C O NT RO L Y OU R HEAL TH
VOLUME 3, NO. 7
The latest theories about the dietary and environmental causes of
diabetes and how to minimize its effects.
Diabetes
iabetes
A dietary
mellitus affects ers, hydralazine — increases the type, the pancreas stops producing
D around 2 per cent of the pop-
ulation and its incidence is
becoming more common—
with 60,000 cases currently diag-
nosed each year.
What triggers the condition is not
fully understood. It does seem clear,
however, that like many ailments,
its increased prevalence is linked to
the Western lifestyle.
A 12-year study published in the
British Medical Journal (H. Bodan-
sky et al, 18 April 1992) shows that
environment is a major factor. The
researchers found that when chil-
dren of families from an area where
diabetes is rare move to an area
where it is more common, they show
a corresponding rise in the disease.
The incidence of diabetes in Asian
children in Bradford went from
3.1/100,000 per year in 1978-1981 to
11.7/100,000 per year in 1988- 1990.
The level for indigenous children re-
mained constant at 10.5/100,000 per
year.
Prescribed drugs and diet are
thought to have a role as a trigger. A
study looking at nutrients and food
additives suggests a diet with large
amounts of foods rich in protein and
carbohydrate, along with food addi-
tives such as nitrosamines, may in-
crease the likelihood of developing
diabetes (Dr Gisela Dahlquist et al,
BMJ, 19 May 1990). Other research
suggests long-term use of antihyper-
tensive drugs— thiazides, betablock-
1
Special Report: Diabetes. How to
minimize its effects.
4 6
Updates: Fish oils; contingency
negligence suits; Down's Syndrome.
What Doctors Don't Tell You, 4 Wallace Road, London N1 2PG. Editor Lynne McTaggart Editor's PA Jan Green Editorial Assistant Dorothy Rothermel Designer Clerkenwell
Design Group Printed by Premier Press Publisher The Wallace Press Copyright The Wallace Press No part of this publication may be reproduced without permission.
ap p ro a ch
odds of diabetes by a factor of around
1.7, independent of any other risk
factors (Dr Elinar Skarfors et al,
BMJ, 28 September 1991). Stress is
also thought to play a part.
Diabetes is divided into two types:
insulin dependent and non-insulin
dependent. With the first, which
strikes younger people, the pancreas
stops producing any insulin. (Insulin
enables the body to convert sugar
into energy; without it, sugar re-
mains in the blood.) Treatment is by
‘Judicious diet
and
supplements
may enable
many
diabetics to go
without drugs.’
daily injections of insulin and by fol-
lowing a careful diet to match the
amount of energy taken in with the
amount of insulin injected so that
blood sugar levels stay as near nor-
mal as possible.
The second type is also known as
middle-age onset diabetes. With this
C O N T E N T S
5
What Doctors Read: foetal scalp
monitors; dermatitis; IBS.
Q&A: More on VDUs and cataracts;
sufficient insulin to counteract the
amount of sugar in the blood. It is of-
ten treated by diet alone, or by diet
and insulin-stimulating drugs—
which have their own side-effects
(see below). Both types of diabetes
can be associated with a range of
side-effects, commonly hypogly-
caemia, where the blood sugar falls
too low, causing the diabetic to pass
out if not caught in time. In the
longer term, raised blood-sugar lev-
els can lead to blindness, heart dis-
ease, kidney damage and gangrene.
Obesity is thought to be a major
factor in triggering type two dia-
betes; however, a study published in
The Lancet (28 September 1991)
suggests regular exercise may help
stave off diabetes, even in those who
are overweight. The researchers
tracked 87,253 American women be-
tween the ages of 34 and 59 for an
eight-year period. "Physical activity
was associated with a greater reduc-
tion in risk of NIDDM (non-insulin
dependent diabetes mellitus) during
this period for women exercising at
least once a week compared with
sedentary women," they said.
Leading nutritional doctor Stephen
Davies believes low levels of
chromium—which tends to decrease
with age—may be a trigger of type
two diabetes. "We have many exam-
ples of patients whose glycosolated
haemoglobin [the part of the blood
tested to measure blood sugar levels]
7
Books: Beat Sugar Craving and The
NCT Book of Breastfeeding.
Second Opinion: Deborah Jackson.
Moving at a child's pace.
 has come down into the normal range
once their chromium levels are
raised," he says. Supplements of
chromium and "judicious dietary in-
tervention" may enable many more di-
abetics to control their condition
without resorting to drugs. Recog-
nized side-effects of insulin-stimulat-
ing drugs are nausea, anorexia,
diarrhoea, skin allergies, reversible
leucopaenia (reduction in the number
of white corpuscles in the blood),
thrombocytopenia (blood platelets re-
duction) and transient changes in
liver enzymes. Davies recommends
that elderly diabetics boost their
chromium intake with 20-30 brewer's
yeast tablets a day.
Chromium levels may also be de-
pleted in insulin-dependent diabetics.
Supplementation can improve control
and—because chromium allows in-
sulin to work properly—may allow
some diabetics to reduce their insulin
doses, says Davies. (He warns, how-
ever, to be aware that greater insulin
efficiency may increase the number of
hypoglycaemic episodes—hypos—un-
til the insulin dose is correspondingly
reduced.)
Dr Davies says dietary supplements
may also be helpful in staving off other
side effects. Diabetics with symptoms
of eczema or thrush should be tested
for zinc deficiency. Zinc supplements
may also help the healing of resistant
leg ulcers, along with doses of vitamin
C. (Davies recommends 1-3 g of vita-
min C and 20-80 mg zinc a day.) Vita-
min C is also helpful with a host of
other side-effects; it strengthens weak
blood vessels associated with eye dis-
ease and reduces cholesterol levels in
blood. Diabetics who have suffered
from ketoacidosis (where severe in-
sulin deficiency has caused fat break-
down leading to acidification of the
blood) are likely to be deficient in mag-
nesium. Potassium levels may also be
depleted.
Other recommended vitamin sup-
plements are B6 and B12 — to aid con-
trol and reduce the likelihood of
nervous system disorders — and vita-
min E, which helps minimize damage
to small blood vessels. Increased con-
sumption of polyunsaturated fatty
acids and their derivatives such as
evening primrose oil and vitamin C
will help reduce the levels of fats in
the blood. Dr Davies also recommends
eating plenty of salmon, mackerel,
herring and linseed oil to reduce the
risk of blood platelet clumping which
can cause eye disorders.
An underexplored factor which may
affect diabetic control is the impact of
food allergies.Dr Davies says animal
studies have shown that certain foods
may have an impact on blood sugar
levels, which have nothing to do with
the amount of carbohydrate ingested.
Such allergies may often be masked,
so Dr Davies recommends using a pro-
cess of self-testing to isolate foods
which may provoke an allergic reac-
tion if sugar levels are fluctuating for
no apparent reason. One such sub-
stance is bovine serum albumin, a
protein in cow's milk, which may trig-
ger an autoimmune response that de-
stroys pancreatic cells in genetically
susceptible individuals. A recent
study (The New England Journal of
Medicine, 30 July 1992) examined the
blood of 142 children with IDDM and
found that all had elevated anti-BSA
antibodies, which the University of
Toronto researchers concluded had
precipitated pancreatic dysfunction.

