Cassava contains linamarin, a cyanogenic glucoside thought to be a causative agent in the develop... more Cassava contains linamarin, a cyanogenic glucoside thought to be a causative agent in the development of diabetes mellitus especially in the tropics. A study was done on a cohort of thirty-eight (38) diabetics, 18 cassava eating and 20 non-cassava eating attending the Diabetic Clinic at the University Hospital. The form of cassava eaten was the cake properly referred to as "bammy". Although extensive extraction was done in the preparation of bammy, linamarin was still present in all bammy extracts in concentrations varying from 0.137 to 6.11 ug/ul extract. TMCS - (Trimethyl chloro silyl) derivatization and gas liquid chromatography analysis was done on bammy extracts, and sera of cassava eaters and non-cassava eaters. Linamarin was used as standard reference. Linamarin was found in the serum of 5 (37 percent) of the diabetics consuming cassava, concentrations varying from 0.0158 - 0.180 ug linamarin/ul serum. No linamarin was found in the serum of the non-cassava consuming diabetic group. Detailed investigation of the group of five diabetics consuming cassava and showing linamarin in their serum showed that this group had relatively lower C peptide and higher glycosylated haemoglobin values than the other diabetics. These findings, though preliminary could suggest an aggravating role for linamarin in the control of diabetes in our Jamaican patients. (AU)
An insulin-dependent diabetic was diagnosed at the age of 7 years. After two years of satisfactor... more An insulin-dependent diabetic was diagnosed at the age of 7 years. After two years of satisfactory control she began to have several bouts of hospitalization with hyperglycaemic ketoacidosis, and developed tender hepatomegaly, which persisted to age 11 years. With restabilisation of her diabetes, the liver regressed and she continued to maintain good health for another 1 1/2 years when she died suddenly while asleep. Post-mortem examination by the coroner revealed ascites in the abdomen, hepatomegaly and fatty metamorphosis of the liver. Her diabetes control required up to 2.3 i.u. insulin per kg body weight per day plus a 1,900 calorie diet. Her growth was well below the tenth percentile, weight for height (Harvard charts). This clinical picture of high insulin dosage, hepatomegaly, unstable diabetes and growth failure approximates to the Mauriac syndrome.
This study investigates the alteration of serum cholinesterase levels in diabetics and its possib... more This study investigates the alteration of serum cholinesterase levels in diabetics and its possible relationship to blood glucose, insulin, triglyceride, and cholesterol levels. Fourteen phasic insulin-dependent diabetes mellitus patients were compared with 10 insulin-dependent diabetes mellitus, 10 noninsulin-dependent diabetes mellitus, and 10 normal controls. Each group was matched for age, sex, body mass index, and duration of diabetes. Mean age was 56.7 +/- 2.5 years; mean body mass index, 24.0 +/- 0.8 kg/m2; and mean duration of diabetes, 14.2 +/- 2.2 years. Serum acetylcholinesterase, insulin, triglyceride, and cholesterol levels as well as fasting blood sugar were all assayed using standard techniques. Results suggest an associated increase of serum acetylcholinesterase with triglyceride levels in diabetics and may point to a possible association between increased serum acetylcholinesterase and vascular complications in Jamaican diabetics.
Clinical neurological studies, blood pressure measurements and some haematological investigations... more Clinical neurological studies, blood pressure measurements and some haematological investigations were performed on a random sample of forty-four patients, at the Diabetes Out-Patient Clinic of the University Hospital of the West Indies (UHWI), to examine some of the factors that predispose to the development of the diabetic foot. Our results revealed that 86% of the patients had elevated glycosylated haemoglobin (HbA1 > 9.0%), 82% had clinical signs of peripheral sensory neuropathy, 29% had signs of autonomic neuropathy in addition to peripheral sensory neuropathy. Sixty-one per cent (61%) of the patients had ankle/arm systolic blood pressure ratio less than 1.0 and were diagnosed as having peripheral vascular disease (PVD). The group with neuropathy was found to have a significantly lower diastolic blood pressure (p < 0.0005) than the group without neuropathy. We believe that hyperglycaemia-induced vasodilation (indicated by a lower diastolic blood pressure) in a significant number of diabetics resulted in compensatory shunting of blood from the deeper tissues, including nerves, to the periphery. The resulting endoneural hypoxia could be responsible for the unusually high incidence of peripheral sensory neuropathy detected in this sample of diabetic patients. Metabolic factors may also play a role.
