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Glycaemic responses after ingestion of some local foods by non-insulin dependent diabetic subjects.

Fifteen non-insulin dependent diabetic volunteers, aged 51 +/- 3.9 years, were studied over a two month period to determine their glycaemic responses to various local foods. They were all on chlorpropamide and one subject was removed from analysis due to concurrent use of insulin. They received on separate occasions two servings of white bread, one serving of: brown bread, white lice, English potatoes, maize meal, millet and cassava each. Each meal contained 50 g of carbohydrate. A total of 107 glucose tolerance tests (GTTs) were performed and the glycaemic index (GI) for each food calculated. The mean blood sugars at 0,60 and 120 minutes were comparable for each food, and the peak rise occurred at 60 minutes. The highest rise (4.0 mmol/I) was seen with millet porridge. The highest GI was seen with white rice and the lowest with English potatoes (159.9 and 34.3 respectively). Overall, the cereals conferred higher GIs than the root vegetables. The GIs of English potatoes, maize meal, millet and cassava significantly differed from that of white bread. It is concluded that, using GIs, dietary guidelines comprising locally available and affordable foods can be made.

Adult↗

Evaluation of phototoxic properties of oral antidiabetics and diuretics. Photohemolysis model as a screening method for recognizing potential photosensitizing drugs.

The oral hypoglycemic drugs carbutamide, chlorpropamide, glibenclamide, glubornuride, gliclazide, glipizide, gliquidone, glisoxepide, glymidine, tolazamide and tolbutamide, and the diuretics acetazolamide, bemetizide, bendroflumethiazide, benzthiazide, benzylhydrochlorothiazide, bumetanide, butizide, chlorazanile, chlorothiazide, chlortalidone, clopamide, cyclopenthiazide, cyclothiazide, diazoxide, etozoline, furosemide, hydrochlorothiazide, hydroflumethiazide, indapamide, mefruside, metolazone, piretanide, polythiazide, trichlormethiazide, and xipamide were investigated for photohemolytic properties in vitro. Irradiation with a SOL 3 apparatus (solar simulating irradiation) revealed hemolysis in the presence of five oral hypoglycemic agents and in the presence of 19 out of the 25 tested diuretics. Photohemolysis was induced in the presence of three substances, respectively, after exposure to UVA or visible light. UVB alone did not induce phototoxic hemolysis in the presence of the tested drugs. Compared to clinical reports on photosensitivity reactions, the photohemolysis model seems a good predictive model in recognizing potential photosensitizing sulfonamides.

Dermatitis, Phototoxic↗

Hypoglycaemia in the elderly.

AIM: To determine the prevalence, presentation, causes and consequences of hypoglycaemia in the elderly, and to make preventive recommendations. METHOD: Retrospective review of case records. RESULTS: The definition of hypoglycaemia is defined as symptoms with a capillary blood sugar of less than 3 mmol/L measured on the Reflolux II or Accutrend glucometer. Out of 1,919 admissions to our department from November 1993 to January 1996, there were 45 cases of hypoglycaemia. The average age was 76.2 years (range 66 to 89 years); 32 were females, 13 males, 35 had diabetes mellitus and 10 were non-diabetics. Forty patients presented with neuroglycopaenic symptoms and 5 patients presented with adrenergic symptoms. Thirteen patients presented were solely due to drugs (mainly glibenclamide); 9 cases were due only to disease (mainly psychiatric illnesses with poor intake); 23 cases were due to both drugs and diseases (mainly a combination of glibenclamide, tolbutamide and psychiatric illness with poor intake, renal failure, gastroenteritis and sepsis). All were easily reversed with an intravenous bolus of 50% glucose or continuous 10% glucose infusions. Forty-three patients did not suffer any morbidity, one suffered a stroke and another fell because of giddiness. CONCLUSION: We recommend that: (1) the importance of having regular meals be emphasised to elderly patients and their carers, especially if they are taking hypoglycaemic agents; (2) regular home glucose monitoring for diabetic patients; (3) assessment and monitoring of renal function before prescribing hypoglycaemic agents; (4) avoidance of the use of long or medium acting sulphonylureas eg. chlorpropamide, glibenclamide in the elderly; (5) adjustment of hypoglycaemic agents (in consultation with a trained nurse/doctor) if the patient suffers from gastroenteritis and (6) less stringent blood glucose control in those with psychiatric illnesses who may have variable food intake.

Aged↗