Role of low-glycemic-index foods in improving overall glycemic control in type 1 and type 2 diabetic patients and correcting excessive postprandial hyperglycemia.
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Animals↗
Biomedical subjects
M Kabir
Publications and source records attributed to M Kabir.
Postpartum beliefs and practices in Danbare village, Northern Nigeria.
Postpartum cultural beliefs and practices are widely prevalent in northern Nigeria. Using a cross-sectional survey, we set out to examine contemporary postpartum beliefs and practices among a cohort of 300 mothers in Danbare village, northern Nigeria. Common postpartum practices included sexual abstinence (100%), physical confinement (88%), hot ritual baths (86%), nursing in heated rooms (84%) and ingestion of gruel enriched with local salt (83%). The majority of mothers (93%) believed that these practices made them stronger and helped them regain their physiologic state. Most respondents believed that non-observance could lead to body swelling, foul-smelling lochia and perineal pain. Mothers with formal education were significantly more likely to believe that these practices were non-beneficial compared with those mothers without formal education (odds ratio (OR) = 9.9, 95% confidence interval (CI) = 3.6 - 28.8). Almost half of the respondents (49%) said they would continue with these practices. In conclusion, women are still holding on to postpartum cultural beliefs and practices in northern Nigeria. However, educated women could act as useful agents of change towards the elimination of practices harmful to the health of mothers and their children.
Adolescent↗
Tobacco consumption and its association with illicit drug use among men in Bangladesh.
AIMS: This study examined the association of tobacco consumption (smoking and chewing) with illicit drug use among Bangladesh males. DESIGN: Cross-sectional survey data from the Bangladesh Demographic and Health Survey 2004 were used. SETTING: Bangladesh. PARTICIPANTS: A total of 4297 males aged 15-54 years. MEASUREMENTS: Age, education, religion, marital status, place of residence; tobacco consumption such as cigarette and bidi smoking, chewing sada, pata, tobacco leaves, gul, betel quid with zarda; taking illicit drugs such as ganja, charas, heroin, pethedine, phensidyl; having sexually transmitted diseases (STDs). FINDINGS: Overall prevalence of tobacco consumption was 59%. Bidi smoking (29.6%), cigarette smoking (27.8%) and chewing betel quid with tobacco/zarda (17.5%) were predominant. Overall prevalence of illicit drug use was 4%. Ganja was the main drug (3%), followed by phensidyl (0.8%), heroin (0.3%) and charas (0.3%). Age, education, place of residence, marital status, having STDs, premarital and extra-marital sex were associated significantly with tobacco smoking. Almost all variables were also associated significantly with illicit drug use. Smoking cigarettes and bidi and eating tobacco leaves/shada pata/gul showed significantly positive associations with illicit drug use when adjusted for other variables. CONCLUSIONS: Tobacco consumption is common and associated positively with the illicit drug use among males in Bangladesh.
Adolescent↗
Economic disparity and child nutrition in Bangladesh.
OBJECTIVE: The aim of this study was to assess the economic difference in nutrition of under-five children. METHODS: Bangladesh Demographic Health Survey data 1999-2000 were used for this study. In this study, quintiles were calculated on the basis of asset and wealth score by use of principal component analysis. To understand the nutrition status and health inequality concentration index was also calculated. RESULTS: The ratio of poorest to the richest indicates that stunting and underweight of the rural under-five children was almost two times higher than that of the richest children. The negative concentration index shows that higher rate of malnutrition among the under-five children from the poorest class. This inequality in health situation of the children can be explained in terms of income inequality. In Bangladesh, about 40% wealth is concentrated to 10% of the families. The results are discussed in terms of policy consideration. CONCLUSION: It is expected that the findings will lead to consider alternative program strategies for the reduction of poor nutritional status of the children and their mothers.
Bangladesh↗
Determinants of utilization of antenatal care services in Kumbotso Village, northern Nigeria.
Women of childbearing age in a rural community in Kano state were interviewed to ascertain the determinants of utilization of antenatal care services in the village. Of the 200 women studied, 118 (59%) utilized antenatal care services during pregnancy. A majority (86%) of those who attained secondary school education, all of those with post-secondary education and 83% of those whose husbands had post-secondary education utilized antenatal care services.
