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Sample records for achieve glycaemic control

  1. Chapter 11: The approach to achieving glycaemic control*

    African Journals Online (AJOL)

    2012-11-08

    Nov 8, 2012 ... therapy.3–7 The concept of patient-centred care incorporates patients as ... The SEMDSA approach to glycaemic control does not lose focus of ... patient. South African Family Practice 2018; 60(2):8-16 ... pancreatic cancer.

  2. Enablers and barriers for women with gestational diabetes mellitus to achieve optimal glycaemic control - a qualitative study using the theoretical domains framework.

    Science.gov (United States)

    Martis, Ruth; Brown, Julie; McAra-Couper, Judith; Crowther, Caroline A

    2018-04-11

    Glycaemic target recommendations vary widely between international professional organisations for women with gestational diabetes mellitus (GDM). Some studies have reported women's experiences of having GDM, but little is known how this relates to their glycaemic targets. The aim of this study was to identify enablers and barriers for women with GDM to achieve optimal glycaemic control. Women with GDM were recruited from two large, geographically different, hospitals in New Zealand to participate in a semi-structured interview to explore their views and experiences focusing on enablers and barriers to achieving optimal glycaemic control. Final thematic analysis was performed using the Theoretical Domains Framework. Sixty women participated in the study. Women reported a shift from their initial negative response to accepting their diagnosis but disliked the constant focus on numbers. Enablers and barriers were categorised into ten domains across the three study questions. Enablers included: the ability to attend group teaching sessions with family and hear from women who have had GDM; easy access to a diabetes dietitian with diet recommendations tailored to a woman's context including ethnic food and financial considerations; free capillary blood glucose (CBG) monitoring equipment, health shuttles to take women to appointments; child care when attending clinic appointments; and being taught CBG testing by a community pharmacist. Barriers included: lack of health information, teaching sessions, consultations, and food diaries in a woman's first language; long waiting times at clinic appointments; seeing a different health professional every clinic visit; inconsistent advice; no tailored physical activities assessments; not knowing where to access appropriate information on the internet; unsupportive partners, families, and workplaces; and unavailability of social media or support groups for women with GDM. Perceived judgement by others led some women only to share

  3. Glycaemic Control amongst Persons with Diabetes Mellitus in Benin ...

    African Journals Online (AJOL)

    Conclusion: This study has shown that poor glycaemic control is common amongst persons with diabetes mellitus in Benin City. Studies have shown that good glycaemic control prevents and delays the complications of diabetes mellitus. We therefore recommend that health education on the benefits of good glycaemic ...

  4. 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...... with T2D. Our previous systematic review of intensive glycaemic control versus conventional glycaemic control was based on 20 randomised clinical trials that randomised 29 ,986 participants with T2D. We now report our updated review....

  5. 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

    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

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

    African Journals Online (AJOL)

    Glycaemic control constitutes an important component in the management of critically ill ... protocols simplifies processes, standardises care, facilitates patient safety, .... Shift work, and in particular working night shifts, is recognised as a source.

  7. Glycaemic control and associated factors among patients with diabetes at public health clinics in Johor, Malaysia.

    Science.gov (United States)

    Mahmood, M I; Daud, Faiz; Ismail, Aniza

    2016-06-01

    To determine the prevalence of glycaemic control and factors associated with poor glycaemic control [glycosylated haemoglobin (HbA1c) ≥6.5%] among patients with type 2 diabetes treated in public health clinics in Johor, Malaysia. Cross-sectional study. A review of all patients aged over 18 years and with a diagnosis of type 2 diabetes for >1 year. The National Diabetic Registry was used as the database for attendees at public health clinics in Johor Bahru between January and December 2013. A required sample of 660 was calculated, and a random sampling method was applied to acquire patient information across the 13 public health clinics in Johor Bahru. All relevant information (e.g. HbA1c, type of treatment and other parameters for glycaemic control) were abstracted from the registry. Sixty-eight percent of 706 patients had HbA1c >6.5%, and mean HbA1c was 7.8%. Younger patients (72.3%) had poorer glycaemic control than older patients (63.0%), and most patients with poor glycaemic control were obese (79.2%). Approximately 31.7% of patients did not achieve the target blood pressure 5 years), body mass index (obese), type of treatment (diet therapy vs combination therapy) and abnormal lipid profile were significantly associated with increased odds of HbA1C >6.5%. More than half (68%) of the patients with diabetes had HbA1c >6.5%. This highlights the importance of providing organized care to manage patients with diabetes in the primary care setting, such as weight reduction programmes, proper prescribing treatment, and age- and gender-specific groups to ensure good glycaemic control. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  8. Moderate intensity sports and exercise is associated with glycaemic control in women with gestational diabetes.

    Science.gov (United States)

    Ehrlich, S F; Hedderson, M M; Brown, S D; Sternfeld, B; Chasan-Taber, L; Feng, J; Adams, J; Ching, J; Crites, Y; Quesenberry, C P; Ferrara, A

    2017-10-01

    To assess the association of regular, unsupervised sports and exercise during pregnancy, by intensity level, with glycaemic control in women with gestational diabetes (GDM). Prospective cohort study of 971 women who, shortly after being diagnosed with GDM, completed a Pregnancy Physical Activity Questionnaire assessing moderate and vigorous intensity sports and exercise in the past 3 months. Self-monitored capillary glucose values were obtained for the 6-week period following the questionnaire, with optimal glycaemic control defined≥80% values meeting the targetssports and exercise ([MET×hours]/week), the highest quartile, compared to the lowest, had significantly increased odds of optimal control (OR=1.82 [95% CI: 1.06-3.14] P=0.03). There were significant trends for decreasing mean 1-hour post breakfast, lunch and dinner glycaemia with increasing quartile of moderate activity (all Psports and exercise was associated with decreased mean 1-hour post breakfast and lunch glycaemia (both Psports and exercise, reported shortly after GDM diagnosis, were significantly associated with increased odds of achieving glycaemic control. Clinicians should be aware that unsupervised moderate intensity sports and exercise performed in mid-pregnancy aids in subsequent glycaemic control among women with GDM. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  9. Glycaemic control and quality of life among ethnically diverse Malaysian diabetic patients.

    Science.gov (United States)

    Daher, Aqil Mohammad; AlMashoor, Syed Ahmad H; Winn, Than

    2015-04-01

    To assess the relationship between glycaemic control and quality of life (QoL) among a sample of Malaysians with type 2 diabetes mellitus. This study is a cross-sectional hospital-based study involving 256 patients from three major ethnic groups in Malaysia. Data about QoL were collected with the 18-item Audit of Diabetes Dependent QoL questionnaire. Other data about putative predictors of QoL including personal characteristics and disease-related factors were also collected. Hierarchical multiple linear regression was used to determine factors associated with QoL and to control for confounding variables. The mean age of participants was 56.79 years. Participants were mostly women, employed and married and had attained secondary education. More than a third of the patients had a disease duration of more than 10 years, and about two-thirds had HbA1c ≥ 6.5 %. Those with desired glycaemic control had poorer QoL than those with less than desired glycaemic control moderated by the use of insulin. Hierarchical multiple linear regression showed that desired glycaemic control (HbA1c), diabetes worry, use of insulin, more than 10 years' duration of diabetes, neuropathy and retinopathy were associated with poor QoL, whereas being satisfied with waiting time for consultation was associated with better QoL. The results of this study show that diabetes was associated with negative impact on quality of life. The use of insulin to achieve desired glycaemic control was particularly associated with negative impact on QoL.

  10. Glycaemic control of diabetic patients in an urban primary health care setting in Sarawak: the Tanah Puteh Health Centre experience.

    Science.gov (United States)

    Wong, J S; Rahimah, N

    2004-08-01

    Achieving glycaemic goals in diabetics has always been a problem, especially in a developing country with inadequate facilities such as in Sarawak in Malaysia. There are no reported studies on the control of diabetes mellitus in a diabetic clinic in the primary health care setting in Sarawak. This paper describes the profile of 1031 patients treated in Klinik Kesihatan Tanah Puteh Health Centre. The mean age was 59 years, the mean BMI 27 kg/m2. There was a female preponderance and mainly type-2 diabetes. Mean HbA1c was 7.4%. Glycaemic control was optimal in 28% (HbA1c 7.5%). Reasonable glycaemic control can be achieved in the primary health care setting in Sarawak.

  11. 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.

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

    Science.gov (United States)

    Ashur, Sana Taher; Shah, Shamsul Azhar; Bosseri, Soad; Fah, Tong Seng; Shamsuddin, Khadijah

    2016-01-01

    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. 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. 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). 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.

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

    Science.gov (United States)

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

    2016-10-01

    Does exercise improve postprandial glycaemic control in women diagnosed with gestational diabetes mellitus? A systematic review of randomised trials. Pregnant women diagnosed with gestational diabetes mellitus. Exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism. Postprandial blood glucose, fasting blood glucose, glycated haemoglobin, requirement for insulin, adverse events and adherence. 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 -0.33mmol/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 30minutes, 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. 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. 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 of Physiotherapy62: 188-196]. Copyright © 2016 Australian Physiotherapy Association. Published by Elsevier B.V. All rights

  14. 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 clinic had poor glycaemic control. The group with the poorest level of glycaemic control were on OHA-only, while best control was observed amongst patients on diet-only, because of possible fair endogenous insulin ...

  15. Improving glycaemic control in children and adolescents

    DEFF Research Database (Denmark)

    Skinner, T. C.; Cameron, F. J.

    2010-01-01

    In paediatric diabetes, the concept of intensive therapy in the post-Diabetes Control and Complications Trial period has become subverted by a pharmaco-technological paradigm at the expense of other aspects of care such as goal-setting and psychosocial support. This review examines which patients...

  16. 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.

  17. Persistent poor glycaemic control in adult Type 1 diabetes. A closer look at the problem

    NARCIS (Netherlands)

    DeVries, J. H.; Snoek, F. J.; Heine, R. J.

    2004-01-01

    Around 25% of the adult Type 1 diabetes population is in persistent poor glycaemic control and thus at increased risk of developing microvascular complications. We here discuss correlates of long-standing poor glycaemic control and review the efficacy of clinical strategies designed to overcome

  18. 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.