Human insulin and MS

When James Marshall in Inverness placed a newspaper ad for diabetics who were suffering terrible side-effects since switching from animal to
human insulin, six of the 30 people who wrote had developed multiple sclerosis-like symptoms within months of making the change.
His own son, Stephen, now 27 — a diabetic for 14 years — went from having his condition well under control to suffering fit-like hypos,
stroke, ataxia (loss of co-ordination), before finally being diagnosed as having MS. Marshall says: "Now he can't walk unless I support him. He
can't stand without help." Stephen has now switched back to animal insulin and, although his diabetic control has returned, he remains disabled.
In Borehamwood, Joe Cooper's daughter also now apparently suffers from MS and uses a wheelchair. Within six months of switching to hu-
man insulin, her health began to deteriorate dramatically: she was diagnosed as having ataxia, epilepsy, a number of minor strokes and MS be-
fore going on to suffer a heart attack which, thankfully, she survived.
Since it was introduced 10 years ago, human insulin has become associated with a catalogue of side-effects, most commonly the loss of warn-
ing signs of an impending hypo and increased severity of attacks.
Paul Lewis, 39, a diabetic since 1962, says he went from around four hypos in 24 years to having four or five a week after switching. Fit-like
hypos, where he would foam at the mouth, would strike without warning, to the point where he, too, was told he was epileptic — a diagnosis
eventually refuted by a neurosurgeon. In August 1989, he was in a diabetic coma for five days. He says he also suffered memory loss (which was
written off by doctors as depression) and searing pain in his limbs. The pain and his other side-effects subsided since reverting to animal insulin.
Lewis and Marshall went on to set up the National Diabetic Federation (see below) and say they now know of 30 diabetics where MS was di-
agnosed within a few months of switching insulin. They believe that human insulin can trigger a condition which is being mistaken for MS.
Yet the British Diabetic Association remains sceptical of any claims of problems. One of its medical spokespeople told WDDTY: "I haven't
seen any data which suggests there is an excess number of diabetics with MS. You have to remember that MS is not that uncommon and hav-
ing diabetes doesn't stop you getting MS."
Human insulin is, of course, not human at all but genetically engineered to resemble true human insulin."It was felt that if it is possible to pro-
duce something which is identical to the insulin the human body produces, it is better to use that than something designed for cows or pigs [the
two sources of animal insulin]", says the BDA spokesperson. "In fairness, there is no proven benefit except in a few cases."
However, writing in the British Medical Journal, Liverpool-based doctors Gareth Williams and Alan Patrick (BMJ, 8 August 1992) identify a
difference which could begin to explain the range of neurological complications associated with human insulin. "Human and porcine insulins dif-
fer in only one out of 51 amino acid residues; although apparently trivial, this change evidently affects the physiochemical and pharmacokinetic
properties of the molecule, as porcine insulin is more lipophilic than human insulin." "The more lipophilic porcine insulin could gain access to
the brain more readily and, in theory, could modulate the effects of low glucose concentrations on hypothalamic or other neurones."
They add: "A direct effect of insulin on the human brain is suggested by the recent demonstrations that counterregulatory hormone re-
sponses and symptoms differ when comparable hypoglycaemia is induced by high or low insulin concentrations." In other words, it may not just
be the level of your blood sugar alone which determines the impact of a hypo.
The National Diabetic Federation can be contacted on (0942)833389 for advice or legal information.