Adolescent↗
Development of an expert system for classification of medical errors.
The 1999 report published by the Institute of Medicine (IOM) indicated that between 44,000 and 98,000 unnecessary deaths per year occurred in hospitals alone, as a result of errors committed by medical professionals in the United States. There has been considerable speculation that these figures are either overestimated or underestimated. For example, the possibility that they focus on isolated injuries rather than error, or the majority of surveyed respondents did not know what constitutes a (medical) error. These disagreements have led experts to challenge the estimates of patient harm attributable to error, as well as the methodologies used to enumerate them. Of particular concern is the process used in the identification, classification and prevention of medical errors. There have been numerous attempts to develop classifications of medical errors, and currently an abundance of taxonomies exist to describe their mechanism.In previous research, (Kopec, Kabir, Reinharth, Rothschild & Castiglione, 2003) a new taxonomy of Medical Errors was designed by expanding the IOM classification. This model and its extension can be used as a blueprint for future design, development and implementation of an expert system for classification of medical errors. Effective classification can facilitate pattern recognition, and pattern recognition will help in understanding the nature, background and abatement of medical errors. Such a system's goal will be to perform convincingly as an advisory consultant, exhibiting expertise on a par with and beyond human experts in specified domains. Despite substantial disagreement on the validity of the published figures for fatalities in hospitals in the IOM report, what is of importance is that the number of deaths caused by such errors is nonetheless alarming. The identification and classification of errors in medical care delivery is a very complex process, and this process can be facilitated and simplified by the implementation of an effective classification system.
Delivery of Health Care↗
Awareness and Practice of Cervical Cancer Screening among Female Health Professionals in Murtala Mohammed Specialist Hospital, Kano.
BACKGROUND: Cervical cancer, although largely preventable, remains the most common cause of cancer mortality among women in the developing world. Other members of the community see health care workers as models, therefore their attitudes and actions are predictors of societal health behaviour. OBJECTIVES: We assessed the knowledge, attitude and practice regarding prevention of cervical cancer among female health professionals in a secondary health facility in Kano, Nigeria. METHODS: A structured questionnaire was administered on 230 female respondents in the various health professions including doctors, pharmacists, nurses and laboratory technologists in Murtala Mohammed Specialist hospital, Kano. RESULTS: Over 60% of the respondents were able to correctly identify all the important aetiological factors associated with cervical cancer, while a similar figure knew the important signs and symptoms of the disease. Up to 94.7% of the respondents had a positive attitude towards Pap smear while 8.2% disapproved of it. Only 20.8% of the respondents have had a Pap smear done previously. Married respondents were more than four times likely to have had a previous Pap smear compared to their single counterparts. (X(2) = 13.3 df=1 P = 0.0003)[O.R=4.8, 95% confidence interval= 1.9 -14.4]. In contrast, religion appeared to have no significant influence on the practice (X(2)= 0.87 df=1 P=0.35). CONCLUSIONS: Despite a moderately high level of knowledge of cervical cancer screening and positive attitude towards it, the uptake of Pap smear was low. There is a need for continuing education to improve uptake of these services by health professionals so as to serve as a motivating factor for the public. Key words: cervical cancer screening, pap smear, female health workers, knowledge, practices.
Early Detection of Cancer↗
Duration of breast-feeding in Bangladesh.
BACKGROUND & OBJECTIVES: The duration of exclusive breast-feeding in Bangladesh is low. Though several studies have been carried out on breast-feeding in Bangladesh, the factors influencing the duration of breast-feeding are not studied. The purpose of this study was to assess the duration of breast-feeding among children in Bangladesh and to study socio-economic and demographic factors affecting the duration. METHODS: The study included 5068 mother-child pairs, selected on the basis of Bangladesh Demographic Health Survey (BDHS) of 1999-2000. The risk of giving supplementary food at different ages was estimated by life table survival method. Independent effects of total duration of breast-feeding of each of the study variables were estimated by using Cox's regression model. RESULTS: The median duration of full breast-feeding was 3.67 months whereas mean and median durations of total breast-feeding was 31.3 and 30 months respectively. Life table analysis showed that 69.9 per cent women gave supplementary food to their babies before reaching six months of age. Cox's regression analysis revealed that women who had lived in rural areas were less likely to terminate breast-feeding than those living in urban areas. Women who had completed at least secondary education were more likely to stop breast-feeding than less or uneducated mothers. Children born in high economic status families had higher risk of stopping breast-feeding compared to those in low economic status families. Further, the deliveries assisted by the relatives had lower risk of terminating breastfeeding than by the health professionals. INTERPRETATION & CONCLUSION: According to the study results, women with higher education, high economic level, lower birth interval and delivery assisted by health personnel had lower duration of breastfeeding. Future breast-feeding programme in Bangladesh should give special attention to these women since they breast-feed relatively shorter periods of time.
