Wata Dama Ta Magance Cutan Ciwon Sukari Da Wahalhalun Da Take Sabbabawa

BABBAN TSARI NA DANDALIN KULA DA MAI CIWON SUKARI (DMF):Wata Dama Ta Magance Cutan Ciwon Sukari Da Wahalhalun Da Take Sabbabawa

Watanni 6 kenan da suka gabata.

Sakamakon sha’awar kawar da ciwon sukari a cikin al’ummarmu, mun kirkiro da DMF (Dandalin Kula da Mai Ciwon Sukari) akan WhatsApp (dandalin Hausa da Turanci) da Telegram (dandalin Hausa da Turanci), inda muka magance kalubalen da ke tare da kula da ciwon sukari tsakanin mambobi. Tare da taimakon likitocinmu, an ƙarfafa ma mambobi gwiwan cike wani nau’in takarda (form) na musamman don taimaka mana fahimtar yanayin rayuwar su da kuma ba su tabbatattun shawarwarin da zai taimaka musu wajen gudanar da yanayin ciwon sukarin su ta hanyar da tafi dacewa. Sakamakon haka – mun sami labarai na cin nasara daga mambobin mu marasa iyaka!!! Domin mu sami daman taimaka muku taimakawa mafi kyau, mun ƙirƙiro da wani babban tsari wanda ake biyan kudi a inda zamu kasance tare da ku a kullum wajen ganin cewa kun cimma burinku na rabuwa da wannan cutan.

 

Yanda Shirin Zai Kasance

Shirin zai kunshi ayyukan da za a dunga yi a kullun ciki har da awon sukarin jini sau da yawa, ire-iren abincin da yakamata a ci (gami da tsarin girke-girke wato recipes, idan da buƙata) da magunguna ko allura (idan da buƙata). Bibiyan wannan tsarin zai kasance ta hanyar cike fom a kullun da kuma sadarwa ta waya, a inda buƙatan hakan ya kama. Babban hanyar sadarwar zata kasance ne ta sashin sada zumunta na DMF group a kan yanar gizo.

Abubuwan Da Ake Da Buƙata Kafin A Fara Wannan Sabon Shirin

(1) Mallakan na’uran awon jini wato glucometer (samfurin da aka fi ba da shawara shine: Accu-Chek Active) tare da isasshen abin da akeyin gwajin da shi wato strips wanda za su isa har zuwa tsawon lokacin da aka zaba.

(2) Gwagwajen asibiti wadanda suka shafi lafiyan aikin ƙoda, zuciya, hanta da idanu.

(3) Gwajin glycated haemoglin domin sanin awon sukarin jini a cikin watanni 3 da suka gabata.

(4) Ganin cewa shirin ya ƙunshi cikakken sauyin abinci, duk wanda zai shiga wannan tsarin ya kamata ya tanadi kudaden da za su ishe shi domin cimma burin da ake so na fatattakan ciwon sukari.

Sakamakon Da Ake Fatan Samu Bayan Kammala Wannan Shirin

(1) Samun kyakkyawan sakamako na awon sukarin jini a ƙarshen wannan shirin tare da yuwuwar barin shan magunguna ƙwata-ƙwata (wanda za a fi dacewa da samun hakan a ƙarƙashin shirin watanni 3) da kuma cikakkiyar waraka daga ciwon sukari ko kuma sauran matsalolin da ciwon sukarin ke kawo wa kamar rashin sha’awa ko kuzari ga ma’aurata, lalacewar ƙafa, rashin gani da kyau, lalacewar koda, da dai sauransu.

(2) Tsarin abinci mai ɗorewa wanda zai ba da tabbacin rage nauyi mai lafiya – rage nauyi yana da mahimmanci a cikin ingantaccen sarrafa wasu cututtuka kamar ciwon hawan jini, cututtukan jijiyoyin zuciya, cututtukan ƙwayar haihuwa na mata (PCOS), amosanin gaɓɓai, da dai sauran su.

Kashe-kashen Farashin Kowane Zango

Cancanta

  • Masu nau’in ciwon sukari mai suna type 2.
  • Masu ƙiba sosai, wadanda suke neman rage ƙiba.

A Tuntube Mu

Don ƙarin bayani, gami da bayanin biyan kuɗi, tuntuɓi:

Wayan Salula: +2349052837957 (saƙon WhatsApp kadai)       +966501968813 (kira kadai)

Adireshin imel (Email): dmf@salihulukman.com                                   

Yanar gizo: salihulukman.com/dmf

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DMF Social Network Group & Ask O & G Doctor

As a sequel to my previous article titled, “My Web Design Experience – DMF Has Moved To The Next Level” where I mentioned that DMF is live on my website and I promised to add many more interesting features to the DMF webpage, I hereby update you on the following important new features added to the website.

Ask O & G Doctor: Due to the current lockdown and the ever-rising cases of O & G-related issues, there is an urgent need to provide succour in that area. Accordingly, a new feature introduced on the website is a provision for our ladies to ask our O & G doctor – Dr. Fatima Mahmud, who is my better half and one of the DMF active Admins – any question related to obstetrics (pregnancy, childbirth, and the postpartum period) and gynaecology (diseases of the women reproductive system) by filling the Contact Form on her website. She will also be presenting webinars (online seminars) periodically on O & G-related topics such as understanding vaginal discharge, cervical cancer, disorders of menstruation, etc. Anybody interested can subscribe to or follow her blog for email notifications.

DMF Social Network Group: It allows registered users to post messages/questions and receive answers. It works pretty much like any other social network group on Facebook. Any user can register, look for the DMF Group and join as a member.

(a) Users can register on my website under My Social Network

(b) Users will be able to create extended user profiles.