2 WDDTY Vol.3 No.7

Diabetic pregnancies: how not to be high risk
iabetic pregnancies— whatever
D the mother's state of health—
are still deemed by standard
medical thinking to be high-risk. Dr
Michel Odent — a leading pioneer of
natural childbirth—rejects such a
blanket approach. "Generally speak-
ing, any label of high-risk brings with
it its own risk," he says, and should,
therefore, be avoided. This high-risk
tag means that the whole parapher-
nalia of science's attempts to improve
on nature will be wheeled out when a
diabetic woman is to give birth.
Inductions and caesareans are still
routinely inflicted on diabetic moth-
ers in many hospitals. Such drastic in-
tervention in the natural birth
process might have been necessary in
the past, when it was much harder for
diabetics to keep their blood sugar
levels well controlled; the excess in-
sulin, which encourages growth, re-
sulted in oversized babies. However,
with the advent of more accurate
blood-sugar testing and improved di-
etary advice, routine inductions and
caesareans are anachronistic.
Many hospitals still persist in induc-
ing diabetic mothers at 38 weeks.
Anna Knopfler, who set up the self-
help group Diabetic Pregnancy Net-
work, suggests asking your doctor
what percentage of diabetic births at
your hospital are induced. If it is
high, you should shop around for a
hospital with a more enlightened atti-
tude, and make sure your doctor
knows that you want to go to term un-
less there are real—rather than just
feared— complications.
Dr Odent says there is no reason
why a healthy, well-controlled dia-
betic shouldn't have a natural birth.
By that, he means privacy, comfort,
familiar surroundings and freedom to
move around. Even if home birth isn't
yet an option for many diabetics, you
should try to mimic those ideal condi-
tions as far as possible.
A speedy birth is particularly impor-
tant for diabetics, yet medicine con-
trives to create conditions where that
is unlikely to happen naturally. Dr
Odent says all mammals instinctively
seek privacy when giving birth for
good reason. Undisturbed labour al-
lows the "primitive structures" of the
brain which should be active during
birth to come to the fore. "When you
take a woman and observe her and
subject her to strong light, you make it
impossible for her to make this change
in her conscious level," he says.
The hospital setting itself, therefore,
slows up the birth process and makes it
more hazardous. To counter a problem
of its own design, medicine has de-
signed a daisychain of interventions.
Case studies
The following stories are excerpted
from Diabetes and Pregnancy , by
Anna Knopfler (Optima):
●"I had a good pregnancy with my first
child, but was amazed that despite having
excellent control and all my scans show-
ing a normal-size baby, they still took me
into hospital at 37 1/2 weeks — they
kept me in quite unnecessarily, as they
left me to look after my own control.
The consultant then examined me and
despite my having a normal-size child,
they still decided to induce me nine days
early, rather than letting me go full term.
Consequently my baby was not ready to
come and after 18 hours of labour, drips,
monitors, etc, he got into distress and
they had to do an emergency caesarean."
●"As I lay on the examination table at
the antenatal clinic the day I was to be in-
duced, I overheard the doctor mention
something about a caesarean section.
This is what angers me — they didn't ask
me what I thought about it, or even tell
me what they intended to do. I piped up
and said that unless it was absolutely
necessary, I wanted the birth to be as
normal as possible, which is why I was so
proud once I'd given birth vaginally."
The Diabetic Pregnancy Network can
be contacted on 071-323-1531.
In the British Diabetic Association's
pregnancy pack,it describes a mother
strapped up to four drips during
labour; hormones to precipitate con-
tractions; glucose; insulin; and a drip
to raise her blood pressure which was
expected to fall as a consequence of the
epidural she had been given.
The process of intervention is self-
perpetuating. The pain and distress
accompanying an induced birth will in
themselves help make the diabetic's
blood sugar levels unstable, which in-
creases the likelihood of needing glu-
cose and insulin drips.
Before selecting your hospital, check
whether you can elect to manage your
own insulin doses during labour.
According to research published in
The Lancet (13 June 1992), birth with-
out infused insulin and glucose re-
mains rare. Some 87 per cent of
respondents (representing 128 of the
UK's 218 health districts) routinely
use insulin and glucose drips, citing
"standard practice" or supposed "diffi-
culty in managing without a drip". The
report's authors are in no doubt that
drips are used simply for the conve-
nience of hospital staff; drips make for
"ease of administration and simplicity
of approach, and can be used by staff
who may not be experts in diabetes
management." Just 2.3 per cent of re-
spondents had ever elected to manage
labour in eight insulin-dependent
women without drips. (Instead, they
used a regime of 4-6 hourly insulin in-
jections and sips of glucose taken as
necessary—which leaves the diabetic
and her partner far more in control.) In
all eight: "The outcome of the preg-
nancy was a live delivery without ma-
jor neonatal problems."
In some hospitals it is still standard
practice for the baby to be taken away
for 24 hours after birth for observation
and to be tested for hypoglycaemia. Dr
Odent deplores this practice. "The best
way for the baby to avoid hypogly-
caemia is for it to get plenty of
colostrum as soon as possible," he says.
Again, you should check with your hos-
pital whether you will be able to keep
your baby with you after the birth.
Unsaturated fats aid the action of
prostaglandins as important cell regu-
lators during the birth process. They
are essential in initiating the process
and in maintaining strong contractions
which will expedite the birth. Low in-
sulin levels and saturated man-made
fats both have the effect of inhibiting
the working of prostaglandins. Dia-
betic mothers should eat plenty of
foods containing unsaturated fats —
corn oil, primrose oil, milk, liver and
kidney — and avoid those containing
man-made fats, including margarines.
(Unsaturated fat also helps the baby's
brain to grow.) Odent also advises sup-
plementing the diet with zinc, vitamin
C, vitamin B and magnesium.
Fiona Bawdon
Fiona Bawdon, formerly of Balance,
the BDA's magazine, is a WDDTY con -
tributing editor.
WDDTY Vol.3 No.7 3
 UPDATES