  19. Peri-operative glycaemic control regimens for preventing surgical site infections in adults.

    Science.gov (United States)

    Kao, Lillian S; Meeks, Derek; Moyer, Virginia A; Lally, Kevin P

    2009-07-08

    Surgical site infections (SSIs) are associated with significant morbidity, mortality, and resource utilization and are potentially preventable. Peri-operative hyperglycaemia has been associated with increased SSIs and previous recommendations have been to treat glucose levels above 200 mg/dL. However, recent studies have questioned the optimal glycaemic control regimen to prevent SSIs. Whether the benefits of strict or intensive glycaemic control with insulin infusion as compared to conventional management outweigh the risks remains controversial. To summarise the evidence for the impact of glycaemic control in the peri-operative period on the incidence of surgical site infections, hypoglycaemia, level of glycaemic control, all-cause and infection-related mortality, and hospital length of stay and to investigate for differences of effect between different levels of glycaemic control. A search strategy was developed to search the following databases: Cochrane Wounds Group Specialised Register (searched 25 March 2009), The Cochrane Central Register of Controlled Trials, The Cochrane Library 2009, Issue 1; Ovid MEDLINE (1950 to March Week 2 2009); Ovid EMBASE (1980 to 2009 Week 12) and EBSCO CINAHL (1982 to March Week 3 2009). The search was not limited by language or publication status. Randomised controlled trials (RCTs) were eligible for inclusion if they evaluated two (or more) glycaemic control regimens in the peri-operative period (within one week pre-, intra-, and/or post-operative) and reported surgical site infections as an outcome. The standard method for conducting a systematic review in accordance with the Cochrane Wounds Group was used. Two review authors independently reviewed the results from the database searches and identified relevant studies. Two review authors extracted study data and outcomes from each study and reviewed each study for methodological quality. Any disagreement was resolved by discussion or by referral to a third review author. Five

  20. Carbohydrate, dietary glycaemic index and glycaemic load, and colorectal cancer risk: a case-control study in China.

    Science.gov (United States)

    Huang, Jing; Fang, Yu-Jing; Xu, Ming; Luo, Hong; Zhang, Nai-Qi; Huang, Wu-Qing; Pan, Zhi-Zhong; Chen, Yu-Ming; Zhang, Cai-Xia

    2018-04-01

    A carbohydrate-rich diet results in hyperglycaemia and hyperinsulinaemia; it may further induce the carcinogenesis of colorectal cancer. However, epidemiological evidence among Chinese population is quite limited. The aim of this study was to investigate total carbohydrate, non-fibre carbohydrate, total fibre, starch, dietary glycaemic index (GI) and glycaemic load (GL) in relation to colorectal cancer risk in Chinese population. A case-control study was conducted from July 2010 to April 2017, recruiting 1944 eligible colorectal cancer cases and 2027 age (5-year interval) and sex frequency-matched controls. Dietary information was collected by using a validated FFQ. The OR and 95 % CI of colorectal cancer risk were assessed by multivariable logistic regression models. There was no clear association between total carbohydrate intake and colorectal cancer risk. The adjusted OR was 0·85 (95 % CI 0·70, 1·03, P trend=0·08) comparing the highest with the lowest quartile. Total fibre was related to a 53 % reduction in colorectal cancer risk (adjusted ORquartile 4 v. 1 0·47; 95 % CI 0·39, 0·58). However, dietary GI was positively associated with colorectal cancer risk, with an adjusted ORquartile 4 v. 1 of 3·10 (95 % CI 2·51, 3·85). No significant association was found between the intakes of non-fibre carbohydrate, starch and dietary GL and colorectal cancer risk. This study indicated that dietary GI was positively associated with colorectal cancer risk, but no evidence supported that total carbohydrate, non-fibre carbohydrate, starch or high dietary GL intake were related to an increased risk of colorectal cancer in a Chinese population.

  1. The Role of Dietary Protein and Fat in Glycaemic Control in Type 1 Diabetes: Implications for Intensive Diabetes Management.

    Science.gov (United States)

    Paterson, Megan; Bell, Kirstine J; O'Connell, Susan M; Smart, Carmel E; Shafat, Amir; King, Bruce

    2015-09-01

    A primary focus of the management of type 1 diabetes has been on matching prandial insulin therapy with carbohydrate amount consumed. However, even with the introduction of more flexible intensive insulin regimes, people with type 1 diabetes still struggle to achieve optimal glycaemic control. More recently, dietary fat and protein have been recognised as having a significant impact on postprandial blood glucose levels. Fat and protein independently increase the postprandial glucose excursions and together their effect is additive. This article reviews how the fat and protein in a meal impact the postprandial glycaemic response and discusses practical approaches to managing this in clinical practice. These insights have significant implications for patient education, mealtime insulin dose calculations and dosing strategies.

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

    DEFF Research Database (Denmark)

    Kähler, Pernille; Grevstad, Berit; Almdal, Thomas

    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 type 1 diabetes mellitus were included. DATA EXTRACTION: Two authors independently assessed studies...... for inclusion and extracted data. RESULTS: 18 randomised clinical trials included 2254 participants with type 1 diabetes mellitus. All trials had high risk of bias. There was no statistically significant effect of targeting intensive glycaemic control on all-cause mortality (risk ratio 1.16, 95% CI 0.65 to 2...

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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

  5. 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....

  6. 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 ...

  7. Glycaemic control status among type 2 diabetic patients and the role ...

    African Journals Online (AJOL)

    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 (92.1), and of the 523 ...

  8. Impaired vascular function during short-term poor glycaemic control in Type 1 diabetic patients

    DEFF Research Database (Denmark)

    Sørensen, V.R.; Mathiassen, E.R.; Clausen, P.

    2005-01-01

    AIM: To study the effects of short-term poor glycaemic control on vascular function in Type 1 diabetic patients. METHODS: Ten Type 1 diabetic patients, with diabetes duration of less than 10 years and normal urinary albumin excretion and ophthalmoscopy, were studied. All patients were examined af...

  9. Effects of Level of Glycaemic Control in Reduction of Maternal and ...

    African Journals Online (AJOL)

    Diabetes in pregnancy is associated with increased risk of morbidity for mother and fetus during pregnancy and at birth as well as later in life. The objective of this study was to determine the association between level of glycaemic control and maternal and perinantal complications in pregnant diabetic women. Institution ...

  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

    AIMS: Lloyd and colleagues (Diabetic Med 2000; 17, 198-202) have described an association between poor glycaemic control and moderate to severe depression in male but not in female diabetes patients. However, the validity of this study may be limited by its small sample size and the influence of ...... across gender. Diabet. Med. 18, 595-598 (2001)...

  11. Influence of vitamin E supplementation on glycaemic control: a meta-analysis of randomised controlled trials.

    Directory of Open Access Journals (Sweden)

    Renfan Xu

    Full Text Available Observational studies have revealed that higher serum vitamin E concentrations and increased vitamin E intake and vitamin E supplementation are associated with beneficial effects on glycaemic control in type 2 diabetes mellitus (T2DM. However, whether vitamin E supplementation exerts a definitive effect on glycaemic control remains unclear. This article involves a meta-analysis of randomised controlled trials of vitamin E to better characterise its impact on HbA1c, fasting glucose and fasting insulin. PubMed, EMBASE and the Cochrane Library were electronically searched from the earliest possible date through April 2013 for all relevant studies. Weighted mean difference (WMD was calculated for net changes using fixed-effects or random-effects models. Standard methods for assessing statistical heterogeneity and publication bias were used. Fourteen randomised controlled trials involving individual data on 714 subjects were collected in this meta-analysis. Increased vitamin E supplementation did not result in significant benefits in glycaemic control as measured by reductions in HbA1c, fasting glucose and fasting insulin. Subgroup analyses revealed a significant reduction in HbA1c (-0.58%, 95% CI -0.83 to -0.34 and fasting insulin (-9.0 pmol/l, 95% CI -15.90 to -2.10 compared with controls in patients with low baseline vitamin E status. Subgroup analyses also demonstrated that the outcomes may have been influenced by the vitamin E dosage, study duration, ethnic group, serum HbA1c concentration, and fasting glucose control status. In conclusion, there is currently insufficient evidence to support a potential beneficial effect of vitamin E supplementation on improvements of HbA1c and fasting glucose and insulin concentrations in subjects with T2DM.

  12. Influence of vitamin E supplementation on glycaemic control: a meta-analysis of randomised controlled trials.

    Science.gov (United States)

    Xu, Renfan; Zhang, Shasha; Tao, Anyu; Chen, Guangzhi; Zhang, Muxun

    2014-01-01

    Observational studies have revealed that higher serum vitamin E concentrations and increased vitamin E intake and vitamin E supplementation are associated with beneficial effects on glycaemic control in type 2 diabetes mellitus (T2DM). However, whether vitamin E supplementation exerts a definitive effect on glycaemic control remains unclear. This article involves a meta-analysis of randomised controlled trials of vitamin E to better characterise its impact on HbA1c, fasting glucose and fasting insulin. PubMed, EMBASE and the Cochrane Library were electronically searched from the earliest possible date through April 2013 for all relevant studies. Weighted mean difference (WMD) was calculated for net changes using fixed-effects or random-effects models. Standard methods for assessing statistical heterogeneity and publication bias were used. Fourteen randomised controlled trials involving individual data on 714 subjects were collected in this meta-analysis. Increased vitamin E supplementation did not result in significant benefits in glycaemic control as measured by reductions in HbA1c, fasting glucose and fasting insulin. Subgroup analyses revealed a significant reduction in HbA1c (-0.58%, 95% CI -0.83 to -0.34) and fasting insulin (-9.0 pmol/l, 95% CI -15.90 to -2.10) compared with controls in patients with low baseline vitamin E status. Subgroup analyses also demonstrated that the outcomes may have been influenced by the vitamin E dosage, study duration, ethnic group, serum HbA1c concentration, and fasting glucose control status. In conclusion, there is currently insufficient evidence to support a potential beneficial effect of vitamin E supplementation on improvements of HbA1c and fasting glucose and insulin concentrations in subjects with T2DM.

  13. External validity of randomized controlled trials of glycaemic control and vascular disease: how representative are participants?

    Science.gov (United States)

    Saunders, C; Byrne, C D; Guthrie, B; Lindsay, R S; McKnight, J A; Philip, S; Sattar, N; Walker, J J; Wild, S H

    2013-03-01

    To describe the proportion of people with Type 2 diabetes living in Scotland who meet eligibility criteria for inclusion in several large randomized controlled trials of glycaemic control to inform physicians and guideline developers about the generalizibility of trial results. A literature review was performed to identify large trials assessing the impact of glycaemic control on risk of macrovascular disease. Inclusion and exclusion criteria from each trial were applied to data on the population of people with a diagnosis of Type 2 diabetes living in Scotland in 2008 (n = 180,590) in a population-based cross-sectional study and the number and proportion of people eligible for each trial was determined. Seven trials were identified. The proportion of people with Type 2 diabetes who met the eligibility criteria for the trials ranged from 3.5 to 50.7%. Trial participants were younger at age of diagnosis of diabetes and at time of trial recruitment than in the Scottish study population. The application of upper age criteria excluded the largest proportion of patients, with up to 39% of people with Type 2 diabetes ineligible for a trial with the most stringent criteria based on age alone. We found that many of the large trials of glycaemic control among people with Type 2 diabetes have limited external validity when applied to a population-based cohort of people with Type 2 diabetes. In particular, the age distribution of trial participants often does not reflect that of people with Type 2 diabetes in a contemporary British population. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

  14. Ethnic differences in glycaemic control and complications: the adult diabetes control and management (ADCM), Malaysia.

    Science.gov (United States)

    Chew, B H; Mastura, I; Lee, P Y; Wahyu, T Sri; Cheong, A T; Zaiton, A

    2011-08-01

    Ethnicity is an important factor in diabetes care. The understanding of its effect in this country may help to improve diabetes care, glycaemic control and diabetic complication rates. This study was to determine the diabetes control profile in relation to complication rates between the three main ethnics group in Malaysia. This nested cross-sectional study was part of the Audit of Diabetes Control and Management (ADCM), an ongoing cohort patient registry focused on diabetes control and management in the primary care setting in Malaysia. This registry registers all diabetes patients aged 18 years old and above. Demographic data, diabetes duration, treatment modalities, as well as various risk factors and diabetes complications are reported. Data was handled by statisticians using STATA version 9. A total of 20330 patients from 54 health centers were registered at the time of this report. The majority were type 2 diabetics (99.1%) of whom 56.6% were female. The mean age was 57.9 years (SD 11.58). Malay accounted for 56.3%, Chinese 19.5% and Indian 22.5%. There were 30.3% who attained HbA1c profiles. The Chinese diabetics suffer as many diabetes-related complications despite better glycaemic control. Further studies will need to look into other socio-genetic factors in order to provide a more personalized effective diabetes care.

  15. 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 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.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.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.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.