Submission of this article implies that the work described has not been published previously exce... more Submission of this article implies that the work described has not been published previously except in the form of an abstract or as part of a published lecture or academic thesis or as an electronic preprint, that it is not under consideration for publication elsewhere, that its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out, and that, if accepted, it will not be published elsewhere including electronically in the same form, in English or in any other language, without the written consent of the copyright-holder. Declaration of interest: The authors state categorically that we have no financial or personal relationship with other people or organizations that could inappropriately influence the work therein contained.
J type diabetes is grouped as a subtype of type III or malnutrition-related diabetes, known as pr... more J type diabetes is grouped as a subtype of type III or malnutrition-related diabetes, known as protein-deficient pancreatic diabetes, (PDPD). J type diabetes has not been reported recently, but a clinical picture called phasic insulin-dependent diabetes mellitus (PIDDM) has been elaborated in Jamaica, the same home country of PDRD and appears to be a "formes frustes" syndrome. The following comparative studies were performed on a group of diabetic patients and normal controls: insulin receptor binding; renal, hepatic, and pancreatic function; and abdominal ultrasonography. The results show a considerably decreased white and red blood cell binding to insulin (P less than .05), extensive kidney damage (P less than .05), and increased pancreatic echogenicity in PIDDM, supporting a separate identity of this latter syndrome from types I and II diabetes mellitus. Also, the features of relative insulin resistance, absence of ketosis even in the presence of severe hyperglycemia, and intermittent insulin requirement suggests that PIDDM, J type diabetes, and PDPD are one and the same syndrome.
... Fotocópia. Id: 11598. Autor: Morrison, Errol Y. St. A; West, Manley E. Título: The effect of ... more ... Fotocópia. Id: 11598. Autor: Morrison, Errol Y. St. A; West, Manley E. Título: The effect of bixa orellana (annatto) on blood sugar levels in the anaesthetized dog. Fonte: West Indian med. j;34(1):38-42, Mar. 1985. Idioma: En. Resumo: The fruit of Bixa has red-coated seeds. ...
Publisher Summary This chapter describes diabetes mellitus and its management in the Caribbean. T... more Publisher Summary This chapter describes diabetes mellitus and its management in the Caribbean. The populations of the Caribbean islands share a similar colonial past and are mainly of African descent. The problems of inadequate health care, education, and socioeconomic stress are common to all. The estimated prevalence of diabetes mellitus ranges from 2% to 6%. Thus, there should be some 600,000 diabetics in the Caribbean, with females probably being affected twice as commonly as males. Prevalence rates are very low in the under-30-year age-group and gradually rise to a peak in the sixth decade. The average diabetic in the Caribbean spends some 10 years between the date of diagnosis and first presentation to a specialist center. It is not surprising that gangrene is still a common presenting problem and the commonest complication, 7% of diabetics, seen in hospital, followed in descending order by neuropathy, 4%; retinopathy, 2% in nonhypertensive; ischaemic heart disease, 2%; and nephropathy, 1%. Associated diseases are common especially in patients over 60 years, where hypertension is found in 53% and obesity in 45%. Diabetes is a related factor in 7% of all deaths in the Caribbean.
I In nt tr ro od du uc ct ti io on n: : The study was carried out to investigate the effect of Ha... more I In nt tr ro od du uc ct ti io on n: : The study was carried out to investigate the effect of Hatha yoga and conventional physical training (PT) exercise intervention on clinical and biochemical parameters in patients with type 2 diabetes. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : The patient population consisted of 77 type 2 diabetic patients in the Hatha yoga exercise group, matched with the same number of patients in the conventional PT exercise and control groups. The clinical parameters were weekly diastolic and systolic blood pressures, along with body mass index (BMI). Biochemical parameters included weekly blood glucose, serum creatinine, microalbumjinuria and glycosylated haemoglobin (HbA 1c) measured at baseline and two consecutive three monthly intervals. R Re es su ul lt ts s: : There were significant differences in the blood glucose concentrations "before exercise" and "after exercise" for the Hatha yoga and conventional PT exercise groups at different weekly intervals (P<0.05). The frequency of signs and symptoms of hypoglycaemia and hyperglycaemia over the weeks during exercise was greater in the conventional PT exercise than in the Hatha yoga exercise group (P=0.004). The HbA 1c concentration decreased after six months in the Hatha yoga and conventional PT exercise groups and was significantly different from that of the control group (P<0.05). There were significant reductions in systolic and diastolic blood pressures observed before and after exercise for the Hatha yoga and conventional PT exercise groups (P=0.0001). C Co on nc cl lu us si io on ns s: : These findings suggest that better glycaemic and blood pressure control can be obtained in type 2 diabetic patients after Hatha yoga and conventional PT exercises.
