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Sample records for achieve tight glycemic

  1. Tight glycemic control in the ICU - is the earth flat?

    Steil, Garry M.; Agus, Michael SD

    2014-01-01

    Tight glycemic control in the ICU has been shown to reduce mortality in some but not all prospective randomized control trials. Confounding the interpretation of these studies are differences in how the control was achieved and underlying incidence of hypoglycemia, which can be expected to be affected by the introduction of continuous glucose monitoring (CGM). In this issue of Critical Care, a consensus panel provides a list of the research priorities they believe are needed for CGM to become...

  2. Tight glycemic control in the ICU - is the earth flat?

    Steil, Garry M; Agus, Michael S D

    2014-01-01

    Tight glycemic control in the ICU has been shown to reduce mortality in some but not all prospective randomized control trials. Confounding the interpretation of these studies are differences in how the control was achieved and underlying incidence of hypoglycemia, which can be expected to be affected by the introduction of continuous glucose monitoring (CGM). In this issue of Critical Care, a consensus panel provides a list of the research priorities they believe are needed for CGM to become routine practice in the ICU. We reflect on these recommendations and consider the implications for using CGM today. PMID:25041720

  3. Tight glycemic control: what do we really know, and what should we expect?

    Nasraway, Stanley A; Rattan, Rishi

    2010-01-01

    Tight glycemic control has engendered large numbers of investigations, with conflicting results. The world has largely embraced intensive insulin as a practice, but applies this therapy with great variability in the manner of glucose control and measurement. The present commentary reviews what we actually know with certainty from this vast sea of literature, and what we can expect looking forward.

  4. Multifaceted Determinants for Achieving Glycemic Control

    Chan, Juliana C N; Gagliardino, Juan Jose; Baik, Sei Hyun; Chantelot, Jean-Marc; Ferreira, Sandra R.G.; Hancu, Nicolae; Ilkova, Hasan; Ramachandran, Ambady; Aschner, Pablo; . .

    2009-01-01

    OBJECTIVE—The International Diabetes Mellitus Practice Study is a 5-year survey documenting changes in diabetes treatment practice in developing regions. RESEARCH DESIGN AND METHODS—Logistic regression analysis was used to identify factors for achieving A1C

  5. Outcome of tight versus standard glycemic control in coronary artery bypass patients

    Objectives: To compare the outcome of tight versus standard glycemic control and its impact on post operative morbidity and short term mortality in patients undergoing Coronary Artery Bypass Grafting (CA-BG). Patients and Methods: A prospective surveillance of 124 patients undergoing isolated CABG surgery (on pump) was included in the study, 62 patients in each group were randomly assigned to tight and standard glucose control group. The main exposure was insulin in respect to level of blood glucose and the primary outcome measures were Sternotomy wound infection, Leg wound infection and new Myocardial Infarction. Surgical Site infection was assessed on a daily basis during the patient's stay in the Department of Cardio-thoracic Surgery, Sheikh Zayed Hospital, Lahore or within 30 days of operation prompting the patient to return to the hospital. Chi-square test or test was used to identify the significance of various short term morbidities and mortality. Results: In this study, 12 patients in the standard group and 4 patients in the tightly controlled group developed Sternal wound infection (p value 0.046). Similarly, 9 versus 2 patients in the standard and tight group respectively developed Leg wound infection (p-value 0.035). Test of proportion was applied and it was found that there was significant difference in the pro-portion of infection in the two groups (p value 0.05). However, there were no significant differences in other morbidities and the short term mortality. Conclusion: Study confirmed that tight glucose con-trol post operatively in CABG patient's results in reduced sternal and leg wound infection rates; however, there was no effect on other morbidities and short term mortality. (author)

  6. Second pilot trials of the STAR-Liege protocol for tight glycemic control in critically ill patients

    Penning Sophie

    2012-08-01

    Full Text Available Abstract Background Critically ill patients often present increased insulin resistance and stress-induced hyperglycemia. Tight glycemic control aims to reduce blood glucose (BG levels and variability while ensuring safety from hypoglycemia. This paper presents the results of the second Belgian clinical trial using the customizable STAR framework in a target-to-range control approach. The main objective is reducing measurement frequency while maintaining performance and safety of the glycemic control. Methods The STAR-Liege 2 (SL2 protocol targeted the 100–140 mg/dL glycemic band and offered 2-hourly and 3-hourly interventions. Only insulin rates were adjusted, and nutrition inputs were left to the attending clinicians. This protocol restricted the forecasted risk of BG  Results During the SL2 trial, 91 measurements were taken over 194 hours. BG levels were tightly distributed: 54.9% of BG within 100–140 mg/dL, 40.7% were ≥ 140 mg/dL and 4.4% were  0.05 with significantly reduced measurement frequency for SL2 (p  Conclusions The SL2 protocol succeeded in reducing clinical workload while maintaining safety and effectiveness of the glycemic control. SL2 was also shown to be safer and tighter than hospital control. Overall results validate the efficacy of significantly customizing the STAR framework.

  7. Validation of a model-based virtual trials method for tight glycemic control in intensive care

    Shaw Geoffrey M

    2010-12-01

    Full Text Available Abstract Background In-silico virtual patients and trials offer significant advantages in cost, time and safety for designing effective tight glycemic control (TGC protocols. However, no such method has fully validated the independence of virtual patients (or resulting clinical trial predictions from the data used to create them. This study uses matched cohorts from a TGC clinical trial to validate virtual patients and in-silico virtual trial models and methods. Methods Data from a 211 patient subset of the Glucontrol trial in Liege, Belgium. Glucontrol-A (N = 142 targeted 4.4-6.1 mmol/L and Glucontrol-B (N = 69 targeted 7.8-10.0 mmol/L. Cohorts were matched by APACHE II score, initial BG, age, weight, BMI and sex (p > 0.25. Virtual patients are created by fitting a clinically validated model to clinical data, yielding time varying insulin sensitivity profiles (SI(t that drives in-silico patients. Model fit and intra-patient (forward prediction errors are used to validate individual in-silico virtual patients. Self-validation (tests A protocol on Group-A virtual patients; and B protocol on B virtual patients and cross-validation (tests A protocol on Group-B virtual patients; and B protocol on A virtual patients are used in comparison to clinical data to assess ability to predict clinical trial results. Results Model fit errors were small ( Self and cross validation results were within 1-10% of the clinical data for both Group-A and Group-B. Self-validation indicated clinically insignificant errors due to model and/or clinical compliance. Cross-validation clearly showed that virtual patients enabled by identified patient-specific SI(t profiles can accurately predict the performance of independent and different TGC protocols. Conclusions This study fully validates these virtual patients and in silico virtual trial methods, and clearly shows they can accurately simulate, in advance, the clinical results of a TGC protocol, enabling rapid in silico

  8. Glucose Information for Tight Glycemic Control: Different Methods with Different Challenges

    Weber, Christian; Neeser, Kurt

    2010-01-01

    Rigorous glucose control is essential for prevention of diabetes-related complications in diabetes patients. Even without diabetes, tight glucose control is beneficial in hospitalized, critically ill patients.

  9. Link between Hypoglycemia and Cardiac Arrhythmias: An Answer to Why Tight Glycemic Control May Increase Mortality in ...

    ... Size: A A A Listen The Link Between Hypoglycemia and Cardiac Arrhythmias: An Answer to Why Tight ... from the University of Sheffield found that overnight hypoglycemia was associated with increased susceptibility to cardiac arrhythmias ...

  10. Tight glycemic control in critical care--the leading role of insulin sensitivity and patient variability: a review and model-based analysis.

    Chase, J Geoffrey; Le Compte, Aaron J; Suhaimi, Fatanah; Shaw, Geoffrey M; Lynn, Adrienne; Lin, Jessica; Pretty, Christopher G; Razak, Normy; Parente, Jacquelyn D; Hann, Christopher E; Preiser, Jean-Charles; Desaive, Thomas

    2011-05-01

    Tight glycemic control (TGC) has emerged as a major research focus in critical care due to its potential to simultaneously reduce both mortality and costs. However, repeating initial successful TGC trials that reduced mortality and other outcomes has proven difficult with more failures than successes. Hence, there has been growing debate over the necessity of TGC, its goals, the risk of severe hypoglycemia, and target cohorts. This paper provides a review of TGC via new analyses of data from several clinical trials, including SPRINT, Glucontrol and a recent NICU study. It thus provides both a review of the problem and major background factors driving it, as well as a novel model-based analysis designed to examine these dynamics from a new perspective. Using these clinical results and analysis, the goal is to develop new insights that shed greater light on the leading factors that make TGC difficult and inconsistent, as well as the requirements they thus impose on the design and implementation of TGC protocols. A model-based analysis of insulin sensitivity using data from three different critical care units, comprising over 75,000h of clinical data, is used to analyse variability in metabolic dynamics using a clinically validated model-based insulin sensitivity metric (S(I)). Variation in S(I) provides a new interpretation and explanation for the variable results seen (across cohorts and studies) in applying TGC. In particular, significant intra- and inter-patient variability in insulin resistance (1/S(I)) is seen be a major confounder that makes TGC difficult over diverse cohorts, yielding variable results over many published studies and protocols. Further factors that exacerbate this variability in glycemic outcome are found to include measurement frequency and whether a protocol is blind to carbohydrate administration. PMID:21145614

  11. Motor vehicle crashes in diabetic patients with tight glycemic control: a population-based case control analysis.

    Donald A Redelmeier

    2009-12-01

    Full Text Available BACKGROUND: Complications from diabetes mellitus can compromise a driver's ability to safely operate a motor vehicle, yet little is known about whether euglycemia predicts normal driving risks among adults with diabetes. We studied the association between glycosylated hemoglobin (HbA1c and the risk of a motor vehicle crash using a population-based case control analysis. METHODS AND FINDINGS: We identified consecutive drivers reported to vehicle licensing authorities between January 1, 2005 to January 1, 2007 who had a diagnosis of diabetes mellitus and a HbA1c documented. The risk of a crash was calculated taking into account potential confounders including blood glucose monitoring, complications, and treatments. A total of 57 patients were involved in a crash and 738 were not involved in a crash. The mean HbA1c was lower for those in a crash than controls (7.4% versus 7.9%, unpaired t-test, p = 0.019, equal to a 26% increase in the relative risk of a crash for each 1% reduction in HbA1c (odds ratio = 1.26, 95% confidence interval 1.03-1.54. The trend was evident across the range of HbA1c values and persisted after adjustment for measured confounders (odds ratio = 1.25, 95% confidence interval 1.02-1.55. The two other significant risk factors for a crash were a history of severe hypoglycemia requiring outside assistance (odds ratio = 4.07, 95% confidence interval 2.35-7.04 and later age at diabetes diagnosis (odds ratio per decade = 1.29, 95% confidence interval 1.07-1.57. CONCLUSIONS: In this selected population, tighter glycemic control, as measured by the HbA1c, is associated with an increased risk of a motor vehicle crash.

  12. Achieving glycemic control in elderly patients with type 2 diabetes: a critical comparison of current options

    Du YF

    2014-11-01

    Full Text Available Ye-Fong Du,1 Horng-Yih Ou,1 Elizabeth A Beverly,2 Ching-Ju Chiu3 1Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; 2Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA; 3Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan Abstract: The prevalence of type 2 diabetes mellitus (T2DM is increasing in the elderly. Because of the unique characteristics of elderly people with T2DM, therapeutic strategy and focus should be tailored to suit this population. This article reviews the guidelines and studies related to older people with T2DM worldwide. A few important themes are generalized: 1 the functional and cognitive status is critical for older people with T2DM considering their life expectancy compared to younger counterparts; 2 both severe hypoglycemia and persistent hyperglycemia are deleterious to older adults with T2DM, and both conditions should be avoided when determining therapeutic goals; 3 recently developed guidelines emphasize the avoidance of hypoglycemic episodes in older people, even in the absence of symptoms. In addition, we raise the concern of glycemic variability, and discuss the rationale for the selection of current options in managing this patient population. Keywords: glycemic target, glycemic variability, blood glucose, frailty

  13. Utility of indices using C‐peptide levels for indication of insulin therapy to achieve good glycemic control in Japanese patients with type 2 diabetes

    Funakoshi, Shogo; Fujimoto, Shimpei; Hamasaki, Akihiro; Fujiwara, Hideya; Fujita, Yoshihito; Ikeda, Kaori; Takahara, Shiho; Nagashima, Kazuaki; Hosokawa, Masaya; Seino, Yutaka; Inagaki, Nobuya

    2011-01-01

    Abstract Aims/Introduction:  Type 2 diabetes is progressive in that therapy must be altered over time, which is partly as a result of the progressive loss of pancreatic β‐cell function. To elucidate the relationship between residual endogenous insulin secretion and the necessity of insulin therapy to achieve good glycemic control, indices using serum C‐peptide immunoreactivity (CPR) were analyzed in patients with type 2 diabetes. Materials and Methods:  The data of 201 Japanese patients with ...

  14. Design and Fabrication of Double-Focused Ultrasound Transducers to Achieve Tight Focusing.

    Jang, Jihun; Chang, Jin Ho

    2016-01-01

    Beauty treatment for skin requires a high-intensity focused ultrasound (HIFU) transducer to generate coagulative necrosis in a small focal volume (e.g., 1 mm³) placed at a shallow depth (3-4.5 mm from the skin surface). For this, it is desirable to make the F-number as small as possible under the largest possible aperture in order to generate ultrasound energy high enough to induce tissue coagulation in such a small focal volume. However, satisfying both conditions at the same time is demanding. To meet the requirements, this paper, therefore, proposes a double-focusing technique, in which the aperture of an ultrasound transducer is spherically shaped for initial focusing and an acoustic lens is used to finally focus ultrasound on a target depth of treatment; it is possible to achieve the F-number of unity or less while keeping the aperture of a transducer as large as possible. In accordance with the proposed method, we designed and fabricated a 7-MHz double-focused ultrasound transducer. The experimental results demonstrated that the fabricated double-focused transducer had a focal length of 10.2 mm reduced from an initial focal length of 15.2 mm and, thus, the F-number changed from 1.52 to 1.02. Based on the results, we concluded that the proposed double-focusing method is suitable to decrease F-number while maintaining a large aperture size. PMID:27509500

  15. Development of a patient decision aid for type 2 diabetes mellitus for patients not achieving glycemic control on metformin alone

    Shillington AC

    2015-04-01

    Full Text Available Alicia C Shillington,1 Nananda Col,2 Robert A Bailey,3 Mark A Jewell11EPI-Q, Inc., Oak Brook, IL, USA; 2Shared Decision-making Resources, Georgetown, ME, USA; 3Janssen Scientific Affairs, LLC, Raritan, NJ, USAPurpose: To describe the process used to develop an evidence-based patient decision aid (PDA that facilitates shared decision-making for treatment intensification in inadequately controlled type 2 diabetes mellitus (T2DM consistent with International Patient Decision Aids Standards.Methods: A PDA was developed by a multidisciplinary steering committee of clinicians, patient advocate, nurse, certified diabetes educators, and decision scientist, using a systematic development process. The process included defining the PDA scope and purpose, outlining the framework, content creation, and designing for integration into clinical practice. This was accomplished through a review of the literature and publically available educational materials and input from practicing clinicians and patients during development and iteratively refining content based on input. Patients with poorly controlled T2DM on metformin considering additional medication assessed the PDA during a pilot.Results: Testing identified six preference-sensitive domains important for choosing T2DM treatment: degree of glycemic response, avoiding weight gain, hypoglycemia risk and other adverse events, avoiding injections, convenience of dose administration, blood glucose monitoring, and cost of therapy. Patient feedback guided content revision. Treatment options were offered after presenting medication class risk–benefit information and eliciting patient values, goals, and preferences. The PDA received the highest International Patient Decision Aids Standards global score to date, 88/100, with 100% of criteria fully met for the following dimensions: development process, disclosures, evaluation process, evidence quality, guidance for users, information quality, language

  16. Glycemic Index and Diabetes

    ... A A Listen En Español Glycemic Index and Diabetes The glycemic index, or GI, measures how a ... 08-book-sabores-de-cuba.html More from diabetes.org Shopdiabetes.org: Take the Guesswork out of ...

  17. The Glycemic Index

    Williams, Pauline; Stubbs, Wendy

    2003-01-01

    The glycemic index is a ranking of carbohydrate containing foods. Foods are ranked according to their immediate effect on blood sugar levels. The higher a food raises blood sugar, the higher its glycemic index

  18. CARDIOVASCULAR IMPACT OF GLYCEMIC CONTROL IN DIABETES

    Biswajit

    2014-01-01

    Full Text Available While type 1 Diabetes Mellitus (DM is characterized by insulin deficiency due to pancreatic beta cell destruction , type 2 DM is characterized by a state of long standing insulin resistance (IR , compensatory hyperinsulinemia and varying degrees of elevated plasma glucose (PG , associated with clustering of cardiovascular (CV risk and development of macrovascular disease prior to diagnosis of D M. Coronary artery disease (CAD accounts for 70% of mortality and morbidity in patients with diabetes. Studies made in diabetes care have helped prevent or reduce microvascular complications in both type 1 and 2 diabetes. However the same cannot be said a bout macrovascular disease. Despite all data concerning the association of diabetes and cardiovascular disease (CVD , the exact mechanism by which diabetes is linked to atherosclerosis is incompletely understood , this is especially true in case of hypergly cemia. The positive effect of intensive glucose management in comparison to non - intensive glucose control is far from proven. DCCT and UKPDS study have shown that while a glycemic control is important for reaching long term macrovascular complications , ear ly glucose control is far more rewarding (metabolic memory.Later trials like ACCORD , ADVANCE and VADT don’t advocate tight glycemic control. In fact , ACCORD trial has shown increased mortality with tight glucose control. Tight glucose control may be benef icial in selected patients with short disease duration , long life expectancy and no CVD. In critically ill patients a blood glucose target of 140 - 180 mg % is fairly reasonable and achievable. The ESC/EASD guidelines of October 2013 , l ike those of ADA , AHA and ACC continue to endorse a treatment target for glucose control in diabetes of HbAlc < 7% , based predominantly on microvascular disease with acknowledged uncertainty regarding the effect of the intensive glucose control on CVD risk. Management of hyperg lycemia in diabetics should

  19. Counting Carbs? Understanding Glycemic Index and Glycemic Load

    ... link, please review our exit disclaimer . Subscribe Counting Carbs? Understanding Glycemic Index and Glycemic Load You’ve ... The glycemic index and load concern carbohydrates, or carbs—one of the main types of nutrients in ...

  20. Improving Care in Older Patients with Diabetes: A Focus on Glycemic Control.

    Lee, Eric A; Gibbs, Nancy E; Martin, John; Ziel, Fred; Polzin, Jennifer K; Palmer-Toy, Darryl

    2016-01-01

    Diabetes affects more than 25% of Americans older than age 65 years. The medical care of older patients must differ from the care of their younger counterparts. Older patients are at high risk of drug toxicity. A hemoglobin A1c (HbA1c) level less than 7.0% has historically been the goal of all patients with diabetes, regardless of age. Recent research has demonstrated that using medications to achieve such tight glycemic control is not necessary and is often not safe.This article discusses the seminal research findings that strongly suggest that HbA1c goals should be relaxed in older patients. The authors then recommend an age-specific and functionally appropriate HbA1c reference range for patients receiving medications to improve glycemic control. Other interventions are suggested that should make diabetes care safer in older patients receiving hypoglycemic medications. PMID:27352408

  1. Relationship between perioperative glycemic control and postoperative infections

    Kazuhiro Hanazaki; Hiromichi Maeda; Takehiro Okabayashi

    2009-01-01

    Perioperative hyperglycemia in critically ill surgery patients increases the risk of postoperative infection (POI), which is a common, and often costly, surgical complication. Hyperglycemia is associated with abnormalities in leukocyte function, including granulocyte adherence, impaired phagocytosis, delayed chemotaxis,and depressed bactericidal capacity. These leukocyte deficiencies are the cause of infection and improve with tight glycemic control, which leads to fewer POIs in critically ill surgical patients. Tight glycemic control, such as intensive insulin therapy, has a risk of hypoglycemia.In addition, the optimal targeted blood glucose range to reduce POI remains unknown. Since 2006, we have investigated tight perioperative blood glucose control using a closed-loop artificial endocrine pancreas system,to reduce POI and to avoid hypoglycemia. In this Topic Highlight, we review the relationship between perioperative glycemic control and POI, including the use of the artificial pancreas.

  2. Tight turns

    Anaïs Schaeffer

    2012-01-01

    The Italian National Institute for Nuclear Physics (INFN) has successfully tested the first model of a new fast-ramping curved dipole magnet. This is great news for CERN, which sees the advance as holding potential for the future of the SPS.   The first model of a new fast-ramping curved dipole magnet being prepared for cryogenic testing at the LASA laboratory (INFN Milano, Italy). On 16 July INFN introduced an innovative dipole magnet. With a length of some 4 metres, it can produce a 4.5 Tesla magnetic field and achieve a tighter bend than ever before (the bending radius has been squeezed to a remarkable 66.7 metres). This new magnet was designed in the first instance for GSI’s SIS300 synchrotron (in Germany), which will require 60 dipoles of this type. "Achieving such a tight bend demanded a major R&D effort," stressed Pasquale Fabbricatore, the spokesman of the INFN collaboration responsible for the magnet’s development. "We had to not o...

  3. The Glycemic Index

    Williams, Pauline

    2004-01-01

    The glycemic index is a ranking of carbohydrate containing foods. Foods are ranked according to their immediate effect on blood sugar levels. The higher a f ood raises blood sugar, the higher its glycemic index. Scientists published the first index in 1981 when they were researching diet therapy for diabetes. This first list contained 51 foods, and the list has continued to expand, with the most recent official list containing 750 foods. Fruits, grains, dairy products, some vegetables, pastas...

  4. Three pillars for achieving quantum mechanical molecular dynamics simulations of huge systems: Divide-and-conquer, density-functional tight-binding, and massively parallel computation.

    Nishizawa, Hiroaki; Nishimura, Yoshifumi; Kobayashi, Masato; Irle, Stephan; Nakai, Hiromi

    2016-08-01

    The linear-scaling divide-and-conquer (DC) quantum chemical methodology is applied to the density-functional tight-binding (DFTB) theory to develop a massively parallel program that achieves on-the-fly molecular reaction dynamics simulations of huge systems from scratch. The functions to perform large scale geometry optimization and molecular dynamics with DC-DFTB potential energy surface are implemented to the program called DC-DFTB-K. A novel interpolation-based algorithm is developed for parallelizing the determination of the Fermi level in the DC method. The performance of the DC-DFTB-K program is assessed using a laboratory computer and the K computer. Numerical tests show the high efficiency of the DC-DFTB-K program, a single-point energy gradient calculation of a one-million-atom system is completed within 60 s using 7290 nodes of the K computer. © 2016 Wiley Periodicals, Inc. PMID:27317328

  5. Relationship between perioperative glycemic control and postoperative infections

    Hanazaki, Kazuhiro; Maeda, Hiromichi; Okabayashi, Takehiro

    2009-01-01

    Perioperative hyperglycemia in critically ill surgery patients increases the risk of postoperative infection (POI), which is a common, and often costly, surgical complication. Hyperglycemia is associated with abnormalities in leukocyte function, including granulocyte adherence, impaired phagocytosis, delayed chemotaxis, and depressed bactericidal capacity. These leukocyte deficiencies are the cause of infection and improve with tight glycemic control, which leads to fewer POIs in critically i...

  6. Glycemic control in cardiac surgery: Rationale and current evidence

    G Girish

    2014-01-01

    Full Text Available Studies in cardiac surgical patients have shown an association of hyperglycemia with increased incidences of sepsis, mediastinitis, prolonged mechanical ventilation, cardiac arrhythmias and longer intensive care and hospital stay. There is considerable controversy regarding appropriate glycemic management in these patients and in the definition of hyperglycemia and hypoglycemia or the blood sugar levels at which therapy should be initiated. There is also dilemma regarding the usage of "tight glycemic control" with studies showing conflicting evidences. Part of the controversy can be explained by the differing designs of these studies and the variable definitions of hyperglycemia and hypoglycemia.

  7. Glycemic index, glycemic load and childhood obesity: A systematic review

    Mohammad Hossein Rouhani

    2014-01-01

    Full Text Available Background: Several evidences have been reported so far in terms of the relationship between obesity and glycemic index and glycemic load in children. However, the number of review studies that have dealt with recent findings is quite low. The purpose of present study is to review the existing evidences in this regard. Materials and Methods: First of all, the phrases: "Glycaemic index", "Glycaemic load", "Glycemic index" OR "Glycemic load" accompanied by one of the words: "Adolescent", "Young", "Youth" "Children" OR "Child" were searched in texts of articles existing in ISI and PUBMED databases which were obtained out of 1001 articles. Among these, some articles, which reviewed the relationship of obesity with glycemic index and glycemic load, were selected. Finally, 20 articles were studied in current review study. Results: The majority of cross-sectional studies have found children′s obesity directly linked with glycemic index and glycemic load; however, cohort studies found controversial results. Also, the intervention studies indicate the negative effect of glycemic index and glycemic load on obesity in children. Conclusion: Published evidences reported inconsistent results. It seems that existing studies are not sufficient and more studies are needed in this regard.

  8. Alternative Assessment of Glycemic Control

    Greven, W.L.

    2015-01-01

    Diabetes mellitus is a chronic disease associated with development of microvascular and macrovascular complications. Optimal glycemic control, usually measured by HbA1c is the cornerstone for prevention of complications. In this thesis glycemic variability (which resembles actual glucose levels, glucose peaks and nadirs) and advanced glycation end products (AGEs) (a more long-term reflection of hyperglycemia and tissue glycation) are investigated as alternative assessment of glycemic control....

  9. Combination therapy with insulin and oral agents: optimizing glycemic control in patients with type 2 diabetes mellitus.

    Yki-Järvinen, Hannele

    2002-01-01

    The United Kingdom Prospective Diabetes Study (UKPDS) showed that tight glycemic control with any of several therapeutic regimens has the potential to significantly reduce the risk for long-term microvascular complications of type 2 diabetes. An important question that remains to be answered is what is the best approach to optimizing glycemic control in patients with this disease. This article reviews results of studies in which insulin was used alone or in combination with oral antidiabetic agents for treatment of patients with type 2 diabetes. Analysis of comparative studies (13 in insulin-naive and 26 in previously insulin-treated patients) showed that combination therapy involving one to two insulin injections per day plus oral therapy is usually more effective than insulin monotherapy for achieving and maintaining glycemic control. Combination treatment for type 2 diabetes can be significantly improved by newly developed preparations that lack the major limitations of older products. Once-daily administration of isophane insulin (NPH insulin) is limited by a 15-18-h duration of action and a peak effect that occurs about 6 h after injection. Insulin glargine, a new insulin analogue developed using recombinant DNA technology, has a flat pharmacodynamic profile and a 24-h duration of action. Results from a recent comparative study indicate that insulin glargine plus oral therapy may provide better post-dinner glucose control as well as less symptomatic and nocturnal hypoglycemia than oral therapy combined with NPH insulin. The studies reviewed in the present article support the conclusion that combination therapy with insulin glargine combined with one or more oral antidiabetic agents may be the treatment of choice for achieving glycemic control in patients with type 2 diabetes. PMID:12324990

  10. Alternative Assessment of Glycemic Control

    Greven, W.L.

    2015-01-01

    Diabetes mellitus is a chronic disease associated with development of microvascular and macrovascular complications. Optimal glycemic control, usually measured by HbA1c is the cornerstone for prevention of complications. In this thesis glycemic variability (which resembles actual glucose levels, gl

  11. Tight Bernoulli tail probability bounds

    Dzindzalieta, Dainius

    2014-01-01

    The purpose of the dissertation is to prove universal tight bounds for deviation from the mean probability inequalities for functions of random variables. Universal bounds shows that they are uniform with respect to some class of distributions and quantity of variables and other parameters. The bounds are called tight, if we can construct a sequence of random variables, such that the upper bounds are achieved. Such inequalities are useful for example in insurance mathematics, for constructing...

  12. Glycemic index and glycemic load of selected Chinese traditional foods

    Stephen; Heung-sang; Wong

    2010-01-01

    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 respon...

  13. Prime tight frames

    Lemvig, Jakob; Miller, Christopher; Okoudjou, Kasso A.

    2014-01-01

    to suggest effective analysis and synthesis computation strategies for such frames. Finally, we describe all prime frames constructed from the spectral tetris method, and, as a byproduct, we obtain a characterization of when the spectral tetris construction works for redundancies below two.......We introduce a class of finite tight frames called prime tight frames and prove some of their elementary properties. In particular, we show that any finite tight frame can be written as a union of prime tight frames. We then characterize all prime harmonic tight frames and use thischaracterization...

  14. Glycemic load, glycemic index, and body mass index in Spanish adults12345

    Mendez, Michelle A; Covas, Maria Isabel; Marrugat, Jaume; Vila, Joan; Schröder, Helmut

    2008-01-01

    Background: Studies on obesity and glycemic index (GI) or glycemic load (GL) have had inconsistent results, perhaps in part because of underreporting or to heterogeneous dietary patterns across food cultures.

  15. Metabolic responses to high glycemic index and low glycemic index meals: a controlled crossover clinical trial

    Bressan Josefina; Cecon Paulo R.; Marins João CB; Pereira Letícia G; Cocate Paula G; Alfenas Rita CG

    2011-01-01

    Abstract Background The consumption of low glycemic index (LGI) foods before exercise results in slower and more stable glycemic increases. Besides maintaining an adequate supply of energy during exercise, this response may favor an increase in fat oxidation in the postprandial period before the exercise compared to high glycemic index (HGI) foods. The majority of the studies that evaluated the effect of foods differing in glycemic index on substrate oxidation during the postprandial period b...

  16. Dietary glycemic index, glycemic load, fiber, simple sugars, and insulin resistance

    Lau, Cathrine; Faerch, Kristine; Glümer, Charlotte;

    2005-01-01

    To examine the relationship between daily glycemic index, daily glycemic load, simple sugars, dietary fiber, and the prevalence of a measure of insulin resistance in 30- to 60-year-old nondiabetic Danish men and women.......To examine the relationship between daily glycemic index, daily glycemic load, simple sugars, dietary fiber, and the prevalence of a measure of insulin resistance in 30- to 60-year-old nondiabetic Danish men and women....

  17. Glycemic Targets in Diabetes Care: Emerging Clarity after Accord

    Buse, John B.