(c) Activity streams allow users to follow site-wide updates and group activities.

(d) Users can send private messages to the Admin.

(e) Special Members can receive their feedback on their pages and follow-up on the recommendations easily with the Admin.

I will recommend you all to register most especially our Special Members, it will make the management of the forum much easier. This is the future of DMF where all its activities will be centrally coordinated.

Special Membership Form: This form is now embedded in the DMF webpage for anyone who wishes to enroll as a Special Member. All Special Members are highly encouraged to register in the new DMF Social Network above for effective monitoring and feedback.

Re: How I fought diabetes in just 15 months – Diabetic Monitoring Forum (DMF)

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By Salihu Lukman, PhD
Twitter Handle: @SalihuLukman

Posted on my Facebook Wall: November 16, 2019

PREAMBLE

As a sequel to sharing my article titled, ‘HOW I FOUGHT DIABETES TO A STANDSTILL IN JUST 15 MONTHS‘ (Part 1Part 2 & Part 3) in commemoration of World Diabetes Day held on November 14, 2019 coupled with my desire and passion to assist diabetics in combating or containing this endemic disease (based on my experience) which has affected about 10 million Nigerians (5 % of the population) and still counting, I have concluded to take my campaign to the “Next Level” by forming a Telegram group called Diabetic Monitoring Forum (DMF) whose details are provided below.

In addition, when I sent this article to Daily Trust to be considered for possible publication and copied the amiable Dr. Ibraheem Dooba, I learned another success story from him where he successfully transitioned from pre-diabetic to normal. It is my belief that there are many other success stories where people fought diabetes to a standstill that remain untold. Through this forum, we can all meet and share our various success stories of how diabetes was defeated so that other diabetics can learn and adopt some of these proven strategies and methods. Anyone who wishes to join the forum MUST read the following and do the needful. Together, we can do this. Let’s join hands.

GOALS

  1. Dissemination of relevant articles on diabetes and nutrition in order to keep members enlightened. Articles would be posted weekly and members are expected to read the articles and can ask questions related to the articles if the need arises. /li>
  2. Counseling of diabetics in terms of what foods they can eat.
  3. Ensure proper use of glucometer and adequate monitoring of blood glucose levels.
  4. Share proven diabetic meal recipes for maintaining optimal blood glucose levels and losing weight.
  5. Answer any questions from members on diabetes, complications and effective management.
  6. Follow-up on diabetic members to ensure that their blood glucose levels remain within the normal ranges at all times. Please note that the forum CANNOT substitute your regular hospital visits (if you are diabetic) to follow-up with your doctor. It is only meant to compliment your regular hospital visits.

MODUS OPERANDI

(1) Membership
This is open to all irrespective of sex, religion, region, country, health status (diabetics and non-diabetics), marital status, etc.

(2) Registration
(a) Ordinary Membership: This entails just clicking the group’s invite link and you will be automatically added to the forum as an ordinary member.
(b) Special Membership: For diabetics, pre-diabetics or those who wish to lose weight and need a thorough analysis of their current status so that they can be guided appropriately in line with goals 2 – 6 above, there is need fill an online form (questionnaire) in addition to joining the forum using the above invite link. Even if you are diabetic you can choose to be an ordinary member, but you will not enjoy goals 2 – 6 to the fullest. In addition to submitting a filled Special Membership Form (SMF) online, one MUST be in possession of a functional glucometer (for measuring blood glucose levels) or can have unrestricted access to one. You can fill and submit the form and purchase the glucometer thereafter or gain access to one. Your blood glucose CANNOT be adequately monitored with it. However, it is HIGHLY RECOMMENDED that you buy your own glucometer set (glucometer pack, test strips, lancets) which sells for about N13,000 in Nigeria and about SR 130 – 200 (on saudi.souq.com). From the foregoing requirements for special members, it is clear that special members MUST have SELF-DISCIPLINE and be ever ready to join hands with the admins to do the needful. Any disease management entails high sense of self-discipline in adhering to medications and doctor’s advice. This cannot be over-emphasized.
(c) Form: Filling this questionnaire is a PRE-REQUISITE for one to be registered under the special membership category. The form consists of 3 sections (A, B & C) and about 50 questions. These questions have been carefully created to capture all the required information necessary to understand the patient’s current health condition and diet. Questions marked with an asterisk (*) are MANDATORY and must be filled before you can submit the form. It takes about 20 min to fill it online.
Section A: Consists of patient’s basic data such as name, email, address, occupation, etc.
Section B: Consists of diabetic-related data such as weight, height, diabetic history, glucometer use and readings, insulin injection, etc. Some of the questions can apply to anyone who wishes to lose weight only.
Section C: Consists of the patient’s dietary details such as one’s specific meals for breakfast, lunch, dinner, snacks, fruits, etc.

To fill the form, login with your Google account login details. If you don’t have a Google account but already have an existing email address, you can create a Google account using that email address. If you don’t have an email address, then, you can create one with Gmail. When you are done filling the form, you should click on the ‘SUBMIT’ button. Admins will review your forwarded filled form and give you feedback. If there is need to find out more about your filled form, you may be contacted privately via Telegram or mobile phone by one of the admins.

(3) Group Admins & Roles
There shall be 2 admins for now. This can be increased later to welcome more volunteers such as doctors (any specialization), nurses (with experience in diabetes management) and nutritionists. The door is open.

1st Admin (My humble self)
(a) Manages the forum’s email address.
(b) Posts relevant and simplified articles on the forum’s Telegram group for members to read and be enlightened.
(c) Liaise with the 2nd admin who is a medical doctor on submitted forms to ensure that patients who submitted their filled forms get feedback promptly.
(d) Follow-up with the patient to ensure full implementation of the feedback received from the 2nd admin while keeping the 2nd admin updated on the progress.
(e) May attempt to answer or comment on questions posted by members on the forum’s Telegram group where applicable.
(f) Ensure that members’ posts are appropriate as per the forum’s guidelines for posting presented below.

