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Sample records for achieve glycaemic control

  1. Achieving effective glycaemic control using an insulin micro-pump.

    Science.gov (United States)

    Kelly, Peter

    2017-02-02

    For those with type 1 diabetes mellitus (T1DM), a deranged blood glucose level can cause hypo/hyperglycaemic episodes and in the long term contribute to microvascular disease. Such outcomes can effect concordance with insulin management regimens and affect the patient's quality of life. A variety of insulin delivery methods are available, including continuous subcutaneous insulin infusion (CSII) via either a tethered or patch pump. Pumps have the potential to improve delivery, monitoring and adjustment of insulin regimens, thus freeing patient's time and affording more control of their disease. This article reports how a new patch pump, has helped a cohort of patients to improve blood glucose variability levels and thus quality of life.

  2. Preconception optimization of glycaemic control in diabetes.

    Science.gov (United States)

    Islam, Najmul

    2016-09-01

    The prevalence of Diabetes Mellitus is increasing worldwide. In developing countries 25% of adult females with diabetes are in the reproductive age. Thus in developing countries increased number of pregnancies are complicated by diabetes. Uncontrolled diabetes in pregnancy is associated with increased risk for both mother and foetus. These risks can be minimized by good control of diabetes before and during pregnancy. Management in the preconception period is discussed in this review article. Detailed management involves general advice of lifestyle modification followed by specific details of screening for complications of diabetes. Changes in the drugs for both glycaemic control and other co-morbid conditions are discussed. The recommended insulin regimen in the preconception period and monitoring of glycaemic control by self-monitoring of blood glucose (SMBG) and HbA1C has also been highlighted.

  3. Doctors' characteristics do not predict long-term glycaemic control in type 2 diabetic patiens

    DEFF Research Database (Denmark)

    Hansen, Lars J.; Olivarius, Niels de Fine; Siersma, Volkert Dirk

    2003-01-01

    diabetes mellitus; glycaemic control; practice organisation; GP characteristics; family practice......diabetes mellitus; glycaemic control; practice organisation; GP characteristics; family practice...

  4. Patient characteristics do not predict poor glycaemic control in type 2 diabetes patients treated in primary care

    NARCIS (Netherlands)

    Goudswaard, AN; Stolk, RP; Zuithoff, P; Rutten, GEHM

    2004-01-01

    Many diabetic patients in general practice do not achieve good glycaemic control. The aim of this study was to assess which characteristics of type 2 diabetes patients treated in primary care predict poor glycaemic control (HbA(1c) greater than or equal to7%). Data were collected from the medical re

  5. Exercise Therapy and Glycaemic Control in Diabetic Persons at the ...

    African Journals Online (AJOL)

    Exercise Therapy and Glycaemic Control in Diabetic Persons at the University of ... proven benefits including improved metabolic indices and physical wellbeing. ... (DM)in the Diabetes Clinic, University of Benin Teaching Hospital, Benin City, ...

  6. Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review

    OpenAIRE

    Anne L Harrison; Nora Shields; Taylor, Nicholas F.; Helena C Frawley

    2016-01-01

    Question: Does exercise improve postprandial glycaemic control in women diagnosed with gestational diabetes mellitus? Design: A systematic review of randomised trials. Participants: Pregnant women diagnosed with gestational diabetes mellitus. Intervention: Exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism. Outcome measures: Postprandial blood glucose, fasting blood glucose, glycated haemoglobin, requirement for insulin, adverse ...

  7. Diabetic patients’ perspectives on the challenges of glycaemic control

    Directory of Open Access Journals (Sweden)

    Oladele V. Adeniyi

    2015-02-01

    Full Text Available Introduction: The factors affecting the control of diabetes are complex and varied. However, little is documented in the literature on the overall knowledge of diabetic patients about glycaemic control. This study explored the patients’ perspectives on the challenges of glycaemic control.Methods: In this qualitative study, semi-structured interviews were conducted with seventeen purposively selected diabetic patients with HBA1c ≥ 9% at Mthatha General Hospital, South Africa. The interviews were conducted in the isiXhosa language and were audiotaped. Two experienced qualitative researchers independently transcribed and translated the interviews.Thematic content analysis was conducted.Results: Three main themes emerged: overall knowledge of diabetes and treatment targets, factors affecting the control of diabetes and how glycaemic control could be improved.The majority of the participants demonstrated poor knowledge of treatment targets for diabetes. The majority of the participants reported that lack of money affected their control of diabetes. Some of the participants reported that the nearest clinics do not have doctors; hence,they are compelled to travel long distances to see doctors.Conclusion: Poverty, lack of knowledge and access to doctors affect the control of diabetes in the rural communities of Mthatha, South Africa. The government should address recruitment and retention of doctors in primary health care.

  8. Metformin and ageing: improving ageing outcomes beyond glycaemic control.

    Science.gov (United States)

    Valencia, Willy Marcos; Palacio, Ana; Tamariz, Leonardo; Florez, Hermes

    2017-08-02

    In a world where the population is ageing, there is growing interest and demand for research evaluating strategies that address the ageing process. After 60 years of successful use of metformin in our pharmaceutical armamentarium, we are learning that, beyond improving glycaemic control, metformin may have additional mechanisms and pathways of action that need further study. Although, metformin's effect on clinical ageing outcomes may still be considered speculative, the findings from studies into cellular and animal models and from observational and pilot human studies support the existence of beneficial effects on ageing. At present, progress for human research, using randomised clinical trials to evaluate metformin's clinical impact, has just started. Here, we present a review on the ageing process and the mechanisms involved, and the role that metformin may have to counter these. We go on to discuss the upcoming large randomised clinical trials that may provide insight on the use of metformin for ageing outcomes beyond glycaemic control.

  9. Glycaemic control status among type 2 diabetic patients and the role of their diabetes coping behaviours: a clinic-based study in Tripoli, Libya

    Directory of Open Access Journals (Sweden)

    Sana Taher Ashur

    2016-03-01

    Full Text Available Background: Achieving good glycaemic control is important in diabetes management. However, poor glycaemic control is widely reported. This article assessed the prevalence of uncontrolled and poor glycaemic control among Libyans with type 2 diabetes and examined the relative contribution of diabetes coping behaviours to their glycaemic control status. Methods: A cross-sectional study was undertaken in 2013 in a large diabetes centre in Tripoli. The study included 523 respondents. Diabetes coping behaviours were measured using the revised version of the Summary of Diabetes Self-Care Activities measure (SDSCA and the eight-item Morisky Medication Adherence Scale (MMAS-8©, while glycaemic control status was based on the HbA1c level. Results: Mean HbA1c was 8.9 (±2.1, and of the 523 patients, only 114 (21.8% attained the glycaemic control target of HbAc1 of less than 7.0%. Females (OR=1.74, 95% CI=1.03–2.91, patients on insulin and oral hypoglycaemic agents (OR=1.92, 95% CI=1.05–3.54, patients on insulin (OR=3.14, 95% CI=1.66–6.03, and low-medication adherents (OR=2.25, 95% CI=1.36–3.73 were more likely to have uncontrolled and poor glycaemic control, while exercise contributed to glycaemic control status as a protective factor (OR=0.85, 95% CI=0.77–0.94. Conclusion: The findings from this study showed the considerable burden of uncontrolled and poor glycaemic control in one of the largest diabetes care settings in Libya. Medication adherence as well as exercise promotion programs would help in reducing the magnitude of poor glycaemic control.

  10. Factors contributing to poor glycaemic control in diabetic patients at Mopani District

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    N.H. Shiluban

    2009-09-01

    Full Text Available Diabetes mellitus is not only a major burden in the developed world, it is also an increasing health problem in less developed countries. Although health education could be a tool to achieve better glycaemic control, it is important to understand that health education should be adjusted to patients’ literacy, cultural environment and economic status. Among other factors, lack of money has an influence on the outcome of diabetes mellitus. Thus the purpose of the study is to identify factors contributing to poor glycaemia control in diabetic patients. Data was collected using self-report questionnaire on a convenient sample of 32 diabetic patients and unstructured, open-ended interviews on eight patients’ inorder to allow them freedom of expressing themselves with regard to factors that contribute to poor glycaemic control on diabetic patients. Data was then analysed using a computer program called Statistical Package for Social Sciences. The socioeconomic factors appeared to have significant influence on glycaemic control among participants, for instance 75% of the total subjects (32 indicated that they experienced problems of accessing health care services due to lack of money. Ignorance related to where to seek support system such as educational programme, and nutrition counselling were factors that were identified to contribute to diabetic patients’ poor glycaemia control.Permission to conduct the study was obtained from the Provincial Department of Health and the managers of the institutions where the study was conducted. Recommendations for dealing with the identified factors have been formulated.

  11. Factors contributing to poor glycaemic control in diabetic patients at Mopani District

    Directory of Open Access Journals (Sweden)

    N. H. Shilubane,

    2010-06-01

    Full Text Available Diabetes mellitus is not only a major burden in the developed world, it is also an increasing health problem in less developed countries. Although health education could be a tool to achieve better glycaemic control, it is important to understand that health education should be adjusted to patients’ literacy, cultural environment and economic status. Among other factors, lack of money has an influence on the outcome of diabetes mellitus. Thus the purpose of the study is to identify factors contributing to poor glycaemia control in diabetic patients. Data was collected using self-report questionnaire on a convenient sample of 32 diabetic patients and unstructured, open-ended interviews on eight patients’ inorder to allow them freedom of expressing themselves with regard to factors that contribute to poor glycaemic control on diabetic patients. Data was then analysed using a computer program called Statistical Package for Social Sciences. The socioeconomic factors appeared to have significant influence on glycaemic control among participants, for instance 75% of the total subjects (32 indicated that they experienced problems of accessing health care services due to lack of money. Ignorance related to where to seek support system such as educational programme, and nutrition counselling were factors that were identified to contribute to diabetic patients’ poor glycaemia control. Permission to conduct the study was obtained from the Provincial Department of Health and the managers of the institutions where the study was conducted. Recommendations for dealing with the identified factors have been formulated.

  12. Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review

    Directory of Open Access Journals (Sweden)

    Anne L Harrison

    2016-10-01

    Full Text Available Question: Does exercise improve postprandial glycaemic control in women diagnosed with gestational diabetes mellitus? Design: A systematic review of randomised trials. Participants: Pregnant women diagnosed with gestational diabetes mellitus. Intervention: Exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism. Outcome measures: Postprandial blood glucose, fasting blood glucose, glycated haemoglobin, requirement for insulin, adverse events and adherence. Results: This systematic review identified eight randomised, controlled trials involving 588 participants; seven trials (544 participants had data that were suitable for meta-analysis. Five trials scored ≥ 6 on the PEDro scale, indicating a relatively low risk of bias. Meta-analysis showed that exercise, as an adjunct to standard care, significantly improved postprandial glycaemic control (MD –0.33 mmol/L, 95% CI –0.49 to –0.17 and lowered fasting blood glucose (MD –0.31 mmol/L, 95% CI –0.56 to –0.05 when compared with standard care alone, with no increase in adverse events. Effects of similar magnitude were found for aerobic and resistance exercise programs, if performed at a moderate intensity or greater, for 20 to 30 minutes, three to four times per week. Meta-analysis did not show that exercise significantly reduced the requirement for insulin. All studies reported that complications or other adverse events were either similar or reduced with exercise. Conclusion: Aerobic or resistance exercise, performed at a moderate intensity at least three times per week, safely helps to control postprandial blood glucose levels and other measures of glycaemic control in women diagnosed with gestational diabetes mellitus. Registration: PROSPERO CRD42015019106. [Harrison AL, Shields N, Taylor NF, Frawley HC (2016 Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review. Journal

  13. Understanding barriers to glycaemic control from the patient's perspective

    Directory of Open Access Journals (Sweden)

    Janes R

    2013-06-01

    Full Text Available INTRODUCTION: To better understand barriers to glycaemic control from the patient's perspective. METHODS: An interpretative phenomenological approach was used to study the experiences of 15 adults with Type 2 diabetes. Participants each gave a semi-structured interview of their experiences of living with diabetes. Interviews were transcribed, and themes extracted and organised using a patientcentred framework. FINDINGS: Participants' stories confirmed many of the barriers in the literature, particularly those related to context, such as family, finances, work. Barriers also related to negative emotional reactions to diabetes: fear of new events (diagnosis, starting pills/insulin; guilt about getting diabetes and not controlling it; and shame about having diabetes. Barriers also related to unscientific beliefs and personal beliefs. There were additional barriers related to poor clinician-patient relationships. Overall, participants had a poor understanding of diabetes, and complained that their clinician simply 'told them what to do'. CONCLUSION: Using a patient-centred approach, this study identified many barriers to glycaemic control. We suggest that a key barrier is clinician ignorance of their patients' fears, beliefs, expectations, context; of what constitutes a positive therapeutic relationship; and of the limitations of a biomedical approach to patient non-adherence. Faced with both a worsening diabetes epidemic and increasing health care workforce shortages, clinicians urgently need to understand that it is they, not their patients, who must change their approach if diabetes care is to be improved.

  14. Addressing Inpatient Glycaemic Control with an Inpatient Glucometry Alert System

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    J. N. Seheult

    2015-01-01

    Full Text Available Background. Poor inpatient glycaemic control has a prevalence exceeding 30% and results in increased length of stay and higher rates of hospital complications and inpatient mortality. The aim of this study was to improve inpatient glycaemic control by developing an alert system to process point-of-care blood glucose (POC-BG results. Methods. Microsoft Excel Macros were developed for the processing of daily glucometry data downloaded from the Cobas IT database. Alerts were generated according to ward location for any value less than 4 mmol/L (hypoglycaemia or greater than 15 mmol/L (moderate-severe hyperglycaemia. The Diabetes Team provided a weekday consult service for patients flagged on the daily reports. This system was implemented for a 60-day period. Results. There was a statistically significant 20% reduction in the percentage of hyperglycaemic patient-day weighted values >15 mmol/L compared to the preimplementation period without a significant change in the percentage of hypoglycaemic values. The time-to-next-reading after a dysglycaemic POC-BG result was reduced by 14% and the time-to-normalization of a dysglycaemic result was reduced from 10.2 hours to 8.4 hours. Conclusion. The alert system reduced the percentage of hyperglycaemic patient-day weighted glucose values and the time-to-normalization of blood glucose.

  15. Addressing Inpatient Glycaemic Control with an Inpatient Glucometry Alert System.

    Science.gov (United States)

    Seheult, J N; Pazderska, A; Gaffney, P; Fogarty, J; Sherlock, M; Gibney, J; Boran, G

    2015-01-01

    Background. Poor inpatient glycaemic control has a prevalence exceeding 30% and results in increased length of stay and higher rates of hospital complications and inpatient mortality. The aim of this study was to improve inpatient glycaemic control by developing an alert system to process point-of-care blood glucose (POC-BG) results. Methods. Microsoft Excel Macros were developed for the processing of daily glucometry data downloaded from the Cobas IT database. Alerts were generated according to ward location for any value less than 4 mmol/L (hypoglycaemia) or greater than 15 mmol/L (moderate-severe hyperglycaemia). The Diabetes Team provided a weekday consult service for patients flagged on the daily reports. This system was implemented for a 60-day period. Results. There was a statistically significant 20% reduction in the percentage of hyperglycaemic patient-day weighted values >15 mmol/L compared to the preimplementation period without a significant change in the percentage of hypoglycaemic values. The time-to-next-reading after a dysglycaemic POC-BG result was reduced by 14% and the time-to-normalization of a dysglycaemic result was reduced from 10.2 hours to 8.4 hours. Conclusion. The alert system reduced the percentage of hyperglycaemic patient-day weighted glucose values and the time-to-normalization of blood glucose.

  16. Glycaemic control and its associated factors in Chinese adults with type 1 diabetes mellitus.

    Science.gov (United States)

    Liu, Li; Yang, Daizhi; Zhang, Yan; Lin, Shuo; Zheng, Xueying; Lin, Shaoda; Chen, Lishu; Zhang, Xiuwei; Li, Lu; Liang, Ganxiong; Yao, Bin; Yan, Jinhua; Weng, Jianping

    2015-11-01

    Glycaemic control is a great challenge in the management of type 1 diabetes mellitus (T1DM). There is limited data concerning glycaemic control among adults with T1DM. We used data from the Guangdong T1DM Translational Medicine Study to evaluate glycaemic control and its associated factors in Chinese adults with T1DM. This cross-sectional analysis included 827 participants who were 18 years of age or older and had been living with T1DM for at least 1 year. Participants with HbA1c levels control. Among the 827 participants, the mean age was 34.2 ± 12.1 years and the median (interquartile range) duration of diabetes was 6.1 (3.4, 10.4) years. The median HbA1c level was 8.5% (7.5%, 10.2%). Only one-fifth of participants had HbA1c levels control (HbA1c  ≥ 7%) was strongly associated with infrequent self-monitoring of blood glucose (OR = 1.21, 95% CI 1.14 ~ 1.29, p = 0.000), high insulin dose (OR = 1.27, 95% CI 1.07 ~ 1.52, p = 0.006), smoking (OR = 3.11, 95% CI 1.44 ~ 6.72, p = 0.004), low-frequency clinical visits (OR = 2.74, 95% CI 1.47 ~ 5.10, p = 0.001), the presence of diabetic autoantibodies (OR = 1.63, 95% CI 1.07 ~ 2.48, p = 0.022) and low fasting C-peptide (FCP) levels (OR = 1.21, 95% CI 1.01 ~ 1.46, p = 0.049) after adjustment for age at disease onset, education level, household income and diet control. Most adult patients with T1DM did not achieve the HbA1c target. Identifying determinants for glycaemic control provides us valuable information to improve glycaemic control in these patients. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  17. A pilot study of factors associated with glycaemic control in adults with Type 1 diabetes mellitus on insulin pump therapy.

    Science.gov (United States)

    Wen, W; Frampton, R; Wright, K; Fattore, S; Shadbolt, B; Perampalam, S

    2016-02-01

    To identify the knowledge and management factors associated with glycaemic control among adults with Type 1 diabetes mellitus treated with insulin pump therapy. A cross-sectional study of adults with Type 1 diabetes mellitus on insulin pump therapy for at least 12 months (n = 50, 18-70 years old) was undertaken between December 2013 and May 2014. A new questionnaire was developed to evaluate participants' knowledge and management related to insulin pump therapy, and were correlated with insulin pump data, HbA1c and frequency of hypoglycaemia. Participants who changed their insulin pump settings when indicated had significantly better glycaemic control than those who did not (P = 0.04). Multivariate logistic regression analysis found that better overall insulin pump therapy management was a significant predictor of better glycaemic control (odds ratio 4.45, 95% confidence interval 1.61-12.3; P = 0.004) after adjusting for potential confounders including age, gender, duration of diabetes and insulin pump therapy. However, overall insulin pump therapy knowledge was not a significant predictor of glycaemic control (P = 0.058). There was no significant association between frequency of hypoglycaemia and insulin pump therapy knowledge or management. We identified some key knowledge and management factors associated with glycaemic control in adults with Type 1 diabetes mellitus on insulin pump therapy using a newly designed questionnaire. The pilot study assessed the clinical utility of this evaluation tool, which may facilitate provision of targeted education to insulin pump therapy users to achieve optimal glycaemic control. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.

  18. Fructosamine and glycated haemoglobin in the assessment of long term glycaemic control in diabetes.

    Science.gov (United States)

    Shield, J P; Poyser, K; Hunt, L; Pennock, C A

    1994-01-01

    Fructosamine and glycated haemoglobin were measured simultaneously in 147 children with diabetes. If glycated haemoglobin is considered as the 'gold standard' for long term glycaemic control, then fructosamine is a poor indicator of actual glycated haemoglobin values, with wide 95% confidence (fiducial) limits. This shows that it is impossible to accurately predict glycated haemoglobin concentrations and therefore, by implication, longer term glycaemic control, from measurements of fructosamine. As the major studies on the prevention of microvascular complications in diabetes have used glycated haemoglobin levels to assess glycaemic control, it is suggested that this measurement should be used in all children with diabetes in preference to the measurement of fructosamine. PMID:7826117

  19. Evaluation of random plasma glucose for assessment of glycaemic control in type 2 diabetes mellitus.

    Science.gov (United States)

    Ain, Qurratul; Latif, Atif; Jaffar, Syed Raza; Ijaz, Aamir

    2017-09-01

    To evaluate the accuracy of random plasma glucose in outpatients with type 2 diabetes mellitus for assessing glycaemic control. This comparative, cross-sectional study was conducted at the chemical pathology department of PNS Shifa Hospital, Karachi, from August 2015 to March 2016, and comprised data of subjects with type 2 diabetes mellitus who reported for evaluation of glycaemic control in non-fasting state. All blood samples were analysed for random plasma glucose and glycated haemoglobin. Random plasma glucose was compared as an index test with glycated haemoglobin considering it as reference standard at a value of less than 7% for good glycaemic control. SPSS 20 was used for data analysis. Of the 222 subjects, 93(42%) had good glycaemic control. Random plasma glucose showed strong positive correlation with glycated haemoglobin (p=0.000).Area under curve for random plasma glucose as determined by plotting receiver operating characteristic curve against glycated haemoglobin value of 7% was 0.89 (95% confidence interval: 0.849-0.930). Random plasma glucose at cut-off value of 150 mg/dl was most efficient for ruling out poor glycaemic control among patients with type 2 diabetes mellitus with 90.7% sensitivity and69.9% specificity and Youden's index of 0.606. Random plasma glucose may be used to reflect glycaemic control in adults with type 2 diabetes mellitus in areas where glycated haemoglobin is not feasible.

  20. Glycaemic Control Impact on Renal Endpoints in Diabetic Patients on Haemodialysis

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    Danielle Creme

    2015-01-01

    Full Text Available Objective. To identify the number of haemodialysis patients with diabetes in a large NHS Trust, their current glycaemic control, and the impact on other renal specific outcomes. Design. Retrospective, observational, cross-sectional study. Methods. Data was collected from an electronic patient management system. Glycaemic control was assessed from HbA1c results that were then further adjusted for albumin (Alb and haemoglobin (Hb. Interdialytic weight gains were analysed from weights recorded before and after dialysis, 2 weeks before and after the most recent HbA1c date. Amputations were identified from electronic records. Results. 39% of patients had poor glycaemic control (HbA1c > 8%. Adjusted HbA1c resulted in a greater number of patients with poor control (55%. Significant correlations were found with interdialytic weight gains (P<0.02, r=0.14, predialysis sodium (P<0.0001, r=-1.9, and predialysis bicarbonate (P<0.02, r=0.12. Trends were observed with albumin and C-reactive protein. Patients with diabetes had more amputations (24 versus 2. Conclusion. Large number of diabetic patients on haemdialysis have poor glycaemic control. This may lead to higher interdialytic weight gains, larger sodium and bicarbonate shifts, increased number of amputations, and possibly increased inflammation and decreased nutritional status. Comprehensive guidelines and more accurate long-term tests for glycaemic control are needed.

  1. Does exercise improve glycaemic control in type 1 diabetes? A systematic review and meta-analysis.

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    Amy Kennedy

    Full Text Available OBJECTIVE: Whilst regular exercise is advocated for people with type 1 diabetes, the benefits of this therapy are poorly delineated. Our objective was to review the evidence for a glycaemic benefit of exercise in type 1 diabetes. RESEARCH DESIGN AND METHODS: Electronic database searches were carried out in MEDLINE, Embase, Cochrane's Controlled Trials Register and SPORTDiscus. In addition, we searched for as yet unpublished but completed trials. Glycaemic benefit was defined as an improvement in glycosylated haemoglobin (HbA1c. Both randomised and non-randomised controlled trials were included. RESULTS: Thirteen studies were identified in the systematic review. Meta-analysis of twelve of these (including 452 patients demonstrated an HbA1c reduction but this was not statistically significant (standardised mean difference (SMD -0.25; 95% CI, -0.59 to 0.09. CONCLUSIONS: This meta-analysis does not reveal evidence for a glycaemic benefit of exercise as measured by HbA1c. Reasons for this finding could include increased calorie intake, insulin dose reductions around the time of exercise or lack of power. We also suggest that HbA1c may not be a sensitive indicator of glycaemic control, and that improvement in glycaemic variability may not be reflected in this measure. Exercise does however have other proven benefits in type 1 diabetes, and remains an important part of its management.

  2. Glycaemic Control and Associated Self-Management Behaviours in Diabetic Outpatients: A Hospital Based Observation Study in Lusaka, Zambia

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    Emmanuel Mwila Musenge

    2016-01-01

    Full Text Available Background. The control of diabetes mellitus depends on several factors that also include individual lifestyles. We assessed glycaemic control status and self-management behaviours that may influence glycaemic control among diabetic outpatients. Methods. This cross-sectional study among 198 consenting randomly selected patients was conducted at the University Teaching Hospital diabetic clinic between September and December 2013 in Lusaka, Zambia. A structured interview schedule was used to collect data on demographic characteristics, self-management behaviours, and laboratory measurements. Binary logistic regression analysis using IBM SPSS for Windows version 20.0 was carried out to predict behaviours that were associated with glycaemic control status. Results. The proportion of patients that had good glycaemic control status (HbA1c≤ 48 mmol/mol was 38.7% compared to 61.3% that had poor glycaemic control status (HbA1c≥ 49 mmol/mol. Adherence to antidiabetic treatment and fasting plasma glucose predicted glycaemic control status of the patients. However, self-blood glucose monitoring, self-blood glucose monitoring means and exercise did not predict glycaemic control status of the patients.  Conclusion. We find evidence of poor glycaemic control status among most diabetic patients suggesting that health promotion messages need to take into account both individual and community factors to promote behaviours likely to reduce nonadherence.

  3. Glycaemic Control and Associated Self-Management Behaviours in Diabetic Outpatients: A Hospital Based Observation Study in Lusaka, Zambia.

    Science.gov (United States)

    Musenge, Emmanuel Mwila; Michelo, Charles; Mudenda, Boyd; Manankov, Alexey

    2016-01-01

    The control of diabetes mellitus depends on several factors that also include individual lifestyles. We assessed glycaemic control status and self-management behaviours that may influence glycaemic control among diabetic outpatients. This cross-sectional study among 198 consenting randomly selected patients was conducted at the University Teaching Hospital diabetic clinic between September and December 2013 in Lusaka, Zambia. A structured interview schedule was used to collect data on demographic characteristics, self-management behaviours, and laboratory measurements. Binary logistic regression analysis using IBM SPSS for Windows version 20.0 was carried out to predict behaviours that were associated with glycaemic control status. The proportion of patients that had good glycaemic control status (HbA1c≤ 48 mmol/mol) was 38.7% compared to 61.3% that had poor glycaemic control status (HbA1c≥ 49 mmol/mol). Adherence to antidiabetic treatment and fasting plasma glucose predicted glycaemic control status of the patients. However, self-blood glucose monitoring, self-blood glucose monitoring means and exercise did not predict glycaemic control status of the patients. We find evidence of poor glycaemic control status among most diabetic patients suggesting that health promotion messages need to take into account both individual and community factors to promote behaviours likely to reduce nonadherence.

  4. Intensive glycaemic control for patients with type 2 diabetes: systematic review with meta-analysis and trial sequential analysis of randomised clinical trials

    DEFF Research Database (Denmark)

    Hemmingsen, Bianca; Lund, Søren; Gluud, Christian Nyfeldt;

    2011-01-01

    To assess the effect of targeting intensive glycaemic control versus conventional glycaemic control on all cause mortality and cardiovascular mortality, non-fatal myocardial infarction, microvascular complications, and severe hypoglycaemia in patients with type 2 diabetes.......To assess the effect of targeting intensive glycaemic control versus conventional glycaemic control on all cause mortality and cardiovascular mortality, non-fatal myocardial infarction, microvascular complications, and severe hypoglycaemia in patients with type 2 diabetes....

  5. Insulin monotherapy compared with the addition of oral glucose-lowering agents to insulin for people with type 2 diabetes already on insulin therapy and inadequate glycaemic control

    NARCIS (Netherlands)

    Vos, Rimke C; van Avendonk, Mariëlle JP; Jansen, Hanneke; Goudswaard, Alexander N; van den Donk, Maureen; Gorter, Kees; Kerssen, Anneloes; Rutten, Guy EHM

    2016-01-01

    BACKGROUND: It is unclear whether people with type 2 diabetes mellitus on insulin monotherapy who do not achieve adequate glycaemic control should continue insulin as monotherapy or can benefit from adding oral glucose-lowering agents to the insulin therapy. OBJECTIVES: To assess the effects of insu

  6. Glycated albumin is the preferred marker for assessing glycaemic control in advanced chronic kidney disease.

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    Vos, Frederiek E; Schollum, John B; Walker, Robert J

    2011-12-01

    Diabetic nephropathy is the most common aetiology of end-stage kidney disease (ESKD). Strict glycaemic control reduces the development and progression of diabetes-related complications, and there is evidence that improved metabolic control improves outcomes in diabetic subjects with advanced chronic kidney disease (CKD). Glycaemic control in people with kidney disease is complex. Changes in glucose and insulin homeostasis may occur as a consequence of loss of kidney function and dialysis. The reliability of measures of long-term glycaemic control is affected by CKD and the accuracy of glycated haemoglobin (HbA1c) in the setting of CKD and ESKD is questioned. Despite the altered character of diabetes in CKD, current guidelines for diabetes management are not specifically adjusted to this patient group. The validity of indicators of longer term glycaemic control has been the focus of increased recent research. This review discusses the current understanding of commonly used indicators of metabolic control (HbA1c, fructosamine, glycated albumin) in the setting of advanced CKD (Stages 4 and 5, glomerular filtration rate <30 mL/min/1.73m(2)).

  7. The impact of improved glycaemic control with GLP-1 receptor agonist therapy on diabetic retinopathy.

    Science.gov (United States)

    Varadhan, Lakshminarayanan; Humphreys, Tracy; Walker, Adrian B; Varughese, George I

    2014-03-01

    Rapid improvement in glycaemic control with GLP-1 receptor agonist (RA) therapy has been reported to be associated with significant progression of diabetic retinopathy. This deterioration is transient, and continuing GLP-1 RA treatment is associated with reversal of this phenomenon. Pre-existent maculopathy, higher grade of retinopathy and longer duration of diabetes may be risk factors for persistent deterioration.

  8. Time course of specific AGEs during optimised glycaemic control in type 2 diabetes

    NARCIS (Netherlands)

    Mentink, CJAL; Kilhovd, BK; Rondas-Colbers, GJWM; Torjesen, PA; Wolffenbuttel, BHR

    2006-01-01

    Background: Several advanced glycation endproducts (AGEs) are formed in the hyperglycaemic state. Although serum AGEs correlate with average glycaemic control in patients with type 2 diabetes and predict the development of complications, it is not known how serum AGEs change during optimisation of d

  9. Impact of glycaemic control on the effect of direct renin inhibition in the AVOID study

    DEFF Research Database (Denmark)

    Persson, Frederik; Lewis, Julia B; Lewis, Edmund J;

    2012-01-01

    Hyperglycaemia induces development and progression of microvascular complications in diabetes. A direct link between high glucose levels and intrarenal renin-angiotensin activation has been demonstrated. This post-hoc analysis assessed the influence of baseline glycaemic control on the reduction...

  10. Association between symptoms of depression and glycaemic control may be unstable across gender

    DEFF Research Database (Denmark)

    Pouwer, F; Snoek, Frank J

    2001-01-01

    : The association between depression and HbA1c may be stronger in women with Type 2 diabetes. Oestrogen levels and self-care behaviours may play a mediating role in this association. Further research is required before we can conclude that the association between symptoms of depression and glycaemic control differs...... across gender. Diabet. Med. 18, 595-598 (2001)...

  11. Targeting intensive versus conventional glycaemic control for type 1 diabetes mellitus

    DEFF Research Database (Denmark)

    Kähler, Pernille; Grevstad, Berit; Almdal, Thomas;

    2014-01-01

    , EMBASE, Science Citation Index Expanded and LILACS to January 2013. STUDY SELECTION: Randomised clinical trials that prespecified different targets of glycaemic control in participants at any age with type 1 diabetes mellitus were included. DATA EXTRACTION: Two authors independently assessed studies...

  12. Periodontal treatment and glycaemic control in patients with diabetes and periodontitis: an umbrella review.

    Science.gov (United States)

    Botero, J E; Rodríguez, C; Agudelo-Suarez, A A

    2016-06-01

    Studies suggest that non-surgical periodontal treatment improves glycaemic control in patients with diabetes and periodontitis. The aim of this umbrella review is to summarize the effects of periodontal treatment on glycaemic control in patients with periodontitis and diabetes. A systematic review of systematic reviews with or without meta-analysis published between 1995 and 2015 was performed. Three independent reviewers assessed for article selection, quality and data extraction. Thirteen (13) systematic reviews/meta-analysis were included for qualitative synthesis. A reduction (0.23 to 1.03 percentage points) in the levels of HbA1c at 3 months after periodontal intervention was found. This reduction was statistically significant in 10/12 meta-analysis. One review with sufficiently large samples found a non-significant reduction (-0.014 percentage points; 95% CI -0.18 to 0.16; p = 0.87). Only three studies separated the use of adjunctive antibiotics and found a reduction of 0.36 percentage points but the difference was not statistically significant. Highly heterogeneous short-term studies with small sample size suggest that periodontal treatment could help improve glycaemic control at 3 months in patients with type 2 diabetes and periodontitis. However, longer term studies having sufficient sample size do not provide evidence that periodontal therapy improves glycaemic control in these patients. © 2016 Australian Dental Association.

  13. Daily energy expenditure, cardiorespiratory fitness and glycaemic control in people with type 1 diabetes.

    Directory of Open Access Journals (Sweden)

    John Joseph Valletta

    Full Text Available OBJECTIVE: Encouraging daily physical activity improves cardiorespiratory fitness and many cardiovascular risk factors. However, increasing physical activity often creates a challenge for people with type 1 diabetes, because of difficulties maintaining euglycemia in the face of altered food intake and adjustments to insulin doses. Our aim was to examine the triangular relationship between glucose control measured by continuous glucose monitoring system (CGMS, objective measures of total daily energy expenditure (TEE recorded by a multi-sensory monitoring device, and cardiorespiratory fitness (CRF, in free-living subjects with type 1 diabetes. RESEARCH DESIGN AND METHODS: Twenty-three individuals (12 women with type 1 diabetes who were free from micro- and macrovascular complications were recruited. TEE and glucose control were monitored simultaneously for up to 12 days, using a multi-sensory device and CGMS respectively. CRF was recorded as V02 max from a maximal treadmill test with the Bruce protocol. RESULTS: Subjects (mean±SD were aged 37±11 years, with BMI = 26.5±5.1 kg.m⁻², HbA1c = 7.7±1.3% (61±14 mmol/mol and V02 max (ml.min⁻¹.kg⁻¹  = 39.9±8.4 (range 22.4-58.6. TEE (36.3±5.5 kcal.kg⁻¹.day⁻¹ was strongly associated with CRF(39.9±8.4 ml.min⁻¹.kg⁻¹ independently of sex (r = 0.63, p<0.01. However, neither TEE (r = -0.20, p = 0.36 nor CRF (r = -0.20, p = 0.39; adjusted for sex, were significantly associated with mean glycaemia measured by CGMS. CONCLUSION: Higher levels of energy expenditure (due to a more active lifestyle are associated with increased cardiorespiratory fitness, but not necessarily better glycaemic control. Since increased levels of energy expenditure and good glycaemic control are both needed to protect against diabetes-related complications our data suggest they need to be achieved independently.

  14. Insulin analogues: have they changed insulin treatment and improved glycaemic control?

    DEFF Research Database (Denmark)

    Madsbad, Sten

    2002-01-01

    in a long half-life with a residual activity of about 50% 24 h after injection. Insulin glargine is a peakless insulin and studies in both type 1 and type 2 diabetic patients indicate that glargine improves fasting blood glucose control and reduces the incidence of nocturnal hypoglycaemia. Surprisingly...... have not been able to show any improvement in overall glycaemic control with the fast-acting analogues. A reduced post-prandial increase in blood glucose has been found in all studies, whereas between 3 and 5 h after the meal and during the night an increased blood glucose level is the normal course....... This is probably the main explanation for the absence of improvement in overall glycaemic control when compared with regular human insulin. A tendency to a reduction in hypoglycaemic events during treatment with fast-acting analogues has been observed in most studies. Recent studies have indicated that NPH insulin...

  15. Periodontal disease progression and glycaemic control among Gullah African Americans with type-2 diabetes

    Science.gov (United States)

    Bandyopadhyay, Dipankar; Marlow, Nicole M.; Fernandes, Jyotika K.; Leite, Renata S.

    2010-01-01

    Aim To evaluate associations between glycaemic control and periodontitis progression among Gullah African Americans with type-2 diabetes mellitus (T2DM). Materials and Methods From an ongoing clinical trial among T2DM Gullah, we extracted a cohort previously in a cross-sectional study (N 5 88). Time from baseline (previous study) to follow-up (trial enrollment, before treatment interventions) ranged 1.93–4.08 years [mean 5 2.99, standard deviation (SD) = 0.36]. We evaluated tooth site-level periodontitis progression [clinical attachment loss (CAL) worsening of ≥ 2 mm, periodontal probing depth (PPD) increases of ≥ 2 mm and bleeding on probing (BOP) from none to present] by glycaemic control status (well-controlled = HbA1c periodontitis, particularly among those with disparities for both diseases. PMID:20507373

  16. Racial ethnic differences in type 2 diabetes treatment patterns and glycaemic control in the Boston Area Community Health Survey

    OpenAIRE

    2015-01-01

    Objectives Numerous studies continue to report poorer glycaemic control, and a higher incidence of diabetes-related complications among African–Americans and Hispanic–Americans as compared with non-Hispanic Caucasians with type 2 diabetes. We examined racial/ethnic differences in receipt of hypoglycaemic medications and glycaemic control in a highly insured Massachusetts community sample of individuals with type 2 diabetes. Setting Community-based sample from Boston, Massachusetts, USA. Parti...

  17. Mechanisms of improved glycaemic control after Roux-en-Y gastric bypass

    DEFF Research Database (Denmark)

    Dirksen, C; Jørgensen, N B; Bojsen-Møller, K N

    2012-01-01

    Roux-en-Y gastric bypass (RYGB) greatly improves glycaemic control in morbidly obese patients with type 2 diabetes, in many even before significant weight loss. Understanding the responsible mechanisms may contribute to our knowledge of the pathophysiology of type 2 diabetes and help identify new...... in hepatic insulin sensitivity induced, at least in part, by energy restriction and (2) improved beta cell function associated with an exaggerated postprandial glucagon-like peptide 1 secretion owing to the altered transit of nutrients. Later a weight loss induced improvement in peripheral insulin...... drug targets or improve surgical techniques. This review summarises the present knowledge based on pathophysiological studies published during the last decade. Taken together, two main mechanisms seem to be responsible for the early improvement in glycaemic control after RYGB: (1) an increase...

  18. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus.

    Science.gov (United States)

    Simpson, Terry C; Weldon, Jo C; Worthington, Helen V; Needleman, Ian; Wild, Sarah H; Moles, David R; Stevenson, Brian; Furness, Susan; Iheozor-Ejiofor, Zipporah

    2015-11-06

    antimicrobials to SRP was of any benefit to delivering SRP alone (mean HbA1c 0.00% lower: 12 studies, 450 participants; 95% CI 0.22% lower to 0.22% higher) at 3-4 months post-treatment, or after 6 months (mean HbA1c 0.04% lower: five studies, 206 patients; 95% CI 0.41% lower to 0.32% higher).Less than half of the studies measured adverse effects. The evidence was insufficient to conclude whether any of the treatments were associated with harm. No other patient-reported outcomes (e.g. quality of life) were measured by the included studies, and neither were cost implications or diabetic complications.Studies showed varying degrees of success with regards to achieving periodontal health, with some showing high levels of residual inflammation following treatment. Statistically significant improvements were shown for all periodontal indices (BOP, CAL, GI, PI and PPD) at 3-4 and 6 months in comparison 1; however, this was less clear for individual comparisons within the broad category of comparison 2. There is low quality evidence that the treatment of periodontal disease by SRP does improve glycaemic control in people with diabetes, with a mean percentage reduction in HbA1c of 0.29% at 3-4 months; however, there is insufficient evidence to demonstrate that this is maintained after 4 months.There was no evidence to support that one periodontal therapy was more effective than another in improving glycaemic control in people with diabetes mellitus.In clinical practice, ongoing professional periodontal treatment will be required to maintain clinical improvements beyond 6 months. Further research is required to determine whether adjunctive drug therapies should be used with periodontal treatment. Future RCTs should evaluate this, provide longer follow-up periods, and consider the inclusion of a third 'no treatment' control arm.Larger, well conducted and clearly reported studies are needed in order to understand the potential of periodontal treatment to improve glycaemic control among

  19. [Adjunctive therapies to glycaemic control of type 1 diabetes mellitus].

    Science.gov (United States)

    Gabbay, Mônica de A Lima

    2008-03-01

    Since Diabetes Control and Complications Trial (DCCT), intensive therapy has been directed at achieving glucose and glycosylated hemoglobin (HbA1c) values as close to normal as possible regarding safety issues. However, hyperglycemia (especially postprandial hyperglycemia) and hypoglicemia continue to be problematic in the management of type 1 diabetes. The objective of associating other drugs to insulin therapy is to achieve better metabolic control lowering postprandial blood glucose levels. Adjunctive therapies can be divided in four categories based on their mechanism of action: enhancement of insulin action (e.g. the biguanides and thiazolidinediones), alteration of gastrointestinal nutrient delivery (e.g. acarbose and amylin) and other targets of action (e.g. pirenzepine, insulin-like growth factor I and glucagon-like peptide-1). Many of these agents have been found to be effective in short-term studies with decreases in HbA1c of 0.5-1%, lowering postprandial blood glucose levels and decreasing daily insulin doses.

  20. Poor numeracy skills are associated with glycaemic control in Type 1 diabetes.

    Science.gov (United States)

    Marden, S; Thomas, P W; Sheppard, Z A; Knott, J; Lueddeke, J; Kerr, D

    2012-05-01

    To assess the numeracy and literacy skills of individuals with Type 1 diabetes and determine if there is a relationship with achieved glycaemic control independent of their duration of diabetes, diabetes education, demographic and socio-economic factors. One hundred and twelve patients completed the study (mean current age 43.8 ± 12.5 years, 47% male, mean duration of diabetes 22.0 ± 13.2 years) out of 650 randomly selected patients from the Bournemouth Diabetes and Endocrine Centre's diabetes register. The Skills for Life Initial Assessments were used to measure numeracy and literacy. These indicate skills levels up to level 2, equivalent to the national General Certificate of Secondary Education grades A*-C. HbA(1c) was also measured. Pearson's correlation was used to measure the correlation of numeracy and literacy scores with HbA(1c.) To compare mean HbA(1c) between those with or without level 2 skills, t-tests were used, and multiple linear regression was used to investigate whether any differences were independent of duration of diabetes, diabetes education, demographic and socio-economic factors. Literacy was not associated with achieved HbA(1c). In contrast, participants with numeracy skills at level 2 or above achieved an HbA(1c) lower than those with numeracy skills below level 2 (P = 0.027). Although higher socio-economic status was associated with lower mean HbA(1c) , the relationship between numeracy and HbA(1c) appeared to be independent of socio-economic factors. Low numeracy skills were adversely associated with diabetes control. Assessment of numeracy skills may be relevant to the structure of diabetes education programmes. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  1. Clinical and histological effect of a low glycaemic load diet in treatment of acne vulgaris in Korean patients: a randomized, controlled trial.

    Science.gov (United States)

    Kwon, Hyuck Hoon; Yoon, Ji Young; Hong, Jong Soo; Jung, Jae Yoon; Park, Mi Sun; Suh, Dae Hun

    2012-05-01

    Recent studies have suggested that dietary factors, specifically glycaemic load, may be involved in the pathogenesis of acne. The aim of this study was to determine the clinical and histological effects on acne lesions of a low glycaemic load diet. A total of 32 patients with mild to moderate acne were randomly assigned to either a low glycaemic load diet or a control group diet, and completed a 10-week, parallel dietary intervention trial. Results indicate successful lowering of the glycaemic load. Subjects within the low glycaemic group demonstrated significant clinical improvement in the number of both non-inflammatory and inflammatory acne lesions. Histopathological examination of skin samples revealed several characteristics, including reduced size of sebaceous glands, decreased inflammation, and reduced expression of sterol regulatory element-binding protein-1, and interleukin-8 in the low glycaemic load group. A reduction in glycaemic load of the diet for 10 weeks resulted in improvements in acne.

  2. Glycaemic Responses to Corn Meals in Type 2 Diabetics and Non-Diabetic Controls

    Directory of Open Access Journals (Sweden)

    Akinola Dada

    2015-09-01

    Full Text Available Purpose: Dietary modification in association with life style changes is important in the management of the diabetes. Cereals account for as much as 77% of total caloric consumption in most African diets. Corn which is the largest cultivated cereal crop in Nigeria is prepared as a meal in many forms. The objective of this study was to assess the glycaemic responses to different preparations of corn meals. Material and Method: The design was a quasi-experimental with a total of 32 participants, 16 subjects with type diabetes and 16 age-and sex-matched non-diabetic control subjects. After an overnight fast, the participants were given corn meals to eat and had their blood sample collected every 30 minutes for over a 2 hour period for the assessment of blood sugar level and estimation of glycaemic responses. This was repeated weekly till the glycaemic index (GI and plasma sugar level response to the different test corn meal preparation, such as boiled corn, roasted corn, pap and cornflakes had been assessed. Results: All the different corn meal preparations had high GI, with corn flakes having the highest GI and pap the lowest. The GI for the corn meals in the non-diabetic were; pap 71.7±14.4%, roasted corn 76.5±14.9%, boiled corn 82.2±14.9% and cornflakes 88.1±14.4%. Discussion: Methods of preparing a meal from corn affect glycaemic response. Turk Jem 2015; 19: 79-82

  3. Glycaemic control in type 1 diabetes mellitus among children and adolescents in a resource limited setting in Dar es Salaam - Tanzania

    OpenAIRE

    Noorani, Mariam; Ramaiya, Kaushik; Manji, Karim

    2016-01-01

    Background Type 1 Diabetes Mellitus is a rapidly growing problem in Tanzania. Children and adolescents with type 1 diabetes have previously been found to have poor glycaemic control and high prevalence of complications. Strict glycaemic control reduces the incidence and progression of chronic complications. The aim of this study was to identify the factors associated with glycaemic control among children and adolescents. Methods A cross sectional study was done at the diabetes clinic for chil...

  4. [Lixisenatide in patients with type 2 diabetes and obesity: Beyond glycaemic control].

    Science.gov (United States)

    Roca-Rodríguez, M Mar; Muros de Fuentes, María Teresa; Piédrola-Maroto, Gonzalo; Quesada-Charneco, Miguel; Maraver-Selfa, Silvia; Tinahones, Francisco J; Mancha-Doblas, Isabel

    2017-05-01

    To evaluate tolerance to lixisenatide and its effects on weight and metabolic control in type2 diabetes and obese patients. Prospective study. Endocrinology clinics in Almeria, Granada and Malaga. Patients with type2 diabetes and obesity. Response and tolerance to lixisenatide treatment. Clinical and analytical data of the subjects were evaluated at baseline and after treatment. The study included 104 patients (51% women) with type2 diabetes and obesity (Almeria 18.3%; Granada 40.4%; Malaga 41.3%). The mean age was 58.4±10.5years, and the mean duration of diabetes was 11.2±6.7years. The patients were re-evaluated at 3.8±1.6months after treatment with lixisenatide. Significant improvements were found in weight (P<.001), body mass index (P<.001), waist circumference (P=.002), systolic blood pressure (P<.001), diastolic blood pressure (P=.001), fasting glucose (P<.001), HbA1c (P=.022), Total cholesterol (P<.001), LDL-cholesterol (P=.046), triglycerides (P=.020), hypertension drugs (P<.001), and lipids drugs (P<.001). No changes were observed in levels of amylase related to lixisenatide treatment, and 7.9% of patients did not tolerate it. Lixisenatide achieved significant improvements in anthropometric parameters, glycaemic control (fasting glucose and HbA1c), blood pressure and lipids. It was safe and well tolerated in most patients. In addition, there was a significant increase in the use of antihypertensive and lipid-lowering therapy. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  5. Glycaemic index and glycaemic load of breakfast predict cognitive function and mood in school children: a randomised controlled trial.

    Science.gov (United States)

    Micha, Renata; Rogers, Peter J; Nelson, Michael

    2011-11-01

    The macronutrient composition of a breakfast that could facilitate performance after an overnight fast remains unclear. As glucose is the brain's major energy source, the interest is in investigating meals differing in their blood glucose-raising potential. Findings vary due to unaccounted differences in glucoregulation, arousal and cortisol secretion. We investigated the effects of meals differing in glycaemic index (GI) and glycaemic load (GL) on cognition and mood in school children. A total of seventy-four school children were matched and randomly allocated either to the high-GL or low-GL group. Within each GL group, children received high-GI and low-GI breakfasts. Cognitive function (CF) and mood were measured 95-140 min after breakfast. Blood glucose and salivary cortisol were measured at baseline, before and after the CF tests. Repeated-measures ANOVA was used to identify differences in CF, mood, glucose and cortisol levels between the breakfasts. Low-GI meals predicted feeling more alert and happy, and less nervous and thirsty (P meals predicted feeling more confident, and less sluggish, hungry and thirsty (P meals increased glucose levels 90 min after breakfast, and high-GI meals increased cortisol levels (P meals predicted better declarative-verbal memory (P = 0·03), and high-GI meals better vigilance (P < 0·03); observed GI effects were valid across GL groups. GI effects on cognition appear to be domain specific. On balance, it would appear that the low-GI high-GL breakfast may help to improve learning, and of potential value in informing government education policies relating to dietary recommendations and implementation concerning breakfast.

  6. The effect of Ramadan fasting on glycaemic control in insulin dependent diabetic patients: A literature review.

    Science.gov (United States)

    Alabbood, Majid H; Ho, Kenneth W; Simons, Mary R

    Ramadan fasting is one of the five pillars of Islam. People with diabetes are exempted from fasting according to Islamic rules. However, many people with diabetes wish to fast. Physicians are asked frequently by their patients about their ability to fast and the possible impact of fasting on their glycaemic control. Studies about the effect of Ramadan on people with insulin-treated diabetes are scarce. This review aims to provide clinicians with the best recommendations for their patients with insulin-treated diabetes who wish to fast. Four databases (Medline, EMBASE, Scopus and PubMed) were searched using the following MeSH terms and keywords: "insulin dependent diabetes mellitus", "type 1 diabetes mellitus", 'Ramadan' "and" "fasting". In addition, a hand search of key journals and reference lists was performed. Sixteen full text articles were selected for review and critical analysis. All of the included studies except one found improvement or no change in glycaemic control parameters during Ramadan fasting. The incidence of major complications were negligible. Minor hypoglycaemic events were reported in some studies but did not adversely affect fasting. Postprandial hyperglycaemia was a major concern in other studies. However, the incidence of severe hyperglycaemia and diabetic ketoacidosis were trivial. Ramadan fasting is feasible for insulin dependent diabetic patient who wish to fast. Clinicians should advise their patients about the importance of adequate glycaemic control before Ramadan and frequent glucose monitoring during fasting. Certain types of Insulin seem to be more beneficial than other. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  7. Higher body mass index and lower intake of dairy products predict poor glycaemic control among Type 2 Diabetes patients in Malaysia.

    Science.gov (United States)

    Shu, Ping Soon; Chan, Yoke Mun; Huang, Soo Lee

    2017-01-01

    This cross-sectional study was designed to determine factors contributing to glyceamic control in order to provide better understanding of diabetes management among Type 2 Diabetes patients. A pre-tested structured questionnaire was used to obtain information on socio-demographic and medical history. As a proxy measure for glycaemic control, glycosylated haemoglobin (HbA1c) was obtained as secondary data from the medical reports. Perceived self-care barrier on diabetes management, diet knowledge and skills, and diet quality were assessed using pretested instruments. With a response rate of 80.3%, 155 subjects were recruited for the study. Mean HbA1c level of the subjects was 9.02 ± 2.25% with more than 70% not able to achieve acceptable level in accordance to WHO recommendation. Diet quality of the subjects was unsatisfactory especially for vegetables, fruits, fish and legumes as well as from the milk and dairy products group. Higher body mass index (BMI), poorer medication compliance, lower diet knowledge and skill scores and lower intake of milk and dairy products contributed significantly on poor glycaemic control. In conclusion, while perceived self-care barriers and diet quality failed to predict HbA1c, good knowledge and skill ability, together with appropriate BMI and adequate intake of dairy products should be emphasized to optimize glycaemic control among type 2 diabetes patients.

  8. Higher body mass index and lower intake of dairy products predict poor glycaemic control among Type 2 Diabetes patients in Malaysia

    Science.gov (United States)

    Shu, Ping Soon; Chan, Yoke Mun; Huang, Soo Lee

    2017-01-01

    This cross-sectional study was designed to determine factors contributing to glyceamic control in order to provide better understanding of diabetes management among Type 2 Diabetes patients. A pre-tested structured questionnaire was used to obtain information on socio-demographic and medical history. As a proxy measure for glycaemic control, glycosylated haemoglobin (HbA1c) was obtained as secondary data from the medical reports. Perceived self-care barrier on diabetes management, diet knowledge and skills, and diet quality were assessed using pretested instruments. With a response rate of 80.3%, 155 subjects were recruited for the study. Mean HbA1c level of the subjects was 9.02 ± 2.25% with more than 70% not able to achieve acceptable level in accordance to WHO recommendation. Diet quality of the subjects was unsatisfactory especially for vegetables, fruits, fish and legumes as well as from the milk and dairy products group. Higher body mass index (BMI), poorer medication compliance, lower diet knowledge and skill scores and lower intake of milk and dairy products contributed significantly on poor glycaemic control. In conclusion, while perceived self-care barriers and diet quality failed to predict HbA1c, good knowledge and skill ability, together with appropriate BMI and adequate intake of dairy products should be emphasized to optimize glycaemic control among type 2 diabetes patients. PMID:28234927

  9. Glycaemic control in a cardiothoracic surgical population: Exploring ...

    African Journals Online (AJOL)

    evaluate adherence to the glucose control protocol by nurses in the ... of ICU charts of all post-cardiac surgery patients ≥16 years admitted to the cardiothoracic ..... S. National audit of critical care resources in South Africa: Nursing profile.

  10. A Novel Multidisciplinary Intervention for Long-Term Weight Loss and Glycaemic Control in Obese Patients with Diabetes

    Directory of Open Access Journals (Sweden)

    Anna Lih

    2015-01-01

    Full Text Available Introduction. Obesity and diabetes are difficult to treat in public clinics. We sought to determine the effectiveness of the Metabolic Rehabilitation Program (MRP in achieving long-term weight loss and improving glycaemic control versus “best practice” diabetes clinic (DC in obese patients using a retrospective cohort study. Methods. Patients with diabetes and BMI > 30 kg/m2 who attended the MRP, which consisted of supervised exercise and intense allied health integration, or the DC were selected. Primary outcomes were improvements in weight and glycaemia with secondary outcomes of improvements in blood pressure and lipid profile at 12 and 30 months. Results. Baseline characteristics of both cohorts (40 MRP and 40 DC patients were similar at baseline other than age (63 in MRP versus 68 years in DC, P=0.002. At 12 months, MRP patients lost 7.65 ± 1.74 kg versus 1.76 ± 2.60 kg in the DC group (P<0.0001 and 9.70 ± 2.13 kg versus 0.98 ± 2.65 kg at 30 months (P<0.0001. Similarly, MRP patients had significant absolute reductions in %HbA1c at 30 months versus the DC group (−0.86 ± 0.31% versus 0.12% ± 0.33%, P<0.038, with nonsignificant improvements in lipids and blood pressure in MRP patients. Conclusion. Further research is needed to establish the MRP as an effective strategy for achieving sustained weight loss and improving glycaemic control in obese patients with type 2 diabetes.

  11. What are the preferred strategies for control of glycaemic variability in patients with type 2 diabetes mellitus?

    Science.gov (United States)

    Zenari, L; Marangoni, A

    2013-09-01

    The aim of therapy in type 2 diabetes in terms of blood glucose control is to reduce to target levels HbA1c and to reduce glycaemic variability in order to avoid both hypoglycaemia and wide excursions of postprandial glucose. The first approach to reduce glycaemic variability should consider a dietary and behavioural approach aiming to limit the glycaemic index and the glycaemic load of food and the prescription and implementation of a physical activity plan appropriate for the subject. From the pharmacological point of view, the diabetes specialist has now a much richer therapeutic armamentarium. The therapeutic algorithms can help the physician to choose the most appropriate drug. The traditional approach involves: i) metformin, acting mainly on fasting blood glucose; ii) sulphonylureas, that have shown a number of drawbacks, including the high risk of hypoglycemia; iii) pioglitazone, with a substantial effect on fasting and postprandial glucose and a low risk of hypoglycaemia; iv) insulin, that can be utilized with the basal or prandial approach. The new drugs belonging to the class of dipeptidyl peptidase-4 inhibitors have shown the reduction of postprandial glucose, a neutral effect on weight increase, a good safety profile and preliminary positive cardiovascular effects. When excess weight prevails, the glucagon-like peptide-1 agonists may be the preferred choice for their effect on weight reduction, reduction of hyperinsulinism and glycaemic variability.

  12. Glycaemic control, treatment satisfaction and quality of lifein type 2 diabetes patients in Greece: The PANORAMA studyGreek results

    Institute of Scientific and Technical Information of China (English)

    Iraklis Avramopoulos; Alexandros Moulis; Nikos Nikas

    2015-01-01

    AIM To provide an update on glycaemic control inEuropean patients with type 2 diabetes mellitus (T2DM).We present the Greek population data of the study.METHODS: An observational multicenter, cross-sectionalstudy evaluating glycaemic control and a range of otherclinical and biological measures as well as quality of life(QoL) and treatment satisfaction in 375 patients withT2DM enrolled by 25 primary care sites from Greece.RESULTS: The mean age of the patients was 63.5years and the male/female ratio 48.9%/51.1%. 79.7%of the patients exerted none or light physical activity,82.4% were overweight or obese and 32.9% did notmeet HbA1c target of less than 7.0% (53 mmol/mol).Patients reported high satisfaction to continue withtreatment, high satisfaction with administered treatmentand increased willingness to recommend treatmentto others (mean Diabetes Treatment SatisfactionQuestionnaire score 29.1 ± 5.6). However, 80% of thepatients reported that their QoL would be better withoutdiabetes. Finally, the most challenging parameterreported was the lack of freedom to eat and drink.CONCLUSION: This analysis of the Greek Panoramastudy results showed that a considerable percentageof T2DM patients in Greece do not achieve glycaemictarget levels, despite the favourably reported patientsatisfaction from administered therapy. Additionally, themajority of primary care T2DM patients in Greece depictthe negative effect of the disease in their QoL.

  13. Are there better alternatives than haemoglobin A1c to estimate glycaemic control in the chronic kidney disease population?

    DEFF Research Database (Denmark)

    Speeckaert, Marijn; Van Biesen, Wim; Delanghe, Joris

    2014-01-01

    paper based on narrative literature review. RESULTS: As a different association between glycaemic control and morbidity/mortality might be observed in patients with and without renal insufficiency, the European Renal Best Practice, the official guideline body of the European Renal Association......-European Dialysis and Transplant Association, presents the current knowledge and evidence of the use of alternative glycaemic markers (glycated albumin, fructosamine, 1,5-anhydroglucitol and continuous glucose monitoring). CONCLUSION: Although reference values of HbA1C might be different in patients with chronic...

  14. Improved metabolic control after 12-week dietary intervention with low glycaemic isomalt in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Holub, I; Gostner, A; Hessdörfer, S; Theis, S; Bender, G; Willinger, B; Schauber, J; Melcher, R; Allolio, B; Scheppach, W

    2009-12-01

    The polyol isomalt (Palatinit) is a very low glycaemic sugar replacer. The effect of food supplemented with isomalt instead of higher glycaemic ingredients like sucrose and/or starch hydrolysates on metabolic control in patients with type 2 diabetes was examined in this open study. Thirty-three patients with type 2 diabetes received a diet with foods containing 30 g/d isomalt instead of higher-glycaemic carbohydrates for 12 weeks. Metformin and/or thiazolidindiones were the only concomitant oral antidiabetics allowed during the study. Otherwise, the participants maintained their usual diet during the test phase, but were instructed to refrain from additional sweetened foods. Before start, after 6 weeks and 12 weeks (completion of the study), blood samples were taken and analysed for clinical routine parameters, metabolic, and risk markers. Thirty-one patients completed the study. The test diet was well accepted and tolerated. After 12 weeks, significant reductions were observed for: glycosylated haemoglobin, fructosamine, fasting blood glucose, insulin, proinsulin, C-peptide, insulin resistance (HOMA-IR), and oxidised LDL (an atherosclerosis risk factor). In addition, significant lower nonesterified fatty acid concentrations were found in female participants. Routine blood measurements and blood lipids remained unchanged. The substitution of glycaemic ingredients by isomalt and the consequent on reduction of the glycaemic load within otherwise unchanged diet was accompanied by significant improvement in the metabolic control of diabetes. The present study is in agreement with findings of previous reported studies in human subjects demonstrating beneficial effects of low glycaemic diets on glucose metabolism in patients with diabetes mellitus type 2.

  15. Effect of adjunct metformin treatment in patients with type-1 diabetes and persistent inadequate glycaemic control. A randomized study

    DEFF Research Database (Denmark)

    Lund, Søren Søgaard; Tarnow, Lise; Astrup, Anne Sofie;

    2008-01-01

    BACKGROUND: Despite intensive insulin treatment, many patients with type-1 diabetes (T1DM) have longstanding inadequate glycaemic control. Metformin is an oral hypoglycaemic agent that improves insulin action in patients with type-2 diabetes. We investigated the effect of a one-year treatment wit...

  16. Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century

    DEFF Research Database (Denmark)

    McKnight, J A; Wild, S H; Lamb, M J E

    2015-01-01

    of people using insulin pumps varied between the 12 sources with data available. CONCLUSION: These results suggest that there are substantial variations in glycaemic control among people with Type 1 diabetes between the data sources and that there is room for improvement in all populations, especially...

  17. Glycaemic Control among Patients with Diabetes in Primary Care Clinics in Jamaica, 1995 and 2012

    Directory of Open Access Journals (Sweden)

    MA Harris

    2014-11-01

    Full Text Available Objective: To compare the quality of care received by patients with diabetes in public primary care clinics in 2012 with that reported in 1995. Methods: Patient records were audited at six randomly selected Type III health centres in the South East Health Region of Jamaica. The 2012 audit data were compared with published data from a similar audit conducted in 1995. Quality of care measures included timely screening tests and counselling of the patients. Fasting and postprandial glucose tests were used to assess glycaemic control. Results: Two hundred and forty-two patient records were analysed in 2012, and 185 in 1995. In 2012, 88% of patients were weighed within the last year compared with 43% in 1995. Advice on physical activity increased from 1% to 60% and on dietary practices from 6% to 79%. No patient had done the HBA1C in 1995 compared to 38% in 2012. In 1995, 66% had blood glucose measured at a laboratory during the last year while in 2012, 60% had a laboratory test and 90% were tested at the clinic by glucometer. Blood pressure control increased from 19% in 1995 to 41% in 2012 (p < 0.001. Poor glucose control was recorded among 61% of patients in 1995 compared with 68% in 2012. Conclusions: There was no improvement in glycaemic control. Health providers and patients must work together to improve patient outcomes. This will involve closer patient monitoring, treatment intensification where indicated, and the adoption of lifestyle practices that can lead to better control.

  18. Effect of Aloe vera on glycaemic control in prediabetes and type 2 diabetes: a systematic review and meta-analysis.

    Science.gov (United States)

    Suksomboon, N; Poolsup, N; Punthanitisarn, S

    2016-04-01

    Aloe vera (Aloe vera (L.) Burm.f., Xanthorrhoeaceae family) has long been used in folk or traditional medicine for diabetes. Several studies have been conducted on the effect of Aloe vera on glycaemic control, but the results appear inconsistent. We undertook a systematic review and meta-analysis to assess the effect of Aloe vera on glycaemic control in prediabetes and type 2 diabetes. A comprehensive literature search was conducted through MEDLINE, CENTRAL, CINAHL, Scopus, http://clinicaltrials.gov, Web of Science, Proquest, LILACS, HerbMed, NAPRALERT and CNKI to the end of January 2016 without language restriction. Historical search of relevant articles and personal contact with experts in the area were also undertaken. Studies were included if they were (1) randomized controlled trials of Aloe vera aimed at assessing glycaemic control in prediabetes or type 2 diabetes and (2) reporting fasting plasma glucose (FPG) or haemoglobin A1c (HbA1c ). Treatment effect was estimated with mean difference in the final value of FPG and HbA1c between the treatment and the control groups. Eight trials involving 470 patients (235 each for prediabetes and type 2 diabetes) were included. In prediabetes, Aloe vera significantly improved FPG (mean difference -0·22 mmol/L, 95% CI -0·32 mmol/L to -0·12 mmol/L, P Aloe vera may improve glycaemic control in type 2 diabetes, with a marginal improvement in FPG (mean differences -1·17 mmol/L, 95% CI -2·35 mmol/L to 0·00 mmol/L, P = 0·05) and a significant improvement in HbA1c (mean difference -11 mmol/mol, 95% CI -19 mmol/mol to -2 mmol/mol, P = 0·01). The current evidence suggests some potential benefit of Aloe vera in improving glycaemic control in prediabetes and type 2 diabetes. However, given the limitations of the available evidence and the high heterogeneity in study results, high-quality, well-powered randomized controlled trials using standardized preparations are needed to quantify any beneficial effects of Aloe vera on

  19. The effect of diurnal distribution of carbohydrates and fat on glycaemic control in humans: a randomized controlled trial

    Science.gov (United States)

    Kessler, Katharina; Hornemann, Silke; Petzke, Klaus J.; Kemper, Margrit; Kramer, Achim; Pfeiffer, Andreas F. H.; Pivovarova, Olga; Rudovich, Natalia

    2017-01-01

    Diurnal carbohydrate and fat distribution modulates glycaemic control in rodents. In humans, the optimal timing of both macronutrients and its effects on glycaemic control after prolonged consumption are not studied in detail. In this cross-over trial, 29 non-obese men were randomized to two four-week diets: (1) carbohydrate-rich meals until 13.30 and fat-rich meals between 16.30 and 22.00 (HC/HF) versus (2) inverse sequence of meals (HF/HC). After each trial period two meal tolerance tests were performed, at 09.00 and 15.40, respectively, according to the previous intervention. On the HF/HC diet, whole-day glucose level was increased by 7.9% (p = 0.026) in subjects with impaired fasting glucose and/or impaired glucose tolerance (IFG/IGT, n = 11), and GLP-1 by 10.2% (p = 0.041) in normal glucose-tolerant subjects (NGT, n = 18). Diet effects on fasting GLP-1 (p = 0.009) and PYY (p = 0.034) levels were observed in IFG/IGT, but not in NGT. Afternoon decline of glucose tolerance was more pronounced in IFG/IGT and associated with a stronger decrease of postprandial GLP-1 and PYY levels, but not with changes of cortisol rhythm. In conclusion, the HF/HC diet shows an unfavourable effect on glycaemic control in IFG/IGT, but not in NGT subjects. Consequently, large, carbohydrate-rich dinners should be avoided, primarily by subjects with impaired glucose metabolism. PMID:28272464

  20. The effect of diurnal distribution of carbohydrates and fat on glycaemic control in humans: a randomized controlled trial.

    Science.gov (United States)

    Kessler, Katharina; Hornemann, Silke; Petzke, Klaus J; Kemper, Margrit; Kramer, Achim; Pfeiffer, Andreas F H; Pivovarova, Olga; Rudovich, Natalia

    2017-03-08

    Diurnal carbohydrate and fat distribution modulates glycaemic control in rodents. In humans, the optimal timing of both macronutrients and its effects on glycaemic control after prolonged consumption are not studied in detail. In this cross-over trial, 29 non-obese men were randomized to two four-week diets: (1) carbohydrate-rich meals until 13.30 and fat-rich meals between 16.30 and 22.00 (HC/HF) versus (2) inverse sequence of meals (HF/HC). After each trial period two meal tolerance tests were performed, at 09.00 and 15.40, respectively, according to the previous intervention. On the HF/HC diet, whole-day glucose level was increased by 7.9% (p = 0.026) in subjects with impaired fasting glucose and/or impaired glucose tolerance (IFG/IGT, n = 11), and GLP-1 by 10.2% (p = 0.041) in normal glucose-tolerant subjects (NGT, n = 18). Diet effects on fasting GLP-1 (p = 0.009) and PYY (p = 0.034) levels were observed in IFG/IGT, but not in NGT. Afternoon decline of glucose tolerance was more pronounced in IFG/IGT and associated with a stronger decrease of postprandial GLP-1 and PYY levels, but not with changes of cortisol rhythm. In conclusion, the HF/HC diet shows an unfavourable effect on glycaemic control in IFG/IGT, but not in NGT subjects. Consequently, large, carbohydrate-rich dinners should be avoided, primarily by subjects with impaired glucose metabolism.

  1. The Health Economic Value of Changes in Glycaemic Control, Weight and Rates of Hypoglycaemia in Type 1 Diabetes Mellitus

    Science.gov (United States)

    McEwan, Phil; Bennett, Hayley; Fellows, Jonathan; Priaulx, Jennifer; Bergenheim, Klas

    2016-01-01

    Aims Therapy-related consequences of treatment for type 1 diabetes mellitus (T1DM), such as weight gain and hypoglycaemia, act as a barrier to attaining optimal glycaemic control, indirectly influencing the incidence of vascular complications and associated morbidity and mortality. This study quantifies the individual and combined contribution of changes in hypoglycaemia frequency, weight and HbA1c to predicted quality-adjusted life-years (QALYs) within a T1DM population. Materials and methods We describe the Cardiff Type 1 Diabetes (CT1DM) Model, originally informed by the Diabetes Control and Complications Trial (DCCT) and updated with the Epidemiology of Diabetes Interventions and Complications (EDIC) study and Swedish National Diabetes Registry for microvascular and cardiovascular complications respectively. We report model validation results and the QALY impact of HbA1c, weight and hypoglycaemia changes. Results Validation results demonstrated coefficients of determination for clinical endpoints of R2 = 0.863 (internal R2 = 0.999; external R2 = 0.823), costs R2 = 0.980 and QALYs R2 = 0.951. Achieving and maintaining a 1% HbA1c reduction was estimated to provide 0.61 additional discounted QALYs. Weight changes of ±1kg, ±2kg or ±3kg led to discounted QALY changes of ±0.03, ±0.07 and ±0.10 respectively, while modifying hypoglycaemia frequency by -10%, -20% or -30% resulted in changes of -0.05, -0.11 and -0.17. The differences in discounted costs, life-years and QALYs associated with HbA1c 6% versus 10% were -£19,037, 2.49 and 2.35 respectively. Conclusions Using a model updated with contemporary epidemiological data, this study presents an outcome-focused perspective to assessing the health economic consequences of differing levels of glycaemic control in T1DM with and without weight and hypoglycaemia effects. PMID:27632534

  2. Inadequate glycaemic control and antidiabetic therapy among inpatients with type 2 diabetes in Guangdong Province of China

    Institute of Scientific and Technical Information of China (English)

    BI Yan; CAI De-hong; WU Ge; ZHANG Fan; LIN Shao-da; XIAO Zheng-hua; ZHU Da-long; WENG Jian-ping; YAN Jin-hua; LIAO Zhi-hong; LI Yan-bing; ZENG Long-yi; TANG Kuan-xiao; XUE Yao-ming; YANG Hua-zhang; LI Lu

    2008-01-01

    Background Diabetes mellitus has become epidemic in recent years in China.We investigated the prevalence of hyperglycaemia and inadequate glycaemic control among type 2 diabetic inpatients from ten university teaching hospitals in Guangdong Province,China. Methods Inadequate glycaemic control in diabetic patients was defined as HbA1c(≥)6.5%.Therapeutic regimens included no-intervention,lifestyle only,oral antiglycemic agents(OA),insulin plus OA(insulin+OA),or insulin only. Antidiabetic managements included monotherapy,double therapy,triple or quadruple therapy. Results Among 493 diabetic inpatients with known history,75%had HbA1c≥6.5%.Inadequate glucose control rates were more frequently seen in patients on insulin+OA regimen(97%) than on OA regimen(71%)(P<O.001),and more frequent in patients on combination therapy(81%-96%)than monotherapy(75%)(P<0.05).Patients on insulin differed significantly from patients on OA by mean HbA1c,glycemic control rate,diabetes duration,microvascular complications,and BMI(P<0.01). Conclusions This study showed that glycaemic control of type 2 diabetic patients deteriorated for patients who received insulin and initiation time of insulin was usually delayed.It is up to clinicians to move from the traditional stepwise therapy to a more active and early combination antidiabetic therapy to provide better glucose control.