    2015-01-01

    Through the 1990s convincing evidence emerged from studies involving relatively recent onset diabetes that glycemic control achieving glycated hemoglobin A1c levels of approximately 7% was associated with improved microvascular outcomes. Based on advocacy groups' statements encouraging lower targets and recognition of cardiovascular disease as the leading cause of death in diabetes, the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was funded in 1999 to explore more intensi...

  18. Tight Diabetes Control

    ... Size: A A A Listen En Español Tight Diabetes Control Keeping your blood glucose levels as close ... and syringes, than before. What About Type 2 Diabetes? The DCCT studied only people with type 1 ...

  19. Dietary glycemic index, glycemic load, fiber, simple sugars, and insulin resistance - The Inter99 study

    Lau, Cathrine; Pedersen, Oluf; Færch, Kristine; Carstensen, Bendix; Glumer, Charlotte; Jørgensen, Torben; Tetens, Inge; Borch-Johnsen, Knut

    2005-01-01

    high glycemic load or diets with a high content of total carbohydrate including simple sugars was not associated with the probability of having insulin resistance. Furthermore, intake of dietary fiber was inversely associated with the probability of having insulin resistance.......OBJECTIVE - To examine the relationship between daily glycemic index daily glycemic, load, simple sugars, dietary fiber, and the prevalence of a measure of insulin resistance in 30- to 60-year-old nondiabetic Danish men and women. RESEARCH DESIGN AND METHODS - The inter99 study is a.......05). Intake of dietary fiber explained the associations with daily glycemic load and total carbohydrate and attenuated the association with fruit and vegetables. No significant associations were observed for daily glycemic index or sucrose. CONCLUSIONS - Habitual intake of diets with a high glycemic index and...

  20. Tight products and Expansion

    Daniely, Amit

    2010-01-01

    In this paper we study a new product of graphs called {\\em tight product}. A graph $H$ is said to be a tight product of two (undirected multi) graphs $G_1$ and $G_2$, if $V(H)=V(G_1)\\times V(G_2)$ and both projection maps $V(H)\\to V(G_1)$ and $V(H)\\to V(G_2)$ are covering maps. It is not a priori clear when two given graphs have a tight product (in fact, it is $NP$-hard to decide). We investigate the conditions under which this is possible. This perspective yields a new characterization of class-1 $(2k+1)$-regular graphs. We also obtain a new model of random $d$-regular graphs whose second eigenvalue is almost surely at most $O(d^{3/4})$. This construction resembles random graph lifts, but requires fewer random bits.

  1. A Mixed Methods Study Exploring the Factors and Behaviors That Affect Glycemic Control Following a Structured Education Program: The Irish DAFNE Study

    Casey, Dympna; O'Hara, Mary Clare; Meehan, Ben; Byrne, Molly; Dinneen, Sean F.; Murphy, Kathy

    2016-01-01

    Aim: To explain the factors affecting glycemic control (measured by HbA1c) following the Dose Adjustment for Normal Eating (DAFNE) program. Background: DAFNE is a structured education program designed to assist persons with type 1 diabetes mellitus achieve optimal glycemic control. However, not all participants reach this goal. Few studies…

  2. Tight bifunctional hierarchical catalyst.

    Højholt, Karen T; Vennestrøm, Peter N R; Tiruvalam, Ramchandra; Beato, Pablo

    2011-12-28

    A new concept to prepare tight bifunctional catalysts has been developed, by anchoring CoMo(6) clusters on hierarchical ZSM-5 zeolites for simultaneous use in HDS and hydrocracking catalysis. The prepared material displays a significant improved activity in HDS catalysis compared to the impregnated counterpart. PMID:22048337

  3. Leak-tightness technology

    In this chapter on the leak-tightness of welded joints a study is made of welding and bonding technology (metals, glass-metals, ceramic-metals), the welding of flanges and collars, the welding of end pieces, the welding of an electric crossover and a bellows

  4. Glycemic Index values of some Jaffna fruits

    Selladurai Pirasath; Kulasingam Thayananthan; Sandrasekarampillai Balakumar; Vasanthy Arasaratnam

    2012-01-01

    Background: The incidence of diabetes mellitus has recently increased in developing countries. Scientific data on glycemic index values of common meals is essential to modify the diets for diabetes mellitus patients. This study aimed to evaluate the glycemic index (GI) values of fruits such as ‘Kathali’ (Yellow plantain), ‘Kappal’ (Golden plantain), and ‘Itharai’ (Green plantain) varieties of plantains, jack fruit and papaya. The results will be helpful to physicians and the general public t...

  5. Depression, glycemic control and type 2 diabetes

    Papelbaum Marcelo; Moreira Rodrigo de O.; Coutinho Walmir; Kupfer Rosane; Zagury Leão; Freitas Silvia; Appolinário José C

    2011-01-01

    Abstract Background Comorbid depression in diabetes has been suggested as one of the possible causes of an inadequate glycemic control. The purpose of this study was to investigate the association between major depression and the glycemic control of type 2 diabetes mellitus (T2DM). Methods Seventy T2DM patients were evaluated. They underwent a psychiatric examination using the following instruments: Structured Clinical Interview for DSM-IV and Beck Depression Inventory. The diabetes status wa...

  6. Understanding the Glycemic Index and Glycemic Load and Their Practical Applications

    Lazarim, Fernanda Lorenzi; Stancanelli, Mirtes; Brenzikofer, Rene; de Macedo, Denise Vaz

    2009-01-01

    We have introduced the study of synthesis pathways using two experiments: 1--the determination of the glycemic index (GI) of some foods and the effects of fiber and fat on the GI; 2--the determination of blood glucose levels after the ingestion of meals with high and low glycemic loads (GL). After a practice assembly, when the foods and meals that…

  7. On weakly tight families

    Raghavan, Dilip

    2010-01-01

    Using ideas from Shelah's recent proof that a completely separable maximal almost disjoint family exists when $\\c < {\\aleph}_{\\omega}$, we construct a weakly tight family under the hypothesis $\\s \\leq \\b < {\\aleph}_{\\omega}$. The case when $\\s < \\b$ is handled in $\\ZFC$ and does not require $\\b < {\\aleph}_{\\omega}$, while an additional PCF type hypothesis, which holds when $\\b < {\\aleph}_{\\omega}$ is used to treat the case $\\s = \\b$. The notion of a weakly tight family is a natural weakening of the well studied notion of a Cohen indestructible maximal almost disjoint family. It was introduced by Hru{\\v{s}}{\\'a}k and Garc{\\'{\\i}}a Ferreira \\cite{Hr1}, who applied it to the Kat\\'etov order on almost disjoint families.

  8. BEYOND GLYCEMIC CONTROL IN DIABETES MELLITUS: EFFECTS OF INCRETIN-BASED THERAPY ON BONE METABOLISM

    FRANCESCODOTTA

    2013-06-01

    Here we will review the established as well as the putative effects of incretin hormones and of incretin-based drugs on bone metabolism, both in preclinical models and in man, taking into account that such therapeutic strategy may be effective not only to achieve a good glycemic control, but also to improve bone health in diabetic patients.

  9. Continuous Shearlet Tight Frames

    Grohs, Philipp

    2010-10-22

    Based on the shearlet transform we present a general construction of continuous tight frames for L2(ℝ2) from any sufficiently smooth function with anisotropic moments. This includes for example compactly supported systems, piecewise polynomial systems, or both. From our earlier results in Grohs (Technical report, KAUST, 2009) it follows that these systems enjoy the same desirable approximation properties for directional data as the previous bandlimited and very specific constructions due to Kutyniok and Labate (Trans. Am. Math. Soc. 361:2719-2754, 2009). We also show that the representation formulas we derive are in a sense optimal for the shearlet transform. © 2010 Springer Science+Business Media, LLC.

  10. Effect of glycemic control on diabetic dyslipidemia

    To determine whether good glycemic control has an effect on lipid profile in diabetics After taking relevant history and physical examination, serum urea, creatinine, thyroid stimulating hormone, bilirubin, alanine transaminase and HbA1c were measured. Blood samples for determination of fasting plasma glucose, serum total cholesterol, triglycerides, HDL and LDL levels were collected in a fasting state. Patients were divided into two groups based on HbA1c levels. They were compared using SPSS 13. 42 patients had good glycemic control and 58 had poor control. The two groups were age and weight matched. 43 patients had abnormal lipid profiles. Serum total cholesterol and triglycerides were lower and HDL levels higher in the good control group but serum LDL levels were equal. Conclusion: Good glycemic control improves lipid profile in patients with type 2 diabetes mellitus. (author)

  11. Patient perception of understanding health education and instructions has moderating effect on glycemic control

    2014-01-01

    Background Whether health literacy is independently associated with processes or outcomes of diabetes-related care is controversial. We tried to demonstrate the interaction of health literacy and understanding of health education and instructions in achieving glycemic control. Methods Five hundred and one consecutive patients with type 2 diabetes mellitus (DM) in the outpatient clinic of the metabolism department were recruited into this pilot study. The demographic data were collected from patients’ self-reports. The clinical background information was collected through electronic medical records. A questionnaire derived from part of the Mandarin Health Literacy Scale was used to measure numeracy and functional health literacy of people with diabetes. Health literacy levels were categorized into inadequate, marginal and adequate. Patient self-ratings of their perceived understanding of the health education information and instructions provided by their case manager in the past were categorized into two subgroups: better and poor. Patients with an HbA1c level equal to or below 7% were considered to have good glycemic control. Multivariate logistic regression was used to find associated factors of health literacy and understanding of health education and instructions. GENMOD procedures were used to analyze repeated outcome measurements of glycemic control. Results Higher educational attainment and higher household income (odds ratios were 2.23 and 2.22, respectively) were significantly associated with patients who had adequate health literacy. Higher educational attainment and patients with a family history of DM (odds ratios were 4.99 and 1.85, respectively) were significantly associated with better understanding of health education and instructions. Adequate health literacy is not the only factor associated with good glycemic control. The effect of adequate health literacy in achieving good glycemic control might be masked by patients with better understanding

  12. Determinants of glycemic control among insulin treated diabetic patients in Southwest Ethiopia: hospital based cross sectional study.

    Mulugeta Tarekegn Angamo

    Full Text Available BACKGROUND: Good glycemic control reduces the risk of diabetic complications. Despite this, achieving good glycemic control remains a challenge in diabetic patients. The objective of this study is to identify determinants of glycemic control among insulin treated diabetic patients at Jimma University Hospital, Southwest Ethiopia. METHODS: Hospital-based cross-sectional study was conducted on systematically sampled 284 insulin-treated diabetic patients with a regular follow up. Data was collected by interviewing patients during hospital visits and reviewing respective databases of September 2010 to December 2011. Data collection took place from February 20 to May 20, 2012. Poor glycemic control was defined as fasting blood sugar (FBS ≥126 mg/dL. Binary logistic regression analysis was conducted to identify predictors of poor glycemic control. RESULTS: Patients had a mean age of 41.37 (±15.08 years, 58.5% were males, the mean duration of insulin treatment was 4.9 (±5.1 years, 18.3% achieved good glycemic control (FBS≤126 mg/dL, 95% self-reported repeated use of disposable insulin syringe-needle and 48% correctly rotating insulin injection sites. Most (83.1% of study participants had one or more complications. On multivariable logistic regression analyses, body weight of >70 Kg (AOR = 0.21; P<0.001, total daily dose of insulin ≤35 IU/day (AOR = 0.26; P<0.001, total daily dose variation without checking glycemic level (AOR = 3.39; P = 0.020, knowledge deficit about signs and symptoms of hyperglycemia (AOR = 3.60; P = 0.004, and non-adherence to dietary management (AOR = 0.35; P = 0.005 were independent predictors of poor glycemic control. CONCLUSIONS: The proportion of patients with poor glycemic control was high, which resulted in the development of one or more complications regardless of duration on insulin treatment. Hence, appropriate management of patients focusing on the relevant associated factors and

  13. Subjective Assessment of Diabetes Self-Care Correlates with Perceived Glycemic Control but not with Actual Glycemic Control

    Jung Hun Ohn; Ju Hee Lee; Eun Shil Hong; Bo Kyung Koo; Sang Wan Kim; Ka Hee Yi; Min Kyong Moon

    2015-01-01

    Background We investigated whether patients' perceived glycemic control and self-reported diabetes self-care correlated with their actual glycemic control. Methods A survey was administered among patients with diabetes mellitus at an outpatient clinic with structured self-report questionnaires regarding perceived glycemic control and diabetes self-management. Actual glycemic control was defined as a change in glycated hemoglobin (A1C) or fasting plasma glucose (FPG) since the last clinic visi...

  14. Correlation bethealtyy ween dietary glycemic index and glycemic load and blood lipid levels in a group of women from Ahvaz

    Farideh Shishebor; Zahra Shamekhi; Majid Karandish; Seyed Mahmood Latifi

    2011-01-01

    Background & Objectives: There are limited number of studies conducted on the correlation between Glycemic index and Glycemic load of a food program and metabolic factors such as blood lipids in Asian countries including Iran. Therefore, this study aimed at analyzing the correlation between Glycemic index and Glycemic load of Iranian food program and blood lipids. Materials & Methods: The subjects were 95 women working in Ahvaz University of Medical Sciences in the range of 20 to 55 years old...

  15. Glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases

    Tatiana Uchôa Passos; Helena Alves de Carvalho Sampaio; Maria Olganê Dantas Sabry; Maria Luisa Pereira de Melo; Maria Auristela Magalhães Coelho; José Wellington de Oliveira Lima

    2015-01-01

    The objective was to determine the glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases. Nine fruits were investigated: coconut water (for the purpose of this study, coconut water was classified as a “fruit”), guava, tamarind, passion fruit, custard apple, hog plum, cashew, sapodilla, and soursop. The GI and GL were determined according to the Food and Agriculture Organization protocol. The GL was calculated taking into consideration intake recommend...

  16. Practice of strict glycemic control in critically ill patients.

    Schultz, Marcus J; de Graaff, Mart J; Royakkers, Annic A N M; van Braam Houckgeest, Floris; van der Sluijs, Johannes P; Kieft, Hans; Spronk, Peter E

    2008-11-01

    Blood glucose control aiming at normoglycemia, frequently referred to as "strict glycemic control", decreases mortality and morbidity of critically ill patients. We searched the medical literature for export opinions, surveys, and clinical reports on blood glucose control in intensive care medicine. While strict glycemic control has been recommended standard of care for critically ill patients, the risk of severe hypoglycemia with strict glycemic control is frequently mentioned by experts. Some rationalize this risk, though others strongly point out the high incidence of hypoglycemia to be (one) reason not to perform strict glycemic control. Implementation of strict glycemic control is far from complete in intensive care units across the world. Frequently local guidelines accept higher blood glucose levels than those with strict glycemic control. Only a minority of retrieved manuscripts are on blood glucose regimens with the lower targets as with strict glycemic control. Hypoglycemia certainly is encountered with blood glucose control, in particular with strict glycemic control. Reports show intensive care-nurses can adequately and safely perform strict glycemic control. Implementation of strict glycemic control is far from complete, at least in part because of the feared risks of hypoglycemia. The preference for hyperglycemia over intermittent hypoglycemia is irrational, however, because there is causal evidence of harm for the former but only associative evidence of harm for the latter. For several reasons it is wise to have strict glycemic control being a nurse-based strategy. PMID:18971884

  17. Reeling of tight fit pipe

    Focke, E.S.

    2007-01-01

    If it would be possible to install Tight Fit Pipe by means of reeling, it would be an attractive new option for the exploitation of offshore oil and gas fields containing corrosive hydrocarbons. Tight Fit Pipe is a mechanically bonded double walled pipe where a corrosion resistant alloy liner pipe i

  18. Tight closure and vanishing theorems

    Tight closure has become a thriving branch of commutative algebra since it was first introduced by Mel Hochster and Craig Huneke in 1986. Over the past few years, it has become increasingly clear that tight closure has deep connections with complex algebraic geometry as well, especially with those areas of algebraic geometry where vanishing theorems play a starring role. The purpose of these lectures is to introduce tight closure and to explain some of these connections with algebraic geometry. Tight closure is basically a technique for harnessing the power of the Frobenius map. The use of the Frobenius map to prove theorems about complex algebraic varieties is a familiar technique in algebraic geometry, so it should perhaps come as no surprise that tight closure is applicable to algebraic geometry. On the other hand, it seems that so far we are only seeing the tip of a large and very beautiful iceberg in terms of tight closure's interpretation and applications to algebraic geometry. Interestingly, although tight closure is a 'characteristic p' tool, many of the problems where tight closure has proved useful have also yielded to analytic (L2) techniques. Despite some striking parallels, there had been no specific result directly linking tight closure and L∼ techniques. Recently, however, the equivalence of an ideal central to the theory of tight closure was shown to be equivalent to a certain 'multiplier ideal' first defined using L2 methods. Presumably, deeper connections will continue to emerge. There are two main types of problems for which tight closure has been helpful: in identifying nice structure and in establishing uniform behavior. The original algebraic applications of tight closure include, for example, a quick proof of the Hochster-Roberts theorem on the Cohen-Macaulayness of rings of invariants, and also a refined version of the Brianqon-Skoda theorem on the uniform behaviour of integral closures of powers of ideals. More recent, geometric

  19. Subjective Assessment of Diabetes Self-Care Correlates with Perceived Glycemic Control but not with Actual Glycemic Control

    Jung Hun Ohn

    2015-02-01

    Full Text Available BackgroundWe investigated whether patients' perceived glycemic control and self-reported diabetes self-care correlated with their actual glycemic control.MethodsA survey was administered among patients with diabetes mellitus at an outpatient clinic with structured self-report questionnaires regarding perceived glycemic control and diabetes self-management. Actual glycemic control was defined as a change in glycated hemoglobin (A1C or fasting plasma glucose (FPG since the last clinic visit.ResultsPatients who perceived their glycemic control as "improved" actually showed a mild but significant decrease in the mean A1C (-0.1%, P=0.02, and those who perceived glycemic control as "aggravated" had a significant increase in the mean FPG (10.5 mg/dL or 0.59 mmol/L, P=0.04 compared to the "stationary" group. However, one-half of patients falsely predicted their actual glycemic control status. Subjective assessment of diabetes self-care efforts, such as adherence to a diet regimen or physical activity, correlated positively with perceived glycemic control but showed no association with actual glycemic control.ConclusionPatients should be encouraged to assess and monitor diabetes self-care more objectively to motivate behavioral modifications and improve their actual glycemic control.

  20. Glycemic control and outcome related to cardiopulmonary bypass.

    Thiessen, Steven; Vanhorebeek, Ilse; Van den Berghe, Greet

    2015-06-01

    Perioperative hyperglycemia, aggravated by cardiopulmonary bypass, is associated with adverse outcome in adult and pediatric patients. Whereas hyperglycemia was originally perceived as an adaptive response to surgical stress, it is now clear that glycemic control is a strategy to reduce adverse outcomes after cardiac surgery and cardiopulmonary bypass. The optimal blood glucose target, whether or not glycemic control should be initiated already intraoperatively, and whether or not perioperative glucose administration affects the impact of glycemic control on ischemia-reperfusion damage remain open questions. Hypoglycemia, the risk of which is increased with glycemic control, is also associated with adverse outcomes. However, it remains controversial whether brief episodes of hypoglycemia, rapidly corrected during glycemic control, have adverse effects on outcome. This review gives an overview of the currently available literature on glycemic control during and after cardiac surgery and focuses on the indicated open questions about this intervention for this specific patient population. PMID:26060029

  1. Tight control benefits dewatering

    Dahlstrom, D.A. (University of Utah, Salt Lake City, UT (USA). Depts. of Chemical Engineering Metallurgy and Metallurgical Engineering)

    1990-04-01

    Dewatering of fine coal can be effectively achieved by the proper control of: particle size distribution, concentration of feed solids, slimes content in the feed, vacuum level, filter media, and filter cycle time. Attention must also be paid to the operation of the tailings thickener, to control: feed size distribution, concentration of feed solids, flocculant preparation, concentration of underflow solids and overflow quality. 8 refs., 3 figs.

  2. Glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases

    Tatiana Uchôa Passos

    2015-03-01

    Full Text Available The objective was to determine the glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases. Nine fruits were investigated: coconut water (for the purpose of this study, coconut water was classified as a “fruit”, guava, tamarind, passion fruit, custard apple, hog plum, cashew, sapodilla, and soursop. The GI and GL were determined according to the Food and Agriculture Organization protocol. The GL was calculated taking into consideration intake recommendation guidelines; 77.8% of the fruits had low GI although significant oscillations were observed in some graphs, which may indicate potential risks of disease. Coconut water and custard apple had a moderate GI, and all fruits had low GL. The fruits evaluated are healthy and can be consumed following the daily recommended amount. However, caution is recommended with fruits causing early glycemic peak and the fruits with moderated GI (coconut water and custard apple.

  3. Glycemic and blood pressure control in older patients with hypertension and diabetes: association with carotid atherosclerosis

    Hong-Wei Du; Jia-Yue Li; Yao He

    2011-01-01

    Backgroud Numerous studies have confirmed the effectiveness of slowing the progression of atherosclerosis by blood pressure (Bp)control in patients with hypertension and several studies also showed the efficacy of intensive glycemic control in decreasing progression of carotid intima-media thickness (CIMT) in patients with type 1 and type 2 diabetes.However, few studies have compared the relative importance of glycemic vs.Bp control in patients with diabetes and hypertension.We aimed to investigate the association between Bp and glycemic control and subclinical carotid atherosclerosis in older patients with hypertension and type 2 diabetes.Methods In a cross-sectional study, B-mode high-resolution ultrasonography of the carotid artery was performed in 670 subjects (508 males and 162 females) aged 60 years or over who had self-reported hypertension and diabetes but no history of coronary heart disease or stroke.Subjects were categorized by their systolic blood pressure: tight control, < 130 mmHg; usual control, 130-139 mmHg; or uncontrolled, > 140 mmHg,and by their hemoglobin Alc (HbAlc) level: tight control, < 6.5%; usual control, 6.5%-7.5%; or uncontrolled, ≥ 7.5%, respectively.Results The mean CIMT was 8.20 ± 0.11 mm, and carotid plaque was found in 52.5% (352/670) subjects.Overall, 62.1% of the subjects had subclinical carotid atherosclerosis, defined as having either carotid plaque or elevated CIMT (≥1.1 mm).The mean CIMT was significantly different between Bp control categories (7.60 ± 0.09 mm, 7.90 ± 0.08 mm, and 8.60 ± 0.12 mm, respectively, P = 0.03) but not between glycemic control categories (8.20 ± 0.10 mm, 8.1 ± 0.08 mm, and 8.40 ± 0.14 mm, respectively, P = 0.13) using ANCOVA analysis.Multivariable logistic regression adjusting for potential confounding factors showed that usual or uncontrolled Bp control were associated with having carotid plaque (OR = 1.08 and OR = 1.42, respectively), or elevated CIMT [Odd ratio (OR) = 1

  4. Patient perception of understanding health education and instructions has moderating effect on glycemic control

    Chen, Gin-Den; Huang, Chien-Ning; Yang, Yi-Sun; Lew-Ting, Chin-Yin

    2014-01-01

    Background Whether health literacy is independently associated with processes or outcomes of diabetes-related care is controversial. We tried to demonstrate the interaction of health literacy and understanding of health education and instructions in achieving glycemic control. Methods Five hundred and one consecutive patients with type 2 diabetes mellitus (DM) in the outpatient clinic of the metabolism department were recruited into this pilot study. The demographic data were collected from p...

  5. Reeling of tight fit pipe

    Focke, E.S.

    2007-01-01

    If it would be possible to install Tight Fit Pipe by means of reeling, it would be an attractive new option for the exploitation of offshore oil and gas fields containing corrosive hydrocarbons. Tight Fit Pipe is a mechanically bonded double walled pipe where a corrosion resistant alloy liner pipe is mechanically fitted inside a carbon steel outer pipe through a thermo-hydraulic manufacturing process. Reeling is a fast method of offshore pipeline installation where a pipe is spooled on a reel...

  6. Tight p-fusion frames

    Bachoc, Christine; Ehler, Martin

    2012-01-01

    Fusion frames enable signal decompositions into weighted linear subspace components. For positive integers p, we introduce p-fusion frames, a sharpening of the notion of fusion frames. Tight p-fusion frames are closely related to the classical notions of designs and cubature formulas in Grassmann spaces and are analyzed with methods from harmonic analysis in the Grassmannians. We define the p-fusion frame potential, derive bounds for its value, and discuss the connections to tight p-fusion fr...

  7. Better Glycemic Control with Insulin Premix 50/50 TID Compared to Insulin Premix 70/30 BID - Original Article

    Hasan Aydın; Hülya Demir; İbrahim Volkan Şenkal; Fevzi Fırat Yalnız; Ayşe Ayrılmaz

    2010-01-01

    Objective: Since only a small proportion of diabetics achieve optimal glycemic targets, intensification of treatment with insulin is needed in most of the cases. Application of insulin lispro premix 50/50 TID provides better glycemic control compared to human insulin premix 70/30 and comparable results reported with basal-bolus insulin regimen. The aim of this study was to determine the effect of insulin lispro premix 50/50 TID (Group 1, n=60) in comparison with insulin aspart premix 70/30 (...

  8. Dietary glycemic index, glycemic load, fiber, simple sugars, and insulin resistance - The Inter99 study

    Lau, Cathrine; Pedersen, Oluf; Færch, Kristine;

    2005-01-01

    OBJECTIVE - To examine the relationship between daily glycemic index daily glycemic, load, simple sugars, dietary fiber, and the prevalence of a measure of insulin resistance in 30- to 60-year-old nondiabetic Danish men and women. RESEARCH DESIGN AND METHODS - The inter99 study is a nonpharmacolo......OBJECTIVE - To examine the relationship between daily glycemic index daily glycemic, load, simple sugars, dietary fiber, and the prevalence of a measure of insulin resistance in 30- to 60-year-old nondiabetic Danish men and women. RESEARCH DESIGN AND METHODS - The inter99 study...... is a nonpharmacological intervention study. We used baseline data and examined cross-sectional associations between carbohydrate-related dietary factors and an estimate of insulin resistance in 5,675 subjects at 30 - 60 years. The dietary intake was estimated from a self-administered food frequency questionnaire......, and insulin resistance was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR). Multiple regressions were performed with HOMA-IR as the dependent variable and carbohydrate-related factors as explanatory variables. All models were adjusted for age, sex, smoking, physical activity...

  9. Equivalent glycemic load (EGL: a method for quantifying the glycemic responses elicited by low carbohydrate foods

    Spolar Matt

    2006-08-01

    Full Text Available Abstract Background Glycemic load (GL is used to quantify the glycemic impact of high-carbohydrate (CHO foods, but cannot be used for low-CHO foods. Therefore, we evaluated the accuracy of equivalent-glycemic-load (EGL, a measure of the glycemic impact of low-CHO foods defined as the amount of CHO from white-bread (WB with the same glycemic impact as one serving of food. Methods Several randomized, cross-over trials were performed by a contract research organization using overnight-fasted healthy subjects drawn from a pool of 63 recruited from the general population by newspaper advertisement. Incremental blood-glucose response area-under-the-curve (AUC elicited by 0, 5, 10, 20, 35 and 50 g CHO portions of WB (WB-CHO and 3, 5, 10 and 20 g glucose were measured. EGL values of the different doses of glucose and WB and 4 low-CHO foods were determined as: EGL = (F-B/M, where F is AUC after food and B is y-intercept and M slope of the regression of AUC on grams WB-CHO. The dose-response curves of WB and glucose were used to derive an equation to estimate GL from EGL, and the resulting values compared to GL calculated from the glucose dose-response curve. The accuracy of EGL was assessed by comparing the GL (estimated from EGL values of the 4 doses of oral-glucose with the amounts actually consumed. Results Over 0–50 g WB-CHO (n = 10, the dose-response curve was non-linear, but over the range 0–20 g the curve was indistinguishable from linear, with AUC after 0, 5, 10 and 20 g WB-CHO, 10 ± 1, 28 ± 2, 58 ± 5 and 100 ± 6 mmol × min/L, differing significantly from each other (n = 48. The difference between GL values estimated from EGL and those calculated from the dose-response curve was 0 g (95% confidence-interval, ± 0.5 g. The difference between the GL values of the 4 doses of glucose estimated from EGL, and the amounts of glucose actually consumed was 0.2 g (95% confidence-interval, ± 1 g. Conclusion EGL, a measure of the glycemic impact of

  10. Glycemic Index values of some Jaffna fruits

    Selladurai Pirasath

    2012-02-01

    Full Text Available Background: The incidence of diabetes mellitus has recently increased in developing countries. Scientific data on glycemic index values of common meals is essential to modify the diets for diabetes mellitus patients. This study aimed to evaluate the glycemic index (GI values of fruits such as ‘Kathali’ (Yellow plantain, ‘Kappal’ (Golden plantain, and ‘Itharai’ (Green plantain varieties of plantains, jack fruit and papaya. The results will be helpful to physicians and the general public to decide the benefits ofthe consumption of fruits, particularly by diabetic and coronary heart disease patients.Methods: Healthy volunteers (20 Nos. of 21.05(±0.92 years, 53.90 (±9.36 kg body weights, 153.92 (±9.15 m heights, and 20.55 (±2.22 kgm-2body mass indexes were selected with their written consent. After overnight fasting, 75g glucose and each test fruit containing 75g digestible carbohydrate were administered at different instances and blood glucose levels were measured half hourly for two hours. The glycemic response and GI values were calculated and analyzed by Randomized Complete Block Design using SAS analytical package.Results: The mean GI values of the ‘Kathali’, ‘Kappal’, ‘Itharai’ varieties of plantains, jack fruit and papaya were 54.45 (±9.26, 50.43 (±5.79, 48.47 (±10.13, 65.36 (±8.00 and 34.80 (±12.78 % respectively. The GI value of papaya differed significantly (P<0.05 from other fruits. The GI value of ‘Itharai’ variety of plantain differed significantly (P<0.05 from other fruits except the ‘Kappal’ varietyof plantain.Conclusion: The three varieties of plantains and papaya were low GI fruits, and jack fruit was found to be an intermediate GI fruit. The presence of dietary fiber, esp. soluble fiber, reduces the glycemicresponse and glycemic index of foods.

