John Philip Tarburton has completed his Ph.D at the age of 25 years from the University of Nebraska and also did postdoctoral studies at the University of Nebraska. Dr. Tarburton is an Associate Professor at National University, the second-largest private nonprofit institution of higher learning in California and the twelfth largest in the United States. Dr. Tarburton has published more than 55 papers and abstracts in reputed journals and a book chapter about his research findings.
The effect of isopropyl nitrite on human Type 2 diabetics blood was undertaken using nondiabetics blood as the control group. The differences in patient characteristics such as the mean ages and weights of the two groups were not statistically significant (P>0.05), and the ratios of non-smokers to smokers were similar meaning that the two groups were well matched. These studies revealed that diabetics erythrocytes with a mean HbA1C value ± SEM of 11.4 ± 0.27% were oxidized at a significantly greater rate than the control blood (P<0.05). The isopropyl nitrite mean oxidation time ± SEM of diabetics blood was 1.5 ± 0.05 min (n = 20). For the nondiabetics blood a mean HbA1C ± SEM value of 5.5 ± 0.08% was obtained with a mean oxidation time ± SEM of the non-diabetics blood of 4.6 ± 0.13 min (n=20). These studies demonstrate that diabetics blood has an enhanced susceptibility of oxidation into methemoglobin by isopropyl nitrite compared to its respective control group ,i.e., the normal blood. This finding could be attributed to the fact that isopropyl nitrite is a nitrite ester which contains a saturated three hydrocarbon chain similar to other analogous nitrite esters (ethyl nitrite, butyl nitrite, pentyl nitrite and hexyl nitrite) which also contain saturated hydrocarbon chains that previously showed a statistically significant increased oxidation time for diabetics blood (P<0.05) (1-6). Thus this study confirms that the difference in the number of methylene molecules has no impact on the rate of oxidation on either diabetics blood or nondiabetics blood (P>0.05). These findings also imply that the increased susceptibility to isopropyl nitrite induced oxidation reaction in diabetics blood is a direct function of the amount of HbA1C present in the blood, i.e., a clear inverse relation appears to exist between the amount of HbA1C present and the oxidation time.
Dr Ashok Kumar Das is currently the Professor of Medicine & Endocrinology at Pondicherry Institute of Medical Sciences, Pondicherry. He has served as Director – Professor of Medicine & Medical Superintendent, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry. He has pursued his MBBS in 1973 and MD (General Medicine) in 1976. He has over 100 publications to his credit in journals of national and international repute. He has held various reputed posts in the past including National President, Association of Physicians of India and National President, RSSDI Deanna to name a few.
Introduction: Approximately 425 million people were living with diabetes in 2017 and by 2045, it is expected to increase to 629 million. A healthy lifestyle, including a nutritious balanced diet is a key component of diabetes management. Medical Nutrition Therapy (MNT) is defined as “nutritional diagnostic, therapy, and counseling services” for the purpose of disease management, which are furnished, by a registered dietitian or nutrition professional. Incorporating MNT into diabetes-specific nutritional management has shown to improve glycemic profiles and to reduce the risk of disease complications.rnMethodology: Keeping in view the direct correlation between diet and diabetes management, we undertook a survey on the MNT in diabetes management in adults across India. A total of 380 Diabetologist/ Endocrinologist/ Consulting Physician/ Gynecologist completed the 15-item survey by rating on a 5 point Likert scale, where 1=strongly disagree, 2=disagree, 3=neutral, 4=agree, 5=strongly agree.rnThe questionnaire is about identifying the complete requirement of diabetic population, impact of 3Ds: diet, daily lifestyle modification and drug therapy, preference as formula feed or home-cooked food, recommendation pattern, benefits of MNT, the importance and awareness of low Glycemic index and Glycemic load, indications of MNT and practice trends of doctors across India.rnResult: More than 91% of doctors agreed or strongly agreed that complete management of diabetes requires 3D’s: Diet, Daily lifestyle modification and Drug therapy. A total of 89.4% doctors were of opinion that MNT is important in preventing diabetes, managing existing diabetes, and preventing or slowing complications, however they believe that MNT should be individualized based on the requirement. The most common indication for MNT was glycemic control and the most common pattern of prescription was either as snack supplement or snack replacement.rnConclusion: Doctors strongly recommend the need of MNT in complete management of diabetes under the guidance from a registered dietician.rn