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| Sunday, 16 May 2004 |
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Features |  |
| News Business Features Editorial
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Compiled by Carol Aloysius Diabetes and pregnancy
Q: Diabetes has gone from being a disease of the elderly to a disease affecting much younger persons. I understand that women of reproductive age are at high risk. Why is this? A: For several reasons. Urbanisation is one of them. More people are now moving to the towns and cities and acquiring new lifestyles. Unlike the rural women who eat healthy foods, their city counterparts prefer to eat 'instant' foods that have a high content of fat, sugar or oil. Junk foods, 'instant' foods and processed foods which most urban women, consume put them as high risk foods to diabetes. For example, whereas previously our women ate red rice for all three meals, today most women living in the city have switched to wheat flour based foods which also pose a risk of diabetes. Still another contributory factor in recent years has been the change in diet of women going to the Middle East. Many of these women who are in their reproductive age, often return with various illnesses including diabetes due to their change in diet. Q: Any other reasons?
Q: What is the prevalence rate of diabetes for men and women in Sri Lanka today? A: Around 16 per cent. But this risk increases with age, although we are now seeing an increase in the reproductive age as well. Q: How early can you lay the foundation to a healthy diabetic free life? A: From conception. Basically a woman has to be fit first so that she can have a healthy child. Q: What do you see as the most important role for a woman? A: To bear children. Q: Does this apply to a woman who is diabetic as well? A: Only if she has got a clearance from the doctor to say that she is fit and able to carry a pregnancy to its full term. Unfortunately this is not always the case. Over a quarter of diabetic mothers and mothers-to-be who we treat in our special unit at the Lady Soyza Maternity Hospital, have had unplanned pregnancies and not sought the advice of a doctor before becoming pregnant. Many of them are undiagnosed cases of diabetics or else women who have not bothered controlling their diabetes before becoming pregnant. Q: What are the risks they run? A: Established diabetes can affect your eyes, kidneys etc. Eye problems can get accelerated during pregnancy. The baby's organs are formed in the first trimester. If the mother's kidneys are not functioning well she can miscarry. Ideally, these high risk mothers should have converted to insulin treatment before pregnancy because tablets for controlling diabetes should not be taken during pregnancy. This is why it is so important their pregnancies should be planned and that their diabetes is brought under control before pregnancy with the help of a doctor by using insulin, so that they can have a healthy baby. Q: Can pregnancy provoke diabetes? A: Yes. This is known as gestational diabetes which is prevalent among high risk mothers. Q: Explain. A: Excess weight in a young girl for example can make her a potential diabetic. Childhood diabetes is often the precursor to becoming a diabetic mother. For example, a ten-year-old girl who is fat and continues to remain obese as a teenager, can become a diabetic mother and a chronic diabetic by the age of 35 years. Q: How can this be prevented? A: By putting your child on a proper diet at a very early age and ensuring that she gets plenty of exercise . Q: What are the indications of diabetes in pregnancy? A: One of the risks of a diabetic mother is when she produces large babies. The average weight of a new born baby is around 2.8 kg. If a woman has had a baby that weighs more than 3.5 kgs then one can suspect that the mother has had mild diabetes during pregnancy. Q: What are the risks that overweight babies face? A: The child has a higher risk of getting diabetes and heart disease. In the UK a study has found that Asian Indians ran the highest risk of diabetes, premature heart attacks and blood pressure among other illnesses. In fact, over the past 20-30 years it has been found that South Asians ( including Sri Lanka) run the biggest risk of getting these diseases. Q: Why? A: Because of their genes, their economic environment, their lifestyles, urbanisation and stress factors. Q: What are the risk factors for developing diabetes? A: Family history of diabetes and obesity are some of them. If you are gaining a lot of fat around the tummy i.e central obesity, then look out. Q: How would you recognise the signs of developing diabetes in pregnancy? A: In young girls, two years after menarche the periods can become irregular and they could have hormonal imbalances leading to excessive hair growth as well as and obesity. This could lead to polycysitis ovary syndrome (i.e. multiple immature unruptured eggs). This condition is not cancerous. Nor is it a disease. But a change in lifestyle and diet can improve the existing hormonal imbalance considerably. These problems begin to show in the late teens with the girl child running the risk of diabetes specially during pregnancy. Darkening of skin is another marker. If a young girl develops velvety dark thickening around the neck and the inner parts of the elbows, knuckles, armpits, it shows that she is very resistant to insulin and thus runs the risk of diabetes. Q: What is your advice to mothers of such children? A: Such children must lose weight and do regular exercise. Diet and Exercise are more important than Doctor and Drugs! 