  11. Use of the glycemic index in nutrition education

    Flávia Galvão Cândido

    2013-02-01

    Full Text Available Recently, the lack of studies providing practical guidance for the use of the glycemic index has been indicated as the cause of its little use in nutrition education. The aim of this study is to give instructions on the use of the glycemic index as a tool to be used in nutrition education to estimulate the consumption of low glycemic index foods. Studies published over the past 12 years, in addition to classic studies on this topic, found in the databases MedLine, ScienceDirect, SciELO and Lilacs exploring the importance of the glycemic index and the factors that affect the glycemic index were selected for this article. The preparation of lists grouping foods according to their glycemic index should be based on information found in tables and specific web sites. This is an interesting strategy that must be very carefully conducted, considering the eating habits of the assisted people. To reduce the postprandial blood glucose response, high glycemic index foods should be consumed in association with the following foods: high protein and low fat foods, good quality oils and unprocessed foods with high fiber content. Caffeine should also be avoided. The glycemic index should be considered as an additional carbohydrate-selection tool, which should be part of a nutritionally balanced diet capable of promoting and/or maintaining body weight and health.

  12. Dietary carbohydrates, glycemic index, glycemic load, and endometrial cancer risk within the European prospective investigation into cancer and nutrition cohort

    Cust, Anne E.; Slimani, Nadia; Kaaks, Rudolf; van Bakel, Marit; Biessy, Carine; Ferrari, Pietro; Laville, Martine; Tjonneland, Anne; Olsen, Anja; Overvad, Kim; Lajous, Martin; Clavel-Chapelon, Francoise; Boutron-Ruault, Marie-Christine; Linseisen, Jakob; Rohrmann, Sabine; Noethlings, Ute; Boeing, Heiner; Palli, Domenico; Sieri, Sabina; Panico, Salvatore; Tumino, Rosario; Sacerdote, Carlotta; Skeie, Guri; Engeset, Dagrun; Gram, Inger Torhild; Quiros, J. Ramon; Jakszyn, Paula; Sanchez, Maria Jose; Larranaga, Nerea; Navarro, Carmen; Ardanaz, Eva; Wirfalt, Elisabet; Berglund, Goran; Lundin, Eva; Hallmans, Goeran; Bueno-de-Mesquita, H. Bas; Du, Huaidong; Peeters, Petra H. M.; Bingham, Shelia; Khaw, Kay-Tee; Allen, Naomi E.; Key, Timothy J.; Jenab, Mazda; Riboli, Elio

    2007-01-01

    The associations of dietary total carbohydrates, overall glycemic index, total dietary glycemic load, total sugars, total starch, and total fiber with endometrial cancer risk were analyzed among 288,428 women in the European Prospective Investigation into Cancer and Nutrition cohort (1992-2004), inc

  13. Association between dietary glycemic index, glycemic load, and body mass index in the Inter99 study: is underreporting a problem?

    Lau, C.; Toft, U.; Tetens, Inge; Richelsen, B.; Jørgensen, T.; Borch-Johnsen, K.; Glumer, C.

    2006-01-01

    Background: The few studies examining the potential associations between glycemic index (GI), glycemic load (GL), and body mass index (BMI) have provided no clear pictures. Underreporting of energy intake may be one explanation for this. Objective: We examined the associations between GI, GL, and...

  14. Intraoperative glycemic control procedures and the use of an artificial pancreas

    Koichi Yamashita; Tomoaki Yatabe

    2009-01-01

    Strict intraoperative glycemic control can significantly decrease the incidence of postoperative infection;however, anesthesiologists must carefully control blood glucose levels as well as properly manage the respiratory and cardiovascular systems. However,standard blood glucose measurement systems and insulin dosing algorithms, which are necessary for achieving strict glycemic control, have not yet been developed. An artificial pancreas (STG-22TM;Nikkiso Co., Tokyo, Japan) is considered a highly accurate blood glucose monitoring system capable of closedloopcontrol of blood glucose. The device has, however,many problems to be addressed since it is a large and expensive system with little versatility, and it requires a large amount of blood to be collected. Therefore,the development of less invasive and inexpensive systems with future technological progress is greatly anticipated.

  15. Microfine grouting in tight fractures

    Microfine cements were used to grout tight fractures in basalt at McNary Dam in Umatilla, Oregon. Six boreholes were grouted with different microfine mixes. Hydraulic conductivity testing before and after the grouting provided a quantitative estimate of average fracture apertures and the effect of grouting on rock mass permeability. A downhole video camera survey was conducted in each hole to determine which fractures and joint sets allowed grout penetration. Pressure and the flow rate for grout were monitored during the testing. Total grout takes were calculated for each borehole stage grouted. Grouting pressures varied from less than a quarter to more than five times the estimated overburden pressure. The results of this testing indicate that tight fractures can be grouted with microfine cements. In addition, for tight fracture the relationship of injection pressures to grout take is significantly more non-linear than conventional grouting experience has suggested

  16. Metabolic responses to high glycemic index and low glycemic index meals: a controlled crossover clinical trial

    Bressan Josefina

    2011-01-01

    Full Text Available Abstract Background The consumption of low glycemic index (LGI foods before exercise results in slower and more stable glycemic increases. Besides maintaining an adequate supply of energy during exercise, this response may favor an increase in fat oxidation in the postprandial period before the exercise compared to high glycemic index (HGI foods. The majority of the studies that evaluated the effect of foods differing in glycemic index on substrate oxidation during the postprandial period before the exercise are acute studies in which a single meal is consumed right before the exercise. The purpose of this study was to investigate the effect of consuming two daily HGI or LGI meals for five consecutive days on substrate oxidation before the exercise and in the concentrations of glucose, insulin and free fatty acids before and during a high intensity exercise. Methods Fifteen male cyclists, aged 24.4 ± 3.8 years, with body mass index of 21.9 ± 1.4 kg.m-2 and a VO2 max of 70.0 ± 5.3 mL.kg-1.min-1, participated in this crossover study. All test meals were consumed in the laboratory. On days 1 and 5, substrate oxidation (30 minutes before and 90 minutes after breakfast (HGI or LGI and diet-induced thermogenesis (90 minutes postprandial were assessed before the exercise. The levels of glucose, insulin, and free fatty acids were determined during 2 h after breakfast on these same days. Ninety minutes after breakfast, subjects completed a 30 min cycloergometric exercise at 85 to 95% of their maximum heart rate, during which lactate concentrations were assessed. Results The consumption of HGI meals resulted in higher areas under the glycemic and insulinemic curves in the postprandial period. However, glycemia did not differ by study treatment during exercise. There were no differences in free fatty acids in the postprandial period or in lactate levels during exercise. LGI meals resulted in lower fat oxidation and higher carbohydrate oxidation than the

  17. Sotagliflozin improves glycemic control in nonobese diabetes-prone mice with type 1 diabetes

    Powell DR

    2015-02-01

    diabetic mice maintained on a low insulin dose. This sotagliflozin-mediated improvement in glycemic control was comparable to that achieved by raising the insulin dose alone, but was not accompanied by the increased rate of hypoglycemia measurements observed with the higher insulin dose. Keywords: insulin, glucose, hypoglycemia, hemoglobin A1c

  18. Glycemic Variability Assessed by Continuous Glucose Monitoring and Short-Term Outcome in Diabetic Patients Undergoing Percutaneous Coronary Intervention: An Observational Pilot Study.

    Nusca, Annunziata; Lauria Pantano, Angelo; Melfi, Rosetta; Proscia, Claudio; Maddaloni, Ernesto; Contuzzi, Rocco; Mangiacapra, Fabio; Palermo, Andrea; Manfrini, Silvia; Pozzilli, Paolo; Di Sciascio, Germano

    2015-01-01

    Poor glycemic control is associated with unfavorable outcome in patients undergoing percutaneous coronary intervention (PCI), irrespective of diabetes mellitus. However a complete assessment of glycemic status may not be fully described by glycated hemoglobin or fasting blood glucose levels, whereas daily glycemic fluctuations may influence cardiovascular risk and have even more deleterious effects than sustained hyperglycemia. Thus, this paper investigated the effectiveness of a continuous glucose monitoring (CGM), registering the mean level of glycemic values but also the extent of glucose excursions during coronary revascularization, in detecting periprocedural outcome such as renal or myocardial damage, assessed by serum creatinine, neutrophil gelatinase-associated lipocalin (NGAL), and troponin I levels. High glycemic variability (GV) has been associated with worse postprocedural creatinine and NGAL variations. Moreover, GV, and predominantly hypoglycemic variations, has been observed to increase in patients with periprocedural myocardial infarction. Thus, our study investigated the usefulness of CGM in the setting of PCI where an optimal glycemic control should be achieved in order to prevent complications and improve outcome. PMID:26273664

  19. Glycemic Variability Assessed by Continuous Glucose Monitoring and Short-Term Outcome in Diabetic Patients Undergoing Percutaneous Coronary Intervention: An Observational Pilot Study

    Annunziata Nusca

    2015-01-01

    Full Text Available Poor glycemic control is associated with unfavorable outcome in patients undergoing percutaneous coronary intervention (PCI, irrespective of diabetes mellitus. However a complete assessment of glycemic status may not be fully described by glycated hemoglobin or fasting blood glucose levels, whereas daily glycemic fluctuations may influence cardiovascular risk and have even more deleterious effects than sustained hyperglycemia. Thus, this paper investigated the effectiveness of a continuous glucose monitoring (CGM, registering the mean level of glycemic values but also the extent of glucose excursions during coronary revascularization, in detecting periprocedural outcome such as renal or myocardial damage, assessed by serum creatinine, neutrophil gelatinase-associated lipocalin (NGAL, and troponin I levels. High glycemic variability (GV has been associated with worse postprocedural creatinine and NGAL variations. Moreover, GV, and predominantly hypoglycemic variations, has been observed to increase in patients with periprocedural myocardial infarction. Thus, our study investigated the usefulness of CGM in the setting of PCI where an optimal glycemic control should be achieved in order to prevent complications and improve outcome.

  20. Perioperative glycemic control%围手术期病人的血糖调控

    赵春临; 袁甲翔

    2011-01-01

    糖尿病病人围手术期维持血糖稳定是一大难题.围手术期高血糖能引发病人术后感染和增加病死率.尽管如此,严格控制血糖(如胰岛素强化治疗)却能导致低血糖等不良事件的发生.围手术期血糖控制的合理目标和最佳方式仍无充分的依据.本文作者复习近年来的有关研究,并结合自己临床经验,现就围手术期病人的血糖控制作一探讨.%Maintaining glycemic control is difficult in diabetic patients who are undergoing surgery. Perioperative hyperglycemia increases the risk of postoperative infection and mortality. However, tight glycemic control such as intensive insulin therapy has a risk of hypoglycemia. In addition, the optimal target range and the best way for blood glucose to reduce postoperative infection remains unknown.

  1. Glycemic index, glycemic load and mammographic breast density: the EPIC Florence longitudinal study.

    Giovanna Masala

    Full Text Available A few studies have evaluated the association between diet and mammographic breast density (MBD and results are inconsistent. MBD, a well-recognized risk factor for breast cancer, has been proposed as a marker of cumulative exposure to hormones and growth factors. Diets with a high glycemic index (GI or glycemic load (GL may increase breast cancer risk, via an effect on the insulin-like growth factor axis. We have investigated the association between carbohydrate intake, GI, GL and MBD in a prospective study. We identified a large series of women, in the frame of the EPIC-Florence cohort, with a mammogram taken five years after enrolment, when detailed information on dietary and lifestyle habits and anthropometric measurements had been collected. Mammograms have been retrieved (1,668, 83% and MBD assessed according to Wolfe's classification. We compared women with high MBD (P2+DY Wolfe's categories with those with low MBD (N1+P1 through logistic models adjusted for age, education, body mass index, menopause, number of children, breast feeding, physical activity, non-alcohol energy, fibers, saturated fat and alcohol. A direct association between GL and high MBD emerged in the highest quintile of intake in comparison with the lowest quintile (OR = 1.73, 95%CI 1.13-2.67, p for trend = 0.048 while no association with glycemic index was evident. These results were confirmed after exclusion of women reporting to be on a diet or affected with diabetes, and when Hormone Replacement Therapy at the date of mammographic examination used to assess MBD was considered. The effect was particularly evident among leaner women, although no interaction was found. A positive association was suggested for increasing simple sugar and total carbohydrates intakes limited to the highest quintiles. In this Italian population we observed an association between glycemic load, total and rapidly absorbed carbohydrates and high MBD. These novel results warrant further

  2. Dietary patterns associated with glycemic index and glycemic load among Alberta adolescents.

    Forbes, Laura E; Storey, Kate E; Fraser, Shawn N; Spence, John C; Plotnikoff, Ronald C; Raine, Kim D; Hanning, Rhona M; McCargar, Linda J

    2009-08-01

    The purpose of this study was to assess the dietary glycemic index (GI) and glycemic load (GL) of adolescents, based on a Web-based 24-h recall, and to investigate dietary predictors of GI and GL. In addition, the relationship between GI and GL and weight status was examined. A Web-based 24-h recall was completed by 4936 adolescents, aged 9-17 years; macronutrient and food group intakes were assessed using the ESHA Food Processor, the Canadian Nutrient File, and Canada's Food Guide. Dietary GI and GL were calculated based on published GI values for foods. Students provided self-reported height and mass. Multiple regression models assessed the ability of food group choices and food behaviours to predict GI and GL. Mean GI was 55 for girls and 56 for boys. Mean GL was 128 for girls and 168 for boys. Food group choices explained 26% of the variation in GI (p GL (p GL; however, these results disappeared when adjusted for total energy intake. The GI was positively correlated with body mass index in girls (r = 0.05, p = 0.02), and GL was significantly higher among nonoverweight boys than overweight boys. This study identified eating patterns related to daily GI and GL, and suggests certain dietary patterns that could have beneficial effects on health. It also showed that GI and GL were weakly related to weight status. PMID:19767800

  3. Dietary glycemic index and glycemic load and their relationship to cardiovascular risk factors in Chinese children.

    Zhang, Xinyu; Zhu, Yanna; Cai, Li; Ma, Lu; Jing, Jin; Guo, Li; Jin, Yu; Ma, Yinghua; Chen, Yajun

    2016-04-01

    The purpose of this study was to examine the cross-sectional associations between dietary glycemic index (GI) and glycemic load (GL) and cardiovascular disease (CVD) risk factors in Chinese children. A total of 234 Chinese schoolchildren aged 8-11 years in Guangdong participated in the study. Dietary intake was assessed via a 3-day dietary record. Seven established cardiovascular indicators were analyzed in this study: fasting plasma glucose (FPG), fasting triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure, and diastolic blood pressure. Higher dietary GI was significantly associated with higher TG levels (P = 0.037) and lower HDL-C levels (P = 0.005) after adjusting for age, sex, nutritional intake, physical activity, and body mass index z score. LDL-C was found to differ across tertiles of dietary GL. The middle tertile tended to show the highest level of LDL-C. TC, FPG, and blood pressure were independent of both dietary GI and GL. Our findings suggest that higher dietary GI is differentially associated with some CVD risk factors, including lower HDL-C and higher TG, in school-aged children from south China. PMID:26944225

  4. [The glycemic index of some foods common in Mexico].

    Frati-Munari, A C; Roca-Vides, R A; López-Pérez, R J; de Vivero, I; Ruiz-Velazco, M

    1991-01-01

    To investigate the increase of glycemia due to the ingestion of usual food in Mexico, portions with 50 g of carbohydrate form white corn tortilla, yellow corn tortilla, spaghetti, rice, potatoes, beans brown and black, nopal (prickle pear cactus) and peanuts, compared with white bread, were given to 21 healthy and 27 non-insulin-dependent diabetic subjects. Serum glucose and insulin were measured every 30 min for 180 min long. Glycemic index was obtained as: (area under curve of glucose with test food/area under curve of glucose with white bread) X 100. A corrected index was calculated subtracting the area corresponding to initial values. Insulin index was obtained similarly. Each sample was studied 14-18 times. Glycemic and insulin indexes of white and yellow corn tortilla, spaghetti, rice and potatoes were not different from bread (P greater than 0.05). Corrected glycemic indexes of brown beans (54 +/- 15, +/- SE) and black beans (43 +/- 17) were low (p less than 0.05), as well as corrected insulin indexes (69 +/- 11 and 64 +/- 10 respectively, (P less than 0.02). Peanuts had low glycemic (33 +/- 17, P less than 0.01), but normal insulin index. Nopal had very low glycemic and insulin indexes (10 +/- 17 and 10 +/- 16, P less than 0.0001). These data might be useful in prescribing diets for diabetic subjects. PMID:1959761

  5. Better Glycemic Control with Insulin Premix 50/50 TID Compared to Insulin Premix 70/30 BID - Original Article

    Hasan Aydın

    2010-09-01

    Full Text Available Objective: Since only a small proportion of diabetics achieve optimal glycemic targets, intensification of treatment with insulin is needed in most of the cases. Application of insulin lispro premix 50/50 TID provides better glycemic control compared to human insulin premix 70/30 and comparable results reported with basal-bolus insulin regimen. The aim of this study was to determine the effect of insulin lispro premix 50/50 TID (Group 1, n=60 in comparison with insulin aspart premix 70/30 (Group 2, n=62. Materials and Methods: Type 2 diabetic patients, who were started on insulin treatment for the first time, were screened retrospectively. Change in A1C levels, 4-point self-monitored blood glucose measurements and rate of hypoglycemia within a 3-month period were recorded. Results: Basal A1C levels were higher (p=0.002 and the rate of improvement was greater in patients of Group 1 than in Group 2 patients (p=0.0006. There was no difference between the patients in achieving target A1C level and in the rate of hypoglycemia. A greater decrease in postprandial blood glucose level was achieved in patients of Group 1 (p<0.0001. Conclusion: Compared to insulin aspart premix 70/30, insulin lispro premix 50/50 provided better glycemic control without increasing the risk of hypoglycemia. Turk Jem 2010; 14: 60-5

  6. Diagnosing the tight building syndrome

    Rogers, S.A.

    1987-12-01

    Formaldehyde is but one of many chemicals capable of causing the tight building syndrome or environmentally induced illness (EI). The spectrum of symptoms it may induce includes attacks of headache, flushing, laryngitis, dizziness, nausea, extreme weakness, arthralgia, unwarranted depression, dysphonia, exhaustion, inability to think clearly, arrhythmia or muscle spasms. The nonspecificity of such symptoms can baffle physicians from many specialties. Presented herein is a simple office method for demonstrating that formaldehyde is among the etiologic agents triggering these symptoms. The very symptoms that patients complain of can be provoked within minutes, and subsequently abolished, with an intradermal injection of the appropriate strength of formaldehyde. This injection aids in convincing the patient of the cause of the symptoms so he can initiate measure to bring his disease under control.

  7. Invasive tightly coupled processor arrays

    LARI, VAHID

    2016-01-01

    This book introduces new massively parallel computer (MPSoC) architectures called invasive tightly coupled processor arrays. It proposes strategies, architecture designs, and programming interfaces for invasive TCPAs that allow invading and subsequently executing loop programs with strict requirements or guarantees of non-functional execution qualities such as performance, power consumption, and reliability. For the first time, such a configurable processor array architecture consisting of locally interconnected VLIW processing elements can be claimed by programs, either in full or in part, using the principle of invasive computing. Invasive TCPAs provide unprecedented energy efficiency for the parallel execution of nested loop programs by avoiding any global memory access such as GPUs and may even support loops with complex dependencies such as loop-carried dependencies that are not amenable to parallel execution on GPUs. For this purpose, the book proposes different invasion strategies for claiming a desire...

  8. Fingerprinting with Equiangular Tight Frames

    Mixon, Dustin G; Kiyavash, Negar; Fickus, Matthew

    2011-01-01

    Digital fingerprinting is a framework for marking media files, such as images, music, or movies, with user-specific signatures to deter illegal distribution. Multiple users can collude to produce a forgery that can potentially overcome a fingerprinting system. This paper proposes an equiangular tight frame fingerprint design which is robust to such collusion attacks. We motivate this design by considering digital fingerprinting in terms of compressed sensing. The attack is modeled as linear averaging of multiple marked copies before adding a Gaussian noise vector. The content owner can then determine guilt by exploiting correlation between each user's fingerprint and the forged copy. The worst-case error probability of this detection scheme is analyzed and bounded. Simulation results demonstrate the average-case performance is similar to the performance of orthogonal and simplex fingerprint designs, while accommodating several times as many users.

  9. Glycemic Control for Patients With Acute Myocardial Infarction

    Hai-peng XIAO; Juan CHEN

    2009-01-01

    @@ The risk of myocardial infarction increases in patients with diabetes mellitus. The incidence of myocardial in-farction is similar in patients with type 2 diabetes without history of myocardial infarction and in non-diabetic pa-tients with history of myocardial infarction. Diabetes mellitus was considered as a coronary disease equivalent by the National Cholesterol Education Program. Strict glycemic control can improve the long-term outcome of both type 1 and type 2 diabetes mellitus. Whatever with diabetic or non-diabetic, strict glycemic control with in-tensive insulin therapy can reduce the mortality of criti-cally ill patients in hospital. After myocardial infarction, there would be a worse outcome for patients with poor glycemic control, whatever in diabetic or non-diabetic patients with stress hyperglycemia.

  10. Correlation between glycemic excursion by CGMS and diabetic retinopathy among Type 2 diabetes mellitus

    Objective: To investigate correlation between glycemic excursion by CGMS and diabetic retinopathy among type 2 diabetes mellitus. Methods: Used continuous glucose monitoring system (CGMS) to monitoring glycemic excursion within a day of twenty four patients with type 2 diabetes mellitus, and inspect fundus photography, correlation was analyzed. Results: Glycemic excursion might reveal the risk for diabetic retinopathy better than HbA1c does. Conclusion: Diabetic retinopathy may correlate with glycemic excursion. (authors)

  11. Naturally fractured tight gas reservoir detection optimization

    NONE

    1998-11-30

    potential field data, the GGRB was divided into partitions that will be used to analyze the resource potential of the Frontier and Mesaverde Upper Cretaceous tight gas play. A total of 20 partitions were developed, which will be instrumental for examining the Upper Cretaceous play potential. (5) Partition Analysis. Resource assessment associated with individual partitions was initiated starting with the Vermilion Sub-basin and the Green River Deep (which include the Stratos well) partitions (see Chapter 5). (6) Technology Transfer. Tech transfer was achieved by documenting our research and presenting it at various conferences.

  12. [Dapagliflozin: Beyond glycemic control in the treatment of type 2 diabetes mellitus].

    Sanz-Serra, Pol; Pedro-Botet, Juan; Flores-Le Roux, Juana A; Benaiges, David; Chillarón, Juan J

    2015-01-01

    Patients with type 2 diabetes mellitus (T2DM) have a high or very high cardiovascular risk. The clinical practice guidelines focus on the need to achieve optimal glycemic control, and strategies for a multifactorial therapeutic approach have shown significant cardiovascular benefits in these patients. Inhibitors of sodium-glucose co-transporter 2 (SGLT-2) are a new class of orally administered drugs in the treatment of T2DM, which act by inhibiting reabsorption of glucose in the renal proximal tubule with consequent glycosuric effect and lowering of blood glucose. Dapagliflozin, SGLT-2 inhibitor marketed in Europe and Australia, has been shown to achieve glycosylated hemoglobin reductions similar to other oral agents, as well as beneficial effects on major comorbidities associated with T2DM. Therefore, it is considered of interest to review the clinical efficacy of this new oral hypoglycemic on glycemic control, risk of hypoglycemia, and its impact on body weight, blood pressure, lipid profile and renal function. PMID:25648671

  13. Glycemic Status and Brain Injury in Older Individuals

    Saczynski, Jane S.; Siggurdsson, Sigurdur; Jonsson, Palmi V.; Eiriksdottir, Gudny; Olafsdottir, Elin; Kjartansson, Olafur; Harris, Tamara B; van Buchem, Mark A.; Gudnason, Vilmundur; Launer, Lenore J

    2009-01-01

    OBJECTIVE To examine the association of glycemic status to magnetic resonance imaging indicators of brain pathological changes. RESEARCH DESIGN AND METHODS This was a cross-sectional, population-based study of 4,415 men and women without dementia (mean age 76 years) participating in the Age Gene/Environment Susceptibility–Reykjavik Study. Glycemic status groups included the following: type 2 diabetes (self-report of diabetes, use of diabetes medications, or fasting blood glucose ≥7.0 mmol/l [...

  14. Carbohydrate Intake, Glycemic Index, Glycemic Load, and Stroke: A Meta-analysis of Prospective Cohort Studies.

    Cai, Xianlei; Wang, Chen; Wang, Shan; Cao, Gaoyang; Jin, Chao; Yu, Jiawei; Li, Xiuyang; Yan, Jing; Wang, Fudi; Yu, Wei; Ding, Fang

    2015-07-01

    The objective of this study was to investigate associations between carbohydrate intake/glycemic index (GI)/glycemic load (GL) and stroke risk. A literature search of MEDLINE, Embase, Web of Science, and CBM databases was performed to retrieve eligible studies published up to March 2014. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were used to evaluate the strength of this association. Publication bias was assessed by the Egger's regression asymmetry test and Begg's rank correlation test with Begg's funnel plot. All analyses were conducted using software STATA 12.0 (StataCorp LP, College Station, TX) and SAS version 9.1 (SAS Institute Inc, Cary, NC). We identified 7 prospective studies that met the inclusion criteria and processed data from cohort studies to update available evidence. There were 25 independent estimates and 225 000 participants free of diabetes from 6 different countries; 3046 stroke events were included; and the follow-up range was 5 to 18 years. High GI was not associated with risk of stroke events (pooled RR = 1.10; 95% CI: 0.99-1.21); GL was a risk factor for stroke (pooled RR = 1.19; 95% CI: 1.05-1.36). There was no significant association between high carbohydrate intake and stroke risk (RR = 1.12; 95% CI: 0.93-1.35). A daily high GL diet is the risk factor of stroke event, and further researches need to verify the meta-analyses results and study associated mechanisms. PMID:25593213

  15. Utility of different glycemic control metrics for optimizingmanagement of diabetes

    Klaus-Dieter Kohnert; Peter Heinke; Lutz Vogt; Eckhard Salzsieder

    2015-01-01

    The benchmark for assessing quality of long-termglycemic control and adjustment of therapy is currentlyglycated hemoglobin (HbA1c). Despite its importanceas an indicator for the development of diabeticcomplications, recent studies have revealed that thismetric has some limitations; it conveys a rather complexmessage, which has to be taken into considerationfor diabetes screening and treatment. On the basis ofrecent clinical trials, the relationship between HbA1cand cardiovascular outcomes in long-standing diabeteshas been called into question. It becomes obvious thatother surrogate and biomarkers are needed to betterpredict cardiovascular diabetes complications and assessefficiency of therapy. Glycated albumin, fructosamin,and 1,5-anhydroglucitol have received growing interestas alternative markers of glycemic control. In additionto measures of hyperglycemia, advanced glucosemonitoring methods became available. An indispensibleadjunct to HbA1c in routine diabetes care is selfmonitoringof blood glucose. This monitoring methodis now widely used, as it provides immediate feedbackto patients on short-term changes, involving fasting,preprandial, and postprandial glucose levels. Beyondthe traditional metrics, glycemic variability has beenidentified as a predictor of hypoglycemia, and it mightalso be implicated in the pathogenesis of vasculardiabetes complications. Assessment of glycemicvariability is thus important, but exact quantificationrequires frequently sampled glucose measurements. Inorder to optimize diabetes treatment, there is a needfor both key metrics of glycemic control on a day-to-daybasis and for more advanced, user-friendly monitoringmethods. In addition to traditional discontinuous glucosetesting, continuous glucose sensing has become auseful tool to reveal insufficient glycemic management.This new technology is particularly effective in patientswith complicated diabetes and provides the opportunityto characterize glucose dynamics. Several

  16. Improvement of Glycemic Control in Insulin-Dependent Diabetics with Depression by Concomitant Treatment with Antidepressants.

    Radojkovic, Jana; Sikanic, Natasa; Bukumiric, Zoran; Tadic, Marijana; Kostic, Nada; Babic, Rade

    2016-01-01

    BACKGROUND It is still disputable whether negative effects of comorbid depression in diabetics can be diminished by successful treatment of depression. The primary aim of this study was to assess whether addition of antidepressants to existing insulin treatment would further improve glycemic control in these patients. A secondary objective was to assess whether such treatment impairs their lipid and inflammatory status. MATERIAL AND METHODS Total of 192 patients with poorly controlled diabetes (defined as HbA1c ≥8%) in the absence of any uncontrolled medical condition entered the 6-month run-in phase with optimization of diabetic therapy. Depression status was screened at the end of this phase by BDI-II depression testing. Patients with BDI-II ≥14 and psychiatric confirmation of depression (58 patients) entered the 6-month interventional phase with SSRI class antidepressants. RESULTS Fifty patients completed the study. During the run-in phase, HbA1c dropped from 10.0±1.8% to 8.5±1.2% (pdepression scale and improvement in glycemic control was observed (R²=0.139, p=0.008). Lipid profile and inflammatory status did not change significantly during the interventional phase. CONCLUSIONS Patients with poorly controlled diabetes and comorbid depression might benefit from screening and treatment of depression with SSRI antidepressants by achieving an incremental effect on glycoregulation. This therapy did not have any adverse effects on lipid profile or inflammatory status. PMID:27329213

  17. Clinical Outcomes of Metabolic Surgery: Efficacy of Glycemic Control, Weight Loss, and Remission of Diabetes.

    Schauer, Philip R; Mingrone, Geltrude; Ikramuddin, Sayeed; Wolfe, Bruce

    2016-06-01

    Since the 2007 Diabetes Surgery Summit in Rome, Italy, and the subsequent publishing of the world's first guidelines for the surgical treatment of type 2 diabetes (T2D), much new evidence regarding the efficacy and safety of metabolic surgery has emerged. Additional observational cohort studies support the superior effects of surgery over medical treatment with respect to glycemic control, weight loss, and even reduction in mortality and microvascular complications associated with T2D. Furthermore, new safety data suggest that the perioperative morbidity and mortality of metabolic surgery (5% and 0.3%, respectively) are now similar to that of common low-risk procedures, such as cholecystectomy and hysterectomy. The largest advance, however, has been the completion of 11 randomized controlled trials from around the globe that compare surgery with medical treatment of T2D. These studies with follow-up duration of 1-5 years involve nearly 800 patients without surgical mortality and with major complication rates of less than 5% and a reoperation rate of 8%. All but 1 of the 11 randomized controlled trials have shown the superiority of surgery over medical management at achieving remission or glycemic improvement. Surgery was also superior to medical treatment with respect to improving cardiovascular risk factors, such as weight loss and dyslipidemia, while reducing medication burden. This new efficacy and safety evidence should help guide physicians across the globe to the appropriate use of surgery as an effective treatment for patients suffering from T2D and obesity. PMID:27222548

  18. Approaches to reduce the glycemic response of gluten-free products: in vivo and in vitro studies.

    Capriles, V D; Arêas, J A G

    2016-03-01

    This article aims to discuss the current approaches used to reduce the postprandial glycemic response (GR) of starchy gluten-free products (GFP) and to provide some further prospects. The GR is evaluated through in vivo trials to determine the glycemic index (GI) and the glycemic load (GL) of foods or using the in vitro starch digestibility method to predict the GI. The reviewed studies demonstrated that a reduction in the GR of GFP can be achieved by replacing traditionally used refined flours and starches with nutrient-dense alternative raw materials due to an increase in dietary fiber, resistant starch and protein contents, which can alter the rate of starch digestion, reduce the GI and dilute the amount of available carbohydrate; both the factors contribute to reduce the GL. The addition of viscous dietary fibers could also be a successful way to reduce the GR of GFP. Some studies have demonstrated the potential of germination of GF grains and sourdough fermentation in decreasing the GR of GF bread. Further studies could evaluate alternative GF flours, soluble fibers, resistant starch, and other formulation factors that may affect the GR of different types of GFP. New studies should be performed to test and optimize processing methods by considering the reduction of GR of GFP. Another key aspect for further investigation is the confirmation of the promising results obtained through in vitro assays by in vivo GI evaluation. PMID:26838096

  19. Relationship of morphological changes of blood cells with endothelial function, renal function and lipidemic profile in patients with type 2 diabetes mellitus with suboptimal glycemic control and hypertension

    Pertseva N.O.

