Effect of Fiber bread on the management of diabetes mellitus

To evaluate the effects of soluble fiber rich bread on lowering blood glucose, blood pressure and blood lipid levels. An interventional study. The study was undertaken at Medical Unit III, Jinnah Postgraduate Medical Centre, Karachi. Duration of the project was one year [1997-1998]. Twenty stable diabetics of both genders were included in this study. They were provided with this bread [test diet] to replace their usual breakfast bread and chapati for lunch and dinner. The intakes of other foods as well as medications were unchanged. Anthropometric measurements, fasting and 2 hours postprandial blood sugar, fasting serum cholesterol and triglyceride levels were recorded before and after 4 weeks of intervention. Blood sugar and blood pressure were checked every week. Quality of life was assessed subjectively with the help of questionnaire, which were asked before and after the end of the intervention. Glycemic control, both fasting and postprandial, improved significantly during intervention. Satisfactory reduction of blood pressure as well as serum cholesterol and triglyceride level was also observed in these cases. The medicines reduced significantly and quality of life improved in all subjects. None of these subjects complained any gastrointestinal discomfort during their consumption of this bread for 4 weeks. The use of soluble fiber rich bread helps to control blood sugar, the hyperlipidemia, and blood pressure which are elevated in poorly controlled diabetics. Thus, integrated improvement will improve the quality of life, reduce the cost of drugs as well as help to avoid harmful effect of drugs

Relative frequency of arterial hypertension in patients with diabetes mellitus, current perspective

Diabetes mellitus with its long term complications is a common problem in our country. Arterial hypertension is commonly found in association with diabetes mellitus. As hypertension constitutes a major cardiovascular risk factor, it is essential to diagnose and treat elevated blood pressure as a part of a multiple risk factor intervention strategy in diabetic patients. There is relatively limited data available of diabetic hypertensive patients with regard to its prevalence and associated nephropathy in our country. This hospital based small size prospective study of 1.86 diabetics, comprised 42 patients with IDDM and 144 patients with NIDDM, of both sexes and ages between 18 to 60 years. The main objective of this study was to evaluate the prevalence of hypertension in diabetic patients and its development and progression of diabetic nephropathy. The overall frequency of arterial hypertension was higher [47%] in NIDDM group as compared to IDDM which was 24%. In NIDDM group, the prevalence of normoalbuminuria 49% while microalbuminuria was 33% and macroalbuminuria was 18%, while in IDDM group, the of normoalbuminuria was, 38%, microalbuminuria 33% and macroalbuminuria was 29%. In NIDDM group, the frequency of arterial hypertension was 37% in norm oalbuminuric group, while 52% in microalbuminuria and 61% in macroalbuminuric patients. The IDDM group showed a high frequency of raised arterial hypertension with onset of clinical nephropathy being 17% in normoalbuminuric, 30% in micro and 65% in macroalbuminuric patients. In order to decrease the disability and to prevent, induced or accelerated by hypertension, easy detection and treatment is mandatory. The JNCVI, criteria approved by American Diabetic Association [ADA] are the most sensitive detectors of the early harbingers of potentially serious diabetic complications