Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determin...Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.展开更多
Insulin resistance increases the risk of developing diabetes,and the degree of resistance influences the glycemic control of patients with diabetes.Numerous researchers have focused on improving insulin sensitivity in...Insulin resistance increases the risk of developing diabetes,and the degree of resistance influences the glycemic control of patients with diabetes.Numerous researchers have focused on improving insulin sensitivity in order to prevent diabetes-related complications and other chronic diseases.Several studies have also linked vitamin D levels to insulin secretion and resistance,given that both vitamin D and its receptor complex play important roles in regulating pancreaticβ-cells.It has been suggested that vitamin D supplementation improves vitamin D levels,but further research is needed to confirm this as neither insulin function nor glycemic control improves when vitamin D levels increase.Magnesium is a cofactor for many enzymes.Although the role of magnesium in the management of diabetes has long been evaluated,it has not yet been determined whether magnesium supplements improve insulin function.However,several researchers have found that patients with good glycemic control have high magnesium levels.Magnesium is closely related to vitamin D and is necessary for the transport and activation of vitamin D in humans.Combined supplementation with vitamin D and magnesium improves glycemic control in patients with diabetes.展开更多
The detrimental effects of both diabetes mellitus(DM)and hyperglycemia in the perioperative period are well established and have driven extensive efforts to control blood glucose concentration(BGC)in a variety of clin...The detrimental effects of both diabetes mellitus(DM)and hyperglycemia in the perioperative period are well established and have driven extensive efforts to control blood glucose concentration(BGC)in a variety of clinical settings.It is now appreciated that acute BGC spikes,hypoglycemia,and high glycemic variability(GV)lead to more endothelial dysfunction and oxidative stress than uncomplicated,chronically elevated BGC.In the perioperative setting,fasting is the primary approach to reducing the risk for pulmonary aspiration;however,prolonged fasting drives the body into a catabolic state and therefore may increase GV.Elevated GV in the perioperative period is associated with an increased risk for postoperative complications,including morbidity and mortality.These challenges pose a conundrum for the management of patients typically instructed to fast for at least 8 h before surgery.Preliminary evidence suggests that the administration of an oral preoperative carbohydrate load(PCL)to stimulate endogenous insulin production and reduce GV in the perioperative period may attenuate BGC spikes and ultimately decrease postoperative morbidity,without significantly increasing the risk of pulmonary aspiration.The aim of this scoping review is to summarize the available evidence on the impact of PCL on perioperative GV and surgical outcomes,with an emphasis on evidence pertaining to patients with DM.The clinical relevance of GV will be summarized,the relationship between GV and postoperative course will be explored,and the impact of PCL on GV and surgical outcomes will be presented.A total of 13 articles,presented in three sections,were chosen for inclusion.This scoping review concludes that the benefits of a PCL outweigh the risks in most patients,even in those with well controlled type 2 DM.The administration of a PCL might effectively minimize metabolic derangements such as GV and ultimately result in reduced postoperative morbidity and mortality,but this remains to be proven.Future efforts to standardize the content and timing of a PCL are needed.Ultimately,a rigorous data-driven consensus opinion regarding PCL administration that identifies optimal carbohydrate content,volume,and timing of ingestion should be established.展开更多
BACKGROUND Gestational diabetes mellitus(GDM)has become increasingly prevalent globally.Glycemic control in pregnant women with GDM has a critical role in neonatal complications.AIM To analyze the early neonatal compl...BACKGROUND Gestational diabetes mellitus(GDM)has become increasingly prevalent globally.Glycemic control in pregnant women with GDM has a critical role in neonatal complications.AIM To analyze the early neonatal complications in GDM,and examine the effect of blood glucose control level on neonatal infection.METHODS The clinical data of 236 pregnant women with GDM and 240 healthy pregnant women and newborns during from March 2020 to December 2021 the same period were retrospectively analyzed,and the early complications in newborns in the two groups were compared.The patients were divided into the conforming glycemic control group(CGC group)and the non-conforming glycemic control group(NCGC group)based on whether glycemic control in the pregnant women with GDM conformed to standards.Baseline data,immune function,infectionrelated markers,and infection rates in neonates were compared between the two groups.RESULTS The incidence of neonatal complications in the 236 neonates in the GDM group was significantly higher than that in the control group(P<0.05).Pregnant women with GDM in the NCGC group(n=178)had significantly higher fasting plasma glucose,2 h postprandial blood glucose and glycated hemoglobin A1C levels than those in the CGC group(n=58)(P<0.05).There were no differences in baseline data between the two groups(P>0.05).Additionally,the NCGC group had significantly decreased peripheral blood CD3^(+),CD4^(+),CD8^(+)T cell ratios,CD4/CD8 ratios and immunoglobulin G in neonates compared with the CGC group(P<0.05),while white blood cells,serum procalcitonin and C-reactive protein levels increased significantly.The neonatal infection rate was also significantly increased in the NCGC group(P<0.05).CONCLUSION The risk of neonatal complications increased in pregnant women with GDM.Poor glycemic control decreased neonatal immune function,and increased the incidence of neonatal infections.展开更多
Background: A balanced diet with a low glycemic index (GI) plays an important role in controlling and managing type 2 diabetes mellitus (T2DM). Here, we compared the GI of 2 flavors (vanilla and chocolate) of diabetes...Background: A balanced diet with a low glycemic index (GI) plays an important role in controlling and managing type 2 diabetes mellitus (T2DM). Here, we compared the GI of 2 flavors (vanilla and chocolate) of diabetes-specific nutritional (DSN) supplements to its comparator in healthy Indian adults under fasting conditions. Methods: This study was a 39-day open-label, non-comparative, single-center trial involving healthy adults aged between 18 to 45 years. The subjects received equal doses of 2 DSN powder (Treatments A and B), the comparator product (Treatment C), and dextrose monohydrate as a reference (Treatment R). Doses were administered as per the dosing schedule, after an overnight fast for 10 hours, with 2 intervening non-dosing days. Blood samples were collected on the dosing days to assess changes in capillary blood glucose levels. The primary endpoint of the study was the mean GI of Treatments A, B, and C (Defined as low: GI ≤ 55;medium: 55 GI ≤ 70;High: GI > 70), generated using the incremental area under the curve (AUC<sub>i</sub>) methodology. Safety was assessed throughout the study. Values of all study parameters were represented in ±SD or standard deviation. Results: Fourteen adult male subjects with a mean age of 29.42 ± 4.46 years, and a body mass index of 22.0 ± 1.95 Kg/m<sup>2</sup>, were enrolled in the study. The mean AUC<sub>i</sub> for treatments A, B, and C were 104 ± 10, 111 ± 12, and 87 ± 12 mmol min/L, respectively and for Treatment R it was 276 ± 16, 319 ± 28 and 338 ± 25 mmol min/L for Days 1, 6 and 8, respectively. The mean GI of Treatment A was 33 ± 3, Treatment B was 35 ± 3 and Treatment C was 29 ± 5;all GI means were ≤55. Mild adverse events were reported in 2 (14.3%) subjects. No serious adverse events or deaths were reported in the study. All treatments were well tolerated by the subjects. Conclusion: The glycemic index of both test products and comparator was low (i.e., GI 55) as per ISO 26642:2010 standard.展开更多
