Tjokroprawiro, A., M.D., Ph.D (1980) High Carbohydrate Diet Plus Green Beans (Phaseolus Vulgaris,L) In The Treatment Of Diabetes Mellitus And Its Prevention Of Vascular Complications. Laporan Penelitian. FAKULTAS KEDOKTERAN, UNIVERSITAS AIRLANGGA, SURABAYA. (Unpublished)

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Abstract

The number of patients registered at the Diabetic Clinic of the Dr. Soetomo Hospital during 16 years (1964-1979) amounted to 4976, consisting of 3748 (75.3%) treated with oral hypoglycemic drugs, 396 (8.0%) treated with insulin and 832 (16.7%) treated with diet only. Based on the kinds and the price of durqs available, oral hypoglycemic agents such as tolbutamide (1139 . 30.4%) and chlorpropanide (661 = 17.6%) , glihenclamide (1725 = 46.0%), gliclazide (163 = 4.4%), and gliquidone (60 = 1.6%) have been prescribed since 1964,1973 1976 and 1979 respectively. A comparative study, using a crossover design (Tjokroprawiro, 1978) , has been carried out on 260 cooperative diabetic out-patients, to investigate whether the B-diet (68% cbh, 20% fat, 12% protein) was metabolically and socio-econo¬mically better than the A-diet (50% cbh, 30% fat, 20% protein). The results of the study showed that the B-diet is better than the A-diet; interestingly, the serum cholesterol level was significantly 31.75 mg% (p <0.001) lower on the B-diet than on the A-diet after a one week dietary period. It was speculated that HDL cholesterol would be higher on the B-diet, and consequently the incidence of diabetic vascular complications might be lower¬ed; hence, the B-diet has been widely prescribed for the treatment of patients with diabetes mellitus in Indonesia since 1978. Recent studies with crossover designs demonstrated that the B-diet plus 600 grams green beans (Phaseolus Vulgaris, L) daily, showed significant hypogly¬cemic (Tjokroprawiro et al, 1980) and hypolipidemic (Budhiarta et al, 1980) effects on poorly controlled diabetic patients after a one week dietary period It has been postulated that gliclazide is an oral hypoglycemic drug which is able to reduce platelet adhesiveness and aggregation, is able to antagonize adrenaline vasoeonstrictive hyperreectivity in the vessel wall, and which has also a fibrinolytic effect at hypoglycemic doses. We conclude that the combination of the high carbohydrate diet (the B-diet), green beans, and gliclazide may be of reel value in the therapeutical indi¬cation attempting to prevent or minimize vascular complications for non-in¬sulin dependent diabetic patients.

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