"An Exploratory Study To Identify Factors Affecting Non Compliance To Dots Therapy Among Tb Patients At Selected Dots Centre Vadodara"

Abstract

Background: Thorough mastication has the potential to affect postprandial blood sugar levels (BSL) by improving digestibility and absorption of nutrients. Associations between mastication and glucose metabolism in diabetics have been shown in previous studies. However, the association between mastication and BSL in pre-diabetes has not been clarified. Our objective was to examine association between frequency of chewing and BSL in prediabetes population-based cohort. Method: On attaining Institutions ethical committee clearance, considering all inclusion and exclusion criteria and after taking informed consent, we conducted a cross-sectional study in 95 prediabetic individuals. Subjects recruited to study received a fixed calorific load of 150 calories in form of 25 grams of groundnuts on two successive days. We decided to use groundnuts as substrate for our study as we hypothesized this would result in elevated cephalic phase insulin secretion, since it requires thorough mastication for deglutition and is rich in protein (26%), fat (49%) but little carbohydrate (16%), of which >50% is insoluble fiber. On Day 1 subjects were observed as they were chewing at their routine habituated rates without them being conscious that they are being observed while on Day 2 they were asked to chew each bolus forty times before swallowing. Postprandial BSL were estimated, all parameters and their obtained values were scrutinized on both days and data was statistically analyzed. Results: On comparing the mean post prandial BSL between normal chewing versus 40 time chewing, statistically significant decrease was observed with respect to 40 chews per bolus (p < 0.000). Conclusions: These findings support hypothesis that when in pre-diabetic individuals a simple yet effective method of thorough mastication will decrease postprandial BSL vis –a-vis faster chewing and swallowing.