Liver is an essential organ that maintains fasting and postprandial blood glucose response via various metabolic pathways. The liver function gradually deteriorates in chronic liver disease (CLD) due to inflammation a...Liver is an essential organ that maintains fasting and postprandial blood glucose response via various metabolic pathways. The liver function gradually deteriorates in chronic liver disease (CLD) due to inflammation and destruction of liver parenchyma. The development of glucose intolerance and hepatogenous diabetes (HD) in patients with CLD is an inevitable event. Diabetes and CLD can coexist, and function synergistically to cause unfavorable clinical consequences, including poor treatment outcomes and frequent hospitalization. The complications associated with liver disease (malnutrition, hypoglycemia, acute kidney injury, lactic acidosis, etc.) and lack of guidelines limit pharmacological management of HD. Dietary recommendations by The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines (2019), suggested weight reducing hypocaloric diet along with adequate branched-chain amino acid (BCAA) and micronutrient consumption to improve steatosis and insulin sensitivity in patients with CLD. Dietary glycemic index controls prognosis of obesity, non-alcoholic fatty liver disease (NAFLD) and diabetes. The importance of low GI diet in reducing fasting blood glucose, hepatic glucose influx and fat accumulation, thereby improving weight loss and NAFLD score, is being published in patients with diabetes or liver disease. Several countries have already incorporated GI into their national health policies, for identification of the nutrient value, resulting in establishment of worldwide GI and glycemic load tables for specific food items. However, the apparent complexity of GI and lack of low GI meal choices need to be resolved in order to enhance patient’s quality of life, health and well-being. Low GI nutritional supplements, comprising of balanced proportion of carbohydrate, protein, BCAAs, fibers and micronutrients, may reduce the complexity related to dietary management of HD. The review summarizes the importance of nutritional management in HD with focus on low GI diet in people with CLD.展开更多
The management of diabetes mellitus is based on lifestyle and dietary measures suggesting the consumption of foods with a low glycemic index. The present study was conducted in order to propose food formulas based on ...The management of diabetes mellitus is based on lifestyle and dietary measures suggesting the consumption of foods with a low glycemic index. The present study was conducted in order to propose food formulas based on white rice and white beans resulting in a lower glycemic response. For this, food formulations based on these foods were first made, in particular the formulation [75% white rice + 25% white beans] and the formulation [50% rice + 50% white beans]. Then, the biochemical composition of white rice, white bean and these two formulations was determined by the usual methods. Finally, their glycemic responses over 120 minutes were studied by the FAO/ WHO 1998 method. The results showed that white rice [100% white rice] had the highest carbohydrate content (54.61%) followed respectively by the formulation [75% white rice + 25% white bean] (45.69%), the white bean [100% white bean] (29.1%) and the formulation [50% white rice + 50% white bean] (26.16%). In terms of glycemic responses, the formulation [50% white rice + 50% white beans] presented the best evolution with a lower peak (6.041 mmol/L) observed at T45<sub>min</sub> and a lower postprandial glycemia (4.872 mmol/ L) at T120<sub>min</sub>. An increase in the proportion of beans is therefore recommended as it may suggest a beneficial metabolic effect.展开更多
Objective:To investigate the relation between sleep quality and glycemic control among type 2 diabetic patients.Methods:Across sectional descriptive design was used;the study sample including 125 diabetic patients was...Objective:To investigate the relation between sleep quality and glycemic control among type 2 diabetic patients.Methods:Across sectional descriptive design was used;the study sample including 125 diabetic patients was recruited at diabetic clinics in Zagazig University hospitals.The interview questionnaire sheet consists of 4 par ts:(1)demographic data,(2)medical history,(3)an Arabic version of the Pittsburgh sleep quality index(PSQI),and(4)glycated hemoglobin A1c(Hb A1c)analysis test.Results:The mean of sleep duration was the highest score of PSQI components,96.8%of diabetic patients had poor sleep quality,and 90.4%of diabetic patients had poor glycemic control.A highly statistically significant relationship was found between Hb A1c and sleep quality.Moreover,income,duration of disease and smoking were independent positive predictors of Hb A1c level,while the female gender was a statistically significant negative predictor.Additionally,female gender and income were statistically significant independent positive predictors of PSQI score.Conclusions:Poor sleep quality and poor glycemic control were very common among type 2 diabetic patients.There was a highly significant relation between sleep quality and glycemic control.展开更多
Recently, people suffer from the inability to maintain weight with an increasing body mass, and this may be due to several reasons, including the type and quantity of food. In current study, the effect of the glycemic...Recently, people suffer from the inability to maintain weight with an increasing body mass, and this may be due to several reasons, including the type and quantity of food. In current study, the effect of the glycemic index of foods (high-low-medium) on the speed of return of hunger in adult women was discussed. Non-pregnant or lactating women who do not suffer from chronic diseases such as diabetes and pressure, for three days in a row for breakfast, lunch, and dinner, by calculating the number of hours preceding the feeling of hunger, as the results showed that the least hours of hunger were after eating foods with a low glycemic index and then followed by foods with a medium glycemic index, and the number of hours of starvation after eating foods with a high glycemic index was the least, and this leads to an increase in subsequent food intake and an increase in calories during the day. The results indicated: first day that are high in the glycemic index (breakfast). Highest percentage of feeling hungry was 30% after 4 h (lunch). The highest percentage of feeling hungry was 30% after 3 h, (dinner), the highest percentage of not feeling hungry by 50%. The second day with a low glycemic index (breakfast). The highest percentage of feeling hungry after 4 h was 30%, (lunch). The highest percentage of feeling hungry after 4 h was 30%, (dinner). The highest percentage of not feeling hungry was 80%. Third day with a medium glycemic index (breakfast). The highest percentage of feeling hungry was after 3 h and 4 h, with a percentage of 30%, (lunch), the highest percentage of feeling hungry after 4 h, with a percentage of 30%, (dinner), the highest percentage of not feeling hungry by 70%, which increases body mass and weight continuously, and this leads to an increase in vulnerability to chronic diseases. Therefore, it is important to preserve and be careful to eat meals with a low and medium glycemic index in the diets, with the addition of foods with a high glycemic index, without negligence or excess, and we look forward to increasing the research on the effect of the glycemic index of food on the speed of return of hunger while standardizing the quantity and type of food for all volunteers.展开更多
Background: A randomized cross-over study was conducted to assess the glycemic index (GI) of seven Oral Nutritional Supplements (ONSs). These ONSs are designed to support the nutritional requirements of different age-...Background: A randomized cross-over study was conducted to assess the glycemic index (GI) of seven Oral Nutritional Supplements (ONSs). These ONSs are designed to support the nutritional requirements of different age-groups, physiological states, or health conditions among Indian adults. Methods: The study had two phases viz., phase1 (n = 18) studied two ONSs: A1 and B1 and phase 2 (n = 20) studied five ONSs: A2, B2, C2, D2 & E2. The subjects were healthy, non-diabetic adults, aged between 20 - 44 years with a mean Body Mass Index of 21.2 ± 1.52 kg/m<sup>2</sup> (Phase 1) and 21.0 ± 1.45 kg/m<sup>2</sup> (Phase 2). All these ONSs were compared with reference drinks (glucose). The carbohydrates in one serving of each ONS were matched to carbohydrates from 25 grams of glucose following ISO 2010 guidelines. Capillary blood was assessed for blood glucose response at baseline, 15, 30, 45, 60, 90 and 120 minutes. GI was calculated as the incremental area under the curve (iAUC) for the test drinks and expressed as a percentage of the average iAUC from glucose. Results: Phase 1 indicated that the high fiber diabetes-specific nutrition supplement A1 with higher protein (23% energy), higher fat (25% energy) and reduced carbohydrates (40% energy) had a significantly (p = 0.002) lower GI [34 (±6)] as compared to B1 [63 (±7)] (protein 19%, fat 7% and carbohydrates 60% energy) even with similar amount (22%) and type of fiber. Phase 2 reported that all test products [A2 (32 ± 5), B2 (37 ± 4), C2 (31 ± 5), D2 (31 ± 5) and E2 (55 ± 4)] had a low GI. As compared to phase 1, ONSs in phase 2 had lower fiber content (1.6% - 4.6% energy). Conclusion: The glycemic index of oral nutrition supplements is influenced not only by their fiber content, but also by the overall macronutrient composition including protein (≥17% energy), fat (≥10% - 27% energy) and carbohydrates (40% - 57.5% energy).展开更多