  3. Is adjunctive naturopathy associated with improved glycaemic control and a reduction in need for medications among type 2 Diabetes patients? A prospective cohort study from India.

    Science.gov (United States)

    Bairy, Srinivas; Kumar, Ajay M V; Raju, Msn; Achanta, Shanta; Naik, Balaji; Tripathy, Jaya P; Zachariah, Rony

    2016-08-17

    With an estimated 65 million Diabetes Mellitus (DM) patients, India ranks second in the world in terms of DM burden. The emphasis of current medical practice has been on pharmacotherapy but, despite the best combination therapies, acheiving glycaemic control (reduction of blood sugar to desirable levels) is a challenge. 'Integrated Naturopathy and Yoga'(INY) is an alternative system of medicine that lays emphasis on the role of diet and physical exercise. We assessed the short term effect of INY as an adjunct to pharmacotherapy on glycaemic control among type 2 DM patients. In this prospective cohort study with a 3 month follow-up, DM patients consecutively admitted to a hospital in India from May-October 2014 for either 15 or 30 days were offered INY - a package of vegetarian diet with no added oil, sugar and salt, yoga-based exercise, patient counselling and rest. A 'favourable outcome' was defined as glycaemic control (glycosylated hemoglobin (HbA1c) < 7 % or absolute reduction by 1 %) along with at least 50 % reduction in antidiabetes medication at 3 months relative to baseline. Compliance to diet was scored by self-report on a scale of 0-10 and categorized into poor (0-5), moderate (6-8) and excellent (9-10). Of 101 patients with 3-month follow-up data, 65(65 %) achieved a favourable outcome - with 19(19 %) stopping medication while sustaining glycemic control. Factors associated with favourable outcome were baseline HbA1c and compliance to diet, which showed a significant linear relationship with mean HbA1c reductions of 0.4 %, 1.1 % and 1.7 % in relation to poor, moderate and excellent dietary compliance respectively. INY, adjunctive to pharmacotherapy, was associated with a significant beneficial effect on glycaemic control and reduced the overall need for antidiabetes medications. These early results are promising. Further studies with long-term follow-up and using more rigorous randomized controlled trial designs are needed.

  4. Targeting intensive versus conventional glycaemic control for type 1 diabetes mellitus: a systematic review with meta-analyses and trial sequential analyses of randomised clinical trials

    OpenAIRE

    Kähler, Pernille; Grevstad, Berit; Almdal, Thomas; Gluud, Christian; Wetterslev, Jørn; Vaag, Allan; Hemmingsen, Bianca

    2014-01-01

    Objective To assess the benefits and harms of targeting intensive versus conventional glycaemic control in patients with type 1 diabetes mellitus. Design A systematic review with meta-analyses and trial sequential analyses of randomised clinical trials. Data sources The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded and LILACS to January 2013. Study selection Randomised clinical trials that prespecified different targets of glycaemic control in participants at any age with...

  5. Association of low density lipoprotein levels and glycaemic control in type-2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Yathish TR.

    2010-01-01

    Full Text Available Earlier diabetes mellitus (DM was thought to be a disease of carbohydrate metabolism. Looking at the effects of insulin deficiency on carbohydrate and lipid metabolism, diabetes mellitus is now being called more a disease of lipid metabolism than carbohydrate metabolism. A cross-sectional study was conducted during March 2005 to March 2006 to study the low-density lipoproteins (LDL levels in diabetes mellitus and its relation to glycaemic control. LDL levels were estimated. Comparison of lipid levels were made between group of diabetic patients with glycated hemoglobin less than 8.0% and a group of diabetic patients with glycated hemoglobin more than 8.0% and the controls. The lipid fractions i.e. total cholesterol (TC, triglycerides (TG, and low-density lipoprotein (LDL levels were higher in the poorly controlled diabetes patients as compared to well controlled diabetic patients and nondiabetic patients. Increased levels of low-density lipoprotein may be a contributory factor to the high risk of atherosclerosis induced coronary artery disease observed in diabetes mellitus patients. Reduction of blood glucose levels is likely to reduce low density lipoprotein levels and the risk of complication, with the lowest risk being in those with glycosylated hemoglobin values in the normal range ie. Less than 8.0%

  6. Disease related knowledge, medication adherence and glycaemic control among patients with type 2 diabetes mellitus in Pakistan.

    Science.gov (United States)

    Nazir, Saeed Ur Rashid; Hassali, Mohamed Azmi; Saleem, Fahad; Bashir, Sajid; Aljadhey, Hisham

    2016-04-01

    The purpose of this study was to investigate the association of diabetes-related knowledge and treatment adherence with glycaemic control among patients with type 2 diabetes mellitus (T2DM) in Pakistan. The study was designed as a questionnaire-based, cross-sectional analysis. T2DM patients attending a public outpatient clinic in Sargodha, Pakistan, were targeted for the study. In addition to the demographic information, the Urdu version of Michigan Diabetes Knowledge Test and Morisky Medication Adherence Scale was used for data collection. Patients' medical records were reviewed for glycated haemoglobin levels (HbA1c). Descriptive statistics were used to elaborate sociodemographic characteristics. The Spearman's Rho correlation was used to measure association of disease-related knowledge and treatment adherence with glycaemic control. SPSS V 20.0 was used for data analysis and pknowledge score was 8.0 (IQR=6.0-10.0), while the median adherence score was 4.7 (IQR=3.0-6.0). HbA1c had non-significant and weak negative association with diabetes-related knowledge (r=-0.036, p=0.404) and treatment adherence (r=-0.071, p=0.238). There was negative association reported between HbA1c, treatment adherence and diabetes-related knowledge. Greater efforts are clearly required to investigate other factors affecting glycaemic control among T2DM patients in Pakistan. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  7. The gut microbiota modulates glycaemic control and serum metabolite profiles in non-obese diabetic mice.

    Science.gov (United States)

    Greiner, Thomas U; Hyötyläinen, Tuulia; Knip, Mikael; Bäckhed, Fredrik; Orešič, Matej

    2014-01-01

    Islet autoimmunity in children who later progress to type 1 diabetes is preceded by dysregulated serum metabolite profiles, but the origin of these metabolic changes is unknown. The gut microbiota affects host metabolism and changes in its composition contribute to several immune-mediated diseases; however, it is not known whether the gut microbiota is involved in the early metabolic disturbances in progression to type 1 diabetes. We rederived non-obese diabetic (NOD) mice as germ free to explore the potential role of the gut microbiota in the development of diabetic autoimmunity and to directly investigate whether the metabolic profiles associated with the development of type 1 diabetes can be modulated by the gut microbiota. The absence of a gut microbiota in NOD mice did not affect the overall diabetes incidence but resulted in increased insulitis and levels of interferon gamma and interleukin 12; these changes were counterbalanced by improved peripheral glucose metabolism. Furthermore, we observed a markedly increased variation in blood glucose levels in the absence of a microbiota in NOD mice that did not progress to diabetes. Additionally, germ-free NOD mice had a metabolite profile similar to that of pre-diabetic children. Our data suggest that germ-free NOD mice have reduced glycaemic control and dysregulated immunologic and metabolic responses.

  8. Periodontal treatment to improve glycaemic control in diabetic patients: study protocol of the randomized, controlled DIAPERIO trial

    Directory of Open Access Journals (Sweden)

    Bou Christophe

    2009-08-01

    Full Text Available Abstract Background Periodontitis is a common, chronic inflammatory disease caused by gram-negative bacteria leading to destruction of tissues supporting the teeth. Epidemiological studies have consistently shown increased frequency, extent and severity of periodontitis among diabetic adults. More recently, some controlled clinical trials have also suggested that periodontal treatment could improve glycaemic control in diabetic patients. However current evidence does not provide sufficient information on which to confidently base any clinical recommendations. The main objective of this clinical trial is to assess whether periodontal treatment could lead to a decrease in glycated haemoglobin levels in metabolically unbalanced diabetic patients suffering from chronic periodontitis. Methods The DIAPERIO trial is an open-label, 13-week follow-up, randomized, controlled trial. The total target sample size is planned at 150 participants, with a balanced (1:1 treatment allocation (immediate treatment vs delayed treatment. Periodontal treatment will include full mouth non-surgical scaling and root planing, systemic antibiotherapy, local antiseptics (chlorhexidine 0.12% and oral health instructions. The primary outcome will be the difference in change of HbA1c between the two groups after the 13-weeks' follow-up. Secondary outcomes will be the difference in change of fructosamine levels and quality of life between the two groups. Discussion The DIAPERIO trial will provide insight into the question of whether periodontal treatment could lead to an improvement in glycaemic control in metabolically unbalanced diabetic patients suffering from periodontitis. The results of this trial will help to provide evidence-based recommendations for clinicians and a draft framework for designing national health policies. Trial registration Current Controlled Trials ISRCTN15334496

  9. Skin autofluorescence is associated with past glycaemic control and complications in type 1 diabetes mellitus.

    Science.gov (United States)

    Genevieve, M; Vivot, A; Gonzalez, C; Raffaitin, C; Barberger-Gateau, P; Gin, H; Rigalleau, V

    2013-09-01

    As skin autofluorescence (AF) can assess subcutaneous accumulation of fluorescent advanced glycation end-products (AGEs), this study aimed to investigate whether it was linked to glycaemic control and complications in patients with type 1 diabetes mellitus (T1DM). Using the AGE Reader™, AF was measured in T1DM patients referred to Haut-Levêque Hospital (Bordeaux, France); data on their HbA1c levels measured every 6months as far back as the last 5years were also collected. The association of AF with the patients' past glucose control, based on their latest HbA1c values, and the means of the last five and 10 HbA1c values, and with diabetic complications was also examined by linear regression analysis. The sample included 300 patients: 58% were male; the mean age was 49 (SD 17) years and the mean diabetes duration was 21 (SD 13) years. The median skin AF measurement was 2.0 [25th-75th percentiles: 1.7-2.4] arbitrary units (AU), and this was associated with age (β=0.15 per 10years, P<0.001) and diabetes duration (β=0.17 per 10years, P<0.001). After adjusting for age and estimated glomerular filtration rate (eGFR), the skin AF measurement was also related to the means of the last five and 10 HbA1c values (β=0.10 per 1% of HbA1c, P=0.005, and β=0.13 per 1% of HbA1c, P=0.001, respectively). In addition, the skin AF was associated with retinopathy (P<0.001), albuminuria (P<0.001) and decreased eGFR (P<0.001). In conclusion, the skin AF is related to the long-term glucose control and diabetic complications.

  10. Assessing Diabetes Self-Management with the Diabetes Self-Management Questionnaire (DSMQ Can Help Analyse Behavioural Problems Related to Reduced Glycaemic Control.

    Directory of Open Access Journals (Sweden)

    Andreas Schmitt

    Full Text Available To appraise the Diabetes Self-Management Questionnaire (DSMQ's measurement of diabetes self-management as a statistical predictor of glycaemic control relative to the widely used SDSCA.248 patients with type 1 diabetes and 182 patients with type 2 diabetes were cross-sectionally assessed using the two self-report measures of diabetes self-management DSMQ and SDSCA; the scales were used as competing predictors of HbA1c. We developed a structural equation model of self-management as measured by the DSMQ and analysed the amount of variation explained in HbA1c; an analogue model was developed for the SDSCA.The structural equation models of self-management and glycaemic control showed very good fit to the data. The DSMQ's measurement of self-management showed associations with HbA1c of -0.53 for type 1 and -0.46 for type 2 diabetes (both P < 0.001, explaining 21% and 28% of variation in glycaemic control, respectively. The SDSCA's measurement showed associations with HbA1c of -0.14 (P = 0.030 for type 1 and -0.31 (P = 0.003 for type 2 diabetes, explaining 2% and 10% of glycaemic variation. Predictive power for glycaemic control was significantly higher for the DSMQ (P < 0.001.This study supports the DSMQ as the preferred tool when analysing self-reported behavioural problems related to reduced glycaemic control. The scale may be useful for clinical assessments of patients with suboptimal diabetes outcomes or research on factors affecting associations between self-management behaviours and glycaemic control.

  11. Seminal vesicles and diabetic neuropathy: ultrasound evaluation in patients with couple infertility and different levels of glycaemic control

    Institute of Scientific and Technical Information of China (English)

    Sandro La Vignera; Rosita A Condorelli; Enzo Vicari; Rosario D'Agata; Aldo E Calogero

    2011-01-01

    The aim of this study was to evaluate the ultrasound characteristics of the seminal vesicles (SVs) of infertile patients with diabetes mellitus (DM) and diabetic neuropathy (DN) and to investigate possible changes in ultrasound characteristics related to glycaemic control.To accomplish this,45 infertile patients with type 2 DM and symptomatic DN were selected.Twenty healthy fertile men and 20 patients with idiopathic oligoasthenoteratozoospermia without DM represented the control groups.DM patients were arbitrarily divided into three groups according to glycaemic control level (A=glycosylated haemoglobin <7%; B=glycosylated haemoglobin between 7% and 10%; C=glycosylated haemoglobin > 10%).Patients underwent prostate-vesicular transrectal ultrasonography and sperm analysis.The following SV ultrasound parameters were recorded:(i) body antero-posterior diameter (APD); (ii) fundus APD; (iii) parietal thicknesses of the right and left SVs; and (iv) the number of polycyclic areas within both SVs.We then calculated the following parameters:(i) fundus/body (F/B) ratio; (ii) difference of the parietal thickness between the right and the left SV; and (iii) pre-and post-ejaculatory APD difference.All DM patients had a higher F/B ratio compared to controls (P<0.05).Group C had a higher F/B ratio compared to the other DM groups (P<0.05).All DM patients had a lower pre-and post-ejaculatory difference of the body SV APD compared to controls (P<0.05).Groups A and B had a similar pre-and post-ejaculatory difference of the body SV APD,whereas this difference was lower in Group C (P<0.05).In conclusion,infertile DM patients with DN showed peculiar SV ultrasound features suggestive of functional atony,and low glycaemic control was associated with greater expression of these features.

  12. Effect of adjunct metformin treatment in patients with type-1 diabetes and persistent inadequate glycaemic control. A randomized study

    DEFF Research Database (Denmark)

    Lund, S.S.; Tarnow, L.; Astrup, A.S.;

    2008-01-01

    = 0.422; Total daily insulin dose, -5.7 U/day (-8.6; -2.9), pMinor and overall major hypoglycaemia was not significantly different between treatments. Treatments were well tolerated. CONCLUSIONS/SIGNIFICANCE: In patients with poorly controlled T......1DM, adjunct metformin therapy did not provide any improvement of glycaemic control after one year. Nevertheless, adjunct metformin treatment was associated with sustained reductions of insulin dose and body weight. Further investigations into the potential cardiovascular-protective effects...

  13. Glucose excursions and glycaemic control during Ramadan fasting in diabetic patients: insights from continuous glucose monitoring (CGM).

    Science.gov (United States)

    Lessan, N; Hannoun, Z; Hasan, H; Barakat, M T

    2015-02-01

    Ramadan fasting represents a major shift in meal timing and content for practicing Muslims. This study used continuous glucose monitoring (CGM) to assess changes in markers of glycaemic excursions during Ramadan fasting to investigate the short-term safety of this practice in different groups of patients with diabetes. A total of 63 subjects (56 with diabetes, seven healthy volunteers; 39 male, 24 female) had CGM performed during, before and after Ramadan fasting. Mean CGM curves were constructed for each group for these periods that were then used to calculate indicators of glucose control and excursions. Post hoc data analyses included comparisons of different medication categories (metformin/no medication, gliptin, sulphonylurea and insulin). Medication changes during Ramadan followed American Diabetes Association guidelines. Among patients with diabetes, there was a significant difference in mean CGM curve during Ramadan, with a slow fall during fasting hours followed by a rapid rise in glucose level after the sunset meal (iftar). The magnitude of this excursion was greatest in the insulin-treated group, followed by the sulphonylurea-treated group. Markers of control deteriorated in a small number (n=3) of patients. Overall, whether fasting or non-fasting, subjects showed no statistically significant changes in mean interstitial glucose (IG), mean amplitude of glycaemic excursion (MAGE), high and low blood glucose indices (HBGI/LBGI), and number of glucose excursions and rate of hypoglycaemia. The main change in glycaemic control with Ramadan fasting in patients with diabetes is in the pattern of excursions. Ramadan fasting caused neither overall deterioration nor improvement in the majority of patients with good baseline glucose control. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  14. Functional health literacy and glycaemic control in older adults with type 2 diabetes: a cross-sectional study.

    Science.gov (United States)

    Souza, Jonas Gordilho; Apolinario, Daniel; Magaldi, Regina Miksian; Busse, Alexandre Leopold; Campora, Flavia; Jacob-Filho, Wilson

    2014-02-12

    To investigate the relationship between functional health literacy and glycaemic control in a sample of older patients with type 2 diabetes. Cross-sectional study. A government-financed outpatient geriatric clinic in São Paulo, Brazil. 129 older patients with type 2 diabetes, a mean (SD) age of 75.9 (6.2) years, a mean glycosylated haemoglobin (HbA1c) of 7.2% (1.4), of which 14.7% had no formal education and 82.9% had less than a high-school diploma. HbA1c was used as a measure of glycaemic control. Functional health literacy was assessed with the 18-item Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18), a validated instrument to evaluate pronunciation and comprehension of commonly used medical terms. Regression models were controlled for demographic data, depressive symptoms, diabetes duration, treatment regimen, diabetes knowledge and assistance for taking medications. Functional health literacy below adequate was encountered in 56.6% of the sample. After controlling for potential confounding factors, patients with inadequate functional health literacy were more likely than patients with adequate functional health literacy to present poor glycaemic control (OR=4.76; 95% CI 1.36 to 16.63). In a fully adjusted linear regression model, lower functional health literacy (β=-0.42; pdiabetes duration (β=0.24; p=0.012) and lack of assistance for taking medications (β=0.23; p=0.014) were associated with higher levels of HbA1c. Contrary to our expectations, illiterate patients did not have poorer outcomes when compared with patients with adequate functional health literacy, raising the hypothesis that illiterate individuals are more likely to have their difficulties recognised and compensated. However, the small subsample of illiterate patients provided limited power to reject differences with small magnitude. Patients with inadequate functional health literacy presented with higher odds of poor glycaemic control. These findings reinforce

  15. Statins use is associated with poorer glycaemic control in a cohort of hypertensive patients with diabetes and without diabetes

    OpenAIRE

    2014-01-01

    Background The US Federal and Drug Administration (FDA) recently revised statin drug labels to include the information that increases in fasting serum glucose and glycated haemoglobin levels have been reported with the use of statins. Yet in a survey, 87% of the doctors stated that they had never or infrequently observed increases in glucose or HbA1c levels in patients on statin. In this study we would like to determine the association between the use of statins and glycaemic control in a ret...

  16. Diabetes-specific emotional distress mediates the association between depressive symptoms and glycaemic control in Type 1 and Type 2 diabetes

    DEFF Research Database (Denmark)

    van Bastelaar, Kim M P; Pouwer, F; Geelhoed-Duijvestijn, P H L M

    2010-01-01

    the relation between depression and glycaemic control and not differently for both disease types. Post-hoc analyses revealed that patients depressed and distressed by their diabetes were in significantly poorer glycaemic control relative to those not depressed nor distressed (HbA(1c) 8.7 +/- 1.7 vs. 7.6 +/- 1......OBJECTIVES: To investigate whether diabetes-specific emotional distress mediates the relationship between depression and glycaemic control in patients with Type 1 and Type 2 diabetes. RESEARCH DESIGN AND METHODS: Data were derived from the baseline assessment of a depression in diabetes screening...... and diabetes-specific emotional distress respectively. Linear regression was performed to examine the mediating effect of diabetes-distress. RESULTS: Complete data were available for 627 outpatients with Type 1 (n = 280) and Type 2 (n = 347) diabetes. Analyses showed that diabetes-distress mediated...

  17. Glycaemic control in type 1 diabetes mellitus among children and adolescents in a resource limited setting in Dar es Salaam - Tanzania.

    Science.gov (United States)

    Noorani, Mariam; Ramaiya, Kaushik; Manji, Karim

    2016-05-31

    Type 1 Diabetes Mellitus is a rapidly growing problem in Tanzania. Children and adolescents with type 1 diabetes have previously been found to have poor glycaemic control and high prevalence of complications. Strict glycaemic control reduces the incidence and progression of chronic complications. The aim of this study was to identify the factors associated with glycaemic control among children and adolescents. A cross sectional study was done at the diabetes clinic for children and adolescents. Data on socioeconomic, demographic and diabetes specific variables including adherence, diabetes knowledge, caregivers knowledge and their involvement in the care of the child was obtained. Glycaemic control was assessed by measuring glycosylated hemoglobin. (HbA1C). Linear regression analysis was done to determine factors associated with glycaemic control Seventy-five participants were recruited into the study (51 % males). The mean HbA1c was 11.1 ± 2.1 %. Children aged control (9.8 %) as compared to 10-14 year olds (11.5 %) and >14 year olds (11.4 %) (P value = 0.022). Sixty-eight percent of patients had good adherence to insulin while adherence to blood glucose monitoring regimen was 48 % and to diet control was 28 %. Younger age, having the mother as the primary caregiver, better caregiver knowledge of diabetes, better adherence to blood glucose monitoring regimen and diabetes duration of less than 1 year were associated with better glycaemic control. In multivariate analysis, age, adherence to blood glucose monitoring regimen and the mother as the primary caregiver were found to independently predict glycaemic control (R(2) = 0.332, p value = 0.00). Children and adolescents with type 1 diabetes in Dar es Salaam have poor glycaemic control. In order to improve metabolic control, adherence to blood glucose monitoring should be encouraged and caregivers encouraged to participate in care of their children especially the adolescents.

  18. Improving glycaemic control and life skills in adolescents with type 1 diabetes: A randomised, controlled intervention study using the Guided Self-Determination-Young method in triads of adolescents, parents and health care providers integrated into routine paediatric outpatient clinics

    DEFF Research Database (Denmark)

    Thorsteinsson, Birger; Esbensen, Bente Appel; Hommel, Eva

    2011-01-01

    ABSTRACT: BACKGROUND: Adolescents with type 1 diabetes face demanding challenges due to conflicting priorities between psychosocial needs and diabetes management. This conflict often results in poor glycaemic control and discord between adolescents and parents. Adolescent-parent conflicts are thu...

  19. Fatores associados à interrupção de tratamento anti-retroviral Factors associated to glycaemic control in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Daniel Panarotto

    2008-08-01

    Full Text Available OBJETIVO: Avaliar as variáveis que influenciam no controle glicêmico de indivíduos diabéticos tipo 2 que freqüentam um serviço de saúde terciário. MÉTODOS: Estudo retrospectivo realizado através de revisão de prontuários dos pacientes atendidos no Ambulatório de Diabetes da Universidade de Caxias do Sul. Avaliamos os pacientes quanto ao controle glicêmico e metabólico e os subdividimos em compensados e descompensados segundo à hemoglobina glicada no início e no final do período avaliado. Analisamos os fatores associados ao controle glicêmico. RESULTADOS: Incluímos na análise 73 pacientes. Em média, observamos que houve melhora de parâmetros relacionados com o controle glicêmico, pressórico e lipídico no período médio de 20 meses de tratamento. No início do acompanhamento, 25% estavam com hemoglobina glicada OBJECTIVE: Evaluate the factors influencing blood glucose control of type 2 diabetic patients attended at a tertiary health care center. METHODS: A retrospective study by review of medical records of patients who attended the Diabetes Clinic at the University of Caxias do Sul was carried out. Patients were evaluated for glycaemic and metabolic control and divided according to glycated hemoglobin at the beginning and end of the period in question, in compensated and not compensated. The factors associated with glycaemic control were analyzed. RESULTS: Seventy three patients were included in the analysis. On the average, improvement of parameters related to glycaemic, pressure and lipid control during the average of 20 months of treatment was observed. In the beginning of the follow-up period, 25% of patients had glycated hemoglobin < 7%, 22.7% had LDL cholesterol < 100mg/dL, 8.7% had systolic blood pressure < 130 mmHg and diastolic < 80 mmHg and no patients had all parameters meeting the recommended goals. At the last visit the percentages were, 42.3%, 37.5%, 30.2% and 9.6% respectively. In the multivariate

  20. Mechanisms behind the superior effects of interval vs continuous training on glycaemic control in individuals with type 2 diabetes

    DEFF Research Database (Denmark)

    Karstoft, Kristian; Winding, Kamilla; Knudsen, Sine H.

    2014-01-01

    AIMS/HYPOTHESIS: By use of a parallel and partly crossover randomised, controlled trial design we sought to elucidate the underlying mechanisms behind the advantageous effects of interval walking training (IWT) compared with continuous walking training (CWT) on glycaemic control in individuals...... with type 2 diabetes, no exogenous insulin treatment) were allocated to three groups: a control group (CON, n = 8), an IWT group (n = 12) and an energy expenditure-matched CWT group (n = 12). Training groups were prescribed free-living training, five sessions per week (60 min/session). A three...... expenditure-matched CWT. These results suggest that training with alternating intensity, and not just training volume and mean intensity, is a key determinant of changes in whole body glucose disposal in individuals with type 2 diabetes. TRIAL REGISTRATION: ClinicalTrials (NCT01234155)....

  1. High Intensity Interval Training Improves Glycaemic Control and Pancreatic β Cell Function of Type 2 Diabetes Patients.

    Directory of Open Access Journals (Sweden)

    Søren Møller Madsen

    Full Text Available Physical activity improves the regulation of glucose homeostasis in both type 2 diabetes (T2D patients and healthy individuals, but the effect on pancreatic β cell function is unknown. We investigated glycaemic control, pancreatic function and total fat mass before and after 8 weeks of low volume high intensity interval training (HIIT on cycle ergometer in T2D patients and matched healthy control individuals. Study design/method: Elderly (56 yrs±2, non-active T2D patients (n = 10 and matched (52 yrs±2 healthy controls (CON (n = 13 exercised 3 times (10×60 sec. HIIT a week over an 8 week period on a cycle ergometer. Participants underwent a 2-hour oral glucose tolerance test (OGTT. On a separate day, resting blood pressure measurement was conducted followed by an incremental maximal oxygen uptake (VO2max cycle ergometer test. Finally, a whole body dual X-ray absorptiometry (DXA was performed. After 8 weeks of training, the same measurements were performed. Results: in the T2D-group, glycaemic control as determined by average fasting venous glucose concentration (p = 0.01, end point 2-hour OGTT (p = 0.04 and glycosylated haemoglobin (p = 0.04 were significantly reduced. Pancreatic homeostasis as determined by homeostatic model assessment of insulin resistance (HOMA-IR and HOMA β cell function (HOMA-%β were both significantly ameliorated (p = 0.03 and p = 0.03, respectively. Whole body insulin sensitivity as determined by the disposition index (DI was significantly increased (p = 0.03. During OGTT, the glucose continuum was significantly reduced at -15 (p = 0.03, 30 (p = 0.03 and 120 min (p = 0.03 and at -10 (p = 0.003 and 0 min (p = 0.003 with an additional improvement (p = 0.03 of its 1st phase (30 min area under curve (AUC. Significant abdominal fat mass losses were seen in both groups (T2D: p = 0.004 and CON: p = 0.02 corresponding to a percentage change of -17.84%±5.02 and -9.66%±3.07, respectively. Conclusion: these results

  2. Effect of adjunct metformin treatment in patients with type-1 diabetes and persistent inadequate glycaemic control. A randomized study.

    Directory of Open Access Journals (Sweden)

    Søren Søgaard Lund

    Full Text Available BACKGROUND: Despite intensive insulin treatment, many patients with type-1 diabetes (T1DM have longstanding inadequate glycaemic control. Metformin is an oral hypoglycaemic agent that improves insulin action in patients with type-2 diabetes. We investigated the effect of a one-year treatment with metformin versus placebo in patients with T1DM and persistent poor glycaemic control. METHODOLOGY/PRINCIPAL FINDINGS: One hundred patients with T1DM, preserved hypoglycaemic awareness and HaemoglobinA(1c (HbA(1c > or = 8.5% during the year before enrolment entered a one-month run-in on placebo treatment. Thereafter, patients were randomized (baseline to treatment with either metformin (1 g twice daily or placebo for 12 months (double-masked. Patients continued ongoing insulin therapy and their usual outpatient clinical care. The primary outcome measure was change in HbA(1c after one year of treatment. At enrolment, mean (standard deviation HbA(1c was 9.48% (0.99 for the metformin group (n = 49 and 9.60% (0.86 for the placebo group (n = 51. Mean (95% confidence interval baseline-adjusted differences after 12 months with metformin (n = 48 versus placebo (n = 50 were: HbA(1c, 0.13% (-0.19; 0.44, p = 0.422; Total daily insulin dose, -5.7 U/day (-8.6; -2.9, p<0.001; body weight, -1.74 kg (-3.32; -0.17, p = 0.030. Minor and overall major hypoglycaemia was not significantly different between treatments. Treatments were well tolerated. CONCLUSIONS/SIGNIFICANCE: In patients with poorly controlled T1DM, adjunct metformin therapy did not provide any improvement of glycaemic control after one year. Nevertheless, adjunct metformin treatment was associated with sustained reductions of insulin dose and body weight. Further investigations into the potential cardiovascular-protective effects of metformin therapy in patients with T1DM are warranted. TRIAL REGISTRATION: ClinicalTrials.gov NCT00118937.

  3. A randomised control trial of low glycaemic index carbohydrate diet versus no dietary intervention in the prevention of recurrence of fetal macrosomia.

    LENUS (Irish Health Repository)

    Walsh, Jennifer

    2010-04-23

    Abstract Background Maternal weight and maternal weight gain during pregnancy exert a significant influence on infant birth weight and the incidence of macrosomia. Fetal macrosomia is associated with an increase in both adverse obstetric and neonatal outcome, and also confers a future risk of childhood obesity. Studies have shown that a low glycaemic diet is associated with lower birth weights, however these studies have been small and not randomised 1 2 . Fetal macrosomia recurs in a second pregnancy in one third of women, and maternal weight influences this recurrence risk 3 . Methods\\/Design We propose a randomised control trial of low glycaemic index carbohydrate diet vs. no dietary intervention in the prevention of recurrence of fetal macrosomia. Secundigravid women whose first baby was macrosomic, defined as a birth weight greater than 4000 g will be recruited at their first antenatal visit. Patients will be randomised into two arms, a control arm which will receive no dietary intervention and a diet arm which will be commenced on a low glycaemic index diet. The primary outcome measure will be the mean birth weight centiles and ponderal indices in each group. Discussion Altering the source of maternal dietary carbohydrate may prove to be valuable in the management of pregnancies where there has been a history of fetal macrosomia. Fetal macrosomia recurs in a second pregnancy in one third of women. This randomised control trial will investigate whether or not a low glycaemic index diet can affect this recurrence risk. Current Controlled Trials Registration Number ISRCTN54392969

  4. Diabetes-specific emotional distress mediates the association between depressive symptoms and glycaemic control in Type 1 and Type 2 diabetes.

    NARCIS (Netherlands)

    Bastelaar, K.M. van; Pouwer, F.; Geelhoed-Duijvestijn, P.H.; Tack, C.J.J.; Bazelmans, E.; Beekman, A.T.; Heine, R.J.; Snoek, F.J.

    2010-01-01

    OBJECTIVES: To investigate whether diabetes-specific emotional distress mediates the relationship between depression and glycaemic control in patients with Type 1 and Type 2 diabetes. RESEARCH DESIGN AND METHODS: Data were derived from the baseline assessment of a depression in diabetes screening st

  5. Random blood glucose may be used to assess long-term glycaemic control among patients with type 2 diabetes mellitus in a rural African clinical setting

    DEFF Research Database (Denmark)

    Rasmussen, Jon B; Nordin, Lovisa S; Rasmussen, Niclas S

    2014-01-01

    OBJECTIVES: To investigate the diagnostic accuracy of random blood glucose (RBG) on good glycaemic control among patients with diabetes mellitus (DM) in a rural African setting. METHODS: Cross-sectional study at St. Francis' Hospital in eastern Zambia. RBG and HbA1c were measured during one...

  6. Effects of androgen deprivation on glycaemic control and on cardiovascular biochemical risk factors in men with advanced prostate cancer with diabetes.

    Science.gov (United States)

    Haidar, Ahmad; Yassin, Aksam; Saad, Farid; Shabsigh, Ridwan

    2007-12-01

    Androgen deprivation therapy of prostate cancer with luteinizing hormone releasing hormone agonists may result in loss of bone mass, changes in body composition and a deterioration of arterial stiffness. The present study monitored the effects of androgen deprivation therapy in men with insulin-dependent diabetes on glycaemic control and on biochemical cardiovascular risk markers. Twenty-nine patients from a urology practice were included. All men had insulin-dependent diabetes mellitus prior to being diagnosed with metastatic prostate cancer. In a retrospective analysis, levels of fasting glucose, haemoglobin A1c, insulin requirements, total cholesterol, HDL, LDL, triglycerides, fibrinogen, PAI-1, tPA and C-reactive protein were obtained on at least eight occasions over a period of up to 24 months. Glycaemic control worsened substantially with increases of serum glucose requiring increases in insulin dosages. HbA1c levels rose indicating impaired glycaemic control. All biochemical cardiovascular risk markers deteriorated. In men with insulin-dependent diabetes, androgen deprivation therapy may have negative effects on their glycaemic control and may aggravate the biochemical risk profile of cardiovascular disease to which diabetics are predisposed. These observations are in agreement with the emerging role of low levels of testosterone in metabolic syndrome and insulin resistance.

  7. Lower dose basal insulin infusion has positive effect on glycaemic control for children with type I diabetes on continuous subcutaneous insulin infusion therapy

    NARCIS (Netherlands)

    Schulten, Ron J; Piet, Jessica; Bruijning-Verhagen, Patricia; de Waal, Wouter J

    2017-01-01

    Objective: The aim of our study was to explore a possible relationship between proportion of basal insulin dose (%BD/T) and glycaemic control in children with type I diabetes on continuous subcutaneous insulin infusion (CSII) therapy. Methods: All patients under the age of 18 with type I diabetes

  8. Automated bolus advisor control and usability study (ABACUS: does use of an insulin bolus advisor improve glycaemic control in patients failing multiple daily insulin injection (MDI therapy? [NCT01460446

    Directory of Open Access Journals (Sweden)

    Cavan David A

    2012-10-01

    Full Text Available Abstract Background People with T1DM and insulin-treated T2DM often do not follow and/or adjust their insulin regimens as needed. Key contributors to treatment non-adherence are fear of hypoglycaemia, difficulty and lack of self-efficacy associated with insulin dose determination. Because manual calculation of insulin boluses is both complex and time consuming, people may rely on empirical estimates, which can result in persistent hypoglycaemia and/or hyperglycaemia. Use of automated bolus advisors (BA has been shown to help insulin pump users to more accurately meet prandial insulin dosage requirements, improve postprandial glycaemic excursions, and achieve optimal glycaemic control with an increased time within optimal range. Use of a BA containing an early algorithm based on sliding scales for insulin dosing has also been shown to improve HbA1c levels in people treated with multiple daily insulin injections (MDI. We designed a study to determine if use of an automated BA can improve clinical and psychosocial outcomes in people treated with MDI. Methods/design The Automated Bolus Advisor Control and Usability Study (ABACUS is a 6-month, prospective, randomised, multi-centre, multi-national trial to determine if automated BA use improves glycaemic control as measured by a change in HbA1c in people using MDI with elevated HbA1c levels (#62;7.5%. A total of 226 T1DM and T2DM participants will be recruited. Anticipated attrition of 20% will yield a sample size of 90 participants, which will provide #62;80% power to detect a mean difference of 0.5%, with SD of 0.9%, using a one-sided 5% t-test, with 5% significance level. Other measures of glycaemic control, self-care behaviours and psychosocial issues will also be assessed. Discussion It is critical that healthcare providers utilise available technologies that both facilitate effective glucose management and address concerns about safety and lifestyle. Automated BAs may help people using MDI to

  9. Maternal early pregnancy lipid profile and offspring's lipids and glycaemic control at age 5-6 years: The ABCD study.

    Science.gov (United States)

    van Lieshout, Noekie; Oostvogels, Adriëtte J J M; Gademan, Maaike G J; Vrijkotte, Tanja G M

    2016-10-15

    Maternal early pregnancy lipid profile might influence offspring's lipids and glycaemic control, through an increased offspring's fat percentage. This explorative study investigates whether maternal early pregnancy lipid profile is associated with offspring's lipids and glycaemic control independently of offspring's fat percentage and if these associations are mediated by offspring's fat percentage. Possible sex differences in these associations are also examined. 1133 mother-child pairs of the prospective ABCD-study were included. Maternal non-fasting lipids were collected in early pregnancy: triglycerides, total cholesterol (TC), Apolipoprotein A1 (ApoA1), Apolipoprotein B (ApoB) and free fatty acids (FFA). Fasting triglycerides, TC, high density lipoprotein (HDL), low density lipoprotein (LDL), glucose and C-peptide were assessed in offspring aged 5-6 years and HOMA2-IR was calculated. After adjustment for covariates, strongest associations were found between maternal TC and offspring's TC (boys β(95%CI) = 0.141 (0.074-0.207); girls β(95%CI) = 0.268 (0.200; 0.336)) and LDL (boys β(95%CI) = 0.114 (0.052; 0.176); girls β(95%CI) = 0.247 (0.181-0.312)), maternal ApoB and offspring's TC (boys β(95%CI) = 0.638 (0.311-0.965); girls β(95%CI) = 1.121 (0.766-1.475)) and LDL (boys β(95%CI) = 0.699 (0.393-1.005); girls β(95%CI) = 1.198 (0.868-1.529)), and maternal ApoA1 and offspring's HDL (only boys β(95%CI) = 0.221 (0.101-0.341)). No significant association was found between maternal lipids and offspring's glycaemic control, and offspring's fat percentage played no mediating role. Maternal early pregnancy lipid profile is associated with offspring's lipid profile in childhood, with overall stronger associations in girls. This study provides further evidence that lowering lipid levels during pregnancy might be beneficial for the long term health of the offspring. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and

  10. Maternal Diet and Weight at 3 Months Postpartum Following a Pregnancy Intervention with a Low Glycaemic Index Diet: Results from the ROLO Randomised Control Trial

    Directory of Open Access Journals (Sweden)

    Mary K. Horan

    2014-07-01

    Full Text Available Pregnancy increases the risk of being overweight at a later time period, particularly when there is excessive gestational weight gain. There remains a paucity of data into the effect of low glycaemic index (GI pregnancy interventions postpartum. Aim: To examine the impact of a low glycaemic index diet during pregnancy on maternal diet 3 months postpartum. Methodology: This analysis examined the diet, weight and lifestyle of 460 participants of the ROLO study 3 months postpartum. Questionnaires on weight, physical activity, breastfeeding, supplement use, food label reading and dietary habits were completed. Results: The intervention group had significantly greater weight loss from pre-pregnancy to 3 months postpartum than the control group (1.3 vs. 0.1 kg, p = 0.022. The intervention group reported greater numbers following a low glycaemic index diet (p < 0.001 and reading food labels (p = 0.032 and had a lower glycaemic load (GL (128 vs. 145, p = 0.014 but not GI (55 vs. 55, p = 0.809 than controls. Conclusions: Low GI dietary interventions in pregnancy result in improved health-behaviours and continued reported compliance at 3 months postpartum possibly through lower dietary GL as a result of portion control. Greater levels of weight loss from pre-pregnancy to 3 months postpartum in the intervention group may have important positive implications for overweight and obesity.

  11. Associations between patient characteristics, social relations, diabetes management, quality of life, glycaemic control and emotional burden in type 1 diabetes

    DEFF Research Database (Denmark)

    Joensen, Lene Eide; Almdal, Thomas P; Willaing, Ingrid

    2016-01-01

    AIM: The objective was to investigate associations between emotional burden and a number of individual variables: patient characteristics, social relations, diabetes management in everyday life, generic quality of life and glycaemic control, including determining to what extend these variables...... empowerment, low generic quality of life and low diabetes-specific support were associated with the largest difference in emotional burden level. CONCLUSIONS: A variety of psychosocial and behavioural factors such as low social support, low generic quality of life and difficulties in managing diabetes...... of interest with emotional burden of diabetes as the dependent variable. RESULTS: High emotional burden of diabetes was associated with being female, younger age, other chronic illness, low diabetes-specific support, low generic quality of life, low diabetes empowerment and high Hba1c. Low diabetes...

  12. Circulating microRNA levels predict residual beta cell function and glycaemic control in children with type 1 diabetes mellitus

    DEFF Research Database (Denmark)

    Samandari, Nasim; Mirza, Aashiq H; Nielsen, Lotte B

    2017-01-01

    from the Danish Remission Phase Cohort, and profiled for miRNAs. At the same time points, meal-stimulated C-peptide and HbA1c levels were measured and insulin-dose adjusted HbA1c (IDAA1c) calculated. miRNAs that at 3 months after diagnosis predicted residual beta cell function and glycaemic control......, hsa-miR-197-3p, hsa-miR-301a-3p and hsa-miR-375) at 3 months correlated with residual beta cell function 6-12 months after diagnosis. Stimulated C-peptide at 12 months was predicted by hsa-miR-197-3p at 3 months (p = 0.034). A doubling of this miRNA level corresponded to a sixfold higher stimulated C-peptide...

  13. The effect of nurse prescribers on glycaemic control in type 2 diabetes: A systematic review and meta-analysis.

    Science.gov (United States)

    Tabesh, Maryam; Magliano, Dianna J; Koye, Digsu N; Shaw, Jonathan E

    2017-08-31

    The creation of advanced nursing roles in diabetes management, with specific skills such as nurse prescribing, has resulted in nurses taking on roles that have traditionally been associated with doctors. We aimed to examine the effectiveness of nurse-led clinics, in which nurses were involved in prescribing, on haemoglobin A1c (HbA1c) among people with type 2 diabetes. We systematically searched the literature, Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and Allied Health Literature database guide (CINAHL) databases, to identify randomised controlled trials (RCTs) assessing the effect of nurse prescribers on HbA1c. We focused on randomised controlled trials which compared nurse prescriber interventions with usual care in adults aged 18 years or over with a diagnosis of type 2 diabetes. The main outcome measure was change in HbA1c levels. We performed a random effects model meta-analysis to assess the pooled effect size of the intervention. Studies were divided into two groups according to the role of nurses in the intervention. In one group, the nurses supplemented a team, as an add-on to usual care; in the other group, they worked independently, and were compared directly to a doctor. Nine RCTs were identified and included in this study. All studies were from developed countries, with a medium risk of bias and a moderate heterogeneity between studies. In the five RCTs in which nurse prescribers supplemented a team, there was no significant difference in change of HbA1c compared to usual care (-0.34 percentage points; 95% CI: -0.71, 0.02). In the four RCTs in which nurses replaced doctors, the outcomes of nurse prescribers were comparable to those of doctors. No data on adverse events were available. There was no clear evidence of benefit on glycaemic control, when nurses who undertake prescribing work alongside a doctor and other practitioners. However, in those studies in which nurses replaced physicians, the glycaemic control

  14. Fish oil supplemented for 9 months does not improve glycaemic control or insulin sensitivity in subjects with impaired glucose regulation: a parallel randomised controlled trial.

    Science.gov (United States)

    Clark, Louise F; Thivierge, M C; Kidd, Claire A; McGeoch, Susan C; Abraham, Prakash; Pearson, Donald W M; Horgan, Graham W; Holtrop, Grietje; Thies, Frank; Lobley, Gerald E

    2016-01-14

    The effects of fish oil (FO) supplementation on glycaemic control are unclear, and positive effects may occur only when the phospholipid content of tissue membranes exceeds 14% as n-3 PUFA. Subjects (n 36, thirty-three completed) were paired based on metabolic parameters and allocated into a parallel double-blind randomised trial with one of each pair offered daily either 6 g of FO (3·9 g n-3 PUFA) or 6 g of maize oil (MO) for 9 months. Hyperinsulinaemic-euglycaemic-euaminoacidaemic (HIEGEAA) clamps (with [6,6 2H2 glucose]) were performed at the start and end of the intervention. Endogenous glucose production (EGP) and whole-body protein turnover (WBPT) were each measured after an overnight fast. The primary outcome involved the effect of oil type on insulin sensitivity related to glycaemic control. The secondary outcome involved the effect of oil type on WBPT. Subjects on FO (n 16) had increased erythrocyte n-3 PUFA concentrations >14%, whereas subjects on MO (n 17) had unaltered n-3 PUFA concentrations at 9%. Type of oil had no effect on fasting EGP, insulin sensitivity or total glucose disposal during the HIEGEAA clamp. In contrast, under insulin-stimulated conditions, total protein disposal (P=0·007) and endogenous WBPT (P=0·001) were both increased with FO. In an associated pilot study (n 4, three completed), although n-3 PUFA in erythrocyte membranes increased to >14% with the FO supplement, the enrichment in muscle membranes remained lower (8%; Psupplementation with FO, at amounts near the safety limits set by regulatory authorities in Europe and the USA, did not alter glycaemic control but did have an impact on WBPT.

  15. Mechanisms behind the superior effects of interval vs continuous training on glycaemic control in individuals with type 2 diabetes: a randomised controlled trial.

    Science.gov (United States)

    Karstoft, Kristian; Winding, Kamilla; Knudsen, Sine H; James, Noemi G; Scheel, Maria M; Olesen, Jesper; Holst, Jens J; Pedersen, Bente K; Solomon, Thomas P J

    2014-10-01

    By use of a parallel and partly crossover randomised, controlled trial design we sought to elucidate the underlying mechanisms behind the advantageous effects of interval walking training (IWT) compared with continuous walking training (CWT) on glycaemic control in individuals with type 2 diabetes. We hypothesised that IWT, more than CWT, would improve insulin sensitivity including skeletal muscle insulin signalling, insulin secretion and disposition index (DI). By simple randomisation (sequentially numbered, opaque sealed envelopes), eligible individuals (diagnosed with type 2 diabetes, no exogenous insulin treatment) were allocated to three groups: a control group (CON, n = 8), an IWT group (n = 12) and an energy expenditure-matched CWT group (n = 12). Training groups were prescribed free-living training, five sessions per week (60 min/session). A three-stage hyperglycaemic clamp, including glucose isotope tracers and skeletal muscle biopsies, was performed before and after a 4 month intervention in a hospitalised setting. No blinding was performed. The improved glycaemic control, which was only seen in the IWT group, was consistent with IWT-induced increases in insulin sensitivity index (49.8 ± 14.6%; p training with alternating intensity, and not just training volume and mean intensity, is a key determinant of changes in whole body glucose disposal in individuals with type 2 diabetes. ClinicalTrials (NCT01234155).

  16. Predicting self-care practices and glycaemic control using health belief model (HBM) in patients with insulin-treated diabetes in Malaysia

    OpenAIRE

    Aris, Aishairma

    2016-01-01

    Background: The practice of diabetes self-care plays an important role in glycaemic control. However, not all patients with insulin-treated diabetes engage in their self-care activities. Although there is evidence that self-care practices in patients with insulin-treated diabetes can be understood and predicted by health beliefs proposed by Health Belief Model (HBM), little is known about adult patients due to several methodological weaknesses of previous studies. Furthermore, knowledge is la...

  17. Job strain and supervisor support in primary care health centres and glycaemic control among patients with type 2 diabetes: a cross-sectional study

    OpenAIRE

    Koponen, Anne; Vahtera, Jussi; Pitkäniemi, Janne; Virtanen, Marianna; Pentti, Jaana; Simonsen-Rehn, Nina; Kivimäki, Mika; Suominen, Sakari

    2013-01-01

    Objectives This study investigates associations between healthcare personnel's perceived job strain, supervisor support and the outcome of care in terms of glycaemic control among patients with type 2 diabetes. Design A cross-sectional study from 2006. Setting 18 primary care health centres (HCs) from five municipalities in Finland. Participants Aggregated survey data on perceived job strain and supervisor support from healthcare personnel (doctors, n=122, mean age 45.5 years, nurses, n=300, ...

  18. Local recruitment experience in a study comparing the effectiveness of a low glycaemic index diet with a low calorie healthy eating approach at achieving weight loss and reducing the risk of endometrial cancer in women with polycystic ovary syndrome (PCOS).

    Science.gov (United States)

    Atiomo, William; Read, Anna; Golding, Mary; Silcocks, Paul; Razali, Nuguelis; Sarkar, Sabitabrata; Hardiman, Paul; Thornton, Jim

    2009-09-01

    Feasibility of a clinical-trial comparing a low-glycaemic diet with a low-calorie healthy eating approach at achieving weight loss and reducing the risk of endometrial cancer in women with PCOS. A pilot Randomised-Controlled-Trial using different recruitment strategies. A University Hospital in the United Kingdom. Women seen at specialist gynaecology clinics over a 12 month period in one University Hospital, and women self identified through a website and posters. Potential recruits were assessed for eligibility, gave informed consent, randomised, treated and assessed as in the definitive trial. Eligibility and recruitment rates, compliance with the allocated diet for 6 months and with clinical assessments, blood tests, pelvic ultrasound scans and endometrial biopsies. 1433 new and 2598 follow up patients were seen in 153 gynaecology clinics for over 12 months. 441 (11%) potentially eligible women were identified, 19 (0.4%) of whom met the trial entry criteria. Eleven consented to take part, of which 8 (73%) completed the study. Planned future trials on over-weight women with PCOS should be multicentre and should incorporate primary care. This data will help other researchers plan and calculate the sample size and potential recruitment rates in future clinical trials in PCOS. The results will also be useful for inclusion in future meta-analyses.

  19. Determinants for inadequate glycaemic control in Chinese patients with mild-to-moderate type 2 diabetes on oral antidiabetic drugs alone

    Institute of Scientific and Technical Information of China (English)

    ZHANG Shao-ling; CHEN Zong-cun; YAN Li; CHEN Li-hong; CHENG Hua; JI Li-nong

    2011-01-01

    Background Prevalence of inadequate glycaemic control among patients with type 2 diabetes mellitus (T2DM)remains high. We assessed glycaemic control in the real-life practice among people with T2DM in metropolises in China who were treated with oral antidiabetic drugs (OAD) alone and to determine factors associated with inadequate giycaemic control in this population.Methods An observational, cross-sectional multicentre study was conducted in 16 metropolitan medical centers.People with T2DM who had been followed-up before the index visit which occurred from January to September 2007 were included in the study. All subjects were ≥30 years of age at the time of T2DM diagnosis and had received monotherapy or combination therapy of OAD for at least 6 months. Demographic and clinical data were collected from medical records. The main study outcome was the inadequate glucose control rate, which was calculated by the proportion of patients with haemoglobin A1c (HbA1c) ≥6.5% detected on the index visit.Results In this cohort of 455 patients with T2DM whose mean age was 60.6 years and mean disease duration was 6.1 years, 45.5% had inadequate glycaemic control. The mean (SD) HbA1c was 6.7% (1.3). Multivariate Logistic regression showed that physical inactivity, disease duration >10 years, body mass index (BMI) ≥24 kg/m2, low homeostasis model assessment of β-cell function (HOMA-β) index, less frequency of medical visit and hypertriglyceridaemia were independent determinants of inadequate glycaemic control. Higher incidence of self-reported hypoglycemia experience (47.1% vs. 34.8%, P=0.008) and more fear of hypoglycemia quantified by Worry subscaie of the Hypoglycaemia Fear Survey (HFS) Ⅱ were happened in subjects with good glycemic control.Conclusion Approximately one half of these outpatients with T2DM from the metropolitan medical centers in China had inadequate glycaemic control treated with OAD alone, which raises the need for more effective educational and

  20. Self-knowledge of HbA1c in people with Type 2 Diabetes Mellitus and its association with glycaemic control.

    Science.gov (United States)

    Trivedi, Hina; Gray, Laura J; Seidu, Samuel; Davies, Melanie J; Charpentier, Guillaume; Lindblad, Ulf; Kellner, Christiane; Nolan, John; Pazderska, Agnieszka; Rutten, Guy; Trento, Marina; Khunti, Kamlesh

    2017-10-01

    The aim of this study was to evaluate the prevalence of accurate self-knowledge of a patient's own HbA1c level (HbA1cSK), as a component of structural education (University Hospital's of Leicester (UHL), 2013) and its association with glycaemic control. Data from the GUIDANCE study, a cross-sectional study involving 7597 participants from eight European countries was used. HbA1cSK was evaluated and compared with laboratory measured HbA1c levels (HbA1cLAB), which represented the measure of glycaemic control. Accuracy of the self-reported HbA1c was evaluated by using agreement statistical methods. The prevalence of HbA1cSK was 49.4%. Within this group, 78.3% of the participants had accurately reported HbA1cSK. There was good level of agreement between HbA1cSK and HbA1cLAB (intra-class correlation statistic=0.84, pself-knowledge of their own HbA1c level. Moreover, the participants with accurately reported HbA1cSK were found to have associated better glycaemic control. Copyright © 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  1. The effects of 2 weeks of interval vs continuous walking training on glycaemic control and whole-body oxidative stress in individuals with type 2 diabetes

    DEFF Research Database (Denmark)

    Karstoft, Kristian; Clark, Margaret A; Jakobsen, Ida

    2017-01-01

    in physical fitness or body composition. Compared with baseline, IWT reduced mean glucose levels non-significantly (-0.7 ± 0.3 mmol/l, p = 0.08) and significantly reduced maximum glucose levels (-1.8 ± 0.5 mmol/l, p = 0.04) and mean amplitude of glycaemic excursions (MAGE; -1.7 ± 0.4 mmol/l, p = 0...... oxidative stress levels are unaffected by short-term walking and changes in oxidative stress levels are not associated with changes in glycaemic control. TRIAL REGISTRATION: ClinicalTrials.gov NCT02320526 FUNDING : The Centre for Physical Activity Research (CFAS) is supported by a grant from Tryg...... training-induced improvements in glycaemic control were associated with systemic oxidative stress levels. METHODS: Participants (n = 14) with type 2 diabetes completed a crossover trial using three interventions (control intervention [CON], CWT and IWT), each lasting 2 weeks. These were performed...

  2. The zinc transporter, Slc39a7 (Zip7 is implicated in glycaemic control in skeletal muscle cells.

    Directory of Open Access Journals (Sweden)

    Stephen A Myers

    Full Text Available Dysfunctional zinc signaling is implicated in disease processes including cardiovascular disease, Alzheimer's disease and diabetes. Of the twenty-four mammalian zinc transporters, ZIP7 has been identified as an important mediator of the 'zinc wave' and in cellular signaling. Utilizing siRNA targeting Zip7 mRNA we have identified that Zip7 regulates glucose metabolism in skeletal muscle cells. An siRNA targeting Zip7 mRNA down regulated Zip7 mRNA 4.6-fold (p = 0.0006 when compared to a scramble control. This was concomitant with a reduction in the expression of genes involved in glucose metabolism including Agl, Dlst, Galm, Gbe1, Idh3g, Pck2, Pgam2, Pgm2, Phkb, Pygm, Tpi1, Gusb and Glut4. Glut4 protein expression was also reduced and insulin-stimulated glycogen synthesis was decreased. This was associated with a reduction in the mRNA expression of Insr, Irs1 and Irs2, and the phosphorylation of Akt. These studies provide a novel role for Zip7 in glucose metabolism in skeletal muscle and highlight the importance of this transporter in contributing to glycaemic control in this tissue.

  3. EFFECT OF GLYCAEMIC CONTROL (HBA1C ON PULMONARY FUNCTION TESTS (SPIROMETRY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Senthilnathan

    2016-03-01

    Full Text Available BACKGROUND Diabetes mellitus is a metabolic disorder affecting almost all the organs by its micro and macrovascular complications. Like other organs the respiratory system is also affected by diabetic complications like microangiopathy. Very few studies investigated the complications and the relationship with the duration of the diabetes and glycaemic status. So in this point of view, we planned to study the effect of pulmonary function in our type 2 diabetic patients. AIMS AND OBJECTIVES To study the influence of glycaemic control (based on HbA1c levels on pulmonary function tests and the correlation between spirometric abnormalities and duration of diabetes in type 2 diabetic patients. MATERIALS AND METHODS 55 type 2 diabetic patients who gave informed consent were recruited. History regarding duration of diabetes, treatment, history suggestive of complications like neuropathy, retinopathy, nephropathy, regular sugar monitoring, exercise, etc. were recorded. BMI was calculated. Chest x-ray was taken for all patients. They underwent spirometry and the predicted and measured values of FEV1, FVC, FEV1/FVC, PEFR, FEF 25-75 for all the patients were recorded. After spirometry, HbA1c estimation was done using ion exchange resin method. Oneway ANOVA, correlation, paired and unpaired-t-test were used for analysis. RESULTS There was significant difference between the mean predicted FVC, FEV1, PEFR, and FEF 25-75, and measured values. The mean of measured spirometric values decreases as the HbA1c increases. There was reducing trend of the spirometric values as HbA1c increases, this was not statistically significant. The incidence of restrictive pattern was more common among the male patients compared with female patients but this was not statistically significant. DISCUSSION AND CONCLUSION: Restrictive pattern was more with increase in duration of diabetes. Out of 55 patients, 33 had probable restriction, 5 had moderate obstruction and 1 had severe

  4. Diabetes with poor glycaemic control does not promote atherosclerosis in genetically modified hypercholesterolaemic minipigs

    DEFF Research Database (Denmark)

    Al-Mashhadi, Rozh H; Bjørklund, Martin M; Mortensen, Martin B

    2015-01-01

    ' weight gain and cholesterol intake. After 49 weeks of high-fat feeding, the major arteries were harvested for a detailed analysis of the plaque burden and histological plaque type. RESULTS: Stable hyperglycaemia was achieved in the diabetic minipigs, while the plasma total and LDL...... atherogenesis in a novel pig model of atherosclerosis, the D374Y-PCSK9 (+) transgenic minipig. METHODS: Nineteen minipigs were fed a cholesterol-enriched, high-fat diet; ten of these pigs were injected with streptozotocin to generate a model of diabetes. Restricted feeding was implemented to control the pigs...... with no alterations in plasma cholesterol or creatinine concentrations did not augment the plaque burden or promote the development of more advanced lesions in this large-animal model of human-like atherosclerosis. This is consistent with clinical studies in patients with type 1 diabetes, indicating...

  5. Clinical, behavioural and social indicators for poor glycaemic control around the time of transfer to adult care

    DEFF Research Database (Denmark)

    Castensøe-Seidenfaden, P; Jensen, Andreas Kryger; Smedegaard, Heidi

    2017-01-01

    last paediatric and first adult visit, comorbidity, learning disability and/or mental health conditions and family structure. We examined associations between acute hospital admissions, low visit attendance rate, loss to follow-up and baseline HbA1c level. RESULTS: Among 126 participants, the mean HbA1......c level was 80 mmol/mol (9.4%) pre-transfer but decreased by an average of 3 mmol/mol (0.3%) each year post-transfer (P = 0.005). Young people with a learning disability and/or a mental health condition had worse glycaemic control (P = 0.041) and the mean HbA1c of those with divorced parents was 14...... mmol/mol (1.2%) higher (P = 0.014). Almost one-third of participants were admitted to the hospital for acute diabetes care. Low visit attendance rate, high baseline HbA1c level, learning disability and/or mental health conditions and divorced parents predicted acute hospital admissions. CONCLUSIONS...

  6. Associations between patient characteristics, social relations, diabetes management, quality of life, glycaemic control and emotional burden in type 1 diabetes.

    Science.gov (United States)

    Joensen, Lene E; Almdal, Thomas P; Willaing, Ingrid

    2016-02-01

    The objective was to investigate associations between emotional burden and a number of individual variables: patient characteristics, social relations, diabetes management in everyday life, generic quality of life and glycaemic control, including determining to what extend these variables explain the differences in emotional burden in a large Danish population of people with type 1 diabetes. We analysed a cross-sectional survey of 2419 Danish adults with type-1 diabetes mellitus and data from an electronic patient record. Data were analysed using hierarchical regression of factors of interest with emotional burden of diabetes as the dependent variable. High emotional burden of diabetes was associated with being female, younger age, other chronic illness, low diabetes-specific support, low generic quality of life, low diabetes empowerment and high Hba1c. Low diabetes empowerment, low generic quality of life and low diabetes-specific support were associated with the largest difference in emotional burden level. A variety of psychosocial and behavioural factors such as low social support, low generic quality of life and difficulties in managing diabetes are associated with high emotional burden in type-1 diabetes. These findings may call for an expansion of the effort to decrease the emotional burden of diabetes for those who are heavily burdened. Future research should explore the causality of the explored associations as well as potential subgroup differences in order to guide the development of appropriate interventions. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  7. Does a single bout of resistance or aerobic exercise after insulin dose reduction modulate glycaemic control in type 2 diabetes? A randomised cross-over trial.

    Science.gov (United States)

    Gordon, Brett A; Bird, Stephen R; MacIsaac, Richard J; Benson, Amanda C

    2016-10-01

    Regular exercise is advocated for individuals with type 2 diabetes, without fully understanding the acute (0-72h post-exercise) glycaemic response. This study assessed post-exercise glycaemic profiles of non-exercising individuals with insulin treated type 2 diabetes, following resistance and aerobic exercise. Randomised cross-over trial. Fourteen individuals with insulin treated type 2 diabetes (9 males, 5 females) aged 58.1±7.1 years (HbA1c: 8.0±0.6%) were allocated to single sessions of resistance (six whole-body exercises, three sets, 8-10 repetitions, 70% 1RM) and aerobic (30min cycling, 60% VO2peak) exercise, 7-days apart, with the day prior to the first exercise day of each intervention being the control condition. Immediately prior to exercise, insulin dosage was halved and breakfast consumed. Continuous glucose monitoring was undertaken to determine area under the curve and glucose excursions. Blood glucose initially increased (0-2h) following both resistance and aerobic exercise (presistance (222±41mmolL(-1)24h(-1)) or aerobic (211±40 mmolL(-1)24h(-1)) exercise (p=0.56). Incidence of hyperglycaemia did not differ between exercise modes (p=0.68). Hypoglycaemic events were identified in three and four participants following resistance and aerobic exercise respectively: these did not require treatment. Glycaemic response is not different between exercise modes, although 50% insulin dose reduction prior to exercise impairs the expected improvement. A common clinical recommendation of 50% insulin dose reduction does not appear to cause adverse glycaemic events. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  8. Efficacy and safety of liraglutide for overweight adult patients with type 1 diabetes and insufficient glycaemic control (Lira-1)

    DEFF Research Database (Denmark)

    Dejgaard, Thomas Fremming; Frandsen, Christian Seerup; Hansen, Tanja Stenbæk

    2016-01-01

    . Secondary endpoints were changes in hypoglycaemic events, glycaemic variability, glycaemic excursions, insulin dose, bodyweight, postprandial plasma concentrations of glucagon and GLP-1, gastric emptying, blood pressure, heart rate, patient-reported outcome measures, time spent in hypoglycaemia, near......-normoglycaemia, and hyperglycaemia, plasma fasting glucose, mean glucose, and cholesterol. Efficacy analyses were calculated by use of a mixed model, whereby a patient's data are used as long as the patient is in the study. The safety analyses were done in the intention-to-treat population, which consisted of all patients who...

  9. Effect of orlistat on glycaemic control in overweight and obese patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Aldekhail, N M; Logue, J; McLoone, P; Morrison, D S

    2015-12-01

    Orlistat is an effective adjunctive treatment to lifestyle modifications in the treatment of obesity. While the majority of current evidence is on the effect of orlistat in obese patients without diabetes, some studies suggest that patients who are obese and have diabetes mellitus lose more weight and have greater improvements in diabetic outcomes when treated with orlistat plus a lifestyle intervention than when treated by lifestyle interventions alone. The aim of this study was to review the evidence of the effects of orlistat on glycaemic control in overweight and obese patients with type 2 diabetes. A systematic review of randomized controlled trials of orlistat in people with type 2 diabetes reporting diabetes outcomes in studies published between January 1990 and September 2013 was conducted. We searched for articles published in English in MEDLINE and EMBASE. Inclusion criteria included all randomized controlled trials of orlistat carried out on adult participants with a body mass index of 25 kg m(-2) or over diagnosed with type 2 diabetes, which reported weight change and at least one diabetic outcome. A total of 765 articles were identified out of which 12 fulfilled the inclusion criteria. The overall mean weight reduction (3, 6 and 12 months) in the orlistat group was -4.25 kg (95% CI: -4.5 to -3.9 kg). The mean weight difference between treatment and control groups was -2.10 kg (95% CI: -2.3 to -1.8 kg, P orlistat plus lifestyle intervention resulted in significantly greater weight loss and improved glycaemic control in overweight and obese patients with type 2 diabetes compared with lifestyle intervention alone.

  10. MANAGEMENT OF ENDOCRINE DISEASE: The effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.

    Science.gov (United States)

    Krul-Poel, Yvonne H M; Ter Wee, Marieke M; Lips, Paul; Simsek, Suat

    2017-01-01

    Epidemiologic studies suggest that vitamin D status plays a role in glycaemic control in patients with type 2 diabetes. However, intervention studies yielded inconsistent results. The aim of this study is to systematically review the effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes. Systematic review and meta-analysis. We searched Medline, Embase and the Cochrane Library for RCTs examining the effect of vitamin D supplementation on glycaemic control in patients with type 2 diabetes. A random-effects model meta-analysis was performed to obtain a summarized outcome of vitamin D supplementation on HbA1c, fasting glucose and homeostasis model assessment - insulin resistance (HOMA-IR). Twenty-three RCTs were included in this systematic review representing a total of 1797 patients with type 2 diabetes. Mean (± s.d.) change in serum 25-hydroxyvitamin D varied from 1.8 ± 10.2 nmol/L to 80.1 ± 54.0 nmol/L. Nineteen studies included HbA1c as outcome variable. Combining these studies no significant effect in change of HbA1c was seen after vitamin D intervention compared with placebo. A significant effect of vitamin D supplementation was seen on fasting glucose in a subgroup of studies (n = 4) with a mean baseline HbA1c ≥ 8% (64 mmol/mol) (standardized difference in means: 0.36; 95% CI: 0.12-0.61, P = 0.003). Current evidence of RCTs does not support short-term vitamin D supplementation in a heterogeneous population with type 2 diabetes. However, in patients with poorly controlled diabetes, a favourable effect of vitamin D is seen on fasting glucose. © 2017 European Society of Endocrinology.

  11. Insulin analogues: have they changed insulin treatment and improved glycaemic control?

    DEFF Research Database (Denmark)

    Madsbad, Sten

    2002-01-01

    To improve insulin therapy, new insulin analogues have been developed. Two fast-acting analogues with a more rapid onset of effect and a shorter duration of action combined with a low day-to-day variation in absorption rate are now available. Despite this favourable time-action profile most studi......, the new fast-acting analogues have not achieved the expected commercial success, which emphasises the need for new strategies for basal insulin supplementation, exercise, diet and blood glucose monitoring....

  12. EFFECT OF GLYCAEMIC CONTROL (HBA1C) ON PULMONARY FUNCTION TESTS (SPIROMETRY) IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

    OpenAIRE

    Senthilnathan; Muthumani,; Nehru

    2016-01-01

    BACKGROUND Diabetes mellitus is a metabolic disorder affecting almost all the organs by its micro and macrovascular complications. Like other organs the respiratory system is also affected by diabetic complications like microangiopathy. Very few studies investigated the complications and the relationship with the duration of the diabetes and glycaemic status. So in this point of view, we planned to study the effect of pulmonary function in our type 2 diabetic patients. AIM...

  13. Evaluation of a mobile phone telemonitoring system for glycaemic control in patients with diabetes.

    Science.gov (United States)

    Istepanian, Robert S H; Zitouni, Karima; Harry, Diane; Moutosammy, Niva; Sungoor, Ala; Tang, Bee; Earle, Kenneth A

    2009-01-01

    We conducted a randomized controlled trial using mobile health technology in an ethnically diverse sample of 137 patients with complicated diabetes. Patients in the intervention group (n = 72) were trained to measure their blood glucose with a sensor which transmitted the readings to a mobile phone via a Bluetooth wireless link. Clinicians were then able to examine and respond to the readings which were viewed with a web-based application. Patients in the control arm of the study (n = 65) did not transmit their readings and received care with their usual doctor in the outpatient and/or primary care setting. The mean follow-up period was 9 months in each group. The default rate was higher in the patients in the intervention arm due to technical problems. In an intention-to-treat analysis there were no differences in HbA(1c) between the intervention and control groups. In a sub-group analysis of the patients who completed the study, the telemonitoring group had a lower HbA(1c) than those in the control group: 7.76% and 8.40%, respectively (P = 0.06).

  14. Dapagliflozin treatment in patients with different stages of type 2 diabetes mellitus: effects on glycaemic control and body weight.

    Science.gov (United States)

    Zhang, L; Feng, Y; List, J; Kasichayanula, S; Pfister, M

    2010-06-01

    Dapagliflozin is a stable, competitive, reversible, and highly selective inhibitor of sodium-glucose co-transporter 2, the major transporter responsible for renal glucose reabsorption. With an insulin-independent mechanism of action, dapagliflozin is currently being developed for the treatment of type 2 diabetes mellitus (T2DM). This work aims to compare the efficacy of dapagliflozin, as measured by the change in hemoglobin A1c concentration (A1c) and body weight, and to determine the pharmacodynamic effects of dapagliflozin, as measured by urinary glucose excretion in early-stage and late-stage T2DM patient populations. A total of 151 early-stage patients and 58 late-stage patients with T2DM randomly assigned 10 or 20 mg once daily (QD) dapagliflozin treatment or placebo for 12 weeks from two phase 2 studies were included in the analysis. A1c, body weight, and urinary glucose were compared between the two patient populations. Compared with the early-stage population, patients in the late-stage population had a longer duration of T2DM and higher baseline levels of A1c, body weight, fasting plasma glucose, and urinary glucose excretion. After 12 weeks of dapagliflozin treatment, A1c reduction, weight loss, and increased urinary glucose excretion from baseline were observed in both populations. Baseline A1c level impacted the A1c reduction after dapagliflozin treatment with a comparable effect in patients with early and late stage disease. Late-stage patients had greater reduction in body weight. There was no statistically significant difference in the amount of urinary glucose excretion between the early-stage and late-stage patients. Dapagliflozin treatment at 10 and 20 mg QD for 12 weeks resulted in significant improvement in glycaemic control and body weight reduction in both early-stage and late-stage patients with T2DM. The findings suggest that dapagliflozin could be a promising treatment option for a wide range of patients with T2DM.

