The Effect of Phyllanthus Amarus Aqueous Extract on Blood Glucose in Non-Insulin Dependent Diabetic Patients

The glycaemic response to 124.5 ± 9.3 (mean ± SD) g of pancakes was monitored in 21 non-insulin dependent diabetic (NIDDM) patients while on oral hypoglycaemics, after a one week washout period and after a one week twice daily treatment with 100 ml of an aqueous extract from 12.5 g of powdered aerial parts of Phyllanthus amarus. After the one week washout period, fasting blood glucose (FBG) and postprandial blood glucose increased significantly compared to when on oral hypoglycaemics (P ≤ 0.05). After one week herbal treatment no hypoglycaemic activity was observed. Both FBG and postprandial blood glucose remained very similar to that recorded after the washout period (P > 0.05). Both liver and renal functions based on alanine transaminase (ALAT) and serum creatinine, respectively, were not significantly affected by the use of the extract. Although lymphocyte and monocyte levels were significantly decreased (P ≤ 0.05) and granulocyte level was significantly increased after treatment (P ≤ 0.05) overall total white blood cell (WBC) count and haemoglobin (Hb) were not significantly affected by the one week herbal treatment. We conclude that one week treatment with the aqueous extract of Phyllanthus amarus was incapable of lowering both FBG and postprandial blood glucose in untreated NIDDM patients

Managment of diabetic ketoacidosis in children and adolescents in sub-Saharan Africa: A review

Background: Diabetic ketoacidosis (DKA) is a complex metabolic state of hyperglycaemia, ketosis, and acidosis. Diabetes in sub-Saharan Africa is, in many patients a serious disease with a poor prognosis. Most deaths, however, are due to preventable causes.Objective: To improve knowledge on the management of DKA in sub-Saharan Africa.Data sources: Literature review from different published sources. Data synthesis: Health systems in sub-Saharan Africa are currently organised for the treatment of episodes of illness and not long-term conditions like diabetes. Therefore the high rates of DKA is essentially due to lack of training of health professionals, lack of facilities in most hospitals, lack of public awareness as well as lack of health education to individual patients/families. In addition erratic insulin supply coupling with infections, low parental education, poor insulin storage and lack of facilities for self monitoring of blood glucose.Conclusion: A complex unfavourable social and economic environment is the basis of the high prevalence of DKA in sub-Saharan Africa. Several episodes of DKA can be prevented by effective public awareness programmes and education to healthcare providers

A cross-sectional study of vascular risk factors in a rural South African population : data from the Southern African Stroke Prevention Initiative (SASPI)

Background: Rural sub-Saharan Africa is at an early stage of economic and health transition. It is predicted that the 21st century will see a serious added economic burden from non-communicable disease including vascular disease in low-income countries as they progress through the transition. The stage of vascular disease in a population is thought to result from the prevalence of vascular risk factors. Already hypertension and stroke are common in adults in sub-Saharan Africa. Using a multidisciplinary approach we aimed to assess the prevalence of several vascular risk factors in Agincourt, a rural demographic surveillance site in South Africa. Methods: We performed a cross sectional random sample survey of adults aged over 35 in Agincourt (population ≈ 70 000). Participants were visited at home by a trained nurse who administered a questionnaire, carried out clinical measurements and took a blood sample. From this we assessed participants' history of vascular risk, blood pressure using an OMRON 705 CP monitor, waist circumference, body mass index (BMI), ankle brachial index (ABI), and total and HDL cholesterol. Results: 402 people (24% men) participated. There was a high prevalence of smoking in men, but the number of cigarettes smoked was small. There was a striking difference in mean BMI between men and women (22.8 kg/m2 versus 27.2 kg/m2), but levels of blood pressure were very similar. 43% of participants had a blood pressure greater than 140/90 or were on anti-hypertensive treatment and 37% of participants identified with measured high blood pressure were on pharmacological treatment. 12% of participants had an ABI of < 0.9, sugesting the presence of sub-clinical atheroma. 25.6% of participants had a total cholesterol level > 5 mmol/l. Conclusion: We found a high prevalence of hypertension, obesity in women, and a suggestion of subclinical atheroma despite relatively favourable cholesterol levels in a rural South African population. South Africa is facing the challenge of an emerging epidemic of vascular disease. Research to establish the social determinates of these risk factors and interventions to reduce both individual and population risk are required