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.