  16. 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 studies....... 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...... administered several times daily at mealtimes can improve glycaemic control without increasing the risk of hypoglycaemia. The fast-acting analogues are now also available as insulin mixed with NPH. Insulin glargine is a new long-acting insulin which is soluble and precipitates after injection, resulting...

  17. Ethnic differences in glycaemic control in people with type 2 diabetes mellitus living in Scotland

    OpenAIRE

    Negandhi, Preeti H; Ghouri, Nazim; Colhoun, Helen M; Fischbacher, Colin M; Lindsay, Robert S; McKnight, John A; Petrie, John; Philip, Sam; Sattar, Naveed; Wild, Sarah H; Scottish Diabetes Research Network Epidemiology Group

    2013-01-01

    Background and Aims:\\ud \\ud Previous studies have investigated the association between ethnicity and processes of care and intermediate outcomes of diabetes, but there are limited population-based studies available. The aim of this study was to use population-based data to investigate the relationships between ethnicity and glycaemic control in men and women with diabetes mellitus living in Scotland.\\ud \\ud Methods:\\ud \\ud We used a 2008 extract from the population-based national electronic d...

  18. 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 breakfast, and high-GI meals increased cortisol levels (P breakfast may help to improve learning, and of potential value in informing government education policies relating to dietary recommendations and implementation concerning breakfast.

  19. Family CHAOS is associated with glycaemic control in children and adolescents with type 1 diabetes mellitus.

    Science.gov (United States)

    Chae, M; Taylor, B J; Lawrence, J; Healey, D; Reith, D M; Gray, A; Wheeler, B J

    2016-02-01

    Despite advances in the medical management of type 1 diabetes mellitus (T1DM), for many, glycaemic control remains substandard. Other factors are clearly important in determining success, or lack thereof, with diabetes management. With this in mind, we have investigated whether family CHAOS may provide a novel tool to identify when environmental confusion could impact on diabetes management and subsequent glycaemic control. A case-control study of children and adolescents with established T1DM and age-/sex-matched controls was conducted. Demographic information, both maternal and paternal CHAOS scores, and HbA1c were collected. Statistical analysis was undertaken to explore associations between T1DM and CHAOS and between CHAOS and HbA1c. Data on 65 children with T1DM and 60 age-/sex-matched controls were obtained. There was no evidence of group differences for maternal CHAOS (p = 0.227), but paternal CHAOS scores were higher for the T1DM group (p = 0.041). Greater maternal and paternal CHAOS scores were both associated with higher HbA1c (p ≤ 0.027). The maternal association remained after controlling for diabetes duration, SMBG frequency, and insulin therapy. In children with T1DM, there appears to be a negative association between increased environmental confusion, as rated by CHAOS, and glycaemic control. In addition, when compared to controls, fathers of children and adolescents with T1DM appear to experience CHAOS differently to mothers. These findings contribute to the growing body of literature exploring psychosocial factors in T1DM. Continuing efforts are required to fully understand how the family and psychosocial environment interact with diabetes to impact on long-term health outcomes.

  20. 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.

  1. Effect of Optimization of Glycaemic Control on Mannan-Binding Lectin in Type 1 Diabetes

    Directory of Open Access Journals (Sweden)

    Gry Høst Dørflinger

    2017-01-01

    Full Text Available Objective. Mannan-binding lectin (MBL concentration in plasma is increased in subjects with type 1 diabetes and associated with increased mortality and risk of diabetic nephropathy. Recent findings show that pancreas transplantation reduces MBL concentration. Whether the increased MBL concentration is reversed by improved glycaemic control remains unknown. We investigated the effects of improved glycaemic control on MBL concentration in patients with type 1 diabetes. Methods. We measured MBL, fructosamine, and HbA1cat baseline and after 6 weeks in 52 type 1 diabetic patients following the change from conventional insulin therapy to insulin pump therapy. Results. After initiation of insulin pump therapy, the total daily insulin dose was significantly reduced (from 51 ± 18 IE/day to 39 ± 13 IE/day, P<0.0001. There was a significant decrease in HbA1c from 8.6% to 7.7% (from 70 mmol/mol to 61 mmol/mol, P<0.0001 and in fructosamine levels (from 356 μmol/L to 311 μmol/L, P<0.0001. MBL levels decreased by 10% from 2165 μg/L (IQR 919–3389 μg/L at baseline to 1928 μ/L (IQR 811–2758 μg/L at follow-up (P=0.005, but MBL change was not significantly correlated with changes in insulin dose, HbA1c, or fructosamine. Conclusions. MBL concentration decreased following the initiation of insulin pump therapy in patients with type 1 diabetes and did not correlate with changes in glycaemic control.

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    Ping Soon Shu

    Full Text Available 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.

  4. 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.

  5. Self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control.

    Science.gov (United States)

    Tan, Ming Yeong; Magarey, Judy

    2008-08-01

    To investigate the self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control. Using a one-to-one interviewing approach, data were collected from 126 diabetic adults from four settings. A 75-item questionnaire was used to assess diabetes-related knowledge and self-care practices regarding, diet, medication, physical activity and self-monitoring of blood glucose (SMBG). Most subjects had received advice on the importance of self-care in the management of their diabetes and recognised its importance. Sixty-seven subjects (53%) scored below 50% in their diabetes-related knowledge. Subjects who consumed more meals per day (80%), or who did not include their regular sweetened food intakes in their daily meal plan (80%), or who were inactive in daily life (54%), had higher mean fasting blood glucose levels (p=0.04). Subjects with medication non-adherence (46%) also tended to have higher fasting blood glucose levels. Only 15% of the subjects practiced SMBG. Predictors of knowledge deficit and poor self-care were low level of education (p = <0.01), older subjects (p=0.04) and Type 2 diabetes subjects on oral anti-hyperglycaemic medication (p = <0.01). There were diabetes-related knowledge deficits and inadequate self-care practices among the majority of diabetic patients with sub-optimal glycaemic control. This study should contribute to the development of effective education strategies to promote health for adults with sub-optimal diabetes control.

  6. Quality of glycaemic control in ambulatory diabetics at the out-patient clinic of Kenyatta National Hospital, Nairobi.

    Science.gov (United States)

    Otieno, C F; Kariuki, M; Ng'ang'a, L

    2003-08-01

    Treatment of diabetes mellitus is based on the evidence that lowering blood glucose as close to normal range as possible is a primary strategy for reducing or preventing complications or early mortality from diabetes. This suggests poorer glycaemic control would be associated with excess of diabetes-related morbidity and mortality. This presumption is suspected to reach high proportions in developing countries where endemic poverty abets poor glycaemic control. There is no study published on Kenyan patients with diabetes mellitus about their glycaemic control as an audit of diabetes care. To determine the glycaemic control of ambulatory diabetic patients. Cross-sectional study on each clinic day of a randomly selected sample of both type 1 and 2 diabetic patients. Kenyatta National Hospital. Over a period of six months, January 1998 to June 1998. During routine diabetes care in the clinic, mid morning random blood sugar and glycated haemoglobin (HbA1c) were obtained. A total of 305 diabetic patients were included, 52.8% were females and 47.2% were males. 58.3% were on Oral Hypoglycaemic Agent (OHA) only, 22.3% on insulin only; 9.2% on OHA and insulin and 4.6% on diet only. 39.5% had mean HbA1c or = 8%. Patients on diet-only therapy had the best mean HbA1c = 7.04% while patients on OHA-only had the worst mean HbA1c = 9.06%. This difference was significant (p=0.01). The former group, likely, had better endogenous insulin production. The influence of age, gender and duration of diabetes on the level of glycaemic control observed did not attain statistically significant proportions. The majority of ambulatory diabetic patients attending the out-patient diabetic clinic had poor glycaemic control. The group with the poorest level of glycaemic control were on OHA-only, while best control was observed amongst patients on diet-only, because of possible fair endogenous insulin production. Poor glycaemic control was presumed to be due to sub-optimal medication and

  7. Effect of a group-based rehabilitation programme on glycaemic control and cardiovascular risk factors in type 2 diabetes patients: The Copenhagen Type 2 Diabetes Rehabilitation Project

    DEFF Research Database (Denmark)

    Vadstrup, Eva Soelberg; Frølich, Anne; Perrild, Hans Jørgen Duckert

    2011-01-01

    To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes.......To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes....

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

    Directory of Open Access Journals (Sweden)

    Phil McEwan

    Full Text Available 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.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.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.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.

  9. Sodium-glucose co-transporter-2 inhibitors, the latest residents on the block: Impact on glycaemic control at a general practice level in England.

    Science.gov (United States)

    Heald, Adrian H; Fryer, Anthony A; Anderson, Simon G; Livingston, Mark; Lunt, Mark; Davies, Mark; Moreno, Gabriela Y C; Gadsby, Roger; Young, Robert J; Stedman, Mike

    2018-03-08

    To determine, using published general practice-level data, how differences in Type 2 diabetes mellitus (T2DM) prescribing patterns relate to glycaemic target achievement levels. Multiple linear regression modelling was used to link practice characteristics and defined daily dose (DDD) of different classes of medication in 2015/2016 and changes between that year and the year 2014/2015 in medication to proportion of patients achieving target glycaemic control (glycated haemoglobin A1c [HbA1c] ≤58 mmol/mol [7.5%]) and proportion of patients at high glycaemic risk (HbA1c >86 mmol/mol [10.0%]) for practices in the National Diabetes Audit with >100 people with T2DM on their register. Overall, HbA1c outcomes were not different between the years studied. Although, in percentage terms, most practices increased their use of sodium-glucose co-transporter-2 (SGLT2) inhibitors (96%), dipeptidyl peptidase-4 (DPP-4) inhibitors (76%) and glucagon-like peptide 1 (GLP-1) analogues (53%), there was wide variation in the use of older and newer therapies. For example, 12% of practices used >200% of the national average for some newer agents. In cross-sectional analysis, greater prescribing of metformin and analogue insulin were associated with a higher proportion of patients achieving HbA1c ≤58 mmol/mol; the use of SGLT2 inhibitors and metformin was associated with a reduced proportion of patients with HbA1c >86 mol/mol; otherwise associations for sulphonylureas, GLP-1 analogues, SGLT2 inhibitors and DPP-4 inhibitors were neutral or negative. In year-on-year analysis there was ongoing deterioration in glycaemic control, which was offset to some extent by increased use of SGLT2 inhibitors and GLP-1 analogues, which were associated with a greater proportion of patients achieving HbA1c levels ≤58 mmol/mol and a smaller proportion of patients with HbA1c levels >86 mmol/mol. SGLT2 inhibitor prescribing was associated with significantly greater improvements than those found

  10. 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

    to insulin for overweight adult patients with type 1 diabetes. Methods We did a randomised, double-blind, placebo-controlled trial at Steno Diabetes Center (Gentofte, Denmark). Patients aged 18 years or older with type 1 diabetes, insufficient glycaemic control (HbA1c >8% [64 mmol/mol]), and overweight (BMI...

  11. The effects of intermittent compared to continuous energy restriction on glycaemic control in type 2 diabetes; a pragmatic pilot trial.