  15. Glycaemic control and prevalence of hypoglycaemic events in children and adolescents with type 1 diabetes mellitus treated with insulin analogues

    Directory of Open Access Journals (Sweden)

    Plavšić Ljiljana

    2014-01-01

    Full Text Available Background/Aim. An ideal insulin regimen for children and adolescents with type 1 diabetes mellitus (T1DM should be physiological, flexibile and predictable, protecting against hypoglycaemia. The aim of this study was to evaluate the influence of insulin analogues on glycaemic control and the occurrence of hypoglycaemic episodes in children and adolescents with T1DM. Methods. The study group consisted of 151 children and adolescents (90 boys, 61 girls treated with human insulins for at least 12 months before introducing insulin analogues. All the patients were divided into two groups: the group I consisted of 72 (47.7% patients treated with three injections of regular human insulin before meals and long-acting analogue (RHI/LA, and the group II of 79 (52.3% patients treated with a combination of rapid-acting and long-acting analogue (RA/LA. The levels of glycated hemoglobin (HbA1c and the number of hypoglycaemic episodes were assessed at the beginning of therapy with insulin analogues, and after 6 and 12 months. Results. The mean HbA1c was significantly lower in the group I (RHI/LA after 6 months (9.15% vs 8.20%, p < 0.001 and after 12 months (9.15% vs 8.13%, p < 0.001 as well as in the group II (RA/LA after 6 months (9.40% vs 8.24%, p < 0.001 and after 12 months of insulin analogues treatment (9.40% vs 8.38%, p < 0.001. The frequency of severe hypoglycaemia was significantly lower in both groups after 6 months (in the group I from 61.1% to 4.2% and in the group II from 54.4% to 1.3%, p < 0.001, and after 12 months (in the group I from 61.1% to 1.4% and in the group II from 54.4% to 1.3%, p < 0.001. Conclusion. Significantly better HbA1c values and lower risk of severe hypoglycaemia were established in children and adolescents with T1DM treated with insulin analogues.

  16. Improved postprandial glycaemic control with insulin Aspart in type 2 diabetic patients treated with insulin

    DEFF Research Database (Denmark)

    Rosenfalck, A M; Thorsby, P; Kjems, L;

    2000-01-01

    The effect on postprandial blood glucose control of an immediately pre-meal injection of the rapid acting insulin analogue Aspart (IAsp) was compared with that of human insulin Actrapid injected immediately or 30 minutes before a test meal in insulin-treated type 2 diabetic patients with residual....../kg) immediately (Act0) or 30 minutes before (Act-30) a test meal. We studied 25 insulin-requiring type 2 diabetic patients, including 14 males and 11 females, with a mean age of 59.7 years (range, 43-71), body mass index 28.3 kg/m2 (range, 21.9-35.0), HbA1c 8.5% (range, 6.8-10.0), glucagon-stimulated C-peptide 1...... between IAsp, administered with a meal and Actrapid injected 30 minutes before the meal (AUCglucose IAsp, 899 +/- 609 mmol/l min vs. Act-30, 868 +/- 374 mmol/l min; Cmax IAsp, 10.8 +/- 2.2 mmol/l vs. Act-30, 11.1 +/- 1.8 mmol/l). No concerns about the safety of IAsp were raised. Immediate pre...

  17. Age at type 2 diabetes onset and glycaemic control: results from the National Health and Nutrition Examination Survey (NHANES) 2005–2010

    Science.gov (United States)

    Berkowitz, Seth A.; Meigs, James B.; Wexler, Deborah J.

    2013-01-01

    Aims/hypothesis We tested the hypothesis that age younger than 65 years at type 2 diabetes diagnosis is associated with worse subsequent glycaemic control. Methods A cross-sectional analysis of data from participants in the 2005–2010 National Health and Nutrition Examination Survey was performed. For adults with self-reported diabetes, we dichotomised age at diabetes diagnosis as younger (9.0% (75 mmol/mol). Secondary outcomes were HbA1c >8.0% (64 mmol/mol) and >7.0% (53 mmol/mol). We used multivariable logistic regression for analysis. Results Among 1,438 adults with diabetes, a higher proportion of those 9.0% (14.4% vs 2.5%, p 9.0% (OR 3.22, 95% CI 1.54, 6.72), HbA1c > 8.0% (OR 2.72, 95% CI 1.43, 5.16) and HbA1c >7.0% (OR 1.92, 95% CI 1.18, 3.11). The younger group reported fewer comorbidities, but were less likely to report good health (OR 0.54, 95% CI 0.36, 0.83). Conclusions/interpretation Younger age at type 2 diabetes diagnosis is significantly associated with worse subsequent glycaemic control. Because patients who are younger at diagnosis have fewer competing comorbidities and complications, safe, aggressive, individualised treatment could benefit this higher-risk group. PMID:23995472

  18. Inadequate Vitamin C Status in Prediabetes and Type 2 Diabetes Mellitus: Associations with Glycaemic Control, Obesity, and Smoking.

    Science.gov (United States)

    Wilson, Renée; Willis, Jinny; Gearry, Richard; Skidmore, Paula; Fleming, Elizabeth; Frampton, Chris; Carr, Anitra

    2017-09-09

    Vitamin C (ascorbate) is an essential micronutrient in humans, being required for a number of important biological functions via acting as an enzymatic cofactor and reducing agent. There is some evidence to suggest that people with type 2 diabetes mellitus (T2DM) have lower plasma vitamin C concentrations compared to those with normal glucose tolerance (NGT). The aim of this study was to investigate plasma vitamin C concentrations across the glycaemic spectrum and to explore correlations with indices of metabolic health. This is a cross-sectional observational pilot study in adults across the glycaemic spectrum from NGT to T2DM. Demographic and anthropometric data along with information on physical activity were collected and participants were asked to complete a four-day weighed food diary. Venous blood samples were collected and glycaemic indices, plasma vitamin C concentrations, hormone tests, lipid profiles, and high-sensitivity C-reactive protein (hs-CRP) were analysed. A total of 89 participants completed the study, including individuals with NGT (n = 35), prediabetes (n = 25), and T2DM managed by diet alone or on a regimen of Metformin only (n = 29). Plasma vitamin C concentrations were significantly lower in individuals with T2DM compared to those with NGT (41.2 µmol/L versus 57.4 µmol/L, p C deficiency (i.e. C intake (p = 0.032) to be significant independent predictors of plasma vitamin C concentrations. In conclusion, these results suggest that adults with a history of smoking, prediabetes or T2DM, and/or obesity, have greater vitamin C requirements. Future research is required to investigate whether eating more vitamin C rich foods and/or taking vitamin C supplements may reduce the risk of progression to, and/or complications associated with, T2DM.

  19. Glycaemic index methodology.

    Science.gov (United States)

    Brouns, F; Bjorck, I; Frayn, K N; Gibbs, A L; Lang, V; Slama, G; Wolever, T M S

    2005-06-01

    The glycaemic index (GI) concept was originally introduced to classify different sources of carbohydrate (CHO)-rich foods, usually having an energy content of >80 % from CHO, to their effect on post-meal glycaemia. It was assumed to apply to foods that primarily deliver available CHO, causing hyperglycaemia. Low-GI foods were classified as being digested and absorbed slowly and high-GI foods as being rapidly digested and absorbed, resulting in different glycaemic responses. Low-GI foods were found to induce benefits on certain risk factors for CVD and diabetes. Accordingly it has been proposed that GI classification of foods and drinks could be useful to help consumers make 'healthy food choices' within specific food groups. Classification of foods according to their impact on blood glucose responses requires a standardised way of measuring such responses. The present review discusses the most relevant methodological considerations and highlights specific recommendations regarding number of subjects, sex, subject status, inclusion and exclusion criteria, pre-test conditions, CHO test dose, blood sampling procedures, sampling times, test randomisation and calculation of glycaemic response area under the curve. All together, these technical recommendations will help to implement or reinforce measurement of GI in laboratories and help to ensure quality of results. Since there is current international interest in alternative ways of expressing glycaemic responses to foods, some of these methods are discussed.

  20. Bromocriptine improves glycaemic control and serum lipid profile in obese Type 2 diabetic subjects: a new approach in the treatment of diabetes.

    Science.gov (United States)

    Cincotta; Meier; Cincotta Jr

    1999-10-01

    Bromocriptine, a potent dopamine D(2) receptor agonist, has been shown to reduce insulin resistance, glucose intolerance and hyperlipidaemia in both numerous animal studies and in Phase II studies. Bromocriptine has been used worldwide for over 20 years to treat Parkinson's disease, macroprolactinoma and other disorders; it has been found to be generally safe. We therefore investigated the possible beneficial effects of Ergoset(R) (Ergo Science Corp.), a new quick release formulation of bromocriptine, on glycaemic control and serum lipid profile in obese Type 2 diabetic subjects in two large Phase III studies. A large, randomised, double-blind placebo-controlled study was conducted in which Ergoset was given once daily at 8 am. (4.8 mg maximum dose) for 24 weeks as adjunctive therapy to sulphonylurea (485 subjects) to obese Type 2 diabetics held on a weight- maintaining diet. Treatment efficacy parameters included change from baseline in glycated haemoglobin A(1c) (HbA(1c)), fasting and post-prandial serum glucose, insulin, triglyceride and free fatty acid levels. Baseline glycated haemoglobin, fasting glucose, insulin, triglyceride and free fatty acid levels did not differ between treatment groups. and on average were 9.4 +/- 0.05%, 222 +/- 2 mg/dl, 24 +/- 1 µU/ml, 248 +/- 11 mg/dl, and 850 +/- 32 µEq/l, respectively. A similarly designed study of Ergoset as monotherapy in Type 2 diabetics (154 subjects) with similar baseline clinical characteristics was conducted. Addition of Ergoset treatment to sulphonylurea reduced percent glycated HbA(1c) by 0.55 (P fasting and post-prandial glucose by 23 and 26 mg/dl (P fasting and post-prandial triglycerides by 72 and 63 mg/dl (P fasting and post-prandial free fatty acids by 150 and 165 µEq/l (P < 0.05), relative to placebo. Twelve percent of all Ergoset subjects, compared to 3% of placebo subjects, withdrew from the study due to adverse events. The most common events causing withdrawal were nausea, dizziness, asthenia

  1. Glycaemic control and antidiabetic treatment trends in primary care centres in patients with type 2 diabetes mellitus during 2007–2013 in Catalonia: a population-based study

    Science.gov (United States)

    Mata-Cases, Manel; Franch-Nadal, Josep; Real, Jordi; Mauricio, Dídac

    2016-01-01

    Objectives To assess trends in prescribing practices of antidiabetic agents and glycaemic control in patients with type 2 diabetes mellitus (T2DM). Design Cross-sectional analysis using yearly clinical data and antidiabetic treatments prescribed obtained from an electronic population database. Setting Primary healthcare centres, including the entire population attended by the Institut Català de la Salut in Catalonia, Spain, from 2007 to 2013. Participants Patients aged 31–90 years with a diagnosis of T2DM. Results The number of registered patients with T2DM in the database was 257 072 in 2007, increasing up to 343 969 in 2013. The proportion of patients not pharmacologically treated decreased by 9.7% (95% CI −9.48% to −9.92%), while there was an increase in the percentage of patients on monotherapy (4.4% increase; 95% CI 4.16% to 4.64%), combination therapy (2.8% increase; 95% CI 2.58% to 3.02%), and insulin alone or in combination (increasing 2.5%; 95% CI 2.2% to 2.8%). The use of metformin and dipeptidyl peptidase-IV inhibitors increased gradually, while sulfonylureas, glitazones and α-glucosidase inhibitors decreased. The use of glinides remained stable, and the use of glucagon-like peptide-1 receptor agonists was still marginal. Regarding glycaemic control, there were no relevant differences across years: mean glycated haemoglobin (HbA1c) value was around 7.2%; the percentage of patients reaching an HbA1c≤7% target ranged between 52.2% and 55.6%; and those attaining their individualised target from 72.8% to 75.7%. Conclusions Although the proportion of patients under pharmacological treatment increased substantially over time and there was an increase in the use of combination therapies, there have not been relevant changes in glycaemic control during the 2007–2013 period in Catalonia. PMID:27707830

  2. Glucose- and glycaemic factor-lowering effects of probiotics on diabetes: a meta-analysis of randomised placebo-controlled trials.

    Science.gov (United States)

    Sun, Jing; Buys, Nicholas J

    2016-04-14

    This meta-analysis examined the effect of probiotics on glucose and glycaemic factors in diabetes and its associated risk factors. All randomised-controlled trials published in English in multiple databases from January 2000 to June 2015 were systematically searched. Only studies that addressed glucose- and glycaemic-related factors as outcome variables were included. The main outcomes of interest in trials were mean changes in glucose, HbA1c, insulin and homoeostasis model assessment-estimated insulin resistance (HOMA-IR). Using the Physiotherapy Evidence Database (PEDro) scale to assess the quality of studies, a total of eleven studies with 614 subjects were included. The pooled mean difference and effect size with a 95% CI were extracted using a random-effect model. It was found that there are statistically significant pooled mean differences between the probiotics and the placebo-controlled groups on the reduction of glucose (-0·52 mmol/l, 95% CI -0·92, -0·11 mmol/l; P=0·01) and HbA1c (-0·32%, 95% CI -0·57, -0·07%; P=0·01). There was no statistically significant pooled mean difference between the probiotics and the placebo-controlled groups on the reduction of insulin (-0·48 µIU/ml, 95% CI -1·34, 0·38 µIU/ml; P=0·27) and HOMA-IR (pooled effect of -0·44, 95% CI -1·57, 0·70; P=0·45). Meta-regression analysis identified that probiotics had significant effects on reduction of glucose, HbA1c, insulin and HOMA-IR in participants with diabetes, but not in participants with other risk factors. The present meta-analysis suggested that probiotics may be used as an important dietary supplement in reducing the glucose metabolic factors associated with diabetes.

  3. Effect of insulin lispro on glycaemic control in Chinese diabetic patients receiving twice-daily regimens of insulin

    Institute of Scientific and Technical Information of China (English)

    Chan Wing Bun 陈颖斌; Chow Chun Chung 周振中; Yeung Vincent Tok Fai 杨铎辉; Chan Juliana Chung Ngor 陈重娥; So Wing Yee 苏咏仪; Cockram Clive Stewart

    2004-01-01

    @@ Insulin lispro is an insulin analogue that has the advantages of being fast-acting, convenient, and less likely to lead to hypoglycaemic episodes. Previous studies have proven its value in treating both Type 1 and Type 2 diabetes both alone and in combination with different treatment regimens.1,2 However, diabetes is heterogeneous and differs in etiology and clinical characteristics in different ethnic groups. Even with the same insulin treatment, different diets will produce different glycaemic profiles. Diet patterns differ between different ethnic groups. Traditional oriental foods are characterized by a higher proportion of carbohydrates and a lower proportion of fat compared to Caucasian diets. To date, there has been no study on the use of insulin lispro in Chinese diabetic patients. Whether the Chinese dietary pattern will affect the efficacy of insulin lispro treatment remains unknown. Therefore, we conducted this trial to assess the efficacy of insulin lispro treatment in Chinese patients.

  4. Near-normalization of glycaemic control with glucagon-like peptide-1 receptor agonist treatment combined with exercise in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Mensberg, Pernille; Nyby, Signe; Jørgensen, Peter Godsk;

    2016-01-01

    .002)). Greater reductions in fasting plasma glucose (-3.4 ± 2.3 vs -0.3 ± 2.6 mM, p quality of life during......AIMS: Exercise as well as glucagon-like peptide-1 receptor agonist (GLP-1RA) treatment improves glycaemic control in patients with type 2 diabetes. We investigated the effects of exercise in combination with a GLP-1RA (liraglutide) or placebo for the treatment of type 2 diabetes. METHODS: Thirty......-three overweight, dysregulated and sedentary patients with type 2 diabetes were randomly allocated to 16 weeks of exercise and liraglutide or exercise and placebo. Both groups had three supervised 60-minute training sessions per week including spinning and resistance training. RESULTS: HbA1c levels dropped by 2...

  5. Initiating therapy or switching to biphasic insulin aspart improves glycaemic control in type 2 diabetes: an Indian experience from the A1chieve study.

    Science.gov (United States)

    Kumar, A; Sharma, S K; Rajput, R; Unnikrishnan, A G

    2013-01-01

    Biphasic insulin aspart 30 (BIAsp 30) has been used in patients for almost a decade; There is a wealth of knowledge from clinical trials to document its efficacy and safety and suggest that BIAsp 30 is an option for initiation and intensification of insulin therapy in patients with type 2 diabetes mellitus (T2DM). The A1chieve was a non-interventional study that explored the safety and effectiveness of initiating or switching to insulin analogues in routine clinical practice in more than 60,000 patients from 28 different countries. In this manuscript, we discuss the findings from the subgroup of the Indian cohort who were treated with BIAsp 30. In a cohort of 15287 who were on BIAsp 30, 12645 (83%) were insulin naive and 2642 (17%) had been on insulin therapy earlier. Glycaemic parameters were high at baseline. Mean (SD) HbA1c was 9.2% (1.3) in the these and was comparable in the insulin naive and insulin experienced groups. After 24 weeks of therapy with BIAsp 30, there were reductions in HbA1c in both the insulin naive group, [-1.8 (1.3)] and insulin experienced group [-1.6 (1.3)]. Fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) levels were also reduced significantly from baseline [-3.4 (2.7) and -4.8 (3.8) mmol/L, respectively, p < 0.05). Overall, hypoglycaemia decreased from 1.33 events/patient years at baseline to 0.19 events/patient years at 24 weeks. There was also an increase in quality of life score as evaluated by EQ-5D questionnaire. Initiating insulin therapy with or switching to BIAsp 30 in patients with poor glycaemic control leads to an improvement in glycaemic profile with no major hypoglycaemia or clinically significant weight gain. Therapy with BIAsp 30 also improves the quality of life in patients with type 2 diabetes.

  6. Efficacy of nonsurgical periodontal therapy on glycaemic control in type II diabetic patients: a randomized controlled clinical trial

    OpenAIRE

    Telgi, Ravishankar Lingesha; Tandon, Vaibhav; Tangade, Pradeep Shankar; Tirth, Amit; Kumar, Sumit; Yadav, Vipul

    2013-01-01

    Purpose Diabetes and periodontal disease are two common diseases with high prevalence rates. Recent evidence has shown a bidirectional relationship between diabetes and periodontitis. The aim of this study was to investigate the effects of nonsurgical periodontal therapy on glycemic control in type 2 diabetes mellitus patients. Methods Sixty subjects aged 35-45 years with blood sugar controlled by oral hypoglycaemic agents were randomly divided equally among 3 groups: group A (scaling, mouthw...

  7. The effect of periodontal therapy on glycaemic control in a Hispanic population with type 2 diabetes: a randomized controlled trial.

    Science.gov (United States)

    Gay, Isabel C; Tran, Duong T; Cavender, Adriana C; Weltman, Robin; Chang, Jennifer; Luckenbach, Estelle; Tribble, Gena D

    2014-07-01

    In the Mexican-American population, the prevalence of Type 2 diabetes mellitus (T2DM) is as high as 50% of the population. This randomized controlled clinical trial was designed to elucidate how treatment of periodontal disease affects HbA1c values in this population. One hundred and fifty-four T2DM patients with periodontal disease were enrolled in the study. The test group was treated with scaling and root planing (SRP); the control group received oral hygiene instructions. At baseline and 4-6 weeks after therapy, a complete periodontal examination was performed. Blood was collected at baseline and 4 months later for HbA1c levels. One hundred and twenty-six individuals completed the study. Baseline mean ± SD HbA1c for the test and control groups were 9.0 ± 2.3% and 8.4 ± 2.0% respectively. Non-significant difference in HbA1c reductions (0.6 ± 2.1% and 0.3 ± 1.7%) was found between test and control groups at 4 months. Comparisons of the periodontal clinical parameters between the test and control groups found significant differences with improved results in the test subjects. No statistically significant differences were found in the changes of HbA1c levels between test and control groups. Non-surgical periodontal therapy improved the magnitude of change in periodontal parameters as compared to the control subjects. ClinicalTrials.gov Identifier: NCT01128374. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. The effect of macronutrients on glycaemic control: a systematic review of dietary randomised controlled trials in overweight and obese adults with type 2 diabetes in which there was no difference in weight loss between treatment groups.

    Science.gov (United States)

    Emadian, Amir; Andrews, Rob C; England, Clare Y; Wallace, Victoria; Thompson, Janice L

    2015-11-28

    Weight loss is crucial for treating type 2 diabetes mellitus (T2DM). It remains unclear which dietary intervention is best for optimising glycaemic control, or whether weight loss itself is the main reason behind observed improvements. The objective of this study was to assess the effects of various dietary interventions on glycaemic control in overweight and obese adults with T2DM when controlling for weight loss between dietary interventions. A systematic review of randomised controlled trials (RCT) was conducted. Electronic searches of Medline, Embase, Cinahl and Web of Science databases were conducted. Inclusion criteria included RCT with minimum 6 months duration, with participants having BMI≥25·0 kg/m2, a diagnosis of T2DM using HbA1c, and no statistically significant difference in mean weight loss at the end point of intervention between dietary arms. Results showed that eleven studies met the inclusion criteria. Only four RCT indicated the benefit of a particular dietary intervention over another in improving HbA1c levels, including the Mediterranean, vegan and low glycaemic index (GI) diets. However the findings from one of the four studies showing a significant benefit are questionable because of failure to control for diabetes medications and poor adherence to the prescribed diets. In conclusion there is currently insufficient evidence to suggest that any particular diet is superior in treating overweight and obese patients with T2DM. Although the Mediterranean, vegan and low-GI diets appear to be promising, further research that controls for weight loss and the effects of diabetes medications in larger samples is needed.

  9. Self-monitoring of blood glucose improved glycaemic control and 10-year coronary heart disease risk profile of type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Ezenwaka Chidum; JonesLeCointe Altheia; Dimgba Agbai; Okali Fidelis; Skinner Teppany; Rodriguez Martina; Extavour Rian; Davis Verdine; Spencer Alida; Mayers Hasina

    2011-01-01

    Background The debate over the overall benefits of self-monitoring of blood glucose in type 2 diabetes patients is still continuing.We aimed to assess the difference in glycaemic control and coronary heart disease (CHD) risk levels of experimental type 2 diabetes patients provided with facilities for self-monitoring blood glucose and their counterparts without such facilities.Methods Sixty-one patients who had no prior experience in using glucometers were studied as intervention (n=30) and control (n=31) groups.The intervention group was trained in self-monitoring of blood glucose and documentation.Baseline blood glucose and fasting blood glucose were measured and the intervention patients were provided with glucometers and advised to self-monitor their fasting and postprandial blood glucose over six months.The 10-year CHD risk levels were determined with the United Kingdom Prospective Diabetes Study-derived risk engine calculator.Results The age and diabetes duration were similar in the two groups (P >0.05).The majority of the patients were unemployed or retired females with only a primary level education.After 3 months,the haemogolbin A1c (HbA1c) levels of the control patients remained unchanged ((7.8±0.3)% vs.(7.9±0.4)%,P >0.05) whereas the HbA1c levels of the intervention patients were significantly reduced from the baseline at three ((9.6±0.3)% vs.(7.8±0.3)%,P <0.001) and six ((9.2±0.4)% vs.(7.5±0.3)%,P <0.001) months.Interestingly,while the 10-year CHD risk level of the control group remained unchanged after three months,that of the intervention group was remarkably reduced at three and six months from the baseline level ((7.4±1.3)% vs.(4.5±0.9)%,P=0.056).Conclusion Self-monitoring of blood glucose in type 2 diabetes patients significantly improved glycaemic control and the CHD risk profile,suggesting that type 2 diabetes patients will potentially benefit from inclusion of glucose meters and testing strips in their health-care package.

  10. Lack of synergism between long-term poor glycaemic control and three gene polymorphisms of the renin angiotensin system on risk of developing diabetic nephropathy in type I diabetic patients

    DEFF Research Database (Denmark)

    Tarnow, L; Kjeld, T; Knudsen, E

    2000-01-01

    AIMS/HYPOTHESIS: Reports on a putative synergism between poor glycaemic control and carriage of the angiotensin II type 1 receptor (AGTR1) C1166-allele and risk of diabetic nephropathy have been conflicting. Therefore, we investigated the interaction between long-term glycaemic control and three...... polymorphisms in the genes coding for AGTR1 (A1166-->C), angiotensin converting enzyme (ACE/ID) and angiotensinogen (M235T) on risk of developing diabetic nephropathy. Furthermore, we investigated the relation between a random measurement and long-term measurements of haemoglobin A1c (HbA1c). METHODS: We...... difference (limits of agreement) [0.2 (-1.8 to 2.1)%] between the two estimates. CONCLUSION/INTERPRETATION: Poor metabolic control is a major risk factor for diabetic nephropathy in Caucasian Type I diabetic patients. This risk was similar in carriers and non-carriers of the mutant alleles of the AGTR1 (A...

  11. Initiation of insulin glargine in patients with Type 2 diabetes in suboptimal glycaemic control positively impacts health-related quality of life. A prospective cohort study in primary care

    DEFF Research Database (Denmark)

    Hajós, Tibor R S; Pouwer, F; de Grooth, R

    2011-01-01

    control (HbA(1c) > 53 mmol/mol; 7%) on maximum dose of oral glucose-lowering medications were included from 363 primary care practices (n = 911). Patients started insulin glargine and were followed up for 6 months. At baseline (start insulin therapy), 3 and 6 months, HbA(1c) was measured and patients......AIMS: To study prospectively the impact of initiating insulin glargine in suboptimally controlled insulin-naïve patients with Type 2 diabetes on health-related quality of life in relation to glycaemic control. METHODS: Insulin-naïve Dutch patients with Type 2 diabetes in suboptimal glycaemic......-revised score decreased from 15 ± 14 to 10 ± 12 and 10 ± 13 (P up and 67 ± 21.8 at 6-month follow-up (P

  12. Impact of an educational DVD on anxiety and glycaemic control in women diagnosed with gestational diabetes mellitus (GDM): A randomised controlled trial.

    Science.gov (United States)

    Draffin, Claire R; Alderdice, Fiona A; McCance, David R; Maresh, Michael; Harper, Roy; Patterson, Christopher C; Bernatavicius, Giovanna; Brennan, Sarah F; Gough, Aisling; McSorley, Oonagh; Holmes, Valerie A

    2017-04-01

    The diagnosis of gestational diabetes mellitus (GDM) during pregnancy can lead to anxiety. This study evaluated the impact of an innovative patient-centred educational DVD on anxiety and glycaemic control in women newly diagnosed with GDM. 150 multi-ethnic women, aged 19-44years, from three UK hospitals were randomised to either usual care plus DVD (DVD group, n=77) or usual care alone (control group, n=73) at GDM diagnosis. Primary outcomes were anxiety (State-Trait Anxiety Inventory) and mean 1-h postprandial capillary self-monitored blood glucose for all meals, on day prior to follow-up. No significant difference between the DVD and control group were reported, for anxiety (37.7±11.7 vs 36.2±10.9; mean difference after adjustment for covariates (95% CI) 2.5 (-0.8, 5.9) or for mean 1-h postprandial glucose for all meals (6.9±0.9 vs 7.0±1.2mmol/L; -0.2 (-0.5, 0.2). However, the DVD group had significantly lower postprandial breakfast glucose compared to the control group (6.8±1.2 vs 7.4±1.9mmol/L; -0.5 (-1.1, -<0.1; p=0.04). The results in this trial did not highlight any differences between those who received the intervention and those who received usual care. It is possible that women already felt supported by their frequent attendance at specialist clinics for monitoring and advice. Healthcare professional and family support are key elements to empowering women with GDM and require further consideration in future interventions. Nonetheless, educational resources such as this will be beneficial to help support women given the current resource and time implications of the year on year rises in the incidence of gestational diabetes. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Tight glycaemic control is a key factor in wound healing enhancement strategies in an experimental diabetes mellitus model.

    LENUS (Irish Health Repository)

    O'Sullivan, J B

    2012-02-01

    BACKGROUND: Diabetes mellitus is a leading cause of impaired wound healing. The aim of this study was to establish a glucose-controlled diabetic wound healing model. METHOD: Sprague-Dawley rats were divided into three groups: Control group (C), Diabetic Non-glucose Controlled group (DNC) and Diabetic glucose Controlled group (DC). RESULTS: Glucose control was achieved using Insulman Rapid (average daily glucose level <10 mmol\\/L). 18 Sprague-Dawley rats underwent a dorsal skin wound incision and 10 days later were killed. Fresh and fixed wound tensile strength, hydroxyproline and transforming growth factor beta-1 levels were improved in the DC group when compared to the DNC group. The quantity of fibroblasts present was similar in each group. CONCLUSION: This study demonstrates the impact that diabetes has on acute wound healing and suggests that wound modulating agents must be tested in both the tightly glucose-controlled as well as the poorly glucose-controlled diabetic animal models prior to proceeding with translational clinical studies.

  14. Smoking control: challenges and achievements.

    Science.gov (United States)

    Silva, Luiz Carlos Corrêa da; Araújo, Alberto José de; Queiroz, Ângela Maria Dias de; Sales, Maria da Penha Uchoa; Castellano, Maria Vera Cruz de Oliveira

    2016-01-01

    Smoking is the most preventable and controllable health risk. Therefore, all health care professionals should give their utmost attention to and be more focused on the problem of smoking. Tobacco is a highly profitable product, because of its large-scale production and great number of consumers. Smoking control policies and treatment resources for smoking cessation have advanced in recent years, showing highly satisfactory results, particularly in Brazil. However, there is yet a long way to go before smoking can be considered a controlled disease from a public health standpoint. We can already perceive that the behavior of our society regarding smoking is changing, albeit slowly. Therefore, pulmonologists have a very promising area in which to work with their patients and the general population. We must act with greater impetus in support of health care policies and social living standards that directly contribute to improving health and quality of life. In this respect, pulmonologists can play a greater role as they get more involved in treating smokers, strengthening anti-smoking laws, and demanding health care policies related to lung diseases. RESUMO O tabagismo é o fator de risco mais prevenível e controlável em saúde e, por isso, precisa ter a máxima atenção e ser muito mais enfocado por todos os profissionais da saúde. O tabaco é um produto de alta rentabilidade pela sua grande produção e pelo elevado número de consumidores. As políticas de controle e os recursos terapêuticos para o tabagismo avançaram muito nos últimos anos e têm mostrado resultados altamente satisfatórios, particularmente no Brasil. Entretanto, ainda resta um longo caminho a ser percorrido para que se possa considerar o tabagismo como uma doença controlada sob o ponto de vista da saúde pública. Já se observam modificações do comportamento da sociedade com relação ao tabagismo, mas ainda em escala muito lenta, de modo que os pneumologistas têm nesse setor um campo

  15. Insulin glargine provides greater improvements in glycaemic control vs. intensifying lifestyle management for people with type 2 diabetes treated with OADs and 7-8% A1c levels. The TULIP study.

    Science.gov (United States)

    Blicklé, J-F; Hancu, N; Piletic, M; Profozic, V; Shestakova, M; Dain, M-P; Jacqueminet, S; Grimaldi, A

    2009-04-01

    To determine whether earlier administration of insulin glargine (glargine) vs. the intensification of lifestyle management (LM) improves glycaemic control in type 2 diabetes patients with A1c 7-8% treated with oral therapy. TULIP [Testing the Usefulness of gLargine when Initiated Promptly in type 2 diabetes mellitus (T2DM)] was a 9-month, 12-visit, open-label, multinational, multicentre, randomized study to evaluate starting glargine or intensifying LM in T2DM patients aged 40-75 years, body mass index (BMI) 24-35 kg/m2 and A1c 7-8%, treated with maximum doses of metformin and sulphonylurea for > or = 2 years. Glargine was injected once daily (evening) and titrated to fasting blood glucose 0.7-1.0 g/l. In the LM arm, dietary and physical activity counselling recommended stable weight for people with BMI or = 27 kg/m2. A total of 215 patients were randomized to glargine (n = 106) or LM (n = 109). The primary objective was patients achieving A1c < 7% at endpoint. Secondary endpoints included changes in A1c, in fasting plasma glucose (FPG), body weight and hypoglycaemia incidence. Two hundred and eleven (52.6% male) patients were randomized and treated; mean (+/- s.d.) age 60.7 +/- 7.9 years, weight 84.5 +/- 13.1 kg, BMI 29.9 +/- 3.5 kg/m2 and A1c 7.6 +/- 0.4%. More patients reached A1c < 7% (66 vs. 38%; p < 0.0001) or < 6.5% (34 vs. 11%; p = 0.0001) with glargine vs. LM. The change in FPG from baseline to study endpoint was significantly greater in the glargine vs. the LM arm (-0.50 +/- 0.47 vs. -0.05 +/- 0.39 g/l respectively; p < 0.0001). Compared with the glargine group, the LM group showed a decrease in weight (+0.9 +/- 2.9 vs. -2.5 +/- 3.2 kg; p < 0.0001), as well as the expected lower symptomatic hypoglycaemia (55.3 vs. 25.0%; p < 0.0001) and nocturnal hypoglycaemia (20.4 vs. 5.6%; p = 0.0016). No significant changes were observed from baseline to study endpoint in any of the lipid parameters tested. In patients with T2DM with A1c 7-8%, who were previously

  16. Study to determine the durability of glycaemic control with early treatment with a vildagliptin-metformin combination regimen vs. standard-of-care metformin monotherapy-the VERIFY trial: a randomized double-blind trial.

    Science.gov (United States)

    Del Prato, S; Foley, J E; Kothny, W; Kozlovski, P; Stumvoll, M; Paldánius, P M; Matthews, D R

    2014-10-01

    Durability of good glycaemic control (HbA1c ) is of importance as it can be the foundation for delaying diabetic complications. It has been hypothesized that early initiation of treatment with the combination of oral anti-diabetes agents with complementary mechanisms of action can increase the durability of glycaemic control compared with metformin monotherapy followed by a stepwise addition of oral agents. Dipeptidyl peptidase-4 inhibitors are good candidates for early use as they are efficacious in combination with metformin, show weight neutrality and a low risk of hypoglycaemia. We aimed to test the hypothesis that early combined treatment of metformin and vildagliptin slows β-cell deterioration as measured by HbA1c . Approximately 2000 people with Type 2 diabetes mellitus who were drug-naive or who were treated with metformin for less than 1 month, and who have HbA1c of 48-58 mmol/mol (6.5-7.5%), will be randomized in a 1:1 ratio in VERIFY, a 5-year multinational, double-blind, parallel-group study designed to compare early initiation of a vildagliptin-metformin combination with standard-of-care initiation of metformin monotherapy, followed by the stepwise addition of vildagliptin when glycaemia deteriorates. Further deterioration will be treated with insulin. The primary analysis for treatment failure will be from a Cox proportional hazard regression model and the durability of glycaemic control will be evaluated by assessing treatment failure rate and the rate of loss in glycaemic control over time as co-primary endpoints. VERIFY is the first study to investigate the long-term clinical benefits of early combination treatment vs. the standard-of-care metformin monotherapy with a second agent added by threshold criteria. © 2014 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  17. Maternal Nutrition and Glycaemic Index during Pregnancy Impacts on Offspring Adiposity at 6 Months of Age—Analysis from the ROLO Randomised Controlled Trial

    Directory of Open Access Journals (Sweden)

    Mary K. Horan

    2016-01-01

    Full Text Available Childhood obesity is associated with increased risk of adult obesity and metabolic disease. Diet and lifestyle in pregnancy influence fetal programming; however the influence of specific dietary components, including low glycaemic index (GI, remains complex. We examined the effect of a maternal low GI dietary intervention on offspring adiposity at 6 months and explored the association between diet and lifestyle factors in pregnancy and infant body composition at 6 months. 280 6-month old infant and mother pairs from the control (n = 142 and intervention group (n = 138, who received low GI dietary advice in pregnancy, in the ROLO study were analysed. Questionnaires (food diaries and lifestyle were completed during pregnancy, followed by maternal lifestyle and infant feeding questionnaires at 6 months postpartum. Maternal anthropometry was measured throughout pregnancy and at 6 months post-delivery, along with infant anthropometry. No difference was found in 6 months infant adiposity between control and intervention groups. Maternal trimester three GI, trimester two saturated fats and trimester one and three sodium intake were positively associated with offspring adiposity, while trimester two and three vitamin C intake was negatively associated. In conclusion associations were observed between maternal dietary intake and GI during pregnancy and offspring adiposity at 6 months of age.

  18. Maternal Nutrition and Glycaemic Index during Pregnancy Impacts on Offspring Adiposity at 6 Months of Age--Analysis from the ROLO Randomised Controlled Trial.

    LENUS (Irish Health Repository)

    Horan, Mary K

    2016-01-04

    Childhood obesity is associated with increased risk of adult obesity and metabolic disease. Diet and lifestyle in pregnancy influence fetal programming; however the influence of specific dietary components, including low glycaemic index (GI), remains complex. We examined the effect of a maternal low GI dietary intervention on offspring adiposity at 6 months and explored the association between diet and lifestyle factors in pregnancy and infant body composition at 6 months. 280 6-month old infant and mother pairs from the control (n = 142) and intervention group (n = 138), who received low GI dietary advice in pregnancy, in the ROLO study were analysed. Questionnaires (food diaries and lifestyle) were completed during pregnancy, followed by maternal lifestyle and infant feeding questionnaires at 6 months postpartum. Maternal anthropometry was measured throughout pregnancy and at 6 months post-delivery, along with infant anthropometry. No difference was found in 6 months infant adiposity between control and intervention groups. Maternal trimester three GI, trimester two saturated fats and trimester one and three sodium intake were positively associated with offspring adiposity, while trimester two and three vitamin C intake was negatively associated. In conclusion associations were observed between maternal dietary intake and GI during pregnancy and offspring adiposity at 6 months of age.

  19. Weight gain is associated with improved glycaemic control but with adverse changes in plasma lipids and blood pressure isn Type 1 diabetes.

    LENUS (Irish Health Repository)

    Ferriss, J B

    2012-02-03

    AIMS: To assess the effects of weight gain on metabolic control, plasma lipids and blood pressure in patients with Type 1 diabetes. METHODS: Patients in the EURODIAB Prospective Complications Study (n = 3250) were examined at baseline and 1800 (55%) were re-examined a mean of 7.3 years later. Patients had Type 1 diabetes, defined as a diagnosis made before age 36 years and with a need for continuous insulin therapy within a year of diagnosis. Patients were aged 15-60 years at baseline and were stratified for age, sex and duration of diabetes. RESULTS: The change in HbA(1c) from baseline to follow-up examination was significantly more favourable in those who gained 5 kg or more during follow-up (\\'marked weight gain\\') than in patients who gained less or no weight or lost weight (\\'less or no weight gain\\'). In those with marked weight gain, there was a significantly greater rise in plasma triglycerides and total cholesterol and significantly less favourable changes in low-density lipoprotein and high-density lipoprotein cholesterol compared with those with less or no weight gain, with or without adjustment for HbA(1c). Systolic and diastolic blood pressure also rose significantly more in the group with marked weight gain. CONCLUSION: Weight gain in patients with Type 1 diabetes has adverse effects on plasma lipids and blood pressure, despite a small improvement in glycaemic control.

  20. Sodium‐glucose cotransporter 2 inhibitor luseogliflozin improves glycaemic control, assessed by continuous glucose monitoring, even on a low‐carbohydrate diet

    Science.gov (United States)

    Nishimura, R.; Omiya, H.; Sugio, K.; Ubukata, M.; Sakai, S.

    2016-01-01

    This randomized, double‐blind, placebo‐controlled, crossover study was the first to determine the effects of luseogliflozin in combination with a low‐carbohydrate diet (LCD) on 24‐h glucose variability, assessed by continuous glucose monitoring (CGM). A total of 18 Japanese patients with type 2 diabetes were randomized into two groups, in which patients first received luseogliflozin 2.5 mg once daily then placebo for 8 days each, or vice versa. Patients took luseogliflozin or placebo with a normal‐carbohydrate diet (NCD) on day 7 and with the LCD on day 8. CGM was performed on both days. Luseogliflozin significantly reduced glucose exposure in terms of the area under the curve over the course of 24 h when administered with the NCD (difference vs placebo: −555.6 mg/dl·h [1 mg/dl = 0.0556 mmol/l]; p diet. Although glucose levels were lower with the LCD than with the NCD in the placebo treatment period, luseogliflozin with the LCD improved glycaemic control throughout the day to nearly the same extent as luseogliflozin with the NCD, without inducing hypoglycaemia. PMID:26639943

  1. EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA); Scientific Opinion on the substantiation of health claims related to intense sweeteners and contribution to the maintenance or achievement of a normal body weight (ID 1136, 1444, 4299), reduction of post-prandial glycaemic responses

    DEFF Research Database (Denmark)

    Tetens, Inge

    claims in relation to intense sweeteners and contribution to the maintenance or achievement of a normal body weight, reduction of post-prandial glycaemic responses, maintenance of normal blood glucose concentrations, and maintenance of tooth mineralisation by decreasing tooth demineralisation...... sweeteners, which should replace sugars in foods and beverages in order to obtain the claimed effects. The Panel considers that intense sweeteners are sufficiently characterised in relation to the claimed effects....

  2. A Randomized controlled trial of the effect of yoga and peer support on glycaemic outcomes in women with type 2 diabetes mellitus: a feasibility study.

    Science.gov (United States)

    Sreedevi, Aswathy; Gopalakrishnan, Unnikrishnan Ambika; Karimassery Ramaiyer, Sundaram; Kamalamma, Leelamoni

    2017-02-07

    Type two diabetes is a complex and demanding chronic disease and its impact in a state (Kerala) which leads India in terms of the number of people with Diabetes is profound. Though the male to female ratio among the people with diabetes is roughly equal, women are uniquely and more severely affected. Management of type two Diabetes requires considerable dexterity on the part of the patient to manage drugs, diet and exercise. Therefore, in a low middle-income country like India it is necessary to look at low cost interventions that can empower the patient and build on available resources to help manage diabetes. Hence, we studied the feasibility and effect of two low cost interventions; yoga and peer support on glycaemic and other outcomes among women with type two diabetes. An open label parallel three armed randomized control trial was conducted among 124 recruited women with Diabetes for three months. Block randomization with a block length of six was carried out with each group having at least 41 women. In the Yoga arm, sessions by an instructor, consisting of a group of postures coordinated with breathing were conducted for an hour, two days a week. In the peer support arm each peer mentor after training visited 13-14 women with diabetes every week followed by a phone call. The meeting was about applying disease management or prevention plans in daily life. There was a trend in decline of fasting plasma glucose in the peer and yoga group and of glycosylated haemoglobin (HbA1c) in the yoga group only, though not significant. A significant decrease was observed in diastolic blood pressure and hip circumference in the yoga group. The process indicated that most (80%) of the women in the yoga group attended classes regularly and 90% of the women in the peer group reported that peer mentoring was useful. The effect of yoga and peer support on glycaemic outcomes was incremental. Longer term studies are necessary to ascertain the benefits shown by this feasibility

  3. Metabolic effects of low glycaemic index diets

    Directory of Open Access Journals (Sweden)

    Rusu Emilia

    2009-01-01

    Full Text Available Abstract The persistence of an epidemic of obesity and type 2 diabetes suggests that new nutritional strategies are needed if the epidemic is to be overcome. A promising nutritional approach suggested by this thematic review is metabolic effect of low glycaemic-index diet. The currently available scientific literature shows that low glycaemic-index diets acutely induce a number of favorable effects, such as a rapid weight loss, decrease of fasting glucose and insulin levels, reduction of circulating triglyceride levels and improvement of blood pressure. The long-term effect of the combination of these changes is at present not known. Based on associations between these metabolic parameters and risk of cardiovascular disease, further controlled studies on low-GI diet and metabolic disease are needed.

  4. A new fructose-free, resistant-starch type IV-enriched enteral formula improves glycaemic control and cardiovascular risk biomarkers when administered for six weeks to elderly diabetic patients.

    Science.gov (United States)

    Mesa García, María Dolores; García-Rodríguez, Cruz Erika; Rico, María de la Cruz; Aguilera, Concepción María; Pérez-Rodríguez, Milagros; Pérez-de-la-Cruz, Antonio Jesús; Gil, Ángel

    2017-02-01

    Reducing the dietary glycaemic response has been proposed as a way to reduce the risk of diabetes complications. The aim of the present study was to evaluate the glycaemic control and cardiovascular risk biomarkers in fragile, elderly type 2 diabetes patients after the intake of a new fructose-free diabetes-specific formula enriched with resistant-starch type IV and high in monounsaturated fatty acids. Forty-one type 2 diabetes patients aged 78.9 ± 2.8 years were fed exclusively with an enteral diabetes-specific formula for 6 weeks. Data were collected at baseline and after 6 weeks of feeding. Carbohydrate and lipid metabolism and inflammatory and cardiovascular risk biomarkers were measured to evaluated the course of diabetes complications. Blood glycated haemoglobin significantly decreased after the intervention (6.1 ± 0.1 vs. 5.8 ± 0.1 %; p< 0,045), as well as monocyte chemotactic protein-1 and soluble E-selectin (p < 0.05), while soluble vascular cell adhesion molecule and plasminogen activator inhibitor-1 tended to decrease from baseline to 6 weeks (p = 0.084 and p = 0.05, respectively). The new product improves glycaemic control and cardiovascular risk without altering lipid metabolism, which is useful for the prevention of diabetic complications. Longer intervention studies are needed in order to validate these results in a larger population.

  5. The cross-sectional associations between sense of coherence and diabetic microvascular complications, glycaemic control, and patients' conceptions of type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Saraheimo Markku

    2010-11-01

    Full Text Available Abstract Background Sense of coherence (SOC has been associated with various self-care behaviours in the general population. As the management of type 1 diabetes heavily relies on self-management, the SOC concept could also prove important in this population. This paper is a report of a study conducted among patients with type 1 diabetes to assess the associations between SOC and glycaemic control, microvascular complications, and patients' conceptions of their disease. Methods Altogether 1,264 adult patients (45% men, age range 18-82 years with type 1 diabetes participated in this cross-sectional study. SOC was evaluated using a 13-item SOC questionnaire. Standardized assays were used to determine HbA1c. Nephropathy status was based on albumin excretion rate and retinal laser-treatment was used as an indication of severe retinopathy. Patients' subjective conceptions of diabetes were studied using a questionnaire. Results Higher SOC scores, reflecting stronger SOC, were associated with lower HbA1c values. Strong SOC was independently associated with reaching the HbA1c level 1c, weak SOC was associated with the presence of nephropathy among men, but not women. No associations were observed between SOC and severe retinopathy. Four dimensions describing patients' conceptions of HbA1c, complications, diabetes control and hypoglycaemia were formed from the diabetes questionnaire. Weak SOC was independently associated with worse subjective conceptions in the dimensions of HbA1c and hypoglycaemia. Furthermore among men, an association between weak SOC and the complications factor was observed. Conclusion Interventions to improve patients' SOC, if available, could improve patients' metabolic control and therefore also reduce the incidence of diabetic complications.

  6. Improving glycaemic control and life skills in adolescents with type 1 diabetes: A randomised, controlled intervention study using the Guided Self-Determination-Young method in triads of adolescents, parents and health care providers integrated into routine paediatric outpatient clinics

    Directory of Open Access Journals (Sweden)

    Esbensen Bente

    2011-06-01

    Full Text Available Abstract Background Adolescents with type 1 diabetes face demanding challenges due to conflicting priorities between psychosocial needs and diabetes management. This conflict often results in poor glycaemic control and discord between adolescents and parents. Adolescent-parent conflicts are thus a barrier for health care providers (HCPs to overcome in their attempts to involve both adolescents and parents in improvement of glycaemic control. Evidence-based interventions that involve all three parties (i.e., adolescents, parents and HCPs and are integrated into routine outpatient clinic visits are lacking. The Guided Self-Determination method is proven effective in adult care and has been adapted to adolescents and parents (Guided Self-Determination-Young (GSD-Y for use in paediatric diabetes outpatient clinics. Our objective is to test whether GSD-Y used in routine paediatric outpatient clinic visits will reduce haemoglobin A1c (HbA1c concentrations and improve adolescents' life skills compared with a control group. Methods/Design Using a mixed methods design comprising a randomised controlled trial and a nested qualitative evaluation, we will recruit 68 adolescents age 13 - 18 years with type 1 diabetes (HbA1c > 8.0% and their parents from 2 Danish hospitals and randomise into GSD-Y or control groups. During an 8-12 month period, the GSD-Y group will complete 8 outpatient GSD-Y visits, and the control group will completes an equal number of standard visits. The primary outcome is HbA1c. Secondary outcomes include the following: number of self-monitored blood glucose values and levels of autonomous motivation, involvement and autonomy support from parents, autonomy support from HCPs, perceived competence in managing diabetes, well-being, and diabetes-related problems. Primary and secondary outcomes will be evaluated within and between groups by comparing data from baseline, after completion of the visits, and again after a 6-month follow-up. To

  7. Comparative evaluation of glipizide and fenugreek (Trigonella foenum-graecum seeds as monotherapy and combination therapy on glycaemic control and lipid profile in patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Amandeep Singh

    2016-06-01

    Conclusions: Monotherapy with fenugreek produced significant improvement in glycaemic control and dyslipidaemia. Glipizide monotherapy was more efficacious in controlling FBG and HbA1c levels than fenugreek monotherapy or in combination with fenugreek; glipizide monotherapy had no effect on lipid profile whereas fenugreek monotherapy was more efficacious in controlling dyslipidaemia than in combination with glipizide. Both drugs as monotherapy or in combination were well-tolerated by the patients. [Int J Basic Clin Pharmacol 2016; 5(3.000: 942-950

  8. EFFECT OF AEROBIC EXERCISE, RESISTANCE TRAINING OR COMBINED TRAINING ON GLYCAEMIC CONTROL AND CARDIOVASCULAR RISK FACTORS IN PATIENTS WITH TYPE 2 DIABETES

    Directory of Open Access Journals (Sweden)

    Majid Mobasseri

    2012-04-01

    Full Text Available Physical activity has been proven as a useful intervention for prevention and treatment of type 2 diabetes mellitus (T2DM. The purpose of this article was to compare the effects of aerobic exercise alone and resistance training alone as well as the combination of aerobic plus resistance training on glycaemic control, cardiovascular risk factors, and body composition in patients with T2DM. Eighty T2DM participants (37 men, 43 women, aged 33-69 years, were randomly divided in equal numbers (n=20 into one of four groups (aerobic, resistance, combined training, and control. Exercise training was performed three times per week for 52 weeks. After one year, 60 subjects (15 subjects in each group were entered into the statistical analysis. Seventeen parameters were evaluated. Mean HbA1c showed statistically significant reductions in the three training groups. All subjects of training groups experienced improvement in postprandial glucose, blood pressure, VO2max, and muscular percentage. Furthermore, the reduced concentration of plasma triglycerides was significant in both aerobic exercise and combined training groups. Also, a significant reduction was observed in body fat percentage in resistance and combined groups. Combination of two forms of exercise training led to an additional improvement in some of the parameters such as A1c and triglycerides compared with aerobic alone or resistance training alone. In general, the reported results in previous studies were not obtained for whole lipid profile and BMI. Both aerobic and resistance training are effective interventions for the management of T2DM complications, but combined training is associated with greater positive changes.

  9. A novel and selective sodium-glucose cotransporter-2 inhibitor, tofogliflozin, improves glycaemic control and lowers body weight in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Ikeda, S; Takano, Y; Cynshi, O; Tanaka, R; Christ, A D; Boerlin, V; Beyer, U; Beck, A; Ciorciaro, C; Meyer, M; Kadowaki, T

    2015-10-01

    To assess the efficacy, safety and tolerability of different doses of tofogliflozin, a novel, highly selective sodium-glucose cotransporter 2 (SGLT2) inhibitor, in patients with type 2 diabetes mellitus (T2DM). In a 12-week, multicentre, multinational, randomized, double-blind, parallel-group, placebo-controlled, dose-finding study, patients with inadequate glycaemic control from diet and exercise alone, or from diet and exercise plus a stable dose of metformin, were randomized to one of five doses of tofogliflozin (2.5, 5, 10, 20, or 40 mg) or placebo. The primary efficacy endpoint was absolute change at week 12 from baseline in glycated haemoglobin (HbA1c), minus the change in the placebo group. Statistically significant dose-dependent reductions in HbA1c were shown in all treated groups except the 2.5-mg dose group, with a maximum reduction of 0.56% (placebo-subtracted) at the 40-mg dose, along with increased urinary glucose excretion. Metformin treatment had no substantial influence on tofogliflozin efficacy. Dose-dependent reductions in fasting plasma glucose and body weight were observed, and glucose intolerance was improved, with a trend towards blood pressure reduction. Slight increases were observed for mean ketone bodies with no abnormal change in ketone body ratio. No deaths or treatment-related serious adverse events were reported. The incidence of adverse events was similar in the placebo (37.9%) to that in the tofogliflozin group (35.9-46.3%). Withdrawal because of adverse events was rare (≤2 patients per treatment group), with similar rates of withdrawal in the placebo and tofogliflozin groups. A once-daily dose of tofogliflozin for 12 weeks was an effective, safe and well-tolerated treatment for T2DM. © 2015 John Wiley & Sons Ltd.

  10. Maternal vitamin D status in type 1 diabetic pregnancy: impact on neonatal vitamin D status and association with maternal glycaemic control.

    Directory of Open Access Journals (Sweden)

    Sarah E Bennett

    Full Text Available OBJECTIVE: The first aim of this study was to assess 25-hydroxy vitamin D (25OHD concentrations in women with type 1 diabetes (T1DM during pregnancy, post-delivery and also foetal (cord blood 25OHD concentrations and to examine relationships between these. The second aim of the study was to investigate potential interactions between maternal body mass index (BMI and foetal vitamin D status. A further study aim was to examine potential relationships between maternal 25OHD and glycosylated haemoglobin (HbA1c throughout pregnancy. RESEARCH DESIGN AND METHODS: This was an observational study of 52 pregnant controls without diabetes and 65 pregnant women with T1DM in a university teaching hospital. Maternal serum 25OHD was measured serially throughout the pregnancy and post-delivery. Cord blood 25OHD was measured at delivery. 25OHD was measured by liquid chromatography tandem mass spectrometry (LC-MS/MS. RESULTS: Vitamin D deficiency (25OHD 30 kg/m(2 (nmol/L ± SD; 19.93 ± 11.15 vs. 13.73 ± 4.74, p=0.026]. In the T1DM group, HbA1c at booking was significantly negatively correlated with maternal 25OHD at all 3 trimesters (p=0.004; p=0.001; p=0.05. CONCLUSION: In T1DM pregnancy, low vitamin D levels persist throughout gestation and post-delivery. Cord blood vitamin D levels correlate with those of the mother, and are significantly lower in obese women than in their normal weight counterparts. Maternal vitamin D levels exhibit a significant negative relationship with HbA1c levels, supporting a potential role for this vitamin in maintaining glycaemic control.

  11. Chronic administration of DSP-7238, a novel, potent, specific and substrate-selective DPP IV inhibitor, improves glycaemic control and beta-cell damage in diabetic mice.

    Science.gov (United States)

    Furuta, Y; Horiguchi, M; Sugaru, E; Ono-Kishino, M; Otani, M; Sakai, M; Masui, Y; Tsuchida, A; Sato, Y; Takubo, K; Hochigai, H; Kimura, H; Nakahira, H; Nakagawa, T; Taiji, M

    2010-05-01

    The purpose of this study is to assess the in vitro enzyme inhibition profile of DSP-7238, a novel non-cyanopyrrolidine dipeptidyl peptidase (DPP) IV inhibitor and to evaluate the acute and chronic effects of this compound on glucose metabolism in two different mouse models of type 2 diabetes. The in vitro enzyme inhibition profile of DSP-7238 was assessed using plasma and recombinant enzymes including DPP IV, DPP II, DPP8, DPP9 and fibroblast activation protein alpha (FAPalpha) with fluorogenic substrates. The inhibition type was evaluated based on the Lineweaver-Burk plot. Substrate selectivity of DSP-7238 and comparator DPP IV inhibitors (vildagliptin, sitagliptin, saxagliptin and linagliptin) was evaluated by mass spectrometry based on the changes in molecular weight of peptide substrates caused by release of N-terminal dipeptides. In the in vivo experiments, high-fat diet-induced obese (DIO) mice were subjected to oral glucose tolerance test (OGTT) following a single oral administration of DSP-7238. To assess the chronic effects of DSP-7238 on glycaemic control and pancreatic beta-cell damage, DSP-7238 was administered for 11 weeks to mice made diabetic by a combination of high-fat diet (HFD) and a low-dose of streptozotocin (STZ). After the dosing period, HbA1c was measured and pancreatic damage was evaluated by biological and histological analyses. DSP-7238 and sitagliptin both competitively inhibited recombinant human DPP IV (rhDPP IV) with K(i) values of 0.60 and 2.1 nM respectively. Neither vildagliptin nor saxagliptin exhibited competitive inhibition of rhDPP IV. DSP-7238 did not inhibit DPP IV-related enzymes including DPP8, DPP9, DPP II and FAPalpha, whereas vildagliptin and saxagliptin showed inhibition of DPP8 and DPP9. Inhibition of glucagon-like peptide-1 (GLP-1) degradation by DSP-7238 was apparently more potent than its inhibition of chemokine (C-X-C motif) ligand 10 (IP-10) or chemokine (C-X-C motif) ligand 12 (SDF-1alpha) degradation. In

  12. Lower dose basal insulin infusion has positive effect on glycaemic control for children with type I diabetes on continuous subcutaneous insulin infusion therapy.

    Science.gov (United States)

    Schulten, Ron J; Piet, Jessica; Bruijning, Patricia Cjl; de Waal, Wouter J

    2017-02-01

    The aim of our study was to explore a possible relationship between proportion of basal insulin dose (%BD/T) and glycaemic control in children with type I diabetes on continuous subcutaneous insulin infusion (CSII) therapy. All patients under the age of 18 with type I diabetes mellitus, treated in a general hospital in Utrecht, The Netherlands, who were on CSII therapy between 2000 and 2011 were selected for inclusion. All data as recorded during outpatient visits were retrospectively collected from patients' charts. Analyses were performed using R Statistical Software. Data of 847 outpatient visits of 78 patients [31 males (39.7%) and 47 females (60.3%)] were analyzed. Mean age at diagnosis was 7.1 ± 3.7 yr, mean age at start of pump therapy 10.1 ± 3.8 yr. Mean HbA1c before pump start was 8.3 ± 1.0%, median BMI standard deviation score for age and gender was 0.64 (-1.89-3.79). Median follow-up time per patient was 29 months with an average of 10 visits (range: 3-25). Multivariate analysis revealed that a change of 10% in %BD/T resulted in a decrease or increase of HbA1c of 0.22% [95% confidence interval (CI): 0.15-0.29). No significant effect was observed from SDS BMI, sex, or duration of diabetes. Low dose basal insulin infusion as a percentage of total insulin dose has a positive effect on metabolic outcome as expressed in HbA1c-levels. A change of 10% in %BD/T results in a decrease or increase of HbA1c of 0.22%. This supports the tendency to aim at the lowest basal insulin requirements in pump setting strategy. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. The longitudinal association between glycaemic control and health-related quality of life following insulin therapy optimisation in type 2 diabetes patients. A prospective observational study in secondary care

    DEFF Research Database (Denmark)

    Hajós, Tibor R S; Pouwer, F; de Grooth, R

    2012-01-01

    PURPOSE: To test whether improvement in glycosylated haemoglobin (HbA(1c)) as a marker of glycaemic control, following intensifying insulin therapy, is associated with improvements in HRQoL. METHODS: Dutch sub-optimally controlled (HbA(1c) > 7%) type 2 diabetes patients (N = 447, mean age 59 ± 11...... of optimising insulin therapy and improvement in HRQoL in type 2 diabetes patients has been observed. A weak, yet significant longitudinal association was found between improved HbA(1c) and emotional well-being and diabetes symptom distress....

  14. Day and night glycaemic control with a bionic pancreas versus conventional insulin pump therapy in preadolescent children with type 1 diabetes: a randomised crossover trial.

    Science.gov (United States)

    Russell, Steven J; Hillard, Mallory A; Balliro, Courtney; Magyar, Kendra L; Selagamsetty, Rajendranath; Sinha, Manasi; Grennan, Kerry; Mondesir, Debbie; Ehklaspour, Laya; Zheng, Hui; Damiano, Edward R; El-Khatib, Firas H

    2016-03-01

    The safety and efficacy of continuous, multiday, automated glycaemic management has not been tested in outpatient studies of preadolescent children with type 1 diabetes. We aimed to compare the safety and efficacy of a bihormonal bionic pancreas versus conventional insulin pump therapy in this population of patients in an outpatient setting. In this randomised, open-label, crossover study, we enrolled preadolescent children (aged 6-11 years) with type 1 diabetes (diagnosed for ≥1 year) who were on insulin pump therapy, from two diabetes camps in the USA. With the use of sealed envelopes, participants were randomly assigned in blocks of two to either 5 days with the bionic pancreas or conventional insulin pump therapy (control) as the first intervention, followed by a 3 day washout period and then 5 days with the other intervention. Study allocation was not masked. The autonomously adaptive algorithm of the bionic pancreas received data from a continuous glucose monitoring (CGM) device to control subcutaneous delivery of insulin and glucagon. Conventional insulin pump therapy was administered by the camp physicians and other clinical staff in accordance with their established protocols; participants also wore a CGM device during the control period. The coprimary outcomes, analysed by intention to treat, were mean CGM-measured glucose concentration and the proportion of time with a CGM-measured glucose concentration below 3·3 mmol/L, on days 2-5. This study is registered with ClinicalTrials.gov, number NCT02105324. Between July 20, and Aug 19, 2014, 19 children with a mean age of 9·8 years (SD 1·6) participated in and completed the study. The bionic pancreas period was associated with a lower mean CGM-measured glucose concentration on days 2-5 than was the control period (7·6 mmol/L [SD 0·6] vs 9·3 mmol/L [1·7]; p=0·00037) and a lower proportion of time with a CGM-measured glucose concentration below 3·3 mmol/L on days 2-5 (1·2% [SD 1·1] vs 2·8% [1·2

  15. A comparative evaluation of the glycaemic potential of commercial breads consumed in South East Asia.

    Science.gov (United States)

    Ranawana, Viren; Henry, C Jeya K

    2013-03-01

    Bread has become a widely consumed staple food in South-east Asia. However, there is very little data on the glycaemic potential of local commercial breads. The objective of this study was to comparatively assess the glycaemic potential of some commonly consumed commercial breads using a validated in vitro model. Sixteen types of breads representing the most popular brands and types were evaluated. The results showed that white and enriched white breads had a greater glycaemic potential than wholemeal breads (rapidly digestible starch (RDS) content >450 mg of glucose/g of sample). The lowest glycaemic potential was observed for wholegrain breads (RDS content breads such as pandan bread, milk bread and corn loaf was also examined. Whist the data show that South-east Asian breads have notably differential effects on glycaemia, it highlights the need to formulate Asian dietary guidelines for bread which will enable better food choice and glycaemic control.

  16. The effect of motivational interviewing on glycaemic control and perceived competence of diabetes self-management in patients with type 1 and type 2 diabetes mellitus after attending a group education programme: a randomised controlled trial

    DEFF Research Database (Denmark)

    Rosenbek Minet, L K; Wagner, L; Lønvig, E M

    2011-01-01

    AIMS/HYPOTHESIS: The aim of this study was to measure the efficacy of motivational interviewing (MI) compared with usual care on changes in glycaemic control and competence of diabetes self-management in patients with diabetes mellitus. METHODS: Patients were eligible if they had type 1 or 2...... permuted blocks, with allocation concealment by sequentially numbered, sealed, opaque envelopes. The primary outcome was glycated haemoglobin (HbA(1c)). Analysis regarding measurements of glycated haemoglobin (HbA(1c)) and competence of self-management (using the Problem Areas in Diabetes Scale [PAID......] and Perceived Competence for Diabetes Scale [PCDS]) was based on 298 participants followed for a 24 month period. Data were collected at the Department of Endocrinology at Odense University Hospital. Our hypotheses were that MI could: (1) reduce HbA(1c) levels; (2) increase self-efficacy; and (3) increase...

  17. Major diabetes-related vascular events do not improve glycaemic control in a population-based cohort of type 1 diabetic individuals

    DEFF Research Database (Denmark)

    Mejnert Jørgensen, Trine; Grauslund, Jakob; Sjølie, Anne Katrin;

    2009-01-01

    this in a population-based cohort of patients with long-term type 1 diabetes. Methods: This study was based on a cohort of type 1 diabetes patients with at least 20 years duration of diabetes. Of the 460 patients from the original cohort still alive at 1 January 1994, all patients with a major first-time diabetes......Objective: It is known that sudden serious events alter life styles related to treatment efficiency, as for example in cancer patients. However, it has not been specifically addressed if a first-time diabetes-related clinical event has impact on glycaemic regulation. We therefore assessed...... of the patients. Only a minority worsened or improved their regulation, and in all groups only non-significant changes were seen. Conclusions: Surprisingly, complication-related events did not improve glycaemic regulation in long-term type 1 diabetes patients. This is in contrast with the experience from other...

  18. Maternal Nutrition and Glycaemic Index during Pregnancy Impacts on Offspring Adiposity at 6 Months of Age—Analysis from the ROLO Randomised Controlled Trial

    OpenAIRE

    Horan, Mary K.; Ciara A. McGowan; Gibney, Eileen R.; Jacinta Byrne; Donnelly, Jean M.; McAuliffe, Fionnuala M.

    2016-01-01

    Childhood obesity is associated with increased risk of adult obesity and metabolic disease. Diet and lifestyle in pregnancy influence fetal programming; however the influence of specific dietary components, including low glycaemic index (GI), remains complex. We examined the effect of a maternal low GI dietary intervention on offspring adiposity at 6 months and explored the association between diet and lifestyle factors in pregnancy and infant body composition at 6 months. 280 6-month old inf...

  19. Unchanged gene expression of glycogen synthase in muscle from patients with NIDDM following sulphonylurea-induced improvement of glycaemic control

    DEFF Research Database (Denmark)

    Vestergaard, H; Lund, S; Bjørbaek, C

    1995-01-01

    We have previously shown that the mRNA expression of muscle glycogen synthase is decreased in non-insulin-dependent diabetic (NIDDM) patients; the objective of the present protocol was to examine whether the gene expression of muscle glycogen synthase in NIDDM is affected by chronic sulphonylurea...... treatment. Ten obese patients with NIDDM were studied before and after 8 weeks of treatment with a weight-maintaining diet in combination with the sulphonylurea gliclazide. Gliclazide treatment was associated with significant reductions in HbA1C (p=0.001) and fasting plasma glucose (p=0.005) as well...... metabolism (p=0.02) was demonstrated in teh gliclazide-treated patients when compared to pre-treatment values. In biopsies obtained from vastus lateralis muscle during insulin infusion, the half-maximal activation of glycogen synthase was achieved at a significantly lower concentration of the allosteric...

  20. Phytogenic Polyphenols as Glycogen Phosphorylase Inhibitors: The Potential of Triterpenes and Flavonoids for Glycaemic Control in Type 2 Diabetes.

    Science.gov (United States)

    Leonidas, Demetres D; Hayes, Joseph M; Kato, Atsushi; Skamnaki, Vassiliki T; Chatzileontiadou, Demetra S M; Kantsadi, Anastassia L; Kyriakis, Efthimios; Chetter, Ben A; Stravodimos, George A

    2017-01-01

    Glycogen phosphorylase (GP) is a validated pharmaceutical target for the development of antihyperglycaemic agents. Phytogenic polyphenols, mainly flavonoids and pentacyclic triterpenes, have been found to be potent inhibitors of GP. These compounds have both pharmaceutical and nutraceutical potential for glycemic control in diabetes type 2. This review focuses mainly on the most successful (potent) of these compounds discovered to date. The protein-ligand interactions that form the structural basis of their potencies are discussed, highlighting the potential for exploitation of their scaffolds in the future design of new GP inhibitors. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  1. Impact of insulin pumps on glycaemic control in a pump-naïve paediatric regional population.

    Science.gov (United States)

    de Bock, Martin; Gunn, Alistair Jan; Holt, Jean-Ann; Derraik, José G B; Reed, Peter; Cutfield, Wayne; Mouat, Fran; Hofman, Paul; Jefferies, Craig

    2012-03-01

    To examine the clinical impact of insulin-pump therapy for children with type 1 diabetes mellitus (T1DM) in a regional paediatric service, Auckland, New Zealand. Retrospective analysis of children with T1DM from the Starship paediatric diabetes database who started on insulin-pump therapy from 2002 to 2008 compared with the whole T1DM population and with an equal number of non-pump patients matched by age, sex, ethnicity and duration of diabetes. From 621 subjects with 6680 clinic visits, 75 children were treated with insulin-pump therapy for more than 12 months. Transitioning to insulin-pump treatment was associated with an improvement in HbA1c compared with baseline (-0.3%/year, P pump controls showed a continuing trend to higher HbA1C values (+0.2%/year, P pump start (from 27 (0-223) to 5 (0-0.91) events/100 patient years) with no change in non-pump controls; the rate of diabetic ketoacidosis remained low in both groups. In a pump-naïve regional paediatric population, insulin-pump therapy for T1DM was safe and effective, and associated with sustained improvements in HbA1c and lower risk of hypoglycaemia. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  2. Intensive multifactorial treatment modifies the effect of family history of diabetes on glycaemic control in people with Type 2 diabetes

    DEFF Research Database (Denmark)

    Eliraqi, G M; Vistisen, D; Lauritzen, T

    2015-01-01

    pressure, lipids and HbA1c) after 5 years of follow-up in participants with and without a family history of diabetes. An interaction term between family history of diabetes and treatment group was included in the models to test for a modifying effect of the intervention. All analyses were adjusted for age......Aim To investigate whether intensive multifactorial treatment can reverse the predisposed adverse phenotype of people with Type 2 diabetes who have a family history of diabetes. Methods Data from the randomized controlled trial ADDITION-Denmark were used. A total of 1441 newly diagnosed patients...... with diabetes (598 with family history of diabetes) were randomized to intensive treatment or routine care. Family history of diabetes was defined as having one parent and/or sibling with diabetes. Linear mixed-effects models were used to assess the changes in risk factors (BMI, waist circumference, blood...

  3. Dietary glycaemic index from an epidemiological point of view

    NARCIS (Netherlands)

    Feskens, E.J.M.; Du, H.

    2006-01-01

    The concept of glycaemic index (GI) was developed 25 years ago by Jenkins and co-workers in 1981 and first studied to help diabetic patients with blood glucose control. In 1997 two epidemiological studies were published showing that high GI food consumption is associated with an increased risk of ty

  4. The effect of the glycaemic response of three commonly consumed ...

    African Journals Online (AJOL)

    2015-06-30

    Jun 30, 2015 ... classifying glycaemic response to carbohydrate-containing foods. The GI is ... food is a scale used to classify the quality of carbohydrate consumed ..... management of diabetes: a meta-analysis of randomized controlled trials. ... insulinemic index and soy beverage with low and high in Carbohydrates.

  5. Glycaemic control with modified intensive insulin injections (MII) using insulin pens and premixed insulin in children with type-1 diabetes: a randomized controlled trial.

