Diabetes and food intake Dr. Debabrata Halder

Diabetes is a condition where your body can't use glucose (sugar) properly. There are two main types of diabetes, Type 1 and Type 2. With Type 1, the body doesn't produce any of the hormone insulin that helps regulate how much glucose is in the blood. This type usually develops before the age of 40 and is treated with insulin injections, diet and physical activity.
   With Type 2, not enough insulin is produced or the insulin that is produced doesn't work properly. Traditionally, Type 2 diabetes was only seen in people over 40 but due to increasing levels of obesity, it is now appearing in younger people. Type 2 diabetes is treated with diet and physical activity with the addition of pills or insulin as the condition progresses.
   What you eat is an extremely important part of managing both types of diabetes. If you have diabetes, it's vital to keep your weight under control so a healthy diet, together with regular exercise, will help you do that too.
   According to Diabetic Associasion of Bangladesh, around 10 million people have diabetes and up to a further 2,500,000 people may have Type 2 diabetes without even realising it. The number of children with diabetes has tripled in the last 30 years.
   Not only will a healthy diet help keep your blood glucose levels stable, it will help you maintain a healthy weight too. Around 80 per cent of people diagnosed with Type 2 diabetes are overweight. In fact, a healthy diet could prevent or delay you getting Type 2 diabetes in the first place.
   What diet is recommended for people with diabetes?
   1. Eat three regular meals a day. Avoid skipping meals and spread your breakfast, lunch and evening meal over the day. This will not only help control your appetite but also help in controlling your blood glucose levels.
   2. At each meal include starchy carbohydrate foods such as bread, pasta, chapattis, potatoes, yam, noodles, rice and cereals. The amount of carbohydrate you eat is important to control your blood glucose levels. All varieties are fine but try to include those that are more slowly absorbed (have a lower glycaemic index) as these won't affect your blood glucose levels as much. Better choices include:
   Pasta, rice, grainy breads such as granary, pumpkin and rye, new potatoes, sweet potato and yam, the high fibre varieties of starchy foods will also help to maintain the health of your digestive system and prevent problems such as constipation.
   3. Cut down on the fat you eat, particularly saturated fats as this type of fat is linked to heart disease. Choose unsaturated fats or oils, especially monounsaturated fat (eg, olive oil and rapeseed oil) as these types of fats are better for your heart. All fats contain calories. Fat is the greatest source of calories so eating less fat and fatty foods will help you to lose weight.
   4. Include more beans, lentils, chickpeas, as these can help to control your blood glucose levels and blood fats. Try adding them to soups, or to a salad.
   5. Eat more fruit and vegetables. Aim for at least five servings in total a day to provide you with vitamins, minerals and fibre as well as to help you balance your overall diet. A portion is for example a whole banana or apple a slice of melon two plums a handful of grapes a cereal bowl of salad 3 heaped tablespoons of vegetables.
   6. Limit sugar and sugary foods. Use sugar-free squashes and drinks, as sugary drinks cause blood glucose levels to rise quickly
   7. Reduce salt in your diet to 6g or less a day - more than this can raise your blood pressure, which can lead to stroke and heart disease. Limit the amount of processed foods you eat and try flavouring foods with herbs and spices instead of salt
   8. Drink alcohol moderately only, that is a maximum of two units of alcohol per day for a woman and three units per day for a man. For example, 25ml of spirit or half a pint of normal strength beer is about one unit. Never drink in empty stomach, as alcohol can make hypoglycaemia (low blood glucose levels) more likely to occur when taking certain diabetes medication.
   It is essential that people with diabetes take regular physical exercise as well as eating a healthy, balanced diet.You do at least 30 mins of physical activity five times a week.
   Email: drdbhalder001@yahoo.com