    Science.gov (United States)

    Carter, S; Clifton, P M; Keogh, J B

    2016-12-01

    Weight loss improves glycaemic control in type 2 diabetes mellitus (T2DM). However, as achieving and maintaining weight loss is difficult, alternative strategies are needed. Our primary aim was to investigate the effects of intermittent energy restriction (IER) compared to continuous energy restriction (CER) on glycated haemoglobin A1c (HbA1c). Secondary aims were to assess effects on weight loss, body composition, medication changes and subjective measures of appetite. Using a 2-day IER method, we expected equal improvements to HbA1c and weight in both groups. Sixty-three overweight or obese participants (BMI 35.2±5kg/m 2 ) with T2DM (HbA1c 7.4±1.3%) (57mmol/mol) were randomised to a 2-day severe energy restriction (1670-2500kJ/day) with 5days of habitual eating, compared to a moderate CER diet (5000-6500kJ/day) for 12weeks. At 12weeks HbA1c (-0.7±0.9% P<0.001) and percent body weight reduction (-5.9±4% P<0.001) was similar in both groups with no group by time interaction. Similar reductions were also seen for medication dosages, all measures of body composition and subjective reports of appetite. In this pilot trial, 2days of IER compared with CER resulted in similar improvements in glycaemic control and weight reduction offering a suitable alternative treatment strategy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. 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...

  13. Impact of Education on Disease Knowledge and Glycaemic Control Among Type 2 Diabetic Patients in Family Practice

    Directory of Open Access Journals (Sweden)

    Samira Herenda

    2007-08-01

    Full Text Available In patients with diabetes type 2, good knowledge about disease often doesn’t follow appropriate behavior in their life. Therefore, we wanted to find out basic level of disease knowledge and glycemic control among type 2 diabetic patients, and after that impact of passive and intensive education on knowledge and glycemic control. Starting with 130 participants, 91 patients with type 2 diabetes, from four family medicine services in Tuzla Canton, completed six months education about their disease. Disease Knowledge Test of Michigan Diabetes Training and Research Center was used to evaluate knowledge about diabetes and glycaemic control was assessed by HbAic. Participants were tested at the beginning of survey, after 3 months of passive education and additional 3 months of intensive one. Basic test showed good knowledge of participants (score 8,3 out of 15, improved knowledge after passive education (score 9,23 and intensive one (11,19 (P<0,0001. Demographic characteristics of patients (age, sex, living area, level of education, duration of disease and type of treatment had no influence on disease knowledge and glycaemic control during education. Generally, patient education improved significantly glycaemic control by HbA1c reduction 0,45% (P=0,011 without significant differences between passive and intensive one. Education of patients improves both disease knowledge and glycaemic control among type 2 diabetic patients.

  14. Iron Profile and Glycaemic Control in Patients with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Gunjan Misra

    2016-12-01

    Full Text Available Iron overload is increasingly being connected to insulin resistance in Type 2 Diabetes Mellitus (T2DM patients. Free iron causes the assembly of reactive oxygen species that invariably steer the body’s homeostasis towards oxidative stress-mediated diabetic complications. This study aims to assess the serum iron, total iron binding capacity (TIBC, and percentage transferrin saturation (Tsat of 150 subjects divided into three groups (I,II,III of 50. Healthy individuals (controls constituted Group I. Group II consisted of T2DM patients with optimal glycaemic control. T2DM patients with suboptimal glycaemic control formed group III. Mean serum free iron concentration was 105.34 ± 3.5, 107.33 ± 3.45, and 125.58 ± 3.45 μg/dL in Group I, Group II, and Group III, respectively. Mean serum TIBC concentration in Group I, Group II, and Group III was 311.39 ± 5.47, 309.63 ± 6.1, and 284.2 ± 3.18 μg/dL, respectively. Mean serum transferrin saturation (% in Group I, Group II, and Group III was 34.17 ± 1.21, 35.02 ± 1.2, and 44.39 ± 1.07, respectively. The difference between TIBC, mean serum free iron concentration, and transferrin saturation between Group I and Group III (for all, p values <0.001, as well as between Group II and Group III (p values 0.0012, 0.0015, and <0.0001, respectively was statistically significant. The fasting plasma glucose values of Groups II and III were significantly higher than those of Group I, (p < 0.0001. Glycated haemoglobin (HbA1c values were also shown to increase from Group I to II and then III, and the increase was highly significant (all p values <0.0001. Thus, decreased glycaemic control and an increase in the glycation of haemoglobin was the key to elevation in serum iron values and alterations in other parameters. However, a significant correlation was absent between serum iron and HbA1c (r = 0.05 and transferrin saturation (r = 0.0496 in Group III.

  15. 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.

  16. Night-shift work is associated with poorer glycaemic control in patients with type 2 diabetes.

    Science.gov (United States)

    Manodpitipong, Areesa; Saetung, Sunee; Nimitphong, Hataikarn; Siwasaranond, Nantaporn; Wongphan, Thanawat; Sornsiriwong, Chotima; Luckanajantachote, Pranee; Mangjit, Prasitchai; Keesukphan, Prasit; Crowley, Stephanie J; Hood, Megan M; Reutrakul, Sirimon

    2017-12-01

    The circadian system plays a role in regulating metabolism. Night-shift work, a form of circadian misalignment, is associated with increased type 2 diabetes risk. This study aimed to determine if night-shift workers with type 2 diabetes experience poorer glycaemic control than non-shift workers. Patients with type 2 diabetes (104 unemployed, 85 day workers and 60 night-shift workers) participated. Sleep duration, sleep quality, morningness-eveningness preference, depressive symptoms and dietary intake were assessed using standardized questionnaires. Haemoglobin A1c levels were measured. Night-shift workers had significantly higher haemoglobin A1c levels compared with others, while there were no differences between day workers and unemployed participants (median 7.86% versus 7.24% versus 7.09%, respectively). Additionally, night-shift workers were younger, had a higher body mass index, and consumed more daily calories than others. Among night-shift workers, there were no significant differences in haemoglobin A1c levels between those performing rotating versus non-rotating shifts (P = 0.856), or those with clockwise versus counterclockwise shift rotation (P = 0.833). After adjusting for age, body mass index, insulin use, sleep duration, morningness-eveningness preference and percentage of daily intake from carbohydrates, night-shift work, compared with day work, was associated with significantly higher haemoglobin A1c (B = 0.059, P = 0.044), while there were no differences between unemployed participants and day workers (B = 0.016, P = 0.572). In summary, night-shift work is associated with poorer glycaemic control in patients with type 2 diabetes. © The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.

  17. Green leafy porridges: how good are they in controlling glycaemic response?

    Science.gov (United States)

    Anuruddhika Subhashinie Senadheera, Senadheera Pathirannehelage; Ekanayake, Sagarika

    2013-03-01

    Green leafy porridges made with leaf water extracts, rice and coconut milk are common Sri Lankan dietary remedies for diabetes. Though water and ethanolic extracts of most leaves elicit hypoglycaemic effects, data are not available on the efficacy when leaf extracts are incorporated into porridges. Thus, an effort was made to evaluate the proximate compositions and glycaemic index (GI) of some commonly consumed green leafy porridges. The GI of rice porridge and coconut milk porridge were measured to evaluate the effect of other ingredients other than the leaf extracts. Rice was the main contributor to carbohydrate (56-68% on dry weight) and water was the main component in porridges (89-93%). Fat and total dietary fibre contents ranged between 2.5-27% and 5-10%, respectively. The GI of all porridges was low (GI ≤ 55), except Cassia auriculata which had a high GI of 77 ± 12. The GIs of coconut milk, Aerva lanata, Hemidesmus indicus, Scoparia dulcis, Asparagus racemosus, Cephalandra indica, Cardiospermum halicacabum, Murraya koenigii and Aegle marmelos were 31 ± 5, 32 ± 5, 40 ± 8, 39 ± 8, 37 ± 4, 49 ± 8, 46 ± 8, 44 ± 8 and 50 ± 8, respectively. All porridges had a low or medium glycaemic loads ( ≤ 19). However, peak blood glucose reductions of ≥ 25% were observed in all leafy and coconut milk porridges, except in C. auriculata and Atlantia zeylanica, when compared with the glucose control. Therefore, green leafy porridges, except Cassia, can be recommended as breakfast meals for diabetics due to their low GI, peak blood glucose reduction and presence of other nutrients in green leaves.

  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. Effectiveness of cognitive-behavioural therapy on glycaemic control and psychological outcomes in adults with diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Uchendu, C; Blake, H

    2017-03-01

    Diabetes is a chronic progressive condition presenting physical, social and psychological challenges that increase the risk of comorbid mental health problems. Cognitive-behavioural therapy (CBT) is effective in treating a variety of psychological disorders, and may potentially improve glycaemic control and psychological outcomes in diabetes. This systematic review and meta-analysis aims to establish the effectiveness of CBT on glycaemic control and comorbid diabetes-related distress, depression, anxiety and quality of life in the short, medium and longer term among adults with diabetes. An electronic search was conducted in PubMed, Embase, MEDLINE, PsycINFO, CINAHL, Web of Knowledge, Cochrane Central Register of Controlled Trials and references in reviews. Twelve randomized controlled trials (RCTs) were identified that evaluated the effectiveness of CBT on at least one of: glycaemic control, diabetes-related distress, anxiety, depression or quality of life in adults with Type 1 or Type 2 diabetes. The Cochrane Risk of Bias Tool and Review Manager version 5.3 were used for risk of bias assessment and meta-analysis, respectively. CBT is effective in reducing short-term and medium-term glycaemic control, although no significant effect was found for long-term glycaemic control. CBT improved short- and medium-term anxiety and depression, and long-term depression. Mixed results were found for diabetes-related distress and quality of life. CBT is beneficial in improving depression for adults with diabetes. It may have benefits for improving glycaemic control and other aspects of psychological health, although the findings are inconclusive. © 2016 Diabetes UK.

  20. Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting.

    OpenAIRE

    Tharek, Zahirah; Ramli, Anis Safura; Whitford, David L; Ismail, Zaliha; Mohd Zulkifli, Maryam; Ahmad Sharoni, Siti Khuzaimah; Shafie, Asrul A; Jayaraman, Thevaraajan

    2018-01-01

    BACKGROUND: Self-efficacy has been shown to be positively correlated with self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus. However, such evidence is lacking in the Malaysian primary care setting. The objectives of this study were to i) determine the levels of self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting ii) determine the relationship between self-efficacy, self...

  1. 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

    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...

  2. Influence of a high fibre diet on glycaemic control and quality of life in dogs with diabetes mellitus.

    Science.gov (United States)

    Graham, P A; Maskell, E; Rawlings, J M; Nash, A S; Markwell, P J

    2002-02-01

    A study was undertaken to evaluate a high fibre diet used in the management of 10 dogs with naturally occurring insulin-dependent diabetes mellitus. Following baseline measurements of health and glycaemic control, the dogs were fed a canned diet containing a blend of insoluble and soluble dietary fibres and were monitored during the ensuing four months. Switching to the high fibre diet was associated with significantly lower mean 24-hour and postprandial plasma glucose concentrations, which were maintained over the study period. The high fibre diet was also associated with significant reductions in plasma concentrations of fructosamine, glycated haemoglobin, free glycerol and cholesterol, and there were significant improvements in dog activity and demeanour. Bodyweight declined during the fourth month of feeding the diet, which is likely to have resulted from underfeeding relative to increased activity. The results indicate that a high fibre diet can significantly improve glycaemic control and quality of life in dogs with diabetes mellitus.

  3. Effect of Oral Pre-Meal Administration of Betaglucans on Glycaemic Control and Variability in Subjects with Type 1 Diabetes.