Center in Seattle. The Ameri- then selling the drugs for a

A COURT OF LAST RESORT cans warn that large doses of fraction of their value to
The medical profession fears that the number of cases fish oil can slow coagulation. middle men, who then sold
Bleeding times have been them at discount rates to
brought against GPs could dramatically increase if contin- known to increase by 50 per pharmacists, who in turn
gency fees for solicitors—the "no win, no fee" arrangement cent, they warn. As a result, resold them to the public at
—are introduced. the Danish women in the full price.
Contingency fees are being considered by the Law Society study group reported a "We are advising patients
at the moment. If introduced, solicitors would take on cases greater blood loss. to look at their medicine to
on the understanding that they would be paid a proportion of Excessive intake of n-3 can make sure it is the one they
also disrupt cellular function are supposed to be taking,
any financial award. No payment would be and once they have verified
and damage membranes, as
made if the case was lost. well as increasing the need that it's the right drug, to
Mr David Bolt, chairman of the BMA's work- for Vitamin E, although the keep taking it according to
ing party on no-fault compensation, has extra amount needed is not instructions," said a Food
warned that contingency fees would encour- known. and Drug Administration
age the "opportunistic" cases seen in the US. So what can the perplexed (FDA) spokesman.
pregnant woman do? One
"It will lead to an increase in those bringing
simple remedy would be just
cases simply to make some money," he said. to eat more fish which also
The Law Society will debate contingency
fees internally before bringing a proposal be-
has the added benefit of dis-
placing other saturated and
Growth hormone
fore its council in December. The law would n-6 fats from the diet. test halted
have to be changed before contingency fees
A legal petition to stop
could be introduced. growth hormone trials
While we do not advocate American-style Down's syndrome among children has been
ambulance chasing , a litigious climate may ul-
timately benefit ordinary patients like you and me. and low zinc served in the US. The Na-
tional Institutes of Health
For one thing, it may cause NHS hospitals to clean up their has been charged with abuse
Children with Down's syn-
practices, which might lessen the number of cases of negli- of children and the violation
drome have low levels of zinc,
of regulations over the treat-
gence caused by juniors placed in charge of emergency ser- according to a recent study.
ment of children in research.
vices after only a few hours' experience (and often only a few Zinc is involved in thyroid
The petition, served by the
hormone production, and the
hours' sleep). It may also mean a drop in the number of cases Foundation on Economic
Down's children had signifi-
like this month's case study, of a woman who got progres- Trends and the Physicians'
cantly lower plasma levels of
sively worse while doctors kept changing their mind about Committee for Responsible
zinc and zinc-dependent thy-
her diagnosis until she was too frail to survive the operation Medicine, argues that re-
roid hormones than others in
peated radiological exami-
that might have saved her life. In other words, the everpre- the controlled study.
nations, numerous injec-
sent threat of litigation could mean the institutions of The cause of the low plasma
tions of placebo and invasive
medicine are finally subject to quality control. It could help to zinc was unclear, but it was
physiological monitoring,
not due to nutritional defi-
end the two-tier system of medicine since NHS patients will which includes nude photog-
ciency. One possibility is de-
have the same resources as private patients to sue. raphy, amounts to a viola-
creased intestinal absorption.
It could also mean that drug companies will be forced to tion of the regulations.
When the Down's syndrome
The petition specifically
provide patients (and not just doctors) detailed information children were given dietary
calls for a halt to the placebo
about side effects supplements that increased
trials among children for re-
Contingency lawyering could mean that you are offered their plasma zinc levels into
combitant human growth
the normal range, their thy-
more just-in-case medicine so that the doctor covers himself hormone (hGH). It is also
roid hormone levels returned
just in case you sue. But for the most part, we view it as a testing short children with
to normal.
silent deterrent—a large, effective court of last resort—to Turner's syndrome.
The study was first re-
The petitioners refute an
prevent hospitals and drug companies—and even some doc- ported in The Lancet (4 July).
NIH claim that the stress as-
tors—from getting away with murder. .
sociated with the placebo in-
Lynne McTaggart jection could stimulate
growth. Data obtained from
In the middle is the preg-
nant woman, trying to make US chemists in the trials is also unlikely to
yield new understanding of
some sense of it all.
Lines were drawn back in
drug fraud Turner's syndrome.

April when a Dr Olsen and QUOTE OF THE MONTH

Fish oil: longer
pregnancy
Battle lines have been drawn
in the medical profession over
fish oil.
On the one side is a study
group from Denmark which
advocates the taking of fish oil
supplements during preg-
nancy. On the other is a group
in the US which warns that it
can lead to longer bleeding
times and cell damage.
team reported that fish oil
supplements could prolong
gestation and increase birth-
weight. The n-3 fatty acids in
fish oil can also improve
learning and vision. Studies
among rhesus monkeys have
shown that a supply of these
fatty acids is particularly im-
portant in the last trimester
and first three months of life.
Their findings were coun-
tered recently by Anne Tobin
and her team at the Fred
Hutchinson Cancer Research
More than 100 pharmacists
in the US have been arrested
"It is as important to know
the person with the disease
following the uncovering of a
nationwide drug diversion
as it is to know the disease. . .
It is equally important to
operation. The arrests are be-
know about the people the
lieved to be the most exten-
places, the things, the beliefs.
sive crackdown on
. . even the small animals that
prescription drug fraud in the
surround the person with
US.
the disease."--Dr Clifton K.
The multi-million dollar
Meador, Nashville, Tenn.,
fraud involved Medicaid and
about an 11-year-old diabetic
Medicare patients obtaining
patient whose deteriorating
prescriptions for unneeded
condition improved after she
drugs from doctors, having
moved and made a new
the prescriptions filled by
friend with a kitten.
pharmacists for free, and