Other Admins (medical doctors, pharmacist, etc.)
(a) Closely study all submitted forms and provide feedback.
(b) May follow-up with the patient to ensure the full implementation of the feedback.
(c) Posts relevant and simplified articles on the forum’s Telegram group for members to read and be enlightened.
(d) May attempt to answer or comment on questions posted by members on the forum’s Telegram group where applicable.

(4) Posts
ONLY diabetes, weight loss or diet-related articles should be posted on the forum’s Telegram platform in addition to asking the admins any related questions for clarification.

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How I fought diabetes in just 15 months (3)

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Hypoglycemia is worse than hyperglycemia according to doctors, hence it should be avoided under all circumstances as much as possible. It may damage some brain cells that cannot regenerate. I had fasted the complete holy month of Ramadan (29 – 30 days) from sunrise until sunset without any problem with sugar control. Three months later (August) HbA1c had dropped further to 6.4 % (prediabetic), it shot up to 6.8 % in October and ultimately stabilized at 6.1 % (prediabetic) in January 2016 (less than 1 year from the start of treatment) as well as January 2017. My weight had stabilized at 78 kg in 2017. Even though the sugar level had stabilized, but I would one in a while check my blood sugar level using my glucometer most especially during cheat periods. On a few occasions, I would record hyperglycemia and would identify the cause to become more cautious with my diet. Someone may ask, what about the doctor who failed to inform me that I was diabetic since 2013? Actually, I had wanted to take him to task by suing him for grave negligence. I am a staunch proponent of taking doctors to task in case of any negligence that may arise in their course of patient management. I believe that this would make them become very vigilant and improve patient management. Unfortunately, one hears of medical negligence and mismanagement almost everyday in Nigeria without any serious litigation. Only recently a medical doctor in Adamawa state was barred from practicing for life owing to gross mismanagement of a patient. If not for my relocation in 2014 to another town about 500 km away, I would not have allowed the matter to just die.

An important event took place in June 2016 during the holy month of Ramadan that changed the entire management strategy. I had started fasting here in Saudi Arabia and then traveled to Nigeria for the summer vacation. I continued to fast in Nigeria but then I started recording hyperglycemia 2 hours after suhur (just before dawn) meal. To counteract this effect, I increased the Metformin dose slightly, then I recorded hypoglycemia just before breaking my fast i.e. sunset. This happened repeatedly a couple of times. At this point, I took one of the most important decisions in my life without consulting any doctor. Not even my wife knew about it until when I told her later. I stopped fasting and stopped taking Metformin. I changed my diet completely to one that was made up of only high fiber. These include beans porridge (fate in Hausa) with spinach and oats porridge with spinach. Yes, you read it correctly, oats porridge. I must confess that I have been blessed with a very passionate and ingenious person as my better half, who breaks all barriers to see to it that I am healthy. She would invent different dishes just to satisfy my craving for my favorite dishes despite my diabetic condition. Whenever I would talk about oats porridge and tuwon oats (thick oat pudding prepared from powdered oats) with okra or kuka soup nobody knows that oats can be put to such use. I would always advise her to apply for food patents whenever I noticed a new meal. To be candid, she is the most intelligent person I have ever seen in my life and she remains my greatest ‘asset’.

I monitored my blood glucose after I stopped taking the Metformin and surprisingly, the glucose levels were within normal ranges. I continued until January 2017 when I took the HbA1c test to find out how I was faring. It was 6.1 % – what a surprise! I was also gradually losing weight and in January 2019 my test result read 5.8 % and my weight had dropped to 72 kg. As per Saudi Arabian range, 5.8 % falls within the normal range, hence I had successfully fought diabetes to a standstill. Nonetheless, I still had a low glucose tolerance level. Declaring me non-diabetic based on the test result did not mean that I was free to go back to my pre-diabetic stage where I would eat anything without any consideration for the carbs content. I still take my low carb, high fiber diet until today and my blood sugar has been normal. In just 15 months, I was able to successfully wean myself off any diabetic medication or insulin injection. Even doctors are surprised about my relying on dietary modifications and weight loss alone to abstain from taking any diabetic medication. In fact, most of them would be hesitant to tell you to go without taking any medication and rely on dietary modifications and weight loss alone. When I asked my doctor at the beginning of the treatment if I would ever live without taking any diabetic medication again, he replied no. Well, I have achieved just that and I am sharing my success story to encourage diabetics that they can actually live a healthy life without taking the diabetic medication depending on the extent of their sugar control and adherence to the necessary lifestyle changes. More importantly, they can also live a healthy life while taking the medication without any diabetic complication provided they will control their blood sugar level always. Currently, I weigh 70 kg and still counting down, remember that I weighed 86 kg in 2015 when I started treatment for diabetes and 90 kg in 2013. I lost a total of 20 kg altogether. I have resumed fasting in Ramadhan since 2017 without encountering any problem again.

Now, let me shed light on some diabetic dietary myths by presenting some ABCs of junk foods and healthy foods. Sometimes you can hear a diabetic telling you that the following food items are good for a diabetic: pasta, couscous, Indomie, maize or millet pap, etc.