    Science.gov (United States)

    Frid, Anders; Tura, Andrea; Pacini, Giovanni; Ridderstråle, Martin

    2017-09-12

    We conducted a double-blind placebo-controlled crossover pilot study to investigate the effect of oat betaglucans (β-glucan) on glycaemic control and variability in adults with type 1 diabetes (T1D; n = 14). Stomacol ® tablets (1.53 g of β-glucan) or placebo (Plac) were administered three times daily before meals for two weeks. Glucose levels were monitored during the second week by continuous glucose monitoring (CGM). There was an increase in basic measures of glycaemic control (maximal glucose value 341 ± 15 vs. 378 ± 13 mg/dL for Plac and β-glucan, p = 0.004), and average daily risk range (62 ± 5 vs. 79 ± 4 mg/dL for Plac and β-glucan, p = 0.003) favouring Plac over β-glucan, but no increase in the M-value (the weighted average of the glucose values) or other more complex measures. Basic measures of glucose variability were also slightly increased during β-glucan treatment, with no difference in more complex measures. However, glycaemic variability increased between the first and last two CGM days on Plac, but remained unchanged on β-glucan. In conclusion, in this pilot study we were unable to demonstrate a general positive effect of β-glucan before meals on glucose control or variability in T1D.

  4. Effect of Oral Pre-Meal Administration of Betaglucans on Glycaemic Control and Variability in Subjects with Type 1 Diabetes

    DEFF Research Database (Denmark)

    Frid, Anders; Tura, Andrea; Pacini, Giovanni

    2017-01-01

    We conducted a double-blind placebo-controlled crossover pilot study to investigate the effect of oat betaglucans (β-glucan) on glycaemic control and variability in adults with type 1 diabetes (T1D; n = 14). Stomacol(®) tablets (1.53 g of β-glucan) or placebo (Plac) were administered three times...... daily before meals for two weeks. Glucose levels were monitored during the second week by continuous glucose monitoring (CGM). There was an increase in basic measures of glycaemic control (maximal glucose value 341 ± 15 vs. 378 ± 13 mg/dL for Plac and β-glucan, p = 0.004), and average daily risk range......, with no difference in more complex measures. However, glycaemic variability increased between the first and last two CGM days on Plac, but remained unchanged on β-glucan. In conclusion, in this pilot study we were unable to demonstrate a general positive effect of β-glucan before meals on glucose control...

  5. Relationship between vitamin D levels and glycaemic control in Type 2 diabetes mellitus patients in Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Anyanwu Anthony Chinedu

    2017-01-01

    Full Text Available Background: Studies have reported a relationship between Vitamin D deficiency and type 2 diabetes mellitus (T2DM. There is no information on the Vitamin D status or relationship between Vitamin D and glycaemia in Nigerian patients with T2DM. The objective of this study was to determine the relationship between serum Vitamin D levels and glycaemic control, as determined by glycated haemoglobin (HbA1c in adult patients with T2DM. Methods: This was a cross-sectional analytical study involving T2DM participants attending the Diabetes Clinic of the Lagos University Teaching Hospital. The study participants consisted of 114 T2DM and sixty healthy controls. Levels of serum Vitamin D, fasting glucose, insulin, HbA1c, calcium, albumin, phosphate, creatinine and alanine transaminase were determined. Insulin resistance and beta cell function were estimated with the homeostasis model assessment (HOMA-IR and HOMA-B, respectively. Statistical analysis was done using Statistical Package for Social Sciences, Version 20. Results: The mean age of the study participants was 52 ± 7.6 years for T2DM patients and 50 ± 8.4 years for controls. The female to male ratio in both T2DM and healthy controls was 3:2. The mean HbA1c was 7.3 ± 1.8%. Poor glycaemic control (HbA1c >6.5% was present in 67 (58.8% T2DM controls; forty-five (39.5% subjects had both low Vitamin D levels and poor glycaemic control. There was a significant inverse correlation between serum Vitamin D concentration and HbA1c levels in T2DM patients (rs= −0.185; P < 0.05 A non-significant inverse association was seen between serum Vitamin D level and HOMA-IR. Conclusion: This study shows an inverse association between serum levels of Vitamin D and glycaemic control, as determined by HbA1c. T2DM patients with poor glycaemic control may need to be assessed for serum Vitamin D levels and possibly treated for Vitamin D deficiency.

  6. Ischaemic heart disease and glycaemic control in type-2 diabetes mellitus by questionnaire method

    International Nuclear Information System (INIS)

    Yathish, T.R.; Annamalai, N.; Shankar, V.

    2010-01-01

    Background: Various tests like Echocardiogram, Nuclear scan, Electron-beam computed tomography, Coronary angiography, and magnetic resonance angiography are available for diagnosis of ischemic heart disease (IHD). But most of these are expensive, invasive and cannot be afforded in developing countries. An attempt was made to study sensitivity, specificity, and predictive value of non-invasive technique like questionnaire method and compared with traditional clinical evaluation. This study compared diagnosis of angina made with the Rose uestionnaire to diagnosis by physician in type-2 diabetes mellitus and the effect of glycaemic control. Methods: A cross-sectional study was done from March 2005 to March 2006. Cases were collected from outpatients and inpatients visiting RL Jalappa hospital and SNR Hospital attached to Sri Devraj Urs Medical College Kolar, Karnataka, India. Glycosylated haemoglobin levels were estimated. Data on Rose questionnaire angina and physician diagnosed angina were collected and compared between groups of well controlled diabetics, poorly controlled diabetics and controls. The 12 lead Electrocardiogram was used to confirm the diagnosis. Results: The Rose questionnaire had 63.63% sensitivity, 97.5% specificity, 73% positive predictive value, and 96% negative predictive value. This study also showed the occurrence of IHD was higher in the poorly controlled diabetics (16.3%) as compared to well controlled diabetic patients (6%) and controls (5%) which were significant. Conclusions: The questionnaire diagnosis showed good sensitivity and high specificity as compared with diagnosis by physicians. The questionnaire method can be frequently used and incorporated in cardiovascular risk assessment and epidemiologic screening programs. (author)

  7. Clinical benefits of tight glycaemic control: focus on the intensive care unit.

    Science.gov (United States)

    Mesotten, Dieter; Van den Berghe, Greet

    2009-12-01

    While stress hyperglycaemia has traditionally been regarded as an adaptive, beneficial response, it is clear that hyperglycaemia and hypoglycaemia are associated with increased risk of death in critically ill intensive care unit (ICU) patients. Recent studies on blood-glucose control failed to fully clarify whether this association is causal. Early proof-of-concept single-centre randomised controlled studies found that maintaining normoglycaemia by intensive insulin therapy, as compared with tolerating hyperglycaemia as an adaptive response, improved patient outcome. However, recent large multicentre studies VISEP, GLUCONTROL and NICE-SUGAR) could not confirm this survival benefit. Methodological disparity in the execution of the complex intervention of tight glycaemic control may have contributed significantly to the contradicting results. First, different target ranges for blood glucose were used in the control group of the GLUCONTROL and 'Normoglycemia in intensive care evaluation and survival using glucose algorithm' regulation' (NICE-SUGAR) studies. Second, problems to steer blood-glucose levels within target range in the intervention group resulted in a significant overlap of the treatment groups. Third, allowing inaccurate blood-glucose measurement devices, in combination with different blood sampling sites and types of infusion pumps, may have led to unnoticed swings in blood-glucose levels. Fourth, the level of expertise of the intensive care nurses with the therapy may have been variable due to low number of study patients per centre. Finally, the studies on tight blood-glucose control were done with vastly different nutritional and end-of-life strategies. The currently available studies do not allow to confidently recommend one optimal target for glucose in heterogeneous ICU patient groups and settings. Provided that adequate devices for blood-glucose measurement and insulin administration are available, together with an extensive experience of the

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

    Science.gov (United States)

    Vergnes, Jean-Noel; Arrivé, Elise; Gourdy, Pierre; Hanaire, Hélène; Rigalleau, Vincent; Gin, Henri; Sédarat, Cyril; Dorignac, Georges; Bou, Christophe; Sixou, Michel; Nabet, Cathy

    2009-08-02

    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. 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. 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. Current Controlled Trials ISRCTN15334496.

  9. Glycaemic control and cardiovascular risk factor management in patients with diabetes with and without coronary artery disease: insights from the diabetes mellitus status in Canada survey.

    Science.gov (United States)

    Grenier, Jasmine; Leiter, Lawrence A; Langer, Anatoly; Goldin, Lianne; Teoh, Hwee; Connelly, Kim A; Cheng, Alice Y Y; Tan, Mary K; Fitchett, David; McGuire, Darren K; Goodman, Shaun G; Yan, Andrew T

    2016-10-01

    Current diabetes guidelines recommend an individualized approach to glycaemic control. There are limited data on the contemporary and comprehensive management of patients with diabetes in relation to coronary artery disease (CAD). The Diabetes Mellitus Status in Canada (DM-SCAN) survey included 5123 patients with type 2 diabetes seen in primary care in November 2012. Primary care physicians (PCPs) collected clinical data and specified the A1C target for each patient on standardized forms. We compared management strategies and achievement of treatment targets in patients with and without CAD. Among the 4994 patients with data on CAD history, 22.5% had CAD. Primary care physicians were more likely to select a higher A1C target for patients with CAD (≤7.5 or ≤8.0%) versus without (≤7.0%). There was no difference in median A1C or in the proportion of patients with A1C ≤7.0% between the two groups. Compared with the group without known CAD, patients with CAD had a higher reported prevalence of hypoglycaemia in the preceding 6 months; more frequently received aspirin, statins, ACE inhibitors, or angiotensin receptor blockers, and were more likely to achieve blood pressure and low-density lipoprotein-cholesterol targets. Only 15.4 and 12.0% of patients with and without CAD (P = 0.002), respectively, achieved all three guideline-recommended targets. Compared with patients with diabetes without CAD, those with CAD more frequently had a less stringent A1C target selected by their PCPs but achieved similar glycaemic control. Overall, risk factor management remained suboptimal in both groups. There remains an important opportunity to improve the care and outcome of patients with diabetes.

  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. Challenges of optimizing glycaemic control in children with Type 1 diabetes: a qualitative study of parents' experiences and views.

    Science.gov (United States)

    Lawton, J; Waugh, N; Barnard, K D; Noyes, K; Harden, J; Stephen, J; McDowell, J; Rankin, D

    2015-08-01

    To explore the difficulties parents encounter in trying to achieve clinically recommended blood glucose levels and how they could be better supported to optimize their child's glycaemic control. In-depth interviews were conducted with 54 parents of children with Type 1 diabetes (≤ 12 years). Data were analysed thematically. Parents described being reluctant and finding it difficult to keep their child's blood glucose levels consistently within clinically recommended ranges. As well as worrying about their child's ability to detect/report hypoglycaemia, parents highlighted a multitude of factors that had an impact on their child's blood glucose levels and over which they could exercise little control. These included: leaving their child with other caregivers who could not be trusted to detect hypoglycaemia; difficulties remotely monitoring and regulating their child's food consumption and activity; and physical and social changes accompanying childhood development. Most parents used two sets of blood glucose targets, with clinically recommended targets employed when their child was in their immediate care and higher targets when in the care of others. Parents described health professionals as lacking understanding of the difficulties they encountered keeping blood glucose within target ranges and needing more empathetic, tailored and realistic advice. It is not parents' fear of hypoglycaemia in isolation that leads to decisions to raise their child's blood glucose but, rather, parental fear in conjunction with other factors and considerations. Hence, to improve diabetes management in children, these factors may need to be addressed; for instance, by training others in diabetes management and using new technologies. Changes to consultations are also recommended. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  12. 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 ppatients were included in the study. The mean age (SD) of these patients was 50.77±9.671 years, 56.6% were males and 90% (n=353) of respondents were married. The mean (SD) duration of disease was 5.58 (4.09) years with median HbA1c of 9.00 (IQR=8.20-10.40). The median knowledge 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.

  13. Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting.