4 WDDTY Vol.3 No.7


Herbal cure for
dermatitis
Chinese herbal medicine can
help sufferers of atopic der-
matitis, a study team from
three London hospitals has
discovered.
The team decided to carry
out a double-blind, placebo-
controlled study because of
the great interest in Chinese
herbal therapy as a treat-
ment of the condition.
Forty adult patients with
longstanding and widespread
atopic dermatitis were ran-
domly selected into two
groups to receive two months'
treatment of either a formula
of 10 herbs or placebo herbs.
The second group were then
switched to the active herbs
formula after a four-week
"washout" period.
The active herbs had a ben-
eficial effect, the team re-
vealed. Patients showed a
rapid and continued improve-
ment. Of the 31 patients who
completed the study and ex-
pressed a preference, 20 pre-
ferred receiving the Chinese
remedy and just four pre-
ferred the placebo. No side-ef-
fects were reported, although
many said the concoction was
unpalatable.
The research team said that
the safety of the herbs still
needs to be assured, and that
they need to be made more
palatable. They strongly rec-
ommended that sufferers
should receive liver and kid-
ney testing before embarking
on a herbal treatment, while
all patients with a history of
jaundice or alcohol misuse
should be excluded.—The
Lancet, 4 July 1992.
Foetal tests:
complications
Foetal scalp monitoring can
trigger complications such as
trauma, haemorrhage and in-
fection which can even lead to
death, warns a US study
team.
While monitoring the foetal
heart rate through scalp elec-
tronics is common in obstetric
care, four cases of infection
were noted by the study team
from 282 infants delivered in
WHAT DOCTORS READ
one month. Of those, 195 had
been monitored with scalp
electrodes.
The incidence of infection
can be anything up to 4.5 per
cent, warns the study team,
John Leatherman, Michael
Parchman and Frank Lawler,
all of the University of Okla-
homa. Infection can occur up
to one month after birth.
They urge doctors to be
more aware of the dangers of
infection and to take preven-
tive precautions,recognize in-
fection and begin therapy.
—American Family Physi-
cian, February 1992.
Preemie drugs
found useless
Drugs used for the past 20
years to arrest premature
labour do nothing to help im-
prove birth weight or perina-
tal mortality, a Canadian
study group has discovered.
It had been assumed that
the drugs—beta-adrenergic
agonists—reduced perinatal
mortality and the frequency
of long-term handicaps by re-
ducing the rate of prematu-
rity.
The study group, the Cana-
dian Preterm Labor Investi-
gators Group, decided to
assess the risks and benefits
of the drugs to the mother
and infant before and after
delivery. They randomly se-
lected 708 women with
preterm labour at six hospi-
tals to receive an injection of
either beta-adrenergic ago-
nist ritodrine or a placebo.
Their first objective was to
discover the effect of ritodrine
on prenatal mortality, while
also evaluating the causes of
perinatal death, the extent to
which delivery was delayed
with ritodrine, and the effects
on birth weight, maternal
deaths, neonatal deaths and
infant deaths at 18 months.
They confirmed that the ri-
todrine would indeed arrest
labour by up to 48 hours, but
little else. It had "no signifi-
cant beneficial effect" on mor-
tality, nor on weight or
prolongation of the preg-
nancy to term.
They concluded that it is
important to use the time
gained more beneficially.
Since the use of glucocorticoid
hormones during preterm
labour had been shown in tri-
als to decrease neonatal mor-
tality, more liberal use of it
"might have substantial ben-
efit". In fact, the group has
recommended that ritodrine
not be used after 28 weeks'
term unless used so the
mother can receive glucocor-
ticoid treatment as well.—
New England Journal of
Medicine, 30 July 1992.
. placebo-controlled trial on
. calcium supplementation on
Hypnosis helps
bowel syndrome
Hypnosis may help sufferers
of irritable bowel syndrome
and other gut disorders, a re-
search team at University
Hospital of South Man-
chester has revealed.
The discovery was a by-
product of an experiment
with 18 patients with irrita-
ble bowel syndrome to mea-
sure the physiological effects
of physical and emotional
stress on their condition.
The research team said that
hypnosis was an ideal way of
viewing, under laboratory
conditions, the effect on distal
colonic motility by inducing
the emotions of excitement,
anger and happiness.
However, they discovered
that hypnosis reduced colonic
motility index, and lessened
the pulse and respiration
rates. These effects were re-
versed when anger and ex-
citement were induced.
Happiness also reduced
motility, but not signifi-
cantly.
"Although this study was
not concerned with the thera-
peutic aspects of hypnosis, a
striking observation was that
induction of hypnosis led to a
profound reduction in colonic
motility," the research team
concluded.—The Lancet, 11
July 1992.
.
Bone boost
with calcium
The long-held belief that milk
(or the equivalent in calcium)
can help strengthen bones
has been vindicated by a US
study group.
It has discovered that chil-
dren who receive the recom-
mended daily allowance of
calcium increased their bone
mineral density, which
should reduce the risk of frac-
ture in later life. The intake
could be by supplement or
diet, such as milk (or the
equivalent).
The study team, led by Con-
rad Johnston of Indiana Uni-
versity, carried out a
three-year, double-blind,
bone mineral density in 70
pairs of identical twins.
The daily intake of the
twins given placebo was
908mg against the 1612mg
intake of the others. This was
achieved from 894mg from
diet and 718mg from the sup-
plement.
Among the 22 twin pairs
who were prepubescent
throughout the study, the
twins given supplements had
significantly greater in-
creases in bone mineral den-
sity, the team reported.
However, the 23 pairs who
were past puberty received no
benefit from the supple-
ment.—New England Jour-
nal of Medicine, 9 July 1992.
.
SHORT TAKES
●One case has been noted
of a patient taking tamox-
ifen for breast cancer who
developed "radiation re-
call" an inflammatory reac-
tion at a site previously
irradiated after taking can-
cer-killing drugs. The pa-
tient was taking tamoxifen
after a tumour had been
removed and she'd been
receiving radiation.—The
Lancet, 4 July 1992.
●The first case of pseu-
domembranous colitis has
been reported in a patient
taking diclofenac, a non-
steroidal, anti-inflamma-
tory drug.—The Lancet, 11
July 1992.
●Eight cases of Guillain-
Barre paralysis have been
reported in patients given
gangliosides, a fatty sub-
stance normally occurring
in the brain, for spinal cord
injury or diabetic wasting
of the nerve.—The Lancet,
4 July 1992.
WDDTY Vol.3 No.7 5