Vegetable oils are the umbrella that may actually represent soybean oil, corn oil, groundnut (peanut) oil, palm oil or sunflower seed oil. Their chemical structures are similar in that they are all unsaturated oils except palm oil coconut oil which are saturated oil. If you are on a low cholesterol diet, then palm oil is a no-no for you because of its high saturated fat content (50 %). Trans fats are found in processed foods. Food manufacturers in the US must list trans fat on food labels. Words like “hydrogenated” or “partially-hydrogenated” are used to identify trans fats that are hiding in your food. Other saturated fats are those found in meat and dairy products which are generally solid at room temperature. On the other hand, unsaturated fats and oils are generally liquid, even when refrigerated. These trans fats raise your LDL cholesterol levels (the bad kind) and lower your HDL cholesterol levels (the good kind) at the same time. Hence, they raise your risk of developing heart disease, stroke, and type 2 diabetes. Vegetable oils with the exception of palm oil and coconut oil contain the essential fatty acids omega-6 which are essential for our body, yet, our body cannot manufacture them and must be taken in through diet. Pure groundnut oil processed from groundnuts and sold by Kuli-kuli (groundnut cake) vendors is the most reliable groundnut oil and has a lower smoke point than the conventionally packaged vegetable oils and that is why it is not economical for frying purposes. Unfortunately, the good unsaturated oils can also be hydrogenated to create trans fats and a more shelf-stable product. I hope NAFDAC ensures that the so-called vegetable oils are not hydrogenated.

What is usually sold on shelves as butter is actually margarine. These are two different fats with different nutritional values and ingredients. While butter contains saturated fats, many brands of margarine contain trans fat listed as “hydrogenated oil” or “partially hydrogenated oil” on the ingredients list. Trans fat should be completely avoided according to health experts. Before 1990s, trans fats were regarded as a healthier alternative to saturated fats, hence margarine was promoted as a heart-healthy option over butter. However, since the recent discovery that trans fats are bad, many margarine companies in the US have reformulated their product and eliminated trans fats. The popular Blue Band ‘butter’ is nothing but margarine. Pure and natural butter is sold by Fura Da Nono vendors as Man Shanu. The best and recommended butter for diabetics is peanut butter called Tunkuza in Hausa. Health experts recommend that one takes one tablespoon of Extra Virgin olive oil daily owing to its heart-healthy benefits.

Processed foods have a generally bad reputation and bring to mind things like additives, preservatives, sweeteners, colors, excess sugar or sodium. They contribute to public health problems like obesity, high blood pressure, and type 2 diabetes. Processed foods are better viewed on a spectrum of minimally (e.g. roasted nuts, canned tomatoes, canned sardine) to heavily (e.g. crackers, potato chips, cookies, microwaveable dinners, hot dogs, sausages) processed foods. However, certain foods benefit from processing. These include milk (pasteurized to kill bacteria), dried fruits (have more fiber and phenols – an antioxidant), etc. Refined foods mean they have been stripped of nutrients through processing such as white flour instead of whole grains. Pasta and couscous are made from refined wheat, hence possess a higher glycemic index than pasta made from whole wheat. The same thing applies to processed and refined parboiled or white rice and brown rice. Processed foods are linked to increased rates of anxiety, depression and colon cancer. Glycemic index (GI) is an estimate of how blood glucose levels are affected by carbohydrate foods. High GI food can raise blood glucose levels faster than low GI food. A sudden spike in blood glucose levels is undesirable in persons with TTD. As a rule, proper diabetic diets should have a low glycemic index or load. Junk foods are usually heavily processed and refined, hence possess high GI and calories. Healthy diets are unrefined fresh or minimally processed foods that possess high fiber and other nutrients and have a low GI. Examples of healthy foods and snacks for diabetics include whole beans (starch-resistant and high in insoluble fiber), oats (whole grains and contains soluble fiber), whole grain wheat, carrot (high in insoluble fiber), apple (high in insoluble fiber), avocado, almond, salmon, veggies, Zogale (moringa), etc.

One key point for the successful management of any disease is the patient’s ability to read and research about the disease as widely as possible irrespective of one’s discipline. This is will go a long way in simplifying the work of the doctor. You should be able to take charge of your wellbeing and discuss extensively with your doctor about any management plan. Based on your readings, be willing to provide the relevant details that could guide your doctor in charting an appropriate management plan for you, do not wait for your doctor to ask you for the details. This is one thing that has been helping me to manage any disease that comes my way. You can find articles with more details on diabetes and nutrition than what I presented above in the following websites: www.verywellhealth.com and www.verywellfit.com. In case you are a diabetic or one of your loved ones is and want to get more details on the different food recipes and effective blood glucose monitoring plan, contact me using Whatsapp only on +2349031310423.

Dr. Salihu Lukman an assistant professor at the University of Hafr Al-Batin and writes from Saudi Arabia. Email: slukman@uhb.edu.sa

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How I fought diabetes in just 15 months (2)

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By Salihu Lukman, PhD
Twitter Handle: @SalihuLukman

Published in Daily Trust Newspaper: December 24, 2019

Diabetes is one of the chronic diseases that can go undetected for many years. American Association of Clinical Endocrinologists (AACE) recommends the following reference ranges for interpreting HbA1c results: no diabetes: 5.6 % or less, borderline/prediabetes: 5.7 – 6.4 % (you have a higher chance of getting diabetes), diabetes: 6.5 % or higher. In Saudi Arabia, 4.3 – 6.0 % represents the normal range, it may slightly vary from one hospital to another depending on their internal normal ranges. For diabetics, the target level is usually less than 7 %. The higher the HbA1c levels, the higher the risk of having diabetes-related complications listed earlier. Based on my HbA1c result (9.6 %), I should have been declared a diabetic and start a treatment plan right away. unfortunately, that did not happen. The doctor circled the high HbA1c value on the result sheet but failed to inform me that I was diabetic based on the result. He did not even comment on the result, he only told me that my vitamin D level is fine now and that was it! My wife who is a medical doctor and I saw the results but missed the high HbA1c level because the target at the time was the vitamin D result only.