    Science.gov (United States)

    Tharek, Zahirah; Ramli, Anis Safura; Whitford, David Leonard; Ismail, Zaliha; Mohd Zulkifli, Maryam; Ahmad Sharoni, Siti Khuzaimah; Shafie, Asrul Akmal; Jayaraman, Thevaraajan

    2018-03-09

    Self-efficacy has been shown to be positively correlated with self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus. However, such evidence is lacking in the Malaysian primary care setting. The objectives of this study were to i) determine the levels of self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting ii) determine the relationship between self-efficacy, self-care behaviour and glycaemic control iii) determine the factors associated with glycaemic control. This was a cross-sectional study involving patients with type 2 diabetes mellitus from two public primary care clinics in Malaysia. Self-efficacy and self-care behaviour levels were measured using previously translated and validated DMSES and SDSCA questionnaires in Malay versions, respectively. Glycaemic control was measured using HbA 1c. RESULTS: A total of 340 patients with type 2 diabetes mellitus were recruited. The total mean (±SD) of self-efficacy and self-care behaviour scores were 7.33 (±2.25) and 3.76 (±1.87), respectively. A positive relationship was found between self-efficacy and self-care behaviour (r 0.538, P self-efficacy score was shown to be correlated with lower HbA 1c (r - 0.41, P self-efficacy scores (b - 0.398; 95% CI: -0.024, - 0.014; P diabetes (b 0.177; 95% CI: 0.002, 0.007; P self-efficacy was correlated with improved self-care behaviour and better glycaemic control. Findings of this study suggest the importance of including routine use of self-efficacy measures in the management of type 2 diabetes mellitus in primary care.

  14. 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

    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......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 glycaemic control, diabetes-specific emotional distress appears to be an important mediator. Addressing diabetes-specific emotional problems as part of depression treatment in diabetes patients may help improve glycaemic outcomes....

  15. Does the ingestion of a 24 hour low glycaemic index Asian mixed meal diet improve glycaemic response and promote fat oxidation? A controlled, randomized cross-over study.

    Science.gov (United States)

    Camps, Stefan Gerardus; Kaur, Bhupinder; Quek, Rina Yu Chin; Henry, Christiani Jeyakumar

    2017-07-12

    The health benefits of consuming a low glycaemic index (GI) diet to reduce the risk of type 2 Diabetes are well recognized. In recent years the GI values of various foods have been determined. Their efficacy in constructing and consuming a low GI diet over 24 h in modulating glycaemic response has not been fully documented. The translation of using single-point GI values of foods to develop a 24 h mixed meal diet can provide valuable information to consumers, researchers and dietitians to optimize food choice for glycaemic control. By using GI values of foods to develop mixed meals, our study is the first to determine how both blood glucose and substrate oxidation may be modulated over 24 h. The study included 11 Asian men with a BMI between 17-24 kg/m 2 who followed both a 1-day low GI and 1-day high GI diet in a randomized, controlled cross-over design. Test meals included breakfast, lunch, snack and dinner. Glycaemic response was measured continuously for over 24 h and postprandial substrate oxidation for 10 h inside a whole body calorimeter. The low GI diet resulted in lower 24 h glucose iAUC (860 ± 440 vs 1329 ± 614 mmol/L.min; p = 0.014) with lower postprandial glucose iAUC after breakfast (p low GI vs high GI diet (1.44 ± 0.63 vs 2.33 ± 0.82 mmol/L; p fat oxidation was less during the low vs high GI diet (-0.033 ± 0.021 vs -0.050 ± 0.017 g/min; p low GI local foods to construct a 24 h low GI diet, is able to reduce glycaemic response and variability as recorded by continuous glucose monitoring. Our observations also confirm that a low GI diet promotes fat oxidation over carbohydrate oxidation when compared to a high GI diet. These observations provide public health support for the encouragement of healthier nutrition choices by consuming low GI foods. NCT 02631083 (Clinicaltrials.gov).

  16. 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

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

    Science.gov (United States)

    Madsen, Søren Møller; Thorup, Anne Cathrine; Overgaard, Kristian; Jeppesen, Per Bendix

    2015-01-01

    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 (V˙O2max) 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

  18. 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

  19. 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

  20. 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

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

    NARCIS (Netherlands)

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

    2017-01-01

    Objective 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. Methods Data from the GUIDANCE

  2. Clinical, behavioural and social indicators for poor glycaemic control around the time of transfer to adult care: a longitudinal study of 126 young people with diabetes

    DEFF Research Database (Denmark)

    Castensøe-Seidenfaden, P.; Jensen, A. K.; Smedegaard, H.

    2017-01-01

    participants aged 14–22 years from 2 years before to 2 years after transfer from paediatric to adult care. Changes in glycaemic control were calculated using repeated measurements. We adjusted for gender, age at diabetes onset, age at transfer, duration of diabetes at transfer, gap (amount of time) between...... levels and thereby reduce hospitalization rates....

  3. The effect of tight glycaemic control, during and after cardiac surgery, on patient mortality and morbidity: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Carter Gordon H

    2011-01-01

    Full Text Available Abstract Background Hyperglycaemia is a common occurrence during cardiac surgery, however, there remains some uncertainty surrounding the role of tight glycaemic control (blood glucose Method The literature was systematically reviewed, based on pre-determined search criteria, for clinical trials evaluating the effect of tight versus normal glycaemic control during and/or after cardiac surgery. Each paper was reviewed by two, independent reviewers and data extracted for statistical analysis. Data from identified studies was combined using meta-analysis (RevMan5®. The results are presented either as odds ratios (OR or mean differences (MD with 95% confidence intervals (CIs. Results A total of seven randomised controlled trials (RCTs were identified in the literature, although not all trials could be used in each analysis. Tight glycaemic control reduced the incidence of early mortality (death in ICU (OR 0.52 [95% CI 0.30, 0.91]; of post-surgical atrial fibrillation (odds ratio (OR 0.76 [95%CI 0.58, 0.99]; the use of epicardial pacing (OR 0.28 [95%CI 0.15, 0.54]; the duration of mechanical ventilation (mean difference (MD -3.69 [95% CI -3.85, -3.54] and length of stay in the intensive care unit (ICU (MD -0.57 [95%CI -0.60, -0.55] days. Measures of the time spent on mechanical ventilation (I2 94% and time spent in ICU (I2 99% both had high degrees of heterogeneity in the data. Conclusion The results from this study suggest that there may be some benefit to tight glycaemic control during and after cardiac surgery. However, due to the limited number of studies available and the significant variability in glucose levels; period of control; and the reporting of outcome measures, further research needs to be done to provide a definitive answer on the benefits of tight glycaemic control for cardiac surgery patients.

  4. Effects of diabetes self-management education on glycaemic control in children with insulin-dependent diabetes mellitus

    International Nuclear Information System (INIS)

    Qayyum, A.A.; Lone, S.W.; Ibrahim, M.N.; Raza, J.

    2010-01-01

    To evaluate the effect of diabetes self-management education (DSME) on glycaemic control (HbA1c) in Pakistani children suffering from type-1 diabetes mellitus. Study Design: Quasi-experimental study. Place and Duration of Study: This study was conducted at the Diabetic OPD of National Institute of Child Health, Karachi, from April to September 2009. Methodology: Sixty children with a mean age of 9.94 years with type-1 Diabetes mellitus (T1DM) were selected conveniently from the diabetic OPD. The patients along with their parents/caregivers attended a modular series of diabetes self-management education program consisting of 2 sessions. Customized program was designed to educate children regarding general information about the disease, basic insulin therapy, planning for hypoglycaemia, hyperglycaemia, activity, traveling and basic nutritional management. It was conducted by a multidisciplinary paediatric diabetes team including an endocrinologist, general paediatrician, nutritionist and diabetic nurse. The educational sessions were followed by monthly revision exercises. HbA1c levels were measured at baseline and after 3 months and compared using paired sample t-test. Results: Out of a total of 60 patients, 50 completed the trial. There was a significant decrease in the HbA1c levels after the DSME program. The mean pre- and post intervention HbA1c levels were 9.67 +- 0.65 and 8.49 +- 0.53 respectively with a p-value < 0.001. Conclusion: In the studied group, DSME programs helped to improve glycaemic control. It should be an integral part of patient treatment in diabetic care setups. (author)

  5. The Effectiveness of Pharmacological and Non-Pharmacological Interventions for Improving Glycaemic Control in Adults with Severe Mental Illness: A Systematic Review and Meta-Analysis

    OpenAIRE

    Taylor, Johanna; Stubbs, Brendon; Hewitt, Catherine; Ajjan, Ramzi A.; Alderson, Sarah L.; Gilbody, Simon; Holt, Richard I. G.; Hosali, Prakash; Hughes, Tom; Kayalackakom, Tarron; Kellar, Ian; Lewis, Helen; Mahmoodi, Neda; McDermid, Kirstine; Smith, Robert D.

    2017-01-01

    People with severe mental illness (SMI) have reduced life expectancy compared with the general population, which can be explained partly by their increased risk of diabetes. We conducted a meta-analysis to determine the clinical effectiveness of pharmacological and non-pharmacological interventions for improving glycaemic control in people with SMI (PROSPERO registration: CRD42015015558). A systematic literature search was performed on 30/10/2015 to identify randomised controlled trials (RCTs...

  6. Therapeutic education among adults with type 2 diabetes: effects of a three-day intervention on perceived competence, self-management behaviours and glycaemic control.

    Science.gov (United States)

    Trouilloud, David; Regnier, Jennifer

    2013-06-01

    The purpose of this study was to evaluate the impact of a three-day therapeutic education programme on perceived competence, self-management behaviours (i.e. physical activity, diet and medication) and glycaemic control among adults with type 2 diabetes. A total of 120 participants were included in this randomized, wait list control group trial. The results confirm that therapeutic education may be a powerful healthcare intervention to improve lifestyle and health status of people with type 2 diabetes. We observed that the education programme used in this study generated positive changes in glycaemic control and adherence to physical activity and diet after three months follow-up. Furthermore, the intervention positively impacted participants' perceived competence towards physical activity and diet. The latter finding is of particular importance, given that perceived competence has been found to be involved in long-term adherence to self-management behaviours.

  7. Effects of exercise training using resistance bands on glycaemic control and strength in type 2 diabetes mellitus: a meta-analysis of randomised controlled trials.

    Science.gov (United States)

    McGinley, Samantha K; Armstrong, Marni J; Boulé, Normand G; Sigal, Ronald J

    2015-04-01

    Resistance exercise using free weights or weight machines improves glycaemic control and strength in people with type 2 diabetes. Resistance band training is potentially less expensive and more accessible, but the effects of resistance band training on glycaemic control and strength in this population are not well understood. This paper aims to systematically review and meta-analyse the effect of resistance band training on haemoglobin A1c (HbA1c) and strength in adults with type 2 diabetes. Database searches were performed in August 2013 (MEDLINE, SPORTDiscus, EMBASE, and CINAHL). Reference lists of eligible articles were hand-searched for additional studies. Randomised trials evaluating the effects of resistance band training in adults with type 2 diabetes on HbA1c or objectively measured strength were selected. Baseline and post-intervention HbA1c and strength were extracted for the intervention and control groups. Details of the exercise interventions and methodological quality were collected. Seven trials met inclusion criteria. Post-intervention-weighted mean HbA1c was nonsignificantly lower in exercise groups compared to control groups [weighted mean difference (WMD) = -0.18 percentage points (-1.91 mmol/mol); P = 0.27]. Post-intervention strength was significantly higher in the exercise groups compared to the control groups in the lower extremities (WMD = 21.90 kg; P diabetes.