    2016-03-01

    Full Text Available Background. Many questions about the relationship between endothelial dysfunction and morphological substrate of hemostasis damage that occur during the progress of type 2 diabetes mellitus and arterial hypertension require clarification and further advance. Objective. The aim of this study is to determine the relationships between endothelial dysfunction, the degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis in patients with type 2 diabetes mellitus with suboptimal glycemic control and hypertension. Methods. In 87 patients with insufficient glycemic compensation using clinical, laboratory, morphological methods and correlational analysis were identified association between endothelial dysfunction, degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis. Results. Against the background of insufficient glycemic compensation glycated hemoglobin concentration tightly correlated with the share of activated platelets (r=+0.77; p<0.05, with the level of aggregated forms (r=+0.82; p<0.05 and the concentration of small blood platelet aggregates (r=+0.76; p<0.05, established a positive relationship with the share degranulated platelets (r=+0.60; p<0.05. Signs of atherogenic dyslipidemia triad that this contingent of patients indicated significant deviation from that of the control group not only had a correlation with the share of activated platelets and content of alpha and delta granules, but also formed a new moderate strength correlations with other observable parameters of platelet morphology. In particular, amid insufficient glycemic compensation formed reliable values of the coefficients of linear correlation in pairs: total cholesterol and activated platelets (r=-0.54, low density lipoprotein cholesterol and activated platelets (r=-0.51, low density lipoprotein cholesterol and aggregated forms (r=+0.59, low density lipoprotein

  20. In vitro starch digestibility and expected glycemic index of pound cakes baked in two-cycle microwave-toaster and conventional oven.

    García-zaragoza, Francisco J; Sánchez-Pardo, María E; Ortiz-Moreno, Alicia; Bello-Pérez, Luis A

    2010-11-01

    Bread baking technology has an important effect on starch digestibility measured as its predicted glycemic index tested in vitro. The aim of this work was to evaluate the changes in predicted glycemic index of pound cake baked in a two-cycle microwave toaster and a conventional oven. The glycemic index was calculated from hydrolysis index values by the Granfeldt method. Non-significant differences (P > 0.05) were found in hydrolysis index (60.67 ± 3.96 for the product baked in microwave oven and 65.94 ± 4.09 for the product baked in conventional oven) and predicted glycemic index content (60.5 for product baked in microwave oven and 65 for the product baked in conventional oven) in freshly-baked samples. Results clearly demonstrate that the baking pound cake conventional process could be replicated using a two-cycle multifunction microwave oven, reducing the traditional baking time. Further research is required in order to achieve pound cake crumb uniformity. PMID:20367217

  1. Lifting scheme of symmetric tight wavelets frames

    ZHUANG BoJin; YUAN WeiTao; PENG LiZhong

    2008-01-01

    This paper proposes a method to realize the lifting scheme of tight frame wavelet filters. As for 4-channel tight frame wavelet filter, the tight frame transforms' ma-trix is 2×4, but the lifting scheme transforms' matrix must be 4×4. And in the case of 3-channel tight frame wavelet filter, the transforms' matrix is 2×3, but the lifting scheme transforms' matrix must be 3×3. In order to solve this problem, we intro-duce two concepts: transferred polyphase matrix for 4-channel filters and trans-ferred unitary matrix for 3-channel filters. The transferred polyphase matrix is sym-metric/antisymmetric. Thus, we use this advantage to realize the lifting scheme.

  2. Critical heat flux experiments in tight lattice core

    Kureta, Masatoshi [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    2002-12-01

    Fuel rods of the Reduced-Moderation Water Reactor (RMWR) are so designed to be in tight lattices as to reduce moderation and achieve higher conversion ratio. As for the BWR type reactor coolant flow rate is reduced small compared with the existing BWR, so average void fraction comes to be langer. In order to evaluate thermo hydraulic characteristics of designed cores, critical heat flux experiments in tight lattice core have been conducted using simulated high pressure coolant loops for both the PWR and BWR seven fuel rod bundles. Experimental data on critical heat flux for full bundles have been accumulated and applied to assess the critical power of designed cores using existing codes. Evaluated results are conservative enough to satisfy the limiting condition. Further experiments on axial power distribution effects and 37 fuel rod bundle tests will be performed to validate thermohydraulic characteristics of designed cores. (T. Tanaka)

  3. Complex Hadamard matrices and Equiangular Tight Frames

    Szöll\\Hosi, Ferenc

    2011-01-01

    In this paper we give a new construction of parametric families of complex Hadamard matrices of square orders, and connect them to equiangular tight frames. The results presented here generalize some of the recent ideas of Bodmann et al. and extend the list of known equiangular tight frames. In particular, a (36,21) frame coming from a nontrivial cube root signature matrix is obtained for the first time.

  4. Advanced Hydraulic Fracturing Technology for Unconventional Tight Gas Reservoirs

    Stephen Holditch; A. Daniel Hill; D. Zhu

    2007-06-19

    The objectives of this project are to develop and test new techniques for creating extensive, conductive hydraulic fractures in unconventional tight gas reservoirs by statistically assessing the productivity achieved in hundreds of field treatments with a variety of current fracturing practices ranging from 'water fracs' to conventional gel fracture treatments; by laboratory measurements of the conductivity created with high rate proppant fracturing using an entirely new conductivity test - the 'dynamic fracture conductivity test'; and by developing design models to implement the optimal fracture treatments determined from the field assessment and the laboratory measurements. One of the tasks of this project is to create an 'advisor' or expert system for completion, production and stimulation of tight gas reservoirs. A central part of this study is an extensive survey of the productivity of hundreds of tight gas wells that have been hydraulically fractured. We have been doing an extensive literature search of the SPE eLibrary, DOE, Gas Technology Institute (GTI), Bureau of Economic Geology and IHS Energy, for publicly available technical reports about procedures of drilling, completion and production of the tight gas wells. We have downloaded numerous papers and read and summarized the information to build a database that will contain field treatment data, organized by geographic location, and hydraulic fracture treatment design data, organized by the treatment type. We have conducted experimental study on 'dynamic fracture conductivity' created when proppant slurries are pumped into hydraulic fractures in tight gas sands. Unlike conventional fracture conductivity tests in which proppant is loaded into the fracture artificially; we pump proppant/frac fluid slurries into a fracture cell, dynamically placing the proppant just as it occurs in the field. From such tests, we expect to gain new insights into some of the critical

  5. Dietary Glycemic Index and the Risk of Birth Defects

    Parker, Samantha E.; Werler, Martha M.; Shaw, Gary M.; Anderka, Marlene; Yazdy, Mahsa M.

    2012-01-01

    Prepregnancy diabetes and obesity have been identified as independent risk factors for several birth defects, providing support for a mechanism that involves hyperglycemia and hyperinsulinemia in the development of malformations. Data from the National Birth Defects Prevention Study from 1997 to 2007 were used to investigate the association between the maternal dietary glycemic index (DGI) and the risk of birth defects among nondiabetic women. DGI was categorized by using spline regression mo...

  6. Variable Classifications of Glycemic Index Determined by Glucose Meters

    Lin, Meng-Hsueh Amanda; Wu, Ming-Chang; Lin, Jenshinn

    2010-01-01

    The study evaluated and compared the differences of glucose responses, incremental area under curve (IAUC), glycemic index (GI) and the classification of GI values between measured by biochemical analyzer (Fuji automatic biochemistry analyzer (FAA)) and three glucose meters: Accue Chek Advantage (AGM), BREEZE 2 (BGM), and Optimum Xceed (OGM). Ten healthy subjects were recruited for the study. The results showed OGM yield highest postprandial glucose responses of 119.6 ± 1.5, followed by FAA, ...

  7. Postprandial blood glucose control in type 1 diabetes for carbohydrates with varying glycemic index foods.

    Hashimoto, Shogo; Noguchi, Claudia Cecilia Yamamoto; Furutani, Eiko

    2014-01-01

    Treatment of type 1 diabetes consists of maintaining postprandial normoglycemia using the correct prandial insulin dose according to food intake. Nonetheless, it is hardly achieved in practice, which results in several diabetes-related complications. In this study we present a feedforward plus feedback blood glucose control system that considers the glycemic index of foods. It consists of a preprandial insulin bolus whose optimal bolus dose and timing are stated as a minimization problem, which is followed by a postprandial closed-loop control based on model predictive control. Simulation results show that, for a representative carbohydrate intake of 50 g, the present control system is able to maintain postprandial glycemia below 140 mg/dL while preventing postprandial hypoglycemia as well. PMID:25571074

  8. Optimizing glycemic control and minimizing the risk of hypoglycemia in patients with type 2 diabetes

    Stanley S Schwartz

    2013-05-01

    Full Text Available Diabetic microvascular and macrovascular complications arise from hyperglycemia, presenting an increasing healthcare burden as the diabetic population continues to grow. Clinical trial evidence indicates that antihyperglycemic medications are beneficial with regard to microvascular disease (retinopathy, renal impairment, and perhaps neuropathy; however, the benefit of aggressive use of these medications with regard to cardiovascular risk has been less clear in recent studies. These studies were confounded by the propensity of the antihyperglycemic medications involved to cause hypoglycemia, which itself presents cardiovascular risk. This article presents additional context for these seemingly discordant results and maintains that the achievement of glycemic targets is warranted in most patients and provides cardiovascular benefit, provided that hypoglycemia is avoided and the treatment regimen is tailored to the needs of the individual patient. A treatment approach that is driven by these principles and emphasizes diet and exercise, a combination of noninsulin antidiabetic agents, not including sulfonylureas and glinides, and judicious use of insulin is also presented.

  9. Glycemic changes after vitamin D supplementation in patients with type 1 diabetes mellitus and vitamin D deficiency

    A prospective, nonblinded and nonrandomized controlled trial was conducted to test the hypothesis that vitamin D supplementation would improve glycemic control in patients with type 1 diabetes mellitus who have vitamin D deficiency. Patients and 0 Eighty patients with type 1 diabetes mellitus who had 25-hydroxyvitamin D levels less than 50 nmol/L were assigned to receive 4000 IU of vitamin D3. Calcium supplements were provided to ensure a total calcium intake of 1200 mg/d. Glycosylated hemoglobin and 25-hydroxyvitamin D levels were measured at baseline and at 12 weeks.There was a significant difference in mean (SD) glycosylated hemoglobin level (%) between the groups that achieved 25-hydroxyvitamin D levels of 51 nmol/L at 12 weeks (P=.02). There was a significant difference in glycosylated hemoglobin change from baseline between the groups that achieved 25-hydroxyvitamin D levels of 51 nmol/L at 12 weeks (P=.04). There was a significant difference in 25-hydroxyvitamin D level between the groups that achieved glycosylated hemoglobin levels of 9.9 at 12 weeks (P=.001). Patients were more likely to achieve lower glycosylated hemoglobin levels at 12 weeks if they had higher 25-hydroxyvitamin D levels at 12 weeks (r=-0.4, P=.001).There was an observed effect of vitamin D supplementation on glycemic control in vitamin D-replete, type 1 diabetes mellitus patients. Further studies are needed to determine if these findings are applicable (Author).

  10. Effect of the Glycemic Index of Carbohydrates on Acne vulgaris

    Jennie C. Brand-Miller

    2010-10-01

    Full Text Available Acne vulgaris may be improved by dietary factors that increase insulin sensitivity. We hypothesized that a low-glycemic index diet would improve facial acne severity and insulin sensitivity. Fifty-eight adolescent males (mean age ± standard deviation 16.5 ± 1.0 y and body mass index 23.1 ± 3.5 kg/m2 were alternately allocated to high or low glycemic index diets. Severity of inflammatory lesions on the face, insulin sensitivity (homeostasis modeling assessment of insulin resistance, androgens and insulin-like growth factor-1 and its binding proteins were assessed at baseline and at eight weeks, a period corresponding to the school term. Forty-three subjects (n = 23 low glycemic index and n = 20 high glycemic index completed the study. Diets differed significantly in glycemic index (mean ± standard error of the mean, low glycemic index 51 ± 1 vs. high glycemic index 61 ± 2, p = 0.0002, but not in macronutrient distribution or fiber content. Facial acne improved on both diets (low glycemic index −26 ± 6%, p = 0.0004 and high glycemic index −16 ± 7%, p = 0.01, but differences between diets did not reach significance. Change in insulin sensitivity was not different between diets (low glycemic index 0.2 ± 0.1 and high glycemic index 0.1 ± 0.1, p = 0.60 and did not correlate with change in acne severity (Pearson correlation r = −0.196, p = 0.244. Longer time frames, greater reductions in glycemic load or/and weight loss may be necessary to detect improvements in acne among adolescent boys.

  11. Tight coupling UFMArcGIS for simulating inundation depth in densely area

    Kang, S. H.

    2010-01-01

    The integration of hydrological models and Geographical Information Systems (GIS) usually takes two approaches: loose coupling and tight coupling. This paper presents a tight coupling approach within a GIS environment that is achieved by integrating the urban flood model with the macro language of GIS. Such an approach affords an uncomplicated way to capitalize on the GIS visualization and spatial analysis functions, thereby significantly supporting the dynamic simulation process of hydrologi...

  12. 75 FR 2549 - Clinical Accuracy Requirements for Point of Care Blood Glucose Meters; Public Meeting; Request...

    2010-01-15

    ...) Clinical accuracy for blood glucose meters, (2) tight glycemic control in clinical settings, and (3... allow for better glycemic control by diabetics than in the past. Glucose meters are not only used by... evaluated by FDA. For example, glucose meters are increasingly being used to achieve tight glycemic...

  13. Extensor Pollicis Longus Rupture after Mini TightRope Suspensionplasty.

    Seetharaman, Mani; Vitale, Mark A; Desai, Kapil; Crowe, John F

    2016-05-01

    Background Arthritis of the first carpometacarpal (CMC) joint has been surgically treated in multiple ways with varying levels of success as measured by subjective and objective measures. Trapeziectomy with numerous variations in suspensionplasty comprises one of the more commonly used surgical procedures. Recently, the Mini TightRope apparatus has been utilized as a new method for achieving suspensionplasty, and as such lacks significant review of use and safety in the literature. Case Description An extensor pollicis longus (EPL) rupture following a trapeziectomy and Mini TightRope suspensionplasty for CMC arthritis of the thumb is presented. The patient successfully underwent an extensor indicis proprius (EIP) to EPL transfer to treat this complication. Literature Review There is well-established documentation of injury to the extensor tendons from orthopedic hardware such as volar locking plates. Regarding use of the Mini TightRope apparatus, guidelines for placement of the suture button include caution to place the button away from the EPL tendon to minimize the chance of tendon irritation. Additionally, FiberWire sutures, a component of the apparatus, have been shown to demonstrate soft tissue reactions with adjacent inflammatory response. Published reports on adverse events utilizing this device have been limited to case reports including an index metacarpal fracture. Clinical Relevance The aim of this case report was to cite an occurrence of EPL rupture following its use and discuss the possibilities of its direct contribution. PMID:27104081

  14. Exenatide once weekly: sustained improvement in glycemic control and cardiometabolic measures through 3 years

    MacConell L

    2013-01-01

    Full Text Available Leigh MacConell, Richard Pencek, Yan Li, David Maggs, Lisa PorterAmylin Pharmaceuticals, LLC, San Diego, CA, USABackground: Type 2 diabetes mellitus is a progressive metabolic disease necessitating therapies with sustained efficacy and safety over time. Exenatide once weekly (ExQW, an extended-release formulation of the glucagon-like peptide-1 receptor agonist exenatide, has demonstrated improvements in glycemic and cardiometabolic measures from 30 weeks to 2 years of treatment. Here, the efficacy and safety of treatment with ExQW for 3 years are described.Methods: Patients were initially randomized to receive either ExQW (2 mg or exenatide twice daily for 30 weeks. Following the initial 30 weeks, all patients were treated with ExQW in an open-label extension. Analyses of primary glycemic endpoints, beta-cell function, and cardiometabolic measures were assessed for patients who completed 3 years of ExQW treatment and for the intention-to-treat population. Safety and tolerability analyses were provided for the intention-to-treat population.Results: Sixty-six percent of the intention-to-treat population (n = 295 completed 3 years of treatment (n = 194. At 3 years, a significant reduction in hemoglobin A1c (least squares mean ± standard error of -1.6% ± 0.08% was observed, with 55% and 33% of patients achieving hemoglobin A1c targets of <7% and ≤6.5%, respectively. Consistent with a sustained reduction in hemoglobin A1c, improvements in beta-cell function were also observed. Body weight was significantly reduced by -2.3 ± 0.6 kg. Reductions in blood pressure, total cholesterol, low-density lipoprotein cholesterol, and triglycerides were also observed. Adverse events reported most frequently during both controlled and uncontrolled periods included diarrhea, nausea, and vomiting of mostly mild intensity. The incidence of these adverse events decreased over time. Incidence of minor hypoglycemia was low and no major hypoglycemia was observed

  15. Current trends in salivary gland tight junctions.

    Baker, Olga J

    2016-01-01

    Tight junctions form a continuous intercellular barrier between epithelial cells that is required to separate tissue spaces and regulate selective movement of solutes across the epithelium. They are composed of strands containing integral membrane proteins (e.g., claudins, occludin and tricellulin, junctional adhesion molecules and the coxsackie adenovirus receptor). These proteins are anchored to the cytoskeleton via scaffolding proteins such as ZO-1 and ZO-2. In salivary glands, tight junctions are involved in polarized saliva secretion and barrier maintenance between the extracellular environment and the glandular lumen. This review seeks to provide an overview of what is currently known, as well as the major questions and future research directions, regarding tight junction expression, organization and function within salivary glands. PMID:27583188

  16. Factors Predicting Glycemic Control in Middle-Aged and Older Adults With Type 2 Diabetes

    Ching-Ju Chiu, PhD

    2010-01-01

    Full Text Available IntroductionFew studies have prospectively assessed the explanatory effects of demographics, clinical conditions, treatment modality, and general lifestyle behaviors on glycemic control in large heterogeneous samples of middle-aged and older adults with type 2 diabetes. We hierarchically examined these factors, focused especially on the effects of modifiable factors (ie, general lifestyle behaviors, and compared predictive patterns between middle-aged and older adults.MethodsWe used nationally representative data from the 1998 and 2000 Health and Retirement Study (HRS and the HRS 2003 Diabetes Study. We analyzed data from 379 middle-aged adults (aged 51-64 y and 430 older adults (aged ≥65 y who self-reported having type 2 diabetes at baseline.ResultsAmong middle-aged adults, demographic factors and clinical conditions were the strongest predictors of hemoglobin A1c (HbA1c levels. However, among older adults, treatment modality (diet only, oral medication, or insulin only or in combination with other regimens significantly affected HbA1c levels. Lifestyle (physical activity, smoking, drinking, and body weight control, independent of the effects of demographics, clinical conditions, and treatment modality, significantly affected HbA1c levels. An increase of 1 healthy behavior was associated with a decrease in HbA1c levels of more than 1 percentage point.ConclusionOur findings provide support for current diabetes guidelines that recommend a lifestyle regimen across the entire span of diabetes care and highlight the need to help both sociodemographically and clinically disadvantaged middle-aged adults with type 2 diabetes as well as older adults who exhibit poor adherence to medication recommendations to achieve better glycemic control.

  17. Glycemic index: effect of food storage under low temperature

    Marina Cassab Carreira; Franco Maria Lajolo; Elizabete Wenzel de Menezes

    2004-01-01

    This study was carried out to evaluate the influence of food storage under low temperature (-20ºC) and the resistant starch formation, both on the glycemic index (GI). The GI of only cooked and cooked and stored foods under -20ºC for 30 days was evaluated in short-term tests with humans. Significant increase on the RS content was evidenced for all the stored foods. The food storage resulted in a significant decrease on the GI of beans and chick-peas; the GI of pasta remained the same and the ...

  18. Interaction between functional health literacy, patient activation, and glycemic control

    Woodard LD

    2014-07-01

    Full Text Available LeChauncy D Woodard, Cassie R Landrum, Amber B Amspoker, David Ramsey, Aanand D Naik Veterans Affairs Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veterans Affairs Medical Center, and Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA Background: Functional health literacy (FHL and patient activation can impact diabetes control through enhanced diabetes self-management. Less is known about the combined effect of these characteristics on diabetes outcomes. Using brief, validated measures, we examined the interaction between FHL and patient activation in predicting glycosylated hemoglobin (HbA1c control among a cohort of multimorbid diabetic patients.Methods: We administered a survey via mail to 387 diabetic patients with coexisting ­hypertension and ischemic heart disease who received outpatient care at one regional VA medical center between November 2010 and December 2010. We identified patients with the study conditions using the International Classification of Diseases-Ninth Revision-Clinical ­Modification (ICD-9-CM diagnoses codes and Current Procedure Terminology (CPT ­procedures codes. Surveys were returned by 195 (50.4% patients. We determined patient activation levels based on participant responses to the 13-item Patient Activation Measure and FHL levels using the single-item screening question, “How confident are you filling out medical forms by yourself?” We reviewed patient medical records to assess glycemic control. We used multiple logistic regression to examine whether activation and FHL were individually or jointly related to HbA1c control.Results: Neither patient activation nor FHL was independently related to glycemic control in the unadjusted main effects model; however, the interaction between the two was significantly associated with glycemic control (odds ratio 1.05 [95% confidence

  19. Is there a need to optimize glycemic control in hemodialyzed diabetic patients?

    Feldt-Rasmussen, B

    2006-01-01

    The report of Williams et al. gives rise to at least two important questions regarding diabetic patients on maintenance hemodialysis: (1) Does glycemic control play a significant role? (2) Is HbA1c a reliable measure of glycemic control? These questions are discussed. It is recommended that you...

  20. Diets with high or low protein content and glycemic index for weight-loss maintenance

    Larsen, Thomas Meinert; Dalskov, Stine-Mathilde; Baak, Marleen van;

    2010-01-01

    Studies of weight-control diets that are high in protein or low in glycemic index have reached varied conclusions, probably owing to the fact that the studies had insufficient power.......Studies of weight-control diets that are high in protein or low in glycemic index have reached varied conclusions, probably owing to the fact that the studies had insufficient power....

  1. Impact of Air Tightness on the Evaluation of Building Energy Performance in Lithuania

    Jolanta Šadauskienė

    2014-08-01

    Full Text Available In order to fulfil the European Energy Performance of Buildings Directive (EPBD requirements for the reduction of energy consumption, European national requirements have been created for building envelope thermal properties and calculation methodology to determine if building energy efficiency is created. This is however not true in all methodologies. The necessity of building air tightness appears only for new A class buildings, and there are no requirements for air tightness for other building classes. Therefore, the aim of this work is to improve the methodology for the calculation of energy efficiency of buildings, while taking into account the air tightness of the buildings. In order to achieve this aim, the sum energy consumption of investigated buildings was calculated, energy efficiency classes were determined, air tightness of the buildings was measured, and reasons for insufficient air tightness were analyzed. Investigation results show that the average value of air tightness of A energy efficiency class buildings is 0.6 h−1. The results of other investigated buildings, corresponding to B and C energy efficiency classes, show insufficient air tightness (the average n50 value is 6 h−1; herewith, energy consumption for heating is higher than calculated, according to the energy efficiency methodology. This paper provides an energy performance evaluation scheme, under which performed evaluation of energy performance of buildings ensures high quality construction work, building durability, and the reliability of heat-loss calculations.

  2. Study on water leak-tightness of small leaks on a 1 inch cylinder valve

    Practical thresholds for water leak-tightness of small leaks were determined by experimentation. Measurements for small leak samples were taken of air leakage rates and water leakage rates for identical leak samples in order to identify parameters that influence water leak-tightness threshold. Four types of leaks were evaluated: a fine wire inserted in an O-ring seal, a glass capillary tube, a stainless steel orifice, and a scratched valve stem on a 1 inch UF6 cylinder valve. Experimental results demonstrated that the key parameter for water leak-tightness is the opening size of the leak hole. The maximum allowable hole size to achieve water leak-tightness ranged from 10 to 20 μm in diameter in this study. Experimental results with 1 inch UF6 cylinder valve samples demonstrated that the acceptance criteria for preshipment leakage test, 1x10-3 ref-cm3.s-1, as prescribed in ANSI N14.5 is an appropriate value from the point of view of water leak-tightness for enriched UF6 packages. The mechanism of water leak-tightness is plugging by tiny particles existing in water. The water used in experiments in this study contained far fewer particles than in water assumed to be encountered under accident conditions of transport. Therefore, the water leak-tightness threshold determined in this study is a conservative value in a practical evaluation. (author)

  3. Classifying tight Weyl-Heisenberg frames

    Cazsazza, P.; Janssen, A. J. E. M.; Christensen, Ole

    1999-01-01

    A Weyl-Heisenberg frame for L^2(R) is a frame consisting of translates and modulates of a fixed function. In this paper we give necessary and sufficient conditions for this family to form a tight WH-frame. This allows us to write down explicitly all functions g for which all translates and...

  4. Classifying tight Weyl-Heisenberg frames

    Cazsazza, P.; Janssen, A. J. E. M.; Christensen, Ole

    A Weyl-Heisenberg frame for L^2(R) is a frame consisting of translates and modulates of a fixed function. In this paper we give necessary and sufficient conditions for this family to form a tight WH-frame. This allows us to write down explicitly all functions g for which all translates and modula...

  5. A nationwide survey of diabetes education, self-management and glycemic control in patients with type 2 diabetes in China

    GUO Xiao-hui; YUAN Li; LOU Qing-qing; SHEN Li; SUN Zi-lin; ZHAO Fang; DAI Xia; HUANG Jin; YANG Hui-ying

    2012-01-01

    Background Diabetes management could be improved by diabetes education,through influencing attitudes towards diabetes,knowledge and behaviors of patients.The purpose of this study was to characterize the impact of diabetes education on glycemic control,and to assess the attitude,knowledge and self-care behavior in patients with type 2 diabetes in China.Methods This questionnaire-based survey was conducted in 50 medical centers across China from April to July of 2010.The patients with type 2 diabetes were eligible for the study.The information of glycemic control and diabetes education was collected.The diabetes attitude scale-3 formulae,a questionnaire of diabetes knowledge and Summary of Diabetes Self-care Activities scale were used to assess attitude,knowledge and the self-care of patients,respectively.Results Among the 5961 eligible respondents (3233 males; mean age (59.50±12.48) years; mean hemoglobin A1c (HbA1c) (8.27±2.23)%),most patients (79.8%) considered themselves educated on diabetes.Compared with patients without diabetes education,their educated counterparts showed significant lower value of HbA1c,after controlling for age,gender,body mass index and duration of diabetes (P <0.01).The patients who received diabetes education also performed significant higher scores on attitude,knowledge and self-care than their uneducated counterparts.Patients with lower income or education level tended to have higher glucose levels,and showed lower percentage of patients received diabetic education.Conclusions Chinese patients with diabetes education achieved better glycemic control than un-educated patients.Our study indicates effort is required to provide professional education to patients,with emphasis on lower income and lower education level populations.

  6. Repaglinide/metformin fixed-dose combination to improve glycemic control in patients with type 2 diabetes: an update

    Robert G Moses

    2010-05-01

    Full Text Available Robert G MosesClinical Trials and Research Unit, South East Sydney and Illawarra Area Health Service, New South Wales, AustraliaAbstract: Type 2 diabetes is a progressive disease associated with high levels of morbidity and mortality and for which there is both a large and growing prevalence worldwide. Lifestyle advice plus metformin is commonly recommended initially to manage hyperglycemia and to minimize the risk of vascular complications. However, additional agents are required when glycemic targets cannot be achieved or maintained due to the progressive nature of the disease. Repaglinide/metformin fixed-dose combination (FDC therapy (PrandiMet®; Novo Nordisk, Bagsværd, Denmark has been approved for use in the USA. This FDC is a rational second-line therapy given the complementary mechanisms of action of the components. Repaglinide is a rapidly absorbed, short-acting insulin secretagogue targeting postprandial glucose excursions; metformin is an insulin sensitizer with a longer duration of action that principally regulates basal glucose levels. A pivotal, 26-week, randomized study with repaglinide/metformin FDC therapy has been conducted in patients experiencing suboptimal control with previous oral antidiabetes therapy. Repaglinide/metformin FDC improved glycemic control and weight neutrality without adverse effects on lipid profiles. There were no major hypoglycemic episodes and patients expressed greater satisfaction with repaglinide/metformin FDC than previous treatments. Repaglinide/metformin FDC is expected to be more convenient than individual tablets for patients taking repaglinide and metformin in loose combination, and it is expected to improve glycemic control in patients for whom meglitinide or metformin monotherapies provide inadequate control.Keywords: type 2 diabetes, metformin, repaglinide, PrandiMet®, fixed-dose combination

  7. The argument against glycemic index: what are the other options?

    Franz, Marion J

    2006-01-01

    There is debate among professionals regarding the use of the glycemic index (GI) for meal planning. In type-1 diabetes, there are 4 studies (average duration approximately 4 weeks) comparing high versus low GI diets; none reported improvements in HbA1c, and although 2 reported improvements in fructosamine, 2 reported no differences. In type-2 diabetes, there are 12 studies (average duration approximately 5 weeks); 3 reported improvements in HbA1c and fructosamine, 5 reported no differences in HBA1c, and 3 reported no differences in fructosamine. In adults, there is limited evidence that a low GI diet is beneficial for weight loss or satiety. Three epidemiologic studies reported that a low GI/glycemic load (GL) is associated with a reduced risk of developing diabetes or prevalence of insulin resistance; however, 5 studies report no association between GI/GL and the risk of developing diabetes, fasting insulin or insulin resistance, or adiposity. In general, the total amount of carbohydrate in a meal is the primary meal-planning strategy for people with diabetes. The GI can be used as an adjunct for the fine tuning of postprandial blood glucose responses. Other food/meal-planning interventions have been shown to be more effective than the use of the GI. PMID:16820731

  8. Naturally fractured tight gas reservoir detection optimization

    NONE

    1998-11-30

    The goal of the work this quarter has been to partition and high-grade the Greater Green River basin for exploration efforts in the Upper Cretaceous tight gas play and to initiate resource assessment of the basin. The work plan for the quarter of July 1-September 30, 1998 comprised three tasks: (1) Refining the exploration process for deep, naturally fractured gas reservoirs; (2) Partitioning of the basin based on structure and areas of overpressure; (3) Examination of the Kinney and Canyon Creek fields with respect to the Cretaceous tight gas play and initiation of the resource assessment of the Vermilion sub-basin partition (which contains these two fields); and (4) Initiation analysis of the Deep Green River Partition with respect to the Stratos well and assessment of the resource in the partition.