    Science.gov (United States)

    Soliman, Ashraf T; Omar, Magdi; Rizk, Mostafa M; El Awwa, Ahmad; AlGhobashy, Fatma M

    2006-08-01

    The objective of this study was to compare glycemic control and insulin dosage in children with type 1 diabetes treated by a modified intensified insulin therapy MII using insulin pens (and premixed and regular insulin) with those on conventional insulin therapy. This was a longitudinal, randomized controlled trial for 6 months or more. From a cohort of 125 children with previously diagnosed type-1 diabetes (more than a year after diagnosis) two groups were randomly selected Group AI (n=20) and Group B (n=20). Group AI children and 10 children with recently diagnosed type 1 diabetes (Group AII) were allocated to MII using regular insulin and premixed insulin (30/70 and 40/60 and 50/50). Group B patients continued their conventional insulin therapy for the whole period of the trial. The main outcome measures were glycemic control measured by mean blood glucose concentration and percentage of glycated haemoglobin and total daily insulin dose. Mean blood glucose concentrations before the three main meals, and at midnight, (148, 147, 179 and 127 mg/dl, respectively) were lower in children receiving intensified MII compared with those receiving conventional insulin therapy (192, 174, 194 and 179 mg/dl, respectively) (standardized mean difference 34+/-15 mg/dl), equivalent to a difference of 1.9+/-0.8 mmol/l. This improved control during MII was achieved with no change in the average daily insulin dose in group-AI. In group-AII insulin dose decreased significantly during their first 6 moths of treatment (honeymooning). Glycemic control is better during MII using insulin pens and premixed and regular insulin compared with conventional insulin therapy, without any significant change in insulin dose needed to achieve this level of control. The difference in glycemic control between the two methods is significant and could reduce the risk of micro-vascular complications.

  6. Maximal entanglement achievable by controlled dynamics

    CERN Document Server

    Serafini, Alessio

    2009-01-01

    We consider the feedback control of quantum systems comprised of any number of bosonic degrees of freedom. We derive a general upper bound for the logarithmic negativity achievable, at steady state, with continuous Gaussian measurements on the environment and linear driving on the system. Our results apply to rotating wave system-bath couplings and to any quadratic system's Hamiltonian. Furthermore, we apply this upper bound to parametric processes, show it to be tight, and compare it to feedback strategies limited to local measurements.

  7. A randomised control trial of low glycaemic index carbohydrate diet versus no dietary intervention in the prevention of recurrence of macrosomia.

    LENUS (Irish Health Repository)

    Walsh, Jennifer

    2010-01-01

    Maternal weight and maternal weight gain during pregnancy exert a significant influence on infant birth weight and the incidence of macrosomia. Fetal macrosomia is associated with an increase in both adverse obstetric and neonatal outcome, and also confers a future risk of childhood obesity. Studies have shown that a low glycaemic diet is associated with lower birth weights, however these studies have been small and not randomised 12. Fetal macrosomia recurs in a second pregnancy in one third of women, and maternal weight influences this recurrence risk 3.

  8. The DiGEM trial protocol – a randomised controlled trial to determine the effect on glycaemic control of different strategies of blood glucose self-monitoring in people with type 2 diabetes [ISRCTN47464659

    Directory of Open Access Journals (Sweden)

    Goyder Elizabeth

    2005-06-01

    Full Text Available Abstract Background We do not yet know how to use blood glucose self-monitoring (BGSM most effectively in the self-management of type 2 diabetes treated with oral medication. Training in monitoring may be most effective in improving glycaemic control and well being when results are linked to behavioural change. Methods/design DiGEM is a three arm randomised parallel group trial set in UK general practices. A total of 450 patients with type 2 diabetes managed with lifestyle or oral glucose lowering medication are included. The trial compares effectiveness of three strategies for monitoring glycaemic control over 12 months (1 a control group with three monthly HbA1c measurements; interpreted with nurse-practitioner; (2 A self-testing of blood glucose group; interpreted with nurse- practitioner to inform adjustment of medication in addition to 1; (3 A self-monitoring of blood glucose group with personal use of results to interpret results in relation to lifestyle changes in addition to 1 and 2. The trial has an 80% power at a 5% level of significance to detect a difference in change in the primary outcome, HbA1c of 0.5% between groups, allowing for an attrition rate of 10%. Secondary outcome measures include health service costs, well-being, and the intervention effect in sub-groups defined by duration of diabetes, current management, health status at baseline and co-morbidity. A mediation analysis will explore the extent to which changes in beliefs about self-management of diabetes between experimental groups leads to changes in outcomes in accordance with the Common Sense Model of illness. The study is open and has recruited more than half the target sample. The trial is expected to report in 2007. Discussion The DiGEM intervention and trial design address weaknesses of previous research by use of a sample size with power to detect a clinically significant change in HbA1c, recruitment from a well-characterised primary care population, definition

  9. Achieving micelle control through core crystallinity.

    Science.gov (United States)

    Glavas, Lidija; Olsén, Peter; Odelius, Karin; Albertsson, Ann-Christine

    2013-11-11

    We have designed a pathway for controlling the critical micelle concentration and micelle size of polyester-based systems. This was achieved by creating an array of different copolymers with semicrystalline or amorphous hydrophobic blocks. The hydrophobic block was constructed through ring-opening polymerization of ε-caprolactone, L-lactide, and ε-decalactone, either as homopolymers or random copolymers, using PEG as both the initiator and the hydrophilic block. Micelles formed with amorphous cores exhibited considerably higher critical micelle concentrations than those with semicrystalline cores. Micelles with amorphous cores also became larger in size with an increased molecular weight of the hydrophobic bock, in contrast to micelles with semicrystalline cores, which displayed the opposite behavior. Hence, core crystallinity was found to be a potent tool for tailoring micelle properties and thereby facilitating the optimization of drug delivery systems. The introduction of PEG-PεDL also proved to be a valuable asset in the tuning of micelle properties.

  10. Enriching the Hierarchical Model of Achievement Motivation: Autonomous and Controlling Reasons Underlying Achievement Goals

    Science.gov (United States)

    Michou, Aikaterini; Vansteenkiste, Maarten; Mouratidis, Athanasios; Lens, Willy

    2014-01-01

    Background: The hierarchical model of achievement motivation presumes that achievement goals channel the achievement motives of need for achievement and fear of failure towards motivational outcomes. Yet, less is known whether autonomous and controlling reasons underlying the pursuit of achievement goals can serve as additional pathways between…

  11. Efficacy of the sibutramine in the insulin resistance and glycaemic control of obese patients / Eficacia de la sibutramina en la resistencia insulínica y el control glucémico de pacientes obesos

    Directory of Open Access Journals (Sweden)

    Pereira LRL

    2005-12-01

    Full Text Available Objective: This paper compared the effects of the sibutramine and of the metformin in the patients' obesity bearers insulin resistance. Methods: They were appraised 16 subjects obese with IMC above 30 Kg/m2, during 6 months and divided in two groups. The patients, before they begin the study, they were submitted to an evaluation anthropometric, clinic and laboratorial. All the patients received an individualized alimentary plan, respecting the total energy expense daily. Results: At the end of the study, it was observed that the plasmatic concentrations of insulin suffered reduction of 12,1% (sibutramine and 20,7% (metformin, and the values of HOMA also suffered reduction of 11,2% and 23,5%, respectively in the group sibutramine and metformin. In compensation, the patients of the group sibutramine obtained more satisfactory results than the group metformin in the reduction of the corporal weight and in IMC.Conclusion: This study demonstrated that the sibutramine, when compared to the metformin, it presents good results in the patients' glycaemic control, mainly in the insulin values and HOMA. The sibutramine, when prescribed in a rational way, an important therapeutic tool can be considered in the control of the diabetes type 2 and others adjunct pathology, however it should always be used simultaneous with an agent antidiabetic in those patient ones.

  12. Effects of low glycaemic index/low glycaemic load vs. high glycaemic index/ high glycaemic load diets on overweight/obesity and associated risk factors in children and adolescents: a systematic review and meta-analysis.

    Science.gov (United States)

    Schwingshackl, Lukas; Hobl, Lisa Patricia; Hoffmann, Georg

    2015-08-25

    The objective of the present systematic review and meta-analysis was to synthesize the available literature data investigating the effects of low glycaemic index/low glycamic load dietary regimens on anthropometric parameters, blood lipid profiles, and indicators of glucose metabolism in children and adolescents. Literature search was performed using the electronic databases MEDLINE, EMBASE, and the Cochrane Central Register of trials with restrictions to randomized controlled trials, but no limitations concerning language and publication date. Parameters taken into account were: body weight, body mass index, z-score of body mass index, fat mass, fat-free mass, height, waist cicrumference, hip circumference, waist-to-hip ratio, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, diastolic and systolic blood pressure, fasting serum glucose, fasting serum insulin, HOMA-index, glycosylated haemoglobin, and C-reactive protein. Meta-analyses were performed for each parameter to assess pooled effect in terms of weighted mean differences between the post-intervention (or differences in means) of the low glycaemic index diets and the respective high glycaemic index counterparts. Data analysis was performed using the Review Manager 5.3. software. Nine studies enrolling 1.065 children or adolescents met the inclusion criteria. Compared to diets providing a high gylcaemic index, low glycaemic index protocols resulted in significantly more pronounced decreases in serum triglycerides [mean differences -15.14 mg/dl, 95%-CI (-26.26, -4.00)] and HOMA-index [mean difference -0.70, 95%-CI (-1.37, -0.04), fixed-effects model only]. Other parameters under investigation were not affected by either low or high glycaemic indices. The present systematic review and meta-analysis provides evidence of a beneficial effect of a low glycaemic index/load diet in children and adolescents being either overweight or obese. Regarding the limitations of this analysis, further studies

  13. Glycaemic index and glycaemic load of selected popular foods consumed in Southeast Asia.

    Science.gov (United States)

    Sun, Lijuan; Lee, Davina Elizabeth Mei; Tan, Wei Jie Kevin; Ranawana, Dinesh Viren; Quek, Yu Chin Rina; Goh, Hui Jen; Henry, Christiani Jeyakumar

    2015-03-14

    The objective of the present study was to determine the glycaemic index (GI) and glycaemic load (GL) values of standard portion sizes of Southeast Asian traditional foods. A total of fifteen popular Southeast Asian foods were evaluated. Of these foods, three were soft drinks, while the other twelve were solid foods commonly consumed in this region. In total, forty-seven healthy participants (eighteen males and twenty-nine females) volunteered to consume either glucose at least twice or one of the fifteen test foods after a 10-12 h overnight fast. Blood glucose concentrations were analysed before consumption of the test food, and 15, 30, 45, 60, 90 and 120 min after food consumption, using capillary blood samples. The GI value of each test food was calculated by expressing the incremental area under the blood glucose response curve (IAUC) value of the test food as a percentage of each participant's average IAUC value, with glucose as the reference food. Among the fifteen foods tested, six belonged to low-GI foods (Ice Green Tea, Beehoon, Pandan Waffle, Curry Puff, Youtiao and Kaya Butter Toast), three belonged to medium-GI foods (Barley Drink, Char Siew Pau and Nasi Lemak), and the other six belonged to high-GI foods (Ice Lemon Tea, Chinese Carrot Cake, Chinese Yam Cake, Chee Cheong Fun, Lo Mai Gai and Pink Rice Cake). The GI and GL values of these traditional foods provide valuable information to consumers, researchers and dietitians on the optimal food choice for glycaemic control. Moreover, our dataset provides GI values of fifteen foods that were not previously tested extensively, and it presents values of foods commonly consumed in Southeast Asia.

  14. Dietary carbohydrate intake, glycaemic load, glycaemic index and ovarian cancer risk in African-American women.

    Science.gov (United States)

    Qin, Bo; Moorman, Patricia G; Alberg, Anthony J; Barnholtz-Sloan, Jill S; Bondy, Melissa; Cote, Michele L; Funkhouser, Ellen; Peters, Edward S; Schwartz, Ann G; Terry, Paul; Schildkraut, Joellen M; Bandera, Elisa V

    2016-02-28

    Epidemiological evidence regarding the association between carbohydrate intake, glycaemic load (GL) and glycaemic index (GI) and risk of ovarian cancer has been mixed. Little is known about their impact on ovarian cancer risk in African-American women. Associations between carbohydrate quantity and quality and ovarian cancer risk were investigated among 406 cases and 609 controls using data from the African American Cancer Epidemiology Study (AACES). AACES is an ongoing population-based case-control study of ovarian cancer in African-Americans in the USA. Cases were identified through rapid case ascertainment and age- and site-matched controls were identified by random-digit dialling. Dietary information over the year preceding diagnosis or the reference date was obtained using a FFQ. Multivariable logistic regression models were used to estimate odds ratios and 95% CI adjusted for covariates. The OR comparing the highest quartile of total carbohydrate intake and total sugar intake v. the lowest quartile were 1·57 (95% CI 1·08, 2·28; P trend=0·03) and 1·61 (95% CI 1·12, 2·30; P trendcancer (OR 1·18 for each 10 units/4184 kJ (1000 kcal); 95% CI 1·04, 1·33). No associations were observed for starch or GI. Our findings suggest that high intake of total sugars and GL are associated with greater risk of ovarian cancer in African-American women.

  15. Glycaemic Response to Quality Protein Maize Grits

    Directory of Open Access Journals (Sweden)

    Leonora N. Panlasigui

    2010-01-01

    Full Text Available Background. Carbohydrates have varied rates of digestion and absorption that induces different hormonal and metabolic responses in the body. Given the abundance of carbohydrate sources in the Philippines, the determination of the glycaemic index (GI of local foods may prove beneficial in promoting health and decreasing the risk of diabetes in the country. Methods. The GI of Quality Protein Maize (QPM grits, milled rice, and the mixture of these two food items were determined in ten female subjects. Using a randomized crossover design, the control bread and three test foods were given on separate occasions after an overnight fast. Blood samples were collected through finger prick at time intervals of 0, 15, 30, 45, 60, 90, and 120 min and analyzed for glucose concentrations. Results. The computed incremental area under the glucose response curve (IAUC varies significantly across test foods (P<.0379 with the pure QPM grits yielding the lowest IAUC relative to the control by 46.38. Resulting GI values of the test foods (bootstrapped were 80.36 (SEM 14.24, 119.78 (SEM 18.81, and 93.17 (SEM 27.27 for pure QPM grits, milled rice, and rice-QPM grits mixture, respectively. Conclusion. Pure QPM corn grits has a lower glycaemic response compared to milled rice and the rice-corn grits mixture, which may be related in part to differences in their dietary fibre composition and physicochemical characteristics. Pure QPM corn grits may be a more health beneficial food for diabetic and hyperlipidemic individuals.

  16. Enriching the hierarchical model of achievement motivation: autonomous and controlling reasons underlying achievement goals.

    Science.gov (United States)

    Michou, Aikaterini; Vansteenkiste, Maarten; Mouratidis, Athanasios; Lens, Willy

    2014-12-01

    The hierarchical model of achievement motivation presumes that achievement goals channel the achievement motives of need for achievement and fear of failure towards motivational outcomes. Yet, less is known whether autonomous and controlling reasons underlying the pursuit of achievement goals can serve as additional pathways between achievement motives and outcomes. We tested whether mastery approach, performance approach, and performance avoidance goals and their underlying autonomous and controlling reasons would jointly explain the relation between achievement motives (i.e., fear of failure and need for achievement) and learning strategies (Study 1). Additionally, we examined whether the autonomous and controlling reasons underlying learners' dominant achievement goal would account for the link between achievement motives and the educational outcomes of learning strategies and cheating (Study 2). Six hundred and six Greek adolescent students (Mage = 15.05, SD = 1.43) and 435 university students (Mage M = 20.51, SD = 2.80) participated in studies 1 and 2, respectively. In both studies, a correlational design was used and the hypotheses were tested via path modelling. Autonomous and controlling reasons underlying the pursuit of achievement goals mediated, respectively, the relation of need for achievement and fear of failure to aspects of learning outcomes. Autonomous and controlling reasons underlying achievement goals could further explain learners' functioning in achievement settings. © 2014 The British Psychological Society.

  17. The effect of a cinnamon-, chromium- and magnesium-formulated honey on glycaemic control, weight loss and lipid parameters in type 2 diabetes: an open-label cross-over randomised controlled trial.

    Science.gov (United States)

    Whitfield, Patricia; Parry-Strong, Amber; Walsh, Emily; Weatherall, Mark; Krebs, Jeremy D

    2016-04-01

    This randomised controlled trial assessed the acute and long-term effects of daily supplementation of kanuka honey, formulated with cinnamon, chromium and magnesium on glucose metabolism, weight and lipid parameters in individuals with type 2 diabetes. Twelve individuals with type 2 diabetes received 53.5 g of a formulated honey and a control (non-formulated) kanuka honey in a random order for 40 days, using cross-over design. Fasting glucose, insulin, HbA1c, lipids and anthropometric measures were measured at baseline and end of treatment. A meal tolerance test was performed at baseline to assess acute metabolic response. There was no statistically significant difference in acute glucose metabolism between treatment groups, as measured by the Matsuda index and AUC for glucose and insulin. After the 40-day intervention with honey, fasting glucose did not differ significantly between the two treatments (95 % CI -2.6 to 0.07). There was no statistically significant change in HbA1c or fasting insulin. There was a statistically significant reduction in total cholesterol by -0.29 mmol/L (95 % CI -0.57 to -0.23), LDL cholesterol by -0.29 mmol/L (95 % CI -0.57 to -0.23) and weight by -2.2 kg (95 % CI -4.2 to -0.1). There was a trend towards increased HDL and reduced systolic blood pressure in the intervention treatment. The addition of cinnamon, chromium and magnesium supplementation to kanuka honey was not associated with a significant improvement in glucose metabolism or glycaemic control in individuals with type 2 diabetes. Use of the formulated honey was associated with a reduction in weight and improvements in lipid parameters, and should be investigated further.

  18. Comparison of dual-hormone artificial pancreas, single-hormone artificial pancreas, and conventional insulin pump therapy for glycaemic control in patients with type 1 diabetes: an open-label randomised controlled crossover trial.

    Science.gov (United States)

    Haidar, Ahmad; Legault, Laurent; Messier, Virginie; Mitre, Tina Maria; Leroux, Catherine; Rabasa-Lhoret, Rémi

    2015-01-01

    range between single-hormone artificial pancreas and conventional insulin pump therapy was 11% (17; p=0·002) and between dual-hormone artificial pancreas and conventional insulin pump therapy was 12% (21; p=0·00011). There was no difference (15; p=0·75) in the proportion of time spent in the target range between the single-hormone and dual-hormone artificial pancreas systems. There were 52 hypoglycaemic events with conventional insulin pump therapy (12 of which were symptomatic), 13 with the single-hormone artificial pancreas (five of which were symptomatic), and nine with the dual-hormone artificial pancreas (0 of which were symptomatic); the number of nocturnal hypoglycaemic events was 13 (0 symptomatic), 0, and 0, respectively. Single-hormone and dual-hormone artificial pancreas systems both provided better glycaemic control than did conventional insulin pump therapy. The single-hormone artificial pancreas might be sufficient for hypoglycaemia-free overnight glycaemic control. Canadian Diabetes Association; Fondation J A De Sève; Juvenile Diabetes Research Foundation; and Medtronic. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Estimates of Savings Achievable from Irrigation Controller

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Alison; Fuchs, Heidi; Whitehead, Camilla Dunham

    2014-03-28

    This paper performs a literature review and meta-analysis of water savings from several types of advanced irrigation controllers: rain sensors (RS), weather-based irrigation controllers (WBIC), and soil moisture sensors (SMS).The purpose of this work is to derive average water savings per controller type, based to the extent possible on all available data. After a preliminary data scrubbing, we utilized a series of analytical filters to develop our best estimate of average savings. We applied filters to remove data that might bias the sample such as data self-reported by manufacturers, data resulting from studies focusing on high-water users, or data presented in a non-comparable format such as based on total household water use instead of outdoor water use. Because the resulting number of studies was too small to be statistically significant when broken down by controller type, this paper represents a survey and synthesis of available data rather than a definitive statement regarding whether the estimated water savings are representative.

  20. A Cross-Sectional Study Demonstrating Increased Serum Amyloid A Related Inflammation in High-Density Lipoproteins from Subjects with Type 1 Diabetes Mellitus and How this Association Was Augmented by Poor Glycaemic Control.

    Science.gov (United States)

    McEneny, Jane; Daniels, Jane-Ann; McGowan, Anne; Gunness, Anjuli; Moore, Kevin; Stevenson, Michael; Young, Ian S; Gibney, James

    2015-01-01

    Inflammatory atherosclerosis is increased in subjects with type 1 diabetes mellitus (T1DM). Normally high-density lipoproteins (HDL) protect against atherosclerosis; however, in the presence of serum amyloid-A- (SAA-) related inflammation this property may be reduced. Fasting blood was obtained from fifty subjects with T1DM, together with fifty age, gender and BMI matched control subjects. HDL was subfractionated into HDL2 and HDL3 by rapid ultracentrifugation. Serum-hsCRP and serum-, HDL2-, and HDL3-SAA were measured by ELISAs. Compared to control subjects, SAA was increased in T1DM subjects, nonsignificantly in serum (P = 0.088), and significantly in HDL2(P = 0.003) and HDL3(P = 0.005). When the T1DM group were separated according to mean HbA1c (8.34%), serum-SAA and HDL3-SAA levels were higher in the T1DM subjects with HbA1c ≥ 8.34%, compared to when HbA1c was 0.05). This cross-sectional study demonstrated increased SAA-related inflammation in subjects with T1DM that was augmented by poor glycaemic control. We suggest that SAA is a useful inflammatory biomarker in T1DM, which may contribute to their increased atherosclerosis risk.

  1. A Cross-Sectional Study Demonstrating Increased Serum Amyloid A Related Inflammation in High-Density Lipoproteins from Subjects with Type 1 Diabetes Mellitus and How This Association Was Augmented by Poor Glycaemic Control

    Directory of Open Access Journals (Sweden)

    Jane McEneny

    2015-01-01

    Full Text Available Inflammatory atherosclerosis is increased in subjects with type 1 diabetes mellitus (T1DM. Normally high-density lipoproteins (HDL protect against atherosclerosis; however, in the presence of serum amyloid-A- (SAA- related inflammation this property may be reduced. Fasting blood was obtained from fifty subjects with T1DM, together with fifty age, gender and BMI matched control subjects. HDL was subfractionated into HDL2 and HDL3 by rapid ultracentrifugation. Serum-hsCRP and serum-, HDL2-, and HDL3-SAA were measured by ELISAs. Compared to control subjects, SAA was increased in T1DM subjects, nonsignificantly in serum (P=0.088, and significantly in HDL2(P=0.003 and HDL3(P=0.005. When the T1DM group were separated according to mean HbA1c (8.34%, serum-SAA and HDL3-SAA levels were higher in the T1DM subjects with HbA1c ≥ 8.34%, compared to when HbA1c was 0.05. This cross-sectional study demonstrated increased SAA-related inflammation in subjects with T1DM that was augmented by poor glycaemic control. We suggest that SAA is a useful inflammatory biomarker in T1DM, which may contribute to their increased atherosclerosis risk.

  2. Effect of artificial pancreas systems on glycaemic control in patients with type 1 diabetes: a systematic review and meta-analysis of outpatient randomised controlled trials.

    Science.gov (United States)

    Weisman, Alanna; Bai, Johnny-Wei; Cardinez, Marina; Kramer, Caroline K; Perkins, Bruce A

    2017-07-01

    Closed-loop artificial pancreas systems have been in development for several years, including assessment in numerous varied outpatient clinical trials. We aimed to summarise the efficacy and safety of artificial pancreas systems in outpatient settings and explore the clinical and technical factors that can affect their performance. We did a systematic review and meta-analysis of randomised controlled trials comparing artificial pancreas systems (insulin only or insulin plus glucagon) with conventional pump therapy (continuous subcutaneous insulin infusion [CSII] with blinded continuous glucose monitoring [CGM] or unblinded sensor-augmented pump [SAP] therapy) in adults and children with type 1 diabetes. We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials for studies published from 1946, to Jan 1, 2017. We excluded studies not published in English, those involving pregnant women or participants who were in hospital, and those testing adjunct medications other than glucagon. The primary outcome was the mean difference in percentage of time blood glucose concentration remained in target range (3·9-10 mmol/L or 3·9-8 mmol/L, depending on the study), assessed by random-effects meta-analysis. This study is registered with PROSPERO, number 2015:CRD42015026854. We identified 984 reports; after exclusions, 27 comparisons from 24 studies (23 crossover and one parallel design) including a total of 585 participants (219 in adult studies, 265 in paediatric studies, and 101 in combined studies) were eligible for analysis. Five comparisons assessed dual-hormone (insulin and glucagon), two comparisons assessed both dual-hormone and single-hormone (insulin only), and 20 comparisons assessed single-hormone artificial pancreas systems. Time in target was 12·59% higher with artificial pancreas systems (95% CI 9·02-16·16; psystems were associated with a greater improvement in time in target range compared with single-hormone systems (19·52% [95% CI

  3. Is self-monitoring of blood glucose effective in improving glycaemic control in type 2 diabetes without insulin treatment: a meta-analysis of randomised controlled trials

    Science.gov (United States)

    Zhu, Hongmei; Zhu, Yanan; Leung, Siu-wai

    2016-01-01

    Objective The present study aimed to verify the effectiveness of self-monitoring of blood glucose (SMBG) in patients with non-insulin-treated type 2 diabetes (T2D). Methods A comprehensive literature search was conducted in PubMed, Cochrane Library, Web of Science, ScienceDirect and ClinicalTrials.gov from their respective inception dates to 26 October 2015. Eligible randomised controlled trials (RCTs) were included according to prespecified criteria. The quality of the included RCTs was evaluated according to the Cochrane risk of bias tool, and the evidence quality of meta-analyses was assessed by the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) criteria. A meta-analysis of primary and secondary outcome measures was performed. Sensitivity and subgroup analyses were carried out to evaluate the robustness and heterogeneity of the findings. Begg's and Egger's tests were used to quantify publication biases. Results A total of 15 RCTs, comprising 3383 patients with non-insulin-treated T2D, met the inclusion criteria. The SMBG intervention improved glycated haemoglobin (HbA1c) (mean difference −0.33; 95% CI −0.45 to −0.22; p=3.0730e−8; n=18), body mass index (BMI; −0.65; −1.18 to −0.12; p=0.0164; n=9) and total cholesterol (TC; −0.12; −0.20 to −0.04; p=0.0034; n=8) more effectively than the control in overall effect. The sensitivity analysis revealed little difference in overall effect, indicating the robustness of the results. SMBG moderated HbA1c levels better than the control in all subgroup analyses. Most of the RCTs had high risk of bias in blinding, while the overall quality of evidence for HbA1c was moderate according to the GRADE criteria. Publication bias was moderate for BMI. Conclusions SMBG improved HbA1c levels in the short term (≤6-month follow-up) and long term (≥12-month follow-up) in patients with T2D who were not using insulin. Trial registration number CRD42015019099. PMID:27591016

  4. Residential Mobility, Inhibitory Control, and Academic Achievement in Preschool

    Science.gov (United States)

    Schmitt, Sara A.; Finders, Jennifer K.; McClelland, Megan M.

    2015-01-01

    Research Findings: The present study investigated the direct effects of residential mobility on children's inhibitory control and academic achievement during the preschool year. It also explored fall inhibitory control and academic skills as mediators linking residential mobility and spring achievement. Participants included 359 preschool…

  5. Achieving Control of Coating Process in your Foundry

    DEFF Research Database (Denmark)

    Di Muoio, G. L.; Tiedje, N. S.

    2015-01-01

    Achieving control of coating thickness in foundry moulds is needed in order to guarantee uniform properties of the mould but also to achieve control of drying time. Since drying time of water based coatings is heavily dependent on the amount of water present in the coating layer, a stable coating...

  6. Fasting plasma triglycerides predict the glycaemic response to treatment of type 2 diabetes by gastric electrical stimulation. A novel lipotoxicity paradigm.

    Science.gov (United States)

    Lebovitz, H E; Ludvik, B; Yaniv, I; Haddad, W; Schwartz, T; Aviv, R

    2013-06-01

    Non-stimulatory, meal-mediated electrical stimulation of the stomach (TANTALUS-DIAMOND) improves glycaemic control and causes modest weight loss in patients with Type 2 diabetes who are inadequately controlled on oral anti-diabetic medications. The magnitude of the glycaemic response in clinical studies has been variable. A preliminary analysis of data from patients who had completed 6 months of treatment indicated that the glycaemic response to the electrical stimulation was inversely related to the baseline fasting plasma triglyceride level. An analysis of 40 patients who had had detailed longitudinal studies for 12 months. Twenty-two patients with fasting plasma triglycerides ≤ 1.7 mmol/l had mean decreases in HbA1c after 3, 6 and 12 months of gastric contraction modulation treatment of -15 ± 2.1 mmol/mol (-1.39 ± 0.20%), -16 ± 2.2 mmol/mol (-1.48 ± 0.20%) and -14 ± 3.0 mmol/mol (-1.31 ± 0.26%), respectively. In contrast, 18 patients with fasting plasma triglyceride > 1.7 mmol/l had mean decreases in HbA1c of -7 ± 1.7 mmol/mol (-0.66 ± 0.16%), -5 ± 1.6 mmol/mol (-0.44 ± 0.18%) and -5 ± 1.7 mmol/mol (-0.42 ± 0.16%), respectively. Pearson's correlation coefficient between fasting plasma triglyceride and decreases in HbA1c at 12 months of treatment was 0.34 (P triglycerides, while it progressively improved in patients with low fasting plasma triglycerides. Patients with low fasting plasma triglycerides had a tendency to lose more weight than those with high fasting plasma triglycerides, but this did not achieve statistical significance. The data presented suggest the existence of a triglyceride lipotoxic mechanism that interferes with gastric/neural mediated pathways that can regulate glycaemic control in patients with type 2 diabetes. The data suggest the existence of a triglyceride lipotoxic pathway that interferes with gastric/neural mediated pathways that can regulate glycaemic control. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

  7. Food Intake and Dietary Glycaemic Index in Free-Living Adults with and without Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Alexandra M. Johnstone

    2011-06-01

    Full Text Available A recent Cochrane review concluded that low glycaemic index (GI diets are beneficial in glycaemic control for patients with type 2 diabetes mellitus (T2DM. There are limited UK data regarding the dietary GI in free-living adults with and without T2DM. We measured the energy and macronutrient intake and the dietary GI in a group (n = 19 of individuals with diet controlled T2DM and a group (n = 19 without diabetes, matched for age, BMI and gender. Subjects completed a three-day weighed dietary record. Patients with T2DM consumed more daily portions of wholegrains (2.3 vs. 1.1, P = 0.003, more dietary fibre (32.1 vs. 20.9 g, P < 0.001 and had a lower diet GI (53.5 vs. 57.7, P = 0.009 than subjects without T2DM. Both groups had elevated fat and salt intake and low fruit and vegetable intake, relative to current UK recommendations. Conclusions: Patients with T2DM may already consume a lower GI diet than the general population but further efforts are needed to reduce dietary GI and achieve other nutrient targets.

  8. Effortful Control and Academic Achievement in Rural China

    Science.gov (United States)

    Zhang, Li; Rao, Nirmala

    2017-01-01

    Research Findings: This study investigated the relationships between effortful control and early literacy and mathematics achievement. A total of 181 children (85 girls and 96 boys) from rural China were assessed when they were in Grades 1 and 2. Path analyses controlling for maternal education indicated that effortful control at the beginning of…

  9. Can bread processing conditions alter glycaemic response?

    Science.gov (United States)

    Lau, Evelyn; Soong, Yean Yean; Zhou, Weibiao; Henry, Jeyakumar

    2015-04-15

    Bread is a staple food that is traditionally made from wheat flour. This study aimed to compare the starch digestibility of western baked bread and oriental steamed bread. Four types of bread were prepared: western baked bread (WBB) and oriental steamed bread (OSB), modified baked bread (MBB) made with the OSB recipe and WBB processing, and modified steamed bread (MSB) made with the WBB recipe and OSB processing. MBB showed the highest starch digestibility in vitro, followed by WBB, OSB and MSB. A similar trend was observed for glycaemic response in vivo. MBB, WBB, OSB and MSB had a glycaemic index of 75±4, 71±5, 68±5 and 65±4, respectively. Processing differences had a more pronounced effect on starch digestibility in bread, and steamed bread was healthier in terms of glycaemic response. The manipulation of processing conditions could be an innovative route to alter the glycaemic response of carbohydrate-rich foods. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Laboratory Control System's Effects on Student Achievement and Attitudes

    Science.gov (United States)

    Cicek, Fatma Gozalan; Taspinar, Mehmet

    2016-01-01

    Problem Statement: The current study investigates whether the learning environment designed based on the laboratory control system affects the academic achievement, the attitude toward the learning-teaching process and the retention of the students in computer education. Purpose of Study: The study aims to identify the laboratory control system…

  11. Locus of Control in Underachieving and Achieving Gifted Students.

    Science.gov (United States)

    McClelland, Robert; And Others

    1991-01-01

    This study, with 87 underachieving and 77 achieving gifted students in grades 6-9, found that general locus of control measures did not differentiate between the 2 groups, that both scored significantly higher on positive internal than on negative internal locus of control, and that there were no gender or grade effects. (Author/DB)

  12. Locus of Control in Underachieving and Achieving Gifted Students.

    Science.gov (United States)

    McClelland, Robert; And Others

    1991-01-01

    This study, with 87 underachieving and 77 achieving gifted students in grades 6-9, found that general locus of control measures did not differentiate between the 2 groups, that both scored significantly higher on positive internal than on negative internal locus of control, and that there were no gender or grade effects. (Author/DB)

  13. A Low Glycaemic Index Diet Incorporating Isomaltulose Is Associated with Lower Glycaemic Response and Variability, and Promotes Fat Oxidation in Asians

    Directory of Open Access Journals (Sweden)

    Christiani Jeyakumar Henry

    2017-05-01

    Full Text Available Low glycaemic index (GI foods minimize large blood glucose fluctuations and have been advocated to enhance fat oxidation and may contribute to weight management. We determined whether the inclusion of isomaltulose compared to sucrose in a low/high GI meal sequence can modulate the glycaemic response and substrate oxidation in an Asian population. Twenty Chinese men (body mass index (BMI: 17–28 kg/m2 followed a 24 h low GI (isomaltulose, PalatinoseTM or high GI (sucrose diet in a randomized double-blind, controlled cross-over design. Treatment meals included dinner (day 1, breakfast, lunch, and snack (day 2. Continuous glucose monitoring provided incremental area under the curve (iAUC and mean amplitude of glycaemic excursion (MAGE and 10 h indirect calorimetry (whole body calorimeter (day 2 provided energy expenditure and substrate oxidation. Our results demonstrated that the low GI diet resulted in lower 24 h glucose iAUC (502.5 ± 231.4 vs. 872.6 ± 493.1 mmol/L; p = 0.002 and lower 24 h glycaemic variability (MAGE: 1.67 ± 0.53 vs. 2.68 ± 1.13 mmol/L; p < 0.001. Simultaneously, 10 h respiratory quotient increased more during high GI (p = 0.014 and fat oxidation was higher after low GI breakfast (p = 0.026, lunch (p < 0.001 and snack (p = 0.013. This indicates that lower GI mixed meals incorporating isomaltulose are able to acutely reduce the glycaemic response and variability and promote fat oxidation.

  14. Glycaemic and insulinemic response to dietary carbohydrates in horses

    DEFF Research Database (Denmark)

    Brøkner, Christine; Austbø, Dag; Næsset, Jon A.

    2016-01-01

    - and insulinemic index of test meals. The objective was to measure postprandial glucose and insulin concentrations in horses fed meals of different fibre compositions. Methods: Blood was drawn via jugular vein puncture and the glycaemic and insulinemic index were calculated. Results: The meal effect on glycaemic...... (M) and did not differ significantly between meals. Conclusions: In conclusion, meals containing different fibre compositions did not affect the glycaemic- and insulinemic index in horses....

  15. Factors Associated with Academic Achievement in Children with Controlled Epilepsy.

    Science.gov (United States)

    Williams, Jane; Phillips, Tonya; Griebel, May L.; Sharp, Gregory B.; Lange, Bernadette; Edgar, Terence; Simpson, Pippa

    2001-06-01

    Children with epilepsy are at risk for academic underachievement. Multiple etiologies for this academic vulnerability have been suggested by past research including lower self-esteem, inattention, memory inefficiency, and lower socioeconomic status. The present study assessed 65 children (mean age = 10 years, 5 months) with well-controlled epilepsy on the four primary factors, as well as academic achievement and intelligence. A stepwise regression analysis was employed with academic achievement as the dependent variable and measures of self-esteem, attention, memory, and socioeconomic status as independent variables. When intelligence was controlled, attention was the only variable associated with achievement scores. Seizure variables including seizure type and duration of epilepsy were not associated with differences in academic performance. Findings support the importance of measuring attention skills in children with epilepsy and suggest that reduced auditory attention skills may be associated with decreased academic performance in these children.

  16. EFFECTS OF DOMINANCE AND CONTROL ON READING ACHIEVEMENT.

    Science.gov (United States)

    BOOS, ROBERT W.; HILLERICH, ROBERT L.

    TWO DISPARATE STUDIES WERE REPLICATED WITH A PUBLIC SCHOOL POPULATION USED BY HILLERICH IN A 4-YEAR STUDY OF THE DEVELOPMENT OF HANDEDNESS AND EYEDNESS. SUBJECTS WERE 273 SEVENTH AND EIGHTH GRADERS WHO REMAINED FROM AN ORIGINAL POPULATION OF 400. TESTS WERE ADMINISTERED TO DETERMINE EYE DOMINANCE, HANDEDNESS, CONTROLLING EYE, READING ACHIEVEMENT,…

  17. Children's Effortful Control and Academic Achievement: Mediation through Social Functioning

    Science.gov (United States)

    Valiente, Carlos; Eisenberg, Nancy; Haugen, Rg; Spinrad, Tracy L.; Hofer, Claire; Liew, Jeffrey; Kupfer, Anne

    2011-01-01

    Research Findings: The purpose of this study was to test the premise that children's effortful control (EC) is prospectively related to their academic achievement and to specify mechanisms through which EC is related to academic success. We used data from 214 children (M age at Time 1 [T1] = 73 months) to test whether social functioning (e.g.,…

  18. Achieving Control of Lesion Growth in CNS with Minimal Damage

    CERN Document Server

    Raja, Mathankumar

    2012-01-01

    Lesions in central nervous system (CNS) and their growth leads to debilitating diseases like Multiple Sclerosis (MS), Alzheimer's etc. We developed a model earlier which shows how the lesion growth can be arrested through a beneficial auto-immune mechanism. The success of the approach depends on a set of control parameters and their phase space was shown to have a smooth manifold separating the uncontrolled lesion growth region from the controlled. Here we show that an optimal set of parameter values exist which minimizes system damage while achieving control of lesion growth.

  19. Contributors to dietary glycaemic index and glycaemic load in the Netherlands

    DEFF Research Database (Denmark)

    Sluik, Diewertje; Atkinson, Fiona S; Brand-Miller, Jennie

    2016-01-01

    Diets high in glycaemic index (GI) and glycaemic load (GL) have been associated with a higher diabetes risk. Beer explained a large proportion of variation in GI in a Finnish and an American study. However, few beers have been tested according to International Organization for Standardization (ISO......, coffee and tea. The results were more pronounced in men than in women. In conclusion, beer is a high-GI food. Despite its relatively low carbohydrate content (approximately 4-5 g/100 ml), it still made a contribution to dietary GL, especially in men. Next to potatoes, bread, sugar and sugar...

  20. Overall glycaemic index and glycaemic load of habitual diet and risk of heart disease

    DEFF Research Database (Denmark)

    Grau, Katrine; Tetens, Inge; Bjørnsbo, Kirsten S

    2011-01-01

    Objective To test the hypothesis that diets with high glycaemic index (GI) and glycaemic load (GL) increase the risk of heart disease. Design Overall GI and GL were assessed from 7 d diet records or diet history interviews. Setting Information on hospitalization and death due to CVD and CHD...... with either outcome. In women no clear association between overall GI and heart disease was found, whereas positive non-linear associations were found for GL: at very high levels of GL, increase in GL was associated with increasing CVD and CHD morbidity. Conclusions In men low-GI diets were associated...

  1. Increased renal gene transcription of protein kinase C-beta in human diabetic nephropathy: relationship to long-term glycaemic control

    DEFF Research Database (Denmark)

    Langham, R.G.; Kelly, D.J.; Gow, R.M.;

    2008-01-01

    was examined in renal biopsies (n=25) with classical histological features of diabetic nephropathy and compared with that in normal control tissue (n=6). Peptide localisation of PKC-alpha, PKC-beta and the activated forms phosphorylated PKC-alpha and -beta was also performed on matched paraffin......-embedded sections of renal biopsies using immunohistochemistry. The effects of high glucose on PRKC-beta expression and peptide production in cultured human proximal tubular epithelial cells were assessed. RESULTS: Quantitative real-time PCR demonstrated a 9.9-fold increase in PRKC-beta mRNA in kidney biopsies...... quantitative analysis of mRNA from archival, formalin-fixed, paraffin-embedded tissue sections. RNA was extracted from scraped 6 microm sections of biopsy tissue, and PRKC-alpha and PRKC-beta (also known as PRKCA and PRKCB) mRNA measured using real-time PCR. Expression of genes encoding PKC isoforms...

  2. The achievement of glycaemic, blood pressure and LDL cholesterol ...

    African Journals Online (AJOL)

    patients with type 2 diabetes attending a South African tertiary hospital outpatient .... knowledge, only the most recent records and laboratory reports of the patient ... of previous coronary artery disease (CAD), stroke, retinopathy, neuropathy ...

  3. Intraperitoneal insulin delivery provides superior glycaemic regulation to subcutaneous insulin delivery in model predictive control-based fully-automated artificial pancreas in patients with type 1 diabetes: a pilot study.

    Science.gov (United States)

    Dassau, Eyal; Renard, Eric; Place, Jérôme; Farret, Anne; Pelletier, Marie-José; Lee, Justin; Huyett, Lauren M; Chakrabarty, Ankush; Doyle, Francis J; Zisser, Howard C

    2017-05-05

    To compare intraperitoneal (IP) to subcutaneous (SC) insulin delivery in an artificial pancreas (AP). Ten adults with type 1 diabetes participated in a non-randomized, non-blinded sequential AP study using the same SC glucose sensing and Zone Model Predictive Control (ZMPC) algorithm adjusted for insulin clearance. On first admission, subjects underwent closed-loop control with SC delivery of a fast-acting insulin analogue for 24 hours. Following implantation of a DiaPort IP insulin delivery system, the identical 24-hour trial was performed with IP regular insulin delivery. The clinical protocol included 3 unannounced meals with 70, 40 and 70 g carbohydrate, respectively. Primary endpoint was time spent with blood glucose (BG) in the range of 80 to 140 mg/dL (4.4-7.7 mmol/L). Percent of time spent within the 80 to 140 mg/dL range was significantly higher for IP delivery than for SC delivery: 39.8 ± 7.6 vs 25.6 ± 13.1 ( P  = .03). Mean BG (mg/dL) and percent of time spent within the broader 70 to 180 mg/dL range were also significantly better for IP insulin: 151.0 ± 11.0 vs 190.0 ± 31.0 ( P  = .004) and 65.7 ± 9.2 vs 43.9 ± 14.7 ( P  = .001), respectively. Superiority of glucose control with IP insulin came from the reduced time spent in hyperglycaemia (>180 mg/dL: 32.4 ± 8.9 vs 53.5 ± 17.4, P  = .014; >250 mg/dL: 5.9 ± 5.6 vs 23.0 ± 11.3, P  = .0004). Higher daily doses of insulin (IU) were delivered with the IP route (43.7 ± 0.1 vs 32.3 ± 0.1, P  time spent <70 mg/dL (IP: 2.5 ± 2.9 vs SC: 4.1 ± 5.3, P  = .42). Glycaemic regulation with fully-automated AP delivering IP insulin was superior to that with SC insulin delivery. This pilot study provides proof-of-concept for an AP system combining a ZMPC algorithm with IP insulin delivery. © 2017 John Wiley & Sons Ltd.

  4. The effects of corn silk on glycaemic metabolism

    Directory of Open Access Journals (Sweden)

    Han Linna

    2009-11-01

    Full Text Available Abstract Background Corn silk contains proteins, vitamins, carbohydrates, Ca, K, Mg and Na salts, fixed and volatile oils, steroids such as sitosterol and stigmasterol, alkaloids, saponins, tannins, and flavonoids. Base on folk remedies, corn silk has been used as an oral antidiabetic agent in China for decades. However, the hypoglycemic activity of it has not yet been understood in terms of modern pharmacological concepts. The purpose of this study is to investigate the effects of corn silk on glycaemic metabolism. Methods Alloxan and adrenalin induced hyperglycemic mice were used in the study. The effects of corn silk on blood glucose, glycohemoglobin (HbA1c, insulin secretion, damaged pancreatic β-cells, hepatic glycogen and gluconeogenesis in hyperglycemic mice were studied respectively. Results After the mice were orally administered with corn silk extract, the blood glucose and the HbA1c were significantly decreased in alloxan-induced hyperglycemic mice (p 0.05. Although corn silk extract increased the level of hepatic glycogen in the alloxan-induced hyperglycemic mice, there was no significant difference between them and that of the control group(p > 0.05. Conclusion Corn silk extract markedly reduced hyperglycemia in alloxan-induced diabetic mice. The action of corn silk extract on glycaemic metabolism is not via increasing glycogen and inhibiting gluconeogenesis but through increasing insulin level as well as recovering the injured β-cells. The results suggest that corn silk extract may be used as a hypoglycemic food or medicine for hyperglycemic people in terms of this modern pharmacological study.

  5. Dietary glycaemic index and glycaemic load in Danish children in relation to body fatness

    DEFF Research Database (Denmark)

    Nielsen, B. M.; Bjørnsbo, K. B.; Tetens, Inge

    2005-01-01

    population comprised 485 children aged 10 years and 364 children aged 16 years from Odense County, Denmark. Dietary GI and GL were estimated using international food tables, and the associations between energy-adjusted dietary GI, GL and body fatness were analysed by multiple linear regression. The mean......The aim of this study was to describe dietary glycaemic index (GI) and glycaemic load (GL) values in the diets of Danish children, and to examine the associations between dietary GI, GL and body fatness. Data were collected during 1997-8 as part of the European Youth Heart Study. The study...... associations were observed between dietary GI and Sigma SF (beta=0 center dot 60, SE=0 center dot 21, P=0 center dot 006), and between dietary GL and Sigma SF (beta=0 center dot 15, SE=0.06, P=0 center dot 009). In conclusion, dietary GI and GL were positively associated with body fatness among Danish boys...

  6. Parental Behavioural Control and Academic Achievement: Striking the Balance between Control and Involvement

    Science.gov (United States)

    Kramer, Karen Z.

    2012-01-01

    Using a longitudinal US dataset (N = 6,134) we examine the relationship between parental behavioural control and academic achievement and explore the moderating role of parental involvement and parental warmth. Analyses using multiple hierarchical regression with clustering controls shows that parental behavioural control is negatively associated…

  7. Co-ingestion of essence of chicken to moderate glycaemic response of bread.

    Science.gov (United States)

    Sun, Lijuan; Wei Jie Tan, Kevin; Jeyakumar Henry, Christiani

    2015-01-01

    Essence of chicken (EOC) beverage is a chicken meat extract, widely consumed in Asian countries for health benefits. EOC is a rich source of peptides and amino acids. White bread has become a popular staple food in all regions of Southeast Asia. A randomized controlled, crossover, non-blind trial was performed to investigate the role of EOC on glycaemic response (GR) of white bread. Ten healthy young subjects returned on five separate days for three glucose and two bread sessions. Subjects consumed bread or bread with EOC. The 120 min incremental area under the curve was significantly lower after consuming two bottles of EOC with bread than white bread alone. The glycaemic index (GI) of white bread was 83 and white bread with EOC 57. The co-ingestion of EOC may be a practical and simple way to reduce the GR of bread and other starch-based staples.

  8. Carbohydrate-rich foods: glycaemic indices and the effect of constituent macronutrients.

    Science.gov (United States)

    Widanagamage, Rahal D; Ekanayake, Sagarika; Welihinda, Jayantha

    2009-01-01

    The glycaemic index (GI) ranks foods according to their acute glycaemic impact and is used in planning meals for patients invoking glycaemic control through diet. Kurakkan (Eleusine coracana) flour roti, rice flour roti, atta flour roti, boiled breadfruit (Artocarpus altilis/Artocarpus communis) and boiled legumes (mungbean, cowpea and chickpea) were categorized as low-GI foods (relative to white bread; Prima Crust Top), and the corresponding GI (+/- standard error of the mean) values were 70+/-8, 69+/-7, 67+/-9, 64+/-7, 57+/-6, 49+/-8 and 29+/-5, respectively. Kurakkan flour pittu and wheat flour roti were classified as medium-GI foods with GI values of 85+/-6 and 72+/-6. Hoppers, rice flour pittu, wheat flour pittu and Olu-milk rice (seeds of Nymphaea lotus) were categorized as high-GI foods, and the corresponding GI (+/- standard error of the mean) values were 120+/-8, 103+/-7, 101+/-8 and 91+/-8, respectively. The GI values significantly (P<0.01) and negatively correlated with the insoluble dietary fibre (rho = - 0.780), soluble dietary fibre (rho = - 0.712) and protein (rho = - 0.738) contents in grams per 100 g digestible starch containing foods.

  9. Managing Air Quality - Control Strategies to Achieve Air Pollution Reduction

    Science.gov (United States)

    Considerations in designing an effective control strategy related to air quality, controlling pollution sources, need for regional or national controls, steps to developing a control strategy, and additional EPA resources.

  10. Assessment of nutritional quality, glycaemic index, antidiabetic and sensory properties of plantain (Musa paradisiaca)-based functional dough meals.

    Science.gov (United States)

    Famakin, Opeyemi; Fatoyinbo, Akindele; Ijarotimi, Oluwole Steve; Badejo, Adebanjo Ayobamidele; Fagbemi, Tayo Nathaniel

    2016-11-01

    Nutrition transition to high energy-dense foods has been implicated as the major causes of diet related diseases. Plantain-based dough meals supplemented with soybean cake and cassava fibre were developed by combining them in different proportions using response surface methodology. The flour blends were analyzed for the nutritional composition while the glycaemic index, antidiabetic potentials and protein digestibility of the dough meals were determined in wistar rats. The nutritional and essential amino acid contents of the flour blends were comparable to that of cerolina (a commercially available food product commonly recommended for diabetic patients). The rats fed with the formulated dough meals had lower glycaemic index and glycaemic load, and the blood glucose was significantly reduced compared to cerolina and metformin (a synthetic antidiabetic drug). All the plantain-based dough meals were comparable to cerolina and metformin in terms of nutritional quality and blood glycaemic control activities, respectively. Hence, the formulated plantain-based dough meals have potential to be used for the prevention and management of diabetes mellitus.

  11. Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Hemmingsen, Bianca; Lund, Søren; Gluud, Christian;

    2011-01-01

    Patients with type 2 diabetes mellitus (T2D) exhibit an increased risk of cardiovascular disease and mortality compared to the background population. Observational studies report a relationship between reduced blood glucose and reduced risk of both micro- and macrovascular complications in patien...

  12. Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Hemmingsen, Bianca; Lund, Søren; Gluud, Christian;

    2013-01-01

    Patients with type 2 diabetes mellitus (T2D) have an increased risk of cardiovascular disease and mortality compared to the background population. Observational studies report an association between reduced blood glucose and reduced risk of both micro- and macrovascular complications in patients ...

  13. Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Hemmingsen, Bianca; Lund, Søren; Gluud, Christian Nyfeldt;

    2011-01-01

    Patients with type 2 diabetes mellitus (T2D) exhibit an increased risk of cardiovascular disease and mortality compared to the background population. Observational studies report a relationship between reduced blood glucose and reduced risk of both micro- and macrovascular complications in patients...

  14. Glycaemic index and glycaemic load values of a selection of popular foods consumed in Hong Kong.

    Science.gov (United States)

    Lok, Kris Y; Chan, Ruth; Chan, Dicken; Li, Liz; Leung, Grace; Woo, Jean; Lightowler, Helen J; Henry, C Jeya K

    2010-02-01

    The objective of the present paper is to provide glycaemic index (GI) and glycaemic load (GL) values for a variety of foods that are commonly consumed in Hong Kong and expand on the international GI table of Chinese foods. Fasted healthy subjects were given 50 g of available carbohydrate servings of a glucose reference, which was tested twice, and test foods of various brands of noodles (n 5), instant cereals (n 3) and breads (n 2), which were tested once, on separate occasions. For each test food, tests were repeated in ten healthy subjects. Capillary blood glucose was measured via finger-prick samples in fasting subjects ( - 5, 0 min) and at 15, 30, 45, 60, 90 and 120 min after the consumption of each test food. The GI of each test food was calculated geometrically by expressing the incremental area under the blood glucose response curve (IAUC) of each test food as a percentage of each subject's average IAUC for the reference food. GL was calculated as the product of the test food's GI and the amount of available carbohydrate in a reference serving size. The majority of GI values of foods tested were medium (a GI value of 56-69) to high (a GI value of 70 or more) and compared well with previously published values. More importantly, our dataset provides GI values of ten foods previously untested and presents values for foods commonly consumed in Hong Kong.

  15. 牙周基础治疗对2型糖尿病相关性牙周炎患者血糖控制的Meta分析%Meta-analysis of periodontal treatment on glycaemic control of type 2 diabetic associated periodontitis patients

    Institute of Scientific and Technical Information of China (English)

    刘彩云; 孙剑; 孟杨; 曾宪涛; 周静; 庞光明

    2012-01-01

    目的 系统评价牙周基础治疗对2型糖尿病相关性牙周炎患者血糖控制的影响,探讨牙周基础治疗在糖尿病治疗中的具体作用.方法 计算机检索Cochrane图书馆对照试验注册中心、Medline、EMbase、SIGLE、GreyNet、NTIS、中国生物医学文献数据库、中文科技期刊全文数据库、中国期刊全文数据库和万方数据库,查找有关牙周基础治疗对糖尿病血糖控制影响的研究.检索时限均为1991-2011年4月31日.均由2名评价者独立选择试验、提取资料和评估方法学质量,然后采用RevMan 5.1软件对资料进行Meta分析.纳入7个研究,共计471例受试患者.结果 牙周基础治疗能明显降低2型糖尿病相关性牙周炎患者糖化血红蛋白的水平,组间差异有统计学意义(95%CI:-0.94~-0.22,P=0.001).治疗组牙周袋探诊深度低于对照组,组间差异也有统计学意义(95%CI:-2.26~-0.69,P=0.0002).结论 牙周基础治疗有利于2型糖尿病相关性牙周炎患者总体血糖水平的控制.%Objective To evaluate the effect of periodontal therapy on glycaemic control in type 2 diabetic associated periodontitis patients, and explore the role of periodontal therapy in the treatment of diabetes. Methods Studies of periodontal therapy on glycaemic control in diabetic patients were searched in Cochrane Central Register of Controlled Trials (Central), Medline, Embase, SIGLE, GreyNet, NTIS, CBMdisc, VIP, CNKI and Wanfang data from 1991 to April 31, 2011. The studies' selection, extraction and evaluation were performed by two reviewers independently, and meta-analysis was performed with RevMan 5.1 software. A total of 7 studies involving 471 participants were included in the review. Results Periodontal treatment could lead to a significant reduction in glycosylated hemoglobin level. The difference between the groups was significant (95% CI: -0.94 to -0.22, P= 0.001). And the periodontal probing depth in the treatment group was

  16. Self-Esteem, Locus of Control, and Student Achievement.

    Science.gov (United States)

    Sterbin, Allan; Rakow, Ernest

    The direct effects of locus of control and self-esteem on standardized test scores were studied. The relationships among the standardized test scores and measures of locus of control and self-esteem for 12,260 students from the National Education Longitudinal Study 1994 database were examined, using the same definition of locus of control and…

  17. Comparison of the Efficacy of Different Glycaemic Control Methods for the Treatment of Patients with Diabetes Mellitus During Peroperative Period%不同血糖控制方法对糖尿病患者围手术期疗效的比较

    Institute of Scientific and Technical Information of China (English)

    周岩; 吴大方; 杨瑜莹

    2013-01-01

    [目的]比较采用胰岛素泵和诺和灵R笔芯与来得时笔芯(甘精胰岛素注射液)皮下注射CSⅡ、甘精胰岛素皮下注射联合口服降糖药两种方法对胆石症合并T2DM腹腔镜择期手术患者围手术期血糖控制和愈后的影响.[方法]胰岛素泵(A组)110例,胰岛素泵持续24 h皮下输入胰岛素的方式控制血糖;甘精胰岛素皮下注射(B组)123例,使用来得时笔芯及口服降糖药.[结果]A组患者在控制血糖达理想值所需平均时间、平均住院时间方面明显少于B组,组间差异显著(P<0.05),但降糖费用明显高于B组(P<0.05),平均总住院费用两组间无显著差异(P>0.05),两组患者低血糖发生率、抗生素使用时间等并发症相关因素指标以及血糖平稳程度,无显著差异(P>0.05).两组均无切口感染及酮症发生.[结论]两种方法控制围手术期病人血糖水平各有其长.甘精胰岛素联合口服药对围手术期患者的血糖控制安全、便捷,为T2DM患者围手术期血糖控制的理想方法之一.%[Objective] To compare the effect of two methods insulin pump CS Ⅱ vs glargine insulin injection combined with oral blood glucose lowering drugs on glycaemic control and prognosis of patients with cholelithiasis and type 2 diabetes mellitus(T2DM) during peroperative period of laparoscopy elective surgery. [Methods]Insulin pump CSⅡ group( n =110) received 24h continuous subcutaneous insulin injection through insulin pump for controlling blood glucose. Glargine insulin subcutaneous injection group( n =123) received Lantus cartridge and oral blood glucose lowering drugs. [Results] Mean time to reaching the ideal glucose value and average hospital day in patients of CSⅡ group were obviously lower than those in glargine insulin group, and there was significant difference between two groups( P 0. 05). There was no significant difference in the complication-related factors such as the incidence of hypoglycemia

  18. Controlling open quantum systems: tools, achievements, and limitations

    Science.gov (United States)

    Koch, Christiane P.

    2016-06-01

    The advent of quantum devices, which exploit the two essential elements of quantum physics, coherence and entanglement, has sparked renewed interest in the control of open quantum systems. Successful implementations face the challenge of preserving relevant nonclassical features at the level of device operation. A major obstacle is decoherence, which is caused by interaction with the environment. Optimal control theory is a tool that can be used to identify control strategies in the presence of decoherence. Here we review recent advances in optimal control methodology that allow typical tasks in device operation for open quantum systems to be tackled and discuss examples of relaxation-optimized dynamics. Optimal control theory is also a useful tool to exploit the environment for control. We discuss examples and point out possible future extensions.

  19. Improving preschoolers' mathematics achievement with tablets: a randomized controlled trial

    Science.gov (United States)

    Schacter, John; Jo, Booil

    2017-09-01

    With a randomized field experiment of 433 preschoolers, we tested a tablet mathematics program designed to increase young children's mathematics learning. Intervention students played Math Shelf, a comprehensive iPad preschool and year 1 mathematics app, while comparison children received research-based hands-on mathematics instruction delivered by their classroom teachers. After 22 weeks, there was a large and statistically significant effect on mathematics achievement for Math Shelf students (Cohen's d = .94). Moderator analyses demonstrated an even larger effect for low achieving children (Cohen's d = 1.27). These results suggest that early education teachers can improve their students' mathematics outcomes by integrating experimentally proven tablet software into their daily routines.

  20. Improving preschoolers' mathematics achievement with tablets: a randomized controlled trial

    Science.gov (United States)

    Schacter, John; Jo, Booil

    2017-04-01

    With a randomized field experiment of 433 preschoolers, we tested a tablet mathematics program designed to increase young children's mathematics learning. Intervention students played Math Shelf, a comprehensive iPad preschool and year 1 mathematics app, while comparison children received research-based hands-on mathematics instruction delivered by their classroom teachers. After 22 weeks, there was a large and statistically significant effect on mathematics achievement for Math Shelf students (Cohen's d = .94). Moderator analyses demonstrated an even larger effect for low achieving children (Cohen's d = 1.27). These results suggest that early education teachers can improve their students' mathematics outcomes by integrating experimentally proven tablet software into their daily routines.

  1. Glycaemic and insulinemic response to dietary carbohydrates in horses

    DEFF Research Database (Denmark)

    Brøkner, Christine; Austbø, Dag; Næsset, Jon A.;

    2016-01-01

    Background: Dietary sugar and starch affect plasma glucose and insulin concentrations. Little information is available about the effect of dietary fibre on plasma glucose and insulin concentration. It is hypothesized that different dietary fibre compositions will alter post-prandial glycaemic...... and insulinemic response followed the expected pattern, where plasma concentrations increased after feeding and declined after peak concentration. Glycaemic index was 100 (H), 102 (OB), 102 (BB) and 106 (M) and did not differ significantly between meals. Insulinemic index was 100 (H), 140 (OB), 121 (BB) and 125...

  2. The Research on the Effect of the Food with Different Glycaemic Index and Glycaemic Load on the Immunity of Endurance Athletes

    Science.gov (United States)

    Li, Dongmei

    2015-01-01

    For studying the effect of eating the food containing carbohydrates with different glycaemic index and glycaemic load 2 hours before athletics on the exercise tolerance and immune function, select 10 men long-distance endurance athletes, use not completely random balance repeated testing methods, randomized complete the three endurance tests. And each test interval is not less than seven days. The results suggest that there is no apparent effect of eating the food containing carbohydrates with different glycaemic index and glycaemic load 2 hours before athletics on the exercise tolerance and immune function. Compared with the glycaemic index and glycaemic load of food, the carbohydrate content of the diet before athletics may be the more important factor affecting the immune response in endurance sports. PMID:26998178

  3. The Research on the Effect of the Food with Different Glycaemic Index and Glycaemic Load on the Immunity of Endurance Athletes.

    Science.gov (United States)

    Li, Dongmei

    2015-01-01

    For studying the effect of eating the food containing carbohydrates with different glycaemic index and glycaemic load 2 hours before athletics on the exercise tolerance and immune function, select 10 men long-distance endurance athletes, use not completely random balance repeated testing methods, randomized complete the three endurance tests. And each test interval is not less than seven days. The results suggest that there is no apparent effect of eating the food containing carbohydrates with different glycaemic index and glycaemic load 2 hours before athletics on the exercise tolerance and immune function. Compared with the glycaemic index and glycaemic load of food, the carbohydrate content of the diet before athletics may be the more important factor affecting the immune response in endurance sports.

  4. Perceived Classroom Control, Self-Regulated Learning Strategies, and Academic Achievement.

    Science.gov (United States)

    Eshel, Yohanan; Kohavi, Revital

    2003-01-01

    Investigates classroom control, self-regulation strategies, and academic achievement of sixth-grade students (n=302). Hypothesizes that a combination of teacher and student control affects student mathematics achievement. Finds that achievement and self-regulation depended upon classroom processes. Includes references. (CMK)

  5. Contributors to dietary glycaemic index and glycaemic load in the Netherlands: the role of beer.

    Science.gov (United States)

    Sluik, Diewertje; Atkinson, Fiona S; Brand-Miller, Jennie C; Fogelholm, Mikael; Raben, Anne; Feskens, Edith J M

    2016-04-14

    Diets high in glycaemic index (GI) and glycaemic load (GL) have been associated with a higher diabetes risk. Beer explained a large proportion of variation in GI in a Finnish and an American study. However, few beers have been tested according to International Organization for Standardization (ISO) methodology. We tested the GI of beer and estimated its contribution to dietary GI and GL in the Netherlands. GI testing of pilsner beer (Pilsner Urquell) was conducted at The University of Sydney according to ISO international standards with glucose as the reference food. Subsequently, GI and GL values were assigned to 2556 food items in the 2011 Dutch food composition table using a six-step methodology and consulting four databases. This table was linked to dietary data from 2106 adults in the Dutch National Food Consumption Survey 2007-2010. Stepwise linear regression identified contribution to inter-individual variation in dietary GI and GL. The GI of pilsner beer was 89 (SD 5). Beer consumption contributed to 9·6 and 5·3% inter-individual variation in GI and GL, respectively. Other foods that contributed to the inter-individual variation in GI and GL included potatoes, bread, soft drinks, sugar, candy, wine, coffee and tea. The results were more pronounced in men than in women. In conclusion, beer is a high-GI food. Despite its relatively low carbohydrate content (approximately 4-5 g/100 ml), it still made a contribution to dietary GL, especially in men. Next to potatoes, bread, sugar and sugar-sweetened beverages, beer captured a considerable proportion of between-person variability in GI and GL in the Dutch diet.

  6. Revised National Tuberculosis Control Program: Evolution, Achievements, and Challenges

    Directory of Open Access Journals (Sweden)

    Devidas Trimbak Khedkar

    2014-01-01

    For this review, information has been collected from official websites of World Health Organisation (WHO Geneva, WHO South East Asia Regional Office (SEARO New Delhi, Ministry of Health and Family Welfare; Government of India and published literature, through search engines like Google, Google Scholar and Pub Med using MeSH Terms "DOTS" and "Tuberculosis Control."

  7. Health potential of polyols as sugar replacers, with emphasis on low glycaemic properties.

    Science.gov (United States)

    Livesey, Geoffrey

    2003-12-01

    reduced using polyols. Improved glycated haemoglobin as a marker of glycaemic control was found in a 12-week study of type 2 diabetes mellitus patients consuming polyol, adding to other studies showing improved glucose control on ingestion of low-GI carbohydrate. In general some improvement in long-term glycaemic control was discernible on reducing the glycaemic load via GI by as little as 15-20 g daily. Similar amounts of polyols are normally acceptable. Although polyols are not essential nutrients, they contribute to clinically recognised maintenance of a healthy colonic environment and function. A role for polyols and polyol foods to hydrate the colonic contents and aid laxation is now recognised by physicians. Polyols favour saccharolytic anaerobes and aciduric organisms in the colon, purifying the colon of endotoxic, putrefying and pathological organisms, which has clinical relevance. Polyols also contribute towards short-chain organic acid formation for a healthy colonic epithelium. Polyol tooth-friendliness and reduced energy values are affirmed and add to the potential benefits. In regard to gastrointestinal tolerance, food scientists and nutritionists, physicians, and dentists have in their independent professional capacities each now described sensible approaches to the use and consumption of polyols.

  8. Circulating Levels of MicroRNA from Children with Newly Diagnosed Type 1 Diabetes and Healthy Controls: Evidence That miR-25 Associates to Residual Beta-Cell Function and Glycaemic Control during Disease Progression

    DEFF Research Database (Denmark)

    Nielsen, Lotte B.; Wang, Cheng; Sorensen, Kaspar

    2012-01-01

    This study aims to identify key miRNAs in circulation, which predict ongoing beta-cell destruction and regeneration in children with newly diagnosed Type 1 Diabetes (T1D). We compared expression level of sera miRNAs from new onset T1D children and age-matched healthy controls and related the miRN...... for tissue physiopathology and potential intervention targets....

  9. Can Chemical Mouthwash Agents Achieve Plaque/Gingivitis Control?

    Science.gov (United States)

    Van der Weijden, Fridus A; Van der Sluijs, Eveline; Ciancio, Sebastian G; Slot, Dagmar E

    2015-10-01

    Also note that structured abstracts are not allowed per journal style: What is the effect of a mouthwash containing various active chemical ingredients on plaque control and managing gingivitis in adults based on evidence gathered from existing systematic reviews? The summarized evidence suggests that mouthwashes containing chlorhexidine(CHX) and essential oils (EO) had a large effect supported by a strong body of evidence. Also there was strong evidence for a moderate effect of cetylpyridinium chloride(CPC). Evidence suggests that a CHX mouthwash is the first choice, the most reliable alternative is EO. No difference between CHX and EO with respect to gingivitis was observed.

  10. Glycaemic and insulinemic response to dietary carbohydrates in horses

    DEFF Research Database (Denmark)

    Brøkner, Christine; Austbø, Dag; Næsset, Jon A.;

    2016-01-01

    Background: Dietary sugar and starch affect plasma glucose and insulin concentrations. Little information is available about the effect of dietary fibre on plasma glucose and insulin concentration. It is hypothesized that different dietary fibre compositions will alter post-prandial glycaemic- an...

  11. effect of low glycaemic index meals on insulin secretion

    African Journals Online (AJOL)

    DR. AMINU

    2012-12-02

    Dec 2, 2012 ... Keywords: type 2 diabetics, low glycaemic index, insulin, insulinogenic indices. INTRODUCTION ... Salmeron et al., 1997b) and heart disease (Liu et al.,. 2000). ... excessive insulin secretion may increase oxidative stress and ... instructed not to change their physical activity patterns .... Reducing the rate of.

  12. Co-localisation of the Kir6.2/SUR1 channel complex with glucagon-like peptide-1 and glucose-dependent insulinotrophic polypeptide expression in human ileal cells and implications for glycaemic control in new onset type 1 diabetes

    DEFF Research Database (Denmark)

    Nielsen, Lars Bo; Ploug, K.B.; Swift, P.

    2007-01-01

    The ATP-dependent K+-channel (K(ATP)) is critical for glucose sensing and normal glucagon and insulin secretion from pancreatic endocrine alpha- and beta-cells. Gastrointestinal endocrine L- and K-cells are also glucose-sensing cells secreting glucagon-like peptide-1 (GLP-1) and glucose-dependent......The ATP-dependent K+-channel (K(ATP)) is critical for glucose sensing and normal glucagon and insulin secretion from pancreatic endocrine alpha- and beta-cells. Gastrointestinal endocrine L- and K-cells are also glucose-sensing cells secreting glucagon-like peptide-1 (GLP-1) and glucose......-dependent insulinotrophic polypeptide (GIP) respectively. The aims of this study were to 1) investigate the expression and co-localisation of the K(ATP) channel subunits, Kir6.2 and SUR1, in human L- and K-cells and 2) investigate if a common hyperactive variant of the Kir6.2 subunit, Glu23Lys, exerts a functional impact...... on glucose-sensing tissues in vivo that may affect the overall glycaemic control in children with new-onset type 1 diabetes....

  13. Co-localisation of the Kir6.2/SUR1 channel complex with glucagon-like peptide-1 and glucose-dependent insulinotrophic polypeptide expression in human ileal cells and implications for glycaemic control in new onset type 1 diabetes

    DEFF Research Database (Denmark)

    Nielsen, Lotte B; Ploug, Kenneth B; Swift, Peter

    2007-01-01

    OBJECTIVE: The ATP-dependent K+-channel (K(ATP)) is critical for glucose sensing and normal glucagon and insulin secretion from pancreatic endocrine alpha- and beta-cells. Gastrointestinal endocrine L- and K-cells are also glucose-sensing cells secreting glucagon-like peptide-1 (GLP-1) and glucose......-dependent insulinotrophic polypeptide (GIP) respectively. The aims of this study were to 1) investigate the expression and co-localisation of the K(ATP) channel subunits, Kir6.2 and SUR1, in human L- and K-cells and 2) investigate if a common hyperactive variant of the Kir6.2 subunit, Glu23Lys, exerts a functional impact...... on glucose-sensing tissues in vivo that may affect the overall glycaemic control in children with new-onset type 1 diabetes. DESIGN AND METHODS: Western blot and immunohistochemical analyses were performed for expression and co-localisation studies. Meal-stimulated C-peptide test was carried out in 257...

  14. Achieving HIV-1 Control through RNA-Directed Gene Regulation

    Directory of Open Access Journals (Sweden)

    Vera Klemm

    2016-12-01

    Full Text Available HIV-1 infection has been transformed by combined anti-retroviral therapy (ART, changing a universally fatal infection into a controllable infection. However, major obstacles for an HIV-1 cure exist. The HIV latent reservoir, which exists in resting CD4+ T cells, is not impacted by ART, and can reactivate when ART is interrupted or ceased. Additionally, multi-drug resistance can arise. One alternate approach to conventional HIV-1 drug treatment that is being explored involves gene therapies utilizing RNA-directed gene regulation. Commonly known as RNA interference (RNAi, short interfering RNA (siRNA induce gene silencing in conserved biological pathways, which require a high degree of sequence specificity. This review will provide an overview of the silencing pathways, the current RNAi technologies being developed for HIV-1 gene therapy, current clinical trials, and the challenges faced in progressing these treatments into clinical trials.

