XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction

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Methods Of Enzymatic Analysis

IT may occasion some surprise to those men of science who are ill-acquainted with India, and who so frequently express the view that Governments are unappreciative of the importance of science to learn that as far back as 1886 the Government of India arranged for Dr. George (later Sir George) Watt, professor of botany in the Presidency College, Calcutta, to prepare a "Dictionary of the Economic Products of India". The six volumes of this standard work were published during the years 1889-99. In 1908 Sir George Watt published a condensed version, "The Commercial Products of India". Whatever the defects of these 'dictionaries', they have been of inestimable value to all interested in Indian natural products. The Wealth of India A Dictionary of Indian Raw Materials and Industrial Products. Raw Materials, Vol. 1. Pp. xxvii+254+39 plates. 15 rupees ; 24s. Industrial Products, Part 1. Pp. xii+182+8 plates. 8 rupees ; 12s. (New Delhi : Council of Scientific and Industrial Research, 1948.)

The Wealth of India

Trease and Evans' pharmacognosy

Antiulcerogenic effect of methanolic extract of Emblica officinalis: an experimental study.

Prophylactic and curative effects of Bacopa monniera in gastric ulcer models

Antinociceptive and antiarthritic activity of Cissampelos pareira roots

Antiulcer and antimicrobial activity of Anogeissus latifolia.

The anti-ulcerogenic effect of fresh juice from the whole plant of Bocapa monniera Wettst. (BMJ) commonly known as Brahmi in Hindi was examined using gastric ulcer models induced by ethanol, aspirin, 2 h cold restraint stress and 4 h pylorus ligation. Bocapa monniera juice (BMJ) at doses of 100 and 300 mg/kg and sucralfate at a dose of 250 mg/kg were given orally, twice daily for 5 days. BMJ 100-300 mg/kg produced significant antiulcer activity in all the experimental gastric ulcer models except in case of ethanol-induced ulcers where 100 mg/kg was not found to decrease it significantly. BMJ (100-300 mg/kg) was found to have little or no effect on the offensive acid-pepsin secretion, while cell shedding (microgram DNA/mg of protein) and mucin secretion in terms of total carbohydrates:protein ration (TC:P), the two important parameters of defensive factors were significantly decreased and increased respectively indicating enhancement of protective mucosal factors. Both BMJ (300 mg/kg) and SF showed tendency to increase the mucosal glycoproteins in terms of TC:P, though individual carbohydrates and total carbohydrates were either increased or showed a tendency to increase. Thus, ulcer protective effect of BMJ may be due to its effect on mucosal defensive factors like enhanced mucin secretion, mucosal glycoprotein and decreased cell shedding rather than on offensive factors such as acid and pepsin.

Ch V Rao

Papers

Antiulcerogenic effect of methanolic extract of Emblica officinalis: an experimental study.

Prophylactic and curative effects of Bacopa monniera in gastric ulcer models

Antinociceptive and antiarthritic activity of Cissampelos pareira roots

Antiulcer and antimicrobial activity of Anogeissus latifolia.

Experimental evaluation of Bocopa monniera on rat gastric ulceration and secretion.