  9. Tight-binding treatment of conjugated polymers

    Lynge, Thomas Bastholm

    This PhD thesis concerns conjugated polymers which constitute a constantly growing research area. Today, among other things, conjugated polymers play a role in plastic based solar cells, photodetectors and light emitting diodes, and even today such plastic-based components constitute an alternative...... of tomorrow. This thesis specifically treats the three conjugated polymers trans-polyacetylene (tPA), poly(para-phenylene) (PPP) and poly(para-phe\\-nylene vinylene) (PPV). The present results, which are derived within the tight-binding model, are divided into two parts. In one part, analytic results...... are derived for the optical properties of the polymers expressed in terms of the optical susceptibility both in the presence and in the absence of a static electric field. In the other part, the cumputationally efficient Density Functional-based Tight-Binding (DFTB) model is applied to the description...

  10. A combinatorial characterization of tight fusion frames

    Bownik, Marcin; Richmond, Edward

    2011-01-01

    In this paper we give a combinatorial characterization of tight fusion frame (TFF) sequences using Littlewood-Richardson skew tableaux. The equal rank case has been solved recently by Casazza, Fickus, Mixon, Wang, and Zhou. Our characterization does not have this limitation. We also develop some methods for generating TFF sequences. The basic technique is a majorization principle for TFF sequences combined with spatial and Naimark dualities. We use these methods and our characterization to give necessary and sufficient conditions which are satisfied by the first three highest ranks. We also give a combinatorial interpretation of spatial and Naimark dualities in terms of Littlewood-Richardson coefficients. We exhibit four classes of TFF sequences which have unique maximal elements with respect to majorization partial order. Finally, we give several examples illustrating our techniques including an example of tight fusion frame which can not be constructed by the existing spectral tetris techniques. We end the ...

  11. Tightly Coupled UWB/IMU Pose Estimation

    Hol, Jeroen D.; Dijkstra, Fred; Luinge, Henk; Schön, Thomas

    2009-01-01

    In this paper we propose a 6DOF tracking system combining Ultra-Wideband measurements with low-cost MEMS inertial measurements. A tightly coupled system is developed which estimates position as well as orientation of the sensorunit while being reliable in case of multipath effects and NLOS conditions. The experimental results show robust and continuous tracking in a realistic indoor positioning scenario.

  12. New techniques in tightness verification: Eurodif plants

    Leak dection techniques use processes and equipments evidencing on the low pressure side a test fluid which has been put on the other side of the wall. Helium is generally used as a test fluid in leak detection techniques with a mass spectrometer. Natural helium of air (and even natural neon of air) has been used for tightness verification of uranium hexafluoride enrichment circuits in the Eurodif plant at Tricastin (France)

  13. Inward Leakage in Tight-Fitting PAPRs

    Frank C. Koh; Johnson, Arthur T.; Rehak, Timothy E.

    2011-01-01

    A combination of local flow measurement techniques and fog flow visualization was used to determine the inward leakage for two tight-fitting powered air-purifying respirators (PAPRs), the 3M Breathe-Easy PAPR and the SE 400 breathing demand PAPR. The PAPRs were mounted on a breathing machine head form, and flows were measured from the blower and into the breathing machine. Both respirators leaked a little at the beginning of inhalation, probably through their exhalation valves. In both cases,...

  14. Tight and random nonorthogonal fusion frames

    Cahill, Jameson; Casazza, Peter G.; Ehler, Martin; Li, Shidong

    2013-01-01

    First we show that tight nonorthogonal fusion frames a relatively easy to com by. In order to do this we need to establish a classification of how to to wire a self adjoint operator as a product of (nonorthogonal) projection operators. We also discuss the link between nonorthogonal fusion frames and positive operator valued measures, we define and study a nonorthogonal fusion frame potential, and we introduce the idea of random nonorthogonal fusion frames.

  15. Tight Binding Models in Cold Atoms Physics

    Zakrzewski, J.

    2007-05-01

    Cold atomic gases placed in optical lattice potentials offer a unique tool to study simple tight binding models. Both the standard cases known from the condensed matter theory as well as novel situations may be addressed. Cold atoms setting allows for a precise control of parameters of the systems discussed, stimulating new questions and problems. The attempts to treat disorder in a controlled fashion are addressed in detail.

  16. Superconductivity in tight-binding approximation

    An interpretation of Barisic's relation for transition elements between the d-electron contribution to the cohesive energy and the local atomic parameter eta is presented. This relation is extended to a lattice with more than one atom per unit cell in the tight- binding approximation of rigid ions. It is conjectured that Barisic's relation is correct to first order approximation for transition metal alloys, provided the phonon induced d-d coupling is the dominant mechanism for superconductivity

  17. Glycemic targets in pregnancies affected by diabetes: historical perspective and future directions.

    Hernandez, Teri L

    2015-01-01

    The definition of optimal glycemic control in pregnancies affected by diabetes remains enigmatic. Diabetes phenotypes are heterogeneous. Moreover, fetal macrosomia insidiously occurs even with excellent glycemic control. Current blood glucose (BG) targets (FBG ≤95, 1-h post-prandial controlled trial (RCT) has never compared current vs. lower glucose targets powered on maternal/fetal outcomes. This paper provides historical context to the current targets by reviewing evidence supporting their evolution. Using lower targets (FBG optimal glycemic control that minimizes both small for and large for gestational age across pregnancies affected by diabetes. PMID:25398204

  18. Glycemic Variability Is Associated With Reduced Cardiac Autonomic Modulation in Women With Type 2 Diabetes

    Fleischer, Jesper; Lebech Cichosz, Simon; Hoeyem, Pernille;

    2015-01-01

    and 39 women with non-insulin-treated type 2 diabetes and a known duration of diabetes <5 years. All patients were equipped with a continuous glucose monitoring sensor for 3 days, and the mean amplitude of glycemic excursions (MAGE) was calculated to obtain individual glycemic variability. Cardiac......OBJECTIVE: To investigate the sex differences in cardiac autonomic modulation in patients with newly diagnosed type 2 diabetes and to determine whether cardiac autonomic modulation is associated with glycemic variability. RESEARCH DESIGN AND METHODS: We investigated a cohort consisting of 48 men...

  19. Dietary Glycemic Load and Breast Cancer Risk in the Women’s Health Study

    Higginbotham, Susan; Zhang, Zuo-Feng; Lee, I-Min; Cook, Nancy R.; Buring, Julie E.; Liu, Simin

    2004-01-01

    A diet with a high glycemic load (GL) may contribute to a metabolic environment that enhances tumorigenesis. Little is known, however, about whether high glycemic diets increase breast cancer risk in women. We examined the associations between baseline measurements of dietary GL and overall glycemic index (GI) and subsequent breast cancer in a cohort of 39,876 women, ages 45 years or older, participating in the Women’s Health Study. During a mean of 6.8 years of follow-up there were 946 confi...

  20. Glycemic index of cereals and tubers produced in China

    Yue-Xin Yang; Hong-Wei Wang; Hong-Mei Cui; Yan Wang; Lian-Da Yu; Shi-Xue Xiang; Shui-Ying Zhou

    2006-01-01

    AIM: To determine the GI of some cereals and tubers produced in China in an effort to establish the database of glycemic index (GI) of Chinese food.METHODS: Food containing 50 g carbohydrate was consumed by 8-12 healthy adults after they have been fasted for 10 h and blood glucose was monitored for 2 h.Glucose was used as reference food. GI of food was calculated according to a standard method.RESULTS: GI of 9 types of sugar and 60 kinds of food were determined.CONCLUSION: Food GI is mainly determined by nature of carbohydrate and procession. Most of cereals and tubers produced in China have similar GI with their counterparts produced in other countries.

  1. Creatine supplementation and glycemic control: a systematic review.

    Pinto, Camila Lemos; Botelho, Patrícia Borges; Pimentel, Gustavo Duarte; Campos-Ferraz, Patrícia Lopes; Mota, João Felipe

    2016-09-01

    The focus of this review is the effects of creatine supplementation with or without exercise on glucose metabolism. A comprehensive examination of the past 16 years of study within the field provided a distillation of key data. Both in animal and human studies, creatine supplementation together with exercise training demonstrated greater beneficial effects on glucose metabolism; creatine supplementation itself demonstrated positive results in only a few of the studies. In the animal studies, the effects of creatine supplementation on glucose metabolism were even more distinct, and caution is needed in extrapolating these data to different species, especially to humans. Regarding human studies, considering the samples characteristics, the findings cannot be extrapolated to patients who have poorer glycemic control, are older, are on a different pharmacological treatment (e.g., exogenous insulin therapy) or are physically inactive. Thus, creatine supplementation is a possible nutritional therapy adjuvant with hypoglycemic effects, particularly when used in conjunction with exercise. PMID:27306768

  2. Are gastrointestinal symptoms related to diabetes mellitus and glycemic control?

    Koch, Christian A; Uwaifo, Gabriel I

    2008-09-01

    Many patients with diabetes mellitus suffer from upper and lower GI symptoms. The reported prevalence of these symptoms varies among different ethnic groups/populations. The natural history of GI symptoms as well as their pathogenesis in patients with diabetes remains poorly understood, although it is known that gastric emptying is influenced by hyperglycemia, euglycemia, and hypoglycemia. Poor glycemic control over a long period of time can lead to neuropathy and damage the vagus nerve, resulting in diabetic gastroparesis whose signs and symptoms vary in the individual patient. Gastroparesis can further worsen glycemic control by adversely altering the pharmacokinetics of orally administered hypoglycemic agents as well as by altering the delivery of diet-derived calories to intestines from which absorption, subsequently, determines incipient blood glucose, and thus effectiveness of various injectable antidiabetics including various insulins and related insulin analogs. As GI symptoms may overlap with other disorders, including functional dyspepsia, irritable bowel syndrome, and depression, it is important to have such patients/patients with diabetes undergo standardized testing for measuring gastric emptying. Certain medications including metformin, amylin analogues (i.e. pramlintide), glucagon-like peptide 1 analogs (i.e. exenatide, liraglutide), anticholinergic agents, antidepressants, calcium-channel blockers, and others may contribute to GI symptoms observed in patients with diabetes. Given the global diabetes pandemic, it is of utmost importance to not only diagnose and treat present patients with diabetes mellitus and its comorbidities, but also to help prevent the development of further disease burden by educating children and adolescents about healthy lifestyle modifications (avoidance of overeating, portion control, healthy food choices, increased physical and reduced sedentary activity), as changing behavior in adulthood has proven to be notoriously

  3. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus

    Mavropoulos John C

    2008-12-01

    Full Text Available Abstract Objective Dietary carbohydrate is the major determinant of postprandial glucose levels, and several clinical studies have shown that low-carbohydrate diets improve glycemic control. In this study, we tested the hypothesis that a diet lower in carbohydrate would lead to greater improvement in glycemic control over a 24-week period in patients with obesity and type 2 diabetes mellitus. Research design and methods Eighty-four community volunteers with obesity and type 2 diabetes were randomized to either a low-carbohydrate, ketogenic diet (1c. Results Forty-nine (58.3% participants completed the study. Both interventions led to improvements in hemoglobin A1c, fasting glucose, fasting insulin, and weight loss. The LCKD group had greater improvements in hemoglobin A1c (-1.5% vs. -0.5%, p = 0.03, body weight (-11.1 kg vs. -6.9 kg, p = 0.008, and high density lipoprotein cholesterol (+5.6 mg/dL vs. 0 mg/dL, p Conclusion Dietary modification led to improvements in glycemic control and medication reduction/elimination in motivated volunteers with type 2 diabetes. The diet lower in carbohydrate led to greater improvements in glycemic control, and more frequent medication reduction/elimination than the low glycemic index diet. Lifestyle modification using low carbohydrate interventions is effective for improving and reversing type 2 diabetes.

  4. Glycemic Index and Glycemic Load of diets in children and young people with Down’s Syndrome

    Zuzanna Goluch-Koniuszy

    2013-06-01

    Full Text Available Introduction. Down’s Syndrome (DS belongs to the most frequent aberrations of autosomal chromosomes of all known chromosome disorders. The most frequent diseases accompanying Down’s Syndrome include diabetes and obesity. One of the causes of fatty tissue, including visceral tissue accumulation in body is an ill balanced diet in terms of, among others, the quantity and structure of carbohydrates, as well as values of glycemic index (GI and glycemic load (GL. As in Down’s Syndrome the incidence of both obesity and diabetes is higher than in healthy population, it seems essential to evaluate and correct the diet in terms of not only carbohydrates level, but also of GI and GL. The object of this study was to evaluate the nutritive status and nutritional patterns of children and adolescents (both sexes with Down’s Syndrome (DS taking into account the GI and GL of their meals. Material and methods. The state of nutrition was assessed in October and November 2009 in 24 people with clinically-diagnosed trisomy of chromosome 21 including 16 boys (aged 10-22 and 8 girls (aged 13-18 pupils of two school-and-educational centres from the West Pomerania Province. Methods of feeding evaluation that is energy and nutritive value, consumption patterns of groups of food products, GI and GL values were based on analysis of three days menu by currently noting. Results.Among the young people under research 54% were overweight and obese and among those 41% with visceral obesity. Analysis of menus of the young people with Down’s Syndrome has shown low energy value of diet, low realization of the recommended supply of fibre, Ca, Mg, Zn, B vitamin and fluids. The par- ticipation of energy coming from fat and saccharose was too high and too low from carbohydrates compared to the recommended values. Resultant GI of meals of the young people under research exceeded average values and the whole day GL exceeded high values. Conclusions.Everyday food rations of both

  5. Glycemic index and glycemic load of thirteen year old children whose waist circumference (WC ≥ 90 percentile dependent on BMI

    Zuzanna Goluch-Koniuszy

    2011-06-01

    Full Text Available Background. One of the reasons for the accumulation of fat tissue (including visceral fat tissue in the body is an unbalanced diet in respect of the amount and the structure of carbohydrates and the value of the glycemic index (GI and the glycemic load (GL. The research describing the dependence between the BMI (Body Mass Index, WC (Waist Circumference, WHtR (Waist-to-Height Ratio, and GI and GL indexes in adults exists but only a limited number of works discuss children during the pubertal spurt. Therefore the objective of this research is the evaluation of the state of nutrition of 13-year-old children with waist circumference ≥ 90 percentile with various BMI, taking into consideration GL and GL of their meals. Material and methods.The state of nutrition (BMI, WC, WHtR of 871 thirteen-year-old children of both sexes was evaluated and 230 children with WC ≥ 90 percentile were selected (26.4% of the total number examined and divided into three groups regarding the BMI. In 71 children (30.9% of the selected group the method of nutrition, energy and nutritive value of menus, structure of consumption of food groups and GI and GL value were evaluated, on the basis of the analysis of their three day menus, which had been documented. Results.Significantly higher values of BMI and WC were ascertained in boys than in girls. No essential differences in values of WHtR index were ascertained between boys and girls. The analysis of children’s menus, in both sexes with a waist circumference ≥ 90 percentile showed, regardless of BMI value, a low realisation of recommended energetic value of the diet and low realisation of recommended supply of: dietary fibre, fat, mineral components (K, Ca, P, Mg, Fe, Zn, Cu, vitamins (E, B1, PP and liquids with simultaneous occurrence of protein in general and animal protein, sodium and vitamins (A, B2, B6 supply. A significantly higher supply of the most of aforementioned ingredients was ascertained in the

  6. Veganism Is a Viable Alternative to Conventional Diet Therapy for Improving Blood Lipids and Glycemic Control.

    Trepanowski, John F; Varady, Krista A

    2015-01-01

    The American Diabetes Association (ADA) and the National Cholesterol Education Program (NCEP) have each outlined a set of dietary recommendations aimed at improving glycemic control and blood lipids, respectively. However, traditional vegan diets (low-fat diets that proscribe animal product consumption) are also effective at improving glycemic control, and dietary portfolios (vegan diets that contain prescribed amounts of plant sterols, viscous fibers, soy protein, and nuts) are also effective at improving blood lipids. The purpose of this review was to compare the effects of traditional vegan diets and dietary portfolios with ADA and NCEP diets on body weight, blood lipids, blood pressure, and glycemic control. The main findings are that traditional vegan diets appear to improve glycemic control better than ADA diets in individuals with type 2 diabetes mellitus (T2DM), while dietary portfolios have been consistently shown to improve blood lipids better than NCEP diets in hypercholesterolemic individuals. PMID:24922183

  7. Almond consumption improved glycemic control and lipid profiles in patients with type 2 diabetes mellitus

    Almond consumption is associated with ameliorations in obesity, hyperlipidemia, hypertension, and hyperglycemia. The hypothesis of this 12-wk randomized crossover clinical trial was that almond consumption would improve glycemic control and decrease risk to cardiovascular disease in 20 Chinese type ...

  8. A low-glycemic-index diet reduces plasma PAI-1 activity in overweight women

    Jensen, Lotte

    to decrease during weight loss. However, the beneficial effects of healthy diets on PAI-1 levels may not solely depend on weight loss, but other factors may also play a role. For example better glycemic control has been observed in diabetic patients after a low glycemic index (GI) diet compared to a......Introduction An elevated level of plasminogen activator inhibitor-1 (PAI-1) in plasma is a core feature of the metabolic syndrome. Plasma PAI-1 is elevated in obesity and might be responsible for some of the secondary effects of obesity as diabetes and cardiovascular diseases. PAI-1 has been shown...... high GI diet. Still, the relevance of GI in preventing the metabolic syndrome is controversial. Objectives The main purpose of the present study was to investigate the effect of 10 weeks intake of a low glycemic index vs. a high glycemic index high-carbohydrate, low fat ad libitum diet on plasma PAI-1...

  9. Glycemic index and glycemic load in relation to changes in body weight, body fat distribution, and body composition in adult Danes 1-3

    Hare-Bruun, Helle; Flint, Anne; L. Heitmann, Berit

    2006-01-01

    born in 1922, 1932, 1942, or 1952. A baseline health examination and a dietary history interview were carried out in 1987 and 1988; a follow-up health examination was performed in 1993 and 1994. Results: Positive associations between GI and changes in bodyweight (¿BW), percentage body fat (%BF), and......ABSTRACT Background: A diet with a high glycemic index (GI) and glycemic load (GL) may promote overconsumption of energy and increase the risk of weight gain.Objective: The objective of the study was to investigate the relation between GI and GL of habitual diets and subsequent 6-y changes in body...... waist circumference (¿WC) were observed in women after adjustment for covariates.Significant GI X sex X physical activity interactions for ABSTRACTBackground: A diet with a high glycemic index (GI) and glycemicload (GL) may promote overconsumption of energy and increase therisk of weight gain...

  10. Tight gas reservoirs: A visual depiction

    1993-12-01

    Future gas supplies in the US will depend on an increasing contribution from unconventional sources such as overpressured and tight gas reservoirs. Exploitation of these resources and their conversion to economically producible gas reserves represents a major challenge. Meeting this challenge will require not only the continuing development and application of new technologies, but also a detailed understanding of the complex nature of the reservoirs themselves. This report seeks to promote understanding of these reservoirs by providing examples. Examples of gas productive overpressured tight reservoirs in the Greater Green River Basin, Wyoming are presented. These examples show log data (raw and interpreted), well completion and stimulation information, and production decline curves. A sampling of wells from the Lewis and Mesaverde formations are included. Both poor and good wells have been chosen to illustrate the range of productivity that is observed. The second section of this document displays decline curves and completion details for 30 of the best wells in the Greater Green River Basin. These are included to illustrate the potential that is present when wells are fortuitously located with respect to local stratigraphy and natural fracturing, and are successfully hydraulically fractured.

  11. Diabetes management and glycemic control in youth with type 1 diabetes: test of a predictive model

    Drotar, Dennis; Ittenbach, Richard; Rohan, Jennifer M.; Gupta, Resmi; Pendley, Jennifer Shroff; Delamater, Alan

    2012-01-01

    The objective of this study was to test a comprehensive model of biologic (pubertal status), family (communication and conflict), and psychological influences (behavioral autonomy) on diabetes management and glycemic control in a sample of youth (N = 226) with type 1 diabetes recruited during late childhood/early adolescence (ages 9–11 years). The study design was a prospective, multisite, multi-method study involving prediction of diabetes management and glycemic control 1 year post-baseline...

  12. Executive Functioning, Treatment Adherence, and Glycemic Control in Children With Type 1 Diabetes

    McNally, Kelly; Rohan, Jennifer; Pendley, Jennifer Shroff; Delamater, Alan; Drotar, Dennis

    2010-01-01

    OBJECTIVE The primary aim of the study was to investigate the relationship among executive functioning, diabetes treatment adherence, and glycemic control. RESEARCH DESIGN AND METHODS Two hundred and thirty-five children with type 1 diabetes and their primary caregivers were administered the Diabetes Self-Management Profile to assess treatment adherence. Executive functioning was measured using the Behavior Rating Inventory of Executive Functioning and glycemic control was based on A1C. RESUL...

  13. Effect of current glycemic control on qualitative body composition in sedentary ambulatory Type 2 diabetics

    Jayesh Dalpatbhai Solanki

    2016-01-01

    Full Text Available Background: Obesity and Type 2 diabetes mellitus are on rise with cause–effect relationship. Diabetics monitor blood sugar, neglecting qualitative body composition, leaving residual threat of ectopic fat unattended. We tried to correlate glycemic triad with parameters of body composition derived objectively by bioelectrical impedance analysis (BIA. Materials and Methods: A sample of 78 under treatment sedentary Type 2 diabetics of either sex with known glycemic and lipidemic control from our city. Following baseline assessment measurement was done by instrument Omron Karada Scan (Model HBF-510, China using the principle of tetra poplar BIA to derive parameters of body composition. We tried to correlate glycemic triad with these parameters, both directly as well as after defining them as per established cutoff norms. Results: We found poor glycemic control in the study group (20% for Hb1AC, high body mass index, subcutaneous fat, visceral fat (VF, total body fat (TBF, and lesser mass of skeletal muscle in Type 2 diabetics. However, there were small, insignificant, and inconsistent difference of these parameters while directly correlating with the fasting blood sugar, postprandial blood sugar, and glycosylated hemoglobin. On qualitative assessment, the impact of glycemic control as per standard norms, the risk of high VF, high TBF, low skeletal muscle mass was though high (between 1 and 2 in Type 2 diabetics with poor glycemic control as compared to good glycemics, but each strength lacks statistical significance. Conclusion: BIA reveals that Type 2 diabetics have more ectopic fat on expense of skeletal muscle that do not correlate with current glycemic status, both quantitatively and qualitatively. Measurement of body composition can be included and subjects can be motivated for lifestyle modification strategies while managing metabolic derangements of Type 2 diabetes.

  14. The effect of protein and glycemic index on children's body composition

    Papadaki, Angeliki; Linardakis, Manolis; Larsen, Thomas Meinert;

    2010-01-01

    To investigate the effect of protein and glycemic index (GI) on body composition among European children in the randomized, 6-month dietary intervention DiOGenes (diet, obesity, and genes) family-based study.......To investigate the effect of protein and glycemic index (GI) on body composition among European children in the randomized, 6-month dietary intervention DiOGenes (diet, obesity, and genes) family-based study....

  15. EFFECT OF AMLODIPINE ON ORAL GLUCOSE INDUCED GLYCEMIC CHANGES IN NORMAL ALBINO RATS

    Dr. Sushma V. Naidu et al

    2012-01-01

    Objective: To determine the effect of amlodipine on blood glucose levels through oral glucose tolerance test in normoglycemic albino Rats and the magnitude of its effect on basal v/s glucose induced glycemic value compared to control.Methods: Rats were divided into control and test groups to study the effect of glucose induced glycemic changes in normal rats following oral administration of amlodipine. The control group received 1 ml of distilled water everyday, test group received amlo...

  16. Glycemic profile and prebiotic potential "in vitro" of bread with yacon (Smallanthus sonchifolius) flour

    Priscilla Moura Rolim; Silvana Magalhães Salgado; Vivianne Montarroyos Padilha; Alda Verônica de Souza Livera; Samara Alvachian Cardoso Andrade; Nonete Barbosa Guerra

    2011-01-01

    The purpose of this study was to elaborate bread with yacon flour at two different levels (6% and 11%) and to analyze their proximate composition, their glycemic indices and their prebiotic potentials in vitro. Bread with 6% and 11% of yacon flour presented, simultaneously, low and moderate glycemic index. As for the prebiotic potentials, it was evident the presence of probiotic bacteria, particularly Lactobacillus. The results showed that, the addition of yacon flour on bread rendered produc...

  17. Socioeconomic status and glycemic control in adult patients with type 2 diabetes: a mediation analysis

    Houle, Janie; Lauzier-Jobin, François; Beaulieu, Marie-Dominique; MEUNIER, Sophie; Coulombe, Simon; Côté, José; Lespérance, François; Chiasson, Jean-Louis; Bherer, Louis; Lambert, Jean

    2016-01-01

    Objective The purpose of this study is to examine the contribution of health behaviors (self-management and coping), quality of care, and individual characteristics (depressive symptoms, self-efficacy, illness representations) as mediators in the relationship between socioeconomic status (SES) and glycemic control. Methods A sample of 295 adult patients with type 2 diabetes was recruited at the end of a diabetes education course. Glycemic control was evaluated through glycosylated hemoglobin ...

  18. Food Insecurity and Glycemic Control Among Low-Income Patients With Type 2 Diabetes

    Seligman, Hilary K.; Jacobs, Elizabeth A.; López, Andrea; Tschann, Jeanne; Fernandez, Alicia

    2012-01-01

    OBJECTIVE To determine whether food insecurity—the inability to reliably afford safe and nutritious food—is associated with poor glycemic control and whether this association is mediated by difficulty following a healthy diet, diabetes self-efficacy, or emotional distress related to diabetes. RESEARCH DESIGN AND METHODS We used multivariable regression models to examine the association between food insecurity and poor glycemic control using a cross-sectional survey and chart review of 711 pat...

  19. Self-Efficacy Links Health Literacy and Numeracy to Glycemic Control

    Osborn, Chandra Y; Cavanaugh, Kerri; Wallston, Kenneth A.; Rothman, Russell L.

    2010-01-01

    The mechanisms underlying the relationship between health literacy, numeracy, and glycemic control are unclear. We explored the role of self-efficacy in the predicted pathway linking health literacy and numeracy to glycemic control (A1C). Adults with type 1 or type 2 diabetes mellitus (N=383) were enrolled in a cross-sectional study at primary care and diabetes clinics at three medical centers. Data collected included demographic information, health literacy, general numeracy, and A1C. Path a...

  20. Available Carbohydrates, Glycemic Load, and Pancreatic Cancer: Is There a Link?

    Meinhold, Cari L.; Dodd, Kevin W; Jiao, Li; Flood, Andrew; Shikany, James M.; Genkinger, Jeanine M.; Hayes, Richard B; Stolzenberg-Solomon, Rachael Z

    2010-01-01

    High-carbohydrate diets have been linked to pancreatic cancer risk in case-control studies, but prospective studies have shown mostly null results. The authors investigated the associations of glycemic load, glycemic index, and carbohydrate intake with pancreatic cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Dietary intake was assessed by using a self-administered questionnaire. Between 1998 and 2006 (median follow-up = 6.5 years), 266 incident, confirmed ...

  1. Establishment of normal reference ranges for glycemic variability in Chinese subjects using continuous glucose monitoring

    Zhou, Jian; Li, Hong; Ran, Xingwu; Yang, Wenying; LI Qiang; Peng, Yongde; Li, Yanbing; Gao, Xin; Luan, Xiaojun; Wang, Weiqing; Jia, Weiping

    2011-01-01

    Summary Background Glycemic variability is increasingly recognized as an important issue in diabetes management. However, the lack of normative values may limit its applicability in the clinical setting. The objective of this study was to establish preliminary normal reference ranges for glycemic variability by analyzing continuous glucose monitoring (CGM) data obtained from healthy Chinese adults. Material/Methods Three-day CGM data were obtained from 434 healthy adults at 10 academic hospit...

