One-third of diabetic patients are taking alternative medications that they consider efficacious but this is no more than in the control group. The money spent on alternative and non-prescription supplements nearly equals that spent on prescription medications. In view of the money spent in this area the time is past due to evaluate these remedies and to establish what merit they have.

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The long-term effects of incorporating waxy hulless barley (p-glucan = -7%) bread products in the usual dietary pattern of non-insulin-dependent diabetic (Qpe 2) subjects were evaluated via dietary, clinical and biochemical methods. Eleven Qpe 2 men (3 age = 51 f 6.5yr), living in the community, participated in a 24-wk crossover study (two 12-wk periods). Five randomly chosen subjects ate Barley Bread products first; the remainder ate the control White Bread first. Dietary intake was assessed (four 48-h dietary recalldperiod). Blood glucose and insulin (8-h profiles) were measured at 0,12 and 24 wks. Total energy and macronutrient intakes were similar in both dietary periods. Mean total dietary fibre intake was 28 gld in the White Bread period and 39g/d (10gld from barley) in the Barley Bread period. Mean glycemic response area (AUC) was lower (NS) and insulin response area was higher (P I 0.05) for the Barley Bread period than the White Bread period. In the Barley Bread period, AUC after lunch was lower for glucose ( N S ) and higher for insulin (P I 0.05) than in the White Bread period. For the Barley Bread period, insulidglucose ratios for peak 1 and peak 2 were 65% (P 10.05) and 113% (NS), respectively, higher than for the White Bread period. Results indicate that for the Type 2 diabetic subjects incorporation of the well accepted Barley Bread products (5g/d p-glucan) into the diet improved their glycemic response. Insulinemic response increased; some subjects reduced their dose of oral hypoglycemics. Barley Bread products could be readily incorporated into the diet and greatly benefit the overall health of individuals with Type 2 diabetes.Correspondence to Zenia Hawrysh, 4-10

Our results indicate high rates of diabetes, undiagnosed diabetes, pre-diabetes and metabolic syndrome among adult Alberta Métis Settlement dwellers.