  15. Muscle function in avian flight: achieving power and control

    Science.gov (United States)

    Biewener, Andrew A.

    2011-01-01

    Flapping flight places strenuous requirements on the physiological performance of an animal. Bird flight muscles, particularly at smaller body sizes, generally contract at high frequencies and do substantial work in order to produce the aerodynamic power needed to support the animal's weight in the air and to overcome drag. This is in contrast to terrestrial locomotion, which offers mechanisms for minimizing energy losses associated with body movement combined with elastic energy savings to reduce the skeletal muscles' work requirements. Muscles also produce substantial power during swimming, but this is mainly to overcome body drag rather than to support the animal's weight. Here, I review the function and architecture of key flight muscles related to how these muscles contribute to producing the power required for flapping flight, how the muscles are recruited to control wing motion and how they are used in manoeuvring. An emergent property of the primary flight muscles, consistent with their need to produce considerable work by moving the wings through large excursions during each wing stroke, is that the pectoralis and supracoracoideus muscles shorten over a large fraction of their resting fibre length (33–42%). Both muscles are activated while being lengthened or undergoing nearly isometric force development, enhancing the work they perform during subsequent shortening. Two smaller muscles, the triceps and biceps, operate over a smaller range of contractile strains (12–23%), reflecting their role in controlling wing shape through elbow flexion and extension. Remarkably, pigeons adjust their wing stroke plane mainly via changes in whole-body pitch during take-off and landing, relative to level flight, allowing their wing muscles to operate with little change in activation timing, strain magnitude and pattern. PMID:21502121

  16. Intranasal insulin: the effects of three dose regimens on postprandial glycaemic profiles in type II diabetic subjects.

    Science.gov (United States)

    Coates, P A; Ismail, I S; Luzio, S D; Griffiths, I; Ollerton, R L; Vølund, A; Owens, D R

    1995-03-01

    In both fasting normal and diabetic subjects, nasally administered insulin achieves significant falls in plasma glucose concentrations. Repeated administration before and during a meal has been necessary to lower postprandial glycaemic excursion in subjects with NIDDM. We have studied the use of Novolin Nasal which employs a non-irritant, lecithin-based enhancer as a vehicle for human insulin, on postprandial glucose profiles in NIDDM subjects to determine efficacy, optimal dose frequency, and tolerability. Seventeen NIDDM subjects (15 men, 2 women) participated in a randomized, partially blinded, placebo-controlled, crossover trial of three active treatment regimens (nasal insulin, 120 U at 0 min, 60 U at 0 and +20 min or 120 U at +20 min) in relation to a standardized mixed meal given at 0 min. All active treatments significantly reduced postprandial glucose concentrations compared to placebo. Intranasal insulin given at 0 min at a dose of 60 U or 120 U resulted in a 50% reduction in postprandial incremental glucose compared to placebo over the first 2 h, whereas treatment with 60 U both at 0 and 20 min lead to a 70% reduction over the 240 min postprandial period. Post-prandial intravenous insulin was the least effective. There were no episodes of symptomatic hypoglycaemia. Local tolerability was excellent with only four reports of transient nasal irritation out of a total of 68 doses. The delivery device was accurate with intra-device CV of delivered dose of 4.8%.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Type 2 diabetes and impaired glucose tolerance are associated with word memory source monitoring recollection deficits but not simple recognition familiarity deficits following water, low glycaemic load, and high glycaemic load breakfasts.

    Science.gov (United States)

    Lamport, Daniel J; Lawton, Clare L; Mansfield, Michael W; Moulin, Chris A J; Dye, Louise

    2014-01-30

    It has been established that type 2 diabetes, and to some extent, impaired glucose tolerance (IGT), are associated with general neuropsychological impairments in episodic memory. However, the effect of abnormalities in glucose metabolism on specific retrieval processes such as source monitoring has not been investigated. The primary aim was to investigate the impact of type 2 diabetes and IGT on simple word recognition (familiarity) and complex source monitoring (recollection). A secondary aim was to examine the effect of acute breakfast glycaemic load manipulations on episodic memory. Data are presented from two separate studies; (i) 24 adults with type 2 diabetes and 12 controls aged 45-75years, (ii) 18 females with IGT and 47 female controls aged 30-50years. Controls were matched for age, IQ, BMI, waist circumference, and depression. Recognition of previously learned words and memory for specifically which list a previously learned word had appeared in (source monitoring) was examined at two test sessions during the morning after consumption of low glycaemic load, high glycaemic load and water breakfasts according to a counterbalanced, crossover design. Type 2 diabetes (p<0.05) and IGT (p<0.01) were associated with significant source monitoring recollection deficits but not impairments in familiarity. Impairments were only observed in the late postprandial stage at the second test session. These impairments were not attenuated by the breakfast glycaemic load manipulations. Isolated source monitoring recollection deficits indicate that abnormalities in glucose metabolism are not detrimental for global episodic memory processes. This enhances our understanding of how metabolic disorders are associated with memory impairments. © 2013.

  18. Effect of a new insulin treatment regimen on glycaemic control and quality of life of Muslim patients with type 2 diabetes mellitus during Ramadan fast - an open label, controlled, multicentre, cluster randomised study.

    Science.gov (United States)

    Shehadeh, N; Maor, Y

    2015-11-01

    We performed a non-inferiority trial comparing insulin detemir (Levemir) and biphasic insulin (NovoMix70) to standard care during Ramadan fast in insulin treated type 2 diabetes mellitus (T2DM) patients. This was an open label, controlled, multicentre, cluster randomised non-inferiority study. Insulin treated T2DM patients from 12 randomly selected primary clinics received Levemir and NovoMix 70 (intervention, n = 127) or standard care according to the American Diabetes Association recommendations (control, n = 118). Insulin dose (intervention) was 60% of the usual, of this 40% was dosed as Levemir at sunrise and 60% as NovoMix 70 before dinner. Insulin was titrated according to daily 4 point self-measured blood glucose (4P-SMBG) levels. The primary outcome was the difference in mean daily 4P-SMBG during days 23-30 of treatment. Mean age was 60.1 (SD 8.9) and 59.4 (SD 10.1) years in the intervention and control respectively. Mean HbA1c was 8.38% (68 mmol/mol) (SD 0.96) and 8.45% (69 mmol/mol) (SD 1.08). Mean BMI was 32.99 (SD 7.05) and 33.08 (SD 7.24), respectively. The intervention was non-inferior to standard care as assessed by mean 4P-SMBG during days 23-30 of treatment [155 (SD 30.76) mg% and 159 (SD 33.24) mg% respectively, p = 0.269]. Adverse event rate was significantly lower in the intervention group [0.04 (SD 0.06) vs. 0.07 (SD 0.11), p = 0.010]. In particular, hypoglycaemia event rate was lower in the intervention group [0.00 (SD 0.01) vs. 0.01 (SD 0.03), p ≤ 0.001]. To conclude, treatment with Levemir and NovoMix 70 was non-inferior to standard care in this heterogeneous group of patients and was associated with less adverse events.

  19. Children's effortful control and academic achievement: do relational peer victimization and classroom participation operate as mediators?

    Science.gov (United States)

    Valiente, Carlos; Swanson, Jodi; Lemery-Chalfant, Kathryn; Berger, Rebecca H

    2014-08-01

    Given that early academic achievement is related to numerous developmental outcomes, understanding processes that promote early success in school is important. This study was designed to clarify how students' (N=291; M age in fall of kindergarten=5.66 years, SD=0.39 year) effortful control, relational peer victimization, and classroom participation relate to achievement, as students progress from kindergarten to first grade. Effortful control and achievement were assessed in kindergarten, classroom participation and relational peer victimization were assessed in the fall of first grade, and achievement was reassessed in the spring of first grade. Classroom participation, but not relational peer victimization, mediated relations between effortful control and first grade standardized and teacher-rated achievement, controlling for kindergarten achievement. Findings suggest that aspects of classroom participation, such as the ability to work independently, may be useful targets of intervention for enhancing academic achievement in young children.

  20. Why achievement motivation predicts success in business but failure in politics: the importance of personal control.

    Science.gov (United States)

    Winter, David G

    2010-12-01

    Several decades of research have established that implicit achievement motivation (n Achievement) is associated with success in business, particularly in entrepreneurial or sales roles. However, several political psychology studies have shown that achievement motivation is not associated with success in politics; rather, implicit power motivation often predicts political success. Having versus lacking control may be a key difference between business and politics. Case studies suggest that achievement-motivated U.S. presidents and other world leaders often become frustrated and thereby fail because of lack of control, whereas power-motivated presidents develop ways to work with this inherent feature of politics. A reevaluation of previous research suggests that, in fact, relationships between achievement motivation and business success only occur when control is high. The theme of control is also prominent in the development of achievement motivation. Cross-national data are also consistent with this analysis: In democratic industrialized countries, national levels of achievement motivation are associated with strong executive control. In countries with low opportunity for education (thus fewer opportunities to develop a sense of personal control), achievement motivation is associated with internal violence. Many of these manifestations of frustrated achievement motivation in politics resemble authoritarianism. This conclusion is tested by data from a longitudinal study of 113 male college students, showing that high initial achievement motivation combined with frustrated desires for control is related to increases in authoritarianism (F-scale scores) during the college years. Implications for the psychology of leadership and practical politics are discussed.

  1. Achieving glycemic control differs between patients with type 2 diabetes mellitus starting on metformin and sulfonylureas

    NARCIS (Netherlands)

    Lamberts, Egbert J.F.; Souverein, Patrick C.; Hugtenburg, Jacqueline G.; Nijpels, Giel; Bouvy, Marcel L.

    2013-01-01

    Background: Antidiabetic medication is aimed at attaining tight glycemic control, but patients do not always achieve guideline recommended targets. Available observational studies focusing on both drug treatment and glycemic control have some methodological limitations. Objectives: To describe the r

  2. Telemedicine and diabetes: achievements and prospects.

    Science.gov (United States)

    Franc, S; Daoudi, A; Mounier, S; Boucherie, B; Dardari, D; Laroye, H; Neraud, B; Requeda, E; Canipel, L; Charpentier, G

    2011-12-01

    Health authorities currently have high expectations for telemedicine (TM), as it addresses several major challenges: to improve access to healthcare (especially for patients in underserved or remote areas); to overcome the scarcity of specialists faced with epidemic disease; and to reduce the costs of healthcare while improving quality. The aims of TM in the field of diabetes differ according to the type of diabetes. In type 1 diabetes (T1DM) associated with complex insulin regimens, the goal of TM is to help patients achieve better control of their blood glucose levels through accurate adjustment of insulin doses. In type 2 diabetes (T2DM), while therapeutic adjustments may be necessary, improvement in blood glucose control is based primarily on behavioural changes (reduced calorie and carbohydrate intakes, increased physical activity). Many TM studies focusing on management of blood glucose levels have been published, but most failed to demonstrate any superiority of TM vs traditional care. While previously published meta-analyses have shown a slight advantage at best for TM, these meta-analyses included a mix of studies of varying durations and different populations (both T1DM and T2DM patients, adults and children), and tested systems of inconsistent quality. Studies published to date on TM suggest two currently promising approaches. First, handheld communicating devices, such as smartphones, loaded with software to apply physicians' prescriptions, have been shown to improve glycaemic control. These systems provide immediate assistance to the patient (such as insulin-dose calculation and food choice optimization at meals), and all data stored in the smartphone can be transmitted to authorized caregivers, enabling remote monitoring and even teleconsultation. These systems, initially developed for T1DM, appear to offer many possibilities for T2DM, too. Second, systems combining an interactive Internet system (or a mobile phone coupled to a remote server) with a

  3. Promising Role of Exfoliative Cytology in the Evaluation of Glycaemic Status of Type II Diabetics: A Pilot Study.

    Science.gov (United States)

    Satpathy, Yasmin; Kumar, Praveen S; Singh, Navneet

    2015-06-01

    The degree of metabolic control in diabetes mellitus influences the susceptibility of patients to oral diseases. It is mandatory to regularly monitor glycaemic status, however invasive methods may be contraindicated or intolerable to diabetic individuals. Thus, cytology, being a simple, non-invasive and rapid procedure, is a promising protocol for assessing diabetic status and assisting in management. To assess the number of PAS positive glycogen containing cells and associated cellular changes in buccal smears of type II diabetics and correlate the findings with their serum glucose levels. The study was conducted at the out patient Department of Oral and Maxillofacial Pathology, KLES Institute of Dental Sciences, Belgaum. Fifty known cases of type II diabetes mellitus and 50 healthy individuals were included in the study. Fasting blood glucose levels were estimated and buccal smears stained with Periodic Acid Schiff stain. The observed cellular changes were correlated with the glycaemic status of each patient. Statistical evaluations such as Student's t test (P Cytological findings and clinical observations, suggest a correlation between the extent of these changes and clinical parameters like glycaemic control. Further studies in this aspect can help in improving the reliability of oral cytology as a diagnostic tool in diabetes.

  4. Low Glycaemic Index Dietary Interventions in Youth with Cystic Fibrosis: A Systematic Review and Discussion of the Clinical Implications

    Directory of Open Access Journals (Sweden)

    Kate S. Steinbeck

    2012-04-01

    Full Text Available A systematic review was conducted to assess what is known about the effect of low glycaemic index (GI diets on glycaemic control, weight and quality of life in youth with cystic fibrosis (CF. Eligibility criteria were systematic reviews, randomised and non-randomised trials of low GI dietary interventions in CF. Outcomes examined were glycaemic control, quality of life, anthropometry and respiratory function. Reference lists were manually searched and experts in the field were consulted. Four studies met the eligibility criteria; two were excluded because they did not include data on any of the outcomes. The remaining two were studies that examined GI secondary to any other intervention: one used GI as a factor in enteral feeds and the other incorporated low GI dietary education into its treatment methodology. There is insufficient evidence to recommend use of low GI diets in CF. Since there is evidence to support use of low GI diets in type 1, type 2 and gestational diabetes, low GI diets should be tested as an intervention for CF. The potential risks and benefits of a low GI diet in CF are discussed.

  5. Low glycaemic index dietary interventions in youth with cystic fibrosis: a systematic review and discussion of the clinical implications.

    Science.gov (United States)

    Balzer, Ben W R; Graham, Christie L; Craig, Maria E; Selvadurai, Hiran; Donaghue, Kim C; Brand-Miller, Jennie C; Steinbeck, Kate S

    2012-04-01

    A systematic review was conducted to assess what is known about the effect of low glycaemic index (GI) diets on glycaemic control, weight and quality of life in youth with cystic fibrosis (CF). Eligibility criteria were systematic reviews, randomised and non-randomised trials of low GI dietary interventions in CF. Outcomes examined were glycaemic control, quality of life, anthropometry and respiratory function. Reference lists were manually searched and experts in the field were consulted. Four studies met the eligibility criteria; two were excluded because they did not include data on any of the outcomes. The remaining two were studies that examined GI secondary to any other intervention: one used GI as a factor in enteral feeds and the other incorporated low GI dietary education into its treatment methodology. There is insufficient evidence to recommend use of low GI diets in CF. Since there is evidence to support use of low GI diets in type 1, type 2 and gestational diabetes, low GI diets should be tested as an intervention for CF. The potential risks and benefits of a low GI diet in CF are discussed.

  6. Relationship of Metacognition Learning Strategy and Locus of Control with Academic Achievement of Students

    OpenAIRE

    Mohammadi Y; Kaykha A; Sadeghi A; Kazemi S; Raeisoon MR

    2015-01-01

    Aims: Academic achievement is one of the main assessment factors in the higher education system. Metacognitive learning strategy and locus of control are the main factors affecting the students’ academic achievement. The aim of this study was to investigate the correlation between metacognitive learning strategy and locus of control and the students’ academic achievement.  Instrument & Methods: In the descriptive-analytic study, 335 students of Birjand University of Medic...

  7. Glycaemic response to barley porridge varying in dietary fibre content.

    Science.gov (United States)

    Thondre, Pariyarath S; Wang, Ke; Rosenthal, Andrew J; Henry, Christiani J K

    2012-03-01

    The interest in barley as a food is increasing worldwide because of its high dietary fibre (DF) content and low glycaemic index (GI). DF in cereals may prove beneficial in improving blood glucose response in the long term. However, a dose-dependent effect of insoluble fibre on reducing postprandial blood glucose levels is yet to be proven. The objective of the present study was to determine the glycaemic response to two barley porridges prepared from whole barley grains varying in fibre content. In two separate non-blind randomised crossover trials, ten human subjects consumed barley porridge with 16 g/100 g and 10 g/100 g fibre content provided in different serving sizes (equivalent to 25 and 50 g available carbohydrate). The glycaemic response to both barley porridges was significantly lower than the reference glucose (P porridges. We concluded that irrespective of the difference in total fibre content or serving size of barley porridges, their GI values did not differ significantly.

  8. Five cases of acute painful neuropathy induced by rapid glycaemic control with insulin and literature review%应用胰岛素快速控制血糖引发急性痛性神经病变五例报道及文献复习

    Institute of Scientific and Technical Information of China (English)

    张会峰; 徐丹丹; 袁慧娟; 马跃华; 虎子颖; 赵志刚

    2013-01-01

    分析2010年至2012年在本院内分泌科应用胰岛素快速控制血糖引起的急性痛性神经病变5例患者的临床资料及感觉定量和电生理研究等相关检查资料.结果显示,5例患者均为男性,年龄31~49岁,体重指数偏低,诊断为成人隐匿性自身免疫性糖尿病(LADA)或2型糖尿病患者.应用胰岛素前血糖控制很差,应用胰岛素后高血糖在短时间内纠正迅速,在胰岛素控制血糖期间常出现低血糖反应.肢体疼痛于应用胰岛素后2~4周内出现,经治疗2~6个月可部分或完全缓解.疼痛表现为刺痛、触痛,难以忍受,夜间明显.注射胰岛素几分钟后疼痛加重.应用弥可保、硫辛酸、前列地尔等药物治疗无明显好转.常伴有严重焦虑症状.神经肌电图检查显示双下肢胫、腓总神经运动传导速度正常或减慢,手足感觉阈值正常.%[Summary] The characteristics ot clinical data and relevant inspection (quantitative sensory and electrophysiological studies) in 5 patients hospitalized with acute painful neuropathy following rapid glycaemic control with insulin from 2010 to 2012 in our hospital were analyzed.The results showed that 5 patients were all males,aged 31-49 years,with lower body mass index,and diagnosed as latent autoimmune diabetes of adults (LADA) or type 2 diabetes.Glycaemic control was poor before application of insulin.When insulin was used,the hyperglycemia was rapidly corrected in a short time,with recurrent episodes of hypoglycemia during insulin treatment.The painful neuropathic symptoms appeared within 2-4 weeks after application of insulin,and were relieved partially or completely after 2-6 months.Neuropathic symptoms manifested as tingling and tenderness,with worsening during night and after insulin injection.The neuropathic symptoms were not significantly alleviated after application of neurotrophic drugs such as methycobal,protogen,and prostaglandin.These patients often suffered from severe

  9. Relationship of Metacognition Learning Strategy and Locus of Control with Academic Achievement of Students

    Directory of Open Access Journals (Sweden)

    Mohammadi Y

    2015-12-01

    Full Text Available Aims: Academic achievement is one of the main assessment factors in the higher education system. Metacognitive learning strategy and locus of control are the main factors affecting the students’ academic achievement. The aim of this study was to investigate the correlation between metacognitive learning strategy and locus of control and the students’ academic achievement.  Instrument & Methods: In the descriptive-analytic study, 335 students of Birjand University of Medical sciences were selected based on Krejcie-Morgan Table and via Stratified Random Sampling Method in 2014-15 academic year. The study tools were Self-regulating Learning Strategies Questionnaire, Locus of Control Survey, and students’ GPA as academic achievement component. Data was analyzed in SPSS 14 software using Pearson Correlation, Independent T, and One-way ANOVA tests. Findings: There was a positive and significant correlation between the dimensions of meta-cognitive learning strategy and internal locus of control and academic achievement. Nevertheless, there was a negative and significant correlation between meta-cognitive learning strategies and external locus of control (p0.05. There was a significant correlation between the students’ academic achievements based on gender. However, based on age and faculty, it was not significant.    Conclusion: Two important factors affecting learning enhancement and academic achievement in the students are meta-cognitive learning strategy and locus of control.

  10. Dietary glycaemic index, glycaemic load and subsequent changes of weight and waist circumference in European men and women

    DEFF Research Database (Denmark)

    Du, H; van der A, D L; van Bakel, M M E

    2009-01-01

    OBJECTIVES: To investigate whether dietary glycaemic index (GI) and glycaemic load (GL) were associated with subsequent weight and waist circumference change. DESIGN: Population-based prospective cohort study. SETTING: Five European countries, which are Denmark, Germany, Italy, The Netherlands...... with subsequent changes of weight and waist circumference were heterogeneous across centres. Overall, with every 10-unit higher in GI, weight increased by 34 g per year (95% confidence interval (CI): -47, 115) and waist circumference increased by 0.19 cm per year (95% CI: 0.11, 0.27). With every 50-unit higher...... in GL, weight increased by 10 g per year (95% CI: -65, 85) and waist circumference increased by 0.06 cm per year (95% CI: -0.01, 0.13). CONCLUSIONS: Our findings do not support an effect of GI or GL on weight change. The positively significant association between GI, not GL, and subsequent gain in waist...

  11. A comparison of glycaemic variability in CSII vs. MDI treated type 1 diabetic patients using CGMS.

    Science.gov (United States)

    Simon, B; Treat, V; Marco, C; Rosenberg, D; Joseph, J; Hipszer, B; Li, Y; Chervoneva, I; Padron-Massara, L; Jabbour, S

    2008-12-01

    To evaluate and compare glucose variability, hypoglycaemic events and daily glycaemic control in well-controlled (HbA1c meals. A total of 16 patients with type 1 diabetes receiving treatment with either CSII (eight patients) or MDI (eight patients), all with HbA1c levels or= 180 mg/dl] and hypoglycaemic (BG average amount of time spent within the glucose range of 80-140 mg/dl was marginally significantly better for the MDI than for the CSII group. Although the CSII group had significantly more hypoglycaemic episodes below 60 mg/dl, the average duration of hypoglycaemia was not significantly different for the two groups. Similar percentages of nocturnal hypoglycaemia were seen. There were no reported major adverse events throughout the duration of the study. Well-controlled type 1 diabetic patients treated with MDI had fewer hyperglycaemic and hypoglycaemic excursions than patients treated with CSII.

  12. A Model of Parental Achievement-Oriented Psychological Control in Academically Gifted Students

    Science.gov (United States)

    Garn, Alex C.; Jolly, Jennifer L.

    2015-01-01

    This study investigated achievement-oriented parent socialization as it pertains to school avoidance in a sample of gifted students. A serial mediation model examining relationships among parental achievement-oriented psychological control (APC), fear of academic failure, academic amotivation, and school avoidance was tested. The sample included…

  13. Parental Warmth, Control, and Involvement in Schooling: Predicting Academic Achievement among Korean American Adolescents.

    Science.gov (United States)

    Kim, Kyoungho; Rohner, Ronald P.

    2002-01-01

    Explored the relationship between parenting style and academic achievement of Korean American adolescents, investigating the influence of perceived parental warmth and control and improvement in schooling. Survey data indicated that authoritative paternal parenting related to optimal academic achievement. Differences in maternal parenting styles…

  14. Parental Warmth, Control, and Involvement in Schooling: Predicting Academic Achievement among Korean American Adolescents.

    Science.gov (United States)

    Kim, Kyoungho; Rohner, Ronald P.

    2002-01-01

    Explored the relationship between parenting style and academic achievement of Korean American adolescents, investigating the influence of perceived parental warmth and control and improvement in schooling. Survey data indicated that authoritative paternal parenting related to optimal academic achievement. Differences in maternal parenting styles…

  15. Students' Perceptions of Ideal and Actual Teacher Pupil Control Behavior and Reading Achievement.

    Science.gov (United States)

    Forlenza, Vito A.; Willower, Donald J.

    1980-01-01

    Tests the hypothesis that student reading achievement will be a function of the congruence of student's perception of actual and ideal teacher pupil-control behavior. Subjects were 231 students in nine sixth-grade classrooms. (MP)

  16. MULTILOOP PI CONTROLLER FOR ACHIEVING SIMULTANEOUS TIME AND FREQUENCY DOMAIN SPECIFICATIONS

    OpenAIRE

    2015-01-01

    Most of the controllers in control system are designed to satisfy either time domain or frequency domain specifications. This work presents the computation of a multiloop PI controller for achieving time and frequency domain specifications simultaneously. The desired time and frequency domain measures are to be specified initially to the design. To obtain the desired value of the performance measures the graphical relationship between the PI controller and the performance criteria is given. T...

  17. Inventory control system achievement test for dietetics and foodservice management students.

    Science.gov (United States)

    Yang, I S; Fanslow, A M; Finley, D A

    1991-06-01

    The purpose of this study was to develop an inventory control system achievement test that measures cognitive achievement of students in a foodservice management information systems course. We developed a table of specifications for inventory control systems that included the following content areas: receiving, storing, issuing, inventory control, inventory valuation, and inventory control computer systems. We composed 114 test items in a multiple-choice format on the basis of the table of specifications. A sample of 105 students responded to the test; each had previously received 3 hours of instruction on inventory control systems in a foodservice management information systems course. The 50 best items, judged on the basis of item-analysis data and adherence to the table of specification, were selected for the final form of the inventory control system achievement test. The 50-item test was reliable as indicated by a Kuder-Richardson 20 value of .84. The test may be used to evaluate individual student's achievement, to evaluate the effectiveness of instruction, and to compare achievement of different groups.

  18. On the Relation of Locus of Control and L2 Reading and Writing Achievement

    Science.gov (United States)

    Ghonsooly, Behzad; Shirvan, Majid Elahi

    2011-01-01

    Locus of control, a psychological construct, has been the focus of attention in recent decades. Psychologists have discussed the effect of locus of control on achieving life goals in social/psychological interactions. While learning a foreign language involves both social interactions and psychological processes, the role and relation of locus of…

  19. The Research on the Effect of the Food with Different Glycaemic Index and Glycaemic Load on the Immunity of Endurance Athletes

    OpenAIRE

    Li, Dongmei

    2015-01-01

    For studying the effect of eating the food containing carbohydrates with different glycaemic index and glycaemic load 2 hours before athletics on the exercise tolerance and immune function, select 10 men long-distance endurance athletes, use not completely random balance repeated testing methods, randomized complete the three endurance tests. And each test interval is not less than seven days. The results suggest that there is no apparent effect of eating the food containing carbohydrates wit...

  20. How do different components of Effortful Control contribute to children's mathematics achievement?

    Science.gov (United States)

    Sánchez-Pérez, Noelia; Fuentes, Luis J; Pina, Violeta; López-López, Jose A; González-Salinas, Carmen

    2015-01-01

    This work sought to investigate the specific contribution of two different components of Effortful Control (EC) -attentional focusing (AF) and inhibitory control- to children's mathematics achievement. The sample was composed of 142 children aged 9-12 year-old. EC components were measured through the Temperament in Middle Childhood Questionnaire (TMCQ; parent's report); math achievement was measured via teacher's report and through the standard Woodcock-Johnson test. Additionally, the contribution of other cognitive and socio-emotional processes was taken into account. Our results showed that only AF significantly contributed to the variance of children's mathematics achievement; interestingly, mediational models showed that the relationship between effortful attentional self-regulation and mathematics achievement was mediated by academic peer popularity, as well as by intelligence and study skills. Results are discussed in the light of the current theories on the role of children's self-regulation abilities in the context of school.

  1. Perceived Control Mediates the Relations between Depressive Symptoms and Academic Achievement in Adolescence.

    Science.gov (United States)

    Moè, Angelica

    2015-09-17

    The present research examined the protective role played by perceived control in the relation between depressive symptoms and academic achievement in adolescence. A sample of 218 adolescents aged 11 to 16 filled in questionnaires to assess self-reported depressive symptoms and three factors tied with Perceived Control (PC): self-regulated learning strategies use, effort attribution, and perceived competence. Grade Point Average (GPA) was considered as a measure of academic achievement. A path model showed that the relation between GPA and depressive symptoms is mediated by PC (plearning in planning programmes to prevent and treat depressive symptoms in adolescence.

  2. A preliminary study of the effects of Tai Chi and Qigong medical exercise on indicators of metabolic syndrome, glycaemic control, health-related quality of life, and psychological health in adults with elevated blood glucose.

    Science.gov (United States)

    Liu, X; Miller, Y D; Burton, N W; Brown, W J

    2010-08-01

    To evaluate the feasibility, acceptability and effects of a Tai Chi and Qigong exercise programme in adults with elevated blood glucose. A single group pre-post feasibility trial with 11 participants (3 male and 8 female; aged 42-65 years) with elevated blood glucose. Participants attended Tai Chi and Qigong exercise training for 1 to 1.5 h, 3 times per week for 12 weeks, and were encouraged to practise the exercises at home. Indicators of metabolic syndrome (body mass index (BMI), waist circumference, blood pressure, fasting blood glucose, triglycerides, HDL-cholesterol); glucose control (HbA1c, fasting insulin and insulin resistance (HOMA)); health-related quality of life; stress and depressive symptoms. There was good adherence and high acceptability. There were significant improvements in four of the seven indicators of metabolic syndrome including BMI (mean difference -1.05, pstress (-2.27, p<0.05), depressive symptoms (-3.60, p<0.05), and the SF-36 mental health summary score (5.13, p<0.05) and subscales for general health (19.00, p<0.01), mental health (10.55, p<0.01) and vitality (23.18, p<0.05). The programme was feasible and acceptable and participants showed improvements in metabolic and psychological variables. A larger controlled trial is now needed to confirm these promising preliminary results.

  3. Relationships between Locus of Control, Self-Efficacy, Efforts and Academic Achievement among Engineering Students

    Directory of Open Access Journals (Sweden)

    Alias Maizam

    2016-01-01

    Full Text Available The aim of this study is to investigate the relationships between the affective learning needs namely, self-efficacy and locus of control, learning efforts and academic achievement among engineering students. For this purpose, a survey was conducted on first year engineering students from two technical universities in Malaysia. Self-efficacy and locus of control were assessed using existing instruments while learning efforts were assessed using a specifically designed instrument based on Carbonaro’s model of learning effort. Academic achievement data were based on cumulative grade point average (CGPA obtained from self-report by participants. The findings indicate that females engineering students tend to have higher self-efficacy compared to males while both groups have similar locus of control and invest in similar learning efforts. Only locus of control is found to be related to academic achievement while self-efficacy is found to be related to efforts. In conclusion, locus of control seems to be an important factor in predicting academic achievement among engineering students.

  4. A single supplement of a standardised bilberry (Vaccinium myrtillus L.) extract (36 % wet weight anthocyanins) modifies glycaemic response in individuals with type 2 diabetes controlled by diet and lifestyle

    DEFF Research Database (Denmark)

    Hoggard, Nigel; Cruickshank, Morven; Moar, Kim-Marie

    2013-01-01

    in T2D. Male volunteers with T2D (n 8; BMI 30 (sd 4) kg/m(2)) controlling their diabetes by diet and lifestyle alone were given a single oral capsule of either 0·47 g standardised bilberry extract (36 % (w/w) anthocyanins) which equates to about 50 g of fresh bilberries or placebo followed......Dietary strategies for alleviating health complications associated with type 2 diabetes (T2D) are being pursued as alternatives to pharmaceutical interventions. Berries such as bilberries (Vaccinium myrtillus L.) that are rich in polyphenols may influence carbohydrate digestion and absorption...... and thus postprandial glycaemia. In addition, berries have been reported to alter incretins as well as to have antioxidant and anti-inflammatory properties that may also affect postprandial glycaemia. The present study investigated the acute effect of a standardised bilberry extract on glucose metabolism...

  5. Can aerobic exercise complement antihypertensive drugs to achieve blood pressure control in individuals with essential hypertension?

    Science.gov (United States)

    Maruf, Fatai A; Salako, Babatunde L; Akinpelu, Aderonke O

    2014-06-01

    Achieving adequate blood pressure (BP) control with antihypertensive medication remains an elusive goal for many patients. The advances in knowledge of hypertension and the increasingly improved upon therapeutic strategies seem not to guarantee even sustainable control rates at the population level. In addition, patients who either discontinue their medications or are non-adherent to drug therapy run the risk of developing uncontrolled BP. Number of daily tablets more than two and number of daily drug administration at least three have been associated with poor adherence with drug therapy. However, BP control seems to go beyond adherence with drug therapy as there are other associated factors. Studies have demonstrated beneficial effect of aerobic exercise in the prevention and management of hypertension. It appears, however, that the majority of these studies failed to explore the possible additive or synergistic effect of aerobic exercise on antihypertensive drugs such that fewer drugs would be required to achieve BP control or that the BP control rate would be increased with the same number of drugs. This review presents the evidence for poor BP control in the general population, and the possible means and process of aerobic exercise complementing antihypertensive drug therapy in order to achieve higher BP control rates.

  6. The impact of a high versus a low glycaemic index breakfast cereal meal on verbal episodic memory in healthy adolescents.

    Science.gov (United States)

    Smith, Michael A; Foster, Jonathan K

    2008-10-01

    In this study, healthy adolescents consumed either (i) a low glycaemic index breakfast cereal meal or (ii) a high glycaemic index breakfast cereal meal, before completing a test of verbal episodic memory in which the memory materials were encoded under conditions of divided attention. Analysis of remembering/forgetting indices revealed that the high glycaemic index breakfast group remembered significantly more items relative to the low glycaemic index breakfast group after a long delay. The superior performance observed in the high glycaemic index group, relative to the low glycaemic index group, may be due to the additional glucose availability provided by the high glycaemic index meal at the time of memory encoding. This increased glucose availability may be necessary for effective encoding under dual task conditions.

  7. Malaria vaccine-is it still required? Are vaccine alternatives enough to achieve malaria control?

    Institute of Scientific and Technical Information of China (English)

    Fsadni Claudia

    2014-01-01

    Despite ongoing continuous research towards developing a malaria vaccine, we have still not achieved this target and the malaria parasite continues to kill thousands, especially children in developing countries. However, current control methods have had good results in some countries. Can these control methods be enough or should people still keep hoping for a vaccine? Would eradication of malaria be a possibility if no vaccine remains available?

  8. Metabolic Control and Academic Achievement over Time among Adolescents with Type 1 Diabetes

    Science.gov (United States)

    Winnick, Joel B.; Berg, Cynthia A.; Wiebe, Deborah J.; Schaefer, Barbara A.; Lei, Pui-Wa; Butner, Jonathan E.

    2017-01-01

    The relation between metabolic control (HbA1c) and achievement (grade point average [GPA]) was examined over a period of 2.5 years (every 6 months) employing a dynamical systems approach that allowed for the examination of whether HbA1c was associated with change in subsequent GPA and vice versa. Metabolic control tends to deteriorate (i.e., with…

  9. MULTILOOP PI CONTROLLER FOR ACHIEVING SIMULTANEOUS TIME AND FREQUENCY DOMAIN SPECIFICATIONS

    Directory of Open Access Journals (Sweden)

    M. SENTHILKUMAR

    2015-08-01

    Full Text Available Most of the controllers in control system are designed to satisfy either time domain or frequency domain specifications. This work presents the computation of a multiloop PI controller for achieving time and frequency domain specifications simultaneously. The desired time and frequency domain measures are to be specified initially to the design. To obtain the desired value of the performance measures the graphical relationship between the PI controller and the performance criteria is given. Thus by using graphical method a set of PI controller parameters to meet the desired performance measures are obtained in an effective and simpler way. The coupled tank has become a classic design of control engineering for multivariable process. The proposed control strategy has been implemented in the same coupled tank process and validated through simulation studies.

  10. Autonomy Support versus Psychological Control, Perfectionism, and Taiwanese Adolescents' Achievement Goals

    Science.gov (United States)

    Shih, Shu-Shen

    2013-01-01

    The author attempted to explore potential antecedents of achievement goals and relations of teacher and parental autonomy support versus psychological control to Taiwanese adolescents' perfectionistic tendencies. A total of 512 eighth-grade students completed self-reported questionnaires assessing variables of interest. Results indicated that…

  11. Effortful Control and Impulsivity as Concurrent and Longitudinal Predictors of Academic Achievement

    Science.gov (United States)

    Valiente, Carlos; Eisenberg, Nancy; Spinrad, Tracy L.; Haugen, Rg; Thompson, Marilyn S.; Kupfer, Anne

    2013-01-01

    The goal of this study was to test if both effortful control (EC) and impulsivity, a reactive index of temperament, uniquely predict adolescents' academic achievement, concurrently and longitudinally (Time 1: "N" = 168, X-bar[subscript age] = 12 years). At Time 1, parents and teachers reported on students' EC and impulsivity.…

  12. The Exploration of the Associations between Locus of Control & High School Students’ Language Achievement

    Directory of Open Access Journals (Sweden)

    Abbas Eslami-Rasekh

    2012-07-01

    Full Text Available The purpose of the study is to determine the relationships between locus of control (LOC orientation and high school students’ language achievement. The popular categorization of internals and externals was taken into account. The participants of this study were 121 high school students in the second, third and pre-university grades in two public high schools of Isfahan, Iran. One of the instruments used in the study was an adopted version of Julian Rotters’ locus of control (1966 which identified internal and external orientations. The participants’ English scores were regarded as the measure of their achievement. Besides, a questionnaire consisting of 29 items was administered to all 121 students. Responses were put into one way and two-way ANOVA, the regression analysis, the independent t-test, chi-square and linear regression analysis to compare the means of two sets of scores. The findings of this study show a significant relationship between locus control and achievement of high school students. The findings can be used by EFL teachers and syllabus designers. Keywords: locus of control; high school students; language achievement; internals; externals

  13. Children's Sleep and Academic Achievement: The Moderating Role of Effortful Control

    Science.gov (United States)

    Diaz, Anjolii; Berger, Rebecca; Valiente, Carlos; Eisenberg, Nancy; VanSchyndel, Sarah K.; Tao, Chun; Spinrad, Tracy; Doane, Leah D.; Thompson, Marilyn S.; Silva, Kassondra M.; Southworth, Jody

    2017-01-01

    Poor sleep is thought to interfere with children's learning and academic achievement (AA). However, existing research and theory indicate there are factors that may mitigate the academic risk associated with poor sleep. The purpose of this study was to examine the moderating role of children's effortful control (EC) on the relation between sleep…

  14. Children's Sleep and Academic Achievement: The Moderating Role of Effortful Control

    Science.gov (United States)

    Diaz, Anjolii; Berger, Rebecca; Valiente, Carlos; Eisenberg, Nancy; VanSchyndel, Sarah K.; Tao, Chun; Spinrad, Tracy; Doane, Leah D.; Thompson, Marilyn S.; Silva, Kassondra M.; Southworth, Jody

    2017-01-01

    Poor sleep is thought to interfere with children's learning and academic achievement (AA). However, existing research and theory indicate there are factors that may mitigate the academic risk associated with poor sleep. The purpose of this study was to examine the moderating role of children's effortful control (EC) on the relation between sleep…

  15. Chronic administration of ethanol leaf extract of Moringa oleifera Lam. (Moringaceae) may compromise glycaemic efficacy of Sitagliptin with no significant effect in retinopathy in a diabetic rat model.

    Science.gov (United States)

    Olurishe, Comfort; Kwanashie, Helen; Zezi, Abdulkadiri; Danjuma, Nuhu; Mohammed, Bisalla

    2016-12-24

    Moringa oleifera Lam. (Moringaceae) has gained awareness for its antidiabetic effect, and is used as alternative therapy or concurrently with orthodox medicines such as sitagliptin in diabetes mellitus. This is without ascertaining the possibility of drug-herb interactions, which could either lead to enhanced antidiabetic efficacy, increased toxicity, or compromised glycaemic control with negative consequence in diabetic retinopathy. To investigate the effect, of sitagliptin (50mg/kg), Moringa oleifera (300mg/kg) leaf extract, and a combination of both on glycaemic control parameters, lenticular opacity and changes in retinal microvasculature in alloxan (150mg/kg i.p) induced diabetic rat model. Seven groups of eight rats per group were used, with groups I, II and VII as normal (NC), diabetic (DC) and post-prandial controls (PPC). Groups III to VI were diabetic rats on sitagliptin (III), M. oleifera (IV), sitagliptin and M. oleifera (SM) (V), for 42 days with 2 weeks delayed treatment in a post-prandial hyperglycaemic group (PPSM) (VI). Glycaemic control parameters, insulin levels, body weights, and effects of retinal microvasculature on lenticular opacity/morphology were investigated. A significant decrease in fasting blood glucose (FBG) levels was displayed in SM group from day 14(60%) (poleifera showed a progressive decrease in anti-hyperglycaemic effect of sitagliptin, and although it delayed the onset of lenticular opacity (i.e. cataract-like changes) it did not prevent the progression nor ameliorated pathologic lesions in the retina. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Adding glycaemic index and glycaemic load functionality to DietPLUS, a Malaysian food composition database and diet intake calculator.

    Science.gov (United States)

    Shyam, Sangeetha; Wai, Tony Ng Kock; Arshad, Fatimah

    2012-01-01

    This paper outlines the methodology to add glycaemic index (GI) and glycaemic load (GL) functionality to food DietPLUS, a Microsoft Excel-based Malaysian food composition database and diet intake calculator. Locally determined GI values and published international GI databases were used as the source of GI values. Previously published methodology for GI value assignment was modified to add GI and GL calculators to the database. Two popular local low GI foods were added to the DietPLUS database, bringing up the total number of foods in the database to 838 foods. Overall, in relation to the 539 major carbohydrate foods in the Malaysian Food Composition Database, 243 (45%) food items had local Malaysian values or were directly matched to International GI database and another 180 (33%) of the foods were linked to closely-related foods in the GI databases used. The mean ± SD dietary GI and GL of the dietary intake of 63 women with previous gestational diabetes mellitus, calculated using DietPLUS version3 were, 62 ± 6 and 142 ± 45, respectively. These values were comparable to those reported from other local studies. DietPLUS version3, a simple Microsoft Excel-based programme aids calculation of diet GI and GL for Malaysian diets based on food records.

  17. Role of parenting style in achieving metabolic control in adolescents with type 1 diabetes.

    Science.gov (United States)

    Shorer, Maayan; David, Ravit; Schoenberg-Taz, Michal; Levavi-Lavi, Ifat; Phillip, Moshe; Meyerovitch, Joseph

    2011-08-01

    To examine the role of parenting style in achieving metabolic control and treatment adherence in adolescents with type 1 diabetes. Parents of 100 adolescents with type 1 diabetes completed assessments of their parenting style and sense of helplessness. Parents and patients rated patient adherence to the treatment regimen. Glycemic control was evaluated by HbA(1c) values. An authoritative paternal parenting style predicted better glycemic control and adherence in the child; a permissive maternal parenting style predicted poor adherence. A higher sense of helplessness in both parents predicted worse glycemic control and lesser adherence to treatment. Parental sense of helplessness was a significant predictor of diabetes control after correcting for other confounders (patient age, sex, and treatment method). An authoritative nonhelpless parenting style is associated with better diabetes control in adolescents. Paternal involvement is important in adolescent diabetes management. These results have implications for psychological interventions.

  18. Achieving control and synchronization merely through a stochastically adaptive feedback coupling

    Science.gov (United States)

    Lin, Wei; Chen, Xin; Zhou, Shijie

    2017-07-01

    Techniques of deterministically adaptive feedback couplings have been successfully and extensively applied to realize control or/and synchronization in chaotic dynamical systems and even in complex dynamical networks. In this article, a technique of stochastically adaptive feedback coupling is novelly proposed to not only realize control in chaotic dynamical systems but also achieve synchronization in unidirectionally coupled systems. Compared with those deterministically adaptive couplings, the proposed stochastic technique interestingly shows some advantages from a physical viewpoint of time and energy consumptions. More significantly, the usefulness of the proposed stochastic technique is analytically validated by the theory of stochastic processes. It is anticipated that the proposed stochastic technique will be widely used in achieving system control and network synchronization.

  19. Locus of control, interest in schooling, self-efficacy and academic achievement

    Directory of Open Access Journals (Sweden)

    Adedeji Tella

    2009-12-01

    Full Text Available Academic achievement is interestingly an important issue; a fundamental premium upon which all teaching-learning activitiesare measured using some criteria of excellence e.g. good academic performance, poor academic performance and academicfailure. This study examined locus of control, interest in schooling and self-efficacy as predictors of academic achievement ofJunior Secondary School Students. The population of the study consisted of 500 students comprising 300 boys and 200 girls.These were selected from twenty-five secondary schools through stratified random techniques. An ex-post facto researchdesign was adopted. Three independents variables (Locus of Control, Interest in schooling and self –efficacy with thedependent variable (academic achievement were measured with relevant standardized instruments. Two research questionswere developed and answered. The results indicate that locus of control, interest in schooling and self efficacy jointly andrelatively contribute significantly to the prediction of academic achievement of the Junior Secondary School Students. Based onthese findings, the need to continuously stimulate the interest of the students and teaching them time management and forteachers to see all the three variables on the study as important and improve them simultaneously was emphasized.

  20. How do different components of Effortful Control contribute to children's mathematics achievement?

    Directory of Open Access Journals (Sweden)

    Noelia eSánchez-Pérez

    2015-09-01

    Full Text Available This work sought to investigate the specific contribution of two different components of Effortful Control -attentional focusing and inhibitory control- to children’s mathematics achievement. The sample was composed of 142 children aged 9 to 12 years old. Effortful Control components were measured through the Temperament in Middle Childhood Questionnaire (TMCQ; parent´s report; math achievement was measured via teacher’s report and through the standard Woodcock-Johnson test. Additionally, the contribution of other cognitive and socio-emotional processes was taken into account. Our results showed that only attentional focusing significantly contributed to the variance of children’s mathematics achievement; interestingly, mediational models showed that the relationship between effortful attentional self-regulation and mathematics achievement was mediated by academic peer popularity, as well as by intelligence and study skills. Results are discussed in the light of the current theories on the role of children’ self-regulation abilities in the context of school.

  1. High-Achieving High School Students and Not so High-Achieving College Students: A Look at Lack of Self-Control, Academic Ability, and Performance in College

    Science.gov (United States)

    Honken, Nora B.; Ralston, Patricia A. S.

    2013-01-01

    This study investigated the relationship among lack of self-control, academic ability, and academic performance for a cohort of freshman engineering students who were, with a few exceptions, extremely high achievers in high school. Structural equation modeling analysis led to the conclusion that lack of self-control in high school, as measured by…

  2. Patient factors and glycaemic control--associations and explanatory power

    DEFF Research Database (Denmark)

    Rogvi, S; Tapager, I; Almdal, T P

    2012-01-01

    ) in a large Danish population of patients with Type 2 diabetes. METHODS: Cross-sectional survey and record review of 2045 patients from a specialist diabetes clinic. Validated scales measured patient activation, self-management behaviours, diabetes-related emotional distress, and perceived care...

  3. Assessment of glycaemic, lipid and blood pressure control among ...

    African Journals Online (AJOL)

    Diabetes mellitus (DM) is a metabolic disorder primarily characterized by elevated blood glucose levels and microvascular andmacrovascular complications. ... are needed to reduce the likelihood of development of macrovascular disease.

  4. Oxidative Stress and Glycaemic Control in Type 2 Diabetic Patients ...

    African Journals Online (AJOL)

    Uche

    2011-01-15

    Jan 15, 2011 ... The MDA level when compared to fasting blood sugar (FBS) and glycated haemoglobin (HbA1c) showed a positive ... diabetes caused by cardiovascular disease. ... Excess nourishment and sedentary lifestyle lead to glucose ...

  5. Effect of bile acid sequestrants on glycaemic control

    DEFF Research Database (Denmark)

    Hansen, Morten; Sonne, David Peick; Mikkelsen, Kristian Hallundbæk

    2012-01-01

    of hypercholesterolaemia: colestipol, cholestyramine and colesevelam. The BAS colestimide/colestilan is used in Japan. Colesevelam was recently approved by the FDA for the treatment of T2DM. We plan to provide a systematic review with meta-analysis of the glucose-lowering effect of BASs with the aim to evaluate...

  6. High school students' perceptions of EFL teacher control orientations and their English academic achievement.

    Science.gov (United States)

    Kiany, Gholam Reza; Shayestefar, Parvaneh

    2011-09-01

    BACKGROUND. Theories distinguish between student-initiated and teacher-initiated regulation of students' learning activities, or between strong, shared, or loose teacher control during the completion of learning tasks. Empirical validations for such distinctions are scarce, however. AIM. The present study aimed at (a) investigating students' perceptions of control behaviours exhibited by their English teachers; and (b) exploring the contribution of different types of teacher control behaviours to students' cognitive outcomes (English Achievement). SAMPLE. The sample comprised 732 English as a Foreign Language (EFL) students studying in three major fields of high school (Mathematics, Natural Science, and Humanities). The participants (16-17 years of age) were selected from third-grade classes of 27 EFL teachers working in 25 high schools of 6 main different geographical regions in the Isfahan province, Iran. METHOD. To obtain a comprehensive picture of different control types exhibited by Iranian EFL teachers, the control subscales of the two existing questionnaires, i.e., the Questionnaire on Instructional Behaviours (QIB), adapted by Den Brok et al. (2004) and the Questionnaire on Lesson Activities (QLA) used by Den Brok (2001) were merged to form the Questionnaire of Teacher Control (QTC). The development of this Persian instrument involved several steps: translation and back translation by the researchers, one expert translator, and two EFL teachers; piloting; and a final administration of the questionnaire to the student sample. With respect to the second aim of the study, data regarding students' performances on the Standardized National English Achievement Tests were gathered from local educational offices and schools. RESULTS AND CONCLUSION. Statistical analyses supported acceptable reliability and validity of the instrument. A main factor structure with three types of teacher control (strong/high, shared/mid, and loose/low) was found to underlie students

  7. [Relationship between the prone position and achieving head control at 3 months].

    Science.gov (United States)

    Pérez-Machado, J L; Rodríguez-Fuentes, G

    2013-10-01

    Owing to the significant increase of mild motor delays and the strong intolerance of infants to be placed on prone position observed in the Physiotherapy Unit of the Maternal and Children's University Hospital of the Canaries (HUMIC), a study was conducted to determine whether positioning infants in the prone position while awake affected the achievement and quality of head control at three months. A prospective comparative practice-based study of a representative sample of 67 healthy infants born in the HUMIC, and divided into an experimental group (n = 35) and control group (n = 32). The Alberta Infant Motor Scale (AIMS) and a parent questionnaire were used as measurement tools. The intervention consisted of regular home visits to the experimental group (from the first to the third month). The two groups were evaluated in their homes at the end of 3 months. The differences in mean raw score of the AIMS at 3 months were, 16.26 in the experimental group and 10.38 in control group (P<.001). The percentile mean was 94 in the experimental group, and less than 50 (42) in the control group. All of the experimental group babies achieved the head control, with only 8 in the control group (25%). The significant findings suggest a direct relationship between the time spent in the prone position when the baby is awake and the achievement of head control at three months. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  8. Professional training in the workplace: the role of achievement motivation and locus of control.

    Science.gov (United States)

    Suárez-Álvarez, Javier; Campillo-Álvarez, Angela; Fonseca-Pedrero, Eduardo; García-Cueto, Eduardo; Muñiz, José

    2013-01-01

    The core objective of the present work is to explore the reasons why workers from different employment sectors join training courses to improve their job. To this end we assessed achievement motivation, locus of control and professional qualifications according to the participants' employment sector. The final sample consisted of 1460 active Spanish workers from four different employment sectors: services, catering, metal construction, and others. Of the sample, 40.1% were male and 59.9% female, with a mean age of 33.3 years (SD = 9.7). The results show that the new scale developed to assess achievement motivation, locus of control and workers' qualifications presents adequate psychometric characteristics. Statistically significant differences were found in relation to employment sector. The areas studied showed satisfactory levels of workers' effort and achievement motivation to perform their jobs, though their attitudes toward the training courses as a basis for improving their employability are varied. Workers in the catering sector had higher levels of external attribution and the lowest interest in training. Those in the service sector had higher levels of achievement motivation and effort at work. Future research should develop a joint program covering the public and private sectors for the modification of these beliefs, attitudes and attributions.

  9. Building on the Enriched Hierarchical Model of Achievement Motivation: Autonomous and Controlling Reasons Underlying Mastery Goals

    Directory of Open Access Journals (Sweden)

    Aikaterini Michou

    2016-07-01

    Full Text Available Two motivational theories – the Achievement Goal Theory and Self-Determination Theory – have recently been combined to explain students’ motivation, making it possible to study the “what” and the “why” of learners’ achievement strivings. The present study built on this approach by (a investigating whether the distinction between autonomous or volitional and controlling or pressuring reasons can be meaningfully applied to the adoption of mastery-avoidance goals, (b investigating the concurrent and prospective relations between mastery-avoidance goals and their underlying reasons and learning strategies when mastery-approach goals and their underlying reasons were also considered, and by (c incorporating psychological need experiences as an explanatory variable in the relation between achievement motives (i.e., the motive to succeed and motive to avoid failure and both mastery goals and their underlying reasons. In two Turkish university students samples ('N' = 226, 'Mage '= 22.36; 'N' = 331, 'Mage '= 19.5, autonomous and controlling reasons appeared applicable to mastery-avoidance goals and regression and path analysis further showed that mastery-avoidance goals and their underlying autonomous reasons fail to predicted learning strategies over and above the pursuit of mastery-approach goals and their underlying reasons. Finally, need experiences were established as mediators between achievement motives and both mastery goals and their underlying reasons.

  10. Achieving 3-D Nanoparticle Assembly in Nanocomposite Thin Films via Kinetic Control

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Jingyu; Xiao, Yihan; Xu, Ting [UCB

    2017-02-20

    Nanocomposite thin films containing well-ordered nanoparticle (NP) assemblies are ideal candidates for the fabrication of metamaterials. Achieving 3-D assembly of NPs in nanocomposite thin films is thermodynamically challenging as the particle size gets similar to that of a single polymer chain. The entropic penalties of polymeric matrix upon NP incorporation leads to NP aggregation on the film surface or within the defects in the film. Controlling the kinetic pathways of assembly process provides an alternative path forward by arresting the system in nonequilibrium states. Here, we report the thin film 3-D hierarchical assembly of 20 nm NPs in supramolecules with a 30 nm periodicity. By mediating the NP diffusion kinetics in the supramolecular matrix, surface aggregation of NPs was suppressed and NPs coassemble with supramolecules to form new 3-D morphologies in thin films. The present studies opened a viable route to achieve designer functional composite thin films via kinetic control.

  11. Clinical importance of achieving biochemical control with medical therapy in adult patients with acromegaly

    Science.gov (United States)

    Christofides, Elena A

    2016-01-01

    In acromegaly, achieving biochemical control (growth hormone [GH] level acromegaly is challenging because it is rooted in observing subtle clinical manifestations, and it is typical for acromegaly to evolve for up to 10 years before it is recognized. This results in chronic exposure to elevated levels of GH and IGF-1 and delay in patients receiving appropriate treatment, which consequently increases mortality risk. In this review, the clinical impact of elevated GH and IGF-1 levels, the effectiveness of current therapies, and the potential role of novel treatments for acromegaly will be discussed. Clinical burden of acromegaly and benefits associated with management of GH and IGF-1 levels will be reviewed. Major treatment paradigms in acromegaly include surgery, medical therapy, and radiotherapy. With medical therapies, such as somatostatin analogs, dopamine agonists, and GH receptor antagonists, a substantial proportion of patients achieve reduced GH and normalized IGF-1 levels. In addition, signs and symptoms, quality of life, and comorbidities have also been reported to improve to varying degrees in patients who achieve biochemical control. Currently, there are several innovative therapies in development to improve patient outcomes, patient use, and access. Timely biochemical control of acromegaly ensures that the patient can ultimately improve morbidity and mortality from this disease and its extensive consequences. PMID:27471378

  12. The Best Achievable ℋ2 Tracking Performances for SIMO Feedback Control Systems

    Directory of Open Access Journals (Sweden)

    Shinji Hara

    2007-01-01

    Full Text Available This paper is concerned with the inherent ℋ2 tracking performance limitation of single-input and multiple-output (SIMO linear time-invariant (LTI feedback control systems. The performance is measured by the tracking error between a step reference input and the plant output with additional penalty on control input. We employ the plant augmentation strategy, which enables us to derive analytical closed-form expressions of the best achievable performance not only for discrete-time system, but also for continuous-time system by exploiting the delta domain version of the expressions.

  13. Glycaemic and insulin responses, glycaemic index and insulinaemic index values of rice between three Asian ethnic groups.

    Science.gov (United States)

    Tan, V M H; Wu, T; Henry, C J; Lee, Y S

    2015-04-28

    Asians exhibit larger glycaemic response (GR) and insulin response (IR) than Caucasians, predisposing to an increased risk of type 2 diabetes mellitus (T2DM). We aimed to determine the GR and IR as well as the glycaemic index (GI) and insulinaemic index (II) of two rice varieties among three ethnic groups in Singapore. A total of seventy-five healthy males (twenty-five Chinese, twenty-five Malay and twenty-five Asian-Indians) were served the available equivalent carbohydrate amounts (50 g) of test foods (Jasmine rice and Basmati rice) and a reference food (glucose) on separate occasions. Postprandial blood glucose and plasma insulin concentrations were measured at fasting ( -5 and 0 min) and at 15, 30, 45, 60, 90 and 120 min after food consumption. Using the trapezoidal rule, GR, IR, GI and II values were determined. The GR did not differ between ethnic groups for Jasmine rice and Basmati rice. The IR was consistently higher for Jasmine rice (P=0·002) and Basmati rice (P=0·002) among Asian-Indians, probably due to compensatory hyperinsulinaemia to maintain normoglycaemia. The GI and II of both rice varieties did not differ significantly between ethnicities. The overall mean GI for Jasmine rice and Basmati rice were 91 (sd 21) and 59 (sd 15), respectively. The overall mean II for Jasmine rice was 76 (sd 26) and for Basmati rice was 57 (sd 24). We conclude that the GI values presented for Jasmine rice and Basmati rice were applicable to all three ethnic groups in Singapore. Future studies should include deriving the II for greater clinical utility in the prevention and management of T2DM.

  14. Beyond intuitive anthropomorphic control: recent achievements using brain computer interface technologies

    Science.gov (United States)

    Pohlmeyer, Eric A.; Fifer, Matthew; Rich, Matthew; Pino, Johnathan; Wester, Brock; Johannes, Matthew; Dohopolski, Chris; Helder, John; D'Angelo, Denise; Beaty, James; Bensmaia, Sliman; McLoughlin, Michael; Tenore, Francesco

    2017-05-01

    Brain-computer interface (BCI) research has progressed rapidly, with BCIs shifting from animal tests to human demonstrations of controlling computer cursors and even advanced prosthetic limbs, the latter having been the goal of the Revolutionizing Prosthetics (RP) program. These achievements now include direct electrical intracortical microstimulation (ICMS) of the brain to provide human BCI users feedback information from the sensors of prosthetic limbs. These successes raise the question of how well people would be able to use BCIs to interact with systems that are not based directly on the body (e.g., prosthetic arms), and how well BCI users could interpret ICMS information from such devices. If paralyzed individuals could use BCIs to effectively interact with such non-anthropomorphic systems, it would offer them numerous new opportunities to control novel assistive devices. Here we explore how well a participant with tetraplegia can detect infrared (IR) sources in the environment using a prosthetic arm mounted camera that encodes IR information via ICMS. We also investigate how well a BCI user could transition from controlling a BCI based on prosthetic arm movements to controlling a flight simulator, a system with different physical dynamics than the arm. In that test, the BCI participant used environmental information encoded via ICMS to identify which of several upcoming flight routes was the best option. For both tasks, the BCI user was able to quickly learn how to interpret the ICMSprovided information to achieve the task goals.

  15. Operational scale entomological intervention for malaria control: strategies, achievements and challenges in Zambia.

    Science.gov (United States)

    Chanda, Emmanuel; Mukonka, Victor M; Kamuliwo, Mulakwa; Macdonald, Michael B; Haque, Ubydul

    2013-01-08

    While consensus on malaria vector control policy and strategy has stimulated unprecedented political-will, backed by international funding organizations and donors, vector control interventions are expansively being implemented based on assumptions with unequaled successes. This manuscript reports on the strategies, achievements and challenges of the past and contemporary malaria vector control efforts in Zambia. All available information and accessible archived documentary records on malaria vector control in Zambia were reviewed. Retrospective analysis of routine surveillance data from the Health Management Information System (HMIS), data from population-based household surveys and various operations research reports was conducted to assess the status in implementing policies and strategies. Empirical evidence is critical for informing policy decisions and tailoring interventions to local settings. Thus, the World Health Organization (WHO) encourages the adoption of the integrated vector management (IVM) strategy which is a rational decision making process for optimal use of available resources. One of the key features of IVM is capacity building at the operational level to plan, implement, monitor and evaluate vector control and its epidemiological and entomological impact. In Zambia, great progress has been made in implementing WHO-recommended vector control policies and strategies within the context of the IVM Global Strategic framework with strong adherence to its five key attributes. The country has solid, consistent and coordinated policies, strategies and guidelines for malaria vector control. The Zambian experience demonstrates the significance of a coordinated multi-pronged IVM approach effectively operationalized within the context of a national health system.

  16. Glycaemic and insulinaemic response of quarter horses to concentrates high in fat and low in soluble carbohydrates.

    Science.gov (United States)

    Zeyner, A; Hoffmeister, C; Einspanier, A; Gottschalk, J; Lengwenat, O; Illies, M

    2006-08-01

    Quarter Horses are particularly susceptible to polysaccharide storage myopathy (PSSM). Nutritional therapy and possibly prophylaxis includes fat-supplemented diets whilst starch supply should be kept to a minimum. To investigate the glycaemic and insulinaemic response of clinically normal Quarter Horses to concentrates high in fat and low in starch. Twelve Quarter Horses were studied. The precondition for inclusion in the study population was that the horses had not shown clinical signs of myopathy. The Quarter Horses were fed according to a 4 x 4 Latin square design haylage plus isocaloric concentrates based on barley and oats as control (CO), sugar beet pulp, grass meal and soybean oil (SB), rice bran and grass meal (RB) and rice bran, grass meal, sugar beet pulp and soybean oil (CP), each over 2 weeks after 1 week of adaptation. At the end of each period, 1 kg of concentrate was fed and blood sampled 0, 30, 60, 90, 120, 180, 240, and 300 min post prandial (ppr.). Creatine kinase (CK; 0 min ppr. only), glucose and insulin were analysed. Glycaemic and insulinaemic index was calculated from each concentrates area under the curve (AUC) relative to CO. Rice bran containing concentrates were partially refused at the beginning of the trial periods. CK activity, and glucose and insulin patterns (ppr. mean, peak, AUC, index) were highest with CO (Phorses, but also to prevent future PSSM associated discomfort in particularly susceptible horses.

  17. Estimation of secondary effect parameters in glycaemic dynamics using accumulating data from a virtual type 1 diabetic patient.

    Science.gov (United States)

    Mansell, Erin J; Docherty, Paul D; Fisk, Liam M; Chase, J Geoffrey

    2015-08-01

    Some individuals with type 1 diabetes mellitus find self-managed glycaemic control difficult due to the confounding influence of secondary effects. Stress and sleep deprivation temporarily lower insulin sensitivity (SI), often resulting in hyperglycaemia, while aerobic exercise depletes glucose, leading to hypoglycaemia if treatment is unchanged. This study tests the estimation of these factors and circadian rhythms of SI in noisy data. Sparse, irregular and noisy virtual blood glucose data, mimicking the glycaemic dynamics of an individual with type 1 diabetes, was created via adapted pharmacokinetic-pharmacodynamic models of glucose and insulin that included the impact of the secondary effects. A Gauss-Newton algorithm was used to recover the original model parameters for SI, stress, fatigue and exercise. During longer identification periods, compensation was made for drift in SI. Monte Carlo analyses were undertaken to validate the methods. The coefficient of variation (CV) in all parameters decreased as the data accumulated in proportion to the 1/n rule (R(2) > 99.9%). Relatively small biases from the original parameter values occurred (data to override the effect of measurement error. Compensation for SI drift allows viable observation of secondary effects and SI rhythms over longer time periods. Collectively, these outcomes indicate that quality results for identified parameters could be obtained during in vivo studies.

  18. Individual differences in inhibitory control, not non-verbal number acuity, correlate with mathematics achievement.

    Directory of Open Access Journals (Sweden)

    Camilla Gilmore

    Full Text Available Given the well-documented failings in mathematics education in many Western societies, there has been an increased interest in understanding the cognitive underpinnings of mathematical achievement. Recent research has proposed the existence of an Approximate Number System (ANS which allows individuals to represent and manipulate non-verbal numerical information. Evidence has shown that performance on a measure of the ANS (a dot comparison task is related to mathematics achievement, which has led researchers to suggest that the ANS plays a critical role in mathematics learning. Here we show that, rather than being driven by the nature of underlying numerical representations, this relationship may in fact be an artefact of the inhibitory control demands of some trials of the dot comparison task. This suggests that recent work basing mathematics assessments and interventions around dot comparison tasks may be inappropriate.

  19. Individual differences in inhibitory control, not non-verbal number acuity, correlate with mathematics achievement.

    Science.gov (United States)

    Gilmore, Camilla; Attridge, Nina; Clayton, Sarah; Cragg, Lucy; Johnson, Samantha; Marlow, Neil; Simms, Victoria; Inglis, Matthew

    2013-01-01

    Given the well-documented failings in mathematics education in many Western societies, there has been an increased interest in understanding the cognitive underpinnings of mathematical achievement. Recent research has proposed the existence of an Approximate Number System (ANS) which allows individuals to represent and manipulate non-verbal numerical information. Evidence has shown that performance on a measure of the ANS (a dot comparison task) is related to mathematics achievement, which has led researchers to suggest that the ANS plays a critical role in mathematics learning. Here we show that, rather than being driven by the nature of underlying numerical representations, this relationship may in fact be an artefact of the inhibitory control demands of some trials of the dot comparison task. This suggests that recent work basing mathematics assessments and interventions around dot comparison tasks may be inappropriate.

  20. Concepts for Life Cycle Cost Control Required to Achieve Space Transportation Affordability and Sustainability

    Science.gov (United States)

    Rhodes, Russel E.; Zapata, Edgar; Levack, Daniel J. H.; Robinson, John W.; Donahue, Benjamin B.

    2009-01-01

    Cost control must be implemented through the establishment of requirements and controlled continually by managing to these requirements. Cost control of the non-recurring side of life cycle cost has traditionally been implemented in both commercial and government programs. The government uses the budget process to implement this control. The commercial approach is to use a similar process of allocating the non-recurring cost to major elements of the program. This type of control generally manages through a work breakdown structure (WBS) by defining the major elements of the program. If the cost control is to be applied across the entire program life cycle cost (LCC), the approach must be addressed very differently. A functional breakdown structure (FBS) is defined and recommended. Use of a FBS provides the visibifity to allow the choice of an integrated solution reducing the cost of providing many different elements of like function. The different functional solutions that drive the hardware logistics, quantity of documentation, operational labor, reliability and maintainability balance, and total integration of the entire system from DDT&E through the life of the program must be fully defined, compared, and final decisions made among these competing solutions. The major drivers of recurring cost have been identified and are presented and discussed. The LCC requirements must be established and flowed down to provide control of LCC. This LCC control will require a structured rigid process similar to the one traditionally used to control weight/performance for space transportation systems throughout the entire program. It has been demonstrated over the last 30 years that without a firm requirement and methodically structured cost control, it is unlikely that affordable and sustainable space transportation system LCC will be achieved.

  1. Achieving Closed-Loop Control Simulation of Human-Artefact Interaction: A Comparative Review

    Directory of Open Access Journals (Sweden)

    Wilhelm Frederik van der Vegte

    2011-01-01

    Full Text Available To include user interactions in simulations of product use, the most common approach is to couple human subjects to simulation models, using hardware interfaces to close the simulation-control loop. Testing with virtual human models could offer a low-cost addition to evaluation with human subjects. This paper explores the possibilities for coupling human and artefact models to achieve fully software-based interaction simulations. We have critically reviewed existing partial solutions to simulate or execute control (both human control and product-embedded control and compared solutions from literature with a proof-of-concept we have recently developed. Our concept closes all loops, but it does not rely on validated algorithms to predict human decision making and low-level human motor control. For low-level control, validated solutions are available from other approaches. For human decision making, however, validated algorithms exist only to predict the timing but not the reasoning behind it. To identify decision-making schemes beyond what designers can conjecture, testing with human subjects remains indispensable.

  2. The Impact of Achieve3000 on Elementary Literacy Outcomes: Evidence from a Two-Year Randomized Control Trial

    Science.gov (United States)

    Hill, Darryl V.; Lenard, Matthew A.; Page, Lindsay Coleman

    2016-01-01

    School districts are increasingly adopting technology-based resources in an attempt to improve student achievement. This paper reports the two-year results from randomized control trial of Achieve3000 in the Wake County Public School System (WCPSS) in Raleigh, North Carolina. Achieve3000 is an early literacy program that differentiates non-fiction…

  3. Clinical importance of achieving biochemical control with medical therapy in adult patients with acromegaly

    Directory of Open Access Journals (Sweden)

    Christofides EA

    2016-07-01

    Full Text Available Elena A Christofides Endocrinology Associates, Inc., Columbus, OH, USA Abstract: In acromegaly, achieving biochemical control (growth hormone [GH] level <1.0 ng/mL and age- and sex-normalized levels of insulin-like growth factor 1 [IGF-1] through timely diagnosis and appropriate treatment provides an opportunity to improve patient outcomes. Diagnosis of acromegaly is challenging because it is rooted in observing subtle clinical manifestations, and it is typical for acromegaly to evolve for up to 10 years before it is recognized. This results in chronic exposure to elevated levels of GH and IGF-1 and delay in patients receiving appropriate treatment, which consequently increases mortality risk. In this review, the clinical impact of elevated GH and IGF-1 levels, the effectiveness of current therapies, and the potential role of novel treatments for acromegaly will be discussed. Clinical burden of acromegaly and benefits associated with management of GH and IGF-1 levels will be reviewed. Major treatment paradigms in acromegaly include surgery, medical therapy, and radiotherapy. With medical therapies, such as somatostatin analogs, dopamine agonists, and GH receptor antagonists, a substantial proportion of patients achieve reduced GH and normalized IGF-1 levels. In addition, signs and symptoms, quality of life, and comorbidities have also been reported to improve to varying degrees in patients who achieve biochemical control. Currently, there are several innovative therapies in development to improve patient outcomes, patient use, and access. Timely biochemical control of acromegaly ensures that the patient can ultimately improve morbidity and mortality from this disease and its extensive consequences. Keywords: disease burden, growth hormone, insulin-like growth factor 1, medical therapy, pituitary

  4. FISCAL POLICY OF THE REPUBLIC OF MOLDOVA: ACHIEVEMENTS OF THE FISCAL CONTROL AND ENTITY BEHAVIOR

    Directory of Open Access Journals (Sweden)

    Olimpiu GHERMAN

    2015-12-01

    Full Text Available It is an actual theme, determined by achievements of tax control in Moldova and its impact on the behaviour of the entity as important elements of fiscal policy. There are examined different methods for differentiating the problem, supplemented by deduction, induction, synthesis, analysis of defining phenomena of fiscal policy and its elements. The methodology used in this study is based on assessments of the theory, studies and interpretations of specialized literature and analyzes the practical activities specific for taxation at national, European and international levels, depending on which some opinions, conclusions and proposals were founded and formulated, to minimize the impact of tax evasion and fraud.