  2. Status of glycemic control in patients of type 2 diabetes mellitus

    Objective: To determine the status of glycemic control in patients of type 2 diabetes mellitus. Design: Cross sectional descriptive study. Place and Duration of Study: Medical out-patient/ in -patient departments at Military Hospital Rawalpindi from January 2011 to December 2012. Methods: Six hundred and fifty patients of type 2 DM fulfilling the required criteria were included in the study. Glycemic control of these patients was determined by estimation of blood glucose (fasting and random) and glycosylated haemoglobin (HbA1c). The patients were grouped in three categories good, fair and poor diabetic control having their HbA1c values of being 6-7%, 7.1-8% and more than 8.1% respectively. Statistical package for social sciences (SPSS) version 15 was used for analysis. Results: Out of 650 patients 377 (58%) had poor glycemic control with mean HbA1c of 9.5% +- 0.95, 78 (12%) patients had fair control of glycemic control with mean HbA1c of 7.8 +- 0.25, and 195 (30%) patients had good glycemic control with mean HbA1c of 6.4 +- 0.17. Conclusion: Majority of patients had poor control of their glycemic status which is an important indicator and predictor of both micro and macrovascular complications. (author)

  3. Medication adherence and glycemic control in patients with psychotic disorders in the Veterans Affairs healthcare system

    Nelson LA

    2011-06-01

    Full Text Available Objective: To compare antihyperglycemic medication adherence and glycemic control between individuals with schizophrenia and related psychotic disorders and a nonpsychiatric comparison group.Methods: This was a retrospective medical record review. A total of 124 subjects with diabetes (62 patients with schizophrenia or a related psychotic disorder and 62 randomly selected, age-matched patients without a psychiatric illness receiving their medical and psychiatric care exclusively through the Kansas City Veterans Affairs healthcare system during 2008 were included in the study. Adherence to antihyperglycemic and antipsychotic medication was determined by refill records obtained through the computerized patient record system to calculate the cumulative mean gap ratio. Hemoglobin A1C values were utilized to compare glycemic control between groups and compared to glycemic goals established by diabetes treatment guidelines.Results: Antihyperglycemic medication adherence was poor for both groups as approximately 60% of the psychotic disorder group and 75% of the nonpsychiatric comparison group were without antihyperglycemic medication for greater than 30 days during the 12-month period but adherence did not differ between the groups (p=0.182. Antipsychotic adherent subjects (=80% adherent were more likely to be adherent to their antihyperglycemic medication (p=0.0003. There were no significant differences between groups in glycemic control.Conclusion: Antihyperglycemic medication adherence and glycemic control was less than optimal for both groups. There were no significant differences in antihyperglycemic medication adherence and glycemic control between patients with a psychotic disorder and those without a psychiatric illness.

  4. Glycemic Variation in Tumor Patients with Total Parenteral Nutrition

    Jin-Cheng Yang; Yuan-Yuan Dai; Li-Ming Wang; Yi-Bin Xie; Hai-Yan Zhou; Guo-Hui Li

    2015-01-01

    Background:Hyperglycemia is associated with poor clinical outcomes and mortality in several patients.However,studies evaluating hyperglycemia variation in tumor patients receiving total parenteral nutrition (TPN) are scarce.The aim of this study was to assess the relationship between glycemia and tumor kinds with TPN by monitoring glycemic variation in tumor patients.Methods:This retrospective clinical trial selected 312 patients with various cancer types,whose unique nutrition treatment was TPN during the monitoring period.All patients had blood glucose (BG) values assessed at least six times daily during the TPN infusion.The glycemic variation before and after TPN was set as the indicator to evaluate the factors influencing BG.Results:The clinical trial lasted 7.5 ± 3.0 days adjusted for age,gender,family cancer history and blood types.There were six cancer types:Hepatic carcinoma (HC,21.8%),rectal carcinoma (17.3%),colon carcinoma (CC,14.7%),gastric carcinoma (29.8%),pancreatic carcinoma (11.5%),and duodenal carcinoma (DC,4.8%).The patients were divided into diabetes and nondiabetes groups.No statistical differences in TPN glucose content between diabetes and nondiabetes groups were found;however,the tumor types affected by BG values were obvious.With increasing BG values,DC,HC and CC were more represented than other tumor types in this sequence in diabetic individuals,as well as in the nondiabetic group.BG was inclined to be more easily influenced in the nondiabetes group.Other factors did not impact BG values,includiug gender,body mass index,and TPN infusion duration time.Conclusions:When tumor patients are treated with TPN,BG levels should be monitored according to different types of tumors,besides differentiating diabetes or nondiabetes patients.Special BG control is needed for DC,HC and CC in both diabetic and nondiabetic patients.If BG overtly increases,positive measurements are needed to control BG values.The ClinicalTrials.gov ID is NCT

  5. Optimizing screening procedures for early detection of glycemic disorders

    Inna Vldimirovna Misnikova

    2014-03-01

    Full Text Available Aim. To estimate the actual prevalence of type 2 diabetes mellitus (T2DM and prediabetes in individuals at high risk for T2DM and to develop an optimized stepwise screening procedure.Materials and Methods. A mobile diagnostic unit conducted outpatient screening for glycemic disorders. First stage of the survey included distribution of the FINDRISK questionnaire within the target subpopulation. At the second stage, study groups were formed based on the acquired data. Third stage involved clinical evaluation of glucose homeostasis by testing HbA1c levels and performing oral glucose tolerance test (OGTT. Individuals considered at high risk for development of T2DM were referred to specialized educational programs. A total of 2200 subjects were included in the present survey. In 1377 cases OGTT was supplemented with the testing of HbA1c. Statistical processing of the data was performed with Microsoft Excel software utility.Results. The interpretation of OGTT results identified 53.5% (n=1176 of study subjects as positive for glycemic disorders: 26.7% (n=587 with T2DM and 26.8% (n=589 with prediabetes, respectively. Impaired glucose tolerance was detected in 12.1% (n=266, impaired fasting glucose – in 9.1% (n=199, and the combination of these two conditions – in 5.6% (n=124 of examined individuals, respectively. In 235 subjects (17.1% T2DM was diagnosed by means of HbA1c testing. 45% of examined individuals (n=620 had HbA1c<5.7%, 37.9% (n=522 showed HbA1c between 5.7% and 6.4%.Conclusion. A stepwise procedure allows for higher screening performance in subjects at risk for development of T2DM. Overall prevalence of T2DM, identified either by OGTT or HbA1c testing made up 31,1% of the examined sampling. Results from both methods were in agreement in 39.2% of cases.

  6. Effect of Reynolds number and bundle geometry on the turbulent flow in tight lattice bundle

    The flow structure in tight lattice is still of great interest to nuclear industry. The accurate prediction of flow parameter in subchannels of tight lattice is likable. Unsteady Reynolds Averaged Navier Stokes (URANS) is a promising approach to achieve this goal. The implementation of URANS (Unsteady Reynolds Averaged Navier Stokes) approach will be validated by comparing computational results with the experimental data of Krauss (1998). In this paper, the turbulent flow with different Reynolds number (5000~215000) and different P/D(1.005~1.2) are simulated with CFD code CFX12.The effects of the Reynolds number and the bundle geometry(P/D) on wall shear stress, turbulent kinetic energy, turbulent mixing and large scale coherent structure in tight lattice are analyzed in details. It is hoped that the present work will contribute to the understanding of these important flow phenomena and facilitate the prediction and design of rod bundles. (author)

  7. Tight gas sand tax credit yields opportunities

    The U.S. Internal Revenue Service on Apr. 1, 1991, released the inflation adjustments used in the calculations of Non-Conventional Fuel Tax Credits for 1990. The inflation adjustment, 1.6730, when applied to the base price of $3/bbl of oil equivalent, adjusts the tax credit to $5.019/bbl for oil and 86.53 cents/MMBTU for gas. The conversion factor for equivalent fuels is 5.8 MMBTU/bbl. Unfortunately, the tax credit for tight formation gas continues to be unadjusted for inflation and remains 52 cents/MMBTU. As many producers are aware, the Omnibus Budget Reconciliation Act of 1990 expanded the dates of eligibility and the usage for-Non-Conventional Fuel Tax Credits. Among other provisions, eligible wells may be placed in service until Jan. 1, 1992, and once in place may utilize the credit for production through Dec. 31, 2002. Both dates are 2 year extensions from previous regulations

  8. Evaluation of tight-pitch PWR cores

    The impact of tight pinch cores on the consumption of natural uranium ore has been evaluated for two systems of coupled PWR's namely one particular type of thorium system - 235U/UO2 : Pu/ThO2 : 233U/ThO2 - and the conventional recycle-mode uranium system - 235U/UO2 : Pu/UO2. The basic parameter varied was the fuel-to-moderator volume ratio (F/M) of the (uniform) lattice for the last core in each sequence. Although methods and data verification in the range of present interest, 0.5 (current lattices) 1.0, the EPRI-LEOPARD and LASER programs used for the thorium and uranium calculations, respectively, were successfully benchmarked against several of the more pertinent experiments

  9. Naturally fractured tight gas reservoir detection optimization

    NONE

    1999-06-01

    Building upon the partitioning of the Greater Green River Basin (GGRB) that was conducted last quarter, the goal of the work this quarter has been to conclude evaluation of the Stratos well and the prototypical Green River Deep partition, and perform the fill resource evaluation of the Upper Cretaceous tight gas play, with the goal of defining target areas of enhanced natural fracturing. The work plan for the quarter of November 1-December 31, 1998 comprised four tasks: (1) Evaluation of the Green River Deep partition and the Stratos well and examination of potential opportunity for expanding the use of E and P technology to low permeability, naturally fractured gas reservoirs, (2) Gas field studies, and (3) Resource analysis of the balance of the partitions.

  10. Correlation between 1,5-anhydroglucitol and glycemic excursions in type 2 diabetic patients

    SUN Jie; DOU Jing-tao; WANG Xian-ling; YANG Guo-qing; L(U) Zhao-hui; ZHENG Hua; MA Fang-ling; LU Ju-ming; MU Yi-ming

    2011-01-01

    Background The accurate and comprehensive assessment of glycemic control in patients with diabetes is important for optimizing glycemic management and for formulating personalized diabetic treatment schemes.This study aimed to analyze the correlation between 1,5-anhydroglucitol (1,5-AG) and glycemic excursions in type 2 diabetic patients.Methods Seventy-one outpatients with type 2 diabetes mellitus were randomly recruited from Chinese People's Liberation Army General Hospital.Using a continuous glucose monitoring system (CGMS),these patients' blood glucose levels were monitored for three consecutive days to obtain mean blood glucose (MBG) data.Intraday glycemic excursions were evaluated using the mean amplitude of glycemic excursions (MAGE),the largest amplitude of glycemic excursions (LAGE),standard deviation of blood glucose (SDBG) and the M-value.Interday glycemic excursion was assessed by absolute mean of daily difference (MODD).Postprandial glycemic fluctuations were evaluated using postprandial glucose excursions (PPGE) and postprandial incremental area under the curve (iAUC).Fasting venous blood samples were collected to measure serum 1,5-AG,whole-blood hemoglobin A1c (HbA1c) and serum glycated albumin (GA).Clinical markers of glycemia and parameters of glycemic excursions from CGMS were analyzed using the Pearson correlation coefficient and multivariate stepwise regression.Results Pearson correlation analysis revealed that 1,5-AG was significantly correlated with MAGE,SDBG,M-value,LAGE,PPGE and iAUC (r values were -0.509,-0.430,-0.530,-0.462,-0.416 and -0.435,respectively,P <0.01),especially in moderately and well-controlled patients,based on defined HbA1c levels.Multivariate stepwise regression analysis revealed a negative correlation between 1,5-AG and the above parameters,but not HbA1c and GA.Finally,HbA1c and GA were positively correlated with MBG and fasting blood glucose (FBG).Conclusions 1,5-AG was much better than HbA1c and GA as a marker of

  11. Glycemic acute changes in type 2 diabetics caused by low and high glycemic index diets Las variaciones de la glucosa aguda en individuos con diabetes tipo 2 causada por las dietas de bajo y alto índice glucémico

    C. E. Gonçalves Reis; J. Dullius

    2011-01-01

    Introduction: Low-glycemic index diets may improve the glycemic control in type 2 diabetes but the debate over their effectiveness continues. Objectives: To test the effects of low-glycemic index diets on acute glycemic control (2 days) by measuring capillary blood glucose in patients with type 2 diabetes. Methods: This was a crossover randomized clinical trial with 12 type 2 diabetics which were randomly divided into 2 groups and targeted the following draft diets for low and high glycemic i...

  12. Fibrinogen titer and glycemic status in women using contraceptives

    Objective: To assess the coagulation and glycemic status in Pakistani women using contraceptives. Design: The study was conducted prospectively on 70 women and compared with 10 age-matched controls. Place and Duration of Study: The study was conducted at Karachi. Period of study was 18 month. Subjects and Methods: Eighty women aged between 20-45 years selected from low socioeconomic class and poor family background were categorized in control (n=10) and oral and injectable contraceptive users (n = 70). The contraceptives used were tablet Lofemenal, injection Norigest and Norplant implant. Their blood was tested for fibrinogen titer and random blood glucose. Results: There was no appreciable difference either in fibrinogen titer or plasma glucose levels in injectable users as compared to controls, but increased incidence of high fibrinogen titer and borderline blood glucose was observed in oral contraceptive users 25% and 20 % respectively. Conclusion: It was concluded that long-term use of oral contraceptives (> 3 years) might increase the thrombotic tendency and elevate the plasma glucose levels especially in women above 30 years of age. (author)

  13. Adiposity and Glycemic Control in Children Exposed to Perfluorinated Compounds

    Timmermann, Clara Amalie G.; Rossing, Laura I.; Grontved, Anders;

    2014-01-01

    perfluorooctane sulfonic acid/mL plasma was associated with 16.2% (95% confidence interval [CI], 5.2%-28.3%) higher insulin concentration, 12.0% (95% CI, 2.4%-22.4%) higher β-cell activity, 17.6% (95% CI, 5.8%-30.8%) higher insulin resistance, and 8.6% (95% CI, 1.2%-16.5%) higher triglyceride concentrations, and...... an increase of 10 ng perfluorooctanoic acid/mL plasma was associated with 71.6% (95% CI, 2.4%-187.5%) higher insulin concentration, 67.5% (95% CI, 5.5%-166.0%) higher β-cell function, 73.9% (95% CI, 0.2%-202.0%) higher insulin resistance, and 76.2% (95% CI, 22.8%-153.0%) higher triglyceride......Objective: Our objective was to explore whether childhood exposure to perfluorinated and polyfluorinated compounds (PFCs), widely used stain- and grease-repellent chemicals, is associated with adiposity and markers of glycemic control. Materials and Methods: Body mass index, skinfold thickness...

  14. Organoleptic and glycemic properties of chickpea-wheat composite breads.

    Zafar, Tasleem A; Al-Hassawi, Fatima; Al-Khulaifi, Fatima; Al-Rayyes, Ghanima; Waslien, Carol; Huffman, Fatma G

    2015-04-01

    Prevalence of obesity and type-2-diabetes requires dietary manipulation. It was hypothesized that wheat-legume-composite breads will reduce the spike of blood glucose and increase satiety. Four pan bread samples were prepared: White bread (WB) as standard, Whole-wheat bread (WWB), WWB supplemented with chickpea flour at 25 % (25%ChB) and 35 % (35%ChB) levels. These breads were tested in healthy female subjects for acceptability and for effect on appetite, blood glucose, and physical discomfort in digestion. The breads were rated >5.6 on a 9-point hedonic scale with WB significantly higher than all other breads. No difference in area under the curve (AUC) for appetite was found, but blood glucose AUC was reduced as follows: 35%ChB 25%ChB = WWB or 35%ChB. We conclude that addition of chickpea flour at 35 % to whole wheat produces a bread that is acceptable to eat, causing no physical discomfort and lowers the glycemic response. PMID:25829607

  15. Relationship of glycemic and triglycerides with BMI in diabetic patients

    Background: Diabetes mellitus (DM) is a metabolic disorder characterised by chronic hyperglycaemia with disturbances in carbohydrate, fat and protein metabolism arising from defect in insulin secretion or action or both. The clinical guidelines recommend measurement of BMI as vital signs for evaluating the obese and diabetic patients. Methods: This study was carried out on 160 diabetics, which were divided on the basis of BMI into obese (120) and non-obese (40) diabetics from Peshawar district. All patients had their triglycerides and glucose checked after over night fast. Results: The serum triglyceride in diabetics having BMI >30 (obese) was increased as compared to patients having BMI <30 (non-obese). The comparison of serum glucose level in obese diabetics was found to be significantly raised as compared to non-obese diabetics. Conclusions and Recommendations: It was concluded that dyslipidemia is common in all diabetics. The abnormal triglyceride level can improve with good glycemic control, but do not reach the normal state. Good glycaemic control, Reducing BMI, periodic checkups of lipids and blood glucose are recommended for all diabetics in order to avoid complications. (author)

  16. Metabolic Management during Critical Illness: Glycemic Control in the ICU.

    Honiden, Shyoko; Inzucchi, Silvio E

    2015-12-01

    Hyperglycemia is a commonly encountered metabolic derangement in the ICU. Important cellular pathways, such as those related to oxidant stress, immunity, and cellular homeostasis, can become deranged with prolonged and uncontrolled hyperglycemia. There is additionally a complex interplay between nutritional status, ambient glucose concentrations, and protein catabolism. While the nuances of glucose management in the ICU have been debated, results from landmark studies support the notion that for most critically ill patients moderate glycemic control is appropriate, as reflected by recent guidelines. Beyond the target population and optimal glucose range, additional factors such as hypoglycemia and glucose variability are important metrics to follow. In this regard, new technologies such as continuous glucose sensors may help alleviate the risks associated with such glucose fluctuations in the ICU. In this review, we will explore the impact of hyperglycemia upon critical cellular pathways and how nutrition provided in the ICU affects blood glucose. Additionally, important clinical trials to date will be summarized. A practical and comprehensive approach to glucose management in the ICU will be outlined, touching upon important issues such as glucose variability, target population, and hypoglycemia. PMID:26595046

  17. Variable classifications of glycemic index determined by glucose meters.

    Lin, Meng-Hsueh Amanda; Wu, Ming-Chang; Lin, Jenshinn

    2010-07-01

    THE STUDY EVALUATED AND COMPARED THE DIFFERENCES OF GLUCOSE RESPONSES, INCREMENTAL AREA UNDER CURVE (IAUC), GLYCEMIC INDEX (GI) AND THE CLASSIFICATION OF GI VALUES BETWEEN MEASURED BY BIOCHEMICAL ANALYZER (FUJI AUTOMATIC BIOCHEMISTRY ANALYZER (FAA)) AND THREE GLUCOSE METERS: Accue Chek Advantage (AGM), BREEZE 2 (BGM), and Optimum Xceed (OGM). Ten healthy subjects were recruited for the study. The results showed OGM yield highest postprandial glucose responses of 119.6 +/- 1.5, followed by FAA, 118.4 +/- 1.2, BGM, 117.4 +/- 1.4 and AGM, 112.6 +/- 1.3 mg/dl respectively. FAA reached highest mean IAUC of 4156 +/- 208 mg x min/dl, followed by OGM (3835 +/- 270 mg x min/dl), BGM (3730 +/- 241 mg x min/dl) and AGM (3394 +/- 253 mg x min/dl). Among four methods, OGM produced highest mean GI value than FAA (87 +/- 5) than FAA, followed by BGM and AGM (77 +/- 1, 68 +/- 4 and 63 +/- 5, pOGM are more variable methods to determine IAUC, GI and rank GI value of food than FAA. The present result does not necessarily apply to other glucose meters. The performance of glucose meter to determine GI value of food should be evaluated and calibrated before use. PMID:20664730

  18. Glycemic index and glycemic load are associated with some cardiovascular risk factors among the PREMIER study participants

    Pao-Hwa Lin

    2012-06-01

    Full Text Available Background: The clinical significance of glycemic index (GI and glycemic load (GL is inconclusive. Objective : This study was conducted to examine the association of GI and GL with clinical cardiovascular disease (CVD risk factors including body weight, blood pressure (BP, serum lipids, fasting glucose, insulin and homocysteine over time among the PREMIER participants. Design: PREMIER was an 18-month randomized lifestyle intervention trial, conducted from 2000 to 2002, designed to help participants reduce BP by following the Dietary Approaches to Stop Hypertension (DASH dietary pattern, losing weight, reducing sodium and increasing physical activity. GI and GL were estimated from 24 h diet recall data at baseline, 6 and 18 months after intervention. PROC MIXED model was used to examine the association of changes in GI or GL with changes in CVD risk factors. Results: A total of 756 randomized participants, 62% females and 34% African Americans and who averaged 50.0±0.3 years old and 95.3±0.7 kg, were included in this report. Neither GI nor GL changes was associated with changes in any risk factors at 6 months. At 18 months, however, the GI change was significantly and positively associated with total cholesterol (TC change only (p<0.05, β = 23.80±12.11 mg/dL or 0.62±0.31 mmol/L with a significant age interaction. The GL change was significantly associated with TC (p=0.02, β = 0.28±0.15 mg/dL or 0.01±0.00 mmol/L positively and with low density lipoprotein cholesterol (LDL-C changes negatively (p=0.03, β = − 0.01±0.00 mg/dL or −0.00±0.00 mmol/L, and significant age interactions were observed for both. Conclusion: GI and GL was associated with TC and LDL-C after controlling for energy, fat and fiber intake and other potential confounders and the associations were modified by age. Further investigation into this relationship is important because of its potential clinical impact.

  19. Establishment of normal reference ranges for glycemic variability in Chinese subjects using continuous glucose monitoring

    Zhou, Jian; Li, Hong; Ran, Xingwu; Yang, Wenying; Li, Qiang; Peng, Yongde; Li, Yanbing; Gao, Xin; Luan, Xiaojun; Wang, Weiqing; Jia, Weiping

    2011-01-01

    Summary Background Glycemic variability is increasingly recognized as an important issue in diabetes management. However, the lack of normative values may limit its applicability in the clinical setting. The objective of this study was to establish preliminary normal reference ranges for glycemic variability by analyzing continuous glucose monitoring (CGM) data obtained from healthy Chinese adults. Material/Methods Three-day CGM data were obtained from 434 healthy adults at 10 academic hospitals throughout China. Glycemic variability was calculated as the 24-hour mean amplitude of glycemic excursions (MAGE) and standard deviations (SD) of blood glucose readings. Results 434 healthy subjects (male 213, female 221; age 43±14, 20–69 years old; BMI 21.8±1.7 kg/m2, 18.5–24.9 kg/m2) completed the study. MAGE and SD values for the 434 healthy subjects were 1.73 (1.08) mmol/L and 0.75 (0.42) mmol/L [median (interquartile range)], respectively. In both men and women, MAGE and SD tended to increase with age. Neither MAGE nor SD showed a significant difference between men and women. Values for both parameters were non-normally distributed within the population. The 95th percentiles of MAGE and SD were 3.86 and 1.40 mmol/L, respectively. These values were adopted as the upper limits of normal. Conclusions MAGE <3.9 mmol/L and SD <1.4 mmol/L are recommended as the normal reference ranges for glycemic variability in Chinese adults. The values established in this study may facilitate the adoption of glycemic variability as a metric of overall glycemic control in diabetes. PMID:21169911

  20. Coalbed methane and tight gas no longer unconventional resources

    Unconventional gas refers to natural gas contained in difficult-to-produce formations that require special drilling and completion techniques to achieve commercial production. It includes tight gas, coal seams, organic shales, and gas hydrates. Canada's vast unconventional gas resource is becoming an increasingly important part of the country's gas supply. The emergence of unconventional gas production in Canada over the past several years has made the unconventional increasingly conventional in terms of industry activity. It was suggested that in order to realize the potential for unconventional gas in Canada, all stakeholders should engage to ensure the development is environmentally responsible. Unconventional gas accounts for nearly one third of U.S. gas production. It also accounts for nearly 5 Bcf per day and growing. The impetus to this sudden growth has been the gradual and increasing contribution of tight sands and limes to Canadian production, which accounts for more than 4 Bcf per day. Coalbed methane (CBM) is at 0.5 Bcf per day and growing. In response to expectations that CBM will reach 2 to 3 Bcf per day over the next 2 decades, Canadian producers are placing more emphasis on unconventional resource plays, including organic shales and gas hydrates. As such, significant growth of unconventional gas is anticipated. This growth will be facilitated by the adoption of U.S..-developed technologies and new Canadian technologies. It was suggested that research and development will be key to unlocking the unconventional gas potential. It was also suggested that the already existing, strong regulatory structure should continue in order to accommodate this growth in a sustainable manner. figs

  1. Global Coal Trade. From Tightness to Oversupply

    Over the past four years, international coal trade has been reshaped by China's surging imports. China, which was still a net exporter in 2008, became the world's first coal importer in 2011, taking over the position that Japan has occupied for three decades. Its imports have continued their rising trend and reached a record level in 2012, despite the country's economic slowdown. China imported 289 million tons of coal in 2012, up 30% over 2011. It now accounts for 23% of global imports. Although China is the world's largest coal producer, several factors have contributed to the sudden rise in its imports, including the higher cost of domestic coal relative to international prices and bottlenecks in transporting domestic coal to south-eastern provinces. More recently, another event shook the international coal business: the United States have been back on the market. The collapse of U.S. gas prices, to $4/million Btu in 2011 and even $2.75/million Btu in 2012, linked with the 'shale gas revolution', has made coal uncompetitive in the electricity sector, its main outlet on the U.S. market. U.S. coal demand dropped 4% in 2011 and 11% in 2012. The reduction in domestic demand has forced U.S. miners to look for overseas outlets. Their exports surged by 31% in 2011 and 16% in 2012. They reached 112 million tons in 2012, more than twice the level of 2009. The United States, which almost disappeared from the international steam coal market in the 2000's, have regained a larger share of the total coal export market, 9% in 2012, against 6% in 2009. These developments, although not directly linked, have a huge impact on the global market and pricing of coal. Chinese imports have helped the market to quickly recover from its low level of 2008-2009. The speed and magnitude of China's coal imports even shifts the market from a sluggish to a tight situation. Prices started to rise after their collapse in the second half of 2008 caused by the economic and financial crisis

  2. Effects of tight versus non tight control of metabolic acidosis on early renal function after kidney transplantation

    Etezadi Farhad

    2012-09-01

    Full Text Available Abstract Background Recently, several studies have been conducted to determine the optimal strategy for intra-operative fluid replacement therapy in renal transplantation surgery. Since infusion of sodium bicarbonate as a buffer seems to be safer than other buffer compounds (lactate, gluconate, acetatethat indirectly convert into it within the liver, We hypothesized tight control of metabolic acidosis by infusion of sodium bicarbonate may improve early post-operative renal function in renal transplant recipients. Methods 120 patients were randomly divided into two equal groups. In group A, bicarbonate was infused intra-operatively according to Base Excess (BE measurements to achieve the normal values of BE (−5 to +5 mEq/L. In group B, infusion of bicarbonate was allowed only in case of severe metabolic acidosis (BE ≤ −15 mEq/L or bicarbonate ≤ 10 mEq/L or PH ≤ 7.15. Minute ventilation was adjusted to keep PaCO2 within the normal range. Primary end-point was sampling of serum creatinine level in first, second, third and seventh post-operative days for statistical comparison between groups. Secondary objectives were comparison of cumulative urine volumes in the first 24 h of post-operative period and serum BUN levels which were obtained in first, second, third and seventh post-operative days. Results In group A, all of consecutive serum creatinine levels were significantly lower in comparison with group B. With regard to secondary outcomes, no significant difference between groups was observed. Conclusion Intra-operative tight control of metabolic acidosis by infusion of Sodium Bicarbonate in renal transplant recipients may improve early post-operative renal function.

  3. Glycemic control and antidiabetic drugs in type 2 diabetes mellitus patients with renal complications

    Huri HZ

    2015-08-01

    Full Text Available Hasniza Zaman Huri,1,2 Lay Peng Lim,1 Soo Kun Lim3 1Department of Pharmacy, Faculty of Medicine, University of Malaya, 2Clinical Investigation Centre, University Malaya Medical Centre, 3Renal Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Background: Good glycemic control can delay the progression of kidney diseases in type 2 diabetes mellitus (T2DM patients with renal complications. To date, the association between antidiabetic agents and glycemic control in this specific patient population is not well established.Purpose: This study aimed to identify antidiabetic regimens as well as other factors that associated with glycemic control in T2DM patients with different stages of chronic kidney disease (CKD.Patients and methods: This retrospective, cross-sectional study involved 242 T2DM inpatients and outpatients with renal complications from January 2009 to March 2014 and was conducted in a tertiary teaching hospital in Malaysia. Glycated hemoglobin (A1C was used as main parameter to assess patients’ glycemic status. Patients were classified to have good (A1C <7% or poor glycemic control (A1C ≥7% based on the recommendations of the American Diabetes Association.Results: Majority of the patients presented with CKD stage 4 (43.4%. Approximately 55.4% of patients were categorized to have poor glycemic control. Insulin (57.9% was the most commonly prescribed antidiabetic medication, followed by sulfonylureas (43%. Of all antidiabetic regimens, sulfonylureas monotherapy (P<0.001, insulin therapy (P=0.005, and combination of biguanides with insulin (P=0.038 were found to be significantly associated with glycemic control. Other factors including duration of T2DM (P=0.004, comorbidities such as anemia (P=0.024 and retinopathy (P=0.033, concurrent medications such as erythropoietin therapy (P=0.047, a-blockers (P=0.033, and antigouts (P=0.003 were also correlated with A1C.Conclusion: Identification of

  4. Carbohydrate Provision in the Era of Tight Glucose Control

    Miller, Keith R.; Lawson, Christy M; Smith, Vance L.; HARBRECHT, BRIAN G

    2011-01-01

    Glycemic control in the critically ill patient has remained a controversial issue over the last decade. Several large trials, with widely varying results, have generated significant interest in defining the optimal target for blood-glucose control necessary for improving care while minimizing morbidity. Nutritional support has evolved into an additional area of critical care where appropriate practices have been associated with improved patient outcomes. Carbohydrate provision can impact bloo...

  5. Wage Formation, Regional Migration and Local Labour Market Tightness

    Carlsen, Fredrik; Johansen, Kåre; Røed, Knut

    2003-01-01

    Economic theory predicts that local labour market tightness affects local wage setting as well as individuals' migration decisions. But how should we measure local labour market tightness? In this paper we show that the common practice of using the local rate of unemployment as the tightness indicator may be misplaced. Instead, we propose a human capital adjusted outflow rate from unemployment that can be computed on the basis of micro register data. This outflow rate performs better than tra...

  6. A randomized controlled trial to prevent glycemic relapse in longitudinal diabetes care: Study protocol (NCT00362193

    Davis Dianne

    2006-10-01

    Full Text Available Abstract Background Diabetes is a common disease with self-management a key aspect of care. Large prospective trials have shown that maintaining glycated hemoglobin less than 7% greatly reduces complications but translating this level of control into everyday clinical practice can be difficult. Intensive improvement programs are successful in attaining control in patients with type 2 diabetes, however, many patients experience glycemic relapse once returned to routine care. This early relapse is, in part, due to decreased adherence in self-management behaviors. Objective This paper describes the design of the Glycemic Relapse Prevention study. The purpose of this study is to determine the optimal frequency of maintenance intervention needed to prevent glycemic relapse. The primary endpoint is glycemic relapse, which is defined as glycated hemoglobin greater than 8% and an increase of 1% from baseline. Methods The intervention consists of telephonic contact by a nurse practitioner with a referral to a dietitian if indicated. This intervention was designed to provide early identification of self-care problems, understanding the rationale behind the self-care lapse and problem solve to find a negotiated solution. A total of 164 patients were randomized to routine care (least intensive, routine care with phone contact every three months (moderate intensity or routine care with phone contact every month (most intensive. Conclusion The baseline patient characteristics are similar across the treatment arms. Intervention fidelity analysis showed excellent reproducibility. This study will provide insight into the important but poorly understood area of glycemic relapse prevention.