Q Dear Lynne,
I read your very interest-
ing special report in Vol-
ume 3 Number 5 on
cataracts without surgery, and was
surprised to find that the value of
chromium was not mentioned.
As cataracts are so common as a
complication of diabetes and insulin
metabolism can be helped so much
by chromium supplementation, it
seems reasonable to think that
chromium could be helpful in the
prevention of cataracts. Indeed a
study has shown (I cannot put my
hand on the reference at present)
that in a group of diabetic-suscepti-
ble rats chromium supplements can
prevent the development of
cataracts.
In the wonderful book that is now
difficult to obtain, The Trace Ele -
ments and Man, by Henry A.
Schroeder, M.E., (Devin-Adair, 1973),
he comments that in 1959 Claus
Schwarz and Walter Mertz (who is
alive and well today, and well re-
spected for his work on chromium)
had done a number of experiments
on rats. "Another interesting change
occurring in chromium-deficient old
rats is the development of opacities
of the cornea of the eye. There is a
concentration of chromium in the
cornea as in the skin. Opacities and
vascularization were found quite
frequently by Mertz and by us," he
says.
In the proceedings of the third In-
ternational Congress on Trace Ele-
ments in Medicine Biology, volume
32, complete January-March 1992,
(edited by Gerhart D. N. Schrauzer) a
paper is presented by Pineau and
colleagues which quite clearly shows
the lower levels of chromium in the
lenses of diabetic patients with
cataracts.—Kind regards, Dr Patrick
J Kingsley, Osgathorpe.
Dear Dr Kingsley: Thank
A
you for sharing this infor -
mation with us. Readers:
see cover story this month
for the effects of chromium
supplementation on dia -
betes.
Q
I read your latest issue
(WDDTY 3.6) about VDUs
and the risk of miscar-
riage. What about the
risks to non-pregnant
women — or men? Are there any? I
use a VDU for many hours of the
day at work.—M. L., London.
A
We put your question to Si -
mon Best, the author of the
article you refer to, and edi -
tor of Electromagnetic
News. His reply:
6 WDDTY Vol.3 No.7
QUESTIONS FROM READERS
CASE STUDY
My mother had been very ill for two years
wit stomach pain, diarrhoea and loss of ap-
petite. She had numerous Barium meals and
other unpleasant tests. During this time she
was in and out of hospital and they couldn't
find a true diagnosis. We were told it could
be irritable bowel syndrome, a growth,
Crohn's Disease, colitis or adhesions follow-
ing a previous stomach operation. Repeat
tests were done which proved all clear again.
In May it was discovered that she had a
blocked artery leading to her intestines. This
obviously caused a restricted blood supply
and so it was decided that an operation was
needed. By this time my mother weighed
only 5 stone 7 pounds and was very frail. She
had only been allowed clear soup and a pow-
dered food supplement for nearly two
months because whenever she ate she suf-
fered agony.
Eventually she was diagnosed as having is-
chaemia of the bowel. We were told her
condition was very rare and that is why it
took so long to diagnose; by the time they
performed the bypass operation she was
very weak and she died soon after. I would
like to know whether her condition was that
rare and therefore whether it should have
been investigated earlier when she would
have been spared so much suffering and had a
much better chance of survival.
Your terrible story is an object lesson in
bad hospital management and diagnosis.
Undoubtedly your mother would have
had a better chance at surviving a risky
operation had her condition been diag
nosed before she had become so weak
and frail. As you can see in the material
you sent us, ischaemia of the bowel, or
narrowing of the mesenteric artery, can
prevent the blood supply necessary for
the digestion of food from reaching the
gut. If caught early , so long as the mesen -
teric artery is not entirely blocked, bypass
surgery can save a victim's life, although
one study in 1977 (Braunwals, E. New
England Journal of Medicine 297:
663)showed that if the blockage is severe,
patients do not live any longer after
surgery than they would if left untreated.
Furthermore, as in other cases of harden -
ing of the arteries, many patients who un -
dergo angioplasty or bypass surgery go on
to have a recurrence.
As you have offered her story in the hope
that others don't suffer as your mother
did, we would widen its implications. Any -
one with any problem that is not improv -
ing under the care of one practitioner or
consultant should have no compunction
about seeking a second opinion. If one
doctor says he cannot find a true diagno
sis, get your records and the results of
your test and march as quickly as you can
into the office of another, unrelated con
sultant. Being assertive, complaining and
insistent about your medical care is the
attitude most likely to keep you alive.
Although nothing we can suggest will
bring your mother back, you may con -
sider contacting Action for Victims of
Medical Accidents to see if the hospital
was guilty of negligence. (Bank Cham
bers, 1 London Rd, Forest Hill SE23 3TP).
"International surveys indicate that
up to 90 per cent of VDU workers have
been found to suffer from at least one
of the VDU eye-related problems , in -
cluding blurred vision, changes in
the perception of colour, conjunctivi -
tis, deteriorating eyesight, difficulty
in changing focus from near to far
and vice versa, eye strain, headaches
and migraine, irritations and itch -
ing of the eyes, photophobia, visual
fatigue, sinusitis, dry eyes and an in -
ability to produce tears, yellowing of
the whites of the eyes, and cataracts.
(P. Bentham, op cit, p 36). According
to Bentham, no other light source is
so incompatible with the human eye
and brain patterns as that produced
by the VDU.
"Experts vary as to the ideal viewing
distance, from 30 to 70 cm from the
screen. Most operators, correctly
seated, find that their preferred eye-
to-screen distance is about 80 cm.
Those with spectacles should con -
sider for what ranges their lenses
should be focussed and have a pair of
glasses made for that length specifi -
cally for VDU use. Working at the
wrong distance can induce other pos -
tural and muscular strain problems.
Such eye tests for operators will be -
come mandatory under the new EC
Work with Visual Screen Display Di -
rective coming into effect at the end of
1992.
"Contact lens wears may develop
more specific problems, according to
- research by a British ophthalmolo -
gist, Anne Silk. Over the past four
years, she has observed the develop -
ment of microvoids (very small de -
pressions) on the anterior surface of
high oxygen-permeable lenses. The
effect has been found within two
weeks of the issue of virgin lenses.
She found that those lenses that
showed microvoids belonged to wear -
ers who had worked seven hours a
day or longer at a screen. When new,
unworn lenses were exposed to spe -
cific frequencies and intensities of
electromagnetic fields, similar mi -
crovoids appeared after only 20 hours
of exposure. Mrs Silk is continuing to
collect cases and seeking—unsuccess -
fully, so far— to get her findings pub -
lished in an optical journal. If VDU
EMFs are producing such effects in
contact lens material, one can only
surmise what other short- or long-
term effects they may be having on
the actual eyes of operators.
"Another contentious area of effect is
- the claim of cataract development
due to VDU electromagnetic radia -
tion. The New York ophthalmologist,
- Dr Milton Zaret, has long claimed
that certain types of cataract, specifi -
cally posterior sub-capsular ones,
can be caused by the types of radia -
tion emitted by VDUs, especially
older models. (Health Hazards of
VDTs, London, John Wiley, 1982). A
number of successful claims against
- manufacturers or employers have
been made in the States, but this has