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Juicy Campus

Rayyan Kamal

As classes resumed yesterday after spring break, I was not consoled by the e-mail my Dean sent out to us: "Only 7 weeks to go!" he comforted us. Maybe "only" and "seven weeks" can be used in the same sentence when one is talking about the half-life of an extremely stable element or the age of the universe, but the two terms should not even be within a paragraph of each other when one is discussing how many weeks (months, actually) of classes remain. At least I can seek solace in the fact that, regardless of how many months (years) remain, it's not as if I will be doing any schoolwork during that time anyway.
   Maybe I'll pass the time by spending it on www.JuicyCampus.com, the latest scandal to grace our campus. Created in August 2007 by Duke University alumnus Matt Ivester, the website capitalizes on one of our favourite pastimes: gossiping. Students from over 50 colleges have the opportunity to post rumours, slander peers, and ask innocent questions like "Who is the biggest sl*t on campus?" It's free speech at its basest and most cowardly. Not only can you say what you want, but you can say it anonymously. Imagine how much audacity this promise of anonymity produces.
   Many universities have considered banning JuicyCampus.com from their networks but, as far as I know, none have gone through with it. After all, that would be stifling free speech. But this raises the question of whether the privileges of free speech should be allowed without bearing the responsibility of attaching one's name to a particular statement. Otherwise, things may go too far.
   On December 8,2007, a student at Loyola Marymount University made a post threatening to shoot random students on campus: "I am going to shoot and kill as many people as I can until which time I am incapacitated or killed by the police." He was arrested by the Los Angeles Police Department but was released without charges. A student at Colgate University did not get off as easily. After making a post where he wondered if he could get his classes cancelled by beginning a shooting spree, he was arrested, charged with second-degree aggravated harassment, and released on $1,000 bail.
   Ivester has so far stood by his conviction that the website is just a harmless gossip forum. He feels that people who are offended by its content should simply stay away. Simple solution. The website further cautions the reader to "remember that you are reading a Web site run by people you don't know, containing comments made by people you don't know, concerning events which may or may not have occurred. You should take everything you read with a large grain of salt."
   This is all well and good, but what about when people start making malicious posts about you that spiral out of control? Say you've never gone to the website but your friends and acquaintances on campus begin asking you about humiliating but false rumours they've been reading on the website? Is it still as easy to "stay away"?
   I'm just glad I'm not scandalous enough to warrant posts about me on the website.
   Rayyan Kamal is a sophomore at Yale University.

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Louise Chang, MD and Jennifer Warner

Researchers say a new analysis questions the preferred use of certain blood pressure medications over diuretics in people with metabolic syndrome.
   The analysis shows thiazide diuretics worked as effectively at treating high blood pressure (HBP) -- and in some cases better-than calcium channel blockers, ACE inhibitors, or alpha-blockers in people at high risk for complications from high blood pressure and metabolic syndrome.
   The study was published in the Jan. 28, 2008 edition of Archives of Internal Medicine.
   Metabolic syndrome is defined as elevated blood pressure plus at least two other risk factors, such as elevated fasting blood sugar and triglyceride levels. Having metabolic syndrome puts you at increased risk for heart disease and diabetes. Those with high blood pressure who also have metabolic syndrome are at high risk for cardiovascular disease.
   Researchers say that because alpha-blockers, ACE inhibitors, and calcium channel blockers are believed to have favorable short-term effects on blood sugar or cholesterol levels, they have been suggested for treating high blood pressure in people with metabolic syndrome over diuretics.
   (If you have metabolic syndrome, would you try diuretics as a treatment? Why or why not? Talk about it on WebMD's Hypertension Support Group message board.)
   
   Diuretics for HBP
   In the study, Jackson T. Wright Jr., MD, PhD, of Case Western Reserve University, and colleagues analyzed the results of a large national study including 42,418 people at least 55 years old with high blood pressure and at least one other risk factor for heart disease.
   All participants had high blood pressure and some qualified for metabolic syndrome. Groups were randomly assigned to take a diuretic, calcium channel blocker, alpha-blocker, or an ACE inhibitor. Each high blood pressure medication was used to start treatment, and other drugs could be added if needed to control blood pressure.
   The participants were followed for nearly five years, except for the alpha-blocker group, which was discontinued after about three years after higher rates of stroke and heart failure were found compared with those taking diuretics.
   Overall, the results show no significant advantage in preventing heart attack or other fatal heart-related complications with the use of calcium channel blockers, alpha-blockers, or ACE inhibitors over thiazide diuretics in participants with high blood pressure and metabolic syndrome. This was especially evident among African-American participants.
   "These findings fail to provide support for the selection of alpha-blockers, ACE inhibitors, or calcium channel blockers over thiazide-type diuretics" to prevent cardiovascular problems in patients with metabolic syndrome, the researchers conclude.

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