  8. 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

    clinical review only. Other information obtained was age, sex, body mass index, waist circumference, blood pressure, urine albumin-creatinine ratio, duration since diagnosis and medication. RESULTS: One hundred and one patients with DM (type 1 DM = 23, type 2 DM = 78) were included. Spearman's rank......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.......24-0.32, P AUC = 0.80, SE = 0.05), RBG ≤7.5 mmol/l was determined as the optimal cut-off value for good glycaemic control (HbA1c

  9. Comparison of vildagliptin and glimepiride: effects on glycaemic control, fat tolerance and inflammatory markers in people with type 2 diabetes.

    Science.gov (United States)

    Derosa, G; Bonaventura, A; Bianchi, L; Romano, D; Fogari, E; D'Angelo, A; Maffioli, P

    2014-12-01

    To compare the effects of vildagliptin with those of glimepiride on glycaemic control, fat tolerance and inflammatory markers in people with Type 2 diabetes mellitus receiving metformin treatment. A total of 167 participants were randomized to vildagliptin 50 mg twice a day or glimepiride 2 mg three times a day, for 6 months. We evaluated the following variables: BMI; glycaemic control; fasting plasma insulin; homeostatic model assessment of insulin resistance index; fasting plasma proinsulin; glucagon; lipid profile; adiponectin; high-sensitivity C-reactive protein; interleukin-6; and tumour necrosis factor-α. A euglycaemic-hyperinsulinaemic clamp procedure and an oral fat load test were also performed. Despite a similar decrease in HbA1c levels (P = 0.009, and P = 0.008, respectively), body weight increased with glimepiride (P = 0.048 vs baseline) and decreased with vildagliptin (P = 0.041 vs baseline and vs glimepiride). Fasting plasma insulin and homeostatic model assessment of insulin resistance index were significantly lower with vildagliptin compared with glimepiride (P = 0.035 and 0.047). M value, an index of insulin sensitivity, increased with vildagliptin, both compared with baseline and with glimepiride (P = 0.028 and 0.039, respectively). Vildagliptin improved all post-oral fat load peaks of lipid profile compared with glimepiride. Adiponectin levels were higher (P = 0.035) and high-sensitivity C-reactive protein levels were lower (P = 0.038) with vildagliptin vs glimepiride. During the oral fat load test, interleukin-6, high-sensitivity C-reactive protein and tumour necrosis factor-α peaks were lower and adiponectin peak was higher in the vildagliptin group than in the glimepiride group. There was a higher dropout rate as a result of hypoglycaemia in the glimepiride group than in the vildagliptin group. Vildagliptin was more effective than glimepiride in reducing post-oral fat load peaks of lipid-trafficking adipocytokines and

  10. 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.

  11. Effects of lifestyle intervention and meal replacement on glycaemic and body-weight control in Chinese subjects with impaired glucose regulation: a 1-year randomised controlled trial.

    Science.gov (United States)

    Xu, Dan-Feng; Sun, Jian-Qin; Chen, Min; Chen, Yan-Qiu; Xie, Hua; Sun, Wei-Jia; Lin, Yi-Fan; Jiang, Jing-Jing; Sun, Wei; Chen, Ai-Fang; Tang, Qian-Ru

    2013-02-14

    The purpose of the present study was to evaluate the impact of a lifestyle intervention programme, combined with a daily low-glycaemic index meal replacement, on body-weight and glycaemic control in subjects with impaired glucose regulation (IGR). Subjects with IGR were randomly assigned to an intervention group (n 46) and a control group (n 42). Both groups received health counselling at baseline. The intervention group also received a daily meal replacement and intensive lifestyle intervention to promote healthy eating habits during the first 3 months of the study, and follow-up visits performed monthly until the end of the 1-year study. Outcome measurements included changes in plasma glucose, glycated Hb (HbA1c), plasma lipids, body weight, blood pressure and body composition (such as body fat mass and visceral fat area). The results showed that body-weight loss after 1 year was significant in the intervention group compared with the control group (-1·8 (SEM 0·35) v. -0·6 (SEM 0·40) 2·5 kg, Pmeal replacement is beneficial in promoting IGR to NGR.

  12. Understanding the inter-relationship between improved glycaemic control, hypoglycaemia and weight change within a long-term economic model.

    Science.gov (United States)

    McEwan, P; Evans, M; Kan, H; Bergenheim, K

    2010-05-01

    Current guidelines for the management of type 2 diabetes advocate the attainment of sustained near normal glycaemia levels. Metformin is widely accepted as the treatment of choice for the initiation of pharmacotherapy; however, secondary failure of oral monotherapy occurs in 60% of patients resulting in the need for multiple pharmacotherapies. Therapy-related consequences of treatment, such as weight gain and hypoglycaemia impact on the cost-effectiveness profile of various agents. We therefore sought to ascertain the respective contribution of hypoglycaemia, weight change and improved blood glucose control on second-line therapy options added to metformin. This study uses a simulation model designed to evaluate the cost utility of new therapies in a population of patients with type 2 diabetes mellitus. Standard model outputs include incidence of micro- and macrovascular complications and diabetes-specific and all-cause mortality. The mean discounted quality-adjusted life year (QALY) predicted by the model was 12.31 years. Reducing Glycosylated haemoglobin (HbA1c) by 1% gave a predicted gain of 0.413 QALYs per patient. A 3-kg weight loss and 30% reduction in hypoglycaemia frequency produced a combined QALY gain of 0.355, whereas the reverse gave a QALY decrement of 0.356. The results of this analysis quantify the QALY decrement that may result from adverse therapy effects. The beneficial effects of improved glycaemic control on QALYs may be offset by characteristic treatment-specific adverse effects, such as weight gain and hypoglycaemia frequency.

  13. A Low Glycaemic Index Diet in Pregnancy Induces DNA Methylation Variation in Blood of Newborns: Results from the ROLO Randomised Controlled Trial

    Directory of Open Access Journals (Sweden)

    Aisling A. Geraghty

    2018-04-01

    Full Text Available The epigenetic profile of the developing fetus is sensitive to environmental influence. Maternal diet has been shown to influence DNA methylation patterns in offspring, but research in humans is limited. We investigated the impact of a low glycaemic index dietary intervention during pregnancy on offspring DNA methylation patterns using a genome-wide methylation approach. Sixty neonates were selected from the ROLO (Randomised cOntrol trial of LOw glycaemic index diet to prevent macrosomia study: 30 neonates from the low glycaemic index intervention arm and 30 from the control, whose mothers received no specific dietary advice. DNA methylation was investigated in 771,484 CpG sites in free DNA from cord blood serum. Principal component analysis and linear regression were carried out comparing the intervention and control groups. Gene clustering and pathway analysis were also explored. Widespread variation was identified in the newborns exposed to the dietary intervention, accounting for 11% of the total level of DNA methylation variation within the dataset. No association was found with maternal early-pregnancy body mass index (BMI, infant sex, or birthweight. Pathway analysis identified common influences of the intervention on gene clusters plausibly linked to pathways targeted by the intervention, including cardiac and immune functioning. Analysis in 60 additional samples from the ROLO study failed to replicate the original findings. Using a modest-sized discovery sample, we identified preliminary evidence of differential methylation in progeny of mothers exposed to a dietary intervention during pregnancy.

  14. 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.

    Science.gov (United States)

    Rasmussen, Jon B; Nordin, Lovisa S; Rasmussen, Niclas S; Thomsen, Jakúp A; Street, Laura A; Bygbjerg, Ib C; Christensen, Dirk L

    2014-12-01

    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. Cross-sectional study at St. Francis' Hospital in eastern Zambia. RBG and HbA1c were measured during one clinical review only. Other information obtained was age, sex, body mass index, waist circumference, blood pressure, urine albumin-creatinine ratio, duration since diagnosis and medication. One hundred and one patients with DM (type 1 DM = 23, type 2 DM = 78) were included. Spearman's rank correlation coefficient revealed a significant correlation between RBG and HbA1c among the patients with type 2 DM (r = 0.73, P AUC = 0.80, SE = 0.05), RBG ≤7.5 mmol/l was determined as the optimal cut-off value for good glycaemic control (HbA1c blood glucose could possibly be used to assess glycaemic control among patients with type 2 DM in rural settings of sub-Saharan Africa. © 2014 John Wiley & Sons Ltd.

  15. Patient-Related Determinants of Glycaemic Control in People with Type 2 Diabetes in the Gulf Cooperation Council Countries: A Systematic Review.

    Science.gov (United States)

    Alramadan, Mohammed J; Afroz, Afsana; Hussain, Sultana Monira; Batais, Mohammed Ali; Almigbal, Turky H; Al-Humrani, Hassan Ahmad; Albaloshi, Ahmed; Romero, Lorena; Magliano, Dianna J; Billah, Baki

    2018-01-01

    The aim of this systematic review is to assess patient-related factors affecting glycaemic control among people with type 2 diabetes in the Arabian Gulf Council countries. MEDLINE, Embase, PsycINFO, CINAHL, and Cochrane CENTRAL databases were searched from their date of inception to May 2016. Two researchers independently identified eligible studies and assessed the risk of bias. A total of 13 studies met the inclusion criteria. One study was population based, six recruited participants from multiple centres, and the remaining were single centred. The majority of the studies were of low to moderate quality. Factors associated with poor glycaemic control include longer duration of diabetes, low level of education, poor compliance to diet and medication, poor attitude towards the disease, poor self-management behaviour, anxiety, depression, renal impairment, hypertension, and dyslipidaemia. Healthcare providers should be aware of these factors and provide appropriate education and care especially for those who have poor glycaemic control. Innovative educational programs should be implemented in the healthcare systems to improve patient compliance and practices. A variation in the results of the included studies was observed, and some potentially important risk factors such as dietary habits, physical activity, family support, and cognitive function were not adequately addressed. Further research is needed in this area.

  16. 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

    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......' 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......-cholesterol and creatinine levels were unaffected. Diabetes failed to increase atherosclerosis in any of the vessels examined. The plaque burden in the aorta and right coronary artery was comparable between the groups, and was even reduced in the left anterior descending (LAD) coronary and iliofemoral arteries...

  17. Glycaemic Index and Glycaemic Load of Pounded yam in Diabetic ...

    African Journals Online (AJOL)

    Incremental area under the blood glucose curve (IAUC) was used to determine the glycaemic index. Glycaemic load was determined using the percentage of available carbohydrate in the meal multiplied by the glycaemic index. Result: The glycaemic index of pounded yam was 61 and 59 in the diabetic type-2 and healthy ...

  18. 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

    AIMS/HYPOTHESIS: We aimed to identify circulating microRNA (miRNA) that predicts clinical progression in a cohort of 123 children with new-onset type 1 diabetes mellitus. METHODS: Plasma samples were prospectively obtained at 1, 3, 6, 12 and 60 months after diagnosis from a subset of 40 children......RNAs revealed significant enrichment for pathways related to gonadotropin-releasing hormone receptor and angiogenesis pathways. CONCLUSIONS/INTERPRETATION: The miRNA hsa-miR-197-3p at 3 months was the strongest predictor of residual beta cell function 1 year after diagnosis in children with type 1 diabetes...... 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...

  19. The effect on glycaemic control of low-volume high-intensity interval training versus endurance training in individuals with type 2 diabetes.