Adolescent↗
Errors in medical practice: identification, classification and steps towards reduction.
We present a new taxonomy of medical errors, with emphasis on human errors. We illustrate errors due to medication, errors due to diagnosis, errors due to hospital treatment procedures, and errors related to clerical procedures. We also discuss a database of 143 papers on medical errors which we have developed.
Humans↗
Exclusive breastfeeding and nutritional status in Bangladesh.
OBJECTIVE: The purposes of the study were to assess exclusive breastfeeding practice and examine the factors effect on nutritional status of children from 0 to 24 months age. METHOD: Data from a national survey entitled "Surveillance on Breastfeeding and Weaning Situation and Child and Maternal Health in Bangladesh" were used to investigate the exclusive breastfeeding practice and to examine the factors having influence on child nutrition. Information was collected from mothers of 2781 children between 0 and 24 months of age. RESULTS: It was that 16% of women still exclusively breastfed their children for less than 6 months. Of the children 38.1% were stunted and 38% were under weight for their age. Overall, 46% of children were suffering from diseases. Bivariate analysis showed that maternal education and family income were important correlates of exclusive breastfeeding (Chi-square p<0.001). Exclusively breastfed children were nutritionally better off (p<0.001). Logistic regression analysis showed that the children of illiterate women were nutritionally more vulnerable than children of women who had secondary and higher education (OR=1.69, 95% CI=1.33-2.15). The children of older age women were less likely to be stunted than children of younger age women (OR=0.78, 95% CI=0.64-0.96). CONCLUSION: Despite efforts of different government agencies and NGOs, exclusive breastfeeding rate was still low in Bangladesh. Traditional cultural barriers still exist. In order to remove the harmful cultural beliefs and to spread the messages of the benefit of exclusive breastfeeding for survival and nutritional status of the children more behaviour change communication should be made to promote, protect and support breastfeeding.
Adult↗
Regulation of glucose transport and transporter 4 (GLUT-4) in muscle and adipocytes of sucrose-fed rats: effects of N-3 poly- and monounsaturated fatty acids.
The goal of this study was to compare the short-term effects of dietary n-3 polyunsaturated (fish oil) and monounsaturated (olive oil) fatty acids on glucose transport, plasma glucose and lipid controls in a dietary insulin resistance model using sucrose-fed rats. The underlying cellular and molecular mechanisms were also determined in the muscle and adipose tissue. Male Sprague-Dawley rats (5 weeks old) were randomized for diets containing 57.5 % (w/w) sucrose and 14 % lipids as either fish oil (SF), olive oil (SO) or a mixture of standard oils (SC) for 3 weeks. A fourth control group (C) was fed a diet containing 57.5 % starch and 14 % standard oils. After three weeks on the diet, body weight was comparable in the four groups. The sucrose-fed rats were hyperglycemic and hyperinsulinemic in response to glucose load. The presence of fish oil in the sucrose diet prevented sucrose-induced hyperinsulinemia and hypertriglyceridemia, but had no effect on plasma glucose levels. Insulin-stimulated glucose transport in adipocytes increased after feeding with fish oil (p < 0.005). These modifications were associated with increased Glut-4 protein (p < 0.05) and mRNA levels in adipocytes. In the muscle, no effect was found on Glut-4 protein levels. Olive oil, however, could not bring about any improvement in plasma insulin, plasma lipids or Glut-4 protein levels. We therefore conclude that the presence of fish oil, in contrast to olive oil, prevents insulin resistance and hypertriglyceridemia in rats on a sucrose diet, and restores Glut-4 protein quantity in adipocytes but not in muscle at basal levels. Dietary regulation of Glut-4 proteins appears to be tissue specific and might depend on insulin stimulation and/or duration of dietary interventions.