I lived almost a normal life despite this missed diabetes diagnosis for about 1.5 years until one evening in February 2015 when we went out for shopping with my wife. I felt very thirsty during shopping in a supermarket, so I bought and consumed a 2 L bottled water within less than an hour. When we came out of the supermarket, she asked me where was the bottled water which I was holding. I replied to her that I had drunk it all. She asked me about urination frequency which I replied that I had experienced an increase lately. We went straight from the supermarket to a pharmacy to buy a glucometer so she can measure my glucose level because she suspected diabetes. Remember the classic diabetic symptoms I mentioned earlier. We bought the glucometer, measured my glucose level – guess how much – about 376 mg/dL [20.9 mmol/L], super hyperglycemia! We bought Metformin (Glucophage) to bring down the sugar level but to no avail. It took the intervention of an intravenous (IV) saline water drip under observation for about 2 hours in a hospital before my blood glucose could return back to normal. About 33 % of Saudi Arabian population is diabetic, ranked 2nd in the Middle East and 7th in the world for the rate of diabetes by the World Health Organization (WHO). Every big city in the country has a Diabetic Center specifically assigned to render medical services to diabetics and hypertensives. A comorbidity is a disease or condition that coexists with a primary disease but also can stand on its own as a specific disease. For example, hypertension (high blood pressure) is a common comorbidity of TTD which implies that hypertension and diabetes often occur at the same time. Researchers have found out that up to 75 % of adults with diabetes also have hypertension and those with hypertension also usually exhibit signs of insulin resistance. Other common comorbidities of diabetes include cardiovascular disease, kidney disease, obstructive sleep apnea, and obesity. One surprising fact with hypertensives is their compensating for salt with enough seasonings (Maggi, Ajino-Moto, etc.) to taste. The main ingredient in almost all seasoning is Monosodium Glutamate (MSG) obtained by mixing sodium and glutamate. Glutamate is an amino acid that is naturally available in foods such as Parmesan cheese, tomato, mushrooms, cured meats, and soy sauce. In particular, Ajino-Moto is almost 100 % made up of MSG, hence if you run away from the sodium in Sodium Chloride (table salt) you are only substituting it with another sodium from MSG. In the end, the total work done is approaching zero. MSG had been touted to be a carcinogen and unsafe for use in foods, but emerging research on MSG made the U.S. Food and Drug Administration (FDA) state that the “FDA considers the addition of MSG to foods to be generally recognized as safe (GRAS)” that is if you are not sensitive to MSG. Why not try a potassium salt (i.e. one in which the sodium has been substituted with potassium) for a good taste?

I visited one of the Diabetic Center for proper management of my ailment. HbA1c test was conducted and the result was 10.6 % – it had moved up from 9.6 % in 2013 – the doctor declared based on the result that I was diabetic and put me on 1 g Metformin TDS (3 times daily) in addition giving me an empty designed tabular paper where I would be recording my blood glucose levels at least 4 times daily – fasting and 1 or 2 hr after each meal. I weighed 86 kg at the time of the diagnosis in 2015 – a sharp contrast from the 76 kg in 2007. The HbA1c test would be repeated every 3 months for close monitoring on how I would respond to treatment. The doctor emphasized lifestyle changes in my diet, portion size, exercise and ultimately weight loss. I asked the doctor about using artificial sweeteners instead of sugar and he replied no. He advised me to keep off sugar, high carb diets and avoid artificial sweeteners (because of their controversial safety concerns). He encouraged me to be taking high fiber diets, low fats and fruit. I complied as much as possible except for some ‘cheat’ days. My wife took up the diet challenge very seriously and gradually – the nutritionist part of her was awakened. My food portion was almost halved and high fiber meals and fruits such as beans, vegetable soup and undressed salads were introduced in addition to healthy snacks such as almonds, cashew nuts, pistachios, olives, etc. I totally refrained from drinking sweetened juice – I would use sugar-free juice or drink the fresh fruits or fruit smoothies. On my wife’s insistence, I later stopped drinking even the sugar-free juice because it is not as nutritious and fibrous as the fresh juice. In the evenings, I would either follow aerobic lessons on Youtube or take a brisk walk for about 30 – 40 min daily to burn some calories. I would still eat rice but with enough veggies and reduced portion size. My blood sugar level was under good control for one month, the doctor reduced the dosage from TDS to 1 g BID (twice daily). In addition, even though the sugar level was under control with the use of medication alone, he further recommended that I should also be using insulin injection daily at night for 6 months to give my pancreas (responsible for the production of insulin) some rest with the hope that it would pick up adequately after it had rested. He informed us that it was the new management strategy for diabetics. Insulin injection is usually administered for type 1 diabetes or for terrible cases of TTD. Despite my hatred for any injection and the daily insulin self-injection in particular, I accepted his advice and started the insulin injection. Consequent to the multi-targeted attacks (Metformin, insulin injection, dietary modifications, and exercise) on diabetes, after just 2 months of using the insulin injection, I experienced 2 episodes of hypoglycemia attacks at night after taking the insulin injection, I shed 3 kg (weighed 83 kg) and my HbA1c had dropped from 10.6 to 6.7 % – what a marvelous improvement in a short while – the doctor asked me to stop the insulin injection because of the hypoglycemia episodes and he asked me to continue with 500 mg BID.