yet to occur in Britain. By and large,
the Health & Safety Executive dis -
misses the possibility of eye damage
due to VDU radiation. However, it may
be forced to change its view as large
numbers of workers have their eyes
tested when the EC Directive comes
into effect.
"In the meantime, press your employer
to seat you at least 80 cm from your
screen, take frequent breaks, try not to
stare at a screen for many hours, and
work, whenever possible, on a portable
computer with a light emitting diode
(LED) screen, which emits hardly any
radiation."
Q
I have heard of a horren-
dous case of Septrin caus-
ing the most severe side
effects in a penicillin-aller-
gic subject. I understand
that this drug is associated with
Stevens-Johnson Syndrome. I am not
quite sure, but I believe that Septrin
has been banned in the States. Could
you confirm this, please, and perhaps
also collate some data on side effects
of this drug? If indeed this is banned
in the States, why is it still in use in
this country and elsewhere?--D. J., Il-
ford, Essex.
A
According to the 1992 edi -
tion Physician's Desk Ref-
erence, the US drugs bible
(and confirmed by its manu -
facturer, Wellcome), this
drug is still on the market in America.
Septrin, known in the states as Sep -
tra, is a combination of two synthetic
antibiotics (of trimethoprim and sul -
famethoxazole), used to treat urinary
tract infections, acute middle earache,
acute chronic bronchitis in adults,
traveller's diarrhoea, pneumocystis
carinii pneumonia, one of the side ef -
fects of AIDs, as well as prostate and
intestinal infections.
This edition of the PDR writes in bold
capital letters: "Fatalities associated
with the administration of sulfon -
amides, although rare, have occurred
due to severe reactions, including
Stevens-Johnson Syndrome, toxic epi -
dermal necrolysis [severe disorder of
the outer layer of the skin], fulminant
hepatic necrosis [tissue death in the
liver], agranulocytosis [a severe de -
crease in white blood cells], aplastic
anaemia, other blood [disorders], and
hypersensitivity of the respiratory
tract."
Stevens-Johnson syndrome is an in -
flammatory disease, mainly affecting
children or young adults, which
causes blisters on the skin and open
sores on the mucous membranes of the
lips, eyes, mouth, nasal passage and
genitals. It's often accompanied by
pneumonia, fever and pain in the
joints. Besides bedrest, antibiotics
QUESTIONS FROM READERS
ironically are only the treatment. The
drug can also cause life-threatening
liver or kidney disease or one of a vari -
ety of blood disorders or even hyper -
sensitivity of the respiratory tract.
It also inhibits the absorption of folic
acid, and so shouldn't be used by those
who have a deficiency of this nutrient,
such as the elderly, patients receiving
anticonvulsant therapy, those who
have difficulty absorbing nutrients,
chronic alcoholics or those with severe
allergies or bronchial asthma. Pa -
tients with glucose-6-phosphate dehy -
drogenase deficiency, a condition
where red cells lack the above men -
tioned enzyme needed for carbohy -
drate processing in the body, can
suffer a breakdown in red blood cells.
This drug also reacts adversely to a
number of other drugs, particularly
phenytoin, an anti-seizure drug, and
tolbutamide, a drug used for diabetics.
Wellcome also cautions that this
drug has an increase risk of severe ad -
verse reactions in elderly patients,
particularly those with impaired kid -
ney or liver dysfunction or those using
other drugs. These included bone mar -
row suppression, a decrease in blood
platelets or severe skin reactions.
In the PDR here is another entire col -
umn of other reactions, ranging from
hepatitis, to kidney failure, aseptic
meningitis, convulsions and halluci -
nations. Animal studies have shown
that this drug also could cause birth
defects
As you can see, this is by no stretch of
the imagination a benign drug. Any
patient being prescribed this, particu -
larly for the more benign problems like
middle ear infection or traveller's di -
arrhoea, should ask his doctor
whether another antibiotic or a single
drug might do the job without these
sorts of unacceptable risks.
You may be interested. Our
local GP declined to treat
our son's painful verrucae
(warts) and referred us to a
chiropodist. He also de-
clined invasive therapy, saying he
had seen so much damage as a result
of caustics, cryotherapy, etc. He pro-
vided porous insoles to relieve the
pain and much to my surprise, vita-
min A to boost immunity, saying the
verrucae would go when the immune
system was stronger. (By coincidence
both children's verrucae appeared af-
ter virus infections, and, as he said,
suddenly went a few months later.
Verrucae are a small inconvenience
in the scale of health problems, but I
wonder how many people have risked
further damge not knowing of a holis-
tic approach to chiropody.
A
Thank you for this fascinat -
ing anecdote.
It's always heartening to
hear of good doctors who
know when to leave well
enough alone. rather than always
BOOKS
Title: Beat Sugar Craving
Author: Maryon Stewart
( Vermilion )£6.99
Aimed at chocoholics and the like, this
book is the latest offering from the folks
who wrote Beat PMT Through Dietand
who run the Women's Nutritional Advi-
sory Service, an organization which sorts
out many female ills through nutritional
means.
Maryon Stewart, who is married to
noted nutritional doctor Alan Stewart,
coauthor of Nutritional Medicine , devel-
oped her diet against sugar addiction after
discovering that three-quarters of her
PMT patients admitted to regular cravings
for sweets.
The heart of the book is its diet, which
isolates those foods with the nutrients (ie,
B vitamins) most likely to combat sugar
craving. To this end Stewart also pro-
vides a 30-day diet plan.
In that respect the book is gimmicky,
since any wholesome diet with the ap-
propriate nutrients will end sugar addic-
tion. Nevertheless, Stewart provides
excellent handholding, in the form of
checklists. As with giving up smoking, a
structured approach can often mean the
difference between success and failure.
Title: The Book of Breastfeeding
Author: Mary Smale (NCT)
( Vermilion)£7.99
As the official breastfeeding guide by the
National Childbirth Trust, (an organiza-
tion which shies away from advertising
from organizations critical of medicine)
this is a surprisingly radical read, as well as
one of the better guides to breastfeeding
we've ever found.
There are lots of boxes with useful, de-
tailed tips (such as how much extra you
really need to eat, how to express milk or
get the baby to accept a bottle). Particu-
larly instructive are the many personal
testimonials which litter the pages.
Unlike other well-meaning manuals,
these not only tell the success stories but
the experiences of those who've had
problems and discovered all manner of
ingenious means to sort them out.
We're disappointed that the NCT in-
cludes without comment the Department
of Health recommendation that solids be
introduced at three or four months in the
face of so much evidence to the contrary
about allergies, but in nearly every other
respect, this is a down-to-earth guide for
women by others who've been there.
WDDTY Vol.3 No.7 7
 SECOND OPINION

