Q: As a precautionary measure, what’s a good sugar substitute for someone with a family history of diabetes?
A: Those with a family history of diabetes should make conscientious food choices. However, making healthy food choices should be the standard for everybody, whether or not they have a family history of diabetes. It’s good practice to avoid excess carbohydrates and sugar intake and eat more vegetables. Additionally, spreading fruit intake into 3-4 servings a day instead of eating it all at once can reduce glucose load to the body.
Sweeteners with little or no calories don’t increase blood sugar and are suitable for diabetes patients or those with a risk of developing diabetes
Choices include saccharin, aspartame, sucralose, and stevia, which vary in properties and tastes. However, just like sugar, it’s best to use these substitutes in an appropriate amount. Be careful not to overeat just because an item is “sugar-free.” For example, in the case of sugar-free desserts, you’re still consuming other ingredients such as carbohydrates and maybe some fats, which can cause weight gain or high blood sugar. As in most things, moderation is the key to healthy eating.
Dr. Rosanee Valyasevi
, physician, specializing in endocrinology and metabolism
Q: My 75-year-old father’s hands shake. Is this normal for an older adult?
A: Obvious continual shaking or tremors are not normal. We need to find out exactly what’s causing the shaking symptom. While Parkinson’s disease is the one we think of first, several other conditions and diseases can also cause tremor and shaking.
In the early stages, tremor from Parkinson’s disease usually manifests on one side of the body. Approximately 70 percent of people with Parkinson’s develop hand tremors, while the other 30 percent may have Parkinson’s without tremor, presenting mainly through slow movement and stiffness. Parkinsonian tremor can also affect the lips or chin, but usually not the entire head. Tremor usually occurs when the patient is sitting and relaxed with no hands in action. When he or she moves – for example, raising a hand – the shaking becomes less intense, so the patient may not be aware of the tremor.
If tremor persists, worsens, or continues for months, set up anappointment for a doctor to examine him.
Prof. Dr. Roongroj Bhidayasiri, physician, specializing in neurology.