Errol Y. St. A Morrison

The Jamaican Diabetes Survey: A protocol for the Caribbean

OBJECTIVE This study was designed to investigate the point prevalence of diabetes in Jamaica. RESEARCH DESIGN AND METHODS A two-stage stratified random sampling design was used, and individuals aged 15 years and over were interviewed. Nonresponse was documented and factored into the final analysis of the survey data. The overall response rate obtained was 57.9%. All subjects with fasting blood glucose (FBG) > 6.1 mmol/1 (110 mg/dl) were brought back for an abbreviated glucose tolerance test. The data was analyzed using Epi 5, an advanced statistical program designed specifically for use with epidemiological data. RESULTS The 2,109 subjects who participated were the basis for estimates of diabetes and IGT prevalence. Among those with previously diagnosed diabetes, diet therapy alone, oral hypoglycemic agents plus diet therapy, insulin therapy, and lack of treatment were reported. CONCLUSIONS By the World Health Organization (WHO) criteria, Jamaica has a point prevalence of diabetes of 17.9% in the 15-and-over age-group.

Hypoglycaemic Activity of Bixa orellana Extract in the Dog

In West Indian folklore, a variety of plants are used for medicinal purposes. One such plant, Bixa orellana (annatto), is commonly used in the treatment of diabetes mellitus. Preliminary studies have shown that a crude annatto seed extract exhibited either glucose lowering or hyperglycaemia-inducing activity depending on how it was further manipulated. This present investigation sought to determine the effects of the glucose-lowering extract on C-peptide and streptozotocin-induced diabetic dogs. This annatto extract was found to decrease blood glucose levels in fasting normoglycaemic and streptozotocin-induced diabetic dogs. In addition, in normal dogs, it suppressed the postprandial rise in blood glucose after an oral glucose load. Interestingly, the extract also caused an increase in insulin-to-glucose ratio in normal dogs. Increased insulin levels were not due to increased insulin synthesis as after 1-h residence time and half-hour postprandial, decreased C-peptide levels was observed. It was concluded that Bixa orellana (annatto) lowered blood glucose by stimulating peripheral utilization of glucose, and it is possible that this glucose-lowering extract might be of pharmacological importance.

Plasma and liver lipid distributions in streptozotocin-induced diabetic rats fed sapogenin extract of the Jamaican bitter yam (Dioscorea polygonoides)

Abstract Bitter yam ( Dioscorea polygonoides ) steroidal sapogenin extract and commercial diosgenin were administered to diabetic rats for 21 days. Plasma glucose and lipids were assessed. Liver lipid distributions were also determined. The two dietary supplements fed to diabetic rats resulted in significant decreased body weight gain. The test diets significantly lowered plasma glucose and total cholesterol. Sapogenin extract supplement significantly lowered plasma total triglycerides. Plasma and liver VLDL+LDL-cholesterol were significantly reduced while the HDL fraction was increased in diabetic rats fed the test supplements. These results showed that the consumption of the two supplements maybe useful in the management of hypercholesterolemia often associated with diabetes.

Interdisciplinary approach to the demography of Jamaica

BackgroundThe trans-Atlantic slave trade dramatically changed the demographic makeup of the New World, with varying regions of the African coast exploited differently over roughly a 400 year period. When compared to the discrete mitochondrial haplotype distribution of historically appropriate source populations, the unique distribution within a specific source population can prove insightful in estimating the contribution of each population. Here, we analyzed the first hypervariable region of mitochondrial DNA in a sample from the Caribbean island of Jamaica and compared it to aggregated populations in Africa divided according to historiographically defined segments of the continents coastline. The results from these admixture procedures were then compared to the wealth of historic knowledge surrounding the disembarkation of Africans on the island.ResultsIn line with previous findings, the matriline of Jamaica is almost entirely of West African descent. Results from the admixture analyses suggest modern Jamaicans share a closer affinity with groups from the Gold Coast and Bight of Benin despite high mortality, low fecundity, and waning regional importation. The slaves from the Bight of Biafra and West-central Africa were imported in great numbers; however, the results suggest a deficit in expected maternal contribution from those regions.ConclusionsWhen considering the demographic pressures imposed by chattel slavery on Jamaica during the slave era, the results seem incongruous. Ethnolinguistic and ethnographic evidence, however, may explain the apparent non-random levels of genetic perseverance. The application of genetics may prove useful in answering difficult demographic questions left by historically voiceless groups.

Lipid profile of type 2 diabetic and hypertensive patients in the Jamaican population

Aims: Previous studies have shown that diabetes mellitus (DM) increases the risk of cardiovascular diseases in females to a greater extent than in males. In this cross-sectional study, we evaluated the lipid profiles of type 2 diabetic males and females. Materials and Methods: The study included 107 type 2 diabetic patients (41 males and 66 females), and 122 hypertensive type 2 diabetic patients (39 males and 83 females), aged 15 years and older. Total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), very low density lipoprotein-cholesterol (VLDL-C) and high density lipoprotein-cholesterol (HDL-C) concentrations were assayed for each group using standard biochemical methods. Results: The mean TC, TG, VLDL-C, HDL-C and LDL-C concentrations, TG/HDL and LDL/HDL ratios were higher in type 2 diabetic and hypertensive type 2 diabetic patients compared with non-diabetic, and hypertensive non-diabetic control subjects, although these were not significant (P > 0.05). Hypertensive type 2 diabetic females had significantly higher serum TC (7.42 ± 1.63 mmol/L) than hypertensive non-diabetic males (5.76±1.57 mmol/L; P < 0.05). All the other lipid and lipoprotein parameters except HDL-C were non-significantly higher in females with type 2 DM and those with hypertension and type 2 DM, compared with type 2 diabetic and hypertensive type 2 diabetic males, respectively (P > 0.05). Conclusion: This study demonstrated that dyslipidemia exists in our type 2 diabetic population with greater TC in hypertensive type 2 diabetic females compared with hypertensive type 2 diabetic males. This suggests that hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidemia compared with males.