30 minutes of brisk walking can do wonders. I also advise them to give them a balanced nutritious high fibre diet that includes red rice, green gram and plenty of green leaves. Q: When do most mothers develop diabetes for the first time? A: Usually in the fifth month of pregnancy. Q: Why? A: Because the placenta produces hormones that can unmask latent diabetes. Then the mother will develop blood sugar and the excess blood sugar gets transferred to the foetus. The foetus copes with this extra load of sugar by producing additional insulin. The combination of insulin and sugar is a large baby which leads to complications in the birth process. Some of the babies can die without any warning while still inside the womb, because of their unhealthy environment. Once the baby and the placenta are out of the mother's womb, she can revert to a normal life but nevertheless run the risk of developing diabetes later on. Q: What kind of tests are needed to find out if you are diabetic before becoming pregnant? A: A urine test as well as a blood test. Every mother to be should be registered with the midwife so that her health is monitored constantly. Q: How do you sum up the importance of such tests? A: The mother's health plays an important role for the future generation. A healthy mother will have healthy children. ###### Phyto-Chemicals promote healthy living From a reader ... Phyto-Chemicals in vegetables and fruits differ according to their colour. The Phyto Chemicals together with vitamins are important for health. I quote below the following for the readers' information:- 1. Green Phyto Chemicals in green vegetables are lutein and indoles. Some of them prevents cancer and helps to keep clear eyesight. These are found in apples, beans, grapes, limes and herbs of green colour. 2. Red Phyto Chemicals are lycopene and anthocyanin, which prevent heart attacks and help in building a good memory power. Tomatoes have adequate lycopene and they could be consumed frequently. Cherry, pepper, strawberry, beetroot etc., are the others in this category. 3. Purple Phyto Chemicals are anthocyanin and phenolic. These help in building body resistance and ensures prevention of diseases while keeping one healthy and young. Grapes, plums, dark sultanas, blue berries etc. contain this substance. 4. Orange Phyto Chemicals are an tioxcidants. They contribute towards body resistance and also prevent eye problems. Oranges, mandarins, papaws, carats, limes and mangoes contain this substance. 5. White Phyto Chemicals in this colour is allicin. This reduces cholesterol and controls blood pressure. Consumption of white fruits and vegetables reduces the danger of cancer. Plantains, cauliflower, ginger, white potato, knolkhol, and garlic contain this substance. We should encourage our children to take green vegetables and fruits. It is better to have one or two days in a month to consume only vegetable and fruit, without any other fried foods etc. We must also take fruit juice, king coconut, milk, buttermilk, etc. This will make our lives healthier. by S. R. Balachandran ###### The "small container" disease
The highest number of cases have been reported in Colombo, Gampaha and Kandy. Matale has reported a fresh out break. Dengue can be fatal if proper precautions are not taken early. Following are some facts on Dengue and DHF Dengue Fever and Dengue Haemorrhagic Fever are caused by a virus. It is spread by the bite of an infected mosquito, Aedes Aegipti and aedes Albopictus. The dengue mosquito usually bites during day time specially in the morning and evening. Therefore you could be bitten while at work place, school or travelling. Symptoms . High Fever . Headache. . Rash on the face, trunk and extremities. . Muscle and joint pains. . Nausea and vomiting. These symptoms subside in about 3-4 days and the patients recover. But some of them could progress to Dengue Haemorrhagic Status. (DHF) which is much more serious and could lead to death. Symptoms of DHF are similar to dengue fever. . Haemorrhagic manifestations . Petechial rash . Bleeding from nose . Bleeding from gums . Brown or black coloured vomitus or faeces . Severe and continuous stomach pain. . Enlargement of liver. If these symptoms appear take treatment immediately from a hospital. Dengue shock syndrome . The fever may suddenly go down in a patient with DHF. But if the patient still feels ill, it may be a sign of shock. In a patient like this, symptoms of shock include: . Coldness