  5. Achieving glycemic control in special populations in hospital: perspectives in practice.

    Science.gov (United States)

    Cheng, Alice Y Y

    2014-04-01

    Achieving and maintaining glycemic control in patients with diabetes admitted to hospital is challenging because of the many competing factors of nutrition, pharmacotherapy and other patient-related and systemic factors. For patients receiving enteral or parenteral feeding, eating irregularly or receiving glucocorticoid therapy, the challenges are even greater. The basic principles to follow when managing glycemia in these populations are as follows: 1) Recognition of those at risk for hyperglycemia; 2) frequent bedside glucose monitoring; 3) a proactive approach with routine insulin administration based on the predicted glucose patterns; 4) constant reassessment of the glycemic status and titration of the routine insulin accordingly.

  6. The Control-Value Theory of Achievement Emotions: Assumptions, Corollaries, and Implications for Educational Research and Practice

    Science.gov (United States)

    Pekrun, Reinhard

    2006-01-01

    This article describes the control-value theory of achievement emotions and its implications for educational research and practice. The theory provides an integrative framework for analyzing the antecedents and effects of emotions experienced in achievement and academic settings. It is based on the premise that appraisals of control and values are…

  7. Achieving atomistic control in materials processing by plasma-surface interactions

    Science.gov (United States)

    Chang, Jeffrey; Chang, Jane P.

    2017-06-01

    The continuous down-scaling of electronic devices and the introduction of functionally improved novel materials require a greater atomic level controllability in the synthesis and patterning of thin film materials, especially with regards to deposition uniformity and conformality as well as etching selectivity and anisotropy. The richness of plasma chemistry and the corresponding plasma-surface interactions provide the much needed processing flexibility and efficacy. To achieve the integration of the novel materials into devices, plasma-enhanced atomic layer processing techniques are emerging as the enabling factors to obtain atomic scale control of complex materials and nanostructures. This review focuses on an overview of the role of respective plasma species involved in plasma-surface interactions, addressing their respective and synergistic effects, which is followed by two distinct applications: plasma-enhanced atomic layer deposition (ALD) and atomic layer etching (ALE). For plasma-enhanced ALD, this review emphasizes the use of plasma chemistry to enable alternative pathways to synthesize complex materials at low temperatures and the challenges associated with deposition conformality. For plasma enabled ALE processes, the review focuses on the surface-specific chemical reactions needed to achieve desirable selectivity and anisotropy.

  8. Operational scale entomological intervention for malaria control: strategies, achievements and challenges in Zambia

    Directory of Open Access Journals (Sweden)

    Chanda Emmanuel

    2013-01-01

    Full Text Available Abstract Background While consensus on malaria vector control policy and strategy has stimulated unprecedented political-will, backed by international funding organizations and donors, vector control interventions are expansively being implemented based on assumptions with unequaled successes. This manuscript reports on the strategies, achievements and challenges of the past and contemporary malaria vector control efforts in Zambia. Case description All available information and accessible archived documentary records on malaria vector control in Zambia were reviewed. Retrospective analysis of routine surveillance data from the Health Management Information System (HMIS, data from population-based household surveys and various operations research reports was conducted to assess the status in implementing policies and strategies. Discussion and evaluation Empirical evidence is critical for informing policy decisions and tailoring interventions to local settings. Thus, the World Health Organization (WHO encourages the adoption of the integrated vector management (IVM strategy which is a rational decision making process for optimal use of available resources. One of the key features of IVM is capacity building at the operational level to plan, implement, monitor and evaluate vector control and its epidemiological and entomological impact. In Zambia, great progress has been made in implementing WHO-recommended vector control policies and strategies within the context of the IVM Global Strategic framework with strong adherence to its five key attributes. Conclusions The country has solid, consistent and coordinated policies, strategies and guidelines for malaria vector control. The Zambian experience demonstrates the significance of a coordinated multi-pronged IVM approach effectively operationalized within the context of a national health system.

  9. Analog self-powered harvester achieving switching pause control to increase harvested energy

    Science.gov (United States)

    Makihara, Kanjuro; Asahina, Kei

    2017-05-01

    In this paper, we propose a self-powered analog controller circuit to increase the efficiency of electrical energy harvesting from vibrational energy using piezoelectric materials. Although the existing synchronized switch harvesting on inductor (SSHI) method is designed to produce efficient harvesting, its switching operation generates a vibration-suppression effect that reduces the harvested levels of electrical energy. To solve this problem, the authors proposed—in a previous paper—a switching method that takes this vibration-suppression effect into account. This method temporarily pauses the switching operation, allowing the recovery of the mechanical displacement and, therefore, of the piezoelectric voltage. In this paper, we propose a self-powered analog circuit to implement this switching control method. Self-powered vibration harvesting is achieved in this study by attaching a newly designed circuit to an existing analog controller for SSHI. This circuit aims to effectively implement the aforementioned new switching control strategy, where switching is paused in some vibration peaks, in order to allow motion recovery and a consequent increase in the harvested energy. Harvesting experiments performed using the proposed circuit reveal that the proposed method can increase the energy stored in the storage capacitor by a factor of 8.5 relative to the conventional SSHI circuit. This proposed technique is useful to increase the harvested energy especially for piezoelectric systems having large coupling factor.

  10. Establishing Causality Using Longitudinal Hierarchical Linear Modeling: An Illustration Predicting Achievement From Self-Control.

    Science.gov (United States)

    Duckworth, Angela Lee; Tsukayama, Eli; May, Henry

    2010-10-01

    The predictive validity of personality for important life outcomes is well established, but conventional longitudinal analyses cannot rule out the possibility that unmeasured third-variable confounds fully account for the observed relationships. Longitudinal hierarchical linear models (HLM) with time-varying covariates allow each subject to serve as his or her own control, thus eliminating between-individual confounds. HLM also allows the directionality of the causal relationship to be tested by reversing time-lagged predictor and outcome variables. We illustrate these techniques through a series of models that demonstrate that within-individual changes in self-control over time predict subsequent changes in GPA but not vice-versa. The evidence supporting a causal role for self-control was not moderated by IQ, gender, ethnicity, or income. Further analyses rule out one time-varying confound: self-esteem. The analytic approach taken in this study provides the strongest evidence to date for the causal role of self-control in determining achievement.

  11. IL-6 RESPONSES TO GLYCAEMIC INDEX DURING RECOVERY FROM EXERCISE

    Directory of Open Access Journals (Sweden)

    Hasani S.H.

    2015-06-01

    Full Text Available Purpose: This study examined the effect of meal with different glycaemic index (GI on plasma IL-6 concentration and glucose metabolism after maximal lengthening contractions of the knee extensors. Using a cross-over design, Material : 10 healthy males completed 5 sets of 10 lengthening (eccentric contractions at 120% 1 repetition-maximum. Subjects were randomized to consume the GI beverage (high-GI, low-GI (15% weight per volume; 3 g/kg BM or placebo in three times within 10 min following exercise, and again at 50 and 110 min during recovery time. Blood samples were collected before exercise and after 0.60, 180 min and 24 h of recovery. Results: Concentration of plasma IL-6 in HGI group was less than LGI and Pla groups. IL-6 tended to significantly increase after exercise in recovery time in 3 groups (all P < 0.05, except for 24 hours (P = 1.00, furthermore there was significant difference for IL-6 between placebo and high glycemic groups in 3hours after exercise (P=.016. Concentration of serum CK in HGI group was less than LGI and Pla groups, CK was significantly elevated at all times points during recovery in 3 groups (all P < 0.05, except for 1 hour after exercise in HGI group (P = 0.31, but there was no significant difference for CK between groups. Conclusion: In summary, consuming HGI carbohydrate during recovery from exercise attenuate plasma IL-6 concentration.

  12. Is glycaemic index (GI) a valid measure of carbohydrate quality?

    Science.gov (United States)

    Wolever, T M S

    2013-05-01

    Recent criticisms of the glycaemic index (GI) focus on its validity with assertions that GI methodology is not valid, GI values are inaccurate and imprecise, GI does not predict what foods are healthy and that whole grain and fibre are better markers of carbohydrate quality than GI. None of the critics provide sound reasons for rejecting GI because some of their arguments are based on flagrant errors in understanding and interpretation while others are not supported by current data or are inconsistent with other nutritional recommendations. This paper addresses current criticisms of GI and outlines reasons why GI is valid: (1) GI methodology is accurate and precise enough for practical use; (2) GI is a property of foods; and (3) GI is biologically meaningful and relevant to virtually everyone. Current dietary guidelines recommend increased consumption of whole grains and dietary fibre but do not mention GI. However, this is illogical because the evidence that GI affects health outcomes is at least as good or better than that for whole grains and fibre. GI is a novel concept from a regulatory point of view and a number of problems need to be addressed to successfully translate GI knowledge into practice. The problems are not insurmountable but no progress can be made until bias and misunderstanding about GI can be overcome and there is better agreement about what is the actual state of knowledge on GI so that the real issues can be identified and addressed.

  13. The interplay of locus of control and academic achievement among Iranian English foreign language learners

    Directory of Open Access Journals (Sweden)

    Mahbubeh Yazdanpanah

    2010-09-01

    Full Text Available This study sought to look at the relationship between locus of control (LOC orientation and academic achievement (ACH ofuniversity-age English Foreign Language (EFL learners. LOC is the extent to which individuals attribute their achievementseither to external influences such as fate or to their own efforts. The sample for the study included 120 students studyingEnglish literature at the department of Foreign Languages and Linguistics of Shiraz University. They were chosen conveniently,on a voluntary basis, from the sophomores, juniors, and seniors. The instrument used was the revised version of LOCquestionnaire (Rotter, 2003 which identifies orientations of internality or externality. The participants' grade point averageswere the measure of their ACH. A number of statistical analyses such as Pearson product-moment correlation, the regressionanalysis, and the T-tests for the independent samples were performed on the data to achieve the objectives of the study. Thefindings of this study revealed that (a the LOC and the socio-economic status (SES have significant relationships with theuniversity EFL students' ACH (b the LOC is a good predictor of the participants' ACH (c the internals perform at higher levels ofachievement than the externals (d there is a significant difference between mid/high SES-students and low SES-students in LOCorientation (e the external students with a mid/high SES achieve significantly lower averages than the external students with alow SES, but the internal students with a mid/high SES achieve only a little lower averages than the internal students with a lowSES (f the internals' grades for the general and the major courses have significant relationships with their LOC, but this is not sofor the externals (g the age and the year of the study do not have significant relationships with LOC and with ACH (h there isno main difference between male and female participants in LOC orientation (i and finally, there is not a

  14. Longitudinal relations among parents' reactions to children's negative emotions, effortful control, and math achievement in early elementary school.

    Science.gov (United States)

    Swanson, Jodi; Valiente, Carlos; Lemery-Chalfant, Kathryn; Bradley, Robert H; Eggum-Wilkens, Natalie D

    2014-01-01

    Panel mediation models and fixed-effects models were used to explore longitudinal relations among parents' reactions to children's displays of negative emotions, children's effortful control (EC), and children's math achievement (N = 291; M age in fall of kindergarten = 5.66 years, SD = .39 year) across kindergarten through second grade. Parents reported their reactions and children's EC. Math achievement was assessed with a standardized achievement test. First-grade EC mediated the relation between parents' reactions at kindergarten and second-grade math achievement, beyond stability in constructs across study years. Panel mediation model results suggested that socialization of EC may be one method of promoting math achievement in early school; however, when all omitted time-invariant covariates of EC and math achievement were controlled, first-grade EC no longer predicted second-grade math achievement. © 2014 The Authors. Child Development © 2014 Society for Research in Child Development, Inc.

  15. Insulin therapy in poorly controlled type 2 diabetic patients: does it affect quality of life?

    NARCIS (Netherlands)

    Grauw, W.J.C. de; Lisdonk, E.H. van de; Gerwen, W.H.E.M. van; Hoogen, H.J.M. van den; Weel, C. van

    2001-01-01

    BACKGROUND: Strict glycaemic control in type 2 diabetic patients is recommended in a number of treatment protocols. However, although better glycaemic control prevents or postpones chronic diabetic complications, it remains uncertain how this affects quality of life in the short and long term. AIM:

  16. Association of Salivary Osteopontin Levels with Glycaemic Status and Microalbuminuria - in Patients with Type 2 Diabetes Mellitus

    Science.gov (United States)

    Rajagambeeram, Reeta; Venkatkumar, Shruthi; Vijayan, Mohana Valli; Murugaiyan, Sathish Babu; Gopal, Shyam Prakash; Ramsamy, Sathiya; Alwar, Velayutharaj

    2016-01-01

    Introduction The monitoring of glycaemic status in patients with T2DM is mainly through blood tests (Fasting plasma glucose and HbA1c), which are invasive and involves painful pricks. This leads to poor patient compliance and soon could lead to various micro and macro vascular complications, which hamper the quality of life. There are no sensitive and specific markers to predict these complications at the earliest. Sialochemistry has recently gained attention for monitoring chronic diseases. Osteopontin is a phospho-glycoprotein molecule, elevated in many inflammatory conditions. Aim The aim of the study was to evaluate the role of serum and salivary osteopontin in Type 2 Diabetes mellitus (T2DM). Materials and Methods In this case-control study, we recruited 33 cases of T2DM and 31 age and gender matched healthy controls. Body Mass Index (BMI), Waist/Hip Ratio (WHR), Waist Circumference (WC) and blood pressure was recorded. Fasting Plasma Glucose (FPG), salivary glucose, HbA1c, microalbuminuria, systolic BP, serum and salivary osteopontin levels were estimated. Results FPG, salivary glucose, HbA1c, microalbuminuria, systolic BP, BMI, waist / hip ratio serum and salivary osteopontin levels were significantly high in T2DM cases compared to control subjects. Serum and salivary osteopontin levels were significantly correlated with HbA1c and microalbuminuria in T2DM cases. Conclusion Serum and salivary osteopontin levels are significantly elevated in subjects with T2DM and are associated with glycaemic control and microalbuminuria. PMID:27656430

  17. Achieving Energy Savings with Highly-Controlled Lighting in an Open-Plan Office

    Energy Technology Data Exchange (ETDEWEB)

    Rubinstein, Francis; Enscoe, Abby

    2010-04-19

    An installation in a Federal building tested the effectiveness of a highly-controlled, workstation-specific lighting retrofit. The study took place in an open-office area with 86 cubicles and low levels of daylight. Each cubicle was illuminated by a direct/indirectpendant luminaire with three 32 watt lamps, two dimmable DALI ballasts, and an occupancy sensor. A centralized control system programmed all three lamps to turn on and off according to occupancy on a workstation-by-workstation basis. Field measurements taken over the course of several monthsdemonstrated 40% lighting energy savings compared to a baseline without advanced controls that conforms to GSA's current retrofit standard. A photometric analysis found that the installation provided higher desktop light levels than the baseline, while an occupant survey found that occupants in general preferred the lighting system to thebaseline.Simple payback is fairly high; projects that can achieve lower installation costs and/or higher energy savings and those in which greenhouse gas reduction and occupant satisfaction are significant priorities provide the ideal setting for workstation-specific lighting retrofits.

  18. A novel approach to achieving significant reverberation control in performance halls

    Science.gov (United States)

    Conant, David A.; Chu, William

    2005-09-01

    Conventional methods for achieving broadband, variable sound absorption in large halls normally include heavy application of sound-absorptive drapery and/or thick fibrous panels, applied near available surfaces below, at, and in volumes above the catwalk plane. Occasionally, direct adjustments to room air volume are also provided to effect double-sloped decays. The novel method described here combines carefully located, broad scattering and absorption in singular architectural elements and was applied to a new, 1200-seat concert hall. A change of 0.70 s RT60 in midfrequency is achieved in a visually dramatic manner while neither materially changing room volume nor introducing often-maligned drapery. The aggregate of reverberation control methodologies employed reduces the unoccupied RT60 at midfrequencies from about 3.2 to 1.7 s in this space programed principally for music, including pipe organ. Results of MLS measurements including binaural measurements and binaural recordings of anechoic material and CATT-acoustic modeling and auralizations are discussed.

  19. Breakfast replacement with a low-glycaemic response liquid formula in patients with type 2 diabetes : a randomised clinical trial

    NARCIS (Netherlands)

    Stenvers, Dirk J; Schouten, Lydia J; Jurgens, Jordy; Endert, Erik; Kalsbeek, A.; Fliers, Eric; Bisschop, Peter H

    2014-01-01

    Low-glycaemic index diets reduce glycated Hb (HbA1c) in patients with type 2 diabetes, but require intensive dietary support. Using a liquid meal replacement with a low glycaemic response (GR) may be an alternative dietary approach. In the present study, we investigated whether breakfast replacement

  20. Glycaemic load versus carbohydrate counting for insulin bolus calculation in patients with type 1 diabetes on insulin pump.

    Science.gov (United States)

    Bozzetto, L; Giorgini, M; Alderisio, A; Costagliola, L; Giacco, A; Riccardi, G; Rivellese, A A; Annuzzi, G

    2015-10-01

    To evaluate feasibility and effectiveness on short-term blood glucose control of using glycaemic load counting (GLC) versus carbohydrate counting (CC) for prandial insulin dosing in patients with type 1 diabetes (T1D). Nine T1D patients on insulin pump, aged 26-58 years, HbA1c 7.7 ± 0.8 % (61 ± 8.7 mmol/mol), participated in this real-life setting study. By a crossover design, patients were randomised to calculate their pre-meal insulin dose based on the insulin/glycaemic load ratio (GLC period) or the insulin/carbohydrate ratio (CC period) for 1 week, shifting to the alternate method for the next week, when participants duplicated their first week food plan. Over either week, a blind subcutaneous continuous glucose monitoring was performed, and a 7-day food record was filled in. Total daily insulin doses (45 ± 10 vs. 44 ± 9 I.U.; M ± SD, p = 0.386) and basal infusion (26 ± 7 vs. 26 ± 8 I.U., p = 0.516) were not different during GLC and CC periods, respectively. However, the range of insulin doses (difference between highest and lowest insulin dose) was wider during GLC, with statistical significance at dinner (8.4 ± 6.2 vs. 6.0 ± 3.9 I.U., p = 0.041). Blood glucose iAUC after lunch was lower, albeit not significantly, during GLC than CC period (0.6 ± 8.6 vs. 3.4 ± 8.2 mmol/l∙3 h, p = 0.059). Postprandial glucose variability, evaluated as the maximal amplitude after meal (highest minus lowest glucose value), was significantly lower during GLC than CC period at lunch (4.22 ± 0.28 vs. 5.47 ± 0.39 mmol/l, p = 0.002) and dinner (3.89 ± 0.33 vs. 4.89 ± 0.33, p = 0.026). Calculating prandial insulin bolus based on glycaemic load counting is feasible in a real-life setting and may improve postprandial glucose control in people with T1D.

  1. Glycaemic & insulinaemic responses in men at rest following sago meal.

    Science.gov (United States)

    Ahmad, Hishamuddin; Singh, Rabindarjeet; Ghosh, Asok Kumar

    2009-08-01

    Sago (Metroxylin sagu) is one of the main sources of native starch. In Malaysia sago dishes are commonly eaten with sugar. However, other societies use sago as a staple food item instead of rice or potato. The study was undertaken to investigate the effect of ingestion of different physical forms of sago supplementation on plasma glucose and plasma insulin responses, as compared to the white bread supplementation in man, during resting condition. Twelve male subjects were given in random order with three different physical forms of a sago supplementation, viz., sago porridge (SR), sago paste (SP), sago gel (SG) and white bread (WB) which was repeated on separate days, at least, 1 wk apart after an overnight fast. Venous blood samples were collected at baseline and at 15, 30, 45, 60, 90, 120, 150 and 180 min after the start of each meal and were analyzed for plasma levels of glucose and insulin. Plasma glucose reached peak at 45 min after supplementation of various sago meals. Plasma glucose area under the curve (AUC) for WB was significantly lower than SG but not significantly different from SR and SP. No significant difference was observed in plasma glucose AUC among the three sago meals. Plasma insulin AUC for SG was significantly higher than WB and SR. All three sago meals tested were not significantly different in their glycaemic responses. However, the insulin response was significantly lower for SR compared to SP and SG. The present findings suggest that any one of the three sago meals tested in this study may be used to elucidate the effect of sago starch ingestion on exercise performance in the heat. Sago paste and sago porridge may be used for supplementation before and during exercise, whereas, sago gel may be used after endurance exercise during recovery process.

  2. Glycaemic index of four commercially available breads in Malaysia.

    Science.gov (United States)

    Yusof, Barakatun Nisak Mohd; Abd Talib, Ruzita; Karim, Norimah A; Kamarudin, Nor Azmi; Arshad, Fatimah

    2009-09-01

    This study was carried out to determine the blood glucose response and glycaemic index (GI) values of four types of commercially available breads in Malaysia. Twelve healthy volunteers (six men, six women; body mass index, 21.9±1.6 kg/m(2); age, 22.9±1.7 years) participated in this study. The breads tested were multi-grains bread (M-Grains), wholemeal bread (WM), wholemeal bread with oatmeal (WM-Oat) and white bread (WB). The subjects were studied on seven different occasions (four tests for the tested breads and three repeated tests of the reference food) after an overnight fast. Capillary blood samples were taken immediately before (0 min) and 15, 30, 45, 60, 90 and 120 min after consumption of the test foods. The blood glucose response was obtained by calculating the incremental area under the curve. The GI values were determined according to the standardized methodology. Our results showed that the M-Grains and WM-Oat could be categorized as intermediate GI while the WM and WB breads were high GI foods, respectively. The GI of M-Grains (56±6.2) and WM-Oat (67±6.9) were significantly lower than the reference food (glucose; GI = 100) (P food and the GI of WM (85±5.9) and WB (82±6.5) (P > 0.05). Among the tested breads, the GI values of M-Grains and WM-Oat were significantly lower (P foods.

  3. Non-glycaemic effects mediated via GLP-1 receptor agonists and the potential for exploiting these for therapeutic benefit

    DEFF Research Database (Denmark)

    Vilsbøll, T; Garber, A J

    2012-01-01

    The glucagon-like peptide-1 receptor agonists (GLP-1 RAs) liraglutide and exenatide can improve glycaemic control by stimulating insulin release through pancreatic β-cells in a glucose-dependent manner. GLP-1 receptors are not restricted to the pancreas; therefore, GLP-1 RAs cause additional non-...... for GLP-1 RAs in the cardiovascular and central nervous systems has been suggested from animal studies and short-term clinical trials. These effects and other safety aspects of GLP-1 therapy are currently being investigated in ongoing long-term clinical studies....... are affected by β-cell dysfunction, obesity and hypertension. Transient gastrointestinal adverse events, such as nausea and diarrhoea, are also common. To improve gastrointestinal tolerability, an incremental dosing approach is used with liraglutide and exenatide twice daily. A potential protective role...

  4. 40 CFR 63.55 - Maximum achievable control technology (MACT) determinations for affected sources subject to case...

    Science.gov (United States)

    2010-07-01

    ... limitations. 63.55 Section 63.55 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR..., Sections 112(g) and 112(j) § 63.55 Maximum achievable control technology (MACT) determinations for affected...

  5. Academic buoyancy, student's achievement, and the linking role of control: A cross-lagged analysis of high school students.

    Science.gov (United States)

    Collie, Rebecca J; Martin, Andrew J; Malmberg, Lars-Erik; Hall, James; Ginns, Paul

    2015-03-01

    Previous research has indicated that although academic buoyancy and student's achievement are associated, the relationship is relatively modest. We sought to determine whether another construct might link academic buoyancy and student's achievement. Based on prior theoretical and empirical work, we examined a sense of control as one possible linking mechanism. The study analysed data from 2,971 students attending 21 Australian high schools. We conducted a cross-lagged panel design as a first means of disentangling the relative salience of academic buoyancy, control, and achievement (Phase 1). Based upon these results, we proceeded with follow-up analyses of an ordered process model linking the constructs over time (Phase 2). Findings showed that buoyancy and achievement were associated with control over time, but not with one another (Phase 1). In addition, control appeared to play a role in how buoyancy influenced achievement and that a cyclical process may operate among the three factors over time (Phase 2). The findings suggest that control may play an important role in linking past experiences of academic buoyancy and achievement to subsequent academic buoyancy and achievement. © 2015 The British Psychological Society.

  6. The role of locus of control and achievement motivation in the work performance of black managers

    Directory of Open Access Journals (Sweden)

    A. C. Bothma

    1997-06-01

    Full Text Available The primary objective of this study was to predict the work performance of Black managers by using three measures of Locus of Control and five measures of Achievement Motivation. Work performance was assessed by superiors with the aid of the Performance Appraisal Questionnaire of Schepers (1994 which yields three scores, viz, Work Performance, Creativity/Initiative and Management Skills. The sample comprised 102 Black male employees in supervisory and more senior positions in a diversified and geographically dispersed chemical company. In analysing the data, the three sets of measures were intercorrelated and subjected to a factor analysis. Three factors were identified; amongst others a factor representing work performance. A composite score was accordingly computed which served as the criterion measure in a regression analysis. Furthermore/ a canonical correlation procedure was used to maximise the correlation between the predictor variables and the dependent variables. Two statistically significant canonical correlations were obtained. It was found that both the Locus of Control Inventory and the Achievement Motivation Questionnaire can be used as predictors of work performance as assessed by means of the Performance Appraisal Questionnaire (PA. Opsomming Die primêre doelwit van hierdie studie was om die werkverrigting van Swart bestuurders te voorspel deur gebruik te maak van drie metings van Lokus van Beheer en vyf metings van Prestasiemotivering. Werkverrigting is deur bogeskiktes met behulp van die Prestasiebeoordelingsvraelys van Schepers (1994 beoordeel, wat drie tellings lewer, naamlik Werkverigting, Inisiatief/Kreatiwiteit en Bestuursvaardighede. Die steekproef het uit 102 Swart manlike werknemers in toesighoudende en meer senior posisies in 'n gediversifiseerde en geografies verspreide chemiese maatskappy bestaan. In die ontleding van die data is die drie stelle metings geïterkorreleer en aan 'n faktorontleding onderwerp. Drie

  7. The acute effects of a pulse-containing meal on glycaemic responses and measures of satiety and satiation within and at a later meal.

    Science.gov (United States)

    Mollard, R C; Zykus, A; Luhovyy, B L; Nunez, M F; Wong, C L; Anderson, G H

    2012-08-01

    Pulses are low glycaemic foods; however, their effect on satiation is unknown. The objective was to determine the effects of an ad libitum pulse meal on food intake (FI), appetite and blood glucose (BG) before and after a test meal (4 h later) and on FI at the test meal. Males (n 24, 22·8 kg/m2) received one of four treatments or control. The pulse treatments contained pasta and tomato sauce and 44 % of energy from: (1) chickpeas, (2) lentils, (3) navy beans or (4) yellow peas. The control was pasta and tomato sauce (pasta and sauce). FI (satiation) was measured at the treatment meal (0-20 min) and at an ad libitum pizza meal 4 h later. BG and appetite were measured from 0 to 340 min. At the treatment meal, lentils led to lower FI compared to chickpeas and pasta and sauce, whereas navy beans led to lower FI compared to chickpeas. Also, lentils led to lower cumulative FI compared to pasta and sauce. All pulses led to lower BG peak and cumulative area under the curve (AUC; 0-340 min); however, only chickpeas, lentils and navy beans reduced pre-pizza meal BG AUC (0-260 min) relative to pasta and sauce. Chickpeas led to lower post-pizza meal BG AUC (260-340 min) compared to navy beans and yellow peas. Consumption of pulses in a high-glycaemic meal contributes to earlier satiation, lower BG following the meal and after a later meal, but these effects are specific to pulse type and cannot be explained by their glycaemic properties alone.

  8. Rising methods and leavening agents used in the production of bread do not impact the glycaemic index.

    Science.gov (United States)

    Fredensborg, Monica Hardman; Perry, Tracy; Mann, Jim; Chisholm, Alex; Rose, Meredith

    2010-01-01

    The aim of this study was to compare the glycaemic index of breads produced using different rising methods and leavening agents. Eleven bread varieties were selected based on method of production, and divided between three groups of ten participants (mean +/- SD age 30.0 +/- 10.7 years and BMI 22.9 +/- 2.8). Standard glycaemic index testing protocol was implemented after an overnight fast, using glucose as the reference food, and collecting blood samples over a two-hour period. Glycemic index was calculated using the usual method. Additionally, incremental area under the curve data were log transformed and glycaemic index was calculated using regression analysis. Mean glycaemic index values of the breads in ascending order were as follows: Swiss Rye; 60, Long oat; 68, Sourdough+oats; 71, Long rye; 76, Short oat; 77, Short whole meal; 78, Long whole meal; 80, Sourdough; 82, Short rye; 82, Yeast; 88, and Desem; 92. There were significant differences in mean glycaemic index values between Swiss Rye and Yeast (p = 0.010), Swiss Rye and Desem (p = 0.007) and Sourdough+oats and Desem (p = 0.043). The rising method and leavening agents used in this study did not impact on the glycaemic index of the breads tested. Other factors, such as increased bread density, and the addition of whole grains may be required to produce bread with a low glycaemic index.

  9. Effects of an Emotion Control Treatment on Academic Emotions, Motivation and Achievement in an Online Mathematics Course

    Science.gov (United States)

    Kim, ChanMin; Hodges, Charles B.

    2012-01-01

    We designed and developed an emotion control treatment and investigated its effects on college students' academic emotions, motivation, and achievement in an online remedial mathematics course. The treatment group showed more positive emotions of enjoyment and pride than the control group. The treatment group also showed a higher level of…

  10. Child Effortful Control, Teacher-Student Relationships, and Achievement in Academically At-Risk Children: Additive and Interactive Effects

    Science.gov (United States)

    Liew, Jeffrey; Chen, Qi; Hughes, Jan N.

    2010-01-01

    The joint contributions of child effortful control (using inhibitory control and task accuracy as behavioral indices) and positive teacher-student relationships at first grade on reading and mathematics achievement at second grade were examined in 761 children who were predominantly from low-income and ethnic minority backgrounds and assessed to…

  11. Prediction of Kindergartners' Academic Achievement from Their Effortful Control and Emotionality: Evidence for Direct and Moderated Relations

    Science.gov (United States)

    Valiente, Carlos; Lemery-Chalfant, Kathryn; Swanson, Jodi

    2010-01-01

    The relations between effortful control, emotionality (anger, sadness, and shyness), and academic achievement were examined in a short-term longitudinal study of 291 kindergartners. Teachers and parents reported on students' effortful control and emotionality. Students completed the Continuous Performance Task and the Letter-Word, Passage…

  12. Glycaemic threshold for diabetes-specific retinopathy among individuals from Saudi Arabia, Algeria and Portugal

    DEFF Research Database (Denmark)

    Almdal, Thomas Peter; Handlos, Line Neerup; Vistisen, Dorte

    2014-01-01

    We studied the glycaemic threshold and prevalence of diabetic retinopathy in screen-detected diabetes in Saudi Arabia, Algeria and Portugal. The prevalence of diabetes-specific retinopathy started to increase at an HbA1c level of 6-6.4% and in individuals with HbA1c >7.0% the prevalence was 6.0%....

  13. Glycaemic threshold for diabetes-specific retinopathy among individuals from Saudi Arabia, Algeria and Portugal

    DEFF Research Database (Denmark)

    Almdal, Thomas Peter; Handlos, Line Neerup; Vistisen, Dorte

    2014-01-01

    We studied the glycaemic threshold and prevalence of diabetic retinopathy in screen-detected diabetes in Saudi Arabia, Algeria and Portugal. The prevalence of diabetes-specific retinopathy started to increase at an HbA1c level of 6-6.4% and in individuals with HbA1c >7.0% the prevalence was 6.0%....

  14. Locus of Control and Academic Achievement: Integrating Social Learning Theory and Expectancy-Value Theory

    Science.gov (United States)

    Youse, Keith Edward

    2012-01-01

    The current study examines predictors of math achievement and college graduation by integrating social learning theory and expectancy-value theory. Data came from a nationally-representative longitudinal database tracking 12,144 students over twelve years from 8th grade forward. Models for math achievement and college graduation were tested…

  15. Locus of Control and Academic Achievement: Integrating Social Learning Theory and Expectancy-Value Theory

    Science.gov (United States)

    Youse, Keith Edward

    2012-01-01

    The current study examines predictors of math achievement and college graduation by integrating social learning theory and expectancy-value theory. Data came from a nationally-representative longitudinal database tracking 12,144 students over twelve years from 8th grade forward. Models for math achievement and college graduation were tested…

  16. Glycaemic index of parboiled rice depends on the severity of processing: study in type 2 diabetic subjects

    DEFF Research Database (Denmark)

    Larsen, H. N.; Rasmussen, O. W.; Rasmussen, Peter Have

    2000-01-01

    Objective: To study the influence of parboiling and the severity of the process on glycaemic and insulinaemic responses to rice in type 2 diabetes. Moreover, to examine changes in starch structure related to parboiling, which may affect the metabolic responses and digestibility. Design: Nine type...... subjects. There was no effect of TP on glycaemic index, whereas PP reduced the glycaemic index by almost 30% compared to NP....... diabetic subjects ingested four test meals: white bread (WB) and three meals of cooked polished rice of the same variety being non-parboiled (NP), mildly traditionally parboiled (TP) and severely pressure parboiled (PP). The participants ingested the test meals (50 g available carbohydrates) on separate...

  17. The Impact of Parental Support, Behavioral Control, and Psychological Control on the Academic Achievement and Self-Esteem of African American and European American Adolescents.

    Science.gov (United States)

    Bean, Roy A.; Bush, Kevin R.; McKenry, Patrick C.; Wilson, Stephan M.

    2003-01-01

    Relationships between adolescent functioning and parent support, behavioral control, and psychological control were examined among European American and African American adolescents. A number of correlations were significant, including maternal support and academic achievement and self-esteem, and paternal psychological control and self-esteem.…

  18. The Impact of Parental Support, Behavioral Control, and Psychological Control on the Academic Achievement and Self-Esteem of African American and European American Adolescents.

    Science.gov (United States)

    Bean, Roy A.; Bush, Kevin R.; McKenry, Patrick C.; Wilson, Stephan M.

    2003-01-01

    Relationships between adolescent functioning and parent support, behavioral control, and psychological control were examined among European American and African American adolescents. A number of correlations were significant, including maternal support and academic achievement and self-esteem, and paternal psychological control and self-esteem.…

  19. Locus of Control or Self-Esteem; Which One is the Best Predictor of Academic Achievement in Iranian College Students

    Science.gov (United States)

    Hosseini, Seyyed Nasrollah; Mirzaei Alavijeh, Mehdi; Karami Matin, Behzad; Hamzeh, Behrooz; Ashtarian, Hossein; Jalilian, Farzad

    2016-01-01

    Background Self-esteem and behavioral consequences, which are due to external or internal locus of control, are effective on academic achievement of students. Objectives The aim of this study was to determine the prediction of locus of control and self-esteem in academic achievement among the students. Materials and Methods This cross-sectional study was conducted on 300 college students in Kermanshah University of Medical Sciences in 2014. Data collection tools were in three sections: demographic, Rotter internal-external locus of control scale and Coopersmith self-esteem inventory. Data were analyzed using the SPSS software version 21. Results Results showed that 29.8% and 76.2% of the participants had internal locus of control, and high self-esteem, respectively. There was a significant correlation between self-esteem, locus of control and academic achievement of the students. Self-esteem accounted for 39.5% of the variation in academic achievement. Conclusions It seems that interventions to increase self-esteem among student can help improve academic achievement among them. PMID:27284277

  20. Locus of Control or Self-Esteem; Which One is the Best Predictor of Academic Achievement in Iranian College Students.

    Science.gov (United States)

    Hosseini, Seyyed Nasrollah; Mirzaei Alavijeh, Mehdi; Karami Matin, Behzad; Hamzeh, Behrooz; Ashtarian, Hossein; Jalilian, Farzad

    2016-03-01

    Self-esteem and behavioral consequences, which are due to external or internal locus of control, are effective on academic achievement of students. The aim of this study was to determine the prediction of locus of control and self-esteem in academic achievement among the students. This cross-sectional study was conducted on 300 college students in Kermanshah University of Medical Sciences in 2014. Data collection tools were in three sections: demographic, Rotter internal-external locus of control scale and Coopersmith self-esteem inventory. Data were analyzed using the SPSS software version 21. Results showed that 29.8% and 76.2% of the participants had internal locus of control, and high self-esteem, respectively. There was a significant correlation between self-esteem, locus of control and academic achievement of the students. Self-esteem accounted for 39.5% of the variation in academic achievement. It seems that interventions to increase self-esteem among student can help improve academic achievement among them.

  1. Using confirmatory factor analysis to understand executive control in preschool children: sources of variation in emergent mathematic achievement.

    Science.gov (United States)

    Bull, Rebecca; Espy, Kimberly Andrews; Wiebe, Sandra A; Sheffield, Tiffany D; Nelson, Jennifer Mize

    2011-07-01

    Latent variable modeling methods have demonstrated utility for understanding the structure of executive control (EC) across development. These methods are utilized to better characterize the relation between EC and mathematics achievement in the preschool period, and to understand contributing sources of individual variation. Using the sample and battery of laboratory tasks described in Wiebe, Espy and Charak (2008), latent EC was related strongly to emergent mathematics achievement in preschool, and was robust after controlling for crystallized intellectual skills. The relation between crystallized skills and emergent mathematics differed between girls and boys, although the predictive association between EC and mathematics did not. Two dimensions of the child 's social environment contributed to mathematics achievement: social network support through its relation to EC and environmental stressors through its relation with crystallized skills. These findings underscore the need to examine the dimensions, mechanisms, and individual pathways that influence the development of early competence in basic cognitive processes that underpin early academic achievement.

  2. Autonomous and Controlling Reasons Underlying Achievement Goals during Task Engagement: Their Relation to Intrinsic Motivation and Cheating

    Science.gov (United States)

    Ozdemir Oz, Ayse; Lane, Jennie F.; Michou, Aikaterini

    2016-01-01

    The aim of this study was to investigate the relation of autonomous and controlling reasons underlying an endorsed achievement goal to intrinsic motivation and cheating. The endorsement of the achievement goal was ensured by involving 212 (M(subscript age) = 19.24, SD = 0.97) freshman students in a spatial task and asking them to report their most…

  3. Children’s Self-Regulation and School Achievement in Cultural Contexts: The Role of Maternal Restrictive Control

    Directory of Open Access Journals (Sweden)

    Mirjam eWeis

    2016-05-01

    Full Text Available Self-regulation can be developed through parent-child interactions and has been related to developmental outcomes, e.g. such as educational achievement. This study examined cross-cultural differences and similarities in maternal restrictive control, self-regulation (i.e., behavior and emotion regulation and school achievement and relations among these variables in Germany and Chile. Seventy-six German and 167 Chilean fourth graders, their mothers, and their teachers participated. Mothers and teachers rated children’s behavior regulation with a subscale of the Strengths and Difficulties Questionnaire. Children reported their use of emotion regulation strategies on the Questionnaire for the Measurement of Stress and Coping. Mothers rated maternal restrictive control by answering the Parenting Practice Questionnaire. School achievement was assessed by grades for language and mathematics. Results showed higher behavior regulation of German children in comparison to Chilean children and a higher preference of restrictive parental control in Chilean mothers than in German mothers. Regression analyses revealed positive relations between children’s behavior regulation and school achievement in Germany and in Chile. Further, in both cultural contexts, maternal restrictive control was related negatively to behavior regulation and positively to anger-oriented emotion regulation. In sum, the study showed the central function of behavior regulation for school achievement underlining negative relations of maternal restrictive control with children’s self-regulation and school achievement in diverse cultural contexts. Culturally adapted interventions related to parenting practices to promote children’s behavior regulation may assist in also promoting children’s school achievement.

  4. El difícil camino del control sanitario de la tuberculosis The difficult road to achieve sanitary tuberculosis control

    Directory of Open Access Journals (Sweden)

    Carlos Peña M

    2012-12-01

    , que en 2011 concentraba en el 40% de la población nacional el 63% de los casos de tuberculosis. Las tasas en esta población han permanecido sin cambios durante los últimos 6 años. Además, la Región Metropolitana presenta zonas de muy alta incidencia, como son las comunas de Santiago (tasa 71,4 x 100.000, Estación Central (51,9 x 100.000, Independencia (46,8 x 100.000, San Joaquín (41,4 x 100.000 y Recoleta (35,3 x 100.000. Estas zonas pasan a ser prioritarias y requerirán de una intervención sanitaria más intensa y del reforzamiento de los equipos de tuberculosis en la atención primaria para que a través de la colaboración de todo su personal de salud aumenten la pesquisa bacteriológica de la tuberculosis pulmonar bacilífera.Tuberculosis continues to be a worldwide prevalent disease. Chile has established a tuberculosis control program since the earliest 70s which contributed to decrease the annual incidence of tuberculosis by 50% every decade, reaching the rate of 20 per 100.000 inhabitants the year 2000 ("early phase of tuberculosis elimination as a public health problem ". Unfortunately since this time the descent rate is becoming slower and between years 2009-2011 has achieved a stationary rate of13 x 100.000. This deterioration in the epidemiological situation of tuberculosis in Chile runs in parallel with the successive reductions in the budget assignedfor its control. A higher incidence of tuberculosis in high risk groups (HIVpopulation, migrants, prisoners and elderly people were not responsible for this epidemiologic deterioration. Lack of diagnosis in smear positive pulmonary tuberculosis patients is the most important source ofpersistent community infection. Only 25% of the estimated goal of sputum smear screening among medical consultations in primary care was achieved. Between the years 20062010 193.416 less sputum smear examinations were done. This means that nearly 966 smear positive tuberculosis patients were no identified as we know

  5. Power and Control in Kathmandu: A Comparison of Attempted Power, Actual Power, and Achieved Power.

    Science.gov (United States)

    Emery, Clifton R; Thapa, Sirjana; Wu, Shali

    2016-05-05

    We argue that the concept of power has been inadvertently sidelined in recent theory and research on husband violence. Three types of relationship power may matter with respect to husband violence: attempted power, actual power, and achieved power. Analyses of a randomly selected representative sample of 270 married or partnered women in Kathmandu showed that actual power was related to husband violence prevalence, severity, and injury. Achieved power was related to husband violence prevalence and severity, and attempted power was related to husband violence injury. Implications are discussed.

  6. THE RELATIONSHIP BETWEEN THE TYPES OF LOCUS OF CONTROL AND THE ACADEMIC ACHIEVEMENT OF IRANIAN ONLINE FOREIGN LANGUAGE LEARNERS

    Directory of Open Access Journals (Sweden)

    Azizeh Chalak, ,

    2014-03-01

    Full Text Available Online language education is a recent trend around the world. Investigating different factors that might affect learners’ success in this growing channel of education is a must. This study was an attempt to investigate the relationship between locus of control (LOC as a psychological construct and academic achievement of Iranian online learners of English as a Foreign Language (EFL. LOC is the extent to which individuals attribute their achievements either to external factors such as fate or to their own efforts. The participants of the study were 100 students studying English online at Iran Language Institute during 2013. The instrument used was Trice Academic LOC questionnaire which identifies orientations of internality or externality. The participants' grade point averages (GPAs were the measure of their academic achievement. The t-tests for the independent samples were performed on the data. The findings of this study revealed no significant relationship between LOC and academic achievement.

  7. Physically Active Math and Language Lessons Improve Academic Achievement : A Cluster Randomized Controlled Trial

    NARCIS (Netherlands)

    Mullender-Wijnsma, Marijke J.; Hartman, Esther; de Greeff, Johannes W.; Doolaard, Simone; Bosker, Roel J.; Visscher, Chris

    2016-01-01

    OBJECTIVES: Using physical activity in the teaching of academic lessons is a new way of learning. The aim of this study was to investigate the effects of an innovative physically active academic intervention ("Fit & Vaardig op School" [F&V]) on academic achievement of children. METHODS: Using physic

  8. Control Method for Achieving High Power Factor in Single-Phase to Three-Phase Converters without Electrolytic Capacitors

    Science.gov (United States)

    Yokoyama, Takahiro; Ohishi, Kiyoshi; Haga, Hitoshi; Shibata, Junji

    In this paper, we propose a method for the digital control of IPM motors in order to achieve a high power factor in single-phase to three-phase power converters without reactors or electrolytic capacitors. For achieving the unity power factor under any load condition and any speed condition, we propose a new digital control method that involves the use of a new feedback technique and a new feedforward technique on the source-current regulator side. The proposed digital control system is constructed by using DSP devices. In this paper, we also propose a new method for the compensation of one sampling delay time. The superior performance of the proposed method is demonstrated by experimental results. The experimental results were obtained using 1.5[kW] inverter system, which consists of a vector control system with a 14[μF] dc-link capacitor. The maximum power factor obtained in the experiments was 96.8[%].

  9. Advanced, Integrated Control for Building Operations to Achieve 40% Energy Saving

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Yan; Song, Zhen; Loftness, Vivian; Ji, Kun; Zheng, Sam; Lasternas, Bertrand; Marion, Flore; Yuebin, Yu

    2012-10-15

    We developed and demonstrated a software based integrated advanced building control platform called Smart Energy Box (SEB), which can coordinate building subsystem controls, integrate variety of energy optimization algorithms and provide proactive and collaborative energy management and control for building operations using weather and occupancy information. The integrated control system is a low cost solution and also features: Scalable component based architecture allows to build a solution for different building control system configurations with needed components; Open Architecture with a central data repository for data exchange among runtime components; Extendible to accommodate variety of communication protocols. Optimal building control for central loads, distributed loads and onsite energy resource; uses web server as a loosely coupled way to engage both building operators and building occupants in collaboration for energy conservation. Based on the open platform of SEB, we have investigated and evaluated a variety of operation and energy saving control strategies on Carnegie Mellon University Intelligent Work place which is equipped with alternative cooling/heating/ventilation/lighting methods, including radiant mullions, radiant cooling/heating ceiling panels, cool waves, dedicated ventilation unit, motorized window and blinds, and external louvers. Based on the validation results of these control strategies, they were integrated in SEB in a collaborative and dynamic way. This advanced control system was programmed and computer tested with a model of the Intelligent Workplace's northern section (IWn). The advanced control program was then installed in the IWn control system; the performance was measured and compared with that of the state of the art control system to verify the overall energy savings great than 40%. In addition advanced human machine interfaces (HMI's) were developed to communicate both with building

  10. High-School Students' Need for Cognition, Self-Control Capacity, and School Achievement: Testing a Mediation Hypothesis

    Science.gov (United States)

    Bertrams, Alex; Dickhauser, Oliver

    2009-01-01

    In the present article, we examine the hypothesis that high-school students' motivation to engage in cognitive endeavors (i.e., their need for cognition; NFC) is positively related to their dispositional self-control capacity. Furthermore, we test the prediction that the relation between NFC and school achievement is mediated by self-control…

  11. Using Confirmatory Factor Analysis to Understand Executive Control in Preschool Children: Sources of Variation in Emergent Mathematic Achievement

    Science.gov (United States)

    Bull, Rebecca; Espy, Kimberly Andrews; Wiebe, Sandra A.; Sheffield, Tiffany D.; Nelson, Jennifer Mize

    2011-01-01

    Latent variable modeling methods have demonstrated utility for understanding the structure of executive control (EC) across development. These methods are utilized to better characterize the relation between EC and mathematics achievement in the preschool period, and to understand contributing sources of individual variation. Using the sample and…

  12. A Randomized Controlled Design Investigating the Effects of Classroom-Based Physical Activity on Children's Fluid Intelligence and Achievement

    Science.gov (United States)

    Fedewa, Alicia L.; Ahn, Soyeon; Erwin, Heather; Davis, Matthew C.

    2015-01-01

    Existing literature shows promising effects of physical activity on children's cognitive outcomes. This study assessed via a randomized, controlled design whether additional curricular physical activity during the school day resulted in gains for children's fluid intelligence and standardized achievement outcomes. Participants were children…

  13. Perceived Academic Control and Academic Emotions Predict Undergraduate University Student Success: Examining Effects on Dropout Intention and Achievement

    Science.gov (United States)

    Respondek, Lisa; Seufert, Tina; Stupnisky, Robert; Nett, Ulrike E.

    2017-01-01

    The present study addressed concerns over the high risk of university students' academic failure. It examined how perceived academic control and academic emotions predict undergraduate students' academic success, conceptualized as both low dropout intention and high achievement (indicated by GPA). A cross-sectional survey was administered to 883 undergraduate students across all disciplines of a German STEM orientated university. The study additionally compared freshman students (N = 597) vs. second-year students (N = 286). Using structural equation modeling, for the overall sample of undergraduate students we found that perceived academic control positively predicted enjoyment and achievement, as well as negatively predicted boredom and anxiety. The prediction of dropout intention by perceived academic control was fully mediated via anxiety. When taking perceived academic control into account, we found no specific impact of enjoyment or boredom on the intention to dropout and no specific impact of all three academic emotions on achievement. The multi-group analysis showed, however, that perceived academic control, enjoyment, and boredom among second-year students had a direct relationship with dropout intention. A major contribution of the present study was demonstrating the important roles of perceived academic control and anxiety in undergraduate students' academic success. Concerning corresponding institutional support and future research, the results suggested distinguishing incoming from advanced undergraduate students. PMID:28326043

  14. Implementation and control of electrolysers to achieve high penetrations of renewable power

    Energy Technology Data Exchange (ETDEWEB)

    Troncoso, E.; Newborough, M. [ITM Power plc, Orkney House, Great Chesterford Court, Great Chesterford, Saffron Walden CB10 1PF (United Kingdom)

    2007-09-15

    The mass deployment of electrolysers, within a power system serving a region of high wind resource, as the enabling mechanism for achieving five key objectives is assessed (that is: a very high installed capacity of wind power plant (WPP); zero wind curtailment during times of low demand; a very high load factor for thermal power plant; an electricity supply of low-carbon intensity; and a hydrogen supply of low-carbon intensity). Three electrolyser implementation cases were simulated for three days characterised mainly by wind availability and emphasis was placed on maximizing the smoothness of the load profile (LF) applied to thermal power plant. If zero-carbon hydrogen is to be produced a daily load factor for thermal power plant of 90% is the upper limit, but load factors of up to 100% are achievable if a carbon intensity of 3kgCO{sub 2}/kgH{sub 2} is permitted. For wind penetrations exceeding approximately 30% of system maximum demand, the electrolyser stock must include implementations close to WPP if curtailment is to be avoided. To achieve very high wind penetrations and very high load factors for thermal power plant requires a large stock of electrolysers - for the system investigated approximately 1.1 MW of electrolyser capacity is required per installed MW of wind power. (author)

  15. Exhaust Gas Recirculation Control for Large Diesel Engines - Achievable Performance with SISO Design

    DEFF Research Database (Denmark)

    Hansen, Jakob Mahler; Blanke, Mogens; Niemann, Hans Henrik

    2013-01-01

    This paper investigates control possibilities for Exhaust Gas Recirculation (EGR) on large diesel engines. The goal is to reduce the amount of NOx in the exhaust gas by reducing the oxygen concentration available for combustion. Control limitations imposed by the system are assessed using linear...

  16. High Self-Control Predicts More Positive Emotions, Better Engagement, and Higher Achievement in School

    Science.gov (United States)

    King, Ronnel B.; Gaerlan, Marianne Jennifer M.

    2014-01-01

    The control-value theory of academic emotions has emerged as a useful framework for studying the antecedents and consequences of different emotions in school. This framework focuses on the role of control-related and value-related appraisals as proximal antecedents of emotions. In this study, we take an individual differences approach to examine…

  17. High Self-Control Predicts More Positive Emotions, Better Engagement, and Higher Achievement in School

    Science.gov (United States)

    King, Ronnel B.; Gaerlan, Marianne Jennifer M.

    2014-01-01

    The control-value theory of academic emotions has emerged as a useful framework for studying the antecedents and consequences of different emotions in school. This framework focuses on the role of control-related and value-related appraisals as proximal antecedents of emotions. In this study, we take an individual differences approach to examine…

  18. The effect of mixing and changing the order of feeding oats and chopped alfalfa to horses on: glycaemic and insulinaemic responses, and breath hydrogen and methane production.

    Science.gov (United States)

    Vervuert, I; Voigt, K; Hollands, T; Cuddeford, D; Coenen, M

    2009-10-01

    The aim of this study was to investigate the effects of feeding oats alone before or after feeding chopped alfalfa or, in admixture with the alfalfa on the glycaemic and insulinaemic responses of horses as well as post-prandial breath hydrogen and methane excretion. Horses were fed in a randomized order, chopped alfalfa as a source of dietary fibre and unprocessed oats as a source of starch. Chopped alfalfa intake was adjusted to a crude fibre intake of 0.5 g/kg bodyweight (BW) per meal and the oats intake was adjusted to a starch intake of 2 g/kg BW per meal. The feeds were offered in three different ways: (i) alfalfa followed by oats (A/O), (ii) oats followed by alfalfa (O/A) or (iii) a mixture of alfalfa and oats (A + O). Oats alone were used as a control. Blood and breath were collected after the test meal was fed at the end of a 11.5-h overnight fast following a 10-day acclimatization period. The highest glycaemic and insulinaemic responses were measured when the A/O and O/A diets orders were fed, whereas most hydrogen was produced after feeding oats alone. It was concluded that adding alfalfa chaff to a meal of oats prolonged the pre-caecal digestion of starch, but there was no evidence for any effect on pre-caecal starch digestibility.

  19. The Effects of Step-by-Step Self-regulation on Controlling Study Behavior, Attitude to Study and Academic Achievement

    Directory of Open Access Journals (Sweden)

    Gholamreza Sharifiniya

    2014-01-01

    Full Text Available Using personal potential is one of the key elements in behavior modification and the purpose of this research was to study the effects of a new method in changing human attitude and behavior in school context. Following this goal, in current research the authors have tried to examine the role of Step-by-Step Self-Regulation on studying behavior control, attitude to study and students' academic achievement. The total sample size was 120 high school male students in Hamedan. The subjects were divided into two groups: experimental group and control group. Then step-by-step self-regulation method were taught and carried out for eight sessions over the experimental group. Researcher made questionnaires were used for gathering data on study behavior control and students’ attitude to study and for evaluating students’ academic achievement their scholastic scores were used. In testing research hypotheses, a multivariate three-way ANOVA and independent and paired t tests were used. Comparing experimental and control groups data show that applying step-by-step self-regulation improves the personal ability to control study behavior while it does not have any meaningful effect on attitudes to study and students' academic achievement.

  20. Methodology for adding and amending glycaemic index values to a nutrition analysis package.

    LENUS (Irish Health Repository)

    Levis, Sharon P

    2011-04-01

    Since its introduction in 1981, the glycaemic index (GI) has been a useful tool for classifying the glycaemic effects of carbohydrate foods. Consumption of a low-GI diet has been associated with a reduced risk of developing CVD, diabetes mellitus and certain cancers. WISP (Tinuviel Software, Llanfechell, Anglesey, UK) is a nutrition software package used for the analysis of food intake records and 24 h recalls. Within its database, WISP contains the GI values of foods based on the International Tables 2002. The aim of the present study is to describe in detail a methodology for adding and amending GI values to the WISP database in a clinical or research setting, using data from the updated International Tables 2008.

  1. Green tea catechins reduced the glycaemic potential of bread: an in vitro digestibility study.

    Science.gov (United States)

    Goh, Royston; Gao, Jing; Ananingsih, Victoria K; Ranawana, Viren; Henry, Christiani Jeyakumar; Zhou, Weibiao

    2015-08-01

    Green tea catechins are potent inhibitors of enzymes for carbohydrate digestion. However, the potential of developing low glycaemic index bakery food using green tea extract has not been investigated. Results of this study showed that addition of green tea extract (GTE) at 0.45%, 1%, and 2% concentration levels significantly reduced the glycaemic potential of baked and steamed bread. The average retention levels of catechins in the baked and steamed bread were 75.3-89.5% and 81.4-99.3%, respectively. Bread fortified with 2% GTE showed a significantly lower level of glucose release during the first 90 min of pancreatic digestion as well as a lower content of rapidly digested starch (RDS) content. A significantly negative correlation was found between the catechin retention level and the RDS content of bread. The potential of transforming bread into a low GI food using GTE fortification was proven to be promising. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Glycaemic indices of three Sri Lankan wheat bread varieties and a bread-lentil meal.

    Science.gov (United States)

    Hettiaratchi, U P K; Ekanayake, S; Welihinda, J

    2009-01-01

    The glycaemic index (GI) concept ranks individual foods and mixed meals according to the blood glucose response. Low-GI foods with a slow and prolonged glycaemic response are beneficial for diabetic people, and several advantages have been suggested also for non-diabetic individuals. The recent investigations imply an increasing prevalence of diabetes mellitus in Sri Lanka. Thus, the present study was designed primarily to determine the glycaemic indices of some bread varieties in Sri Lanka as bread has become a staple diet among most of the urban people. A second objective was to observe the effects of macronutrients and physicochemical properties of starch on GI. Glycaemic responses were estimated according to FAO/WHO guidelines and both glucose and white bread were used as standards. Non-diabetic individuals aged 22-30 years (n=10) participated in the study. The test meals included white sliced bread, wholemeal bread, ordinary white bread and a mixed meal of wholemeal bread with lentil curry. The GI values (+/-standard error of the mean) of the meals were 77+/-6, 77+/-6, 80+/-4, 61+/-6, respectively (with glucose as the standard). The GI values of the bread varieties or the meal did not differ significantly (P >0.05). However, the meal can be categorized as a medium-GI food while the other bread varieties belong to the high-GI food group. A significant negative correlation was obtained with protein (P=0.042) and fat (P=0.039) contents of the food items and GI. Although the GI values of the foods are not significantly different, the inclusion of lentils caused the GI to decrease from a high-GI category to a medium-GI category. According to the present study, a ratio of 1.36 can be used to interconvert the GI values obtained with the two standards.

  3. Glycaemic threshold for diabetes-specific retinopathy among individuals from Saudi Arabia, Algeria and Portugal.

    Science.gov (United States)

    Almdal, T P; Handlos, L N; Valerius, M; Juul, E; Nielsen, K E; Vistisen, D; Nielsen, L B; Sheikh, A; Belhadj, M; Nadir, D; Zinai, S; Raposo, J; Lund-Andersen, H; Witte, D R

    2014-03-01

    We studied the glycaemic threshold and prevalence of diabetic retinopathy in screen-detected diabetes in Saudi Arabia, Algeria and Portugal. The prevalence of diabetes-specific retinopathy started to increase at an HbA1c level of 6-6.4% (42-47 mmol/mol) and in individuals with HbA(1c) >7.0% the prevalence was 6.0%.

  4. METABOLIC PROPERTIES OF RYE PRODUCTS Focusing on insulinaemia, glycaemic profile and appetite regulation in healthy subjects

    OpenAIRE

    Rosén, Liza

    2011-01-01

    The prevalence of metabolic disorders, such as type 2 diabetes, cardiovascular diseases and the insulin resistance syndrome (IRS) are increasing worldwide. However, disturbances in the metabolic status can be prevented by changing the daily diet towards more whole grains, vegetables, legumes and dairy products. Also the dietary glycaemic- and insulinaemic indices of foods may play a role. Rye products are interesting in this context as they are usually consumed in wholegrain form and have bee...

  5. ACHIEVING HIGH INTEGRITY OF PROCESS-CONTROL SOFTWARE BY GRAPHICAL DESIGN AND FORMAL VERIFICATION

    NARCIS (Netherlands)

    HALANG, WA; Kramer, B.J.

    1992-01-01

    The International Electrotechnical Commission is currently standardising four compatible languages for designing and implementing programmable logic controllers (PLCs). The language family includes a diagrammatic notation that supports the idea of software ICs to encourage graphical design technique

  6. ACHIEVING HIGH INTEGRITY OF PROCESS-CONTROL SOFTWARE BY GRAPHICAL DESIGN AND FORMAL VERIFICATION

    NARCIS (Netherlands)

    HALANG, WA; Kramer, B.J.

    The International Electrotechnical Commission is currently standardising four compatible languages for designing and implementing programmable logic controllers (PLCs). The language family includes a diagrammatic notation that supports the idea of software ICs to encourage graphical design

  7. Robust, integrated computational control of NMR experiments to achieve optimal assignment by ADAPT-NMR.

    Science.gov (United States)

    Bahrami, Arash; Tonelli, Marco; Sahu, Sarata C; Singarapu, Kiran K; Eghbalnia, Hamid R; Markley, John L

    2012-01-01

    ADAPT-NMR (Assignment-directed Data collection Algorithm utilizing a Probabilistic Toolkit in NMR) represents a groundbreaking prototype for automated protein structure determination by nuclear magnetic resonance (NMR) spectroscopy. With a [(13)C,(15)N]-labeled protein sample loaded into the NMR spectrometer, ADAPT-NMR delivers complete backbone resonance assignments and secondary structure in an optimal fashion without human intervention. ADAPT-NMR achieves this by implementing a strategy in which the goal of optimal assignment in each step determines the subsequent step by analyzing the current sum of available data. ADAPT-NMR is the first iterative and fully automated approach designed specifically for the optimal assignment of proteins with fast data collection as a byproduct of this goal. ADAPT-NMR evaluates the current spectral information, and uses a goal-directed objective function to select the optimal next data collection step(s) and then directs the NMR spectrometer to collect the selected data set. ADAPT-NMR extracts peak positions from the newly collected data and uses this information in updating the analysis resonance assignments and secondary structure. The goal-directed objective function then defines the next data collection step. The procedure continues until the collected data support comprehensive peak identification, resonance assignments at the desired level of completeness, and protein secondary structure. We present test cases in which ADAPT-NMR achieved results in two days or less that would have taken two months or more by manual approaches.

  8. Robust, integrated computational control of NMR experiments to achieve optimal assignment by ADAPT-NMR.

    Directory of Open Access Journals (Sweden)

    Arash Bahrami

    Full Text Available ADAPT-NMR (Assignment-directed Data collection Algorithm utilizing a Probabilistic Toolkit in NMR represents a groundbreaking prototype for automated protein structure determination by nuclear magnetic resonance (NMR spectroscopy. With a [(13C,(15N]-labeled protein sample loaded into the NMR spectrometer, ADAPT-NMR delivers complete backbone resonance assignments and secondary structure in an optimal fashion without human intervention. ADAPT-NMR achieves this by implementing a strategy in which the goal of optimal assignment in each step determines the subsequent step by analyzing the current sum of available data. ADAPT-NMR is the first iterative and fully automated approach designed specifically for the optimal assignment of proteins with fast data collection as a byproduct of this goal. ADAPT-NMR evaluates the current spectral information, and uses a goal-directed objective function to select the optimal next data collection step(s and then directs the NMR spectrometer to collect the selected data set. ADAPT-NMR extracts peak positions from the newly collected data and uses this information in updating the analysis resonance assignments and secondary structure. The goal-directed objective function then defines the next data collection step. The procedure continues until the collected data support comprehensive peak identification, resonance assignments at the desired level of completeness, and protein secondary structure. We present test cases in which ADAPT-NMR achieved results in two days or less that would have taken two months or more by manual approaches.

  9. Achieving partial denitrification through control of biofilm structure during biofilm growth in denitrifying biofilter.

    Science.gov (United States)

    Cui, Bin; Liu, Xiuhong; Yang, Qing; Li, Jianmin; Zhou, Xueyang; Peng, Yongzhen

    2017-08-01

    Partial denitrification was one of most effective ways to provide nitrite for annamox; whereas very limited research has been done to achieve nitrite accumulation in biofilm system. In this study, partial denitrification was studied in a lab-scale denitrifying biofilter (DNBF). The results showed biofilm structure variations caused the differences between nitrate specific reduction rate (NaSRR) and nitrite specific reduction rate (NiSRR), which led to nitrite accumulation in different degree at different biofilm formation phases. Hydrodynamic conditions also significantly influenced biofilm structure, nitrate and nitrite reduction activities. At the filtration velocity of 3.86mh(-1), not only biofilm structure, NaSRR and NiSRR kept relatively stable, but also 60% of nitrite accumulation and no nitrate in the effluent were achieved. Furthermore, Thauera genus bacteria, benefited for nitrite accumulation, became the dominant communities in high nitrite accumulation conditions. The partial denitrification combine with anammox in biofilter have the great potential applied in WWTPs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. The effect of dietary fibre on reducing the glycaemic index of bread.

    Science.gov (United States)

    Scazzina, Francesca; Siebenhandl-Ehn, Susanne; Pellegrini, Nicoletta

    2013-04-14

    As bread is the most relevant source of available carbohydrates in the diet and as lowering dietary glycaemic index (GI) is considered favourable to health, many studies have been carried out in order to decrease the GI of bread. The most relevant strategy that has been applied so far is the addition of fibre-rich flours or pure dietary fibre. However, the effectiveness of dietary fibre in bread in reducing the GI is controversial. The purpose of the present review was to discuss critically the effects obtained by adding different kinds of fibre to bread in order to modulate its glycaemic response. The studies were selected because they analysed in vivo whether or not dietary fibre, naturally present or added during bread making, could improve the glucose response. The reviewed literature suggests that the presence of intact structures not accessible to human amylases, as well as a reduced pH that may delay gastric emptying or create a barrier to starch digestion, seems to be more effective than dietary fibre per se in improving glucose metabolism, irrespective of the type of cereal. Moreover, the incorporation of technologically extracted cereal fibre fractions, the addition of fractions from legumes or of specifically developed viscous or non-viscous fibres also constitute effective strategies. However, when fibres or wholemeal is included in bread making to affect the glycaemic response, the manufacturing protocol needs to reconsider several technological parameters in order to obtain high-quality and consumer-acceptable breads.

  11. The influence of maternal glycaemia and dietary glycaemic index on pregnancy outcome in healthy mothers.

    LENUS (Irish Health Repository)

    McGowan, Ciara A

    2010-07-01

    Infant birth weight has increased in Ireland in recent years along with levels of childhood overweight and obesity. The present article reviews the current literature on maternal glycaemia and the role of the dietary glycaemic index (GI) and its impact on pregnancy outcomes. It is known that maternal weight and weight gain significantly influence infant birth weight. Fetal macrosomia (birth weight >4000 g) is associated with an increased risk of perinatal trauma to both mother and infant. Furthermore, macrosomic infants have greater risk of being obese in childhood, adolescence and adulthood compared to normal-sized infants. There is evidence that there is a direct relationship between maternal blood glucose levels during pregnancy and fetal growth and size at birth, even when maternal blood glucose levels are within their normal range. Thus, maintaining blood glucose concentrations within normal parameters during pregnancy may reduce the incidence of fetal macrosomia. Maternal diet, and particularly its carbohydrate (CHO) type and content, influences maternal blood glucose concentrations. However, different CHO foods produce different glycaemic responses. The GI was conceived by Jenkins in 1981 as a method for assessing the glycaemic responses of different CHO. Data from clinical studies in healthy pregnant women have documented that consuming a low-GI diet during pregnancy reduces peaks in postprandial glucose levels and normalises infant birth weight. Pregnancy is a physiological condition where the GI may be of particular relevance as glucose is the primary fuel for fetal growth.

  12. Achievement of control of bronchial asthma at the stage of medical rehabilitation

    Directory of Open Access Journals (Sweden)

    Grygus I.M.

    2011-02-01

    Full Text Available An inspection is conducted 70 patients on intermittent bronchial asthma at the stage of intensifying. The special program of medical rehabilitation, which includes the modified methods of medical physical culture, physical therapy facilities, is offered in permanent establishment. Application of this program brought to the height of size of Asthma Control Test from 17,41±0,35 to 24,03±0,32 points over. Control of flow of disease which did not come at treatment of patients only by medicinal preparations was arrived at in all cases of application of the program of medical rehabilitation.

  13. Achieving control and interoperability through unified model-based systems and software engineering

    Science.gov (United States)

    Rasmussen, Robert; Ingham, Michel; Dvorak, Daniel

    2005-01-01

    Control and interoperation of complex systems is one of the most difficult challenges facing NASA's Exploration Systems Mission Directorate. An integrated but diverse array of vehicles, habitats, and supporting facilities, evolving over the long course of the enterprise, must perform ever more complex tasks while moving steadily away from the sphere of ground support and intervention.

  14. Impact of Attention Training on Academic Achievement, Executive Functioning, and Behavior: A Randomized Controlled Trial

    Science.gov (United States)

    Kirk, Hannah; Gray, Kylie; Ellis, Kirsten; Taffe, John; Cornish, Kim

    2017-01-01

    Children with intellectual and developmental disabilities (IDD) experience significant difficulties in attention, learning, executive functions, and behavioral regulation. Emerging evidence suggests that computerized cognitive training may remediate these impairments. In a double blind controlled trial, 76 children with IDD (4-11 years) were…

  15. Serum ferritin and glucose homeostasis: change in the association by glycaemic state.

    Science.gov (United States)

    Aregbesola, Alex; Virtanen, Jyrki K; Voutilainen, Sari; Mursu, Jaakko; Lagundoye, Ayodele; Kauhanen, Jussi; Tuomainen, Tomi-Pekka

    2015-07-01

    Data on the association between body iron and glucose homeostasis by the three glycaemic states are scarce. Thus, we investigated the association between body iron as assessed by a serum ferritin concentration and glucose homeostasis using homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR) and beta cell function (HOMA-BcF) in different glycaemic states. A cross-sectional analysis was conducted in 2541 men aged 42-60 years in 1984-1989 in the Kuopio Ischemic Heart Disease Risk Factor Study. Subjects were classified into the three glycaemic states, normoglycaemia, prediabetes and type 2 diabetes (T2D), by fasting plasma glucose measurements and the information collected at study visit. The association between serum ferritin quartiles and HOMA-IR and HOMA-BcF for each glycaemic state was examined by analysis of covariance and linear regression analysis. The mean age and serum ferritin concentrations were 53.1 years (standard deviation = 5.7, range = 42.0-61.3 years) and 166.2 µg/L (standard deviation = 141.7, range = 11-960 µg/L), respectively. After multivariable adjustments, a weak and direct association was observed between serum ferritin quartiles and HOMA-IR in normoglycaemia (P-trend = 0.001) but a direct association in prediabetes (P-trend = 0.007) and in T2D (P-trend = 0.078). In HOMA-BcF, the association was weak and direct in normoglycaemia (P-trend = 0.003), direct in prediabetes (P-trend = 0.005) and inverse in T2D (P-trend = 0.105). Strongest associations were observed in prediabetes (β = 0.25, 95% confidence interval = 0.14-0.36 and P = 0.004 in HOMA-IR; β = 0.23, 95% confidence interval = 0.15-0.31 and P = 0.008 in HOMA-BcF) after a 100-µg/L increase in serum ferritin (log-transformed). These data suggest that both the strength and the direction of the association between body iron stores and glucose homeostasis are dependent on the glycaemic state of the population

  16. The Use of Weed Control Robot (WCR for Achieve to the Sustainable Agriculture

    Directory of Open Access Journals (Sweden)

    Behzad Sani

    2013-10-01

    Full Text Available Today, weeds control is very difficult because they are resistant to the herbicide due to excessive use of chemical herbicides in agriculture. Many studies have shown that mechanical and biological control of weeds can be much less damage to the environment of chemical herbicides. Develop of biological herbicides in agriculture was slow due to high prices and this subject the researchers to move toward the elimination of agricultural weed mechanically. This work was originally done by a many number of workers because and workers' rights didn’t work was ultimately economic value. Now solve this subject by the use of robotic technology in agriculture has been studied and a many number of agricultural researchers with the help of computer scientists move towards making robots to remove the weeds. Of course this is difficult due to excessive weeds similar to the plants, but the final results will help to increase crop and save the environment by eliminating chemical herbicides.

