Glucosamine and chondroitin are substances that occur naturally in cartilage. Several studies have shown the benefit of oral glucosamine in osteoarthritis. In a systematic review, glucosamine was found to work as well or better than NSAIDS. (Although other studies have found it less effective.) Often glucosamine is used in combination with chondroitin, although studies are not clear as to whether there is added symptomatic improvement by adding chondroitin, there is suggestion that it may retard progression of the disease. These may be disease modifying agents, rather than just pain suppressing. Doses are 500 mg of glucosamine sulfate three times a day, with or without chondroitin sulfate 400 mg three times/day. A minimum of a 6-week trial should be completed before symptomatic assessment is made.
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Type 1 diabetes is partly inherited, with multiple genes, including certain HLA genotypes, known to influence the risk of diabetes. In genetically susceptible people, the onset of diabetes can be triggered by one or more environmental factors, such as a viral infection or diet. Several viruses have been implicated, but to date there is no stringent evidence to support this hypothesis in humans. Among dietary factors, data suggest that gliadin (a protein present in gluten) may play a role in the development of type 1 diabetes, but the mechanism is not fully understood.
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