Dr. Salihu Lukman an assistant professor at the University of Hafr Al-Batin and writes from Saudi Arabia. E-mail: slukman@uhb.edu.sa

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How I fought diabetes in just 15 months (1)

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By Salihu Lukman, PhD
Twitter Handle: @SalihuLukman

Published in Daily Trust Newspaper: Tuesday, November 19, 2019

Diabetes can be broadly classified into two groups, diabetes mellitus, and diabetes insipidus. Type 2 diabetes (TTD) falls under diabetes mellitus and it is the most common type of diabetes. TTD is a chronic disease in which the body is unable to effectively control the levels of glucose (sugar) in the blood, which can lead to severely high blood glucose levels (hyperglycemia). The symptoms of TTD range from increased thirst, recurrent urination, excessive fatigue, and slow healing of wounds. As the disease continues, more severe complications can develop, including skin disorders, sexual dysfunction, kidney disease, nerve damage, and vision loss. Pretty much every organ could potentially be damaged. Type 2 diabetes develops when the pancreas begins to produce less insulin (a hormone that controls blood sugar levels) or when the body becomes less sensitive to the effects of insulin—known as insulin resistance. A simple blood test can diagnose TTD. Once it’s been confirmed, treatment depends on factors such as age, weight, blood sugar level, and how advanced the disease is. For some people, this might mean being dependent solely on lifestyle modifications such as weight loss, dietary changes, and exercise. For others, managing TTD may require supplemental insulin and/or oral diabetes medications. Other types of diabetes mellitus include type 1 diabetes, type 1.5 diabetes or Latent Autoimmune Diabetes in Adults (LADA), gestational diabetes and type 3 diabetes (Alzheimer’s disease). TTD is the result of one of two conditions: Either the pancreas begins releasing too little insulin. Insulin is a hormone released within a few minutes of eating to help the body store glucose, or the body isn’t able to respond satisfactorily to insulin (insulin resistance).

The following are the risk factors for TTD: obesity, sedentary lifestyle, genes, age, ethnicity, tobacco use. The following tests can be used to diagnose diabetes. The test may be repeated if the results are inconclusive: fasting blood sugar test, glucose tolerance test, fasting plasma glucose test (FPG), hemoglobin (Hb) A1c test and random blood sugar test. Use the following ranges to interpret a random or fasting glucose test: fasting: 70 – 126 mg/dL [3.9 – 7 mmol/L], 1 hr after a meal: 160 – 200 mg/dL [8.9 – 11.1 mmol/L], 2 hr after a meal: 140 – 180 mg/dL [7.8 – 10 mmol/L], random: less than 200 mg/dL [11.1 mmol/L], hypoglycemia: less than 70 mg/dL [3.9 mmol/L]. Hyperglycemia is defined as any level greater than these ranges depending on whether it is a fasting or random test. To convert from mg/dL to mmol/L, you should divide by 18. You should know this conversion factor because some glucometers measure in mg/dL while others in mmol/L.

With this short preamble on diabetes, let me take you on a journey through my personal experience with diabetes. It all started with recurrent development of boils on different parts of my body (e.g. groin, thigh, breast, armpit, eye, nostril, ear, buttocks, etc.) during my adolescence. A boil is a gargantuan whitehead – which is different from acne pimple or zit – that infects hair follicles, often caused by the bacteria Staphylococcus aureus or other fungi. It is also called a furuncle or abscess. You can think of a boil as a large pimple that is ‘boiling over’. After completing my undergraduate studies and I started to work, these boils continued to bother me, day in, day out. I was advised to go for a complete medical check-up in order to find out the exact cause of these recurrent boils. I did a complete check-up at the Sick Bay (Medical Centre), ABU Zaria, in around 2017- from blood culture, random blood sugar to HIV. When the chief technologist mentioned HIV, I opened my eyes wider in awe. He enlightened me that there was a need to include HIV because boils can be caused by a weakened immunity and HIV is one disease that can weaken one’s immunity. That was my first HIV test and it was negative. Random blood sugar test (RBST) is a blood test conducted on a non-fasting person. Fasting here refers to abstaining from food overnight for at least 8 hr. Well, all other tests came out negative except RBST which came out positive. Based on the fact that an RBST can be above normal especially if one ate a little too much carbohydrate before the test was conducted, a fasting blood sugar test (FBST) was conducted to confirm whether I might be diabetic or not. My mother was diagnosed diabetic a few years before she died in her early 60s. My father, till in his 90s, used to make his sugar drinks (tea, pap, etc.) extremely sugary, he never had diabetes. I also used to make my sugar drinks extremely sugary, I took after my father since when I was a little kid. Back to my medical tests, the FBST came out negative. Given my family history of diabetes, I was advised to be cautious with my meals and to engage in regular exercise. I cannot remember my exact weight at the time, but it was close to 76 kg since my estimated Body Mass Index (BMI) was about 24.5 kg/m2 – just about becoming overweight (25 – 29.9 kg/m2). BMI is an indirect measurement of estimating body fat levels based on weight and height measurements which has been found to be a fairly reliable indicator of body fat. It is a simple calculation that can be used to determine health risk due to excess body fat levels and is given by weight (kg) divided by the square of height (m). BMI results can be interpreted as follows: interpreted as follows: below 18.5 = underweight, 18.5 – 24.9 = normal weight, 25.0 – 29.9 = overweight, 30.0 – 39.9 = obese, over 40 is considered morbidly obese. I was not doing any kind of exercise before that time. I had patronized the aerobic class at Teejay Gymnasium, Teejay Hotel, Zaria, for 1 month and later bought table tennis which I used to play with my friends daily at my home. But there was no change in my diet or portion size at all. I used to eat a large quantity of food at a go. For that, my friends nicknamed me Mai Baho (one with a big eating bowl) during my undergraduate days in ABU. I like Indomie noodles and used to patronize it frequently. My favorite dishes were Tuwon Shinkafa (thick white rice pudding) and Jollof spaghetti pasta. Three years later, i.e. in 2010 before I left Nigeria for my PhD in Saudi Arabia, I weighed 83 kg. In Saudi Arabia, I would go out for some workouts like brisk walking and weight lifting and later started using a treadmill. During this period (2010 – 2013), I did not make any attempt at changing my diet (rice, Irish potatoes, pasta, Indomie, juice, yogurt, mutton, beef, chicken, sweetened snacks, soft drinks, etc.) except using a sweetener instead of sugar in my tea which I later changed to honey. I was gradually adding more weight despite the stress of PhD and the infrequent workouts. In 2012, I began to experience chronic headaches and malaise which let to some series of medical tests to find out the exact course. Vitamin D deficiency was identified and treated which lead to final check-up tests in September 2013. This final test included HbA1c test and it was found to be 9.6 % which represents estimated average blood glucose (eAG) of about 229 mg/dL [16.7 mmol/L]. I weighed 90 kg. My vitamin D and other test parameters were within normal ranges. You can convert your HbA1c into estimated average blood sugar (eAG) and vice versa using this formula: 28.7 X HbA1c – 46.7 = eAG.