  17. Determining the impact of computer-aided control of educational achievements for the health of students

    Directory of Open Access Journals (Sweden)

    Savonova A.V.

    2013-06-01

    Full Text Available The problem of the health of students during the control of knowledge on the example of studying valeological disciplines. In the experiment involved 186 students. Age 17-19 years. The positive effect of regular thematic automated monitoring the health of students. In particular, during unit of knowledge and at exam time. Showed a statistically significant reduction in the average level of reactive anxiety in students of the experimental group, compared to its initial values (before the final test, it fell by 37.91. For comparison, before final testing of the control group, it only reduced by 10.42%. It was determined that a regular automated testing knowledge can be used to organize healthkeeping support professional development of future teachers.

  18. Identification of Energy Efficiency Opportunities through Building Data Analysis and Achieving Energy Savings through Improved Controls

    Energy Technology Data Exchange (ETDEWEB)

    Katipamula, Srinivas; Taasevigen, Danny J.; Koran, Bill

    2014-09-04

    This chapter will highlight analysis techniques to identify energy efficiency opportunities to improve operations and controls. A free tool, Energy Charting and Metrics (ECAM), will be used to assist in the analysis of whole-building, sub-metered, and/or data from the building automation system (BAS). Appendix A describes the features of ECAM in more depth, and also provide instructions for downloading ECAM and all resources pertaining to using ECAM.

  19. Old ideas to innovate tuberculosis control: preventive treatment to achieve elimination.

    Science.gov (United States)

    Diel, Roland; Loddenkemper, Robert; Zellweger, Jean-Pierre; Sotgiu, Giovanni; D'Ambrosio, Lia; Centis, Rosella; van der Werf, Marieke J; Dara, Masoud; Detjen, Anne; Gondrie, Peter; Reichman, Lee; Blasi, Francesco; Migliori, Giovanni Battista

    2013-09-01

    The introduction of new rapid diagnostic tools for tuberculosis (TB) and the promising TB drugs pipeline together with the development of a new World Health Organization Strategy post 2015 allows new discussions on how to direct TB control. The European Respiratory Society's European Forum for TB Innovation was created to stimulate discussion on how to best take advantage of old and new opportunities, and advances, to improve TB control and eventually progress towards the elimination of TB. While TB control is aimed at reducing the incidence of TB by early diagnosis and treatment of infectious cases of TB, TB elimination requires focus on sterilising the pool of latently infected individuals, from which future TB cases would be generated. This manuscript describes the three core components that are necessary to implement the elimination strategy fully. 1) Improve diagnosis of latent TB infected individuals. 2) Improve regimens to treat latent TB infection. 3) ensure public health commitment to make both 1) and 2) possible. Old and new evidence is critically described, focusing on the European commitment to reach elimination and on the innovative experiences and best practices available.

  20. A procedure to achieve fine control in MW processing of foods

    Science.gov (United States)

    Cuccurullo, G.; Cinquanta, L.; Sorrentino, G.

    2007-01-01

    A two-dimensional analytical model for predicting the unsteady temperature field in a cylindrical shaped body affected by spatially varying heat generation is presented. The dimensionless problem is solved analytically by using both partial solutions and the variation of parameters techniques. Having in mind industrial microwave heating for food pasteurization, the easy-to-handle solution is used to confirm the intrinsic lack of spatial uniformity of such a treatment in comparison to the traditional one. From an experimental point of view, a batch pasteurization treatment was realized to compare the effect of two different control techniques both based on IR thermography readout: the former assured a classical PID control, while the latter was based on a "shadowing" technique, consisting in covering portions of the sample which are hot enough with a mobile metallic screen. A measure of the effectiveness of the two control techniques was obtained by evaluating the thermal death curves of a strain Lactobacillus plantarum submitted to pasteurization temperatures. Preliminary results showed meaningful increases in the microwave thermal inactivation of the L. plantarum and similar significant decreases in thermal inactivation time with respect to the traditional pasteurization thermal treatment.

  1. Distributed Nonlinear Control with Event-Triggered Communication to Achieve Current-Sharing and Voltage Regulation in DC Microgrids

    DEFF Research Database (Denmark)

    Han, Renke; Meng, Lexuan; Guerrero, Josep M.

    2017-01-01

    A distributed nonlinear controller is presented to achieve both accurate current-sharing and voltage regulation simultaneously in dc microgrids considering different line impedances’ effects among converters. Then, an improved event-triggered principle for the controller is introduced through...... combining the state-dependent tolerance with a nonnegative offset. In order to design the event-triggered principle and guarantee the global stability, a generalized dc microgrid model is proposed and proven to be positive definite, based on which Lyapunov-based approach is applied. Furthermore, considering...... the effects from constant power loads, the damping performance of proposed controller is further improved and compared with the traditional V-I droop controller. The proposed event-triggered-based communication strategy can considerably reduce the communication traffic and significantly relax the requirement...

  2. A quantitative integrated assessment of pollution prevention achieved by integrated pollution prevention control licensing.

    Science.gov (United States)

    Styles, David; O'Brien, Kieran; Jones, Michael B

    2009-11-01

    This paper presents an innovative, quantitative assessment of pollution avoidance attributable to environmental regulation enforced through integrated licensing, using Ireland's pharmaceutical-manufacturing sector as a case study. Emissions data reported by pharmaceutical installations were aggregated into a pollution trend using an Environmental Emissions Index (EEI) based on Lifecycle Assessment methodologies. Complete sectoral emissions data from 2001 to 2007 were extrapolated back to 1995, based on available data. Production volume data were used to derive a sectoral production index, and determine 'no-improvement' emission trends, whilst questionnaire responses from 20 industry representatives were used to quantify the contribution of integrated licensing to emission avoidance relative to these trends. Between 2001 and 2007, there was a 40% absolute reduction in direct pollution from 27 core installations, and 45% pollution avoidance relative to hypothetical 'no-improvement' pollution. It was estimated that environmental regulation avoided 20% of 'no-improvement' pollution, in addition to 25% avoidance under business-as-usual. For specific emissions, avoidance ranged from 14% and 30 kt a(-1) for CO(2) to 88% and 598 t a(-1) for SO(x). Between 1995 and 2007, there was a 59% absolute reduction in direct pollution, and 76% pollution avoidance. Pollution avoidance was dominated by reductions in emissions of VOCs, SO(x) and NO(x) to air, and emissions of heavy metals to water. Pollution avoidance of 35% was attributed to integrated licensing, ranging from between 8% and 2.9 t a(-1) for phosphorus emissions to water to 49% and 3143 t a(-1) for SO(x) emissions to air. Environmental regulation enforced through integrated licensing has been the major driver of substantial pollution avoidance achieved by Ireland's pharmaceutical sector - through emission limit values associated with Best Available Techniques, emissions monitoring and reporting requirements, and

  3. Achieving Thin Films with Micro/Nano-Scale Controllable Morphology by Glancing Angle Deposition Technique

    Institute of Scientific and Technical Information of China (English)

    JIANG Shao-Ji; WANG Chao-Yi; TANG Ji-Jia; HU Lin-Xin

    2008-01-01

    @@ We demonstrate that thin films with micro/nanometre controllable morphology can be fabricated by the glancing angle deposition (GLAD) technique which is a physical vapour deposition technique.In this technique, there are parameters which determine the morphology of the thin films: the incident angle, ratio of the deposition rate with respect to the substrate rotation rate, nature of the material being deposited, etc.We fabricate the morphology of column, pillar, helices, zigzag and study the parameters which determine morphology by given some examples of SEM.

  4. Achievement of controlled resistive response of nanogapped palladium film to hydrogen

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, M. [Research Center for Solid State Physics and Materials, School of Mathematics and Physics, Suzhou University of Science and Technology, Suzhou 215009 (China); Wong, M. H.; Ong, C. W., E-mail: c.w.ong@polyu.edu.hk [Department of Applied Physics and Materials Research Center, The Hong Kong Polytechnic University, Hung Hom, Kowloon (Hong Kong)

    2015-07-20

    Palladium (Pd) film containing nanogaps of well controlled dimension was fabricated on a Si wafer having a high-aspect-ratio micropillar. The Pd film was arranged to experience hydrogen (H{sub 2})-induced volume expansion. (i) If the nanogap is kept open, its width is narrowed down. A discharge current was generated to give a strong, fast, and repeatable on-off type resistive switching response. (ii) If the nanogap is closed, the cross section of the conduction path varies to give continuous H{sub 2}-concentration dependent resistive response. The influence of stresses and related physical mechanisms are discussed.

  5. Controlling Ion Conductance and Channels to Achieve Synaptic-like Frequency Selectivity

    Institute of Scientific and Technical Information of China (English)

    Siheng Lu; Fei Zeng; Wenshuai Dong; Ao Liu; Xiaojun Li; Jingting Luo

    2015-01-01

    Enhancing ion conductance and controlling transport pathway in organic electrolyte could be used to modulate ionic kinetics to handle signals. In a Pt/Poly(3-hexylthiophene-2,5-diyl)/Polyethylene?LiCF3SO3/Pt hetero-junction, the electrolyte layer handled at high temperature showed nano-fiber microstructures accompanied with greatly improved salt solubility. Ions with high mobility were confined in the nano-fibrous channels leading to the semiconducting polymer layer, which is favorable for modulating dynamic doping at the semiconducting polymer/electrolyte interface by pulse frequency. Such a device realized synaptic-like frequency selectivity, i.e., depression at low frequency stimulation but potentiation at high-frequency stimulation.

  6. STRATEGIC MANAGEMENT OF BIOCHEMICAL AND BIOPHYSICAL CONTROL STRUCTURES AND SUSTAINABILITY HEALTH ACHIEVEMENT

    Directory of Open Access Journals (Sweden)

    Ioana-Andreea, MARINESCU

    2014-11-01

    Full Text Available Scientific Investigation of sustainability sanitary herein, matters to a define the structure of the health sector; b knowing the contents of the local health systems, c to obtain information about the properties and characteristics associated with health in Romania; d obtaining views on the mission, objectives, goals and targets pursued by health services; e scheduling results, effects and positive consequences among human communities to ensure sustainable health in the framework of sustainable development of the country and, last but not least; f it is intended to measure people's participation and the rule management process, based on biochemical and biophysical control structures. Mainly, it is considered that the sustainability and health have depicted conceptual content that must be secured effectively recovered, concrete operational activities of health systems in laboratories and hospitals.

  7. Using the accreditation journey to achieve global impact: UHN's experience at the Kuwait Cancer Control Center.

    Science.gov (United States)

    Ladha-Waljee, Nafeesa; McAteer, Stephen; Nickerson, Veronica; Khalfan, Adil

    2014-01-01

    On January 1, 2011, Princess Margaret Cancer Centre (PM) - University Health Network (UHN) began a five-year partnership agreement with the Kuwait Ministry of Health's Kuwait Cancer Control Center (KCCC) to enhance cancer care services. Over the course of the partnership, opportunities for improvement were identified by UHN experts in order to accelerate KCCC's development toward subspecialty cancer care. Many of these opportunities involved building a robust infrastructure to support foundational hospital operation processes and procedures. Harnessing UHN's own successes in accreditation, the partnership took advantage of the national accreditation mandate in Kuwait to initiate a quality program and drive clinical improvement at KCCC. This resulted in improved staff engagement, better awareness and alignment of administration with clinical management and a stronger patient safety culture. This article discusses the successes and lessons learned at KCCC that may provide insight to healthcare providers implementing Accreditation Canada International's accreditation framework in other countries and cultures.

  8. Achieving minimum caseload requirements: an analysis of hospital quality control reports from 2004-2010.

    Science.gov (United States)

    de Cruppé, Werner; Malik, Marc; Geraedts, Max

    2014-08-18

    Legally mandated minimum hospital caseload requirements for certain invasive procedures, including pancreatectomy, esophagectomy, and some types of organ transplantation, have been in effect in Germany since 2004. The goal of such requirements is to improve patient care by ensuring that patients undergo certain procedures only in hospitals that have met the corresponding minimum caseload requirement. We used the case numbers published in legally mandated hospital quality control reports to determine whether the hospitals actually met the stipulated requirements. We performed a secondary analysis of data supplied by hospitals in their quality control reports for the years 2004, 2006, 2008, and 2010 with respect to six procedures that have a minimum caseload requirement: complex interventions on the esophagus and pancreas, total knee replacement, and hepatic, renal, and stem-cell transplantation. The total case numbers for these six different procedures rose from 22 064 (0.1% of all procedures) in 2004 to 170 801 (0.9% of all procedures) in 2010. From 2006 onward, procedures to which minimum caseload requirements apply have been carried out in half of all hospitals studied. These procedures account for 0.9% of all inpatient cases in Germany. The percentage of hospitals that continue to perform certain procedures despite not having met the minimum caseload requirement ranged from 5% to 45%, depending on the type of procedure, and the percentage of cases carried out in such hospitals ranged from 1% to 15%. These values remained nearly constant for each of the six minimum caseload requirements over the 4 reporting years for which data were examined. The establishment of minimum caseload requirements in Germany in 2004 did not lessen the number of cases performed in violation of these requirements over the period 2004 to 2010.

  9. Checking rounds for isolation precautions in the control of multidrug-resistant organisms: reduction achieved.

    Science.gov (United States)

    Barbadoro, P; Martini, E; Gioia, M G; Stoico, R; Savini, S; Manso, E; Serafini, G; Prospero, E; D'Errico, M M

    2017-02-07

    The objective of this investigation was to analyze the effectiveness of a quality improvement initiative in limiting the spread of multidrug-resistant organisms (MDROs) in the hospital setting. During the period 2011-2013, a multimodal intervention was activated at a tertiary care center in Italy. The intervention included: laboratory-based surveillance, interdisciplinary training sessions, monitoring the adoption of isolation precautions and daily supervision provided by infection control nurses, and a monthly feedback. Time series analysis was used to evaluate the trends and correlations between the MDROs rate, intensity of checking rounds, and hospital-wide data (i.e., transfer of patients, patients' days, site of isolation, etc.). A total of 149,251 patients were included in the study. The proportion of patients undergoing transmission-based isolation precautions within 24 h from a positive laboratory finding increased from 83% in 2011 to 99% in 2013 (p < 0.05). The wards appropriately adopting the correct isolation precaution increased from 83% in 2011 to 97.6% in 2013 (p < 0.05). The frequency of controls was significantly reduced after the observation of compliance in the appropriate wards (p < 0.05). After three years, the incidence rate changed from 5.8/1000 days of stay [95% confidence interval (CI) 5.6-6.1] in 2011 to 4.7 (95% CI 4.4-4.9) in 2013 (p < 0.0001). Moreover, microorganisms isolated from different types of specimens showed variable potential for transmission (i.e., skin as the most potential and urine the least). The results demonstrate the efficacy of the multimodal intervention, with sustained reduction of MDROs rate, besides check reduction, and highlight the long-term efficacy of checking rounds in changing professionals' behaviors.

  10. A brief report on the relationship between self-control, video game addiction and academic achievement in normal and ADHD students

    OpenAIRE

    Haghbin, Maryam; Shaterian, Fatemeh; Hosseinzadeh, Davood; Griffiths, Mark D.

    2013-01-01

    Background and aims: Over the last two decades, research into video game addiction has grown increasingly. The present research aimed to examine the relationship between video game addiction, self-control, and academic achievement of normal and ADHD high school students. Based on previous research it was hypothesized that (i) there would be a relationship between video game addiction, self-control and academic achievement (ii) video game addiction, self-control and academic achievement would ...

  11. Advanced Manufacturing for Thermal and Environmental Control Systems: Achieving National Energy Goals

    Energy Technology Data Exchange (ETDEWEB)

    Bogucz, Edward A. [Syracuse Univ., NY (United States)

    2017-02-20

    This project was part of a regional initiative in the five counties of Central New York (CNY) that received funding from the U.S. Department of Energy (DOE) and four other federal agencies through the 2012 Advanced Manufacturing Jobs and Innovation Accelerator Challenge (AMJIAC). The CNY initiative was focused on cultivating the emergent regional cluster in “Advanced Manufacturing for Thermal and Environmental Control (AM-TEC).” As one component of the CNY AM-TEC initiative, the DOE-funded project supported five research & development seed projects that strategically targeted: 1) needs and opportunities of CNY AM-TEC companies, and 2) the goal of DOE’s Advanced Manufacturing Office (AMO) to reduce energy consumption by 50% across product life-cycles over 10 years. The project also sought to fulfill the AMO mission of developing and demonstrating new, energy-efficient processing and materials technologies at a scale adequate to prove their value to manufacturers and spur investment. The five seed projects demonstrated technologies and processes that can reduce energy intensity and improve production as well as use less energy throughout their lifecycles. The project was conducted over three years in two 18-month budget periods. During the first budget period, two projects proposed in the original AMJAIC application were successfully completed: Seed Project 1 focused on saving energy in heat transfer processes via development of nano structured surfaces to significantly increase heat flux; Seed Project 2 addressed saving energy in data centers via subzero cooling of the computing processors. Also during the first budget period, a process was developed and executed to select a second round of seed projects via a competitive request for proposals from regional companies and university collaborators. Applicants were encouraged to form industry-academic partnerships to leverage experience and resources of public and private sectors in the CNY region. Proposals were

  12. Herbicides as weed control agents: state of the art: II. Recent achievements.

    Science.gov (United States)

    Kraehmer, Hansjoerg; van Almsick, Andreas; Beffa, Roland; Dietrich, Hansjoerg; Eckes, Peter; Hacker, Erwin; Hain, Ruediger; Strek, Harry John; Stuebler, Hermann; Willms, Lothar

    2014-11-01

    In response to changing market dynamics, the discovery of new herbicides has declined significantly over the past few decades and has only seen a modest upsurge in recent years. Nevertheless, the few introductions have proven to be interesting and have brought useful innovation to the market. In addition, herbicide-tolerant or herbicide-resistant crop technologies have allowed the use of existing nonselective herbicides to be extended into crops. An increasing and now major challenge is being posed by the inexorable increase in biotypes of weeds that are resistant to herbicides. This problem is now at a level that threatens future agricultural productivity and needs to be better understood. If herbicides are to remain sustainable, then it is a must that we adopt diversity in crop rotation and herbicide use as well as increase the use of nonchemical measures to control weeds. Nevertheless, despite the difficulties posed by resistant weeds and increased regulatory hurdles, new screening tools promise to provide an upsurge of potential herbicide leads. Our industry urgently needs to supply agriculture with new, effective resistance-breaking herbicides along with strategies to sustain their utility.

  13. Combining independent, weighted P-values: achieving computational stability by a systematic expansion with controllable accuracy.

    Directory of Open Access Journals (Sweden)

    Gelio Alves

    Full Text Available Given the expanding availability of scientific data and tools to analyze them, combining different assessments of the same piece of information has become increasingly important for social, biological, and even physical sciences. This task demands, to begin with, a method-independent standard, such as the P-value, that can be used to assess the reliability of a piece of information. Good's formula and Fisher's method combine independent P-values with respectively unequal and equal weights. Both approaches may be regarded as limiting instances of a general case of combining P-values from m groups; P-values within each group are weighted equally, while weight varies by group. When some of the weights become nearly degenerate, as cautioned by Good, numeric instability occurs in computation of the combined P-values. We deal explicitly with this difficulty by deriving a controlled expansion, in powers of differences in inverse weights, that provides both accurate statistics and stable numerics. We illustrate the utility of this systematic approach with a few examples. In addition, we also provide here an alternative derivation for the probability distribution function of the general case and show how the analytic formula obtained reduces to both Good's and Fisher's methods as special cases. A C++ program, which computes the combined P-values with equal numerical stability regardless of whether weights are (nearly degenerate or not, is available for download at our group website http://www.ncbi.nlm.nih.gov/CBBresearch/Yu/downloads/CoinedPValues.html.

  14. Achieving enhanced ionic mobility in nanoporous silica by controlled surface interactions.

    Science.gov (United States)

    Garaga, Mounesha Nagendrachar; Aguilera, Luis; Yaghini, Negin; Matic, Aleksandar; Persson, Michael; Martinelli, Anna

    2017-02-22

    We report a strategy to enhance the ionic mobility in an emerging class of gels, based on robust nanoporous silica micro-particles, by chemical functionalization of the silica surface. Two very different ionic liquids are used to fill the nano-pores of silica at varying pore filling factors, namely one aprotic imidazolium based (1-methyl-3-hexylimidazolium bis(trifluoromethanesulfonyl)imide, C6C1ImTFSI), and one protic ammonium based (diethylmethylammonium methanesulfonate, DEMAOMs) ionic liquid. Both these ionic liquids display higher ionic mobility when confined in functionalized silica as compared to untreated silica nano-pores, an improvement that is more pronounced at low pore filling factors (i.e. in the nano-sized pore domains) and observed in the whole temperature window investigated (i.e. from -10 to 140 °C). Solid-state NMR, diffusion NMR and dielectric spectroscopy concomitantly demonstrate this effect. The origin of this enhancement is explained in terms of weaker intermolecular interactions and a consequent flipped-ion effect at the silica interface strongly supported by 2D solid-state NMR experiments. The possibility to significantly enhance the ionic mobility by controlling the nature of surface interactions is extremely important in the field of materials science and highlights these structurally tunable gels as promising solid-like electrolytes for use in energy relevant devices. These include, but are not limited to, Li-ion batteries and proton exchange membrane (PEM) fuel cells.

  15. Combining independent, weighted P-values: achieving computational stability by a systematic expansion with controllable accuracy.

    Science.gov (United States)

    Alves, Gelio; Yu, Yi-Kuo

    2011-01-01

    Given the expanding availability of scientific data and tools to analyze them, combining different assessments of the same piece of information has become increasingly important for social, biological, and even physical sciences. This task demands, to begin with, a method-independent standard, such as the P-value, that can be used to assess the reliability of a piece of information. Good's formula and Fisher's method combine independent P-values with respectively unequal and equal weights. Both approaches may be regarded as limiting instances of a general case of combining P-values from m groups; P-values within each group are weighted equally, while weight varies by group. When some of the weights become nearly degenerate, as cautioned by Good, numeric instability occurs in computation of the combined P-values. We deal explicitly with this difficulty by deriving a controlled expansion, in powers of differences in inverse weights, that provides both accurate statistics and stable numerics. We illustrate the utility of this systematic approach with a few examples. In addition, we also provide here an alternative derivation for the probability distribution function of the general case and show how the analytic formula obtained reduces to both Good's and Fisher's methods as special cases. A C++ program, which computes the combined P-values with equal numerical stability regardless of whether weights are (nearly) degenerate or not, is available for download at our group website http://www.ncbi.nlm.nih.gov/CBBresearch/Yu/downloads/CoinedPValues.html.

  16. Tools and Strategies for Malaria Control and Elimination: What Do We Need to Achieve a Grand Convergence in Malaria?

    Science.gov (United States)

    Hemingway, Janet; Shretta, Rima; Wells, Timothy N C; Bell, David; Djimdé, Abdoulaye A; Achee, Nicole; Qi, Gao

    2016-03-01

    Progress made in malaria control during the past decade has prompted increasing global dialogue on malaria elimination and eradication. The product development pipeline for malaria has never been stronger, with promising new tools to detect, treat, and prevent malaria, including innovative diagnostics, medicines, vaccines, vector control products, and improved mechanisms for surveillance and response. There are at least 25 projects in the global malaria vaccine pipeline, as well as 47 medicines and 13 vector control products. In addition, there are several next-generation diagnostic tools and reference methods currently in development, with many expected to be introduced in the next decade. The development and adoption of these tools, bolstered by strategies that ensure rapid uptake in target populations, intensified mechanisms for information management, surveillance, and response, and continued financial and political commitment are all essential to achieving global eradication.

  17. Estimation of glycaemic index of peach palm (Bactris gasipaes) cooked fruits and chips, and pitahaya (Hylocereus spp.) pulp.

    Science.gov (United States)

    Jiménez, Gin; Gómez, Georgina; Pérez, Ana M; Blanco-Metzler, Adriana

    2012-09-01

    The glycaemic index (GI) is a physiological measure of a food's potential to increase postprandial blood glucose, as compared to the effect produced by food taken as reference, such as glucose or white bread. Currently researchers and consumers are interested in low GI foods, since their consumption is associated with better weight control and reduced risk of incidence of chronic diseases, like diabetes. In the present study, the GI value for peach palm cooked fruit, peach palm chips and pitahaya pulp was estimated. The methodology established by the FAO/WHO for determining the GI of food was used. A total of 12 healthy, non-smoking volunteers were selected and they ingested the fore mentioned foods on different occasions, in 25 g portions of available carbohydrates, after 12-14 h overnight fast. Blood glucose levels were measured in 30 min intervals up to 120 min after ingestion. Average GI value was 48 +/- 11 for the pitahaya pulp and 35 +/- 6 for the peach palm cooked fruit, which may be classified as low glyceamic index foods. The GI of peach palm chips was 60 +/- 7, corresponding to a food with a moderate GI. The processing for producing the chips caused an increase in the GI value when compared to the cooked fruit, probably because the stages of miIling, moulding and baking promote availability of starch during hydrolysis by the digestive enzymes.

  18. Glycaemic control in patients with type 2 diabetes treated with oral antidiabetic drugs in urban areas of China%中国城市地区口服降糖药治疗的2型糖尿病患者血糖控制达标现状

    Institute of Scientific and Technical Information of China (English)

    陆菊明; 柳洁; 单忠艳; 杨玉芝; 胡仁明; 朱大龙; 杨立勇; 陈丽; 赵志刚; 李启富; 田浩明; 纪立农; 姬秋和; 刘静; 葛家璞; 时立新; 徐焱成; 郭晓蕙; 杨文英; 翁建平; 贾伟平; 邹大进; 周智广; 于德民

    2012-01-01

    )only in urban areas of China.Methods A total of 414 hospitals from 81 cities across China participated in the survey.Outpatients with T2DM on OADs treatment only were eligible for this study.General information of patients,medical history for T2DM,laboratory investigations and treatment regimen were collected from July to September in 2010.Logistic regression analysis was applied in the correlation analysis of glycemic control.Results A total of 97 315 eligible patients with T2DM were included in this study,with a mean age of (59 ± 11 ) years and a mean diabetes duration of (5 ±4) years.The mean glycated hemoglobin A1c (HbA1c) level of all patients was 7.7% ± 1.6%.Total of 35.1% (34 154 cases) and 17.9% ( 17 380 cases) of the patients had a HbA1 c < 7.0% and < 6.5%,respectively.Among all the patients,13.1% ( 12 748 cases) complicated with at least one macrovascular disease,and 15.1% ( 14 694 cases) with at least one microvascular disease. Of the patients with macrovascular complication ( s ),27.3% achieved optimal glycemic target (HbA1c < 7.0% ),it was lower than that in patients without macrovascular complication(s) (36.3% ).Similarly,25.2% of the patients with microvascular complication(s) achieved optimal glycemic target and it was lower than that in patients without microvascular complication (s)( 36.9% ).Among all the OAD treatment regimens,two kinds of OADs ( 51.3% ) and one OAD ( 34.5% )were most frequently used.It's found that 40.6%,33.7%,27.0% and 24.5% of the patients receiving one OAD,two OADs,three OADs and four or more OADs achieved glycemic control target,respectively.The most frequently used OADs were biguanides ( 30.8% ),sulphonylureas ( 24.6% ) and glinides (21.1%).Among the combined treatment regimens,23.7% were biguanides plus sulphonylureas,13.6%were biguanides plus glinides.Regression analysis showed that male,duration of diabetes,kinds of OADs,body mass index,combined with macro or micro

  19. Old method, new drugs: comparison of the efficacy of sevoflurane, isoflurane, and desflurane in achieving controlled hypotension in spinal surgery.

    Science.gov (United States)

    Kurt, Filiz; Derbent, Abdurrahim; Demirag, Kubilay; Eris, Oguz; Uyar, Mehmet; Islekel, Sertac

    2005-01-01

    This study compared the efficacy of isoflurane, sevoflurane, and desflurane in achieving hemodynamic stability in spinal procedures using moderate levels of controlled hypotension. After obtaining ethics committee approval and written informed consent, 32 American Surgical Association I-II patients were randomly allocated to receive isoflurane (n=12), sevoflurane (n=10), or desflurane (n=10) in O2-N2O (1:1) for maintenance of anesthesia. The induction of anesthesia, fentanyl dosage, and initial and maintenance volume replacements were standardized. Blood pressure was invasively monitored and maintained within a target systolic blood pressure (SBP) range of 80 to 90 mm Hg during the study. SBP outside this range was recorded. Volatile anesthetic concentration was adjusted according to the same protocol for all 3 agents. SPB control was maintained better with sevoflurane and isoflurane than desflurane; median SBP was outside the target range during 32% (range, 15%-55%) of study time with isoflurane, 26% (12%-42%) with sevoflurane, and 44% (20%-80%) with desflurane. Total blood loss did not differ among the groups. Sevoflurane and isoflurane administered in 2 L/min fresh gas flow were more effective than desflurane in achieving controlled hypotension in spinal surgery.

  20. Associations of dietary glycaemic index and glycaemic load with food and nutrient intake and general and central obesity in British adults.

    Science.gov (United States)

    Murakami, Kentaro; McCaffrey, Tracy A; Livingstone, M Barbara E

    2013-12-14

    Inconsistent associations between dietary glycaemic index (GI) and glycaemic load (GL) and body fatness may be partly due to differences in the underlying dietary patterns or energy under-reporting. In the present study, we examined the cross-sectional associations of dietary GI and GL with food and nutrient intake and general and central obesity, accounting for energy under-reporting. The subjects were 1487 British adults aged 19-64 years. Dietary intake was assessed using a 7 d weighed dietary record. Breads and potatoes were the positive predictive foods for dietary GI, while fruit, other cereals and dairy products were the negative predictors. These foods were similarly identified in the analysis of only acceptable reporters (AR; ratio of reported energy intake:estimated energy requirement within 0·665-1·335) and under-reporters (UR; ratio intake. Multiple linear regression analyses showed that dietary GI was independently associated with a higher risk of general obesity (BMI ≥ 30 kg/m²) and central obesity (waist circumference ≥ 102 cm in men and ≥ 88 cm in women). Dietary GL was also associated with general (only women) and central obesity. Similarly, in the analysis of AR, the GI showed positive associations with general and central obesity, and, only in women, the GL showed positive associations with general and central obesity. Conversely, in the analysis of UR, the associations were generally weaker and many of them failed to reach statistical significance. In conclusion, we found independent positive associations of dietary GI and GL with general and central obesity in British adults.

  1. Achieving the nitrite pathway using FA inhibition and process control in UASB-SBR system removing nitrogen from landfill leachate

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    An up-flow sludge blanket(UASB) and sequencing batch reactor(SBR) system was introduced to remove organics and nitrogen from landfill leachate.The synergetic effect of free ammonia(FA) inhibition and process control was used to achieve the nitrite pathway in the SBR.In previous research,inhibition of FA on nitrite oxidizing bacteria(NOB) activity has been revealed and the process control parameters(DO,ORP and pH) exactly indicate the end-point of nitritation.The method was implemented in the SBR achieving stable nitrogen removal via the nitrite pathway from landfill leachate.The degree of nitrite accumulation during the nitritation was monitored along with the simultaneous and advanced removal of organics and nitrogen in the UASB-SBR system.The nitrifying bacteria community was quantitatively analyzed by fluorescence in situ hybridization(FISH) techniques.Batch tests were carried out to investigate the denitritation kinetics of microbial bacteria in the SBR.Experimental results showed that the nitrite pathway could be repeatedly and reliably achieved by synergetic effect of FA inhibition and process control.FISH analysis showed the dominant nitrifying bacteria were ammonia-oxidizing β-Proteobacteria. Relationship between nitrite concentration and nitrite reduction rate followed the Monod-type equation.The maximum specific nitrite utilization rate(k) and half-velocity constant(Ks) were calculated as 0.44 gN gVSS-1d-1and 15.8 mg L-1,respectively.

  2. Gaining control: changing relations between executive control and processing speed and their relevance for mathematics achievement over course of the preschool period.

    Science.gov (United States)

    Clark, Caron A C; Nelson, Jennifer Mize; Garza, John; Sheffield, Tiffany D; Wiebe, Sandra A; Espy, Kimberly Andrews

    2014-01-01

    Early executive control (EC) predicts a range of academic outcomes and shows particularly strong associations with children's mathematics achievement. Nonetheless, a major challenge for EC research lies in distinguishing EC from related cognitive constructs that also are linked to achievement outcomes. Developmental cascade models suggest that children's information processing speed is a driving mechanism in cognitive development that supports gains in working memory, inhibitory control and associated cognitive abilities. Accordingly, individual differences in early executive task performance and their relation to mathematics may reflect, at least in part, underlying variation in children's processing speed. The aims of this study were to: (1) examine the degree of overlap between EC and processing speed at different preschool age points; and (2) determine whether EC uniquely predicts children's mathematics achievement after accounting for individual differences in processing speed. As part of a longitudinal, cohort-sequential study, 388 children (50% boys; 44% from low income households) completed the same battery of EC tasks at ages 3, 3.75, 4.5, and 5.25 years. Several of the tasks incorporated baseline speeded naming conditions with minimal EC demands. Multidimensional latent models were used to isolate the variance in executive task performance that did not overlap with baseline processing speed, covarying for child language proficiency. Models for separate age points showed that, while EC did not form a coherent latent factor independent of processing speed at age 3 years, it did emerge as a distinct factor by age 5.25. Although EC at age 3 showed no distinct relation with mathematics achievement independent of processing speed, EC at ages 3.75, 4.5, and 5.25 showed independent, prospective links with mathematics achievement. Findings suggest that EC and processing speed are tightly intertwined in early childhood. As EC becomes progressively decoupled from

  3. Utilisation of preharvest dropped apple peels as a flour substitute for a lower glycaemic index and higher fibre cake.

    Science.gov (United States)

    Jun, Yujin; Bae, In Young; Lee, Suyong; Lee, Hyeon Gyu

    2014-02-01

    Fibre-enriched materials (FEMs) obtained from preharvest dropped apple peels were utilised as a source of dietary fibre in baked cakes and their effects on the textural/nutritional qualities and starch digestibility (glucose release behaviour, starch digestion fraction, predicted glycaemic index) of the cakes were evaluated. When FEMs were incorporated into the cake formulation (3 g and 6 g of dietary fibre per serving (100 g)), the volume of the cakes seemed to be reduced and their texture become harder. However, 3 g of FEMs did not degrade the cake qualities. The use of FEMs in cakes significantly reduced the levels of rapidly digestible starch and slowly digestible starch, while the levels of resistant starch increased. Additionally, the cake samples prepared with FEMs exhibited a lower predicted glycaemic index. This study may give rise to multi-functional bakery products with acceptable quality and low glycaemic index.

  4. Shifting from tuberculosis control to elimination: Where are we? What are the variables and limitations? Is it achievable?

    Directory of Open Access Journals (Sweden)

    Rosella Centis

    2017-03-01

    Full Text Available Tuberculosis (TB is a priority in terms of incidence and mortality, with about 10.4 million new incident cases and 1.8 million deaths in 2015. The End-TB strategy recently launched by the World Health Organization in the context of the post-2015 agenda, aimed to achieve TB elimination, represents an evolution of the previous historical strategies originally aimed to achieve TB control. Globally, the current decline in TB incidence is rather slow at approximately 1,5% per year to reach the TB pre-elimination phase by 2035 (A more aggressive approach based on diagnosis and treatment of latently infected individuals has been proposed in the context of TB elimination to ensure future generations free of TB. We describes 4 scenarios which, combined, describe the TB epidemiology in a given setting: 1 in absence of interventions, 2 with early TB diagnosis and effective treatment, 3 with irregular TB treatment, 4 with TB co-infected by HIV not undergoing anti-retroviral treatment. To achieve TB Elimination, a more concerted action by funders and governments will be required for further investments into TB prevention, detection and treatment.

  5. DTC-SVM Based on PI Torque and PI Flux Controllers to Achieve High Performance of Induction Motor

    Directory of Open Access Journals (Sweden)

    Hassan Farhan Rashag

    2014-01-01

    Full Text Available The fundamental idea of direct torque control of induction machines is investigated in order to emphasize the property produced by a given voltage vector on stator flux and torque variations. The proposed control system is based on Space Vector Modulation (SVM of electrical machines, Improvement model reference adaptive system, real time of stator resistance and estimation of stator flux. The purpose of this control is to minimize electromagnetic torque and flux ripple and minimizing distortion of stator current. In this proposed method, PI torque and PI flux controller are designed to achieve estimated torque and flux with good tracking and fast response with reference torque and there is no steady state error. In addition, design of PI torque and PI flux controller are used to optimize voltages in d-q reference frame that applied to SVM. The simulation Results of proposed DTC-SVM have complete excellent performance in steady and transient states as compared with classical DTC-SVM.

  6. Influence of acute glycaemic level on measures of myocardial infarction in non-diabetic pigs

    DEFF Research Database (Denmark)

    Diemar, Sarah S; Sejling, Anne-Sophie; Iversen, Kasper K;

    2015-01-01

    OBJECTIVE: Patients with diabetes are at increased risk of experiencing myocardial infarction. The influence of the prevailing plasma glucose level on infarction and mortality after acute ischaemia is however unknown. The aim was to study the effect of the acute plasma glucose level on the myocar...... glycaemic level and measures of myocardial infarction, rates of ventricular fibrillation and subsequent premature death in the setting of acute ischaemia and reperfusion.......OBJECTIVE: Patients with diabetes are at increased risk of experiencing myocardial infarction. The influence of the prevailing plasma glucose level on infarction and mortality after acute ischaemia is however unknown. The aim was to study the effect of the acute plasma glucose level...

  7. Discovery of a low-glycaemic index potato and relationship with starch digestion in vitro.

    Science.gov (United States)

    Ek, Kai Lin; Wang, Shujun; Copeland, Les; Brand-Miller, Jennie C

    2014-02-01

    Potatoes are usually a high-glycaemic index (GI) food. Finding a low-GI potato and developing a screening method for finding low-GI cultivars are both health and agricultural priorities. The aims of the present study were to screen the commonly used and newly introduced cultivars of potatoes, in a bid to discover a low-GI potato, and to describe the relationship between in vitro starch digestibility of cooked potatoes and their in vivo glycaemic response. According to International Standard Organisation (ISO) guidelines, seven different potato cultivars were tested for their GI. In vitro enzymatic starch hydrolysis and chemical analyses, including amylose content analysis, were carried out for each potato cultivar, and correlations with the respective GI values were sought. The potato cultivars had a wide range of GI values (53-103). The Carisma cultivar was classified as low GI and the Nicola cultivar (GI = 69) as medium GI and the other five cultivars were classified as high GI according to ISO guidelines. The GI values were strongly and positively correlated with the percentage of in vitro enzymatic hydrolysis of starch in the cooked potatoes, particularly with the hydrolysis percentage at 120 min (r 0·91 and P starch content was not correlated with either in vitro starch digestibility or GI. The findings suggest that low-GI potato cultivars can be identified by screening using a high-throughput in vitro digestion procedure, while chemical composition, including amylose and fibre content, is not indicative.

  8. Bioavailability of milk protein-derived bioactive peptides: a glycaemic management perspective.

    Science.gov (United States)

    Horner, Katy; Drummond, Elaine; Brennan, Lorraine

    2016-06-01

    Milk protein-derived peptides have been reported to have potential benefits for reducing the risk of type 2 diabetes. However, what the active components are and whether intact peptides exert this bioactivity has received little investigation in human subjects. Furthermore, potentially useful bioactive peptides can be limited by low bioavailability. Various peptides have been identified in the gastrointestinal tract and bloodstream after milk-protein ingestion, providing valuable insights into their potential bioavailability. However, these studies are currently limited and the structure and sequence of milk peptides exerting bioactivity for glycaemic management has received little investigation in human subjects. The present article reviews the bioavailability of milk protein-derived peptides in human studies to date, and examines the evidence on milk proteins and glycaemic management, including potential mechanisms of action. Areas in need of advancement are identified. Only by establishing the bioavailability of milk protein-derived peptides, the active components and the mechanistic pathways involved can the benefits of milk proteins for the prevention or management of type 2 diabetes be fully realised in future.

  9. Perceived Barriers to Application of Glycaemic Index: Valid Concerns or Lost in Translation?

    Directory of Open Access Journals (Sweden)

    Shannan M. Grant

    2011-02-01

    Full Text Available The term glycaemic-index (GI originally appeared in the literature in the early 1980s. GI categorizes carbohydrate according to glycaemic effect postprandially. Since its inception, GI has obtained and maintained interest of academics and clinicians globally. Upon review of GI literature, it becomes clear that the clinical utility of GI is a source of controversy. Can and should GI be applied clinically? There are academics and clinicians on both sides of the argument. Certainly, this controversy has been a stimulus for the evolution of GI methodology and application research, but may also negatively impact clinicians’ perception of GI if misunderstood. This article reviews two assessments of GI that are often listed as barriers to application; the GI concept is (1 too complex and (2 too difficult for clients to apply. The literature reviewed does not support the majority of purported barriers, but does indicate that there is a call from clinicians for more and improved GI education tools and clinician GI education. The literature indicates that the Registered Dietitian (RD can play a key role in GI knowledge translation; from research to application. Research is warranted to assess GI education tool and knowledge needs of clinicians and the clients they serve.

  10. Does a Low Glycaemic Index (GI Diet Cost More during Pregnancy?

    Directory of Open Access Journals (Sweden)

    Jennie Brand-Miller

    2012-11-01

    Full Text Available  The aim of this study was to examine the monetary cost of dietary change among pregnant women before and after receiving low glycaemic index (GI dietary advice. The pregnant women in this study were a subgroup of participants in the Pregnancy and Glycaemic Index Outcomes (PREGGIO study. Twenty women from the low GI dietary advice group, who had completed their pregnancies, were randomly chosen. All these women had completed three day food records at 12–16 weeks and again around 36 weeks of gestation. Consumer food prices were applied to recorded dietary intake data. The mean ± SD GI of the diet reduced from 55.1 ± 4.3 to 51.6 ± 3.9 (p = 0.003. The daily cost of the diet (AUD was 9.1 ± 2.7 at enrolment and 9.5 ± 2.1 prior to delivery was not significantly different (p = 0.52. There were also no significant differences in the daily energy intake (p = 0.2 or the daily cost per MJ (p = 0.16. Women were able to follow low GI dietary advice during pregnancy with no significant increase in the daily costs.

  11. Achievement of treatment goals with canagliflozin in patients with type 2 diabetes mellitus: a pooled analysis of randomized controlled trials.

    Science.gov (United States)

    Blonde, Lawrence; Woo, Vincent; Mathieu, Chantal; Yee, Jacqueline; Vijapurkar, Ujjwala; Canovatchel, William; Meininger, Gary

    2015-11-01

    To evaluate attainment of diabetes-related treatment goals with canagliflozin, a sodium glucose co-transporter 2 inhibitor, versus placebo in patients with type 2 diabetes mellitus (T2DM). Data were pooled from four 26-week, placebo-controlled, Phase 3 studies of patients with T2DM (N = 2313). Goal attainment with canagliflozin 100 and 300 mg versus placebo was evaluated in the overall population, and in subgroups based on age and sex, at baseline and Week 26. ClinicalTrials.gov NCT01081834, NCT01106677, NCT01106625, NCT01106690. Proportion of patients achieving hemoglobin A1C (A1C) canagliflozin 100 and 300 mg compared with placebo. More patients achieved body weight reduction of ≥ 5% with canagliflozin 100 and 300 mg versus placebo at Week 26. Fewer patients had LDL-C canagliflozin 100 and 300 mg versus placebo. Canagliflozin 100 and 300 mg also provided better attainment of the composite endpoint of A1C Canagliflozin was associated with better attainment of diabetes-related treatment goals compared with placebo, and was generally well tolerated at 26 weeks.

  12. High effective coverage of vector control interventions in children after achieving low malaria transmission in Zanzibar, Tanzania

    Directory of Open Access Journals (Sweden)

    Beer Netta

    2013-01-01

    appreciated the interventions and recognized the value of sustaining their use. Thus, sustaining high effective coverage of vector control interventions, which is crucial for reaching malaria elimination in Zanzibar, can be achieved by maintaining effective delivery of these interventions.

  13. Important differences in the durability of glycaemic response among second-line treatment options when added to metformin in type 2 diabetes: a retrospective cohort study.

    Science.gov (United States)

    Mamza, Jil; Mehta, Rajnikant; Donnelly, Richard; Idris, Iskandar

    2016-01-01

    There is limited information about the durability of glycaemic control when different oral glucose-lowering therapies (GLTs) are used as add-on treatments to metformin (MET) in patients with type 2 diabetes mellitus (T2DM). To compare time to treatment failure between different classes of oral GLT when used as second line (add-on) treatments to MET monotherapy at HbA1c ≥ 7.5%. A retrospective cohort study on 20,070 patients who were newly treated with a sulphonylurea (SU), dipeptidyl-peptidase-4 (DPP-4) inhibitor or thiazolidinedione (TZD) following MET therapy failure (2007-2014). Patients' data was sourced from UK General Practices via The Health Improvement Network (THIN) database. The risk of dual therapy failure was compared between three treatment groups: MET + SU (reference group, n = 15,508), MET + DPP-4 inhibitor (n = 3,080) and MET + TZD (n = 1,482). Follow-up was until treatment substitution or intensification with a 3rd GLT, or for up to 5 years (totalling 46,430 person-years). Propensity score weighting and Cox proportional hazard regression analyses were employed. Risk of dual therapy failure was compared between treatment groups while adjusting for baseline covariates. Unadjusted survival analysis showed the incidence of dual therapy failure at 1 year was 15% with SU, 23% with DPP-4 inhibitor and 8% with TZD. Corresponding failure rates at 2 years were 26, 38 and 12%, respectively. Adjusted multivariate models showed that, compared to the SU group, adding a DPP-4 inhibitor was associated with an increased risk of treatment failure (adjusted hazard ratio, aHR, 1.58; 95% CI: 1.48-1.68), while adding a TZD was associated with a reduced hazard (aHR, 0.45; 95% CI: 0.41-0.50). Baseline parameters associated with an increased hazard of intensification included HbA1c, diabetes duration, gender, smoking status and the use of statins. In routine clinical practice, adding a DPP-4 inhibitor to MET is associated with an increased

  14. Overall asthma control achieved with budesonide/formoterol maintenance and reliever therapy for patients on different treatment steps

    Directory of Open Access Journals (Sweden)

    Östlund Ollie

    2011-04-01

    Full Text Available Abstract Background Adjusting medication for uncontrolled asthma involves selecting one of several options from the same or a higher treatment step outlined in asthma guidelines. We examined the relative benefit of introducing budesonide/formoterol (BUD/FORM maintenance and reliever therapy (Symbicort SMART® Turbuhaler® in patients previously prescribed treatments from Global Initiative for Asthma (GINA Steps 2, 3 or 4. Methods This is a post hoc analysis of the results of five large clinical trials (>12000 patients comparing BUD/FORM maintenance and reliever therapy with other treatments categorised by treatment step at study entry. Both current clinical asthma control during the last week of treatment and exacerbations during the study were examined. Results At each GINA treatment step, the proportion of patients achieving target levels of current clinical control were similar or higher with BUD/FORM maintenance and reliever therapy compared with the same or a higher fixed maintenance dose of inhaled corticosteroid/long-acting β2-agonist (ICS/LABA (plus short-acting β2-agonist [SABA] as reliever, and rates of exacerbations were lower at all treatment steps in BUD/FORM maintenance and reliever therapy versus same maintenance dose ICS/LABA (P Conclusions BUD/FORM maintenance and reliever therapy may be a preferable option for patients on Steps 2 to 4 of asthma guidelines requiring a more effective treatment and, compared with other fixed dose alternatives, is most effective in the higher treatment steps.

  15. Cognition, academic achievement, and epilepsy in school-age children: a case-control study in a developing country.

    Science.gov (United States)

    Melbourne Chambers, R; Morrison-Levy, N; Chang, S; Tapper, J; Walker, S; Tulloch-Reid, M

    2014-04-01

    We conducted a case-control study of 33 Jamaican children 7 to 12years old with uncomplicated epilepsy and 33 of their classroom peers matched for age and gender to determine whether epilepsy resulted in differences in cognitive ability and school achievement and if socioeconomic status or the environment had a moderating effect on any differences. Intelligence, language, memory, attention, executive function, and mathematics ability were assessed using selected tests from NEPSY, WISCR, TeaCh, WRAT3 - expanded, and Raven's Coloured Progressive Matrices. The child's environment at home was measured using the Middle Childhood HOME inventory. Socioeconomic status was determined from a combination of household, crowding, possessions, and sanitation. We compared the characteristics of the cases and controls and used random effects regression models (using the matched pair as the cluster) to examine the relationship between cognition and epilepsy. We found that there was no significant difference in IQ, but children with epilepsy had lower scores on tests of memory (p<0.05), language (p<0.05), and attention (p<0.01) compared with their controls. In random effects models, epilepsy status had a significant effect on memory (coefficient=-0.14, CI: -0.23, -0.05), language (coefficient=-0.13, CI: -0.23, -0.04), and mathematics ability (coefficient=-0.01, CI: -0.02, -0.00). Adjustment for the home environment and socioeconomic status and inclusion of interaction terms for these variables did not alter these effects. In conclusion, we found that epilepsy status in Jamaican children has a significant effect on performance on tests of memory, language, and mathematics and that this effect is not modified or explained by socioeconomic status or the child's home environment.

  16. Identification of those most likely to benefit from a low-glycaemic index dietary intervention in pregnancy.

    LENUS (Irish Health Repository)

    Walsh, Jennifer M

    2014-08-28

    The present study is a secondary analysis of the ROLO study, a randomised control trial of a low-glycaemic index (GI) diet in pregnancy to prevent the recurrence of fetal macrosomia. The objectives of the present study were to identify which women are most likely to respond to a low-GI dietary intervention in pregnancy with respect to three outcome measures: birth weight; maternal glucose intolerance; gestational weight gain (GWG). In early pregnancy, 372 women had their mid-upper arm circumference recorded and BMI calculated. Concentrations of glucose, insulin and leptin were measured in early pregnancy and at 28 weeks. At delivery, infant birth weight was recorded and fetal glucose, C-peptide and leptin concentrations were measured in the cord blood. Women who benefited in terms of infant birth weight were shorter, with a lower education level. Those who maintained weight gain within the GWG guidelines were less overweight in both their first and second pregnancies, with no difference being observed in maternal height. Women who at 28 weeks of gestation developed glucose intolerance, despite the low-GI diet, had a higher BMI and higher glucose concentrations in early pregnancy with more insulin resistance. They also had significantly higher-interval pregnancy weight gain. For each analysis, women who responded to the intervention had lower leptin concentrations in early pregnancy than those who did not. These findings suggest that the maternal metabolic environment in early pregnancy is important in determining later risks of excessive weight gain and metabolic disturbance, whereas birth weight is mediated more by genetic factors. It highlights key areas, which warrant further interrogation before future pregnancy intervention studies, in particular, maternal education level and inter-pregnancy weight gain.

  17. Evaluation of knowledge regarding gestational diabetes mellitus and its association with glycaemic level: A Malaysian study.

    Science.gov (United States)

    Hussain, Zahid; Yusoff, Zuraidah Mohd; Sulaiman, Syed Azhar Syed

    2015-06-01

    The aim of this study was to evaluate the knowledge about GDM and its corresponding relation with glycaemic level in GDM patients. A cross-sectional study was conducted in antenatal clinic of Hospital Pulau Pinang, Malaysia from June 2013 to December 2013 using Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ) on the sample of 175 GDM patients. Three most recent fasting plasma glucose (FPG) values (mmol/l) were taken from patients profiles and mean was calculated. A total of 166 patients were included in final analysis. A total mean knowledge score of 166 patients was 10.01±3.63 and total mean FPG value was 5.50±1.13. Knowledge had a significant negative association with FPG (r=- 0.306, Pliteracy. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  18. Glycaemic effects of bread and marmalade in insulin-dependent diabetes.

    Science.gov (United States)

    Lean, M E; Tennison, B R; Williams, D R

    1985-03-01

    The glycaemic responses of 12 C-peptide negative insulin-dependent diabetics were studied following four breakfasts with different carbohydrate sources. Total energy content of the meals was the usual for each subject, carbohydrate supplying 55% and fat 32%. The meals comprised: wholemeal bread with margarine; white bread with margarine; marmalade made with sucrose, and cheddar cheese; and marmalade (22% of total energy) on wholemeal bread with margarine. The study demonstrated powerfully that there were no statistically significant or clinically relevant differences between the meals in post-prandial glucose peak elevation, or in incremental area under the blood glucose curve to 120 mins. On these grounds, sucrose, in amounts considered acceptable to the general population, need not be prohibited from diabetic diets.

  19. Yellow mustard bran attenuates glycaemic response of a semi-solid food in young healthy men.

    Science.gov (United States)

    Lett, Aron M; Thondre, Pariyarath S; Rosenthal, Andrew J

    2013-03-01

    In a randomized, repeated-measures design, the glycaemic response and satiety ratings of a potato and leek soup were compared with and without the addition of 5 g of yellow mustard bran. Ten healthy, non-smoking, moderately active male subjects (mean age of 21.1 years and mean body mass index 23.2 kg/m(2)) were recruited to the study. Capillary blood glucose and satiety were measured at 0, 15, 30, 45, 60, 90 and 120 min, postprandial of each food. The incremental area under the blood glucose curve, blood glucose at each time point and satiety rating were calculated and compared via paired t-test. Mean blood glucose values at 15, 30 and 90 min (p soup.

  20. A low glycaemic index breakfast cereal preferentially prevents children's cognitive performance from declining throughout the morning.

    Science.gov (United States)

    Ingwersen, Jeanet; Defeyter, Margaret Anne; Kennedy, David O; Wesnes, Keith A; Scholey, Andrew B

    2007-07-01

    This study investigated whether the glycaemic index (GI) of breakfast cereal differentially affects children's attention and memory. Using a balanced cross-over design, on two consecutive mornings 64 children aged 6-11 years were given a high GI cereal and a low GI cereal in a counterbalanced order. They performed a series of computerised tests of attention and memory, once prior to breakfast and three times following breakfast at hourly intervals. The results indicate that children's performance declines throughout the morning and that this decline can be significantly reduced following the intake of a low GI cereal as compared with a high GI cereal on measures of accuracy of attention (M=-6.742 and -13.510, respectively, p<0.05) and secondary memory (M=-30.675 and -47.183, respectively, p<0.05).

  1. A brief report on the relationship between self-control, video game addiction and academic achievement in normal and ADHD students.

    Science.gov (United States)

    Haghbin, Maryam; Shaterian, Fatemeh; Hosseinzadeh, Davood; Griffiths, Mark D

    2013-12-01

    Over the last two decades, research into video game addiction has grown increasingly. The present research aimed to examine the relationship between video game addiction, self-control, and academic achievement of normal and ADHD high school students. Based on previous research it was hypothesized that (i) there would be a relationship between video game addiction, self-control and academic achievement (ii) video game addiction, self-control and academic achievement would differ between male and female students, and (iii) the relationship between video game addiction, self-control and academic achievement would differ between normal students and ADHD students. The research population comprised first grade high school students of Khomeini-Shahr (a city in the central part of Iran). From this population, a sample group of 339 students participated in the study. The survey included the Game Addiction Scale (Lemmens, Valkenburg & Peter, 2009), the Self-Control Scale (Tangney, Baumeister & Boone, 2004) and the ADHD Diagnostic checklist (Kessler et al., 2007). In addition to questions relating to basic demographic information, students' Grade Point Average (GPA) for two terms was used for measuring their academic achievement. These hypotheses were examined using a regression analysis. Among Iranian students, the relationship between video game addiction, self-control, and academic achievement differed between male and female students. However, the relationship between video game addiction, self-control, academic achievement, and type of student was not statistically significant. Although the results cannot demonstrate a causal relationship between video game use, video game addiction, and academic achievement, they suggest that high involvement in playing video games leaves less time for engaging in academic work.

  2. Research and Achievement of Soft PLC Control System%软PLC控制系统研究与实现

    Institute of Scientific and Technical Information of China (English)

    苏两河

    2013-01-01

      With the development of computer technology and establishment of IEC6113-3 standard, the development of soft PLC technology is strongly developed. Compared with the traditional hard PLC, soft PLC provides the advantage of powerful ability of data process, net communication and open system structure, which can meet the demands of the flexibility and open design of control system in the industry automation field. With the main design of soft PLC, the system structure and the implementation program and achievement of the software are analyzed.%  随着近年来计算机技术的发展以及IEC6113-3标准的制定,软PLC的技术得到了长足发展。较之传统的硬PLC而言,软PLC控制系统具有强大的数据处理能力、网络通信能力、开放的体系结构等优势,可满足当下工业自动化领域中控制系统柔性及开放性的要求。本文从软PLC的总体设计入手,论述了系统结构与软件实施方案及软件的实现。

  3. On the Relation of Locus of Control, Social and Cultural Capital and Oral Proficiency Achievement of EFL Students:

    Directory of Open Access Journals (Sweden)

    Hamid Ashraf

    2014-03-01

    Full Text Available Two areas of difficulty that almost all students might face while learning a second language are speaking and listening skills.  Individuals’ perceptions about the underlying main causes of their lives’ events which is called Locus of Control (LOC, has a great role in their activities as well as the interactions between individuals and socio-cultural environments. This study aims at investigating the relationship between social cultural capital, LOC and oral proficiency (listening and speaking of Iranian EFL learners.  It also aims at examining the relationship between social cultural capital and LOC (internal and external. To meet this end, Social Cultural Capital Questionnaire (Pishghadam, Noghani & Zabihi, 2011 and the Persian version of  LOC questionnaire (Ghonsooly & Elahi, 2010 were administered to a sample of 100 upper intermediate EFL students from some language institutes in Mashhad, Iran. Both male (N=46 and female (N=54 students filled in two questionnaires. The participants’ Grand Point Averages (GPA of their FL Listening and Speaking exams also served as an index of their oral proficiency achievement. The results of the statistical analyses revealed a positive correlation between social cultural capital, LOC, and students’ oral proficiency. The findings also demonstrated a significant relationship between social cultural capital and LOC.

  4. Glycaemic index (GI) of an Indian branded thermally treated basmati rice variety: a multi centric study.

    Science.gov (United States)

    Srinivasa, Dinesh; Raman, Abhi; Meena, P; Chitale, Geetanjali; Marwahat, Ankita; Jainani, Kiran J

    2013-10-01

    Glycaemic Index (GI) is the classification of carbohydrates based on their ability to raise blood glucose levels and evidence shows that its usage has beneficial health implications. Rice forms a part of the Indian staple diet and one of the major energy contributors. Hence, it is important to establish the Glycaemic Index (GI) value of rice. However, due to availability of different varieties of rice it is important first to identify a lower GI variety and to make it available to the Indian population. Subjecting rice to thermal processing is also known to reduce the GI of rice. An Indian thermally treated basmati rice variety was hypothesised to be low in GI. This multi centric study was conducted to test this hypothesis in healthy volunteers. In this study, out of 83 participants, data points of 70 healthy volunteers were taken into consideration for arriving at the final GI value. The study procedure was similar to the recommendations by FAO/WHO. A multi centric trial was conducted to nullify any regional or genetic variability. It was observed that reference glucose curve had the maximum average peak of 166.37 mg/dL while the basmati sample had a lower peak (136.22 mg/dL). The mean blood glucose incremental area under the curve for reference food was 5969.64 mins.mg/dL (SEM 95.94) and for rice it was 3267.81 mins. mg/dL (SEM 76.21). In this studyThe GI of Indian branded basmati rice was found to GI category. The Indian basmati rice because of its lower GI can prove to be a healthier rice alternative.

  5. Achievements and challenges of the World Bank Loan/Department for International Development grant-assisted Tuberculosis Control Project in China.

    Science.gov (United States)

    Kong, Peng; Jiang, Xu; Zhang, Ben; Jiang, Shi-wen; Liu, Bo

    2011-07-01

    In March 2002, the government of China launched the World Bank Loan/ Department for International Development-supported Tuberculosis (TB) Control Project to reduce the prevalence and mortality of TB. The project generated promising results in policy development, strengthening of TB control systems, patient treatment success, funds management, and the introduction of legislation. In light of the global TB epidemic and control environment, it is useful to review the TB control priorities of the project, summarize the achievements and experiences around its implementation.

  6. Reverse sequential therapy achieves a similar eradication rate as standard sequential therapy for Helicobacter pylori eradication: a randomized controlled trial.

    Science.gov (United States)

    Tsay, Feng-Woei; Wu, Deng-Chyang; Kao, Sung-Shuo; Tsai, Tzung-Jium; Lai, Kwok-Hung; Cheng, Jin-Shiung; Chan, Hoi-Hung; Wang, Huay-Min; Tsai, Wei-Lun; Tseng, Hui-Hwa; Peng, Nan-Jin; Hsu, Ping-I

    2015-02-01

    Sequential therapy is a two-step therapy achieving a promising eradication rate for Helicobacter pylori infection. The rationale of sequential method has been proposed that amoxicillin weakens bacterial cell walls in the initial phase of treatment, preventing the development of drug efflux channels for clarithromycin and metronidazole used in the second phase. The aim of this prospective, randomized, controlled study was to investigate whether the efficacy of reverse sequential therapy was noninferior to sequential therapy in the treatment of H. pylori infection. From January 2009 to December 2010, consecutive H. pylori-infected patients were randomly assigned to receive either sequential therapy (a 5-day dual therapy with pantoprazole plus amoxicillin, followed by a 5-day triple therapy with pantoprazole plus clarithromycin and metronidazole) or reverse sequential therapy (a 5-day triple therapy with pantoprazole plus clarithromycin and metronidazole, followed by a 5-day dual therapy with pantoprazole plus amoxicillin). H. pylori status was examined 6 weeks after the end of treatment by rapid urease and histology or urea breath test. One hundred and twenty-two H. pylori-infected participants were randomized to receive sequential (n = 60) or reverse sequential therapy (n = 62). The eradication rates, by intention-to-treat analysis, were similar: 91.9% (95% confidence interval (CI): 85.1-98.7%) for sequential therapy and 96.7% (95% CI: 92.2-101.2%) for reverse sequential therapy (p = .44). Per-protocol analysis also showed similar results: 91.8% (95% CI: 84.9-98.7%) for sequential group and 96.7% (95% CI: 92.2-101.2%) for reverse sequential therapy (p = .43). The two treatments exhibited comparable frequencies of adverse events (11.3% vs 6.7%, respectively) and drug compliance (98.4% vs 100%, respectively). The overall resistance rates of antibiotics were clarithromycin 10.5%, amoxicillin 0%, and metronidazole 44.2% of patients, respectively. The dual

  7. What "No Child Left Behind" Leaves behind: The Roles of IQ and Self-Control in Predicting Standardized Achievement Test Scores and Report Card Grades

    Science.gov (United States)

    Duckworth, Angela L.; Quinn, Patrick D.; Tsukayama, Eli

    2012-01-01

    The increasing prominence of standardized testing to assess student learning motivated the current investigation. We propose that standardized achievement test scores assess competencies determined more by intelligence than by self-control, whereas report card grades assess competencies determined more by self-control than by intelligence. In…

  8. What "No Child Left Behind" Leaves behind: The Roles of IQ and Self-Control in Predicting Standardized Achievement Test Scores and Report Card Grades

    Science.gov (United States)

    Duckworth, Angela L.; Quinn, Patrick D.; Tsukayama, Eli

    2012-01-01

    The increasing prominence of standardized testing to assess student learning motivated the current investigation. We propose that standardized achievement test scores assess competencies determined more by intelligence than by self-control, whereas report card grades assess competencies determined more by self-control than by intelligence. In…

  9. Language Skills, Mathematical Thinking, and Achievement Motivation in Children with ADHD, Disruptive Behavior Disorders, and Normal Controls

    Science.gov (United States)

    Gut, Janine; Heckmann, Carmen; Meyer, Christine Sandra; Schmid, Marc; Grob, Alexander

    2012-01-01

    Recent models of attention deficit/hyperactivity disorder (ADHD) suggest that the association between achievement motivation and school performance may be stronger in children with ADHD than in typically developing children. Therefore, the present study investigated associations between achievement motivation and performance on language skills and…

  10. Relationships between high-stakes testing policies and student achievement after controlling for demographic factors in aggregated data.

    Directory of Open Access Journals (Sweden)

    Gregory J. Marchant

    2006-11-01

    Full Text Available With the mandate of No Child Left Behind, high-stakes achievement testing is firmly in place in every state. The few studies that have explored the effectiveness of high-stakes testing using NAEP scores have yielded mixed results. This study considered state demographic characteristics for each NAEP testing period in reading, writing, mathematics, and science from 1992 through 2002, in an effort to examine the relation of high-stakes testing policies to achievement and changes in achievement between testing periods. As expected, demographic characteristics and their changes were related significantly to most achievement outcomes, but high-stakes testing policies demonstrated few relationships with achievement. The few relationships between high-stakes testing and achievement or improvement in reading, writing, or science tended to appear only when demographic data were missing; and the minimal relationships with math achievement were consistent with findings in previous research. Considering the cost and potential unintended negative consequences, high-stakes testing policies seem to provide a questionable means of improving student learning.

  11. The use of dry Jerusalem artichoke as a functional nutrient in developing extruded food with low glycaemic index.

    Science.gov (United States)

    Radovanovic, Ana; Stojceska, Valentina; Plunkett, Andrew; Jankovic, Slobodan; Milovanovic, Dragan; Cupara, Snezana

    2015-06-15

    This study considers the use of dry Jerusalem artichoke (JA) as a functional nutrient in developing food products with enhanced nutritional characteristics and low glycaemic index (GI). Three different formulations based on buckwheat and JA were developed and processed using extrusion technology. Nutritional properties including the levels of total dietary fibre (TDF), protein, inulin, total carbohydrates and lipids were analysed. A clinical study was performed on ten healthy volunteers (aged between 21 and 56) to determine the level of GI and glycaemic load (GL). The results revealed that JA significantly (Pfood and extruded products, GI and GL. Samples containing 80% of Jerusalem artichoke were considered as a low GI food whilst samples containing 30% and 60% of Jerusalem artichoke as a medium GI food. A similar trend was seen in terms of GL.

  12. Glycaemic responses to different types of bread in insulin-dependent diabetic subjects (IDDM): studies at constant insulinaemia.

    Science.gov (United States)

    Rasmussen, O; Winther, E; Hermansen, K

    1991-02-01

    To study the glycaemic effect of various Danish bread types in insulin-dependent diabetic subjects (IDDM) we looked at the incremental blood glucose areas after isocaloric meals of grained wholemeal rye bread, wholemeal bread (graham bread) and white bread in seven C-peptide negative diabetic subjects. Furthermore, we evaluated the glycaemic potency of dried fruits by exchanging 40 per cent of the starch of grained wholemeal rye bread as dried figs. Prior to the meal intake the patients had attained normoglycaemia and isoinsulinaemia by means of the artificial pancreas. The four test meals containing 50 g of available carbohydrate were taken in random order. The postprandial blood glucose response areas after whole-meal bread (1037 +/- 113 mM X 180 min) and white bread (1021 +/- 100 mM X 180 min) were significantly higher than that to grained wholemeal rye bread (786 +/- 66 mM X 180 min, P less than 0.05). Exchange of 40 per cent of the complex carbohydrate as grained wholemeal rye bread with simple sugars, such as figs, had no influence on the blood glucose response (786 +/- 66 mM X 180 min vs. 766 +/- 56 mM X 180 min). Constant and identical serum-free insulin levels at 30 mU/l and similar amounts of glucose lost in the urine were found after the four test meals. In conclusion, the difference in extraction rate of wheat in the form of white flour (0, 7) and wholemeal flour (1, 0) was not reflected in the glycaemic responses in IDDM subjects. Grained wholemeal rye bread is a fibre-rich, cheap nutrient which elicits a significantly lower glycaemic response compared to wholemeal and white bread and can be recommended to diabetic subjects.

  13. Blood profiling of proteins and steroids during weight maintenance with manipulation of dietary protein level and glycaemic index

    DEFF Research Database (Denmark)

    Wang, Ping; Holst, Claus; Astrup, Arne

    2012-01-01

    Weight regain after weight loss is common. In the Diogenes dietary intervention study, a high-protein and low-glycaemic index (GI) diet improved weight maintenance. The objective of the present study was to identify (1) blood profiles associated with continued weight loss and weight regain (2) bl...... differences between continued weight losers and weight regainers. Increases in leptin (LEP) and C-reactive protein (CRP) were significantly associated with weight regain (P ...

  14. Achievements and challenges of the World Bank Loan/Department for International Development grant-assisted Tuberculosis Control Project in China

    Institute of Scientific and Technical Information of China (English)

    KONG Peng; JIANG Xu; ZHANG Ben; JIANG Shi-wen; LIU Bo

    2011-01-01

    In March 2002,the government of China launched the World Bank Loan/ Department for International Development-supported Tuberculosis (TB) Control Project to reduce the prevalence and mortality of TB. The project generated promising results in policy development, strengthening of TB control systems, patient treatment success,funds management, and the introduction of legislation. In light of the global TB epidemic and control environment, it is useful to review the TB control priorities of the project, summarize the achievements and experiences around its implementation.

  15. Control-value theory: using achievement emotions to improve understanding of motivation, learning, and performance in medical education: AMEE Guide No. 64.

    Science.gov (United States)

    Artino, Anthony R; Holmboe, Eric S; Durning, Steven J

    2012-01-01

    In this AMEE Guide, we consider the emergent theoretical and empirical work on human emotion and how this work can inform the theory, research, and practice of medical education. In the Guide, we define emotion, in general, and achievement emotions, more specifically. We describe one of the leading contemporary theories of achievement emotions, control-value theory (Pekrun 2006), and we distinguish between different types of achievement emotions, their proximal antecedents, and their consequences for motivation, learning, and performance. Next, we review the empirical support for control-value theory from non-medical fields and suggest several important implications for educational practice. In this section, we highlight the importance of designing learning environments that foster a high degree of control and value for students. Finally, we end with a discussion of the need for more research on achievement emotions in medical education, and we propose several key research questions we believe will facilitate our understanding of achievement emotions and their impact on important educational outcomes.

  16. Serum fructosamine and glycated haemoglobin measurements in diabetic control.

    Science.gov (United States)

    Hindle, E J; Rostron, G M; Clark, S A; Gatt, J A

    1986-01-01

    Serum fructosamine and glycated haemoglobin (HbA1) were measured in capillary samples from diabetic children and compared with samples from non-diabetic children. Glycaemic control was assessed clinically and by average daily glucose values recorded by home monitoring. Fructosamine correlated with HbA1 and with average glucose values measured over 30 days. HbA1 also correlated with average glucose values measured over 60 days. Changes in fructosamine with time tended to parallel those of HbA1, and advance indication of deteriorating or improving glycaemic control was possible by observing changes in these. Fructosamine has many advantages over HbA1 measurement such as speed, technical ease, and low cost, and is a reliable alternative to HbA1 estimation as an indication of glycaemic control. PMID:3954436

  17. Impaired vascular function during short-term poor glycaemic control in Type 1 diabetic patients

    DEFF Research Database (Denmark)

    Sørensen, V R; Mathiesen, E R; Clausen, P

    2005-01-01

    in Type 1 diabetic patients may disturb vascular function, possibly mediated through smooth muscle cell dysfunction as well as endothelial dysfunction. We suggest that prolonged and repeated episodes of hyperglycaemia could possibly lead to permanent vascular dysfunction and thereby development...