  7. Glycemic responses to maize flour stiff porridges prepared using local recipes in Malawi.

    Mlotha, Vincent; Mwangwela, Agnes Mbachi; Kasapila, William; Siyame, Edwin W P; Masamba, Kingsley

    2016-03-01

    Glycemic index is defined as the incremental area under the blood glucose response curve of a 50 g carbohydrate portion of a test food expressed as a percent of the response to the same amount of carbohydrate from a standard food taken by the same subject. This study investigated glycemic index of maize stiff porridges consumed as staple food in Malawi and a large majority of other countries in sub-Saharan Africa to identify areas for improvement in consumer diets. Stiff porridges were prepared using flour from whole maize, maize grits, and fermented maize grits. The porridges were served to 11 healthy volunteers for 3 weeks, with two serving sessions a week. Glucose was served as a reference food during weekly serving sessions. Results from descriptive analysis revealed that glycemic responses varied across subjects and porridge types. Porridge prepared from fermented maize grits had moderate glycemic index of 65.49 and was comparable in nutrient composition and sensory characteristics with the other test porridges. Glycemic indices of the porridges prepared from whole maize flour and grits were high at 94.06 and 109.64, respectively, attributed to the effect of traditional maize flour processing, preparation, and cooking methods used. The study also calculated glyaemic load of the porridges and drew recommendations to inform diet planning and modifications for healthy and diabetic individuals. PMID:27004122

  8. US production of natural gas from tight reservoirs

    1993-10-18

    For the purposes of this report, tight gas reservoirs are defined as those that meet the Federal Energy Regulatory Commission`s (FERC) definition of tight. They are generally characterized by an average reservoir rock permeability to gas of 0.1 millidarcy or less and, absent artificial stimulation of production, by production rates that do not exceed 5 barrels of oil per day and certain specified daily volumes of gas which increase with the depth of the reservoir. All of the statistics presented in this report pertain to wells that have been classified, from 1978 through 1991, as tight according to the FERC; i.e., they are ``legally tight`` reservoirs. Additional production from ``geologically tight`` reservoirs that have not been classified tight according to the FERC rules has been excluded. This category includes all producing wells drilled into legally designated tight gas reservoirs prior to 1978 and all producing wells drilled into physically tight gas reservoirs that have not been designated legally tight. Therefore, all gas production referenced herein is eligible for the Section 29 tax credit. Although the qualification period for the credit expired at the end of 1992, wells that were spudded (began to be drilled) between 1978 and May 1988, and from November 5, 1990, through year end 1992, are eligible for the tax credit for a subsequent period of 10 years. This report updates the EIA`s tight gas production information through 1991 and considers further the history and effect on tight gas production of the Federal Government`s regulatory and tax policy actions. It also provides some high points of the geologic background needed to understand the nature and location of low-permeability reservoirs.

  9. US production of natural gas from tight reservoirs

    For the purposes of this report, tight gas reservoirs are defined as those that meet the Federal Energy Regulatory Commission's (FERC) definition of tight. They are generally characterized by an average reservoir rock permeability to gas of 0.1 millidarcy or less and, absent artificial stimulation of production, by production rates that do not exceed 5 barrels of oil per day and certain specified daily volumes of gas which increase with the depth of the reservoir. All of the statistics presented in this report pertain to wells that have been classified, from 1978 through 1991, as tight according to the FERC; i.e., they are ''legally tight'' reservoirs. Additional production from ''geologically tight'' reservoirs that have not been classified tight according to the FERC rules has been excluded. This category includes all producing wells drilled into legally designated tight gas reservoirs prior to 1978 and all producing wells drilled into physically tight gas reservoirs that have not been designated legally tight. Therefore, all gas production referenced herein is eligible for the Section 29 tax credit. Although the qualification period for the credit expired at the end of 1992, wells that were spudded (began to be drilled) between 1978 and May 1988, and from November 5, 1990, through year end 1992, are eligible for the tax credit for a subsequent period of 10 years. This report updates the EIA's tight gas production information through 1991 and considers further the history and effect on tight gas production of the Federal Government's regulatory and tax policy actions. It also provides some high points of the geologic background needed to understand the nature and location of low-permeability reservoirs

  10. Epigenetic Changes in Endothelial Progenitors as a Possible Cellular Basis for Glycemic Memory in Diabetic Vascular Complications

    Poojitha Rajasekar

    2015-01-01

    Full Text Available The vascular complications of diabetes significantly impact the quality of life and mortality in diabetic patients. Extensive evidence from various human clinical trials has clearly established that a period of poor glycemic control early in the disease process carries negative consequences, such as an increase in the development and progression of vascular complications that becomes evident many years later. Importantly, intensive glycemic control established later in the disease process cannot reverse or slow down the onset or progression of diabetic vasculopathy. This has been named the glycemic memory phenomenon. Scientists have successfully modelled glycemic memory using various in vitro and in vivo systems. This review emphasizes that oxidative stress and accumulation of advanced glycation end products are key factors driving glycemic memory in endothelial cells. Furthermore, various epigenetic marks have been proposed to closely associate with vascular glycemic memory. In addition, we comment on the importance of endothelial progenitors and their role as endogenous vasoreparative cells that are negatively impacted by the diabetic milieu and may constitute a “carrier” of glycemic memory. Considering the potential of endothelial progenitor-based cytotherapies, future studies on their glycemic memory are warranted to develop epigenetics-based therapeutics targeting diabetic vascular complications.

  11. High and Low Glycemic Index Mixed Meals and Blood Glucose in Youth with Type 2 Diabetes or Impaired Glucose Tolerance

    Gellar, Lauren; Nansel, Tonja R.

    2009-01-01

    This cross-over pilot study tested blood glucose response to low and high glycemic index meals in 12 obese youth with type 2 diabetes or impaired glucose tolerance. Participants demonstrated significantly lower mean daytime blood glucose and a trend toward lower variability, suggesting a clinically relevant impact of reducing glycemic index.

  12. Construction of Multivariate Tight Framelet Packets Associated with Dilation Matrix

    Firdous A Shah; Abdullah

    2015-01-01

    In this paper, we present a method for constructing multivariate tight framelet packets associated with an arbitrary dilation matrix using unitary extension principles.We also prove how to construct various tight frames for L2(Rd) by replac-ing some mother framelets.

  13. Smooth affine shear tight frames: digitization and applications

    Zhuang, Xiaosheng

    2015-08-01

    In this paper, we mainly discuss one of the recent developed directional multiscale representation systems: smooth affine shear tight frames. A directional wavelet tight frame is generated by isotropic dilations and translations of directional wavelet generators, while an affine shear tight frame is generated by anisotropic dilations, shears, and translations of shearlet generators. These two tight frames are actually connected in the sense that the affine shear tight frame can be obtained from a directional wavelet tight frame through subsampling. Consequently, an affine shear tight frame indeed has an underlying filter bank from the MRA structure of its associated directional wavelet tight frame. We call such filter banks affine shear filter banks, which can be designed completely in the frequency domain. We discuss the digitization of affine shear filter banks and their implementations: the forward and backward digital affine shear transforms. Redundancy rate and computational complexity of digital affine shear transforms are also investigated in this paper. Numerical experiments and comparisons in image/video processing show the advantages of digital affine shear transforms over many other state-of-art directional multiscale representation systems.

  14. Localization of Tight Closure in Two-Dimensional Rings

    Kamran Divaani-Aazar; Massoud Tousi

    2005-02-01

    It is shown that tight closure commutes with localization in any two-dimensional ring of prime characteristic if either is a Nagata ring or possesses a weak test element. Moreover, it is proved that tight closure commutes with localization at height one prime ideals in any ring of prime characteristic.

  15. Differences between tight and loose cultures : A 33-nation study

    Gelfand, M.J.; Raver, R.L.; Nishii, L.; Leslie, L.M.; Lun, J.; Lim, B.C.; Van de Vliert, E.

    2011-01-01

    With data from 33 nations, we illustrate the differences between cultures that are tight (have many strong norms and a low tolerance of deviant behavior) versus loose (have weak social norms and a high tolerance of deviant behavior). Tightness-looseness is part of a complex, loosely integrated multi

  16. Glycemic profile and prebiotic potential "in vitro" of bread with yacon (Smallanthus sonchifolius flour

    Priscilla Moura Rolim

    2011-06-01

    Full Text Available The purpose of this study was to elaborate bread with yacon flour at two different levels (6% and 11% and to analyze their proximate composition, their glycemic indices and their prebiotic potentials in vitro. Bread with 6% and 11% of yacon flour presented, simultaneously, low and moderate glycemic index. As for the prebiotic potentials, it was evident the presence of probiotic bacteria, particularly Lactobacillus. The results showed that, the addition of yacon flour on bread rendered products from low to moderate GI, with prebiotic potential, low fat and high fiber contents, according to the Brazilian food legislation.

  17. Effect of the Glycemic Index of Carbohydrates on Acne vulgaris

    Jennie C. Brand-Miller; Peter Petocz; Karola S. Stockmann; Fiona S. Atkinson; Choi, James Y. J.; Stephen Lee; Reynolds, Rebecca C.

    2010-01-01

    Acne vulgaris may be improved by dietary factors that increase insulin sensitivity. We hypothesized that a low-glycemic index diet would improve facial acne severity and insulin sensitivity. Fifty-eight adolescent males (mean age ± standard deviation 16.5 ± 1.0 y and body mass index 23.1 ± 3.5 kg/m2) were alternately allocated to high or low glycemic index diets. Severity of inflammatory lesions on the face, insulin sensitivity (homeostasis modeling assessment of insulin resistance), androgen...

  18. You Are What You Eat: RCTs show a low glycemic index diet improves facial acne

    Kazemi, Tiana

    2015-01-01

    An evidence-based literature review was conducted in order to identify human clinical trials that assess the effect of a low glycemic index diet on facial acne severity (Acne vulgaris). Of the twenty-one studies identified, three met the inclusion criteria of randomized-controlled clinical trials (RCTs) with a primary endpoint of changes in number and severity of acne lesions and were included for final analysis.7-9 During the trials, mean glycemic load in control groups ranged from 157 to 20...

  19. Improved recovery from prolonged exercise following the consumption of low glycemic index carbohydrate meals

    Stevenson, Emma; McComb, Gareth; Oram, Chris; Williams, Clyde

    2005-01-01

    The present study examined the effects of the glycemic index (GI) of post-exercise carbohydrate (CHO) intake on endurance capacity and the metabolic responses during exercise the following day. Nine active males participated in two trials in a randomised crossover design. The experimental protocol was completed over two days. On day 1, subjects completed a 90 min treadmill run at 70% VO2 max (R1). Thereafter, they were supplied with a diet consisting of either high glycemic index (HGI) or lo...

  20. Dietary Behaviors Predict Glycemic Control in Youth With Type 1 Diabetes

    Mehta, Sanjeev N.; Volkening, Lisa K.; Anderson, Barbara J.; Nansel, Tonja; Weissberg-Benchell, Jill; Wysocki, Tim; Laffel, Lori M. B.; ,

    2008-01-01

    OBJECTIVE—To investigate the association between dietary adherence and glycemic control among youth with type 1 diabetes. RESEARCH DESIGN AND METHODS—We conducted a cross-sectional analysis of 119 youth aged 9–14 years (mean ± SD 12.1 ± 1.6 years) with diabetes duration ≥1 year (5.4 ± 3.1 years). Dietary adherence was assessed using the Diabetes Self-Management Profile diet domain. Higher score defined greater dietary adherence. Glycemic control was determined by A1C. RESULTS—Dietary adherenc...

  1. Giant stretchability and reversibility of tightly wound helical carbon nanotubes.

    Wu, Jianyang; He, Jianying; Odegard, Gregory M; Nagao, Shijo; Zheng, Quanshui; Zhang, Zhiliang

    2013-09-18

    There is a surging interest in 3D graphitic nanostructures which possess outstanding properties enabling them to be prime candidates for a new generation of nanodevices and energy-absorbing materials. Here we study the stretching instability and reversibility of tightly wound helical carbon nanotubes (HCNTs) by atomistic simulations. The intercoil van der Waals (vdW) interaction-induced flattening of HCNT walls prior to loading is constrained by the defects coordinated for the curvature formation of helices. The HCNTs exhibit extensive stretchability in the range from 400% to 1000% as a result of two distinct deformation mechanisms depending on the HCNT size. For small HCNTs tremendous deformation is achieved by domino-type partial fracture events, whereas for large HCNTs this is accomplished by stepwise buckling of coils. The formation and fracture of edge-closed graphene ribbons occur at lower temperatures, while at elevated temperatures the highly distributed fracture realizes a phenomenal stretchability. The results of cyclic stretching-reversing simulations of large HCNTs display pronounced hysteresis loops, which produce large energy dissipation via full recovery of buckling and vdW bondings. This study provides physical insights into the origins of high ductility and superior reversibility of hybrid CNT structures. PMID:24016308

  2. Glycemic index and glycemic load in relation to changes in body weight, body fat distribution, and body composition in adult Danes

    Hare-Bruun, Helle; Flint, Anne; Heitmann, Berit L

    2006-01-01

    born in 1922, 1932, 1942, or 1952. A baseline health examination and a dietary history interview were carried out in 1987 and 1988; a follow-up health examination was performed in 1993 and 1994. RESULTS: Positive associations between GI and changes in body weight (DeltaBW), percentage body fat (Delta......BACKGROUND: A diet with a high glycemic index (GI) and glycemic load (GL) may promote overconsumption of energy and increase the risk of weight gain. OBJECTIVE: The objective of the study was to investigate the relation between GI and GL of habitual diets and subsequent 6-y changes in body weight......%BF), and waist circumference (DeltaWC) were observed in women after adjustment for covariates. Significant GI x sex x physical activity interactions for DeltaBW, Delta%BF, and DeltaWC were observed, and the associations in the sedentary women were particularly positive. No significant associations with GI...

  3. Effects of Low Glycemic Index Diets on Gestational Diabetes Mellitus

    Wei, Jinhua; Heng, Weijun; Gao, Jianbo

    2016-01-01

    Abstract Studies of the effects of low glycemic index (LGI) diets on gestational diabetes mellitus (GDM) have reported conflicting findings. The aim of the study was to evaluate the results of randomized controlled trials (RCTs) that investigated the effects of LGI diets with and without added dietary fiber (DF) on maternal and neonatal outcomes in GDM patients. We searched the MEDLINE, EMBASE, EBSCO, Springer, Ovid, and Cochrane Library databases for studies of the effects of LGI diets in GDM patients. We performed a meta-analysis of the effects of the LGI diets with and without added dietary fiber (DF) on GDM outcomes. Risk ratios (RR) and 95% confidence intervals (CIs) were calculated using random- and fixed-effects models. Five RCTs involving 302 participants were included in our meta-analysis. No statistically significant differences in the risks of cesarean section delivery, large for gestational age, and small for gestational age were observed. The risk of macrosomia in the LGI groups was significantly lower (RR = 0.27; 95% CI: 0.10–0.71; P = 0.008) than that in the control groups. Our subgroup analysis of the effects of DF showed that LGI diets with an increased level of DF, relative to the control diet, reduced the risk of macrosomia beyond that of the LGI diets alone (RR: 0.17 vs 0.47, respectively). The subgroup analysis also showed that LGI diets in which the level of DF was approximately equivalent to that in the control diets significantly reduced the risk of insulin usage (RR = 0.69; 95% CI: 0.52–0.92; P = 0.01). The LGI diets reduced the risk of macrosomia in GDM patients, and LGI diets with added DF reduced the risk of macrosomia further. The LGI diets with levels of DF approximately equivalent to that in the control diets reduced the risk of insulin usage in GDM patients. PMID:27258511

  4. Subchannel analysis of 37-rod tight-lattice bundle experiments for reduced-moderation water reactor

    R and D project to investigate thermal-hydraulic performance of tight-lattice fuel bundles for Reduced-Moderation Water Reactor (RMWR) started at Japan Atomic Energy Research Institute (JAERI) in collaboration with utilities, reactor vendors and universities from 2002. The RMWR realizes a high conversion ratio larger than 0.1 for sustainable energy supply through plutonium multiple recycling based on the well-experienced LWR technologies. The reactor core comprises tight-lattice fuel assemblies with gap clearance of around 1.0 mm to reduce the water volume ratio to achieve the high conversion ratio. A problem of utmost importance from a thermal-hydraulic point of view is the coolability of the tight-lattice assembly with such a small gap width. JAERI has been carrying out experimental study to investigate the system parameter effects on the thermal-hydraulic performance and to confirm the feasibility of the core. In the present study, the subchannel analysis code NASCA was applied to 37-rod tight-lattice bundle experiments. The NASCA can give good predictions of critical power for the gap width of 1.3 mm while the prediction accuracy decreases for the gap width of 1.0 mm. To improve the prediction accuracy, the code will be modified to take the effect of film thickness distribution around fuel rods on boiling transition. (author)

  5. Taking a Low Glycemic Index Multi-Nutrient Supplement as Breakfast Improves Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial

    Di Li

    2014-12-01

    Full Text Available Dietary therapy is the mainstay of treatment for diabetes. This study examined the effect of a low glycemic index (GI multi-nutrient supplement, consumed in place of breakfast, on glycemic control in patients with type 2 diabetes mellitus (T2DM. A total of 71 participants were randomized at a 2:1 ratio into either a breakfast replacement group or a normal breakfast group for a 12-week interventional study. The primary outcome measure was change in hemoglobin A1c (HbA1c. Nutrition status and somatometry were studied as secondary outcomes. The breakfast replacement group displayed a −0.2% absolute reduction in HbA1c (95% CI (confidence interval, −0.38% to −0.07%, p = 0.004, while the HbA1c of the control group increased 0.3% (95% CI, 0.1% to 0.5%, p = 0.005. The baseline Mini Nutritional Assessment score for both groups was 26.0 and no significant changes occurred following intervention. However, there was a statistically significant difference in body mass index between the treatment and control groups (p = 0.032 due to the weight gain in the control group (increased 0.5 kg, 95% CI was 0.2 to 0.9, p = 0.007. These data suggest that breakfast replacement with a low GI multi-nutrient supplement can improve glycemic and weight control in T2DM.

  6. Taking a low glycemic index multi-nutrient supplement as breakfast improves glycemic control in patients with type 2 diabetes mellitus: a randomized controlled trial.

    Li, Di; Zhang, Peiwen; Guo, Honghui; Ling, Wenhua

    2014-12-01

    Dietary therapy is the mainstay of treatment for diabetes. This study examined the effect of a low glycemic index (GI) multi-nutrient supplement, consumed in place of breakfast, on glycemic control in patients with type 2 diabetes mellitus (T2DM). A total of 71 participants were randomized at a 2:1 ratio into either a breakfast replacement group or a normal breakfast group for a 12-week interventional study. The primary outcome measure was change in hemoglobin A1c (HbA1c). Nutrition status and somatometry were studied as secondary outcomes. The breakfast replacement group displayed a -0.2% absolute reduction in HbA1c (95% CI (confidence interval), -0.38% to -0.07%, p = 0.004), while the HbA1c of the control group increased 0.3% (95% CI, 0.1% to 0.5%, p = 0.005). The baseline Mini Nutritional Assessment score for both groups was 26.0 and no significant changes occurred following intervention. However, there was a statistically significant difference in body mass index between the treatment and control groups (p = 0.032) due to the weight gain in the control group (increased 0.5 kg, 95% CI was 0.2 to 0.9, p = 0.007). These data suggest that breakfast replacement with a low GI multi-nutrient supplement can improve glycemic and weight control in T2DM. PMID:25514391

  7. On tight spans and tropical polytopes for directed distances

    Hirai, Hiroshi

    2010-01-01

    An extension $(V,d)$ of a metric space $(S,\\mu)$ is a metric space with $S \\subseteq V$ and $d|_S = \\mu$, and is said to be tight if there is no other extension $(V,d')$ of $(S,\\mu)$ with $d' \\leq d$. Isbell and Dress independently found that every tight extension is isometrically embedded into a certain metrized polyhedral complex associated with $(S,\\mu)$, called the tight span. This paper develops an analogous theory for directed metrics, which are "not necessarily symmetric" distance functions satisfying the triangle inequality. We introduce a directed version of the tight span and show that it has such a universal embedding property for tight extensions. Also we newly introduce another natural class of extensions, called cyclically tight extensions, and show that (a fiber of) the tropical polytope, introduced by Develin and Sturmfels, has a universal embedding property for cyclically tight extensions. As an application, we prove the following directed version of tree metric theorem: directed metric $\\mu$...

  8. INTRAPERITONEAL INSTILLATION OF BUPIVACAINE AND GLYCEMIC LEVELS IN LAPROSCOPIC SURGERIES: A DOUBLE BLIND, PLACEBO - CONTROLLED TRIAL

    Suresh Chander

    2015-09-01

    Full Text Available BACKGROUND: Surgical stress is associated with hormonal changes. Hyperglycemia is an easily measurable factor to quantify stress. Intraoperative stress can be due to pain or surgical manipulation. We made an attempt to see the glycemic response in laparoscopic patients by intraperitoneal instillation of bupivacaine vs placebo. OBJECT IVES: To observe the response of intraperitoneal instillation of Bupivacaine vs placebo on glycemic levels. PATIENTS AND METHODS : A prospective randomized double blind, placebo - controlled study was conducted in the department of Anaesthesiology, Gandhi Hos pital, Secunderabad. Fifty patients were randomly selected to be enrolled in this study who were scheduled for laproscopic surgery. All patients were of ASA I - II physical status. Study group consisted of 25 patients receiving intraperitoneal bupivacaine 2 mg/kg (Group B and the control group consisted of 25 patients receiving 20 ml of normal saline as placebo (Group C. Blood sugar levels were measured at baseline and at interval of 30 min and 90 min after incision. Mean blood pressure and pulse rate were recorded at baseline and and every 15 min from incision to 90 min. RESULT S : There is no significant difference in the glycemic levels in both groups. CONCLUSION: Stress during laproscopic cholecystectomy and appendicectomy may not be high enough to cause glycemic derangement. However, the study group is small and needs further studies to substantiate this

  9. A Low-Glycemic Diet Lifestyle Intervention Improves Fat Utilization during Exercise in Older Obese Humans

    Solomon, Thomas; Haus, Jacob M; Cook, Marc A;

    2013-01-01

    -glycemic (HiGIX) diets. Changes in indirect calorimetry (VO2 ; VCO2 ) were assessed at rest, during a hyperinsulinemic-euglycemic clamp, and during submaximal exercise (walking: 65% VO2 max, 200 kcal energy expenditure). Intramyocellular lipid (IMCL) was measured by (1) H-magnetic resonance spectroscopy...

  10. The combination of colesevelam with sitagliptin enhances glycemic control in diabetic ZDF rat model

    Shang, Quan; Liu, Matthew K; Saumoy, Monica;

    2012-01-01

    with SIT extends the half life of COL-induced GLP-1A and benefits preservation of the islets that delay the development of diabetes and improve glycemic control. This study suggests that the combined therapy (COL+SIT) is more effective than either drug alone for reducing glucose levels in diabetes....

  11. Glycemic index treatment using Japanese foods in a girl with Lennox-Gastaut syndrome.

    Kumada, Tomohiro; Hiejima, Ikuko; Nozaki, Fumihito; Hayashi, Anri; Fujii, Tatsuya

    2013-05-01

    We introduced a low glycemic index treatment using Japanese ethnic foods to a 13-year-old girl with Lennox-Gastaut syndrome caused by tuberous sclerosis complex. She had previously refused the modified Atkins diet within 2 weeks of diet treatment because of its restrictiveness. The low glycemic index treatment was implemented by limiting the daily carbohydrate intake to 50 g of foods with a glycemic index of less than 50 relative to that of glucose, which included udon, soba, and unpolished Japonica rice with natto. One month after the initiation of the diet therapy, the clusters of tonic seizures for 30 to 60 minutes during sleep were reduced from two or three times per week to once or twice per month, and the frequent myoclonic seizures in the awake state disappeared. She has been on the diet therapy for more than 1 year, and the efficacy of the diet has been sustained. Low glycemic index treatment should be considered for patients with medication-resistant epilepsy who cannot tolerate restrictive diet therapies. Japanese ethnic foods can be used for this diet therapy. PMID:23583057

  12. Correlation between glycemic variability and gastroesophageal reflux in adolescentswith type 1 diabetes mellitus

    I L Alimova

    2013-03-01

    Full Text Available Aims. To estimate an impact of glycemic variability on the development of gastroesophageal reflux disease (GERD in adolescents with type 1 diabetes mellitus (T1DM.Materials and methods. We enrolled 33 patients with T1DM aged from 12 to 17 years. 24-h pH-monitoring was performed with “Gas- troskan 24” system (Istok-Sistema, Fryazino; 24-h continuous glucose monitoring utilized CGMS MMT-7310 (Medtronic Minimed, USA with subsequent night-time analysis.Results. As compared to stable night-time glycemia controls (SD <2.0 mmol/L, patients with higher night-time glycemic variability (SD>2.0 mmol/L showed longer period of esophageal acidification (17% [2–58]; p<0.001, higher incidence of acid reflux events with duration above 5 min (2 ev. [1-10]; p<0.001, longer period of most protracted acid reflux event (63 min [5–132]; p<0.001, as well as higher prevalence of pathologic acid GER events (76.4%; χ2=17.11; p<0.001 during night-time. Increase in glycemic in- stability positively correlated with incidence and severity of acid GER events. 6-8 months follow-up supported these findings. Conclusion. Glycemic variability in adolescents with T1DM is a significant risk factor for development of GERD with hypomotor dys- function according to pH-monitoring.

  13. Exercise training in older patients with systolic heart failure: Adherence, exercise capacity, inflammation and glycemic control

    Prescott, Eva; Hjardem-Hansen, Rasmus; Dela, Flemming;

    2009-01-01

    markers of glycemic control (glucose, insulin, glycerol, free fatty acids, HbA1c), inflammation and endothelial function (hsCRP, orosomucoid, interleukin 6, TNF-alpha, urine-orosomucoid and -albumin/creatinin), lipid metabolism, NT-proBNP or other regulatory hormones (cortisol, epinephrine and IGF-1...

  14. Adiponectin and cardiovascular risk factors in relation with glycemic control in type 2 diabetics

    Aniebetabasi S. Obot

    2013-08-01

    Full Text Available Background: Adiponectin has been associated with insulin resistance and dyslipidemia in Type 2 diabetes, though the mechanism of association is still uncertain. The adiponectin levels and lipid profile in relation to glycemic control were investigated in type 2 diabetics. Methods: Forty two diabetic subjects (35-64 years and 33 age-matched non-diabetic subjects were recruited into this case control study. Socio-demographic characteristics, anthropometric indices and blood pressure were obtained. Total cholesterol (TC, triglyceride (TG, low density lipoprotein (LDL, high density lipoprotein, (HDL, fasting plasma glucose (FPG, and glycated hemoglobin (HbA1c were estimated using colorimetric methods, atherogenic index (AI was calculated, while serum adiponectin was determined by ELISA method. Results: Adiponectin levels of type 2 diabetics were not significantly different from the non-diabetics studied (p>0.05. Higher TG levels were observed in diabetics with poor glycemic control compared with those with good glycemic control (p0.05. Conclusion: Type 2 diabetics do not have lower adiponectin levels. Gender, duration of diabetes and glycemic control does not seem to exert any influence on adiponectin levels in type 2 diabetes. Adiponectin may be associated with reduced risk of atherosclerosis through its effects on HDL cholesterol metabolism. [Int J Res Med Sci 2013; 1(4.000: 563-570

  15. The Effect of Pre-Exercise Carbohydrate Feeding with Different Glycemic Index on Endurance Exercise Capacity

    N. Salarkia

    2004-04-01

    Full Text Available Although, it is known that feeding with carbohydrate (CHO during exercise improves endurance performance, the effects of glycemic index (GI of carbohydrate intake are less clear. This study was carried out to assess the effect of glycemic index of pre-exercise carbohydrate feeding on endurance exercise capacity. In a randomized clinical trial 52 endurance – trained men with mean age 21.7 ± 3 years, weight 69.3 ± 9 kg, height 178.4 ± 2 cm and BMI 22.6 ± 2 were studied. Subjects performed exercise treadmill at 70% VO2max after ingestion: Lentil, a low glycemic index; potato, a high glycemic index; glucose and water (as a control one hour before exercise. Blood samples were collected before and one hour after test meal and 30 minutes after exercise. To assess aerobic capacity VO2max (maximum oxygen uptake was measured at the end of the exercise trial. Endurance time was found to be longer after lentil than after the potato, glucose and control respectively (P < 0.05. At the end of exercise, the glucose group and control both gave lower plasma glucose concentrations. Changes of VO2max in lentil. Potato, glucose and control group which were not statistically significant. This study showed that a low GI meal eaten before an event increases endurance capacity during exercise. Furthermore, the low GI meal was found to maintain glucose at higher concentrations during the later stages of exercise.

  16. Dietary glycemic index and carbohydrate in relation to early age-related macular degeneration

    Little is known about the association between dietary carbohydrates and cataract in nondiabetic persons. The aim was to test whether recent dietary carbohydrate intakes or glycemic index (GI; a measure of carbohydrate intake quality) was associated with the presence of cortical or nuclear opacities....

  17. Experience and acceptability of diets of varying protein content and glycemic index in an obese cohort

    McConnon, A; Horgan, G W; Lawton, C;

    2013-01-01

    Background/Objectives:To investigate acceptability and tolerability of diets of different protein and glycemic index (GI) content aimed at weight maintenance following a phase of rapid weight loss, as part of a large pan-European dietary intervention trial.Subjects/Methods:The Diogenes study (www...

  18. Glycemic Control in a Clinic-Based Sample of Diabetics in M'Bour Senegal

    BeLue, Rhonda; Ndiaye, Khadidiatou; NDao, Fatou; Ba, Fatou Niass Niang; Diaw, Mor

    2016-01-01

    Background: Sub-Saharan Africa (SSA) including Senegal is faced with a significant and increasing burden of type 2 diabetes. However, little information is available about diabetes management among Senegalese diabetics. Purpose: The current study aims to describe the level of glycemic control among a convenience sample of diabetics who receive…

  19. The Optimization of Glycemic Control in Patients with Type 2 Diabetes Mellitus in Peracute Stroke

    Grogoryan I.G.

