1. Symptoms and What To Do If You Think You
Have Dengue
The principal symptoms of dengue are:
 High fever and at least two of the following:
o Severe headache
o Severe eye pain (behind eyes)
o Joint pain
o Muscle and/or bone pain
o Rash
o Mild bleeding manifestation (e.g., nose or gum bleed, petechiae, or easy bruising)
o Low white cell count
Generally, younger children and those with their first dengue infection have a milder illness than
older children and adults.
Watch for warning signs as temperature declines 3 to 7 days after symptoms began.
Go IMMEDIATELY to an emergency room or the closest health care provider if any of the
following warning signs appear:
 Severe abdominal pain or persistent vomiting
 Red spots or patches on the skin
 Bleeding from nose or gums
 Vomiting blood
 Black, tarry stools (feces, excrement)
 Drowsiness or irritability
 Pale, cold, or clammy skin
 Difficulty breathing
For a list of Hospitals, laboratories and health care centers in Puerto Rico that will draw serum
samples, in Spanish. [DOC 1 - page]
Dengue hemorrhagic fever (DHF) is characterized by a fever that lasts from 2 to 7 days, with
general signs and symptoms consistent with dengue fever. When the fever declines, warning
signs may develop. This marks the beginning of a 24 to 48 hour period when the smallest blood
vessels (capillaries) become excessively permeable (“leaky”), allowing the fluid component to
escape from the blood vessels into the peritoneum (causing ascites) and pleural cavity (leading to
pleural effusions). This may lead to failure of the circulatory system and shock, and possibly
death without prompt, appropriate treatment. In addition, the patient with DHF has a low platelet
count and hemorrhagic manifestations, tendency to bruise easily or have other types of skin
hemorrhages, bleeding nose or gums, and possibly internal bleeding.

2. Treatment
There is no specific medication for treatment of a dengue infection. Persons who think they have
dengue should use analgesics (pain relievers) with acetaminophen and avoid those containing
ibuprofen, Naproxen, aspirin or aspirin containing drugs. They should also rest, drink plenty of
fluids to prevent dehydration, avoid mosquito bites while febrile and consult a physician.
As with dengue, there is no specific medication for DHF. If a clinical diagnosis is made early, a
health care provider can effectively treat DHF using fluid replacement therapy. Adequately
management of DHF generally requires hospitalization.
Best Diabetes Diets
1inShare
Diet is a crucial tool for managing diabetes, and weight loss can help people who are overweight
prevent Type 2 diabetes. The experts who rated the 32 diets below evaluated each one on its
ability to both prevent and manage diabetes. The Biggest Loser Diet and the Dietary Approaches
to Stop Hypertension (DASH), an eating plan endorsed by the government, came out on top.
#
1
Biggest Loser Diet
(3.6 out of 5.0)
Biggest Loser Diet recipes | Biggest Loser Diet reviews
The plan, which revolves around healthy eating and exercise, tied for the top position as a diet
for managing or preventing diabetes. The approach is generally viewed as an ideal eating pattern
for both.
How the Biggest Loser Diet works

3. #
1
DASH Diet
(3.6 out of 5.0)
DASH Diet recipes | DASH Diet reviews
Dietary Approaches to Stop Hypertension, or DASH, edged out several other diets as a diabetes
weapon, in the judgment of our expert panelists. Its emphasis on whole grains, fruits, and
veggies matches the sort of nutritional prescription that diabetics frequently hear their doctors
recommend.
How the DASH Diet works
#
3
Engine 2 Diet
(3.5 out of 5.0)
Engine 2 Diet recipes | Engine 2 Diet reviews
The Engine 2 diet earned 3.5 stars, tieing for third place in the diabetes category. The plan should
help dieters drop pounds—and being overweight is one of the greatest risk factors for developing
diabetes. Plus, it includes a fitness regimen, which is key for diabetes prevention and control.
How the Engine 2 Diet works
#
3
Flexitarian Diet
(3.5 out of 5.0)

4. Flexitarian Diet recipes | Flexitarian Diet reviews
The Flexitarian diet earned an above-average score in the diabetes category. Eliminating meat
typically leads to consuming fewer calories, and losing weight—and keeping it off—is essential
for preventing type 2 diabetes.
How the Flexitarian Diet works
#
3
Mayo Clinic Diet
(3.5 out of 5.0)
Mayo Clinic Diet recipes | Mayo Clinic Diet reviews
The diet’s eating guidelines and fitness advice are a compelling combination for preventing or
controlling diabetes. Its focus is on coaching dieters to develop healthy, lasting habits around
which foods they choose to eat and which to avoid.
How the Mayo Clinic Diet works
#
3
Ornish Diet
(3.5 out of 5.0)
Ornish Diet recipes | Ornish Diet reviews
The Ornish diet is a good option for preventing or controlling diabetes, experts concluded. It’s
low in saturated fat and cholesterol, which matches the guidelines of the American Diabetes
Association, and it has been found to lower A1C level in diabetics, a positive signal of better
control over blood sugar.
How the Ornish Diet works