The benchmark for assessing quality of long-term glycemic control and adjustment of therapy is currently glycated hemoglobin(Hb A1c). Despite its importance as an indicator for the development of diabeticcomplications...The benchmark for assessing quality of long-term glycemic control and adjustment of therapy is currently glycated hemoglobin(Hb A1c). Despite its importance as an indicator for the development of diabeticcomplications, recent studies have revealed that this metric has some limitations; it conveys a rather complex message, which has to be taken into consideration for diabetes screening and treatment. On the basis of recent clinical trials, the relationship between Hb A1 c and cardiovascular outcomes in long-standing diabetes has been called into question. It becomes obvious that other surrogate and biomarkers are needed to better predict cardiovascular diabetes complications and assess efficiency of therapy. Glycated albumin, fructosamin, and 1,5-anhydroglucitol have received growing interest as alternative markers of glycemic control. In addition to measures of hyperglycemia, advanced glucose monitoring methods became available. An indispensible adjunct to Hb A1 c in routine diabetes care is selfmonitoring of blood glucose. This monitoring method is now widely used, as it provides immediate feedback to patients on short-term changes, involving fasting, preprandial, and postprandial glucose levels. Beyond the traditional metrics, glycemic variability has been identified as a predictor of hypoglycemia, and it might also be implicated in the pathogenesis of vascular diabetes complications. Assessment of glycemic variability is thus important, but exact quantification requires frequently sampled glucose measurements. In order to optimize diabetes treatment, there is a need for both key metrics of glycemic control on a day-to-day basis and for more advanced, user-friendly monitoring methods. In addition to traditional discontinuous glucose testing, continuous glucose sensing has become a useful tool to reveal insufficient glycemic management. This new technology is particularly effective in patients with complicated diabetes and provides the opportunity to characterize glucose dynamics. Several continuous glucose monitoring(CGM) systems, which have shown usefulness in clinical practice, are presently on the market. They can broadly be divided into systems providing retrospective or real-time information on glucose patterns. The widespread clinical application of CGM is still hampered by the lack of generallyaccepted measures for assessment of glucose profiles and standardized reporting of glucose data. In this article, we will discuss advantages and limitations of various metrics for glycemic control as well as possibilities for evaluation of glucose data with the special focus on glycemic variability and application of CGM to improve individual diabetes management.展开更多
AIM:To determine the glycemic index(GI)and glycemic load(GL)values of Chinese traditional foods in Hong Kong.METHODS:Fifteen healthy subjects(8 males and 7 females)volunteered to consume either glucose or one of 23 te...AIM:To determine the glycemic index(GI)and glycemic load(GL)values of Chinese traditional foods in Hong Kong.METHODS:Fifteen healthy subjects(8 males and 7 females)volunteered to consume either glucose or one of 23 test foods after 10-14 h overnight fast.The blood glucose concentrations were analyzed immediately before,15,30,45,60,90 and 120 min after food consumption using capillary blood samples.The GI value of each test food was calculated by expressing the incremental area under the blood glucose response curve(IAUC)value for the test food as a percentage of each subject's average IAUC value for the glucose.The GL value of each test food was calculated as the GI value of the food multiplied by the amount of the available carbohydrate in a usual portion size,divided by 100.RESULTS:Among all the 23 Chinese traditional foods tested,6 of them belonged to low GI foods(Tuna Fish Bun,Egg Tart,Green Bean Dessert,Chinese Herbal Jelly,Fried Rice Vermicelli in Singapore-style,and Spring Roll),10 of them belonged to moderate GI foods(Baked Barbecued Pork Puff,Fried Fritter,"Mai-Lai"Cake,"Pineapple"Bun,Fried Rice Noodles with Sliced Beef,Barbecue Pork Bun,Moon Cakes,Glutinous Rice Ball,Instant Sweet Milky Bun,and Salted Meat Rice Dumpling),the others belonged to high GI foods(Fried Rice in Yangzhou-Style,Sticky Rice Wrapped in Lotus Leaf,Steamed Glutinous Rice Roll,Jam and Peanut Butter Toast,Plain Steamed Vermicelli Roll,Red Bean Dessert,and Frozen Sweet Milky Bun).CONCLUSION:The GI and GL values for these Chinese traditional foods will provide some valuable information to both researchers and public on their food preference.展开更多
Objective The relationship between serum uric acid(SUA)levels and glycemic indices,including plasma glucose(FPG),2-hour postload glucose(2 h-PG),and glycated hemoglobin(HbA1 c),remains inconclusive.We aimed to explore...Objective The relationship between serum uric acid(SUA)levels and glycemic indices,including plasma glucose(FPG),2-hour postload glucose(2 h-PG),and glycated hemoglobin(HbA1 c),remains inconclusive.We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.Methods The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study.A total of 105,922 community-dwelling adults aged≥40 years underwent the oral glucose tolerance test and uric acid assessment.The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.Results A total of 30,941 men and 62,361 women were eligible for the current analysis.Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels,but with different inflection points in men and women.The thresholds for FPG,2 h-PG,and HbA1 c for men and women were 6.5/8.0 mmol/L,11.0/14.0 mmol/L,and 6.1/6.5,respectively(SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes,while the inflection points were reached earlier in men than in women.展开更多
This study aimed to investigate the effect of yam flour substitution (Dioscorea alata L.) and moringa powder in wheat bread on glycemic response. Glycemic index (GI) and glycemic load (GL) of pieces of bread were dete...This study aimed to investigate the effect of yam flour substitution (Dioscorea alata L.) and moringa powder in wheat bread on glycemic response. Glycemic index (GI) and glycemic load (GL) of pieces of bread were determined. A mixture plan design was used to determine the optimal formulation of bread made of yam flour, wheat flour and moringa powder. The mixture of 79.4% soft wheat flour, 20% yam flour and 0.6% moringa leaves powder has a good potential in bread preparation and was used in this study. 100% wheat bread was used as control. Postprandial blood glucose response (glycemic response) was evaluated with the glucose used as a reference food. Blood glucose responses were measured at different intervals for 2 hours. The results indicated that composite bread had low GI and GL values than wheat bread. Values are GI = 80 and GL = 61.2 for wheat bread and GI = 37.78 and GL = 29.65 for the composite bread. This study demonstrated that the inclusion of yam flour of moringa leaves powder in bread production might not pose a threat to blood glucose response compared to wheat bread. These pieces of bread could be included easily in diabetics’ and non-diabetics diet.展开更多
Background: Postprandial plasma glucose concentration is an important diabetes management target. Glycemia-targeted specialized-nutrition (GTSN) beverages, containing various quantities and types of carbohydrates (CHO...Background: Postprandial plasma glucose concentration is an important diabetes management target. Glycemia-targeted specialized-nutrition (GTSN) beverages, containing various quantities and types of carbohydrates (CHO), have been formulated to blunt postprandial hyperglycemia. The objective of this research was to evaluate the effectiveness of these products on postprandial glycemic and hormonal responses based on comparisons of GTSN with differing carbohydrate quantities or types. Methods: In two randomized, double-blind, crossover studies, participants (mean age 61 years) with type 2 diabetes consumed GTSN in a meal tolerance test. In the CHO Quantity Study, a standard nutritional beverage (STD) was compared to a low carbohydrate nutritional beverage with tapioca dextrin (GTSN-TDX) and a balanced carbohydrate nutritional beverage containing a blend of the slowly-digesting carbohydrates maltodextrin and sucromalt (GTSN-SDC). In the CHO Type Study, the GTSN beverages had similar carbohydrate quantities but varied in carbohydrate composition with GTSN-SDC compared to a formula with tapioca starch and fructose (GTSN-TS&F), and one with isomaltulose and resistant starch (GTSN-I&RS). Postprandial (0-240 min) concentrations of blood glucose, insulin (CHO Quantity Study only) and glucagon-like-peptide (GLP)-1 (CHO Quantity Study only) were measured. Results: Despite having substantially different carbohydrate quantities, the GTSN blunted the glucose positive area under the curve (AUC0-240 min) by 65% to 82% compared to the STD formulation (p < 0.001). GTSN also elicited ~50% lower insulin positive AUC0-240 min (p < 0.05), while postprandial GLP-1 responses were increased (p = 0.018) vs. STD. In the CHO Type Study, glucose positive AUC0-240 min tended to be lower for GTSN-SDC (1477 ± 460) than GTSN-TS&F (2203 ± 412;p = 0.062) and GTSN-I&RS (2190 ± 412;p = 0.076). No differences were observed between GTSN-TS&F and GTSN-I&RS. Conclusions: These results demonstrate the effectiveness of several GTSN products and suggest that both CHO quantity and type play important roles in postprandial glycemic response in men and women with type 2 diabetes. Furthermore, GTSN products containing slow-digesting carbohydrates can blunt postmeal glucose and insulin concentration despite delivering greater total grams of CHO, which provides a dietary benefit for people with diabetes.展开更多