    2012-03-01

    Full Text Available The aim of the investigation is to determine an optimal method of glycemic control in patients with cerebrovascular accident and type 2 diabetes mellitus. Materials and methods. 43 patients with insulin and type 2 diabetes mellitus were included into the study. The patients were divided into two groups: the patients of the first group (n=23 had continuous insulin infusion within not less than 24 h, the patients of the second one (n=20 — subcutaneous insulin injections. Results. The patients of both groups had statistically significant difference of glycemic indexes in 24 h, and furthermore, the control group had high variability of glycemic indexes. Continuous insulin infusion compared to discrete subcutaneous injections provides gradual glycemia decline up to target values and more stable retention of glycemia within the given range that increases intensive insulin therapy safety. It allows to consider the method of intravenous insulin administration to be optimal for glycemic control in patients with type 2 diabetes mellitus in peracute stroke.

  20. Tight projections of frames on infinite dimensional Hilbert spaces

    Jasper, John

    2012-01-01

    We characterize the frames on an infinite dimensional separable Hilbert space that can be projected to a tight frame for an infinite dimensional subspace. A result of Casazza and Leon states that an arbitrary frame for a 2N- or (2N-1)-dimensional Hilbert space can be projected to a tight frame for an N-dimensional subspace. Surprisingly, we demonstrate a large class of frames for infinite dimensional Hilbert spaces which cannot be projected to a tight frame for any infinite dimensional subspace.

  1. Comparative evaluation of several parameters of glycemic homeostasis in patients with functional pituitary adenomas

    Miroslava Rostislavovna Mikityuk

    2014-03-01

    Full Text Available Aim. To investigate glycemic homeostasis in patients with acromegaly and hyperprolactinaemia due to functional pituitary adenoma.Materials and Methods. We enrolled 48 patients with somatotropinoma (Group 1, 19 patients with somatomammotropinoma (Group 2 and 24 patients with prolactinoma (Group 3 with no history of glycemic disorders. Median age was 48.63±9.98 years; median disease duration was 13.1±6.9 years. The comparison group was composed of overweight or obese patients (n=75. We conducted a comparative analysis of glycemic parameters (Glc0, immunoreactive insulin, HOMA2_S%, HOMA2_B% и HOMA2_IR, Ssum and S under isolated segments of the glycemic curve. We also tested their correlation with plasma levels of growth hormone, prolactin and IGF-1.Results. We detected hyperinsulinemia (>20 μU/mL in 35.1% of participants from Group 1, 33.3% and 25% from groups 2 and 3, respectively. There was no statistically significant difference between glycemic parameters of the study groups, though patients were mildly insulin resistant (HOMA2_IR 1.88 to 2.38 units independantly from tumour secretory activity. Groups 1 and 2 were characterized by significantly higher fasting blood glucose levels vs. comparison group (though still within the reference values, and glucose homeostasis was maintained with lower activity of pancreatic β-cells. Average Ssumanalysis showed lower glucose tolerance in groups 1 and 2 vs. Group 3. Median S values under isolated glycemic curve segments were significantly higher than in comparison group. Plasma levels of growth hormone did not correlate with Ssum and S parameters in groups 1 and 2. There was a linear correlation between Ssum and plasma IGF-1 levels in patients from Group 1 (r=0.45; p=0.006. We also noted that Ssum had a non-linear correlation with plasma prolactin levels in patients from Group 3 (r=0.41; p<0.05.Conclusion. Postprandial area under the glycemic curve has positive linear association with

  2. Impact of lifestyle modification on glycemic control in patients with type 2 diabetes mellitus

    Nandita B Sanghani

    2013-01-01

    Full Text Available Background: Current treatment guidelines support the role of lifestyle modification, in terms of increasing the quantity and quality of physical activity to achieve target glycemia in patients with type 2 diabetes mellitus. Objective: To assess the effect of structured exercise training and unstructured physical activity interventions on glycemic control. Materials and Methods: This was a randomized six-month exercise intervention study conducted with previously inactive 279 patients of type 2 diabetes mellitus. Before randomization, all enrolled T2DM participants (n: 300; 30 to 60 year old, having diabetes for more than a year with HbA1c levels of 6.5% or higher entered a one-month run-in phase to reduce dropout and maintain adherence. Results: A recommendation to increase physical activity was beneficial (0.14% HbA1c reduction; P = 0.12, but was not bringing significantly declines in HbA1c, whereas, structured exercise training is associated with a significant HbA1c decline of 0.59%. ( P = 0.030. In a subgroup analysis limited to participants with a baseline HbA1c value > 7%, both the unstructured (0. 48%; P = 0.04 and structured exercise training (0.77%; P < 0.01 groups experienced significant decline in HbA1c Vs the control, whereas among participants with baseline hemoglobin A1c values less than 7%, significant reduction occurred only in the structured exercise training group. Changes in blood pressure; total cholesterol, HDL-cholesterol (high-density lipoprotein, LDL-cholesterol (low-density lipoprotein and the atherogenic index factors did not statistically significantly differ within (baseline to follow-up and among groups. Conclusion: Supervised structured training was more efficacious than unstructured activity in achieving declines in HbA1c. Although both structured and unstructured training provide benefits, only the former was associated with significant reductions in HbA1c levels. Therefore, T2DM patients should be stimulated to

  3. Limiting enclosures. Classification of enclosures according to their tightness

    A classification of limiting enclosures according to their tightness is given. This can applied to enclosures or series of enclosures intended for work on radioactive products, toxic or dangerous products, materials sensitive to atmospheric components and work in sterile environment

  4. Tight Planar Contact Manifolds with Vanishing Heegaard Floer Contact Invariants

    Conway, James; Kaloti, Amey; Kulkarni, Dheeraj

    2014-01-01

    In this note, we exhibit infinite families of tight non-fillable contact manifolds supported by planar open books with vanishing Heegaard Floer contact invariants. Moreover, we also exhibit an infinite such family where the supported manifold is hyperbolic.

  5. Multi-scale glycemic variability: a link to gray matter atrophy and cognitive decline in type 2 diabetes.

    Xingran Cui

    Full Text Available OBJECTIVE: Type 2 diabetes mellitus (DM accelerates brain aging and cognitive decline. Complex interactions between hyperglycemia, glycemic variability and brain aging remain unresolved. This study investigated the relationship between glycemic variability at multiple time scales, brain volumes and cognition in type 2 DM. RESEARCH DESIGN AND METHODS: Forty-three older adults with and 26 without type 2 DM completed 72-hour continuous glucose monitoring, cognitive tests and anatomical MRI. We described a new analysis of continuous glucose monitoring, termed Multi-Scale glycemic variability (Multi-Scale GV, to examine glycemic variability at multiple time scales. Specifically, Ensemble Empirical Mode Decomposition was used to identify five unique ultradian glycemic variability cycles (GVC1-5 that modulate serum glucose with periods ranging from 0.5-12 hrs. RESULTS: Type 2 DM subjects demonstrated greater variability in GVC3-5 (period 2.0-12 hrs than controls (P<0.0001, during the day as well as during the night. Multi-Scale GV was related to conventional markers of glycemic variability (e.g. standard deviation and mean glycemic excursions, but demonstrated greater sensitivity and specificity to conventional markers, and was associated with worse long-term glycemic control (e.g. fasting glucose and HbA1c. Across all subjects, those with greater glycemic variability within higher frequency cycles (GVC1-3; 0.5-2.0 hrs had less gray matter within the limbic system and temporo-parietal lobes (e.g. cingulum, insular, hippocampus, and exhibited worse cognitive performance. Specifically within those with type 2 DM, greater glycemic variability in GVC2-3 was associated with worse learning and memory scores. Greater variability in GVC5 was associated with longer DM duration and more depression. These relationships were independent of HbA1c and hypoglycemic episodes. CONCLUSIONS: Type 2 DM is associated with dysregulation of glycemic variability over multiple

  6. Evaluation of indoor air composition time variation in air-tight occupied spaces during night periods

    Markov, Detelin

    2012-11-01

    This paper presents an easy-to-understand procedure for prediction of indoor air composition time variation in air-tight occupied spaces during the night periods. The mathematical model is based on the assumptions for homogeneity and perfect mixing of the indoor air, the ideal gas model for non-reacting gas mixtures, mass conservation equations for the entire system and for each species, a model for prediction of basal metabolic rate of humans as well as a model for prediction of O2 consumption rate and both CO2 and H2O generation rates by breathing. Time variation of indoor air composition is predicted at constant indoor air temperature for three scenarios based on the analytical solution of the mathematical model. The results achieved reveal both the most probable scenario for indoor air time variation in air-tight occupied spaces as well as the cause for morning tiredness after having a sleep in a modern energy efficient space.

  7. Effect of a tight necktie on intraocular pressure

    Božić Marija; Hentova-Senćanin Paraskeva; Branković Aleksandra; Marjanović Ivan; Jocić Đorđević Jasmina; Senćanin Ivan

    2012-01-01

    Introduction. Any factor causing constriction of the neck may lead to an increase in intraocular pressure. A tight necktie may result in increasing intraocular pressure, which could lead to an erroneous diagnosis and treatment of ocular hypertension or even glaucoma. This study was aimed at evaluating the effect of a tight necktie on intraocular pressure measurement using Goldmann applanation tonometry. Material and Methods. This study included forty eyes of 20 patients with primary ope...

  8. Western tight gas sands advanced logging workshop proceedings

    Jennings, J B; Carroll, Jr, H B [eds.

    1982-04-01

    An advanced logging research program is one major aspect of the Western Tight Sands Program. Purpose of this workshop is to help BETC define critical logging needs for tight gas sands and to allow free interchange of ideas on all aspects of the current logging research program. Sixteen papers and abstracts are included together with discussions. Separate abstracts have been prepared for the 12 papers. (DLC)

  9. Tightness-looseness across the 50 united states.

    Harrington, Jesse R; Gelfand, Michele J

    2014-06-01

    This research demonstrates wide variation in tightness-looseness (the strength of punishment and degree of latitude/permissiveness) at the state level in the United States, as well as its association with a variety of ecological and historical factors, psychological characteristics, and state-level outcomes. Consistent with theory and past research, ecological and man-made threats--such as a higher incidence of natural disasters, greater disease prevalence, fewer natural resources, and greater degree of external threat--predicted increased tightness at the state level. Tightness is also associated with higher trait conscientiousness and lower trait openness, as well as a wide array of outcomes at the state level. Compared with loose states, tight states have higher levels of social stability, including lowered drug and alcohol use, lower rates of homelessness, and lower social disorganization. However, tight states also have higher incarceration rates, greater discrimination and inequality, lower creativity, and lower happiness relative to loose states. In all, tightness-looseness provides a parsimonious explanation of the wide variation we see across the 50 states of the United States of America. PMID:24843116

  10. Conservative tightly-coupled simulations of stochastic multiscale systems

    Taverniers, Søren; Pigarov, Alexander Y.; Tartakovsky, Daniel M.

    2016-05-01

    Multiphysics problems often involve components whose macroscopic dynamics is driven by microscopic random fluctuations. The fidelity of simulations of such systems depends on their ability to propagate these random fluctuations throughout a computational domain, including subdomains represented by deterministic solvers. When the constituent processes take place in nonoverlapping subdomains, system behavior can be modeled via a domain-decomposition approach that couples separate components at the interfaces between these subdomains. Its coupling algorithm has to maintain a stable and efficient numerical time integration even at high noise strength. We propose a conservative domain-decomposition algorithm in which tight coupling is achieved by employing either Picard's or Newton's iterative method. Coupled diffusion equations, one of which has a Gaussian white-noise source term, provide a computational testbed for analysis of these two coupling strategies. Fully-converged ("implicit") coupling with Newton's method typically outperforms its Picard counterpart, especially at high noise levels. This is because the number of Newton iterations scales linearly with the amplitude of the Gaussian noise, while the number of Picard iterations can scale superlinearly. At large time intervals between two subsequent inter-solver communications, the solution error for single-iteration ("explicit") Picard's coupling can be several orders of magnitude higher than that for implicit coupling. Increasing the explicit coupling's communication frequency reduces this difference, but the resulting increase in computational cost can make it less efficient than implicit coupling at similar levels of solution error, depending on the communication frequency of the latter and the noise strength. This trend carries over into higher dimensions, although at high noise strength explicit coupling may be the only computationally viable option.

  11. Achieving Standardization

    Henningsson, Stefan

    2016-01-01

    International e-Customs is going through a standardization process. Driven by the need to increase control in the trade process to address security challenges stemming from threats of terrorists, diseases, and counterfeit products, and to lower the administrative burdens on traders to stay...... competitive, national customs and regional economic organizations are seeking to establish a standardized solution for digital reporting of customs data. However, standardization has proven hard to achieve in the socio-technical e-Customs solution. In this chapter, the authors identify and describe what has...... to be harmonized in order for a global company to perceive e-Customs as standardized. In doing so, they contribute an explanation of the challenges associated with using a standardization mechanism for harmonizing socio-technical information systems....

  12. Achieving Standardization

    Henningsson, Stefan

    2014-01-01

    International e-Customs is going through a standardization process. Driven by the need to increase control in the trade process to address security challenges stemming from threats of terrorists, diseases, and counterfeit products, and to lower the administrative burdens on traders to stay...... competitive, national customs and regional economic organizations are seeking to establish a standardized solution for digital reporting of customs data. However, standardization has proven hard to achieve in the socio-technical e-Customs solution. In this chapter, the authors identify and describe what has...... to be harmonized in order for a global company to perceive e-Customs as standardized. In doing so, they contribute an explanation of the challenges associated with using a standardization mechanism for harmonizing socio-technical information systems....

  13. A systematic review on the effect of sweeteners on glycemic response and clinically relevant outcomes

    Wiebe Natasha

    2011-11-01

    Full Text Available Abstract Background The major metabolic complications of obesity and type 2 diabetes may be prevented and managed with dietary modification. The use of sweeteners that provide little or no calories may help to achieve this objective. Methods We did a systematic review and network meta-analysis of the comparative effectiveness of sweetener additives using Bayesian techniques. MEDLINE, EMBASE, CENTRAL and CAB Global were searched to January 2011. Randomized trials comparing sweeteners in obese, diabetic, and healthy populations were selected. Outcomes of interest included weight change, energy intake, lipids, glycated hemoglobin, markers of insulin resistance and glycemic response. Evidence-based items potentially indicating risk of bias were assessed. Results Of 3,666 citations, we identified 53 eligible randomized controlled trials with 1,126 participants. In diabetic participants, fructose reduced 2-hour blood glucose concentrations by 4.81 mmol/L (95% CI 3.29, 6.34 compared to glucose. Two-hour blood glucose concentration data comparing hypocaloric sweeteners to sucrose or high fructose corn syrup were inconclusive. Based on two ≤10-week trials, we found that non-caloric sweeteners reduced energy intake compared to the sucrose groups by approximately 250-500 kcal/day (95% CI 153, 806. One trial found that participants in the non-caloric sweetener group had a decrease in body mass index compared to an increase in body mass index in the sucrose group (-0.40 vs 0.50 kg/m2, and -1.00 vs 1.60 kg/m2, respectively. No randomized controlled trials showed that high fructose corn syrup or fructose increased levels of cholesterol relative to other sweeteners. Conclusions Considering the public health importance of obesity and its consequences; the clearly relevant role of diet in the pathogenesis and maintenance of obesity; and the billions of dollars spent on non-caloric sweeteners, little high-quality clinical research has been done. Studies are

  14. Effects of sildenafil on lipid profile and glycemic control in patients with type 2 diabetes mellitus and metabolic syndrome

    Haedar Abdulhafith Al-biati

    2014-12-01

    Conclusion: We have provided the first evidence that sildenafil therapy improve glycemic control, lipid profile and body mass index in diabetic patients with metabolic syndrome. [Int J Basic Clin Pharmacol 2014; 3(6.000: 1048-1051

  15. Association between hormonal contraceptive use and glycemic severity in women suffering from gestational diabetes mellitus in Bangladesh.

    Sarram, Tasira

    2015-01-01

    With increasing prevalence of gestational diabetes mellitus, prevalence of contraceptive use is also in rise in Bangladesh. This quantitative study was designed with the objectives to estimate the proportion of hormonal contraceptive users and non-users among patients with gestational diabetes mellitus and observe the glycemic level in relation to Hormonal Contraceptive use. The findings suggested no role of hormonal contraceptive in altering glycemic status in patients with gestational diabe...

  16. Prescribing pattern and efficacy of anti-diabetic drugs in maintaining optimal glycemic levels in diabetic patients

    Agarwal, Akshay A.; Jadhav, Pradeep R.; Deshmukh, Yeshwant A.

    2014-01-01

    Context: Despite the availability of efficacious anti-diabetic drugs, which act by different mechanisms to reduce the blood-glucose, the majority of people with diabetes on anti-diabetic drug therapy, have poor glycemic control and diabetic vascular complications. Aim and Objectives: The aim was to study the prescribing pattern and efficacy of anti-diabetic drugs in maintaining optimal glycemic levels in diabetic patients attending tertiary care teaching hospital in Navi Mumbai. Materials and...

  17. Supported Telemonitoring and Glycemic Control in People with Type 2 Diabetes: the Telescot Diabetes Pragmatic Multicenter Randomized Controlled Trial

    Wild, Sarah; Hanley, Janet; Lewis, Stephanie; McKnight, John; McCloughan, Catherine; Padfield, Paul; Parker, Richard; Paterson, Mary; Pinnock, Hilary; Sheikh, Aziz; McKinstry, Brian

    2016-01-01

    Abstract Background Self-monitoring of blood glucose among people with type 2 diabetes not treated with insulin does not appear to be effective in improving glycemic control. We investigated whether health professional review of telemetrically transmitted self-monitored glucose results in improved glycemic control in people with poorly controlled type 2 diabetes.Methods and Findings We performed a randomized, parallel, investigator-blind controlled trial with centralised randomization in fami...

  18. Tight coupling UFMArcGIS for simulating inundation depth in densely area

    S. H. Kang

    2010-07-01

    Full Text Available The integration of hydrological models and Geographical Information Systems (GIS usually takes two approaches: loose coupling and tight coupling. This paper presents a tight coupling approach within a GIS environment that is achieved by integrating the urban flood model with the macro language of GIS. Such an approach affords an uncomplicated way to capitalize on the GIS visualization and spatial analysis functions, thereby significantly supporting the dynamic simulation process of hydrological modeling. The tight coupling approach is illustrated by UFMArcGIS (Urban Flood Model with ArcGIS, which is a realization of an urban flood model integrated with the VBA (visual basic of application language of ArcGIS. Within this model, major stages of model structures are created from the initial parameter input and transformation of datasets, intermediate maps are then visualized, and the results are finally presented in various graphical formats in their geographic context. This approach provides a convenient and single environment in which users can visually interact with the model, e.g. by adjusting parameters while simultaneously observing the corresponding results. This significantly facilitates users in the exploratory data analysis and decision-making stages in terms of the model applications.

  19. Evaluation of critical heat flux of tight lattice core with subchannel analysis code NASCA

    Reduced-Moderation Water reactor (RMWR) is a light water breeder reactor developed by Japan Atomic Energy Research Institute (JAERI). The RMWR comprises tight lattice fuel assemblies with gap clearance of around 1.0 mm to reduce water volume ratio to achieve a high conversion ratio. It is important to estimate the thermal hydraulic safety margin of the tight lattice core of the RMWR. In the present study, the boiling transition (BT) prediction performance of the subchannel analysis code NASCA developed for the current BWR cores was assessed for series of tight lattice critical heat flux (CHF) experiments performed in JAERI. The test section was a 7-rod bundle with rod diameter of 12.3 mm, rod gap of 1.0 mm and heated length of 1.8m. Axial power distribution was flat. With a simple subchannel model, the code overestimates the critical power in the high mass velocity region, although the predicted critical powers in the low mass velocity region were in good agreement with the experimental results. The predicted BT subchannel position differed from the measured one, since the amounts of liquid film in subchannels were not adequately predicted. To improve the prediction accuracy, a fine subchannel model was applied. The result implies that the use of the fine subchannel model can improve the critical power prediction in the high mass velocity region. It can also improve BT position prediction. (author)

  20. Tight coupling of Na+/K+-ATPase with glycolysis demonstrated in permeabilized rat cardiomyocytes.

    Mervi Sepp

    Full Text Available The effective integrated organization of processes in cardiac cells is achieved, in part, by the functional compartmentation of energy transfer processes. Earlier, using permeabilized cardiomyocytes, we demonstrated the existence of tight coupling between some of cardiomyocyte ATPases and glycolysis in rat. In this work, we studied contribution of two membrane ATPases and whether they are coupled to glycolysis--sarcoplasmic reticulum Ca2+ ATPase (SERCA and plasmalemma Na+/K+-ATPase (NKA. While SERCA activity was minor in this preparation in the absence of calcium, major role of NKA was revealed accounting to ∼30% of the total ATPase activity which demonstrates that permeabilized cell preparation can be used to study this pump. To elucidate the contribution of NKA in the pool of ATPases, a series of kinetic measurements was performed in cells where NKA had been inhibited by 2 mM ouabain. In these cells, we recorded: ADP- and ATP-kinetics of respiration, competition for ADP between mitochondria and pyruvate kinase (PK, ADP-kinetics of endogenous PK, and ATP-kinetics of total ATPases. The experimental data was analyzed using a series of mathematical models with varying compartmentation levels. The results show that NKA is tightly coupled to glycolysis with undetectable flux of ATP between mitochondria and NKA. Such tight coupling of NKA to PK is in line with its increased importance in the pathological states of the heart when the substrate preference shifts to glucose.

  1. The Association of Binge Eating Disorder with Glycemic Control in Patients with Type 2 Diabetes

    Fatih Canan

    2011-06-01

    Full Text Available Objective: Our aim was to assess the prevalence of binge eating disorder (BED in individuals with type 2 diabetes and to investigate whether a comorbidity with BED would affect glycemic control in these patients. Materials and Methods: Eighty-two type 2 diabetic patients were enrolled. The participants were assessed for eating disorders by a psychiatrist. Blood samples were drawn and HbA1c and other biochemical parameters were measured. Results: Of the 82 subjects, 27 (34.1% met the criteria for BED. No other types of eating disorders were detected. HbA1c was significantly higher in individuals with BED (p<0.05. Conclusion: Our findings reveal that BED is highly prevalent among type 2 diabetic patients and it impairs glycemic control. Thus, patients with type 2 diabetes should be assessed carefully for eating disorders. Turk Jem 2011; 15: 26-7

  2. Improving Glycemic Control and Insulin Ordering Efficiency for Hospitalized Patients With Diabetes Through Carbohydrate Counting.

    Pearson, Kristina K; Reiland, Sarah A; Meara, John G O; Brown, Julie K; Fedraw, Leslie A; Mapes, David L

    2016-01-01

    Glycemic control in hospitalized patients is challenging but important for optimal outcomes. Insulin dosing through carbohydrate counting may address patient, provider, and institutional factors that complicate hospital glycemic management. On two surgical units at a tertiary care teaching hospital, we pilot tested postmeal insulin dosing based on carbohydrate counting (plus basal insulin) rather than the current process of ordering scheduled premeal insulin without knowledge of the patient's consumption. Analysis assessed hyperglycemia, hypoglycemia, insulin orders, and nurse and provider satisfaction and confidence. On general surgery, mean glucose level improved from 188 to 137 mg/dl (p nurses (preintervention, 72%; postintervention, 100%), and cardiovascular surgery nurses (preintervention, 69%; postintervention, 84%). Confidence in insulin dose accuracy improved for providers (preintervention, 50%; postintervention, 100%), general surgery nurses (preintervention, 59%; postintervention, 100%), and cardiovascular surgery nurses (preintervention, 48%; postintervention, 84%). Carbohydrate counting is effective and efficient and improved staff satisfaction and confidence in hospital mealtime insulin dosing. PMID:26164007

  3. Impact of type 2 diabetes susceptibility variants on quantitative glycemic traits reveals mechanistic heterogeneity

    Dimas, Antigone S; Lagou, Vasiliki; Barker, Adam;

    2013-01-01

    Patients with established type 2 diabetes display both beta-cell dysfunction and insulin resistance. To define fundamental processes leading to the diabetic state, we examined the relationship between type 2 diabetes risk variants at 37 established susceptibility loci and indices of proinsulin...... processing, insulin secretion and insulin sensitivity. We included data from up to 58,614 non-diabetic subjects with basal measures, and 17,327 with dynamic measures. We employed additive genetic models with adjustment for sex, age and BMI, followed by fixed-effects inverse variance meta-analyses. Cluster....... The final group contained twenty risk loci with no clear-cut associations to continuous glycemic traits. By assembling extensive data on continuous glycemic traits, we have exposed the diverse mechanisms whereby type 2 diabetes risk variants impact disease predisposition....

  4. Association between Responsible Pet Ownership and Glycemic Control in Youths with Type 1 Diabetes

    Maranda, Louise; Gupta, Olga T.

    2016-01-01

    Type 1 diabetes mellitus (T1DM) a chronic characterized by an absolute insulin deficiency requires conscientious patient self-management to maintain glucose control within a normal range. Family cohesion and adaptability, positive coping strategies, social support and adequate self-regulatory behavior are found to favorably influence glycemic control. Our hypothesis was that the responsible care of a companion animal is associated with these positive attributes and correlated with the success...

  5. Lipoprotein (a) in type 2 diabetes mellitus: Relation to LDL:HDL ratio and glycemic control

    Singla, Seema; Kaur, Kiranjeet; Kaur, Gurdeep; Kaur, Habir; Kaur, Jasbinder; Jaswal, Shivani

    2009-01-01

    BACKGROUND: Increased lipoprotein (a) [Lp (a)] concentrations are predictive of coronary artery disease (CAD). Type 2 diabetes mellitus also leads to dyslipidemia, like elevated triglyceride levels and low HDL levels, which are known risk factors for CAD. This study was designed to investigate the levels of Lp (a) in type 2 diabetic patients and their association with LDL: HDL ratio and glycemic control. MATERIALS AND METHODS: The study included 60 patients of type 2 diabetes and 50 age and s...

  6. Metformin regulates glycemic homeostasis in patients with type 2 diabetes mellitus as an NO donor

    Ivan Sergeevich Kuznetsov

    2013-11-01

    Full Text Available Aim. To evaluate the influence of metformin on nitric oxide bioavailability in patients with type 2 diabetes mellitus (T2DM regarding glycemic homeostasis, and to investigate a correlation between metformin dosage and NO levels in vivo.Materials and Methods. Two groups – primary and control – were assembled for the clinical section of this study. Patients with newly diagnosed T2DM on metformin therapy were included to the primary group, while drug-naïve T2DM patients were enrolled as control subjects. Glycemic parameters and NO bioavailability was tested in both groups prior to and after the follow-up period. Experimental section was dedicated to the elucidation of potential dose-dependent effects of metformin on NO bioavailability. Mice were intraperitoneally infused with metformin at 0.5; 1.1; 5.6 mg per subject. Tissue detection of NO was performed with diethyldithiocarbamate (DETC iron complexes to form mononitrosyl iron compounds (MIC with paramagnetic properties. Control rodents were intraperitoneally infused with metformin without spin trapping.Results. We found nitrite and methaemoglobin (a marker for NO bioavailability to increase in parallel along with glycemic compensation in the primary but not control group. In vivo rodent models showed linear correlation between accumulation of DETC/MIC and dose of metformin, as well as formation of dinitrosyl iron complexes, known as endogenous NO transporters.Conclusion. Our data suggests that metformin benefits glycemic homeostasis in T2DM as an NO donor via formation of dinitrosyl iron complexes.

  7. A High Legume Low Glycemic Index Diet Improves Serum Lipid Profiles in Men

    Zhang, Zhiying; Lanza, Elaine; Kris-Etherton, Penny M.; Colburn, Nancy H.; Bagshaw, Deborah; Rovine, Michael J.; Ulbrecht, Jan S.; Bobe, Gerd; Chapkin, Robert S.; Hartman, Terryl J.

    2010-01-01

    Clinical studies have shown that fiber consumption facilitates weight loss and improves lipid profiles; however, the beneficial effects of high fermentable fiber low glycemic index (GI) diets under conditions of weight maintenance are unclear. In the Legume Inflammation Feeding Experiment, a randomized controlled cross-over feeding study, 64 middle-aged men who had undergone colonoscopies within the previous 2 years received both a healthy American (HA) diet (no legume consumption, fiber cons...

  8. Sputum Glucose and Glycemic Control in Cystic Fibrosis-Related Diabetes: A Cross-Sectional Study

    Van Sambeek, Lindsey; Cowley, Elise S.; Newman, Dianne K.; Kato, Roberta

    2015-01-01

    Cystic fibrosis-related diabetes affects up to half of cystic fibrosis patients and is associated with increased mortality and more frequent pulmonary exacerbations. However, it is unclear to what degree good glycemic control might mitigate these risks and clinical outcomes have not previously been studied in relation to glucose from the lower airways, the site of infection and CF disease progression. We initially hypothesized that diabetic cystic fibrosis patients with glycosylated hemoglobi...

  9. Non-nutritive sweeteners: no class effect on the glycemic or appetite responses to ingested glucose

    Bryant, Charlotte E.; Wasse, Lucy K.; Astbury, Nerys; Nandra, Gurinder; McLaughlin, John T.

    2014-01-01

    There is considerable interest in whether non-nutritive sweeteners are sensed in the gastrointestinal tract to modulate appetitive or absorptive responses to ingested carbohydrate. We determined the effect of a panel of non-nutritive sweeteners, aspartame, saccharin and acesulfame-K, delivered in doses that would be consumed in normal usage. Each was given in combination with glucose, assessing their effect on glycemic responses and appetite in ten healthy human subjects. There was no additio...

  10. Dietary fiber and the glycemic index: a background paper for the Nordic Nutrition Recommendations 2012

    Øverby, Nina Cecilie; Sonestedt, Emily; David E Laaksonen; Birgisdottir, Bryndis Eva

    2013-01-01

    The aim of this study is to review recent data on dietary fiber (DF) and the glycemic index (GI), with special focus on studies from the Nordic countries regarding cardiometabolic risk factors, type 2 diabetes, cardiovascular disease, cancer, and total mortality. In this study, recent guidelines and scientific background papers or updates on older reports on DF and GI published between 2000 and 2011 from the US, EU, WHO, and the World Cancer Research Fund were reviewed, as well as prospective...