5. #
3
Vegan Diet
(3.5 out of 5.0)
Vegan Diet recipes | Vegan Diet reviews
As a diet for managing diabetes, veganism is a smart option, some experts said. It could also help
prevent the condition, since it helps dieters drop pounds—and being overweight is one of the
greatest risk factors for developing diabetes.
How the Vegan Diet works
#
8
Anti-Inflammatory Diet
(3.4 out of 5.0)
Anti-Inflammatory Diet recipes | Anti-Inflammatory Diet reviews
The Anti-Inflammatory diet earned a respectable 3.6 stars for diabetes control and prevention.
It’s based on a Mediterranean-style diet, which can reverse metabolic syndrome, a group of risk
factors that can lead to diabetes. However, some experts noted that diabetes patients should
exercise additional caution, since daily protein is “on the high side.”
How the Dr. Weil's Anti-Inflammatory Diet works
#
8
Mediterranean Diet
(3.4 out of 5.0)

6. Mediterranean Diet recipes | Mediterranean Diet reviews
Experts gave this diet relatively high marks when it comes to preventing or controlling diabetes.
Research suggests a healthy Mediterranean-style diet can reverse the metabolic syndrome, a
group of risk factors that can lead to diabetes.
How the Mediterranean Diet works
#
8
Vegetarian Diet
(3.4 out of 5.0)
Vegetarian Diet recipes | Vegetarian Diet reviews
On the whole, experts think the vegetarian diet has real ability to help prevent or control
diabetes. Followed right, the diet emphasizes many of the foods Americans should eat to
maintain a healthy, disease-free lifestyle.
How the Vegetarian Diet works

7. Diabetes Diet & Food Tips
Eating to Prevent, Control and Reverse Diabetes
Diabetes is on the rise, yet most cases are preventable with healthy lifestyle changes. Some can
even be reversed. Taking steps to prevent and control diabetes doesn’t mean living in
deprivation. While eating right is important, you don’t have to give up sweets entirely or resign
yourself to a lifetime of bland “health food”. With these tips, you can still enjoy your favorite
foods and take pleasure from your meals without feeling hungry or deprived.
In This Article:
 Taking control of diabetes
 Diabetes and diet
 Choose high-fiber, slow-release carbs
 Be smart about sweets
 Choose fats wisely
 Eat regularly and keep a food diary
Taking control of diabetes
Have you recently been diagnosed with diabetes or prediabetes? Or has your doctor warned you
that you’re at risk? It can be scary to hear that your health’s on the line, especially if you feel
helpless to do anything about it.
Here’s a scenario that may sound familiar: your doctor’s telling you how important it is to lose
weight and transform your eating habits, but you’re already discouraged. After all, you’ve tried

8. dieting in the past without success. And counting calories, measuring portion sizes, and
following complicated food charts sounds like way too much work.
Small changes equal big results
Whether you’re trying to prevent or control diabetes, there is some good news. You can make a
big difference with healthy lifestyle changes. The most important thing you can do for your
health is to lose weight—and you don’t have to lose all your extra pounds to reap the benefits.
Experts say that losing just 5% to 10% of your total weight can help you lower your blood sugar
considerably, as well as lower your blood pressure and cholesterol levels. It’s not too late to
make a positive change, even if you’ve already developed diabetes. The bottom line is that you
have more control over your health than you think.
Not all body fat is created equal
The biggest risk factor for developing diabetes is being overweight, but not all body fat is created
equal. Your risk is higher if you tend to carry your weight around your abdomen—the so-called
“spare tire”—as opposed to your hips and thighs. So why are “apple” shaped people more at risk
than “pears”?
“Pears” store most of their fat close below the skin. “Apples” store their weight around their
middle, much of it deep within the belly surrounding their abdominal organs and liver. This type
of deep fat is closely linked to insulin resistance and diabetes. In fact, many studies show that
waist size is a better predictor of diabetes risk than BMI (body mass index).
You are at an increased risk of developing diabetes if you are:
 A woman with a waist circumference of 35 inches or more
 A man with a waist circumference of 40 inches or more
To measure your waist circumference, place a tape measure around your bare abdomen just
above your hip bone. Be sure that the tape is snug (but does not compress your skin) and that it is
parallel to the floor. Relax, exhale, and measure your waist.
The dangers of "sugar belly"
Calories obtained from fructose (found in sugary beverages such as soda, energy and sports
drinks, coffee drinks, and processed foods like doughnuts, muffins, cereal, candy and granola
bars) are more likely to turn you into an "apple" by adding weight around your abdomen. Cutting
back on sugary foods can mean a slimmer waistline as well as a lower risk of diabetes.
What you need to know about diabetes and diet