Integrating information on the glycemic index (GI) and the glycemic load (GL) of diet is limited in C?te d’Ivoire because of the lack of data. Thus, this study was undertaking for the local management and prevention ...Integrating information on the glycemic index (GI) and the glycemic load (GL) of diet is limited in C?te d’Ivoire because of the lack of data. Thus, this study was undertaking for the local management and prevention of diabetes mellitus and its complications based on nutritional data (GI and GL values). The study included ten healthy subjects with 7 males, 3 females (28 ± 2 years on average age and 20.5 ± 1.7 on average BMI). Participants tested three different meals with equal carbohydrate load (50 g). Blood samples were obtained at 0, 15, 30, 45, 60, 90 and 120 min before and after consumption for glucose levels determination. GIs were determined using a standard method with glucose as reference food and data were used for GLs calculating. Data showed that GIs value of pounded yam with eggplant sauce and cassava paste with granulates palm nut sauce were high ranging to 94 to 86 respectively while rice with groundnut sauce, have a low GI (GI = 45). Nevertheless, the GLs of the all the test foods are high with the values of 47, 43 and 23 (g) for pounded yam with eggplant sauce, cassava paste with granulates palm nut sauce and rice with groundnut sauce respectively. According to GIs and GLs data, the three test foods must be consumed moderately in a diet. So, it is important to associate GL data to GI data of Ivorian traditional foods for the management and the prevention of diabetes mellitus in C?te d’Ivoire and in others countries sharing the same food tradition.展开更多
Food intake has a great influence on blood glucose in patients with diabetes. This study was to determine the glycemic index(GI) and glycemic load(GL) of a particular pomelo named Majia pomelo and its effects on postp...Food intake has a great influence on blood glucose in patients with diabetes. This study was to determine the glycemic index(GI) and glycemic load(GL) of a particular pomelo named Majia pomelo and its effects on postprandial glucose(PPG) in patients with type 2 diabetes(T2D). Twenty healthy subjects and 20 T2D patients(controlled on lifestyle measures and/or metformin) were tested on 2 separate days with 50 g of glucose and 50 g equivalent of carbohydrates from Majia pomelo for GI measurement. To test effects of Majia pomelo on PPG, 19 hospitalized T2D patients(controlled on insulin therapy) were selected for a 9-day study. The dose of insulin for each patient was adjusted on the first 3 days. A total of 100 g Majia pomelo was consumed per meal in the last 3 tested days. Blood glucose was measured to evaluate the glycemic excursions. The GIs for Majia pomelo in healthy individuals and T2D patients were 78.34±1.88 and 72.15±1.95 respectively. The value of GL was as low as 4.23 in diabetic patients with serving size of 100 g pomelo, indicting Majia pomelo as a high GI but low GL fruit. Consumption of Majia pomelo in hospitalized T2D patients did not cause significant glucose fluctuation. It was concluded that high GI pomelo can serve as a low GL fruit if it is consumed with a limited daily amount and thus can be supplied to diabetic patients. These results may mean more varieties of food choices for T2D patients.展开更多
In order to identify those potatoes which exert a low glycemic impact after processing, eight early potato varieties and four processing methods were evaluated for their total starch content, amylose content, rapidly ...In order to identify those potatoes which exert a low glycemic impact after processing, eight early potato varieties and four processing methods were evaluated for their total starch content, amylose content, rapidly digestible starch (RDS), slowly digestible starch (SDS), and resistant starch (RS), estimated glycemic index (eGI), glycemic load (eGL) as well as their relationship among each other. While all these profiles were highly dependent on the potato variety and processing methods, all the eight varieties were classified as low GL foods (p ≤ 0.05). A strong positive correlation was observed between eGI and RDS (r = 0.84, 0.79, and 0.74) for retrograded and reheated, baked and microwaved varieties, respectively), whereas a moderate negative correlation was observed between eGI and RS for retrograded and reheated (r = -0.39) and microwaved (-0.37) varieties (p ≤ 0.05). On the basis of these findings, it can be concluded that potato variety, processing methods, and starch characteristics define the eGI and eGL. Furthermore, for the varieties examined, the present study identified RDS as a major starch factor contributing to eGI.展开更多
The “bai?o de dois” is a typical Brazilian dish and a rich combination of rice and beans. This preparation has a high nutritional value but its effect on glycemic response is not yet studied. To determine the glycem...The “bai?o de dois” is a typical Brazilian dish and a rich combination of rice and beans. This preparation has a high nutritional value but its effect on glycemic response is not yet studied. To determine the glycemic index and glycemic load of foods can help prescribing diets and as a result, improving the treatment and prevention of chronic diseases. This study aimed to access the glycemic index (GI) and glycemic load (GL) of “bai?o de dois”. Following the protocol recommended by the Food and Agriculture Organization, 6 volunteers were recruited to perform blood glucose tests. Each volunteer performed three glucose tolerance tests and a test with “bai?o de dois”. All tests were undertaken in separate weeks. Through the calculation of the areas under each of the curves, it was possible to access the GI of “bai?o de dois” by the average values of six GIs found for each volunteer. It was calculated that the GL of each portion tested and recommended servings per capita. It was found that “bai?o de dois” had low GI (44) and GL (6) at the recommended per capita, but high GL (22) at the portion tested (bigger than the recommended). The “bai?o de dois” do not present a potential risk for developing chronic diseases, but it is recommended consumption to be monitored.展开更多
The diabetes mellitus is a public health problem in C?te d’Ivoire. The Glycemic index (GI) and the Glycemic load (GL) determination of commonly consumed foods such as juice fruits is an alternative to prevent metabol...The diabetes mellitus is a public health problem in C?te d’Ivoire. The Glycemic index (GI) and the Glycemic load (GL) determination of commonly consumed foods such as juice fruits is an alternative to prevent metabolic diseases. This study carried out three wild fruits locally named Baobab (Adansonia digitata), Tomi (Tamarindus indica) and Néré (Parkia biglobosa) collected at maturity stage. The juices from the pulp of fruits have been elaborated, pasteurized, submitted to microbiological and physicochemical analysis before GIs/GLs determination. Ten healthy subjects with body mass index and age average respectively 21.57 ± 1.06 and 28 ± 2 years old tested the three juices and glucose (50 g) as reference food. Blood samples have been collected at 0, 15, 30, 45, 60, 90 and 120 min after foods consumption. The GIs/GLs has been determined according to ISO/FDI 26642:2010 protocol. Data showed that pasteurized juices has a weak microbiologic load (1.0102 - 2.4102 of Mesophylls Aerobic Germs) and not contain pathogen germs. The GI and GL of Néré juice are high with respective values of 89.54 ± 1.63 and 29.22 ± 4.09 whereas those of Baobab and Tomi juice are moderate with respective GI/GL values of 66.48 ± 2.12/13.24 ± 1.99 and 60.41 ± 2.63/12.87 ± 1.67. The juice of Néré should be consumed occasionally when those of Baobab and Tomi should be consumed with moderation. It would be suitable to know more about the GI and GL of all the juice fruits produced locally so as to prevent efficiently diabetes mellitus in the country.展开更多
文摘Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.