At a child's pace
W
e know our children must grow
up, and sometimes we prod and
persuade them into growing up
as soon as possible. A midwife tells us
that cuddling will spoil a newborn infant;
a mother weans her baby early from the
breast in anticipation of her return to
work; a teacher complains that a 3-year-
old is a "mummy's boy" while many par-
ents feel guilty about indulging
themselves with their children.
Since the aim of growing up is to move
from dependency towards autonomy, soci-
ety looks for early evidence of separation
of a child from its mother. The baby who
sleeps all night alone, the toddler who
does not cry when his mother leaves him,
the teenager who does not rebel–-these
are all models of "good" behaviour, with
the implication that they are a product of
"good" parenting.
The tendency to set ourselves goals in
parenting is a legacy of the Western work
ethic. Real work is generally defined as an
intense, self-sacrificial activity, with re-
wards to keep us going. Yet the process
and demands of childcare are quite differ-
ent from the Western approach to work.
Children defy any method or work sched-
ule. No one will pat you on the back at the
end of the day or give you a bonus. And
you can never really hold up your child
and say: "Look what I made!"
Nevertheless, mothers and children
continue to be judged according to unspo-
ken factory rules. These assume that you
"make" children in much the same way as
you make sausages. The end product is
supposed to be an independent child who
does not bother us with his childish
needs. This is the philosophy which in-
forms most of our parenting, whether or
not we realize it, and parents often judge
themselves by this criterion, as harshly as
any health worker or outside authority.
It is the rare mother who accepts her
children exactly as they are at any given
time, despite the fact that their way of in-
teracting with the world is very different
from her own, that they are experiment-
ing with socially unacceptable be-
haviours, and that the limits of her
tolerance are under constant siege.
‘Responding to
our children
means trusting
in the process
of childhood.’
It is difficult to live in the moment with
our children, when we model our day on
the nine-to-five pattern, which is all about
results. By worrying about the desired
end product, we neglect the means used to
get there, and the journey becomes
painful, even perilous.
Even families following alternative par-
enting strategies are prone to worry
about the kinds of children they are creat-
ing, and may try to mould them to a pre-
conceived pattern. Mothers who carry
their babies on slings and breastfeed on
demand, for instance, are under great
pressure to prove that their efforts have
not "spoilt" their children. They, like
other mothers, may be relieved when
their children reach autonomy, are non-
violent and stop clinging to their knees.
I have certainly felt this pressure at
times as my children have passed
through seemingly '"difficult" phases. So
when, despite the benefits of close-contact
nurture, my three-year-old daughter was
reluctant to leave my side to go to nursery
school, I was confused.
In fact, when I watched other children
entering nursery school, I realized that
many (though not all, of course) were per-
suaded over the threshold with bribes or
threats. Parents often ignored their pleas
to go back home. The consensus that
three-year-olds "need" nursery school,
based on society's "need" for women to re-
turn to work, has resulted in yet another
pressure for parents to separate prema-
turely from their children. Not to send
the child to pre-school has become, in
some circles, a sign of neglect.
I became well and truly caught up in the
dilemma, sitting for hours with Frances
in the Montessori classroom. She said she
wanted to go to school and enjoyed many
of the Montessori activities, but was not
yet ready to leave me every day and enter
a large, social group without me. I ex-
pected her to tell me exactly what she
wanted with words, but eventually I
learnt to trust her body language, and I
made the adult decision for her. She came
home with me, where she did not need to
cling or act shy, or be brave: where she
could regulate her own life.
Responding to our children's needs
means knowing ourselves, accepting our
limitations and learning to live in our own
environment. It means trusting in the
process of childhood itself, and not being
so eager to control it. It means letting go.

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8 WDDTY Vol.3 No.7

 ●A woman with lupus erythematosus,
whose skin lesions were cleared with
other drugs, apparently suffered a relapse
after taking naproxen, a NSAID.--JAMA, 1
July 1992.
●The UK has extended its ban on best-
selling sleeping pill Halcion until October
1992. This contrasts with the US position,
which has been to keep the drug on the
market, albiet with stronger warnings.

The petition is the third filed by the

Foundation in the past18 months.
 Frances is due to start at our village school this autumn,
two days before her fifth birthday. She is excited at the
prospect, and manifestly better equipped this time for her
move into the wider world. But I shall be ready with open
arms to provide an emotional refuge, should school prove not
to live up to all its promises.
Deborah Jackson
Deborah Jackson is currently working on a new book about
letting children go, to be published by Bloomsbury in 1993.