9. Eating right is vital if you’re trying to prevent or control diabetes. While exercise is also
important, what you eat has the biggest impact when it comes to weight loss. But what does
eating right for diabetes mean? You may be surprised to hear that your nutritional needs are
virtually the same everyone else: no special foods or complicated diets are necessary.
A diabetes diet is simply a healthy eating plan that is high in nutrients, low in fat, and moderate
in calories. It is a healthy diet for anyone! The only difference is that you need to pay more
attention to some of your food choices—most notably the carbohydrates you eat.
Myths and facts about diabetes and diet
MYTH: You must avoid sugar at all costs.
Fact: The good news is that you can enjoy your favorite treats as long as you plan properly.
Dessert doesn’t have to be off limits, as long as it’s a part of a healthy meal plan or combined
with exercise.
MYTH: A high-protein diet is best.
Fact: Studies have shown that eating too much protein, especially animal protein, may actually
cause insulin resistance, a key factor in diabetes. A healthy diet includes protein, carbohydrates,
and fats. Our bodies need all three to function properly. The key is a balanced diet.
MYTH: You have to cut way down on carbs.
Fact: Again, the key is to eat a balanced diet. The serving size and the type of carbohydrates you
eat are especially important. Focus on whole grain carbs since they are a good source of fiber and
they are digested slowly, keeping blood sugar levels more even.
MYTH: You’ll no longer be able to eat normally. You need special diabetic meals.
Fact: The principles of healthy eating are the same—whether or not you’re trying to prevent or
control diabetes. Expensive diabetic foods generally offer no special benefit. You can easily eat
with your family and friends if you eat in moderation.
Diabetes and diet tip 1: Choose high-fiber, slow-release
carbs
Carbohydrates have a big impact on your blood sugar levels—more so than fats and proteins—
but you don’t have to avoid them. You just need to be smart about what types of carbs you eat.
In general, it’s best to limit highly refined carbohydrates like white bread, pasta, and rice, as well
as soda, candy, and snack foods. Focus instead on high-fiber complex carbohydrates—also
known as slow-release carbs. Slow-release carbs help keep blood sugar levels even because they
are digested more slowly, thus preventing your body from producing too much insulin. They also
provide lasting energy and help you stay full longer.
Choosing carbs that are packed with fiber (and don’t spike your blood sugar)
Instead of… Try these high-fiber options…

10. Choosing carbs that are packed with fiber (and don’t spike your blood sugar)
White rice Brown rice or wild rice
White potatoes (including fries and mashed
potatoes)
Sweet potatoes, yams, winter squash,
cauliflower mash
Regular pasta Whole-wheat pasta
White bread Whole-wheat or whole-grain bread
Sugary breakfast cereal High-fiber breakfast cereal (Raisin Bran, etc.)
Instant oatmeal Steel-cut oats or rolled oats
Cornflakes Bran flakes
Corn Peas or leafy greens
Making the glycemic index easy
What foods are slow-release? Several tools have been designed to help answer this question. The
glycemic index (GI) tells you how quickly a food turns into sugar in your system. Glycemic load,
a newer term, looks at both the glycemic index and the amount of carbohydrate in a food, giving
you a more accurate idea of how a food may affect your blood sugar level. High GI foods spike
your blood sugar rapidly, while low GI foods have the least effect.
You can find glycemic index and glycemic load tables online, but you don’t have to rely on food
charts in order to make smart choices. Australian chef Michael Moore has come up with an
easier way to regulate the carbs you eat. He classifies foods into three broad categories: fire,
water, and coal. The harder your body needs to work to break food down, the better.
 Fire foods have a high GI, and are low in fiber and protein. They include “white foods” (white
rice, white pasta, white bread, potatoes, most baked goods), sweets, chips, and many processed
foods. They should be limited in your diet.
 Water foods are free foods—meaning you can eat as many as you like. They include all
vegetables and most types of fruit (fruit juice, dried fruit, and canned fruit packed in syrup spike
blood sugar quickly and are not considered water foods).
 Coal foods have a low GI and are high in fiber and protein. They include nuts and seeds, lean
meats, seafood, whole grains, and beans. They also include “white food” replacements such as
brown rice, whole-wheat bread, and whole-wheat pasta.
8 principles of low-glycemic eating
1. Eat a lot of non-starchy vegetables, beans, and fruits such as apples, pears, peaches, and
berries. Even tropical fruits like bananas, mangoes, and papayas tend to have a lower glycemic
index than typical desserts.
2. Eat grains in the least-processed state possible: “unbroken,” such as whole-kernel bread,
brown rice, and whole barley, millet, and wheat berries; or traditionally processed, such as
stone-ground bread, steel-cut oats, and natural granola or muesli breakfast cereals.
3. Limit white potatoes and refined grain products such as white breads and white pasta to small
side dishes.
4. Limit concentrated sweets—including high-calorie foods with a low glycemic index, such as ice
cream— to occasional treats. Reduce fruit juice to no more than one cup a day. Completely
eliminate sugar-sweetened drinks.