HbA1C test is a blood test that shows ones’ average blood sugar levels for the previous 2 – 3 months and it is also called A1C test, hemoglobin A1c, glycated hemoglobin, or glycosylated hemoglobin test. It a broader test when compared to the previously listed instantaneous diabetes tests and it can be used for the diagnosis and monitoring of diabetes. It is recommended by the American Diabetes Association (ADA) to run this test for everyone whose age is 45 years and older irrespective of other risk factors. A repeat should be done once every 3 years if the results are normal in the first instance. Are you 45 years and above and have you had a glycated hemoglobin test?

Dr. Salihu Lukman an assistant professor at the University of Hafr Al-Batin and writes from Saudi Arabia. Email: slukman@uhb.edu.sa

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On Mentorship And Project Topic Selection

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By Salihu Lukman, PhD
Twitter Handle: @SalihuLukman

Posted on my Facebook wall on November 3, 2019

As a sequel to sharing Dr. MD Aminu’s piece on MENTORSHIP, one of the commentators aroused my curiosity about whether a professor should ask his student to come up with a project topic or she/he should provide the student with one. Below are some insightful tips for the student and his professor based on my experience. Your opinions are welcomed.

Here is my response:

I would like to elaborate more on the comment based on my experience as a final year project coordinator in the Department of Water Resources and Environmental Engineering (WREE), ABU, Zaria and currently as the senior design project or capstone project (as the Americans call it) coordinator in the Civil Engineering Department, University of Hafr Al-Batin, Saudi Arabia. My discussion will be limited to the engineering and other related basic or applied science disciplines or majors, and it may or may not be 100 % applicable to other majors.

Research Project vs Design Project

A research project is the one geared towards exploring a new process, product, device, new use for or improvement to an existing process or product. If properly conceived and systematically executed, research outcomes can be publishable in journals, presentable in conferences and patentable in the Patent Office depending upon the extent and quality of the research. What is a PATENT? It is “a government authority or license conferring an official legal right or title for a set period, especially the sole right to exclude others from making, using, or selling an invention (Cambridge Dictionary).

On the other hand, a design project is the one that is mainly based on the application of basic scientific or applied mathematical formulations to a new/existing process/product such as designing a new skyscraper, municipal water distribution system, highway, dam, water/wastewater treatment plant, mechanical/electrical device, etc. Please note that some design projects in electrical or mechanical engineering could qualify for a full-blown research project.

Nigerian system

Nigerian undergraduate (UG) projects can be research or design-based or a combination of the two. One distinct feature of a research project is the identification of a ‘gap’. The gap here refers to that empty portion or a discontinuity, however small, that exists within a given specific area and needs to be filled. In other words, one needs to undertake a comprehensive literature review in his/her area of interest to identify some unique and important process or product that is either absent or is poorly understood, and then come up with the missing process/product or improve the existing process/product. Undergraduates and more often than not, even postgraduate students grapple with finding that gap in the literature.

Please note that not all research projects are expected to find this gap and fill it. At undergraduate and master levels, this may be highly recommended depending on the educational system (US or UK), while it is compulsory at PhD level. The gap does not have to be so big, it is expected that at the PhD level, one should be able to add something to the existing body of knowledge, rather than just changing case study or study area. Hence, uniqueness and innovation are key at this level.

In WREE Department, the students were expected to undertake two group design projects in the 1st and 2nd semesters and one individual research project spanning for the whole of the final year. Usually, the lecturers would come up with the topics for the group design projects for students to choose from while each student was expected to come up with his/her research project topic. When I was a final year undergraduate, I approached my mentor (popularly called DAN ALJANNA) for consultation and guidance about my proposed research project topic. While he was driving me in his car, at his instance, I made a mini-project proposal based on my interest and he helped me to fine-tune the topic before we finally agreed on the overview of the whole project. I must confess that many students find it very difficult to come up with research project topics on their own. This is not unexpected, because, the students possess only a shallow knowledge in their respective areas at that point in time, hence, they need guidance on arriving at the most appropriate topic for their projects. Of course, you always have an exception to this rule. There could be excellent students, maybe 5 – 10 % who would come up with not even one researchable topic but many without seeking any assistance from any of their lecturers depending on the discipline.