This book is the first of its kind and will provide much needed information about the toxins that... more This book is the first of its kind and will provide much needed information about the toxins that are present in fifty of the most poisonous plants here, with data on their effects on the body and very importantly, the antidotes that are needed
A retrospective study of 58 hypothyroid patients attending the Endocrine Clinic, University Hospi... more A retrospective study of 58 hypothyroid patients attending the Endocrine Clinic, University Hospital of the West Indies, Jamaica, between July and August 1989, was undertaken. The age range at initial presentation varied from one month to eighty-four years. The majority of cases (51 or 87.9%) were between 21 and 70 years. There were 50 females (86.2%) and 8 males (13.8%). The underlying causes were idiopathic hypothyroidism (35 or 60.3%), posthyroidectomy (13 or 22.4%), post I131 therapy (6 or 10.4%), panhypopituitarism (3 or 5.2%), hypophysectomy (1 or 1.7%). Biochemical parameters used in diagnosis were serum thyroxine (T4) and thyroid-stimulating hormone (TSH). Forty-six patients (79.2%) had elevated TSH, indicative of a high correlation of elevated TSH with hypothyroidism. Duration of symptomatology prior to diagnosis was one year in 27 patients (46.5%), 2-10 years in 23 (39.6%) and 10 years in 4 cases (6.9%). The major presenting signs and symptoms were lethargy (20 or 34.5%), anaemia (mixed normochromic, microcytic (16 or 27.6%), slow relaxation of tendon reflexes (16 or 27.6%), coarsening of skin (15 or 25.9%), weight gain 10 or 17.2%), hoarseness (9 or 15.5%) and psychiatric symptoms (7 or 12%). The known association of primary hypothyroidism with other autoimmune disorders was not borne out in this study. The time-lapse in diagnosis from symptomatology emphasized the need for clinicians to be more alert to the subtle and varied presentation of hypothyroidism.
Cassava contains linamarin, a cyanogenic glucoside thought to be a causative agent in the develop... more Cassava contains linamarin, a cyanogenic glucoside thought to be a causative agent in the development of diabetes mellitus especially in the tropics. A study was done on a cohort of thirty-eight (38) diabetics, 18 cassava eating and 20 non-cassava eating attending the Diabetic Clinic at the University Hospital. The form of cassava eaten was the cake properly referred to as "bammy". Although extensive extraction was done in the preparation of bammy, linamarin was still present in all bammy extracts in concentrations varying from 0.137 to 6.11 ug/ul extract. TMCS - (Trimethyl chloro silyl) derivatization and gas liquid chromatography analysis was done on bammy extracts, and sera of cassava eaters and non-cassava eaters. Linamarin was used as standard reference. Linamarin was found in the serum of 5 (37 percent) of the diabetics consuming cassava, concentrations varying from 0.0158 - 0.180 ug linamarin/ul serum. No linamarin was found in the serum of the non-cassava consuming diabetic group. Detailed investigation of the group of five diabetics consuming cassava and showing linamarin in their serum showed that this group had relatively lower C peptide and higher glycosylated haemoglobin values than the other diabetics. These findings, though preliminary could suggest an aggravating role for linamarin in the control of diabetes in our Jamaican patients. (AU)
An insulin-dependent diabetic was diagnosed at the age of 7 years. After two years of satisfactor... more An insulin-dependent diabetic was diagnosed at the age of 7 years. After two years of satisfactory control she began to have several bouts of hospitalization with hyperglycaemic ketoacidosis, and developed tender hepatomegaly, which persisted to age 11 years. With restabilisation of her diabetes, the liver regressed and she continued to maintain good health for another 1 1/2 years when she died suddenly while asleep. Post-mortem examination by the coroner revealed ascites in the abdomen, hepatomegaly and fatty metamorphosis of the liver. Her diabetes control required up to 2.3 i.u. insulin per kg body weight per day plus a 1,900 calorie diet. Her growth was well below the tenth percentile, weight for height (Harvard charts). This clinical picture of high insulin dosage, hepatomegaly, unstable diabetes and growth failure approximates to the Mauriac syndrome.