Adipocytes↗
Improved glycaemic control by addition of glimepiride to metformin monotherapy in type 2 diabetic patients.
AIM: To compare the effect of glimepiride in combination with metformin with monotherapy of each drug on glycaemic control in Type 2 diabetic patients. DESIGN AND METHODS: Randomized, double-blind, double-dummy, parallel-group multicentre study conducted in France. Type 2 diabetic patients aged 35-70 years inadequately controlled by metformin monotherapy 2550 mg daily for at least 4 weeks were randomized to either metformin, glimepiride or metformin and glimepiride. RESULTS: Three hundred and seventy-two patients aged 56 +/- 8 years were treated for 5 months. Combination treatment was significantly more efficient in controlling HbA1c (% change + 0.07 +/- 1.20 for metformin, + 0.27 +/- 1.10 for glimepiride, -0.74 +/- 0.96 for combination treatment, P < 0.001), fasting blood glucose (FBG) (mmol/l change + 0.8 +/- 0.4 for metformin, + 0.7 +/- 3.1 for glimepiride and -1.8 +/- 2.2 for combination treatment, P < 0.001) and post-prandial blood glucose (PPBG) (mmol/l change + 1.1 +/- 5.9 for metformin, + 0.1 +/- 5.1 for glimepiride and -2.6 +/- 3.9 for combination treatment, P < 0.001) than either glimepiride or metformin alone. There was no significant difference between metformin or glimepiride monotherapy with respect to the change in HbA1c or FBG; however, glimepiride was significantly more effective than metformin in reducing PPBG. The incidence of symptomatic hypoglycaemia was higher in the combination group than in either monotherapy group (P = 0.039). CONCLUSIONS: Addition of glimepiride to metformin in Type 2 diabetic patients inadequately controlled by metformin alone resulted in superior glycaemic control compared with glimepiride or metformin monotherapy.
Adult↗
The impact of mass media family planning programmes on current use of contraception in urban Bangladesh.
A sample of 871 currently married urban Bangladeshi women was used to assess the impact of mass media family planning programmes on current contraceptive use. The analyses suggested that radio had been playing a significant role in spreading family planning messages among eligible clients; 38% of women with access to a radio had heard of family planning messages while the figures for TV and newspaper were 18.5% and 8.5% respectively. Education, number of living children and current contraceptive use were important predictors of exposure to any mass media family planning messages. There was a negative relationship between breast-feeding and the current use of contraception indicating a low need for contraception among women who were breast-feeding.
Adolescent↗
Negative regulation of leptin by chronic high-glycemic index starch diet.
The response of plasma leptin to a high-glycemic index (high-GI) starch diet after a short (3 weeks) and prolonged (12 weeks) period was determined in Sprague-Dawley rats. Age-matched rats were fed an identical isocaloric diet except that the carbohydrates were from either mung bean starch (low-GI) or waxy cornstarch (high-GI). After a single test meal of the high-GI starch diet, postprandial plasma glucose (P < .05) and insulin (P < .01) peaks and plasma glucose (P < .014) and insulin (P < .05) areas were higher versus the low-GI starch diet (n = 8 per group). Other age-matched control rats were fed the same diets for a longer period. After 3 weeks, ob mRNA levels were decreased by 50% (P < .005) in the epididymal adipose tissue of high-GI-fed rats versus low-GI-fed rats, without a significant decrease in plasma leptin. After 12 weeks of the high-GI starch diet, both plasma leptin and ob mRNA were decreased by 34% (P < .005) and 41% (P < .05), respectively, compared with the low-GI diet. Both relative epididymal adipose tissue weight (adjusted per 100 g body weight) and total fat mass, as measured by dual-energy x-ray absorptiometry (DEXA), were unchanged by the high-GI starch diet. Basal nonfasting plasma insulin, glucose, and triglycerides were not altered by the high-GI starch diet, whereas free fatty acids were significantly elevated and associated with a trend (P < .13) for increased plasma free glycerol. Plasma leptin levels were negatively correlated with free fatty acid levels (r = .56, P < .05). Despite low leptin, rats fed on the high-GI diet did not increase their food intake, suggesting increased leptin sensitivity. These findings might precede weight gain and the increase in fat mass. Chronic nutritional factors might alter plasma leptin via several overlapping factors independently of energy intake.