文摘Insulin resistance increases the risk of developing diabetes,and the degree of resistance influences the glycemic control of patients with diabetes.Numerous researchers have focused on improving insulin sensitivity in order to prevent diabetes-related complications and other chronic diseases.Several studies have also linked vitamin D levels to insulin secretion and resistance,given that both vitamin D and its receptor complex play important roles in regulating pancreaticβ-cells.It has been suggested that vitamin D supplementation improves vitamin D levels,but further research is needed to confirm this as neither insulin function nor glycemic control improves when vitamin D levels increase.Magnesium is a cofactor for many enzymes.Although the role of magnesium in the management of diabetes has long been evaluated,it has not yet been determined whether magnesium supplements improve insulin function.However,several researchers have found that patients with good glycemic control have high magnesium levels.Magnesium is closely related to vitamin D and is necessary for the transport and activation of vitamin D in humans.Combined supplementation with vitamin D and magnesium improves glycemic control in patients with diabetes.
文摘The detrimental effects of both diabetes mellitus(DM)and hyperglycemia in the perioperative period are well established and have driven extensive efforts to control blood glucose concentration(BGC)in a variety of clinical settings.It is now appreciated that acute BGC spikes,hypoglycemia,and high glycemic variability(GV)lead to more endothelial dysfunction and oxidative stress than uncomplicated,chronically elevated BGC.In the perioperative setting,fasting is the primary approach to reducing the risk for pulmonary aspiration;however,prolonged fasting drives the body into a catabolic state and therefore may increase GV.Elevated GV in the perioperative period is associated with an increased risk for postoperative complications,including morbidity and mortality.These challenges pose a conundrum for the management of patients typically instructed to fast for at least 8 h before surgery.Preliminary evidence suggests that the administration of an oral preoperative carbohydrate load(PCL)to stimulate endogenous insulin production and reduce GV in the perioperative period may attenuate BGC spikes and ultimately decrease postoperative morbidity,without significantly increasing the risk of pulmonary aspiration.The aim of this scoping review is to summarize the available evidence on the impact of PCL on perioperative GV and surgical outcomes,with an emphasis on evidence pertaining to patients with DM.The clinical relevance of GV will be summarized,the relationship between GV and postoperative course will be explored,and the impact of PCL on GV and surgical outcomes will be presented.A total of 13 articles,presented in three sections,were chosen for inclusion.This scoping review concludes that the benefits of a PCL outweigh the risks in most patients,even in those with well controlled type 2 DM.The administration of a PCL might effectively minimize metabolic derangements such as GV and ultimately result in reduced postoperative morbidity and mortality,but this remains to be proven.Future efforts to standardize the content and timing of a PCL are needed.Ultimately,a rigorous data-driven consensus opinion regarding PCL administration that identifies optimal carbohydrate content,volume,and timing of ingestion should be established.
文摘BACKGROUND Gestational diabetes mellitus(GDM)has become increasingly prevalent globally.Glycemic control in pregnant women with GDM has a critical role in neonatal complications.AIM To analyze the early neonatal complications in GDM,and examine the effect of blood glucose control level on neonatal infection.METHODS The clinical data of 236 pregnant women with GDM and 240 healthy pregnant women and newborns during from March 2020 to December 2021 the same period were retrospectively analyzed,and the early complications in newborns in the two groups were compared.The patients were divided into the conforming glycemic control group(CGC group)and the non-conforming glycemic control group(NCGC group)based on whether glycemic control in the pregnant women with GDM conformed to standards.Baseline data,immune function,infectionrelated markers,and infection rates in neonates were compared between the two groups.RESULTS The incidence of neonatal complications in the 236 neonates in the GDM group was significantly higher than that in the control group(P<0.05).Pregnant women with GDM in the NCGC group(n=178)had significantly higher fasting plasma glucose,2 h postprandial blood glucose and glycated hemoglobin A1C levels than those in the CGC group(n=58)(P<0.05).There were no differences in baseline data between the two groups(P>0.05).Additionally,the NCGC group had significantly decreased peripheral blood CD3^(+),CD4^(+),CD8^(+)T cell ratios,CD4/CD8 ratios and immunoglobulin G in neonates compared with the CGC group(P<0.05),while white blood cells,serum procalcitonin and C-reactive protein levels increased significantly.The neonatal infection rate was also significantly increased in the NCGC group(P<0.05).CONCLUSION The risk of neonatal complications increased in pregnant women with GDM.Poor glycemic control decreased neonatal immune function,and increased the incidence of neonatal infections.
文摘Background: A balanced diet with a low glycemic index (GI) plays an important role in controlling and managing type 2 diabetes mellitus (T2DM). Here, we compared the GI of 2 flavors (vanilla and chocolate) of diabetes-specific nutritional (DSN) supplements to its comparator in healthy Indian adults under fasting conditions. Methods: This study was a 39-day open-label, non-comparative, single-center trial involving healthy adults aged between 18 to 45 years. The subjects received equal doses of 2 DSN powder (Treatments A and B), the comparator product (Treatment C), and dextrose monohydrate as a reference (Treatment R). Doses were administered as per the dosing schedule, after an overnight fast for 10 hours, with 2 intervening non-dosing days. Blood samples were collected on the dosing days to assess changes in capillary blood glucose levels. The primary endpoint of the study was the mean GI of Treatments A, B, and C (Defined as low: GI ≤ 55;medium: 55 GI ≤ 70;High: GI > 70), generated using the incremental area under the curve (AUC<sub>i</sub>) methodology. Safety was assessed throughout the study. Values of all study parameters were represented in ±SD or standard deviation. Results: Fourteen adult male subjects with a mean age of 29.42 ± 4.46 years, and a body mass index of 22.0 ± 1.95 Kg/m<sup>2</sup>, were enrolled in the study. The mean AUC<sub>i</sub> for treatments A, B, and C were 104 ± 10, 111 ± 12, and 87 ± 12 mmol min/L, respectively and for Treatment R it was 276 ± 16, 319 ± 28 and 338 ± 25 mmol min/L for Days 1, 6 and 8, respectively. The mean GI of Treatment A was 33 ± 3, Treatment B was 35 ± 3 and Treatment C was 29 ± 5;all GI means were ≤55. Mild adverse events were reported in 2 (14.3%) subjects. No serious adverse events or deaths were reported in the study. All treatments were well tolerated by the subjects. Conclusion: The glycemic index of both test products and comparator was low (i.e., GI 55) as per ISO 26642:2010 standard.