Carbohydrate digestion and intestinal ATPases in streptozotocin-induced diabetic rats fed extract of yam (Dioscorea cayenensis) or dasheen (Colocasia esculenta)

Abstract Streptozotocin-induced diabetic rats were maintained for four weeks on extracts of yam or dasheen or commercial linamarin. The levels of blood glucose, digestive and membrane-bound enzymes of the intestine were determined. Rats fed commercial linamarin significantly lowered blood glucose level compared to the diabetic rats fed normal diet. Feeding of commercial linamarin to diabetic rats significantly decreased the activity of intestinal amylase compared to normal rats. Dasheen extract or commercial linamarin significantly increased the activities of intestinal disaccharidases compared to the diabetic rats fed normal diet. Na + /K + ATPase activity in the lower segment of the intestine was significantly reduced in diabetic rats compared to normal rats. In the upper segment of the intestine, yam or dasheen extract or commercial linamarin supplementation increased the activity of this enzyme above normal. These observations show that the hypoglycemic property of cyanoglucoside extract from dasheen and to a lesser extent yam, could be due to other chemical constituents of the extract and this needs further investigation.

Importance of mitochondrial haplotypes and maternal lineage in sprint performance among individuals of West African ancestry.

Mitochondrial DNA (mtDNA) is inherited solely along the matriline, giving insight into both ancestry and prehistory. Individuals of sub‐Saharan ancestry are overrepresented in sprint athletics, suggesting a genetic advantage. The purpose of this study was to compare the mtDNA haplogroup data of elite groups of Jamaican and African‐American sprinters against respective controls to assess any differences in maternal lineage. The first hypervariable region of mtDNA was haplogrouped in elite Jamaican athletes (N=107) and Jamaican controls (N=293), and elite African‐American athletes (N=119) and African‐American controls (N=1148). Exact tests of total population differentiation were performed on total haplogroup frequencies. The frequency of non‐sub‐Saharan haplogroups in Jamaican athletes and Jamaican controls was similar (1.87% and 1.71%, respectively) and lower than that of African‐American athletes and African‐American controls (21.01% and 8.19%, respectively). There was no significant difference in total haplogroup frequencies between Jamaican athletes and Jamaican controls (P=0.551 ± 0.005); however, there was a highly significant difference between African‐American athletes and African‐American controls (P<0.001). The finding of statistically similar mtDNA haplogroup distributions in Jamaican athletes and Jamaican controls suggests that elite Jamaican sprinters are derived from the same source population and there is neither population stratification nor isolation for sprint performance. The significant difference between African‐American sprinters and African‐American controls suggests that the maternal admixture may play a role in sprint performance.

Supercritical fluid carbon dioxide extraction of annatto seeds and quantification of trans-bixin by high pressure liquid chromatography

Bixin, a pigment used for food colouring is known to have a hyperglycemic effect. It was extracted using supercritical carbon dioxide, from the seeds of annatto (Bixa orellana L.). The major pigment in annatto, trans-bixin, was quantified by high pressure liquid chromatography. A combination of static and dynamic modes of extraction with carbon dioxide containing acetonitrile (0.05% trifluoroacetic acid) as modifier at 60.62 MPa and 40°C was found to the best set of conditions studied and afforded 2.70 mg bixin/g dry weight of the annatto seeds.

A preliminary report on an assessment of a community-based intervention for diabetes control in adults with type 2 diabetes

OBJECTIVE The aim of this study was to evaluate the effectiveness of lay diabetes facilitators (LDFs) to increase knowledge and improve control among persons with diabetes. Methodology. A prospective cohort study was conducted among persons with diabetes in 16 health care centres in Jamaica to evaluate the effect of LDFs on glycaemia [haemoglobin A1c (HbA1c)] and body mass index (BMI). One hundred and fifty-nine persons with diabetes were recruited for the intervention from eight clinical settings in which LDFs had been recruited and trained. A matched group of 159 were recruited as a comparison sample from eight clinical settings without LDFs. HbA1c and BMI were measured at baseline and 6 months. RESULTS Mean HbA1c at baseline for the intervention and comparison groups were 7.9% and 8%, respectively. After 6 months, the intervention group showed a mean decrease of 0.6% while the comparison group showed an increase of 0.6%, significant after control for potential confounders (P < 0.05). There was no statistically significant change in BMI between groups. CONCLUSION Patients educated by LDFs showed improved metabolic control over the first 6 months of observation.

Alterations in intestinal morphology of streptozotocin-induced diabetic rats fed Jamaican bitter yam (Dioscorea polygonoides) steroidal sapogenin extract

In this study, the effect of yam steroidal sapogenin extract on intestinal morphology in streptozotocin-induced diabetic rats was examined. Diabetic male Wistar rats (n = 32) were fed diets supplemented with 1% bitter yam steroidal sapogenin extract or commercial diosgenin for three weeks. The effect on intestinal morphology was assessed. The induction of diabetes significantly increased villus length and crypt depth compared to the normal group. Supplementation of the diet with sapogenin extract or commercial diosgenin significantly increased villus width compared to the diabetic controls. The dietary supplements also significantly decreased crypt depth towards that of the normal controls. This study shows that the feeding of bitter yam steroidal sapogenin extract to diabetic rats may result in alterations in the intestinal morphology.