes a conservative approach by suggesting that a breastfeeding woman wait 6 weeks after giving birth before taking the medication.

Nuisance Side Effects
Depo­Provera can cause some of the same nuisance side effects as the Pill and Norplant implants: depression, headaches, weight gain, nervousness, and dizziness. As with the implant system, irregular bleeding is by far the most common side effect.

As you continue to use Depo­Provera, you'll notice less and less spotting or breakthrough bleeding, and finally will have no period at all. At the end of one year, 57 percent of women using Depo­Provera have no period, and by the end of two years, 68 percent have stopped menstruating.

Another significant side effect—probably the most undesirable one—is weight gain. Here is an example of the amount of weight gained by the average Depo­Provera user:

After 1 year: 5.4 pounds gained
After 2 years: 8.1 pounds gained
After 4 years: 13.8 pounds gained
After 6 years: 16.5 pounds gained
It seems that the weight gained by Depo­Provera users is related more to an increase in appetite than fluid retention. Reducing your fat and calorie intake and exercising regularly can help you prevent weight gain while using this method.

Whether you use Depo­Provera, Norplant, or the Pill, hormonal birth control takes the guesswork out of family planning and returns spontaneity to sex. It is the most effective method of contraception, and the risks it poses are minimal. As with any medication, it's important to watch for side effects and report them to your doctor. But, if you're like the majority of women, your problems most likely will be few.

Dr Mohans Diabets
American Diabetes Association
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