Adipose Tissue↗
Chronic consumption of fresh but not heated yogurt improves breath-hydrogen status and short-chain fatty acid profiles: a controlled study in healthy men with or without lactose maldigestion.
BACKGROUND: Ingestion of fermented dairy products induces changes in the equilibrium and metabolism of the intestinal microflora and may thus have beneficial effects on the host. OBJECTIVE: We compared the effects of chronic consumption of yogurt with (fresh) or without (heated) live bacterial cultures (Lactobacillus bulgaricus and Streptococcus thermophilus) on plasma glucose, insulin, triacylglycerols, cholesterol, fatty acids, and short-chain fatty acids. DESIGN: Two groups of 12 healthy men with or without lactose malabsorption were selected with use of a breath-hydrogen test after a 30-g lactose load. Subjects were randomly assigned in a crossover design to 500 g/d of either fresh or heated yogurt for 2 periods of 15 d each, separated by a 15-d washout interval. RESULTS: Chronic consumption of fresh or heated yogurt had no detrimental effects on plasma glucose, insulin, or fatty acid areas under the curve in response to acute ingestion of 500 g yogurt in healthy men with or without lactose malabsorption. There were also no detectable changes in fasting plasma glucose, insulin, fatty acid, triacylglycerol, or cholesterol concentrations. In contrast, plasma butyrate was higher (P: < 0.03) and plasma propionate tended to be higher (P: = 0.059) in subjects without lactose malabsorption after fresh yogurt consumption than after heated yogurt consumption. There were no significant changes in plasma acetate. In subjects with lactose malabsorption, 15 d of fresh yogurt consumption also increased propionate production compared with values at baseline (P: < 0.04). In the same group, the production of breath hydrogen was lower after fresh yogurt consumption than after heated yogurt consumption (P: < 0.01). CONCLUSIONS: In men with lactose malabsorption, chronic consumption of yogurt containing live bacterial cultures ameliorated the malabsorption, as evidenced by lower breath-hydrogen excretion, but increased propionate concentrations. In subjects without lactose malabsorption, such yogurt tended to increase propionate and increased butyrate.
Adult↗
Dietary amylose-amylopectin starch content affects glucose and lipid metabolism in adipocytes of normal and diabetic rats.
The aim of this study was to evaluate the effects of the chronic consumption of two starches, characterized by different glycemic indices and amylose-amylopectin content, on glucose metabolism in rat epididymal adipocytes. The two chosen starches were from mung bean (32% amylose) and cornstarch (0.5% amylose). The alpha-amylase digestibility was higher for the waxy cornstarch than that of the mung bean starch (60 +/- 4 vs. 45 +/- 3%, mean +/- SEM, respectively). The glycemic index of the waxy cornstarch diet (575 g starch /kg diet) was higher than that of the mung bean starch diet (107 +/- 7 vs. 67 +/- 5%, P < 0.01) when measured in vivo in two groups of normal rats (n = 9). In a subsequent study, normal and diabetic (streptozotocin-injected on d 2 of life) male Sprague-Dawley rats (18 per group) consumed a diet containing 575 g starch/kg diet as either waxy cornstarch or mung bean starch. After 3 wk, food intake, epididymal fat pad weights, and plasma glucose, insulin and triglyceride concentrations did not differ between diet groups. Adipocyte diameter was smaller in rats that consumed mung bean starch compared with those that consumed the waxy cornstarch diet (P < 0.01). The mung bean diet increased maximal insulin-stimulated 14C-glucose oxidation (% of basal values, P < 0. 05). In contrast, incorporation of 14C-glucose into total lipids was significantly lower in rats that consumed the mung bean diet (P < 0. 05). We conclude that in both normal and diabetic rats, the chronic replacement of a high glycemic index starch by a low glycemic index one in a mixed diet increases insulin-stimulated glucose oxidation, decreases glucose incorporation into total lipids and decreases epididymal adipocyte diameter. Thus, the type of starch mixed into the diet has important metabolic consequences at the cellular level in both normal and diabetic rats.