  18. Can sharing experiences in groups reduce the burden of living with diabetes, regardless of glycaemic control?

    DEFF Research Database (Denmark)

    Due-Christensen, Mette; Zoffmann, Vibeke; Hommel, Eva

    2012-01-01

    Aims To test whether patients with Type 1 diabetes would join support groups and benefit by improving psychosocial functioning, regardless of their HbA1c levels. Methods A pre-post test with follow-up after 6 and 12 months was conducted as a concurrent mixed-method study. The convenience sample...

  19. Improved glycaemic control decreases inner mitochondrial membrane leak in type 2 diabetes

    DEFF Research Database (Denmark)

    Rabøl, R; Højberg, P M V; Almdal, T;

    2009-01-01

    AIM: Several mechanisms have been targeted as culprits of weight gain during antihyperglycaemic treatment in type 2 diabetes (T2DM). These include reductions in glucosuria, increased food intake from fear of hypoglycaemia, the anabolic effect of insulin, decreased metabolic rate and increased...... efficiency in fuel usage. The purpose of the study was to test the hypothesis that mitochondrial efficiency increases as a result of insulin treatment in patients with type 2 diabetes. METHODS: We included ten patients with T2DM (eight males) on oral antidiabetic treatment, median age: 51.5 years (range: 39......-67) and body mass index (BMI): 30.1 +/- 1.2 kg/m2 (mean +/- s.e.). Muscle biopsies from m. vastus lateralis and m. deltoideus were obtained before and after seven weeks of intensive insulin treatment, and mitochondrial respiration was measured using high-resolution respirometry. State 3 respiration...

  20. Exercise-stimulated glucose uptake - regulation and implications for glycaemic control

    DEFF Research Database (Denmark)

    Sylow, Lykke; Kleinert, Maximilian; Richter, Erik

    2017-01-01

    -resistant muscle, emphasizing exercise as a therapeutic cornerstone among patients with metabolic diseases such as diabetes mellitus. Exercise increases uptake of glucose by up to 50-fold through the simultaneous stimulation of three key steps: delivery, transport across the muscle membrane and intracellular flux...... energy supply during physical activity. Here, we review the molecular mechanisms that regulate the movement of glucose from the capillary bed into the muscle cell and discuss what is known about their integrated regulation during exercise. Novel developments within the field of mass spectrometry...

  1. Investigating Endothelial Activation and Oxidative Stress in relation to Glycaemic Control in a Multiethnic Population

    Directory of Open Access Journals (Sweden)

    E. M. Brady

    2012-01-01

    Full Text Available Aim. An exploration of ethnic differences in measures of oxidative stress and endothelial activation in relation to known cardiovascular risk factors within South Asians (SA and White Europeans (WE residing in the UK. Methods. 202 participants within a UK multiethnic population provided biomedical and anthropometric data. Human urinary 2,3-dinor-8-iso-prostaglandin-F1α and plasma ICAM-1 were quantified as measures of oxidative stress and endothelial activation, respectively. Results. 2,3-Dinor-8-iso-prostaglandin-F1α levels were significantly higher in the SA group compared to WE group (10.36 (95% CI: 9.09, 11.79 versus 8.46 (7.71, 9.29, P=0.021 after adjustment for age, gender, smoking status, body weight, HbA1c, and medication. Oxidative stress was positively associated with HbA1c (β=1.08, 95% CI:1.02, 1.14, P=0.009, fasting (β=1.06, 95% CI: 1.02, 1.10, P=0.002, and 2 hr glucose (β=1.02, 95% CI: 1.00, 1.04, P=0.052. In each adjusted model, SA continued to have elevated levels of oxidative stress compared to WE. ICAM-1 levels were significantly higher in the composite IGR group compared to the normoglycaemic group (P<0.001. No ethnic differences in ICAM-1 were observed. Conclusion. These results suggest that SA are more susceptible to the detrimental effects of hyperglycaemia-induced oxidative stress at lower blood glucose thresholds than WE. Further research into the potential mechanisms involved is warranted.

  2. Investigating Endothelial Activation and Oxidative Stress in relation to Glycaemic Control in a Multiethnic Population

    Science.gov (United States)

    Brady, E. M.; Webb, D. R.; Morris, D. H.; Khunti, K.; Talbot, D. S. C.; Sattar, N.; Davies, M. J.

    2012-01-01

    Aim. An exploration of ethnic differences in measures of oxidative stress and endothelial activation in relation to known cardiovascular risk factors within South Asians (SA) and White Europeans (WE) residing in the UK. Methods. 202 participants within a UK multiethnic population provided biomedical and anthropometric data. Human urinary 2,3-dinor-8-iso-prostaglandin-F1α and plasma ICAM-1 were quantified as measures of oxidative stress and endothelial activation, respectively. Results. 2,3-Dinor-8-iso-prostaglandin-F1α levels were significantly higher in the SA group compared to WE group (10.36 (95% CI: 9.09, 11.79) versus 8.46 (7.71, 9.29), P = 0.021) after adjustment for age, gender, smoking status, body weight, HbA1c, and medication. Oxidative stress was positively associated with HbA1c (β = 1.08, 95% CI:1.02, 1.14, P = 0.009), fasting (β = 1.06, 95% CI: 1.02, 1.10, P = 0.002), and 2 hr glucose (β = 1.02, 95% CI: 1.00, 1.04, P = 0.052). In each adjusted model, SA continued to have elevated levels of oxidative stress compared to WE. ICAM-1 levels were significantly higher in the composite IGR group compared to the normoglycaemic group (P < 0.001). No ethnic differences in ICAM-1 were observed. Conclusion. These results suggest that SA are more susceptible to the detrimental effects of hyperglycaemia-induced oxidative stress at lower blood glucose thresholds than WE. Further research into the potential mechanisms involved is warranted. PMID:23304116

  3. Rosiglitazone use and post-discontinuation glycaemic control in two European countries, 2000-2010

    DEFF Research Database (Denmark)

    Ehrenstein, V; Hernandez, R K; Ulrichsen, Sinna Pilgaard

    2013-01-01

    ) in northern Denmark and from the General Practice Research Database (GPRD) in the UK. MAIN OUTCOME MEASURES: We examined the use of rosiglitazone during its entire period of availability on the European market (2000-2010) and evaluated changes in the glycated haemoglobin (HbA1c) and fasting plasma glucose...

  4. Can sharing experiences in groups reduce the burden of living with diabetes, regardless of glycaemic control?

    DEFF Research Database (Denmark)

    Due-Christensen, Mette; Zoffmann, Vibeke; Hommel, Eva

    2012-01-01

    included patients with Type 1 diabetes aged ≥ 21 years, having been diagnosed ≥ 1 year earlier. Primary outcome was diabetes-related distress (using the Problem Areas in Diabetes scale). Secondary outcomes were psychological distress and depressive symptoms (Symptom Check List -90-R/Global Severity Index...

  5. Can sharing experiences in groups reduce the burden of living with diabetes, regardless of glycaemic control?

    DEFF Research Database (Denmark)

    Due-Christensen, Mette; Zoffmann, Vibeke; Hommel, Eva

    2012-01-01

    included patients with Type 1 diabetes aged = 21 years, having been diagnosed = 1 year earlier. Primary outcome was diabetes-related distress (using the Problem Areas in Diabetes scale). Secondary outcomes were psychological distress and depressive symptoms (Symptom Check List -90-R/Global Severity Index...

  6. Is poor glycaemic control in diabetic patients a risk factor of myopia?

    DEFF Research Database (Denmark)

    Jacobsen, N.; Jensen, H.; Lund-Andersen, H.

    2008-01-01

    haemoglobin (HbA(1c)), insulin dosage and myopia in diabetic patients. Methods: All type 1 diabetic patients aged 16-26 years [mean age 22.0, standard deviation (SD) 2.9] attending the eye clinic at Steno Diabetes Center, Copenhagen, in 1995-1997 were included in the study (n = 393). The following data were...... collected from the medical records from baseline to 2005: age at diabetes onset, age at baseline, sex, weight, HbA(1c), insulin dosage, refractive error, visual acuity and ocular diabetes complications. Results: The prevalence of myopia [spherical equivalent (SE)

  7. Dietary cystine level affects metabolic rate and glycaemic control in adult mice.

    Science.gov (United States)

    Elshorbagy, Amany K; Church, Chris; Valdivia-Garcia, Maria; Smith, A David; Refsum, Helga; Cox, Roger

    2012-04-01

    Plasma total cysteine (tCys) is strongly and independently associated with obesity in large human cohorts, but whether the association is causal is unknown. Dietary cyst(e)ine increases weight gain in some rodent models. We investigated the body composition, metabolic rate and metabolic phenotype of mature C3H/HeH mice assigned to low-cystine (LC) or high-cystine (HC) diets for 12 weeks. Compared to LC mice, HC mice gained more weight (P=.004 for 12-week weight gain %), with increased fat mass and lean mass, and lowered O₂ consumption and CO₂ production by calorimetry. The HC mice had 30% increase in intestinal fat/body weight % (P=.003) and ∼twofold elevated hepatic triglycerides (P=.046), with increased expression of hepatic lipogenic factors, peroxisome proliferator-activated receptor-γ and sterol regulatory element binding protein-1. Gene expression of both basal and catecholamine-stimulated lipolytic enzymes, adipose triglyceride lipase and hormone-sensitive lipase was inhibited in HC mice adipose tissue. The HC mice also had elevated fasting glucose (7.0 vs. 4.5 mmol/L, Pcystine intake promotes adiposity and an adverse metabolic phenotype in mice, indicating that the positive association of plasma tCys with obesity in humans may be causal.

  8. quality of glycaemic control in ambulatory diabetics at the out-patient ...

    African Journals Online (AJOL)

    hi-tech

    2003-08-08

    Aug 8, 2003 ... Conclusion: The majority of ambulatory diabetic patients attending the out-patient diabetic ... with knowledge and resources to enhance their individual participation in .... complications of retinopathy, neuropathy (3, 4, 7).

  9. Retinal function in relation to improved glycaemic control in type 1 diabetes

    DEFF Research Database (Denmark)

    Holfort, S K; Nørgaard, K; Jackson, George

    2011-01-01

    To study long-term changes in retinal function in response to sustained glycaemia reduction in participants with type 1 diabetes.......To study long-term changes in retinal function in response to sustained glycaemia reduction in participants with type 1 diabetes....

  10. Intramyocellular triglyceride content in man, influence of sex, obesity and glycaemic control

    DEFF Research Database (Denmark)

    Haugaard, Steen B; Mu, Huiling; Vaag, Allan

    2009-01-01

    It remains unknown whether sex impacts on intramyocellular triglyceride (IMTG) in obesity. as has been shown in non-obese subjects, and if so, whether this may have implications on the association between IMTG and insulin sensitivity. Subject and methods: A Muscle biopsy from vastus lateralis...

  11. Differential associations between depressive symptoms and glycaemic control in outpatients with diabetes

    NARCIS (Netherlands)

    Bot, M.; Pouwer, F.; Jonge, P. de; Tack, C.J.J.; Geelhoed-Duijvestijn, P.H.; Snoek, F.J.

    2013-01-01

    AIMS: Depression is common in people with diabetes, and related to higher HbA(1c) levels. Depression, however, is a heterogeneous construct that involves a variety of symptoms. As little is known about the associations of individual depressive symptoms with HbA(1c) , we explored these associations i

  12. Differential associations between depressive symptoms and glycaemic control in outpatients with diabetes

    DEFF Research Database (Denmark)

    Bot, M; Pouwer, F; De Jonge, P

    2013-01-01

    .001), appetite problems (β = 0.15, P suicidal ideation (β = 0.14, P = 0.001) were significantly related to higher baseline HbA(1c) values. Furthermore, depressed mood (β = 0.09, P = 0.03) sleeping difficulties (β = 0.12, P = 0.004), appetite problems (β = 0.11, P = 0.01) and psychomotor agitation....../retardation (β = 0.09, P = 0.04) were significantly related to higher HbA(1c) values at 1-year follow-up. Associations were more pronounced in Type 1 diabetes than in Type 2 diabetes. None of the depressive symptoms were related to change in HbA(1c) over time, except suicidal ideation. CONCLUSION: In people...

  13. Predicting Academic Achievement from Cumulative Home Risk: The Mediating Roles of Effortful Control, Academic Relationships, and School Avoidance

    Science.gov (United States)

    Swanson, Jodi; Valiente, Carlos; Lemery-Chalfant, Kathryn

    2012-01-01

    Components of the home environment are associated with children's academic functioning. The accumulation of risks in the home are expected to prove more detrimental to achievement than any one risk alone, but the processes accounting for this relation are unclear. Using an index of cumulative home risk (CHR) inclusive of protective factors, as…

  14. Determinants for achieving the LDL-C target of lipid control for secondary prevention of cardiovascular events in Taiwan.

    Directory of Open Access Journals (Sweden)

    Li-Ting Ho

    Full Text Available Epidemiological and clinical studies have clearly established the link between low-density lipoprotein cholesterol (LDL-C and atherosclerosis-related cardiovascular consequences. Although it has been a common practice for physicians to prescribe lipid-lowering therapy for patients with dyslipidemia, the achievement rate is still not satisfied in Taiwan. Therefore, the determinants for achieving the LDL-C target needed to be clarified for better healthcare of the patients with dyslipidemia.This registry-type prospective observational study enrolled the patients with cardiovascular diseases (coronary artery disease (CAD and cerebrovascular disease (CVD from 18 medical centers across Taiwan, and clinically followed them for five years. At every clinical visit, vital signs, clinical endpoints, adverse events, concurrent medications and laboratory specimens were obtained as thoroughly as possible. The lipid profile (total cholesterol, high-density lipoprotein cholesterol, LDL-C, triglyceride, liver enzymes, and creatinine phosphokinase were evaluated at baseline, and every year thereafter. The cross sectional observational data was analyzed for this report.Among the 3,486 registered patients, 54% had their LDL-C < 100 mg/dL. By univariate analysis, the patients achieving the LDL-C target were associated with older age, more male sex, taller height, lower blood pressure, more under lipid-lowering therapy, more smoking cessation, more history of CAD, DM, physical activity, but less history of CVD. The multivariate analysis showed statin therapy was the most significant independent determinant for achieving the treatment target, followed by age, history of CAD, diabetes, blood pressure, and sex. However, most patients were on regimens of very-low to low equipotent doses of statins.Although the lipid treatment guideline adherence is improving in recent years, only 54% of the patients with cardiovascular diseases have achieved their LDL-C target in Taiwan

  15. Association of Serum Selenium, Zinc and Magnesium Levels with Glycaemic Indices and Insulin Resistance in Pre-diabetes: a Cross-Sectional Study from South India.

    Science.gov (United States)

    Yadav, Charu; Manjrekar, Poornima A; Agarwal, Ashish; Ahmad, Afzal; Hegde, Anupama; Srikantiah, Rukmini Mysore

    2017-01-01

    A growing understanding of antioxidant mechanisms and insulin-like actions of trace elements selenium and zinc has rekindled researchers' interest towards their role in diabetes mellitus, nutritional management of which concentrates predominantly on macronutrient intake. However, selenium studies limiting largely to diabetes have yielded inconsistent results with sparse knowledge in the pre-diabetes population. This hospital-based cross-sectional study screened 300 people who came to the institutional hospital laboratory with fasting plasma glucose and glycosylated haemoglobin requisition over a period of 6 months. Thirty-five pre-diabetes subjects aged 25-45 years and 35 age-matched healthy controls were selected as per inclusion criteria and clinical history. Serum selenium was estimated by inductively coupled plasma-mass spectrometry, zinc and magnesium by colorimetric end-point methods and insulin by enzyme-linked immunosorbent assay, and insulin resistance was calculated using a homeostasis model assessment (HOMA) 2 calculator. Data analysis was done using SPSS ver. 16 employing an independent sample t test for intergroup comparison of means and Pearson's correlation for correlation analysis. Serum mineral levels in the pre-diabetes group (selenium 63.01 ± 17.6 μg/L, zinc 55.78 ± 13.49 μg/dL, magnesium 1.37 ± 0.38 mg/dL) were significantly reduced (p zinc 94.53 ± 15.41 μg/dL, magnesium 2.12 ± 0.22 mg/dL). A significant negative correlation was seen with glycaemic indices and insulin resistance. This study conducted in pre-diabetes subjects highlights a considerable deficiency of serum selenium, zinc and magnesium observed at a much earlier pre-clinical phase. This coupled with the evidence of a strong inverse association with glycaemic indices and insulin resistance postulates the role of mineral alterations in the pathophysiology of hyperglycaemia and insulin resistance.

  16. Diet e ect on short- and long-term glycaemic response in adult healthy cats.

    Science.gov (United States)

    Musco, Nadia; Calabro, Serena; Tudisco, Raffaella; Grossi, Micaela; Addi, Laura; Moniello, Giuseppe; Lombardi, Pietro; Cutrignelli, Monica Isabella

    2016-08-03

    In the paper the short- and long-term glycaemic response after 4 diet programmes was evaluated. Each diet programme was alternatively administered to 6 healthy cats for 30 days. At the end of each period cats were weighed and underwent blood sampling for glucose and fructosamine determination. Glycaemia was measured every 2 hours for 24 hours using an automated glucometer. Very high protein level and low starch (VHP/LS) and high protein and moderate starch level (HP/LS) diets showed glucose (Mean and Peak) and fructosamine values signi cantly lower compared to the moderate protein and high starch diets (MP/HS). It is likely that these results are due to the contemporary e ect of the following nutritional characteristics: protein level, protein/starch ratio and dietary bre. All these parameters were higher in VHP/LS and HP/MS diets. These preliminary results suggest that the use of diets with high protein/starch ratio and soluble bre levels favours the carbohydrate metabolism of healthy cats.

  17. Influences of Children's and Adolescents' Action-Control Processes on School Achievement, Peer Relationships, and Coping with Challenging Life Events

    Science.gov (United States)

    Geldhof, G. John; Little, Todd D.

    2011-01-01

    Self-regulation represents a core aspect of human functioning that influences positive development across the life span. This chapter focuses on the action-control model, a key facet of self-regulation during childhood and early adolescence. The authors discuss the development of action-control beliefs, paying particular attention to their…

  18. Method for reducing excess heat supply experienced in typical Chinese district heating systems by achieving hydraulic balance and improving indoor air temperature control at the building level

    DEFF Research Database (Denmark)

    Zhang, Lipeng; Gudmundsson, Oddgeir; Thorsen, Jan Eric;

    2016-01-01

    that once the hydraulic balance is achieved and indoor temperatures are controlled with this integrated approach, 17% heat savings and 42.8% pump electricity savings can be achieved. The energy savings will also have a positive environmental effect with seasonal reductions of 11 kg CO2, 0.1 kg SO2, and 0...... with the actual heat demand. This results in 15-30% of the total supplied heat being lost. This paper proposes an integrated approach that aims to reduce the excess heat loss by introducing pre-set thermostatic radiator valves combined with automatic balancing valves. Those devices establish hydraulic balance...

  19. An Integrated, Multi-Stage, Multi-Scale Framework for Achieving Sustainable Process Synthesis-Intensification-Control

    DEFF Research Database (Denmark)

    Babi, Deenesh Kavi; Kumar Tula, Anjan; Mansouri, Seyed Soheil

    The chemical and biochemical industry needs major reductions in energy consumption, waste generation, etc., in order to remain competitive through the design and operation of more sustainable chemical and biochemical processes. These required reductions can be addressed through process synthesis-intensification-control......, that is, the efficient use of raw materials (feedstock), the use of sustainable technologies and the design (and control) of processes that directly impact and improves sustainability/LCA factors. The unit operations concept, which has been sufficient until now, is one of the most used for performing...... been developed in order to perform process synthesis-intensification-control. The framework operates at different scales, the unit operations scale, task scale and phenomena scale. In stage 1, process synthesis is performed (at the unit operations scale) using computer-aided flowsheet design (CAFD...

  20. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2014-01-01

    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...

  1. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2016-01-01

    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...

  2. Achieving professionalism

    Directory of Open Access Journals (Sweden)

    R.A.E. Thompson

    1983-09-01

    Full Text Available In approaching the subject of professionalism the author has chosen to focus on the practical aspects rather than the philosophical issues. In so doing an attempt is made to identify criteria which demonstrate the achievement of the essence of professionalism.

  3. Controlling Initial and Final Radii to Achieve a Low-Complexity Sphere Decoding Technique in MIMO Channels

    Directory of Open Access Journals (Sweden)

    Fatemeh Eshagh Hosseini

    2012-01-01

    Full Text Available In order to apply sphere decoding algorithm in multiple-input multiple-output communication systems and to make it feasible for real-time applications, its computational complexity should be decreased. To achieve this goal, this paper provides some useful insights into the effect of initial and the final sphere radii and estimating them effortlessly. It also discusses practical ways of initiating the algorithm properly and terminating it before the normal end of the process as well as the cost of these methods. Besides, a novel algorithm is introduced which utilizes the presented techniques according to a threshold factor which is defined in terms of the number of transmit antennas and the noise variance. Simulation results show that the proposed algorithm offers a desirable performance and reasonable complexity satisfying practical constraints.

  4. Rationale and design of a randomized controlled trial examining the effect of classroom-based physical activity on math achievement

    DEFF Research Database (Denmark)

    Have, Mona; Nielsen, Jacob Have; Gejl, Anne Kær

    2016-01-01

    was a 9-month classroom-based PA program that involved integration of PA into the math lessons delivered by the schools' math teachers. The primary study outcome was change in math achievement, measured by a 45-minute standardized math test. Secondary outcomes were change in executive function (using...... a modified Eriksen flanker task and the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire filled out by the parents), creativity (using the Torrance Tests of Creative Thinking, TTCT), aerobic fitness (by the Andersen intermittent shuttle-run test) and body mass index. PA during math...... lessons and total PA (including time spent outside school) were assessed using accelerometry. Math teachers used Short Message Service (SMS)-tracking to report on compliance with the PA intervention and on their motivation for implementing PA in math lessons. Parents used SMS-tracking to register...

  5. How the impact of median neuropathy on sensorimotor control capability of hands for diabetes: an achievable assessment from functional perspectives.

    Directory of Open Access Journals (Sweden)

    Haw-Yen Chiu

    Full Text Available To comprehend the sensorimotor control ability in diabetic hands, this study investigated the sensation, motor function and precision pinch performances derived from a pinch-holding-up activity (PHUA test of the hands of diabetic patients and healthy subjects. The precision, sensitivity and specificity of the PHUA test in the measurements of diabetic patients were also analyzed. We hypothesized that the diabetic hands would have impacts on the sensorimotor functions of the hand performances under functionally quantitative measurements. One hundred and fifty-nine patients with clinically defined diabetes mellitus (DM and 95 age- and gender-matched healthy controls were included. Semmes-Weinstein monofilament (SWM, static and moving two-point discrimination (S2PD and M2PD, maximal pinch strength and precision pinch performance tests were conducted to evaluate the sensation, motor and sensorimotor status of the recruited hands. The results showed that there were significant differences (all p<0.05 in SWM, S2PD, M2PD and maximum pinch strength between the DM and control groups. A higher force ratio in the DM patients than in the controls (p<0.001 revealed a poor ability of pinch force adjustment in the DM patients. The percentage of maximal pinch strength was also significantly different (p<0.001 between the DM and control groups. The sensitivity, specificity and area under the receiver operating characteristic curve were 0.85, 0.51, and 0.724, respectively, for the PHUA test. Statistically significant degradations in sensory and motor functions and sensorimotor control ability were observed in the hands of the diabetic patients. The PHUA test could be feasibly used as a clinical tool to determine the sensorimotor function of the hands of diabetic patients from a functional perspective.

  6. The information system of learning quality control in higher education institutions: achievements and problems of European universities

    Directory of Open Access Journals (Sweden)

    Orekhova Elena

    2016-01-01

    Full Text Available The article deals with the main trends in the development of the system of learning quality control connected with the European integration of higher education and the democratization of education. The authors analyze the state of information systems of learning quality control existing in European higher education and identify their strong and weak points. The authors show that in the learning process universities actively use innovative analytic methods as well as modern means of collecting, storing and transferring information that ensure the successful management of such a complex object as the university of the 21st century.

  7. The effect of food with different glycaemic index on the blood glucose level

    Directory of Open Access Journals (Sweden)

    Lenka Kouřimská

    2015-08-01

    Full Text Available Blood glucose levels are affected by many factors including the type of foods consumed, processing technology and cooking method. Hormone insulin lowers blood glucose to its constant level, while glucagon, growth hormone, adrenalin and glucocorticoids have the opposite effect. High steepness of the blood glucose level rise after meals may be unfavourable for the organism. Sugars are transferred into the blood at different speeds according to the type of food. Therefore the aim of this study was to confirm experimentally the effect of food on blood glucose levels in men and women of different ages. Two types of low, medium and high-glycaemic index (GI foods were given to 4 men and 4 women of different age (from 35 to 65 years. All volunteers were healthy, slightly overweight, and without any regular sporting activity. None of them had any idea about their daily carbohydrates consumption and what the term glycaemic index meant. The volunteers came to the GI determination fasted in the morning. Their rise in blood glucose level was monitored by glucometer before the meal and after 1 and 2 hours of the consumption of baked potatoes (GI 85, white bread bun (GI 70, boiled potatoes (GI 64, rye bread (GI 62, potato dumplings (GI 52 and white cooked spaghetti (GI 41. Fasting blood sugar levels of volunteers highly depended on their age (p <0.0001 and gender (p <0.0001. The blood glucose values increased with age and were higher in men than in women. Significant influence of food GI on blood glucose levels in both men and women in all the age categories was observed (p <0.0001. An interaction between age and gender was also statistically highly significant (p <0.0001. One hour after consuming food the blood glucose values were significantly different from the values of fasting (p = 0.0035. The differences of these values did not depend on the age (p = 0.0574 and sex (p = 0.8256 of volunteers, but there was a significant difference on the GI value of food

  8. Dietary carbohydrates, glycaemic load, food groups and newly detected type 2 diabetes among urban Asian Indian population in Chennai, India (Chennai Urban Rural Epidemiology Study 59).

    Science.gov (United States)

    Mohan, Viswanathan; Radhika, Ganesan; Sathya, Rangaswamy Mohan; Tamil, Selvi Ramjothi; Ganesan, Anbazhagan; Sudha, Vasudevan

    2009-11-01

    The aim of the study was to examine the association of dietary carbohydrates and glycaemic load with the risk of type 2 diabetes among an urban adult Asian Indian population. Adult subjects aged >20 years (n 1843) were randomly selected from the Chennai Urban Rural Epidemiology Study, in Chennai city in southern India. Dietary carbohydrates, glycaemic load and food groups were assessed using FFQ. Oral glucose tolerance tests were performed using 75 g glucose in all subjects. Diagnosis of diabetes was based on WHO Consulting Group criteria. OR for newly detected diabetes were calculated for carbohydrates, glycaemic load and specific food groups comparing subjects in the highest with those in the lowest quartiles, after adjustment for potential confounders such as age, sex, BMI, family history of diabetes, physical activity, current smoking, alcohol consumption and relevant dietary factors. We identified 156 (8.5 %) newly diagnosed cases of type 2 diabetes. Refined grain intake was positively associated with the risk of type 2 diabetes (OR 5.31 (95 % CI 2.98, 9.45); P < 0.001). In the multivariate model, after adjustment for potential confounders, total carbohydrate (OR 4.98 (95 % CI 2.69, 9.19), P < 0.001), glycaemic load (OR 4.25 (95 % CI 2.33, 7.77); P < 0.001) and glycaemic index (OR 2.51 (95 % CI 1.42, 4.43); P = 0.006) were associated with type 2 diabetes. Dietary fibre intake was inversely associated with diabetes (OR 0.31 (95 % CI 0.15, 0.62); P < 0.001). In urban south Indians, total dietary carbohydrate and glycaemic load are associated with increased, and dietary fibre with decreased, risk of type 2 diabetes.

  9. City-specific vehicle emission control strategies to achieve stringent emission reduction targets in China's Yangtze River Delta region.

    Science.gov (United States)

    Zhang, Shaojun; Wu, Ye; Zhao, Bin; Wu, Xiaomeng; Shu, Jiawei; Hao, Jiming

    2017-01-01

    The Yangtze River Delta (YRD) region is one of the most prosperous and densely populated regions in China and is facing tremendous pressure to mitigate vehicle emissions and improve air quality. Our assessment has revealed that mitigating vehicle emissions of NOx would be more difficult than reducing the emissions of other major vehicular pollutants (e.g., CO, HC and PM2.5) in the YRD region. Even in Shanghai, where the emission control implemented are more stringent than in Jiangsu and Zhejiang, we observed little to no reduction in NOx emissions from 2000 to 2010. Emission-reduction targets for HC, NOx and PM2.5 are determined using a response surface modeling tool for better air quality. We design city-specific emission control strategies for three vehicle-populated cities in the YRD region: Shanghai and Nanjing and Wuxi in Jiangsu. Our results indicate that even if stringent emission control consisting of the Euro 6/VI standards, the limitation of vehicle population and usage, and the scrappage of older vehicles is applied, Nanjing and Wuxi will not be able to meet the NOx emissions target by 2020. Therefore, additional control measures are proposed for Nanjing and Wuxi to further mitigate NOx emissions from heavy-duty diesel vehicles.

  10. Loblolly pine growth following operational vegetation management treatments compares favorably to that achieved in complete vegetation control research trials

    Science.gov (United States)

    Dwight K. Lauer; Harold E. Quicke

    2010-01-01

    Different combinations of chemical site prep and post-plant herbaceous weed control installed at three Upper Coastal Plain locations were compared in terms of year 3 loblolly (Pinus taeda L.) pine response to determine the better vegetation management regimes. Site prep treatments were different herbicide rates applied in either July or October. Site...

  11. Glycaemic index values in the Finnish food composition database: an approach to standardised value documentation.

    Science.gov (United States)

    Kaartinen, N E; Similä, M E; Pakkala, H; Korhonen, T; Männistö, S; Valsta, L M

    2010-11-01

    The glycaemic index (GI) is used to describe the blood glucose-raising potential of carbohydrate-containing foods. Only a few descriptions of the addition of GI values to national food composition databases (FCDBs) exist. We tested whether the value documentation framework established within the European Food Information Resource (EuroFIR) Network could be used for GI values when adding them to the Finnish FCDB. The list of foods requiring GI values was based on the National FINDIET 2007 Survey data and extended with foods encoded in a food-frequency questionnaire used in other nationally representative studies. The minimum quality of GI measurements was verified when gathering values from various sources, using earlier defined criteria. If a measured GI value for a food was directly available, or could be imputed or estimated, the value was added to the Finnish FCDB and documented using core standard vocabularies of EuroFIR. The GI values of composite foods were calculated using recipe calculation software. A total of 2210 foods required a GI value. GI values for 1322 foods were available and added to the FCDB. The remaining 888 foods were composite foods and received a GI value through recipe calculation. The standard vocabularies describing the origin of the GI values, the methods used in their derivation and their qualitative characteristics were suitable for GI values. GI values can be added to FCDBs and documented using terms similar to those used for traditional food composition data. Standardised value documentation may provide transparency for GI database compilation processes.

  12. Use of sourdough lactobacilli and oat fibre to decrease the glycaemic index of white wheat bread.

    Science.gov (United States)

    De Angelis, Maria; Rizzello, Carlo G; Alfonsi, Giuditta; Arnault, Philip; Cappelle, Stefan; Di Cagno, Raffaella; Gobbetti, Marco

    2007-12-01

    This work was aimed at decreasing the glycaemic index (GI) of white wheat bread. Breads made with wheat flour (WF) or wholemeal flour (WMF) and fermented with baker's yeast had similar values of resistant starch (RS; 1.4-1.7 %, starch basis). Sourdough Lactobacillus plantarum P1 and Lactobacillus brevis P2 favoured the highest formation of RS (approximately 5 %) when fermented with WF and WMF. The mixture (1:1) of WF and WMF (WF/WMF) was selected. The effect of dietary fibres, chemical or sourdough acidification on the hydrolysis index (HI) of WF/WMF bread was determined. Among fibres, only the addition of oat fibre (5 %) decreased the HI to 90.84 %. Lactic acid determined the lowest HI, and the effect was related to the decrease of pH. For the same decrease of pH, breads fermented with L. plantarum P1 and L. brevis P2 (sourdough WF/WMF) showed values of HI lower than chemical acidification. The glucose response and GI of WF bread or sourdough WF/WMF bread enriched with oat fibre was determined by using fifteen healthy volunteers. Anhydrous glucose was used as reference. The area under the glucose response curve and the value of GI (72 %) of WF bread were significantly (P sourdough WF/WMF bread enriched with oat fibre (GI = 53.7 %). The decrease of GI of the sourdough WF/WMF bread may be due to both fibre content and decreased pH. Compared to WMF bread, sourdough WF/WMF bread, enriched with oat fibre, had higher specific volume, better cell crumb structure and more appreciated acidulous smell, taste and aroma.

  13. The role of locus of control, self-esteem, parenting style, loneliness, and academic achievement in predicting bullying among middle school students

    OpenAIRE

    ATİK, Gökhan

    2006-01-01

    This study aimed at determining the prevalence rate of bullying and victimization among middle school students and investigating the role of locus of control, self- esteem, parenting style, loneliness, and academic achievement in predicting participation in bullying and victimization. The sample consisted of 742 participants recruited from 6th

  14. Longitudinal Relations among Parents' Reactions to Children's Negative Emotions, Effortful Control, and Math Achievement in Early Elementary School

    Science.gov (United States)

    Swanson, Jodi; Valiente, Carlos; Lemery-Chalfant, Kathryn; Bradley, Robert H.; Eggum-Wilkens, Natalie D.

    2014-01-01

    Panel mediation models and fixed-effects models were used to explore longitudinal relations among parents' reactions to children's displays of negative emotions, children's effortful control (EC), and children's math achievement (N = 291; M age in fall of kindergarten = 5.66 years, SD = 0.39 year) across kindergarten through…

  15. Enrichment of an Israeli ethnic food with fibres and their effects on the glycaemic and insulinaemic responses in subjects with non-insulin-dependent diabetes mellitus.

    Science.gov (United States)

    Feldman, N; Norenberg, C; Voet, H; Manor, E; Berner, Y; Madar, Z

    1995-11-01

    The effects of various sources of dietary fibre on the high glycaemic index of an Israeli ethnic food, melawach, were investigated in subjects with non-insulin-dependent diabetes mellitus (NIDDM). Locust-bean (Ceratonia siliqua) gum significantly decreased the glucose response to, and glycaemic index of, melawach in these diabetic subjects (P 30 kg/m2, whereas insulinaemic response decreased. The results indicate that foods containing the same nutrients in almost the same amounts, but differing in added dietary fibre, lead to different physiological responses in diabetic subjects. Furthermore, insulin response should be considered when fibre is incorporated into the diabetic's diet.

  16. Fermentation as a Means of Optimizing the Glycaemic Index - Food Mechanisms and Metabolic Merits with Emphasis on Lactic Acid in Cereal Products

    OpenAIRE

    Östman, Elin

    2003-01-01

    In current recommendations from FAO/WHO, foods that elicit low glycaemic responses and thus have low glycaemic indices (GIs) are advocated. The rationale for this recommendation is that low-GI diets have been shown to reduce risk factors for e.g. type II diabetes and cardiovascular disease. A major problem in this context is that most important starch rich staple foods in our diet, such as potato and bread products, have high GIs. One important task is, therefore, to identify food factors tha...

  17. THE EFFECT OF AN INTEGRATED AFFECTIVE-COGNITIVE TEACHING AND LEARNING APPROACH ON ACADEMIC ACHIEVEMENT, SELF-EFFICACY, LOCUS OF CONTROL AND ATTITUDE TOWARDS ENGINEERING

    Directory of Open Access Journals (Sweden)

    Tahira Anwar Lashari

    2014-05-01

    Full Text Available Engineers are responsible for the sustainable development of society and to be effective in their role they must possess holistic skills that encompass the skills of the affective and the cognitive domain. Therefore, engineering education must place equal emphasis on the needs of the affective domain in addition to the needs of the cognitive domain. However, existing engineering education practices do not pay adequate attention to the needs of the affective domain. Therefore, the study seeks to determine the effect of a teaching and learning approach that integrates the affective and the cognitive learning needs on academic achievement, locus of control, self-efficacy, and attitude towards engineering. A quasi-experimental design study with pre and post-test was conducted on 70 engineering students who were enrolled in the Diploma of engineering programme in the Universiti Tun Hussein Onn Malaysia with n=36 and n=34 for the experimental and control group respectively. The results indicate that the experimental group was better on the achievement test and attitude measure compared to the control group and the academic improvement was most noticeable among the low achievers. In conclusion these results indicate that an integrated affective-cognitive learning approach can be used to induce simultaneous improvements in learning of the cognitive and affective domain.

  18. On the electrostatic control achieved in transistors based on multilayered MoS2: A first-principles study

    Science.gov (United States)

    Lu, Anh Khoa Augustin; Pourtois, Geoffrey; Luisier, Mathieu; Radu, Iuliana P.; Houssa, Michel

    2017-01-01

    In this work, the electrostatic control in metal-oxide-semiconductor field-effect transistors based on MoS2 is studied, with respect to the number of MoS2 layers in the channel and to the equivalent oxide thickness of the gate dielectric, using first-principles calculations combined with a quantum transport formalism. Our simulations show that a compromise exists between the drive current and the electrostatic control on the channel. When increasing the number of MoS2 layers, a degradation of the device performances in terms of subthreshold swing and OFF currents arises due to the screening of the MoS2 layers constituting the transistor channel.

  19. THE TOTALITARIAN ACHIEVEMENT AND MAINTENANCE OF ABSOLUTE CONTROL OVER MAN IN GEORGE ORWELL`S 1984 AND ISMAIL KADARE`S THE PALACE OF DREAMS

    Directory of Open Access Journals (Sweden)

    Ervin XHINAKU

    2015-05-01

    Full Text Available In this study we have subjected Orwell‘s classic dystopia 1984 and Kadare‘s most important anti-totalitarian allegory The Palace of Dreams to a comparative analysis focused on their representation of the essential characteristic of totalitarianism – its urge to achieve and maintain absolute control over all aspects of the individual‘s life. By juxtaposing and comparatively analysing the key features of totalitarian control in Orwell‘s fictional Oceania and in Kadare‘s allegorical rendition of the Ottoman Empire, we hope to throw a more discriminating light on the fundamental conception of totalitarianism that is found in the two novels.

  20. Epidemiology of hepatitis C in the Republic of Moldova: achievements and remaining challenges in prevention and control.

    Science.gov (United States)

    Guriev, Vladimir; Spinu, Constantin; Sajen, Octavian; Isac, Maria; Spinu, Igor; Cebotari, Svetlana; Donos, Ala

    2016-11-24

    Viral hepatitis, especially those with parenteral and sexual transmission, still remain a major problem of public health, both globally and for the Republic of Moldova, due to wide spreading, endemicity, increased morbidity and mortality and high rate of invalidity following the chronization of infection, but usually neglected by population and public health authorities. This paper describes the epidemiology and preventive and control measures of hepatitis C in Moldova. Epidemiological analysis of the surveillance data on hepatitis C incidence in the Republic of Moldova was conducted. The data were obtained from the national reporting system of infectious diseases and serosurvey studies. Epidemiological particularities of acute and chronic hepatitis C in general Moldovan population and specific risk groups were evaluated. National hepatitis policies for prevention and control were analyzed. Only consolidation of all the actions stipulated in the national and international normative documents on the prevention and control of hepatitis, will help to reduce the morbidity of viral hepatitis C and probably to eliminate the new cases of disease in some regions.

  1. Anion control as a strategy to achieve high-mobility and high-stability oxide thin-film transistors.

    Science.gov (United States)

    Kim, Hyun-Suk; Jeon, Sang Ho; Park, Joon Seok; Kim, Tae Sang; Son, Kyoung Seok; Seon, Jong-Baek; Seo, Seok-Jun; Kim, Sun-Jae; Lee, Eunha; Chung, Jae Gwan; Lee, Hyungik; Han, Seungwu; Ryu, Myungkwan; Lee, Sang Yoon; Kim, Kinam

    2013-01-01

    Ultra-definition, large-area displays with three-dimensional visual effects represent megatrend in the current/future display industry. On the hardware level, such a "dream" display requires faster pixel switching and higher driving current, which in turn necessitate thin-film transistors (TFTs) with high mobility. Amorphous oxide semiconductors (AOS) such as In-Ga-Zn-O are poised to enable such TFTs, but the trade-off between device performance and stability under illumination critically limits their usability, which is related to the hampered electron-hole recombination caused by the oxygen vacancies. Here we have improved the illumination stability by substituting oxygen with nitrogen in ZnO, which may deactivate oxygen vacancies by raising valence bands above the defect levels. Indeed, the stability under illumination and electrical bias is superior to that of previous AOS-based TFTs. By achieving both mobility and stability, it is highly expected that the present ZnON TFTs will be extensively deployed in next-generation flat-panel displays.

  2. Controlled Acoustic Bass System (CABS) A Method to Achieve Uniform Sound Field Distribution at Low Frequencies in Rectangular Rooms

    DEFF Research Database (Denmark)

    Celestinos, Adrian; Nielsen, Sofus Birkedal

    2008-01-01

    The sound field produced by loudspeakers at low frequencies in small- and medium-size rectangular listening rooms is highly nonuniform due to the multiple reflections and diffractions of sound on the walls and different objects in the room. A new method, called controlled acoustic bass system (CABS......), is introduced. The system utilizes front loudspeakers and extra loudspeakers on the opposite wall of the room processed to cancel out the rear-wall reflections, which effectively conveys a more uniform sound field. The system works in the time domain and presents good performance over the loudspeaker low...

  3. Achieving the Health Care Financing Administration limits by quality improvement and quality control. A real-world example.

    Science.gov (United States)

    Engebretson, M J; Cembrowski, G S

    1992-07-01

    With the enactment of the Clinical Laboratory Improvement Amendments of 1988 (CLIA 88), the federal government is now using proficiency testing as the primary indicator of laboratory quality. Laboratories with proficiency test failures are now at risk of a variety of harsh penalties including large monetary fines and suspension of operations. To minimize the risk of failed proficiency testing, we initiated a continuous quality improvement program in our general chemistry laboratory in conjunction with the use of a new survey-validated quality control product. This article describes the quality improvement program and our success in reducing the long-term random error in general chemistry. Despite our improvement program, significant analytical errors (greater than 30% of the CLIA limits) still exist in analytes measured by our chemistry analyzer. These errors are present in nearly the same analytes measured by other common chemistry analyzers indicating the need for improvement in their design and manufacture.

  4. Can primary care team-based transition to insulin improve outcomes in adults with type 2 diabetes: the stepping up to insulin cluster randomized controlled trial protocol.

    Science.gov (United States)

    Furler, John S; Young, Doris; Best, James; Patterson, Elizabeth; O'Neal, David; Liew, Danny; Speight, Jane; Segal, Leonie; May, Carl; Manski-Nankervis, Jo-Anne; Holmes-Truscott, Elizabeth; Ginnivan, Louise; Blackberry, Irene D

    2014-02-14

    Type 2 diabetes (T2D) brings significant human and healthcare costs. Its progressive nature means achieving normoglycaemia is increasingly difficult, yet critical to avoiding long term vascular complications. Nearly one-half of people with T2D have glycaemic levels out of target. Insulin is effective in achieving glycaemic targets, yet initiation of insulin is often delayed, particularly in primary care. Given limited access to specialist resources and the size of the diabetes epidemic, primary care is where insulin initiation must become part of routine practice. This would also support integrated holistic care for people with diabetes. Our Stepping Up Program is based on a general practitioner (GP) and practice nurse (PN) model of care supported appropriately by endocrinologists and credentialed diabetes educator-registered nurses. Pilot work suggests the model facilitates integration of the technical work of insulin initiation within ongoing generalist care. This protocol is for a cluster randomized controlled trial to examine the effectiveness of the Stepping Up Program to enhance the role of the GP-PN team in initiating insulin and improving glycaemic outcomes for people with T2D. 224 patients between the ages of 18 and 80 years with T2D, on two or more oral hypoglycaemic agents and with an HbA1c ≥7.5% in the last six months will be recruited from 74 general practices. The unit of randomization is the practice.Primary outcome is change in glycated haemoglobin HbA1c (measured as a continuous variable). We hypothesize that the intervention arm will achieve an absolute HbA1c mean difference of 0.5% lower than control group at 12 months follow up. Secondary outcomes include the number of participants who successfully transfer to insulin and the proportion who achieve HbA1c measurement of <7.0%. We will also collect data on patient psychosocial outcomes and healthcare utilization and costs. The study is a pragmatic translational study with important potential

  5. Effect of coffee and tea on the glycaemic index of foods: no effect on mean but reduced variability.

    Science.gov (United States)

    Aldughpassi, Ahmed; Wolever, Thomas M S

    2009-05-01

    Coffee and tea may influence glycaemic responses but it is not clear whether they affect the glycaemic index (GI) value of foods. Therefore, to see if coffee and tea affected the mean and SEM of GI values, the GI of fruit leather (FL) and cheese puffs (CP) were determined twice in ten subjects using the FAO/WHO protocol with white bread as the reference food. In one series subjects chose to drink 250 ml of either coffee or tea with all test meals, while in the other series they drank 250 ml water. The tests for both series were conducted as a single experiment with the order of all tests being randomised. Coffee and tea increased the overall mean peak blood glucose increment compared with water by 0.25 (SEM 0.09) mmol/l (P=0.02), but did not significantly affect the incremental area under the glucose response curve. Mean GI values were not affected by coffee or tea but the SEM was reduced by about 30% (FL: 31 (SEM 4) v. 35 (SEM 7) and CP: 76 (SEM 6) v. 75 (SEM 8) for coffee or tea v. water, respectively). The error mean square term from the ANOVA of the GI values was significantly smaller for coffee or tea v. water (F(18, 18) = 2.31; P=0.04). We conclude that drinking coffee or tea with test meals does not affect the mean GI value obtained, but may reduce variability and, hence, improve precision.

  6. Achieving Good Outcomes for Asthma Living (GOAL): mixed methods feasibility and pilot cluster randomised controlled trial of a practical intervention for eliciting, setting and achieving goals for adults with asthma.

    Science.gov (United States)

    Hoskins, Gaylor; Williams, Brian; Abhyankar, Purva; Donnan, Peter; Duncan, Edward; Pinnock, Hilary; van der Pol, Marjon; Rauchhaus, Petra; Taylor, Anne; Sheikh, Aziz

    2016-12-08

    Despite being a core component of self-management, goal setting is rarely used in routine care. We piloted a primary care, nurse-led intervention called Achieving Good Outcomes for Asthma Living (GOAL) for adults with asthma. Patients were invited to identify and prioritise their goals in preparation for discussing and negotiating an action/coping plan with the nurse at a routine asthma review. The 18-month mixed methods feasibility cluster pilot trial stratified and then randomised practices to deliver usual care (UC) or a goal-setting intervention (GOAL). Practice asthma nurses and adult patients with active asthma were invited to participate. The primary outcome was asthma-specific quality of life. Semi-structured interviews with a purposive patient sample (n = 14) and 10 participating nurses explored GOAL perception. The constructs of normalisation process theory (NPT) were used to analyse and interpret data. Ten practices participated (five in each arm), exceeding our target of eight. However, only 48 patients (target 80) were recruited (18 in GOAL practices). At 6 months post-intervention, the difference in mean asthma-related quality of life (mAQLQ) between intervention and control was 0.1 (GOAL 6.20: SD 0.76 (CI 5.76-6.65) versus UC 6.1: SD 0.81 (CI 5.63-6.57)), less than the minimal clinically important difference (MCID) of 0.5. However, change from baseline was stronger in the intervention group: at 6 months the change in the emotions sub-score was 0.8 for intervention versus 0.2 for control. Costs were higher in the intervention group by £22.17. Routine review with goal setting was considered more holistic, enhancing rapport and enabling patients to become active rather than passive participants in healthcare. However, time was a major barrier for nurses, who admitted to screening out patient goals they believed were unrelated to asthma. The difference in AQLQ score from baseline is larger in the intervention arm than the control, indicating the

  7. Sensitivity improvement of an electrical sensor achieved by control of biomolecules based on the negative dielectrophoretic force.

    Science.gov (United States)

    Kim, Hye Jin; Kim, Jinsik; Yoo, Yong Kyoung; Lee, Jeong Hoon; Park, Jung Ho; Hwang, Kyo Seon

    2016-11-15

    Effective control of nano-scale biomolecules can enhance the sensitivity and limit of detection of an interdigitated microelectrode (IME) sensor. Manipulation of the biomolecules by dielectrophoresis (DEP), especially the negative DEP (nDEP) force, so that they are trapped between electrodes (sensing regions) was predicted to increase the binding efficiency of the antibody and target molecules, leading to a more effective reaction. To prove this concept, amyloid beta 42 (Aβ42) and prostate specific antigen (PSA) protein were respectively trapped between the sensing region owing to the nDEP force under 5V and 0.05V, which was verified with COMSOL simulation. Using the simulation value, the resistance change (ΔR/Rb) of the IME sensor from the specific antibody-antigen reaction of the two biomolecules and the change in fluorescence intensity were compared in the reference (pDEP) and nDEP conditions. The ΔR/Rb value improved by about 2-fold and 1.66-fold with nDEP compared to the reference condition with various protein concentrations, and these increases were confirmed with fluorescence imaging. Overall, nDEP enhanced the detection sensitivity for Aβ42 and PSA by 128% and 258%, respectively, and the limit of detection improved by up to 2-orders of magnitude. These results prove that DEP can improve the biosensor's performance.

  8. Glycaemic and insulinaemic responses of adult healthy warm-blooded mares following feeding with Jerusalem artichoke meal.

    Science.gov (United States)

    Glatter, M; Bochnia, M; Goetz, F; Gottschalk, J; Koeller, G; Mielenz, N; Hillegeist, D; Greef, J M; Einspanier, A; Zeyner, A

    2017-06-01

    This study aimed to investigate the impact of the supplementation of a pre-biotic compound [Jerusalem artichoke meal (JAM)] on the glycaemic and insulinaemic response in healthy, non-obese warm-blooded horses. Six adult mares [mean body weight (bwt) 529 ± 38.7 kg; body condition score 5.1 ± 0.49/9] were used. In two equal meals per day, the horses received crushed oat grains (1 g starch/kg bwt per day) and meadow hay (2 kg/100 kg bwt per day) which together were likely to meet the energy recommendation for light work (GfE, ). Additionally, they received either 0.15 g fructo-oligosaccharides and inulin (FOS+INU)/kg bwt per day via commercial JAM or maize cob meal without grains as control (CON) in 2 × 3-week periods according to a crossover design. Blood was collected on d21 of the feeding period at different ante- and postprandial (PP) time points (-60, 0, 30, 60, 90, 120, 180, 240 and 300 min), and the plasma glucose and serum insulin levels were determined. Feeding JAM vs. CON did not change the PP peak of glucose or insulin (glucose: 6.3 ± 0.40 vs. 7.0 ± 0.87 mmol/l; insulin: 0.508 ± 0.087 vs. 0.476 ± 0.082 nmol/l) nor did it cause different AUCs until 120 and 300 min PP for glucose and insulin, respectively (AUC120 , glucose: 997 ± 41.6 vs. 1015 ± 41.63 mmol/l per minute, insulin: 49 ± 6.3 vs. 42 ± 6.3 nmol/l per minute; AUC300 , glucose: 1943 ± 142.3 vs. 2115 ± 142.3 mmol/l per minute, insulin: 94 ± 14.8 vs. 106 ± 14.8 nmol/l per minute; p > 0.05). Following JAM vs. CON feeding, glucose and insulin levels declined more rapidly until 240 min PP and tended to be lower (p = 0.053 and p = 0.056, respectively) at this time point. This result might be promising and should further be studied more detailed. Journal of Animal Physiology and Animal Nutrition © 2017 Blackwell Verlag GmbH.

  9. Dietary approach to hypertension based on low glycaemic index and principles of DASH (Dietary Approaches to Stop Hypertension): a randomised trial in a primary care service.

    Science.gov (United States)

    Lima, Sílvia Tereza Rodrigues Moreira; da Silva Nalin de Souza, Bárbara; França, Ana Karina Teixeira; Salgado Filho, Natalino; Sichieri, Rosely

    2013-10-01

    Hypertension is one of the leading causes of morbidity and mortality in Brazil. Diet may play an important role in reducing blood pressure (BP), as has been shown for diets high in fruits, vegetables and low-fat dairy products and low in salt (Dietary Approaches to Stop Hypertension (DASH)-Na). A low-glycaemic index Brazilian diet combined with the principles of the DASH-Na diet was evaluated in a randomised study of 206 individuals who were followed for 6 months. In the control group (CG), counselling was based on standard care and mainly focused on salt intake reduction. An intention-to-treat analysis showed that, after 6 months, systolic BP was reduced by 14·4 mmHg and diastolic BP by 9·7 mmHg in the experimental group (EG), compared with 6·7 and 4·6 mmHg, respectively, in the CG. After adjusting for body weight, BP at baseline and age, these changes were 12·1 and 7·9 mmHg, respectively. Urinary Na excretion was also reduced by 43·4 mEq/24 h in the EG. Food intake was modified accordingly during the intervention with an increase in the consumption of vegetables (2·97-5·85 frequency of consumption measured in three non-consecutive days), fruits (4·09-7·18), beans (1·94-3·13) and fish (1·80-2·74) by the EG. The present study showed the feasibility of a Brazilian dietary approach to treating hypertension by reducing urinary Na excretion and BP, changes that may have a great impact on public health and promote the benefits of controlling hypertension.

  10. Oral versus intubated feeding and the effect on glycaemic and insulinaemic responses, gastric emptying and satiety.

    Science.gov (United States)

    Morey, S; Shafat, A; Clegg, M E

    2016-01-01

    Cephalic phase responses (CPR) are important in early initiation of digestion and maximal absorption of nutrients prior to ingestion. Bypassing CPR has been shown to have consequences on metabolic responses that may influence satiety. The aim of this study was to investigate if using gastric intubation to bypass oro-pharyngeal and oesophageal exposure would reduce CPR including insulin and blood glucose and whether these impact on gastric emptying and satiety. Ten male subjects were tested on 2 occasions, 3-7 days apart after an overnight fast, in randomized order. Subjects were cannulated and intubated with a gastric tube for both tests. For test one, subjects ate 400 ml soup with a spoon and for test two the soup was infused into the stomach at an equivalent rate. Subsequently measurements of glycaemic (GR) and insulinaemic responses (IR) from cannula samples, breath samples for measurement of gastric emptying using the [(13)C] sodium acetate breath test and visual analogue scales (VAS) for satiety were taken over 180 min. There were differences in IR over the first 15 min (Oral: 169.0 ± 22.1; Gastric 124.1 ± 18.8; t(9) = 2.67; p = 0.028) but no difference in GR. There were differences in gastric emptying half time (Oral: 85.0 ± 2.7; Gastric 79.4 ± 3.3; t(9) = 2.40; p = 0.04) and ascension time (Oral: 68.2 ± 2.2; Gastric 64.0 ± 2.2; t(9) = 2.57; p = 0.03) with food taking longer to empty from the stomach on the Oral test day than on the Gastric test day. There was no significant difference in the satiety ratings. This study demonstrated that bypassing oro-pharyngeal and oesophageal exposure decreases the normal physiological CPR with detriment to IR and gastric emptying.

  11. The glycaemic index: importance of dietary fibre and other food properties.

    Science.gov (United States)

    Björck, Inger; Elmståhl, Helena Liljeberg

    2003-02-01

    An increasing body of evidence suggests that a low-glycaemic-index (GI) diet has a therapeutic as well as a preventive potential in relation to the insulin resistance syndrome. The implementation of a low-GI diet, however, will require an extended list of low-GI foods to be available on the market. The tailoring of low-GI bread products offers a particular challenge due to their generally high GI and abundance in the diet. Low-GI bread products can be tailored by, for example,enclosure of cereal kernels, sour dough fermentation and/or addition of organic acids, or use of cereal genotypes with elevated contents of amylose or f-glucans. Low-GI cereal foods appear to vary in effect on 'second-meal' glucose tolerance in healthy subjects. In addition to the slow-release properties of such foods, the content of dietary fibre appears to play a role. The low glycaemia to starch in a pasta breakfast (GI 54) promoted a higher glucose tolerance and lowered triacylglycerol levels at a standardized lunch ingested 4 h later, compared with a white-wheat-bread breakfast (GI 100). The metabolic benefits of the low GI properties per se have been demonstrated also in the longer term. Thus, a reduction in dietary GI improved glucose and lipid metabolism and normalized fibrinolytic activity in type 2 diabetics, while maintaining a similar amount and composition of dietary fibre. However, the higher dietary fibre content frequently associated with low-GI foods may add to the metabolic merits of a low-GI diet. Consequently, a low-GI barley meal rich in dietary fibre (GI 53) improved glucose tolerance from evening meal to breakfast, whereas an evening meal with pasta had no effect (GI 54). The exchange of common high-GI bread for low-GI high-fibre bread, as the only dietary modification, improved insulin economy in women at risk of type 2 diabetes. These results are in accordance with epidemiological evidence of a reduced risk of type 2 diabetes with a low-GI diet rich in cereal fibre. It

  12. Discrepancies between qualitative and quantitative evaluation of randomised controlled trial results: achieving clarity through mixed methods triangulation.

    Science.gov (United States)

    Tonkin-Crine, Sarah; Anthierens, Sibyl; Hood, Kerenza; Yardley, Lucy; Cals, Jochen W L; Francis, Nick A; Coenen, Samuel; van der Velden, Alike W; Godycki-Cwirko, Maciek; Llor, Carl; Butler, Chris C; Verheij, Theo J M; Goossens, Herman; Little, Paul

    2016-05-12

    Mixed methods are commonly used in health services research; however, data are not often integrated to explore complementarity of findings. A triangulation protocol is one approach to integrating such data. A retrospective triangulation protocol was carried out on mixed methods data collected as part of a process evaluation of a trial. The multi-country randomised controlled trial found that a web-based training in communication skills (including use of a patient booklet) and the use of a C-reactive protein (CRP) point-of-care test decreased antibiotic prescribing by general practitioners (GPs) for acute cough. The process evaluation investigated GPs' and patients' experiences of taking part in the trial. Three analysts independently compared findings across four data sets: qualitative data collected view semi-structured interviews with (1) 62 patients and (2) 66 GPs and quantitative data collected via questionnaires with (3) 2886 patients and (4) 346 GPs. Pairwise comparisons were made between data sets and were categorised as agreement, partial agreement, dissonance or silence. Three instances of dissonance occurred in 39 independent findings. GPs and patients reported different views on the use of a CRP test. GPs felt that the test was useful in convincing patients to accept a no-antibiotic decision, but patient data suggested that this was unnecessary if a full explanation was given. Whilst qualitative data indicated all patients were generally satisfied with their consultation, quantitative data indicated highest levels of satisfaction for those receiving a detailed explanation from their GP with a booklet giving advice on self-care. Both qualitative and quantitative data sets indicated higher patient enablement for those in the communication groups who had received a booklet. Use of CRP tests does not appear to engage patients or influence illness perceptions and its effect is more centred on changing clinician behaviour. Communication skills and the patient

  13. Counselee participation in follow-up breast cancer genetic counselling visits and associations with achievement of the preferred role, cognitive outcomes, risk perception alignment and perceived personal control.

    Science.gov (United States)

    Albada, Akke; Ausems, Margreet G E M; van Dulmen, Sandra

    2014-09-01

    The purpose of the study was to assess the counselee participation in the follow-up visits, compared to the first visits, for breast cancer genetic counselling and to explore associations with counselees' achievement of their preferred role in decision making, information recall, knowledge, risk perception alignment and perceived personal control. First and follow-up visits for breast cancer genetic counselling of 96 counselees of a Dutch genetics center were videotaped (2008-2010). Counselees completed questionnaires before counselling (T1), after the follow-up visit (T2) and one year after the follow-up visit (T3). Consultations were rated with the Roter Interaction Analysis System (RIAS). Counselee participation was measured as the percentage of counselee utterances, the percentage of counselee questions and the interactivity (number of turns per minute). Follow-up visits had higher levels of counselee participation than first visits as assessed by the percentage of counselee talk, the interactivity and counselee questions. More counselee talk in the follow-up visit was related to higher achievement of the preferred role (T2) and higher perceived personal control (T3). Higher interactivity in the follow-up visit was related to lower achievement of the preferred role in decision making and lower information recall (T2). There were no significant associations with the percentage of questions asked and none of the participation measures was related to knowledge, risk perception alignment and perceived personal control (T2). In line with the interviewing admonishment 'talk less and listen more', the only assessment of counselee participation associated to better outcomes is the percentage of counselee talk. High interactivity might be associated with lower recall in breast cancer genetic counselees who are generally highly educated. However, this study was limited by a small sample size and a heterogeneous group of counselees. Research is needed on the interactions

  14. Pure visual imagery as a potential approach to achieve three classes of control for implementation of BCI in non-motor disorders

    Science.gov (United States)

    Sousa, Teresa; Amaral, Carlos; Andrade, João; Pires, Gabriel; Nunes, Urbano J.; Castelo-Branco, Miguel

    2017-08-01

    Objective. The achievement of multiple instances of control with the same type of mental strategy represents a way to improve flexibility of brain-computer interface (BCI) systems. Here we test the hypothesis that pure visual motion imagery of an external actuator can be used as a tool to achieve three classes of electroencephalographic (EEG) based control, which might be useful in attention disorders. Approach. We hypothesize that different numbers of imagined motion alternations lead to distinctive signals, as predicted by distinct motion patterns. Accordingly, a distinct number of alternating sensory/perceptual signals would lead to distinct neural responses as previously demonstrated using functional magnetic resonance imaging (fMRI). We anticipate that differential modulations should also be observed in the EEG domain. EEG recordings were obtained from twelve participants using three imagery tasks: imagery of a static dot, imagery of a dot with two opposing motions in the vertical axis (two motion directions) and imagery of a dot with four opposing motions in vertical or horizontal axes (four directions). The data were analysed offline. Main results. An increase of alpha-band power was found in frontal and central channels as a result of visual motion imagery tasks when compared with static dot imagery, in contrast with the expected posterior alpha decreases found during simple visual stimulation. The successful classification and discrimination between the three imagery tasks confirmed that three different classes of control based on visual motion imagery can be achieved. The classification approach was based on a support vector machine (SVM) and on the alpha-band relative spectral power of a small group of six frontal and central channels. Patterns of alpha activity, as captured by single-trial SVM closely reflected imagery properties, in particular the number of imagined motion alternations. Significance. We found a new mental task based on visual motion

  15. Scale-up of community-based malaria control can be achieved without degrading community health workers' service quality: the Village Malaria Worker project in Cambodia.

    Science.gov (United States)

    Yasuoka, Junko; Poudel, Krishna C; Ly, Po; Nguon, Chea; Socheat, Duong; Jimba, Masamine

    2012-01-04

    Malaria control has been scaled up in many developing countries in their efforts to achieve the Millennium Development Goals. Cambodia recently scaled up their Village Malaria Worker (VMW) project by substantially increasing the number of VMWs and expanding the project's health services to include treatment of fever, diarrhoea, and Acute Respiratory Infections (ARI) in children under five. This study examined if the scale-up interfered with VMWs' service quality, actions, and knowledge of malaria control, and analysed VMWs' overall achievements and perceptions of the newly added health services. Structured interviews were conducted pre scale-up in February-March 2008 with 251 VMWs and post scale-up in July-August 2010 with 252 VMWs. Comparing the pre and post scale-up survey results (n = 195), changes were examined in terms of VMWs' 1) service quality, 2) malaria prevention and vector control actions, and 3) knowledge of malaria epidemiology and vector ecology. In addition, VMWs' newly added health services were descriptively analysed based on the post scale-up survey (n = 252). VMWs' service quality and actions significantly improved overall during the scale-up of the VMW project (mean index score: +0.805, p scale-up survey. About 70% of the respondents reported that their health services to control malaria remained the same or that they were more active after the scale-up. Two-thirds (66.3%) had become more enthusiastic about serving as a VMW since the scale-up, and all but one respondent reported being willing to continue the new services. The Cambodian experience clearly demonstrated that a nationwide scale-up of community-based malaria control can be achieved without degrading community health workers' service quality. The government's strategy to expand VMWs' health services, while providing sufficient training to maintain the quality of their original malaria control services, could have contributed to the improvement of VMW's service quality, actions, and

  16. Scientific Opinion on the substantiation of health claims related to glycaemic carbohydrates and maintenance of normal brain function pursuant to Article 13(5) of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Tetens, Inge

    an opinion on the scientific substantiation of health claims related to glycaemic carbohydrates and maintenance of normal brain function. The scope of the applications was proposed to fall under health claims based on newly developed scientific evidence. The Panel considers that the food constituent......, glycaemic carbohydrates, which is the subject of the health claims, is sufficiently characterised in relation to the claimed effect. Maintenance of normal brain function is a beneficial physiological effect. A claim on glycaemic carbohydrates and maintenance of normal brain function has already been...

  17. Radiographic Progression of Patients With Psoriatic Arthritis Who Achieve Minimal Disease Activity in Response to Golimumab Therapy: Results Through 5 Years of a Randomized, Placebo‐Controlled Study

    Science.gov (United States)

    van der Heijde, Désirée; Beutler, Anna; Gladman, Dafna; Mease, Philip; Krueger, Gerald G.; McInnes, Iain B.; Helliwell, Philip; Coates, Laura C.; Xu, Stephen

    2016-01-01

    Objective To evaluate long‐term outcomes in psoriatic arthritis (PsA) patients who achieved or did not achieve minimal disease activity (MDA) through 5 years of golimumab treatment in the GO‐REVEAL trial. Methods The GO‐REVEAL trial was a phase III, randomized, double‐blind trial with placebo‐control through week 24 followed by an open‐label extension of golimumab 50/100 mg treatment up to 5 years. In these post‐hoc analyses, MDA was defined by the presence of ≥5 of 7 PsA outcome measures (≤1 swollen joint, ≤1 tender joint, Psoriasis Area and Severity Index [PASI] ≤1, patient pain score ≤15, patient global disease activity score ≤20 [range 0–100], Health Assessment Questionnaire disability index [HAQ DI] ≤0.5, and ≤1 tender enthesis point). Results Treatment with golimumab yielded significantly higher MDA response rates versus patients randomized to placebo at week 14 (23.5% versus 1.0%; P golimumab‐treated patients overall. Irrespective of treatment randomization, achievement of MDA at ≥3 and ≥4 consecutive visits was associated with significantly less radiographic progression and more improvement in MDA components allowing specific assessment of physical function (HAQ DI) and overall disease activity (patient global assessment of disease activity) at week 256 versus patients not achieving MDA. Logistic regression analyses indicated that a 1‐unit higher baseline HAQ DI score yielded a significantly lower likelihood of achieving MDA at ≥3 (odds ratio 0.514 [95% confidence interval 0.321–0.824]; P = 0.006) and ≥4 (odds ratio 0.480 [95% confidence interval 0.290–0.795]; P = 0.004) consecutive visits. Conclusion Among golimumab‐treated PsA patients, better long‐term functional improvement, patient global assessment, and radiographic outcomes were observed when patients achieved persistent MDA. PMID:25779603

  18. Effectiveness of music education for the improvement of reading skills and academic achievement in young poor readers: a pragmatic cluster-randomized, controlled clinical trial.

    Science.gov (United States)

    Cogo-Moreira, Hugo; Brandão de Ávila, Clara Regina; Ploubidis, George B; Mari, Jair de Jesus

    2013-01-01

    Difficulties in word-level reading skills are prevalent in Brazilian schools and may deter children from gaining the knowledge obtained through reading and academic achievement. Music education has emerged as a potential method to improve reading skills because due to a common neurobiological substratum. To evaluate the effectiveness of music education for the improvement of reading skills and academic achievement among children (eight to 10 years of age) with reading difficulties. 235 children with reading difficulties in 10 schools participated in a five-month, randomized clinical trial in cluster (RCT) in an impoverished zone within the city of São Paulo to test the effects of music education intervention while assessing reading skills and academic achievement during the school year. Five schools were chosen randomly to incorporate music classes (n = 114), and five served as controls (n = 121). Two different methods of analysis were used to evaluate the effectiveness of the intervention: The standard method was intention-to-treat (ITT), and the other was the Complier Average Causal Effect (CACE) estimation method, which took compliance status into account. The ITT analyses were not very promising; only one marginal effect existed for the rate of correct real words read per minute. Indeed, considering ITT, improvements were observed in the secondary outcomes (slope of Portuguese = 0.21 [pread per minute [β = 13.98, p<0.001] and phonological awareness [β = 19.72, p<0.001] as well as secondary outcomes (academic achievement in Portuguese [β = 0.77, p<0.0001] and math [β = 0.49, p<0.001] throughout the school year). The results may be seen as promising, but they are not, in themselves, enough to make music lessons as public policy.

  19. Strict Blood Pressure Control Achieved Using an ICT-Based Home Blood Pressure Monitoring System in a Catastrophically Damaged Area After a Disaster.

    Science.gov (United States)

    Nishizawa, Masafumi; Hoshide, Satoshi; Okawara, Yukie; Matsuo, Takefumi; Kario, Kazuomi

    2017-01-01

    At the time of the Great East Japan earthquake and tsunami (March 2011), the authors developed a web-based information and communications technology (ICT)-based blood pressure (BP) monitoring system (the Disaster CArdiovascular Prevention [DCAP] Network) and introduced it in an area that was catastrophically damaged (Minamisanriku town) to help control the survivors' BP. Using this system, home BP (HBP) was monitored and the data were automatically transmitted to a central computer database and to the survivors' attending physicians. The study participants, 341 hypertensive patients, continued to use this system for 4 years after the disaster and all of the obtained HBP readings were analyzed. This DCAP HBP-guided approach helped achieve a decrease in the participants' HBPs (initial average: 151.3±20.0/86.9±10.2 mm Hg to 120.2±12.1/70.8±10.2 mm Hg) over the 4 years. In addition, the amplitude of seasonal BP variation was suppressed and the duration from the summer lowest HBP values to the winter peak HBP values was gradually prolonged. This ICT-based approach was useful to achieve strict HBP control and minimize the seasonal BP variation even in a catastrophically damaged area during a 4-year period after the disaster, suggesting that this approach could be a routine way to monitor BP in the community.

  20. A thermolysis approach to simultaneously achieve crystal phase- and shape-control of ternary M-Fe-O metal oxide nanoparticles.

    Science.gov (United States)

    Huang, Chih-Chia; Chang, Chich-Neng; Yeh, Chen-Sheng

    2011-10-05

    Significant studies have achieved beautiful control in particle size, while the shape- and phase-control synthesis of nanoparticles remains an open challenge. In this study, we have developed a generalized methodology to selectively prepare either NaCl-type (reduced form) or spinel-type ferrite (oxidized form) M-Fe-O (M = Mn, Co) crystallites with high reproducibility. A two-step heating process was able to control formation of two types of crystal phase, either a thermodynamic spinel-type under air or a kinetic-control of NaCl-type (rock salt structure) under Ar in a cubic morphology. On the other hand, the three-step heating procedure in air obtained the spinel-type with a thermodynamic equilibrium octahedral shape exclusively. Either using metal acetates (M(ac)(2)) or metal acetylacetonates (M(acac)(2)) as the starting precursors (M = Mn, Co) can be introduced to prepare NaCl-type (reduced form) or spinel-type ferrite (oxidized form) crystallites with identical experimental parameters, including precursor concentration, reaction temperature, reaction time, and heating rate. The oleic acid molecule, reaction temperature, and heating rate employed in the synthesis were carefully examined and found acting as determined roles behind the reaction processes. Apart from the previous literature reports as shape-directed and/or stabilizing agents, the oleic acid molecule played an additional phase-tuning role.