11. 5. Eat a healthful type of protein at most meals, such as beans, fish, or skinless chicken.
6. Choose foods with healthful fats, such as olive oil, nuts (almonds, walnuts, pecans), and
avocados. Limit saturated fats from dairy and other animal products. Completely eliminate
partially hydrogenated fats (trans fats), which are in fast food and many packaged foods.
7. Have three meals and one or two snacks each day, and don’t skip breakfast.
8. Eat slowly and stop when full.
Adapted from Ending the Food Fight, by David Ludwig with Suzanne Rostler (Houghton Mifflin,
2008).
Diabetes and diet tip 2: Be smart about sweets
Eating for diabetes doesn’t mean eliminating sugar. If you have diabetes, you can still enjoy a
small serving of your favorite dessert now and then. The key is moderation.
But maybe you have a sweet tooth and the thought of cutting back on sweets sounds almost as
bad as cutting them out altogether. The good news is that cravings do go away and preferences
change. As your eating habits become healthier, foods that you used to love may seem too rich or
too sweet, and you may find yourself craving healthier options.
How to include sweets in a diabetes-friendly diet
 Hold the bread (or rice or pasta) if you want dessert. Eating sweets at a meal adds extra
carbohydrates. Because of this it is best to cut back on the other carb-containing foods at the
same meal.
 Add some healthy fat to your dessert. It may seem counterintuitive to pass over the low-fat or
fat-free desserts in favor of their higher-fat counterparts. But fat slows down the digestive
process, meaning blood sugar levels don’t spike as quickly. That doesn’t mean, however, that
you should reach for the donuts. Think healthy fats, such as peanut butter, ricotta cheese,
yogurt, or some nuts.
 Eat sweets with a meal, rather than as a stand-alone snack. When eaten on their own, sweets
and desserts cause your blood sugar to spike. But if you eat them along with other healthy foods
as part of your meal, your blood sugar won’t rise as rapidly.
 When you eat dessert, truly savor each bite. How many times have you mindlessly eaten your
way through a bag of cookies or a huge piece of cake. Can you really say that you enjoyed each
bite? Make your indulgence count by eating slowly and paying attention to the flavors and
textures. You’ll enjoy it more, plus you’re less likely to overeat.
Tricks for cutting down on sugar
 Reduce how much soft drinks, soda and juice you drink. A recent study found that for each 12
oz. serving of a sugar-sweetened beverage you drink a day, your risk for diabetes increases by
about 15 percent. If you miss your carbonation kick, try sparkling water with a twist of lemon or
lime or a splash of fruit juice. Reduce the amount of creamers and sweeteners you add to tea
and coffee drinks.