Adipocytes↗
A high glycemic index starch diet affects lipid storage-related enzymes in normal and to a lesser extent in diabetic rats.
The of this study was to evaluate the chronic effects of a high (waxy corn) vs. a low (mung beans) glycemic index starch diet on the lipogenic enzymes, fatty acid synthase (FAS) and lipoprotein lipase (LPL). Normal and diabetic (streptozotocin-injected on d 2 of life) male Sprague-Dawley rats consumed a diet containing 575 g/kg carbohydrates either as waxy cornstarch (WCS) or as mung bean starch (MBS). After 3 wk, neither body weights nor relative epididymal fat pad weights differed. In diabetic rats, the WCS diet induced high basal plasma insulin levels. Plasma triglycerides were not significantly affected by diet in either normal or diabetic rats. Adipose tissue and liver LPL activities were not modified by the type of starch in the diet. In normal rats, FAS activity and gene expression in epididymal adipose tissue but not in liver were greater in rats consuming the WCS diet than in those consuming MBS. To evaluate the implication of insulin in this regulation, two genes regulated by insulin [GLUT4 and phosphoenolpyruvate carboxykinase (PEPCK)] were also studied. The high glycemic index WCS diet compared with the low glycemic index MBS diet resulted in lower hepatic PEPCK mRNA in both normal and diabetic rats. Normal, but not diabetic rats fed WCS had greater GLUT4 gene expression in adipocytes than did those fed MBS. We conclude that the total replacement of 575 g/kg low glycemic index starch by a high glycemic index starch for 3 wk caused the following in normal rats: 1) high FAS activity and mRNA in adipose tissue but not in liver and 2) high GLUT4 gene expression in adipose tissue. In both normal and diabetic rats this same diet resulted in lower hepatic PEPCK mRNA. Therefore, high glycemic index starch diet is implicated in stimulating FAS activity and lipogenesis and might have undesirable long-term metabolic effects.
Adipose Tissue↗
Plasma lipids and fatty acid synthase activity are regulated by short-chain fructo-oligosaccharides in sucrose-fed insulin-resistant rats.
The aim of this study was to evaluate the chronic effects of a short-chain fructo-oligosaccharide (FOS)-containing diet on plasma lipids and the activity of fatty acid synthase (FAS) in insulin-resistant rats. Normal male Sprague-Dawley rats, 5 wk old, were randomly assigned to two groups and fed either a sucrose-rich diet (S, 575 g sucrose /kg diet and 140 g lipids/kg diet) or a sucrose-rich diet supplemented with 10 g/100 g short-chain fructo-oligosaccharides (S/FOS). A third reference group (R) was fed a standard nonpurified diet (g/kg, 575 g starch, 50 g fat). After 3 wk the sucrose-fed rats (compared with the R group) were characterized by the following: 1) higher insulin responses after a glucose challenge (P < 0.05); 2) heavier liver (P < 0.001) and retroperitoneal adipose tissue (P < 0.01); 3) hypertriglyceridemia (P < 0.0001) and higher plasma free fatty acids (P < 0.0001); and 4) higher fatty acid synthase activity in the liver but a low activity in the adipose tissue (P < 0.001). The addition of FOS to the diet resulted in 11% lower liver weight than in the S group (P < 0.05) and tended to result in lower adipose tissue weight (P < 0.11). Plasma triglycerides and plasma free fatty acids were lower in S/FOS- than in S-fed rats (P < 0.05). Chylomicrons + VLDL, and intermediate density lipoprotein (IDL) concentrations did not differ between groups, nor was plasma cholesterol influenced by diet. Hepatic FAS activity was lower in S/FOS-fed rats than in the S-fed rats (P < 0.05). In adipose tissue, however, this activity tended to be greater in rats fed S/FOS than in rats fed the S diet (P < 0.07). In conclusion, in a rat model of diet-induced (57.5% sucrose and 14% lipids) insulin resistance, the addition of short-chain FOS prevented some lipid disorders, lowered fatty acid synthase activity in the liver and tended to raise this activity in the adipose tissue. Short-chain FOS, in addition to being a nondigestible sweetener with good bulking capacity, might be useful in the treatment of insulin resistance and hyperlipidemia.
Animals↗