文摘Liver is an essential organ that maintains fasting and postprandial blood glucose response via various metabolic pathways. The liver function gradually deteriorates in chronic liver disease (CLD) due to inflammation and destruction of liver parenchyma. The development of glucose intolerance and hepatogenous diabetes (HD) in patients with CLD is an inevitable event. Diabetes and CLD can coexist, and function synergistically to cause unfavorable clinical consequences, including poor treatment outcomes and frequent hospitalization. The complications associated with liver disease (malnutrition, hypoglycemia, acute kidney injury, lactic acidosis, etc.) and lack of guidelines limit pharmacological management of HD. Dietary recommendations by The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines (2019), suggested weight reducing hypocaloric diet along with adequate branched-chain amino acid (BCAA) and micronutrient consumption to improve steatosis and insulin sensitivity in patients with CLD. Dietary glycemic index controls prognosis of obesity, non-alcoholic fatty liver disease (NAFLD) and diabetes. The importance of low GI diet in reducing fasting blood glucose, hepatic glucose influx and fat accumulation, thereby improving weight loss and NAFLD score, is being published in patients with diabetes or liver disease. Several countries have already incorporated GI into their national health policies, for identification of the nutrient value, resulting in establishment of worldwide GI and glycemic load tables for specific food items. However, the apparent complexity of GI and lack of low GI meal choices need to be resolved in order to enhance patient’s quality of life, health and well-being. Low GI nutritional supplements, comprising of balanced proportion of carbohydrate, protein, BCAAs, fibers and micronutrients, may reduce the complexity related to dietary management of HD. The review summarizes the importance of nutritional management in HD with focus on low GI diet in people with CLD.
文摘The management of diabetes mellitus is based on lifestyle and dietary measures suggesting the consumption of foods with a low glycemic index. The present study was conducted in order to propose food formulas based on white rice and white beans resulting in a lower glycemic response. For this, food formulations based on these foods were first made, in particular the formulation [75% white rice + 25% white beans] and the formulation [50% rice + 50% white beans]. Then, the biochemical composition of white rice, white bean and these two formulations was determined by the usual methods. Finally, their glycemic responses over 120 minutes were studied by the FAO/ WHO 1998 method. The results showed that white rice [100% white rice] had the highest carbohydrate content (54.61%) followed respectively by the formulation [75% white rice + 25% white bean] (45.69%), the white bean [100% white bean] (29.1%) and the formulation [50% white rice + 50% white bean] (26.16%). In terms of glycemic responses, the formulation [50% white rice + 50% white beans] presented the best evolution with a lower peak (6.041 mmol/L) observed at T45<sub>min</sub> and a lower postprandial glycemia (4.872 mmol/ L) at T120<sub>min</sub>. An increase in the proportion of beans is therefore recommended as it may suggest a beneficial metabolic effect.
文摘Objective:To investigate the relation between sleep quality and glycemic control among type 2 diabetic patients.Methods:Across sectional descriptive design was used;the study sample including 125 diabetic patients was recruited at diabetic clinics in Zagazig University hospitals.The interview questionnaire sheet consists of 4 par ts:(1)demographic data,(2)medical history,(3)an Arabic version of the Pittsburgh sleep quality index(PSQI),and(4)glycated hemoglobin A1c(Hb A1c)analysis test.Results:The mean of sleep duration was the highest score of PSQI components,96.8%of diabetic patients had poor sleep quality,and 90.4%of diabetic patients had poor glycemic control.A highly statistically significant relationship was found between Hb A1c and sleep quality.Moreover,income,duration of disease and smoking were independent positive predictors of Hb A1c level,while the female gender was a statistically significant negative predictor.Additionally,female gender and income were statistically significant independent positive predictors of PSQI score.Conclusions:Poor sleep quality and poor glycemic control were very common among type 2 diabetic patients.There was a highly significant relation between sleep quality and glycemic control.
文摘Recently, people suffer from the inability to maintain weight with an increasing body mass, and this may be due to several reasons, including the type and quantity of food. In current study, the effect of the glycemic index of foods (high-low-medium) on the speed of return of hunger in adult women was discussed. Non-pregnant or lactating women who do not suffer from chronic diseases such as diabetes and pressure, for three days in a row for breakfast, lunch, and dinner, by calculating the number of hours preceding the feeling of hunger, as the results showed that the least hours of hunger were after eating foods with a low glycemic index and then followed by foods with a medium glycemic index, and the number of hours of starvation after eating foods with a high glycemic index was the least, and this leads to an increase in subsequent food intake and an increase in calories during the day. The results indicated: first day that are high in the glycemic index (breakfast). Highest percentage of feeling hungry was 30% after 4 h (lunch). The highest percentage of feeling hungry was 30% after 3 h, (dinner), the highest percentage of not feeling hungry by 50%. The second day with a low glycemic index (breakfast). The highest percentage of feeling hungry after 4 h was 30%, (lunch). The highest percentage of feeling hungry after 4 h was 30%, (dinner). The highest percentage of not feeling hungry was 80%. Third day with a medium glycemic index (breakfast). The highest percentage of feeling hungry was after 3 h and 4 h, with a percentage of 30%, (lunch), the highest percentage of feeling hungry after 4 h, with a percentage of 30%, (dinner), the highest percentage of not feeling hungry by 70%, which increases body mass and weight continuously, and this leads to an increase in vulnerability to chronic diseases. Therefore, it is important to preserve and be careful to eat meals with a low and medium glycemic index in the diets, with the addition of foods with a high glycemic index, without negligence or excess, and we look forward to increasing the research on the effect of the glycemic index of food on the speed of return of hunger while standardizing the quantity and type of food for all volunteers.
文摘Background: A randomized cross-over study was conducted to assess the glycemic index (GI) of seven Oral Nutritional Supplements (ONSs). These ONSs are designed to support the nutritional requirements of different age-groups, physiological states, or health conditions among Indian adults. Methods: The study had two phases viz., phase1 (n = 18) studied two ONSs: A1 and B1 and phase 2 (n = 20) studied five ONSs: A2, B2, C2, D2 & E2. The subjects were healthy, non-diabetic adults, aged between 20 - 44 years with a mean Body Mass Index of 21.2 ± 1.52 kg/m<sup>2</sup> (Phase 1) and 21.0 ± 1.45 kg/m<sup>2</sup> (Phase 2). All these ONSs were compared with reference drinks (glucose). The carbohydrates in one serving of each ONS were matched to carbohydrates from 25 grams of glucose following ISO 2010 guidelines. Capillary blood was assessed for blood glucose response at baseline, 15, 30, 45, 60, 90 and 120 minutes. GI was calculated as the incremental area under the curve (iAUC) for the test drinks and expressed as a percentage of the average iAUC from glucose. Results: Phase 1 indicated that the high fiber diabetes-specific nutrition supplement A1 with higher protein (23% energy), higher fat (25% energy) and reduced carbohydrates (40% energy) had a significantly (p = 0.002) lower GI [34 (±6)] as compared to B1 [63 (±7)] (protein 19%, fat 7% and carbohydrates 60% energy) even with similar amount (22%) and type of fiber. Phase 2 reported that all test products [A2 (32 ± 5), B2 (37 ± 4), C2 (31 ± 5), D2 (31 ± 5) and E2 (55 ± 4)] had a low GI. As compared to phase 1, ONSs in phase 2 had lower fiber content (1.6% - 4.6% energy). Conclusion: The glycemic index of oral nutrition supplements is influenced not only by their fiber content, but also by the overall macronutrient composition including protein (≥17% energy), fat (≥10% - 27% energy) and carbohydrates (40% - 57.5% energy).
