The efficacy, safety, and acceptability of high-fiber rice-bran diet ("darak") in the control of diabetes mellitus

Fifteen diabetic patients were maintained on a random sequence of control and experimental diets for a period of 12 weeks each. These diets were identical except for crude fiber content, the control diet containing an additional 8g/r day in the form of rice ground bran or "darak". Three patients dropped out of study, two during the control phase, and one during the experimental phase. Using uniform criteria for dosage adjustment among the 12 who finish the study, there was the mean dropped of 69% in dose of current medications during the experimental phase (p0.01). Only two patients had an increase in medications during the experimental phase. One had very poor medical compliance, while in the other, the drop in the medications seems to have heralded the onset of diabetic nephropathy. There was no significant change in serum cholesterol, triglycerides, uric acid, creatinine, calcium, phosphate, sodium, potassium, and chloride, but sample size may have been too small to detect these. The experimental diet was generally well tolerated in terms of texture, appearance, and flavor but nine patients complained of slightly bitter after taste. At the end of study however, pastries and bread were baked with the "darak" and were considered very acceptable by all patients. Average cost of supplementaion per meal was 20 centavos. We conclude that "darak" is a cheap, acceptable, and safe source of dietary fiber, which may be an effective adjustment in the outpatient control diabetic hyperglycemia. (Author)

Which monotherapy for hypertension

The comparative blood pressure lowering and hemodynamic effects of four types of antihypertensive drugs, i.e.indapamide (diuretic), atenalol (betablocker), verapamil (calcium antagonist), and captopril (converting enzyme inhibitor), were evaluated among 30 middle aged men with mild to moderate essential hypertension in a double-blind randomized multiple crossover study. Blood pressure reduction were comparable regardless of hypotensives used. However atenolol 100 mg once daily also produced significant reduction in exercise-induced rate-pressure product and improved LV compliance echocardiogram indices within 2 weeks. Antihypertensive therapy is lifelong. Thus a daily single dose drug is advantageous for better patient acceptability and compliance during longterm antihypertensive therapy.(Auth)