After becoming a lecturer myself, years later, and appointed as the undergraduate project coordinator, I set out to do things differently that would alleviate the pains that students go through in arriving at the most appropriate project topic. This I did by requesting all the lecturers to submit to me at least 2 project topics based on their respective research interests in order to have enough pool of topics that would be enough for all the students. I generated a pool of topics, pasted the list on a notice board and informed all the final year students to go and select any topic of their interest. Ironically, I personally never suggested any topic to form part of the pool. However, the new topic selection process went a long way to improve the standard of the research projects and enabled the students to gain more knowledge out of the project experience. As to why I never suggested topics like the other lecturers, I had stringent conditions that I thought including my topics among the pool would not lead to the realization of my goals. These conditions were, I expected any student who would work with me to be very hardworking, the outcomes of the project had to be of high quality such that at least a paper could be extracted from the project which can be published in a journal or be presented in a conference. If any student approached me and indicated interest to work with me as his project supervisor, I would explain these conditions and if he accepted my terms, I would give him my own topic based on my area of interest. A research project whose outcome is not publishable was not worthy of my supervision. I am not oblivious of the fact that many people would view these stringent conditions for an undergraduate project as very tough or unachievable. But as an undergraduate student, I was able to do just that. I published my own final year undergraduate project in a journal. From there I got the idea that if I could publish my own project that was not initially executed with any plan to publish the results, why can’t others do the same thing with proper prior planning? In this way, I would not only supervise the student to pass his research project with flying colors, but I would teach him the art of writing a journal article and presentation at a conference. Most of the undergraduate projects I supervised have been published in either a journal or conference proceedings or both. In a design project, different from a research project, no publication is expected from the project outcome. However, a design project has one particular advantage over a research project in that it prepares one more for consultancy jobs either with consultancy firms or as a freelancer.

American system

In the American system, more often than not, seniors (final year students) are expected to do a group design project only, preferably, multidisciplinary in nature. Let me give you an example in Civil Engineering, which is my major. Students can be given an architectural design of a skyscraper and be asked to design all the structural elements (foundation, columns, beams, slabs, etc.) as well as come up with some alternative designs. To make it a multidisciplinary one, they can be asked to design a swimming pool, or parking area, drainage system, water or wastewater treatment plant, etc. I don’t know how the South African system works, but it may not be outside these two systems since it was colonized by the British. The commentator can kindly help us with an insight On the South African system if different from the above.

Tips on Kickstarting a Research Project – Beautiful Serendipity

Start any research project, be it at the undergraduate or postgraduate level, with an open and broad mind. Expect the unexpected. It is not all the time that all your research goals are manifest. Go in with an objective and critical mind and you may end up finding interesting and valuable things not sought for, by chance – yes, by sheer chance – that could herald a breakthrough.

Serendipity is the phenomenon of finding interesting and valuable or agreeable things not sought for, by chance. (Cambridge Dictionary, Meriam-Webster Dictionary). There are numerous ground-breaking scientific discoveries that were obtained by sheer accident and were unintended, yet, they changed the world. These include microwave, radioactivity, x-rays, vulcanized rubber, Teflon, Super Glue, Corn Flakes, Vaseline, penicillin, insulin, Viagra, quinine to mention but few. Serendipity adds flavor to research. I will share with you my serendipitous research journey when I was conducting my final year undergraduate research project at ABU and my PhD research at the prestigious King Fahd University of Petroleum and Minerals (KFUPM), Saudi Arabia.

In my undergraduate research, I had initially set out to utilize a famous FORTRAN computer program for water distribution analysis written by a renowned American professor of water engineering in 1979. Mark you, it was not the objective of my research to write any FORTRAN program code. However, during my preliminary testing of the program, I ACCIDENTALLY found out that the said program was not furnishing the correct results. I was dumbfounded because all the previous research that I could obtain at the time used the same program without any change. Then, I critically analyzed the program from my knowledge of the theory behind the program. Eureka! I identified 3 fundamental errors in the program that rendered the program inaccurate. This finding completely changed the direction of my research. Now, I had to first write another computer program that was error-free and could furnish the correct results when run. I successfully achieved that goal and went on to publish the outcome of my research in a journal.

In my PhD research, I initially set out to carry out simple soil remediation (decontamination) with multiple contaminants using the already established treatment conditions, on a local Saudi Arabian soil. During the preliminary characterization of the soil, I ACCIDENTALLY found it to possess high pH (alkaline) and exchangeable sodium percentage. To describe this, I added an adjective to the local Saudi Arabian soil and I called it sodic soil. Upon further analysis, I ACCIDENTALLY found the soil to possess high electrical conductivity which prevents the application of the standard treatment conditions for such soil. I added another adjective SALINE to describe the soil fully. The soil became SALINE-SODIC SOIL. This type of soil is usually found in arid and semiarid regions. Fortunately or unfortunately, there was no previous remediation study on this type of soil – the gap – hence, I undertook a comprehensive and successful remediation study on this soil at bench scale and pilot scale. Shortly after I submitted my dissertation to the graduate school, I received a message from the Deanship of Scientific Research, KFUPM, that the attorney in their US patent office had studied my abstract and said that my dissertation is patentable, hence, I should file for the US patent through them. Unfortunately, due to some ‘political’ reasons, I did not apply for the patent at the time. Almost, 2 years later, I was again contacted by KFUPM to file a patent for our invention. At this time, the political reasons were resolved, and I filed for a US patent for the invention. Months later, I received a positive prior-art search, which in essence confirmed that my work is unique and innovative. Unfortunately, when I responded to the prior-art search message that will enable the US Patent Office to go ahead and approve the patent, they responded to me that the time within which to process the patent had elapsed and they could no longer continue to process the patent application. That was how I lost that patent. Please learn from my reminiscence that whenever you feel that your research is unique and innovative, don’t waste any time in filing for a patent. You can clearly see from the foregoing, how serendipity significantly affected my research, positively. If not for the delay in filing the patent, I would have been in possession of one US patent today.

I hope this piece would serve as a simple guide and inspiration to the teaming PhD and MSc students who write or call me to seek for assistance in choosing a research topic in their different areas of specialization. I would also like to hear your own reminiscences vis-à-vis serendipity, project topic selection and how your undergraduate research or design project differs from the one I explained above based on your major.

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