文摘The benchmark for assessing quality of long-term glycemic control and adjustment of therapy is currently glycated hemoglobin(Hb A1c). Despite its importance as an indicator for the development of diabeticcomplications, recent studies have revealed that this metric has some limitations; it conveys a rather complex message, which has to be taken into consideration for diabetes screening and treatment. On the basis of recent clinical trials, the relationship between Hb A1 c and cardiovascular outcomes in long-standing diabetes has been called into question. It becomes obvious that other surrogate and biomarkers are needed to better predict cardiovascular diabetes complications and assess efficiency of therapy. Glycated albumin, fructosamin, and 1,5-anhydroglucitol have received growing interest as alternative markers of glycemic control. In addition to measures of hyperglycemia, advanced glucose monitoring methods became available. An indispensible adjunct to Hb A1 c in routine diabetes care is selfmonitoring of blood glucose. This monitoring method is now widely used, as it provides immediate feedback to patients on short-term changes, involving fasting, preprandial, and postprandial glucose levels. Beyond the traditional metrics, glycemic variability has been identified as a predictor of hypoglycemia, and it might also be implicated in the pathogenesis of vascular diabetes complications. Assessment of glycemic variability is thus important, but exact quantification requires frequently sampled glucose measurements. In order to optimize diabetes treatment, there is a need for both key metrics of glycemic control on a day-to-day basis and for more advanced, user-friendly monitoring methods. In addition to traditional discontinuous glucose testing, continuous glucose sensing has become a useful tool to reveal insufficient glycemic management. This new technology is particularly effective in patients with complicated diabetes and provides the opportunity to characterize glucose dynamics. Several continuous glucose monitoring(CGM) systems, which have shown usefulness in clinical practice, are presently on the market. They can broadly be divided into systems providing retrospective or real-time information on glucose patterns. The widespread clinical application of CGM is still hampered by the lack of generallyaccepted measures for assessment of glucose profiles and standardized reporting of glucose data. In this article, we will discuss advantages and limitations of various metrics for glycemic control as well as possibilities for evaluation of glucose data with the special focus on glycemic variability and application of CGM to improve individual diabetes management.
基金Supported by General Research Fund from Research Grants Committee of The Government of the Hong Kong SAR,China, No.4440178
文摘AIM:To determine the glycemic index(GI)and glycemic load(GL)values of Chinese traditional foods in Hong Kong.METHODS:Fifteen healthy subjects(8 males and 7 females)volunteered to consume either glucose or one of 23 test foods after 10-14 h overnight fast.The blood glucose concentrations were analyzed immediately before,15,30,45,60,90 and 120 min after food consumption using capillary blood samples.The GI value of each test food was calculated by expressing the incremental area under the blood glucose response curve(IAUC)value for the test food as a percentage of each subject's average IAUC value for the glucose.The GL value of each test food was calculated as the GI value of the food multiplied by the amount of the available carbohydrate in a usual portion size,divided by 100.RESULTS:Among all the 23 Chinese traditional foods tested,6 of them belonged to low GI foods(Tuna Fish Bun,Egg Tart,Green Bean Dessert,Chinese Herbal Jelly,Fried Rice Vermicelli in Singapore-style,and Spring Roll),10 of them belonged to moderate GI foods(Baked Barbecued Pork Puff,Fried Fritter,"Mai-Lai"Cake,"Pineapple"Bun,Fried Rice Noodles with Sliced Beef,Barbecue Pork Bun,Moon Cakes,Glutinous Rice Ball,Instant Sweet Milky Bun,and Salted Meat Rice Dumpling),the others belonged to high GI foods(Fried Rice in Yangzhou-Style,Sticky Rice Wrapped in Lotus Leaf,Steamed Glutinous Rice Roll,Jam and Peanut Butter Toast,Plain Steamed Vermicelli Roll,Red Bean Dessert,and Frozen Sweet Milky Bun).CONCLUSION:The GI and GL values for these Chinese traditional foods will provide some valuable information to both researchers and public on their food preference.
基金supported by grants from the Ministry of Science and Technology of the People’s Republic of China[grant nos.2016YFC1305600,2016YFC1305202,2016YFC1304904,2017YFC1310700,2018YFC1311800]the National Natural Science Foundation of China[grant nos.81970706,81970691,81970728,81800683]。
文摘Objective The relationship between serum uric acid(SUA)levels and glycemic indices,including plasma glucose(FPG),2-hour postload glucose(2 h-PG),and glycated hemoglobin(HbA1 c),remains inconclusive.We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.Methods The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study.A total of 105,922 community-dwelling adults aged≥40 years underwent the oral glucose tolerance test and uric acid assessment.The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.Results A total of 30,941 men and 62,361 women were eligible for the current analysis.Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels,but with different inflection points in men and women.The thresholds for FPG,2 h-PG,and HbA1 c for men and women were 6.5/8.0 mmol/L,11.0/14.0 mmol/L,and 6.1/6.5,respectively(SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes,while the inflection points were reached earlier in men than in women.
文摘This study aimed to investigate the effect of yam flour substitution (Dioscorea alata L.) and moringa powder in wheat bread on glycemic response. Glycemic index (GI) and glycemic load (GL) of pieces of bread were determined. A mixture plan design was used to determine the optimal formulation of bread made of yam flour, wheat flour and moringa powder. The mixture of 79.4% soft wheat flour, 20% yam flour and 0.6% moringa leaves powder has a good potential in bread preparation and was used in this study. 100% wheat bread was used as control. Postprandial blood glucose response (glycemic response) was evaluated with the glucose used as a reference food. Blood glucose responses were measured at different intervals for 2 hours. The results indicated that composite bread had low GI and GL values than wheat bread. Values are GI = 80 and GL = 61.2 for wheat bread and GI = 37.78 and GL = 29.65 for the composite bread. This study demonstrated that the inclusion of yam flour of moringa leaves powder in bread production might not pose a threat to blood glucose response compared to wheat bread. These pieces of bread could be included easily in diabetics’ and non-diabetics diet.
文摘Background: Postprandial plasma glucose concentration is an important diabetes management target. Glycemia-targeted specialized-nutrition (GTSN) beverages, containing various quantities and types of carbohydrates (CHO), have been formulated to blunt postprandial hyperglycemia. The objective of this research was to evaluate the effectiveness of these products on postprandial glycemic and hormonal responses based on comparisons of GTSN with differing carbohydrate quantities or types. Methods: In two randomized, double-blind, crossover studies, participants (mean age 61 years) with type 2 diabetes consumed GTSN in a meal tolerance test. In the CHO Quantity Study, a standard nutritional beverage (STD) was compared to a low carbohydrate nutritional beverage with tapioca dextrin (GTSN-TDX) and a balanced carbohydrate nutritional beverage containing a blend of the slowly-digesting carbohydrates maltodextrin and sucromalt (GTSN-SDC). In the CHO Type Study, the GTSN beverages had similar carbohydrate quantities but varied in carbohydrate composition with GTSN-SDC compared to a formula with tapioca starch and fructose (GTSN-TS&F), and one with isomaltulose and resistant starch (GTSN-I&RS). Postprandial (0-240 min) concentrations of blood glucose, insulin (CHO Quantity Study only) and glucagon-like-peptide (GLP)-1 (CHO Quantity Study only) were measured. Results: Despite having substantially different carbohydrate quantities, the GTSN blunted the glucose positive area under the curve (AUC0-240 min) by 65% to 82% compared to the STD formulation (p < 0.001). GTSN also elicited ~50% lower insulin positive AUC0-240 min (p < 0.05), while postprandial GLP-1 responses were increased (p = 0.018) vs. STD. In the CHO Type Study, glucose positive AUC0-240 min tended to be lower for GTSN-SDC (1477 ± 460) than GTSN-TS&F (2203 ± 412;p = 0.062) and GTSN-I&RS (2190 ± 412;p = 0.076). No differences were observed between GTSN-TS&F and GTSN-I&RS. Conclusions: These results demonstrate the effectiveness of several GTSN products and suggest that both CHO quantity and type play important roles in postprandial glycemic response in men and women with type 2 diabetes. Furthermore, GTSN products containing slow-digesting carbohydrates can blunt postmeal glucose and insulin concentration despite delivering greater total grams of CHO, which provides a dietary benefit for people with diabetes.