This study investigates the alteration of serum cholinesterase levels in diabetics and its possib... more This study investigates the alteration of serum cholinesterase levels in diabetics and its possible relationship to blood glucose, insulin, triglyceride, and cholesterol levels. Fourteen phasic insulin-dependent diabetes mellitus patients were compared with 10 insulin-dependent diabetes mellitus, 10 noninsulin-dependent diabetes mellitus, and 10 normal controls. Each group was matched for age, sex, body mass index, and duration of diabetes. Mean age was 56.7 +/- 2.5 years; mean body mass index, 24.0 +/- 0.8 kg/m2; and mean duration of diabetes, 14.2 +/- 2.2 years. Serum acetylcholinesterase, insulin, triglyceride, and cholesterol levels as well as fasting blood sugar were all assayed using standard techniques. Results suggest an associated increase of serum acetylcholinesterase with triglyceride levels in diabetics and may point to a possible association between increased serum acetylcholinesterase and vascular complications in Jamaican diabetics.
Clinical neurological studies, blood pressure measurements and some haematological investigations... more Clinical neurological studies, blood pressure measurements and some haematological investigations were performed on a random sample of forty-four patients, at the Diabetes Out-Patient Clinic of the University Hospital of the West Indies (UHWI), to examine some of the factors that predispose to the development of the diabetic foot. Our results revealed that 86% of the patients had elevated glycosylated haemoglobin (HbA1 > 9.0%), 82% had clinical signs of peripheral sensory neuropathy, 29% had signs of autonomic neuropathy in addition to peripheral sensory neuropathy. Sixty-one per cent (61%) of the patients had ankle/arm systolic blood pressure ratio less than 1.0 and were diagnosed as having peripheral vascular disease (PVD). The group with neuropathy was found to have a significantly lower diastolic blood pressure (p < 0.0005) than the group without neuropathy. We believe that hyperglycaemia-induced vasodilation (indicated by a lower diastolic blood pressure) in a significant number of diabetics resulted in compensatory shunting of blood from the deeper tissues, including nerves, to the periphery. The resulting endoneural hypoxia could be responsible for the unusually high incidence of peripheral sensory neuropathy detected in this sample of diabetic patients. Metabolic factors may also play a role.
Submission of this article implies that the work described has not been published previously exce... more Submission of this article implies that the work described has not been published previously except in the form of an abstract or as part of a published lecture or academic thesis or as an electronic preprint, that it is not under consideration for publication elsewhere, that its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out, and that, if accepted, it will not be published elsewhere including electronically in the same form, in English or in any other language, without the written consent of the copyright-holder. Declaration of interest: The authors state categorically that we have no financial or personal relationship with other people or organizations that could inappropriately influence the work therein contained.
J type diabetes is grouped as a subtype of type III or malnutrition-related diabetes, known as pr... more J type diabetes is grouped as a subtype of type III or malnutrition-related diabetes, known as protein-deficient pancreatic diabetes, (PDPD). J type diabetes has not been reported recently, but a clinical picture called phasic insulin-dependent diabetes mellitus (PIDDM) has been elaborated in Jamaica, the same home country of PDRD and appears to be a "formes frustes" syndrome. The following comparative studies were performed on a group of diabetic patients and normal controls: insulin receptor binding; renal, hepatic, and pancreatic function; and abdominal ultrasonography. The results show a considerably decreased white and red blood cell binding to insulin (P less than .05), extensive kidney damage (P less than .05), and increased pancreatic echogenicity in PIDDM, supporting a separate identity of this latter syndrome from types I and II diabetes mellitus. Also, the features of relative insulin resistance, absence of ketosis even in the presence of severe hyperglycemia, and intermittent insulin requirement suggests that PIDDM, J type diabetes, and PDPD are one and the same syndrome.
... Fotocópia. Id: 11598. Autor: Morrison, Errol Y. St. A; West, Manley E. Título: The effect of ... more ... Fotocópia. Id: 11598. Autor: Morrison, Errol Y. St. A; West, Manley E. Título: The effect of bixa orellana (annatto) on blood sugar levels in the anaesthetized dog. Fonte: West Indian med. j;34(1):38-42, Mar. 1985. Idioma: En. Resumo: The fruit of Bixa has red-coated seeds. ...