of body, . Paleness of body, . Restlessness and drowsiness, . Acceleration of breathing and increase in pulse rate. All these symptoms indicate worsening of the disease. Be alert to a sudden drop in temperature in a child having fever. Refrain from giving Aspirin or drugs containing Salicylates to the child. Use only Paracetamol, in correct dosage. Don't exceed 4 times a day. Prevention Prevention of Dengue fever is by eliminating breeding places of mosquito transmitting the Dengue virus. Such mosquitoes breed in containers such as empty yoghurt cups, jam jars, ice cream cups where there is collection of clean water. These containers lie in and around homes, schools and work places. Hence the disease is sometimes referred to as 'small container disease.' . Crush and bury empty tins, coconut shells and earthenware during disposal. . Add salt to the water in flower vases and ant traps. Change water frequently. . Remove leaves and debris blocking drains and gutters. . Fill with sand or pierce the tyres on roof-tops to prevent collection of water. . Cover all utensils container water. . Change water frequently in containers kept for dogs, birds etc. . Avoid throwing Sili Sili (Polythene) bags to the open environment. Keep the surrounding of your house clean. If Dengue fever is suspected - . Get the patients with fever to rest in bed. Refrain from sending children with fever to school. . Give plenty of fluids to drink. . Refrain from giving Aspirin or drug containing Salycilates. If DHF is suspected: . Take treatment immediately from a hospital or a qualified doctor. . Early treatment of DHF can prevent serious sequalae. . Monitor the chid/patients for dengue symptoms even after taking treatment. ****** The Lankan scenario No. of cases reported and deaths from 2001-4 2001 - No. reported was 4304. No. of deaths = 54 2002 - No. reported was 8,931 No. of deaths = 67 2003 - No. reported was 4,672 No. of deaths = 33 2004 (upto March) No. reported was 2,058. No. of deaths = 10 (Courtesy : Health Education Bureau) ###### Effects of mercury on teeth by Dr. Srilal A. Silva The addition of fluoride to city water supplies and the use of mercury in amalgam fillings are two issues related to oral care that have raised quite a controversy in recent times. In this short article, a well-known and respected Sri Lankan dental surgeon discusses the pros and cons and states his views. Amalgam restorations of carious teeth - popularly known as 'silver fillings' - have aroused much controversy. Amalgam restorations contain mercury, silver, tin, copper and a trace amount of zinc. There is a sustained release of mercury and other metals into the body from these fillings. Some researchers claim that there is a daily release of 10 micrograms of mercury into the body. Most people know that mercury is a toxic metal. In fact, quite often in the news they give the names of fish which ingest mercury from the waste in sea water. Harmful effects The nervous system of the human body is sensitive to mercury. Continuous exposure to mercury can damage the brain, kidneys and the developing foetus. The National Academy of Science in the United States reported in 2001 that "the major source of exposure to elemental mercury in the general U.S. population is due to mercury vapour released from dental amalgams". When the amalgam is prepared the mix has to be triturated (grinding to a powder or paste). During the process of triturating, and unless done in controlled conditions, mercury is released into the atmosphere. The most amount of mercury is released when cutting or grinding old amalgam fillings. During this process, mercury is released into the atmosphere and the small particles in the waste can pollute the environment. Now, there is a protocol in place for the filtration and disposal of these particles. Most dentists have vacuum suckers which capture and filter the particles before being released into the atmosphere. Today there are excellent alternatives to amalgam fillings. These tooth coloured materials are referred to as composites. Hence, there is really no need to use amalgam restorations. Another disadvantage is that with amalgam fillings a fair proportion of the tooth has to be cut for retention. With composite fillings, the restorative materials are very adhesive and there is no need to extend the cavity for retention. (From 'Thorathura') |
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News | Business | Features
| Editorial | Security Produced by Lake House |
Diabetes is on the rise among women of reproductive age, says Dr.
Chandrika Wijeratne, Consultant Physician and Senior Lecturer in
Reproductive Medicine, in an interview with Carol Aloysius.
A: Women living in the city lead a sedentary life with hardly any time
for proper exercise, unlike their city rural counterparts. Regular
exercise is one of the best ways of reducing the risk of diabetes.
Dengue is once again on the rise. The cases reported in hospitals last
month shows a rapid increase in numbers, giving rise to another dengue
epidemic.