基金financed within the Agricultural Produc-tivity Program in West Africa(PPAAO/WAAPP 1B.)Don IDA N˚6260 CI et Don N˚TF 098014 CI by FIRCA(Fonds Interprofessionnel pour la Recherche et le Conseil Agricoles).
文摘Integrating information on the glycemic index (GI) and the glycemic load (GL) of diet is limited in C?te d’Ivoire because of the lack of data. Thus, this study was undertaking for the local management and prevention of diabetes mellitus and its complications based on nutritional data (GI and GL values). The study included ten healthy subjects with 7 males, 3 females (28 ± 2 years on average age and 20.5 ± 1.7 on average BMI). Participants tested three different meals with equal carbohydrate load (50 g). Blood samples were obtained at 0, 15, 30, 45, 60, 90 and 120 min before and after consumption for glucose levels determination. GIs were determined using a standard method with glucose as reference food and data were used for GLs calculating. Data showed that GIs value of pounded yam with eggplant sauce and cassava paste with granulates palm nut sauce were high ranging to 94 to 86 respectively while rice with groundnut sauce, have a low GI (GI = 45). Nevertheless, the GLs of the all the test foods are high with the values of 47, 43 and 23 (g) for pounded yam with eggplant sauce, cassava paste with granulates palm nut sauce and rice with groundnut sauce respectively. According to GIs and GLs data, the three test foods must be consumed moderately in a diet. So, it is important to associate GL data to GI data of Ivorian traditional foods for the management and the prevention of diabetes mellitus in C?te d’Ivoire and in others countries sharing the same food tradition.
基金supported by grants from National Natural Science Foundation of China(No.81570740 and No.81100581)the Ministry of Science and Technology of China(No.2011CB100600)+3 种基金the Science and Technology Projects of Wuhan(No.201060938360-04 from the Wuhan Science and Technology Bureau)China International Medical Foundation(CIMF)--Novo Nordisk China Diabetes Yingcai Funding(No.2014)CIMF-Novo Nordisk China β Academy Funding(No.20110059)the Fundamental Research Funds for the Central Universities(No.0118540208)
文摘Food intake has a great influence on blood glucose in patients with diabetes. This study was to determine the glycemic index(GI) and glycemic load(GL) of a particular pomelo named Majia pomelo and its effects on postprandial glucose(PPG) in patients with type 2 diabetes(T2D). Twenty healthy subjects and 20 T2D patients(controlled on lifestyle measures and/or metformin) were tested on 2 separate days with 50 g of glucose and 50 g equivalent of carbohydrates from Majia pomelo for GI measurement. To test effects of Majia pomelo on PPG, 19 hospitalized T2D patients(controlled on insulin therapy) were selected for a 9-day study. The dose of insulin for each patient was adjusted on the first 3 days. A total of 100 g Majia pomelo was consumed per meal in the last 3 tested days. Blood glucose was measured to evaluate the glycemic excursions. The GIs for Majia pomelo in healthy individuals and T2D patients were 78.34±1.88 and 72.15±1.95 respectively. The value of GL was as low as 4.23 in diabetic patients with serving size of 100 g pomelo, indicting Majia pomelo as a high GI but low GL fruit. Consumption of Majia pomelo in hospitalized T2D patients did not cause significant glucose fluctuation. It was concluded that high GI pomelo can serve as a low GL fruit if it is consumed with a limited daily amount and thus can be supplied to diabetic patients. These results may mean more varieties of food choices for T2D patients.
文摘In order to identify those potatoes which exert a low glycemic impact after processing, eight early potato varieties and four processing methods were evaluated for their total starch content, amylose content, rapidly digestible starch (RDS), slowly digestible starch (SDS), and resistant starch (RS), estimated glycemic index (eGI), glycemic load (eGL) as well as their relationship among each other. While all these profiles were highly dependent on the potato variety and processing methods, all the eight varieties were classified as low GL foods (p ≤ 0.05). A strong positive correlation was observed between eGI and RDS (r = 0.84, 0.79, and 0.74) for retrograded and reheated, baked and microwaved varieties, respectively), whereas a moderate negative correlation was observed between eGI and RS for retrograded and reheated (r = -0.39) and microwaved (-0.37) varieties (p ≤ 0.05). On the basis of these findings, it can be concluded that potato variety, processing methods, and starch characteristics define the eGI and eGL. Furthermore, for the varieties examined, the present study identified RDS as a major starch factor contributing to eGI.
文摘The “bai?o de dois” is a typical Brazilian dish and a rich combination of rice and beans. This preparation has a high nutritional value but its effect on glycemic response is not yet studied. To determine the glycemic index and glycemic load of foods can help prescribing diets and as a result, improving the treatment and prevention of chronic diseases. This study aimed to access the glycemic index (GI) and glycemic load (GL) of “bai?o de dois”. Following the protocol recommended by the Food and Agriculture Organization, 6 volunteers were recruited to perform blood glucose tests. Each volunteer performed three glucose tolerance tests and a test with “bai?o de dois”. All tests were undertaken in separate weeks. Through the calculation of the areas under each of the curves, it was possible to access the GI of “bai?o de dois” by the average values of six GIs found for each volunteer. It was calculated that the GL of each portion tested and recommended servings per capita. It was found that “bai?o de dois” had low GI (44) and GL (6) at the recommended per capita, but high GL (22) at the portion tested (bigger than the recommended). The “bai?o de dois” do not present a potential risk for developing chronic diseases, but it is recommended consumption to be monitored.
文摘The diabetes mellitus is a public health problem in C?te d’Ivoire. The Glycemic index (GI) and the Glycemic load (GL) determination of commonly consumed foods such as juice fruits is an alternative to prevent metabolic diseases. This study carried out three wild fruits locally named Baobab (Adansonia digitata), Tomi (Tamarindus indica) and Néré (Parkia biglobosa) collected at maturity stage. The juices from the pulp of fruits have been elaborated, pasteurized, submitted to microbiological and physicochemical analysis before GIs/GLs determination. Ten healthy subjects with body mass index and age average respectively 21.57 ± 1.06 and 28 ± 2 years old tested the three juices and glucose (50 g) as reference food. Blood samples have been collected at 0, 15, 30, 45, 60, 90 and 120 min after foods consumption. The GIs/GLs has been determined according to ISO/FDI 26642:2010 protocol. Data showed that pasteurized juices has a weak microbiologic load (1.0102 - 2.4102 of Mesophylls Aerobic Germs) and not contain pathogen germs. The GI and GL of Néré juice are high with respective values of 89.54 ± 1.63 and 29.22 ± 4.09 whereas those of Baobab and Tomi juice are moderate with respective GI/GL values of 66.48 ± 2.12/13.24 ± 1.99 and 60.41 ± 2.63/12.87 ± 1.67. The juice of Néré should be consumed occasionally when those of Baobab and Tomi should be consumed with moderation. It would be suitable to know more about the GI and GL of all the juice fruits produced locally so as to prevent efficiently diabetes mellitus in the country.