Publisher Summary This chapter describes diabetes mellitus and its management in the Caribbean. T... more Publisher Summary This chapter describes diabetes mellitus and its management in the Caribbean. The populations of the Caribbean islands share a similar colonial past and are mainly of African descent. The problems of inadequate health care, education, and socioeconomic stress are common to all. The estimated prevalence of diabetes mellitus ranges from 2% to 6%. Thus, there should be some 600,000 diabetics in the Caribbean, with females probably being affected twice as commonly as males. Prevalence rates are very low in the under-30-year age-group and gradually rise to a peak in the sixth decade. The average diabetic in the Caribbean spends some 10 years between the date of diagnosis and first presentation to a specialist center. It is not surprising that gangrene is still a common presenting problem and the commonest complication, 7% of diabetics, seen in hospital, followed in descending order by neuropathy, 4%; retinopathy, 2% in nonhypertensive; ischaemic heart disease, 2%; and nephropathy, 1%. Associated diseases are common especially in patients over 60 years, where hypertension is found in 53% and obesity in 45%. Diabetes is a related factor in 7% of all deaths in the Caribbean.
I In nt tr ro od du uc ct ti io on n: : The study was carried out to investigate the effect of Ha... more I In nt tr ro od du uc ct ti io on n: : The study was carried out to investigate the effect of Hatha yoga and conventional physical training (PT) exercise intervention on clinical and biochemical parameters in patients with type 2 diabetes. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : The patient population consisted of 77 type 2 diabetic patients in the Hatha yoga exercise group, matched with the same number of patients in the conventional PT exercise and control groups. The clinical parameters were weekly diastolic and systolic blood pressures, along with body mass index (BMI). Biochemical parameters included weekly blood glucose, serum creatinine, microalbumjinuria and glycosylated haemoglobin (HbA 1c) measured at baseline and two consecutive three monthly intervals. R Re es su ul lt ts s: : There were significant differences in the blood glucose concentrations "before exercise" and "after exercise" for the Hatha yoga and conventional PT exercise groups at different weekly intervals (P<0.05). The frequency of signs and symptoms of hypoglycaemia and hyperglycaemia over the weeks during exercise was greater in the conventional PT exercise than in the Hatha yoga exercise group (P=0.004). The HbA 1c concentration decreased after six months in the Hatha yoga and conventional PT exercise groups and was significantly different from that of the control group (P<0.05). There were significant reductions in systolic and diastolic blood pressures observed before and after exercise for the Hatha yoga and conventional PT exercise groups (P=0.0001). C Co on nc cl lu us si io on ns s: : These findings suggest that better glycaemic and blood pressure control can be obtained in type 2 diabetic patients after Hatha yoga and conventional PT exercises.
This book is the first of its kind and will provide much needed information about the toxins that... more This book is the first of its kind and will provide much needed information about the toxins that are present in fifty of the most poisonous plants here, with data on their effects on the body and very importantly, the antidotes that are needed
A retrospective study of 58 hypothyroid patients attending the Endocrine Clinic, University Hospi... more A retrospective study of 58 hypothyroid patients attending the Endocrine Clinic, University Hospital of the West Indies, Jamaica, between July and August 1989, was undertaken. The age range at initial presentation varied from one month to eighty-four years. The majority of cases (51 or 87.9%) were between 21 and 70 years. There were 50 females (86.2%) and 8 males (13.8%). The underlying causes were idiopathic hypothyroidism (35 or 60.3%), posthyroidectomy (13 or 22.4%), post I131 therapy (6 or 10.4%), panhypopituitarism (3 or 5.2%), hypophysectomy (1 or 1.7%). Biochemical parameters used in diagnosis were serum thyroxine (T4) and thyroid-stimulating hormone (TSH). Forty-six patients (79.2%) had elevated TSH, indicative of a high correlation of elevated TSH with hypothyroidism. Duration of symptomatology prior to diagnosis was one year in 27 patients (46.5%), 2-10 years in 23 (39.6%) and 10 years in 4 cases (6.9%). The major presenting signs and symptoms were lethargy (20 or 34.5%), anaemia (mixed normochromic, microcytic (16 or 27.6%), slow relaxation of tendon reflexes (16 or 27.6%), coarsening of skin (15 or 25.9%), weight gain 10 or 17.2%), hoarseness (9 or 15.5%) and psychiatric symptoms (7 or 12%). The known association of primary hypothyroidism with other autoimmune disorders was not borne out in this study. The time-lapse in diagnosis from symptomatology emphasized the need for clinicians to be more alert to the subtle and varied presentation of hypothyroidism.
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