12.  Sweeten foods yourself. Buy unsweetened iced tea, plain yogurt, or unflavored oatmeal, for
example, and add sweetener (or fruit) yourself. You’re likely to add far less sugar than the
manufacturer would have.
 Reduce the amount of sugar in recipes by ¼ to ⅓. If a recipe calls for 1 cup of sugar, for
example, use ⅔ or ¾ cup instead. You can also boost sweetness with cinnamon, nutmeg, or
vanilla extract.
 Find healthy ways to satisfy your sweet tooth. Instead of ice cream, blend up frozen bananas
for a creamy, frozen treat. Or enjoy a small chunk of dark chocolate, rather than your usual milk
chocolate bar.
 Start with half of the dessert you normally eat, and replace the other half with fruit.
Proceed with caution when it comes to alcohol
It’s easy to underestimate the amount of calories and carbs in alcoholic drinks, including beer
and wine. And cocktails mixed with soda and juice can be loaded with sugar. If you’re going to
drink, do so in moderation (no more than 1 drink per day for women; 2 for men), choose calorie-
free drink mixers, and drink only with food. If you’re diabetic, always monitor your blood
glucose, as alcohol can interfere with diabetes medication and insulin.
Diabetes and your diet tip 3: Choose fats wisely
Fats can be either helpful or harmful in your diet. People with diabetes are at higher risk for heart
disease, so it is even more important to be smart about fats. Some fats are unhealthy and others
have enormous health benefits. But all fats are high in calories, so you should always watch your
portion sizes.
 Unhealthy fats – The two most damaging fats are saturated fats and trans fats. Saturated fats
are found mainly in animal products such as red meat, whole milk dairy products, and eggs.
Trans fats, also called partially hydrogenated oils, are created by adding hydrogen to liquid
vegetable oils to make them more solid and less likely to spoil—which is very good for food
manufacturers, and very bad for you.
 Healthy fats – The best fats are unsaturated fats, which come from plant and fish sources and
are liquid at room temperature. Primary sources include olive oil, canola oil, nuts, and avocados.
Also focus on omega-3 fatty acids, which fight inflammation and support brain and heart health.
Good sources include salmon, tuna, and flaxseeds.
Ways to reduce unhealthy fats and add healthy fats:
 Cook with olive oil instead of butter or vegetable oil.
 Trim any visible fat off of meat before cooking and remove the skin before cooking chicken and
turkey.
 Instead of chips or crackers, try snacking on nuts or seeds. Add them to your morning cereal or
have a little handful for a filling snack. Nut butters are also very satisfying and full of healthy
fats.
 Instead of frying, choose to grill, broil, bake, or stir-fry.
 Serve fish 2 or 3 times week instead of red meat.

13.  Add avocado to your sandwiches instead of cheese. This will keep the creamy texture, but
improve the health factor.
 When baking, use canola oil or applesauce instead of shortening or butter.
 Rather than using heavy cream, make your soups creamy by adding low-fat milk thickened with
flour, pureed potatoes, or reduced-fat sour cream.
Diabetes and diet tip 4: Eat regularly and keep a food diary
If you’re overweight, you may be encouraged to note that you only have to lose 7% of your body
weight to cut your risk of diabetes in half. And you don’t have to obsessively count calories or
starve yourself to do it.
When it comes to successful weight loss, research shows that the two most helpful strategies
involve following a regular eating schedule and recording what you eat.
Eat at regularly set times
Your body is better able to regulate blood sugar levels—and your weight—when you maintain a
regular meal schedule. Aim for moderate and consistent portion sizes for each meal or snack.
 Don’t skip breakfast. Start your day off with a good breakfast. Eating breakfast every day will
help you have energy as well as steady blood sugar levels.
 Eat regular small meals—up to 6 per day. People tend to eat larger portions when they are
overly hungry, so eating regularly will help you keep your portions in check.
 Keep calorie intake the same. Regulating the amount of calories you eat on a day-to-day basis
has an impact on the regularity of your blood sugar levels. Try to eat roughly the same amount
of calories every day, rather than overeating one day or at one meal, and then skimping on the
next.
Keep a food diary
Research shows that people who keep a food diary are more likely to lose weight and keep it off.
In fact, a recent study found that people who kept a food diary lost twice as much weight as those
who didn’t.
Why does writing down what you eat and drink help you drop pounds? For one, it helps you
identify problem areas—such as your afternoon snack or your morning latte—where you’re
getting a lot more calories than you realized. It also increases your awareness of what, why, and
how much you’re eating, which helps you cut back on mindless snacking and emotional eating.
What about exercise?
When it comes to preventing, controlling, or reversing diabetes, you can’t afford to overlook
exercise. Exercise can help your weight loss efforts, and is especially important in maintaining
weight loss. There is also evidence that regular exercise can improve your insulin sensitivity
even if you don’t lose weight.

14. You don’t have to become a gym rat or adopt a grueling fitness regimen. One of the easiest ways
is to start walking for 30 minutes five or more times a week. You can also try swimming, biking,
or any other moderate-intensity activities—meaning you work up a light sweat and start to
breathe harder. Even house and yard work counts.
Next step...
Learn how to lose weight and keep it off. If your last diet attempt wasn't a success, or life
events have caused you to gain weight, don’t be discouraged. The key is to find a plan that works
with your body’s individual needs so that you can avoid common diet pitfalls and instead make
lasting lifestyle changes that can help you find long-term, weight loss success. Read: Healthy
Weight Loss