    Science.gov (United States)

    Winding, Kamilla M; Munch, Gregers W; Iepsen, Ulrik W; Van Hall, Gerrit; Pedersen, Bente K; Mortensen, Stefan P

    2018-05-01

    To evaluate whether high-intensity interval training (HIIT) with a lower time commitment can be as effective as endurance training (END) on glycaemic control, physical fitness and body composition in individuals with type 2 diabetes. A total of 29 individuals with type 2 diabetes were allocated to control (CON; no training), END or HIIT groups. Training groups received 3 training sessions per week consisting of either 40 minutes of cycling at 50% of peak workload (END) or 10 1-minute intervals at 95% of peak workload interspersed with 1 minute of active recovery (HIIT). Glycaemic control (HbA1c, oral glucose tolerance test, 3-hour mixed meal tolerance test with double tracer technique and continuous glucose monitoring [CGM]), lipolysis, VO 2 peak and body composition were evaluated before and after 11 weeks of intervention. Exercise training increased VO 2 peak more in the HIIT group (20% ± 20%) compared with the END group (8% ± 9%) despite lower total energy expenditure and time usage during the training sessions. HIIT decreased whole body and android fat mass compared with the CON group. In addition, visceral fat mass, HbA1c, fasting glucose, postprandial glucose, glycaemic variability and HOMA-IR decreased after HIIT. The reduced postprandial glucose in the HIIT group was driven primarily by a lower rate of exogenous glucose appearance. In the CON group, postprandial lipolysis was augmented over the 11-week control period. Despite a ~45% lower training volume, HIIT resulted in similar or even better improvements in physical fitness, body composition and glycemic control compared to END. HIIT therefore appears to be an important time-efficient treatment for individuals with type 2 diabetes. © 2017 John Wiley & Sons Ltd.

  20. 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 HbA 1c , 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 HbA 1c as outcome variable. Combining these studies no significant effect in change of HbA 1c 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 HbA 1c  ≥ 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.

  1. Nurse-led implementation of an insulin-infusion protocol in a general intensive care unit: improved glycaemic control with increased costs and risk of hypoglycaemia signals need for algorithm revision

    Directory of Open Access Journals (Sweden)

    Bull Eva M

    2008-01-01

    for improved glycaemic control within our ICU. This might be achieved through an improved algorithm and continued efforts to increase nurses' confidence and skills in achieving SGC.

  2. 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...... studied Caucasian patients with Type I (insulin-dependent) diabetes mellitus and nephropathy (120 men 74 women, age 41.1 +/- 9.6 years, diabetes duration 28 +/- 8 years) and long-standing Type I diabetic patients with persistent normoalbuminuria (112 men 69 women, age 42.5 +/- 10.0 years, diabetes...... duration 27 +/- 9 years). Genotyping was PCR-based and metabolic control estimated from all measurements of HbA1c done in each patient [average (range) n = 31 (6-74)]. The median observation time (range) was 13.5 (2-14) years. RESULTS: Type I diabetic patients with a history of poor glycaemic control (HbA1...

  3. Glycaemic control and the risk of mortality in elderly type 2 diabetic patients (ZODIAC-20)

    NARCIS (Netherlands)

    van Hateren, K. J. J.; Kleefstra, N.; Drion, I.; Groenier, K. H.; Houweling, S. T.; Bilo, H. J. G.; Landman, G.

    P>Aims: Studies on macrovascular consequences of glucose control in elderly patients (> 75 years) with type 2 diabetes mellitus (T2DM) are lacking. The present study aimed to investigate the relationship between HbA(1c) and mortality in this specific population. Methods: Between 1998 and 1999, 374

  4. 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).

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

    Science.gov (United States)

    Plavšić, Ljiljana; Mitrović, Katarina; Todorović, Sladjana; Vuković, Rade; Milenković, Tatjana; Zdravković, Dragan

    2014-09-01

    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 occurance of hypoglycaemic episodes in children and adolescents with T1DM. 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 (52.30%) 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. 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 8.240%, 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). Significantly better HbA1c values and lower risk of severe hypoglycaemia were established in children and adolescents with T1DM treated with insulin analogues.

  6. 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

    was obtained in 2 7 obese women (body mass index (BMI) = 35.5 +/- 0.8 kg/m(2) ; mean +/- S.E.M., percentage of body fat (PBF) = 44 +/- 1, n = 7 impaired fasting glucose. n = 7 type 2 diabetes), 20 obese men (BMI = 35.8 +/- 0.8 kg/m(2): PBF = 33 +/- 1, n = 4 impaired-fasting-glucose; n = 6 type 2 diabetes......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......) and 12 lean sedentary healthy individuals (controls: n = 7 women, BMI = 21.8 +/- 0.7 kg/m(2), PBF = 20 +/- 2: n = 5 men, BMI = 23.6 +/- 0.5 kg/m(2). PBF = 13 +/- 2). IMTG was determined by chromatography. Results: IMTG wits increased twofold in obese women compared to obese men, lean men and lean women...

  7. GLP2: an underestimated signal for improving glycaemic control and insulin sensitivity.

    Science.gov (United States)

    Amato, Antonella; Baldassano, Sara; Mulè, Flavia

    2016-05-01

    Glucagon-like peptide 2 (GLP2) is a proglucagon-derived peptide produced by intestinal enteroendocrine L-cells and by a discrete population of neurons in the brainstem, which projects mainly to the hypothalamus. The main biological actions of GLP2 are related to the regulation of energy absorption and maintenance of mucosal morphology, function and integrity of the intestine; however, recent experimental data suggest that GLP2 exerts beneficial effects on glucose metabolism, especially in conditions related to increased uptake of energy, such as obesity, at least in the animal model. Indeed, mice lacking GLP2 receptor selectively in hypothalamic neurons that express proopiomelanocortin show impaired postprandial glucose tolerance and hepatic insulin resistance (by increased gluconeogenesis). Moreover, GLP2 acts as a beneficial factor for glucose metabolism in mice with high-fat diet-induced obesity. Thus, the aim of this review is to update and summarize current knowledge about the role of GLP2 in the control of glucose homeostasis and to discuss how this molecule could exert protective effects against the onset of related obesity type 2 diabetes. © 2016 Society for Endocrinology.

  8. 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

    was assessed: 24 h continuous glucose monitoring (CGM) and urinary free 8-iso prostaglandin F2α (8-iso PGF2α; a marker for oxidative stress), physical fitness and body composition. Neither participants nor assessors were blinded to the interventions. RESULTS: No intervention-induced changes were seen...... 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...... 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...

  9. 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, -gestational diabetes. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. 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 prediabetes and T2DM groups. The results showed fasting glucose ( p = 0.001), BMI ( p = 0.001), smoking history ( p = 0.003), and dietary vitamin 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.

  11. Quantifying the effects of diuretics and β-adrenoceptor blockers on glycaemic control in diabetes mellitus - a systematic review and meta-analysis.

    Science.gov (United States)

    Hirst, Jennifer A; Farmer, Andrew J; Feakins, Benjamin G; Aronson, Jeffrey K; Stevens, Richard J

    2015-05-01

    Although there are reports that β-adrenoceptor antagonists (beta-blockers) and diuretics can affect glycaemic control in people with diabetes mellitus, there is no clear information on how blood glucose concentrations may change and by how much. We report results from a systematic review to quantify the effects of these antihypertensive drugs on glycaemic control in adults with established diabetes. We systematically reviewed the literature to identify randomized controlled trials in which glycaemic control was studied in adults with diabetes taking either beta-blockers or diuretics. We combined data on HbA1c and fasting blood glucose using fixed effects meta-analysis. From 3864 papers retrieved, we found 10 studies of beta-blockers and 12 studies of diuretics to include in the meta-analysis. One study included both comparisons, totalling 21 included reports. Beta-blockers increased fasting blood glucose concentrations by 0.64 mmol l(-1) (95% CI 0.24, 1.03) and diuretics by 0.77 mmol l(-1) (95% CI 0.14, 1.39) compared with placebo. Effect sizes were largest in trials of non-selective beta-blockers (1.33, 95% CI 0.72, 1.95) and thiazide diuretics (1.69, 95% CI 0.60, 2.69). Beta-blockers increased HbA1c concentrations by 0.75% (95% CI 0.30, 1.20) and diuretics by 0.24% (95% CI -0.17, 0.65) compared with placebo. There was no significant difference in the number of hypoglycaemic events between beta-blockers and placebo in three trials. Randomized trials suggest that thiazide diuretics and non-selective beta-blockers increase fasting blood glucose and HbA1c concentrations in patients with diabetes by moderate amounts. These data will inform prescribing and monitoring of beta-blockers and diuretics in patients with diabetes. © 2014 The British Pharmacological Society.

  12. Quantifying the effects of diuretics and β-adrenoceptor blockers on glycaemic control in diabetes mellitus – a systematic review and meta-analysis

    Science.gov (United States)

    Hirst, Jennifer A; Farmer, Andrew J; Feakins, Benjamin G; Aronson, Jeffrey K; Stevens, Richard J

    2015-01-01

    Aims Although there are reports that β-adrenoceptor antagonists (beta-blockers) and diuretics can affect glycaemic control in people with diabetes mellitus, there is no clear information on how blood glucose concentrations may change and by how much. We report results from a systematic review to quantify the effects of these antihypertensive drugs on glycaemic control in adults with established diabetes. Methods We systematically reviewed the literature to identify randomized controlled trials in which glycaemic control was studied in adults with diabetes taking either beta-blockers or diuretics. We combined data on HbA1c and fasting blood glucose using fixed effects meta-analysis. Results From 3864 papers retrieved, we found 10 studies of beta-blockers and 12 studies of diuretics to include in the meta-analysis. One study included both comparisons, totalling 21 included reports. Beta-blockers increased fasting blood glucose concentrations by 0.64 mmol l−1 (95% CI 0.24, 1.03) and diuretics by 0.77 mmol l−1 (95% CI 0.14, 1.39) compared with placebo. Effect sizes were largest in trials of non-selective beta-blockers (1.33, 95% CI 0.72, 1.95) and thiazide diuretics (1.69, 95% CI 0.60, 2.69). Beta-blockers increased HbA1c concentrations by 0.75% (95% CI 0.30, 1.20) and diuretics by 0.24% (95% CI −0.17, 0.65) compared with placebo. There was no significant difference in the number of hypoglycaemic events between beta-blockers and placebo in three trials. Conclusions Randomized trials suggest that thiazide diuretics and non-selective beta-blockers increase fasting blood glucose and HbA1c concentrations in patients with diabetes by moderate amounts. These data will inform prescribing and monitoring of beta-blockers and diuretics in patients with diabetes. PMID:25377481

  13. Differences in diabetes prevalence and inequalities in disease management and glycaemic control by immigrant status: a population-based study (Italy).

    Science.gov (United States)

    Ballotari, Paola; Caroli, Stefania; Ferrari, Francesca; Romani, Gabriele; Marina, Greci; Chiarenza, Antonio; Manicardi, Valeria; Giorgi Rossi, Paolo

    2015-02-06

    The diabetes prevalence increases at an alarming rate around the world and understanding disparities in occurrence, care management, and health outcomes may be a starting point towards achieving more effective strategies to prevent and manage it. The aims of this study are to compare immigrants and Italians in terms of the differences in diabetes prevalence and to evaluate inequalities in disease management and glycaemic control by using information included in Reggio Emilia diabetes register. We retrieved from the diabetes register subjects aged 20-74 on December 31(st), 2009. Using citizenship, we created three main groups: Italy, High Developed Countries (HDC), and High Migration Pressure Countries (HMPC). These were split into sub-regions of origin. We calculated age-adjusted prevalence by gender and sub-region. Using logistic regression model, we analyzed the association between area of origin and following indicators: 1) not being in care of diabetes clinics; 2) not having glycated haemoglobin (HbA1c) test in 2010; 3) among those tested, having a HbA1c value > = 9% (75 mmol/mol). We found 15,889 Italian and 1,295 HMPC citizens with diabetes. HMPC citizens had higher age-adjusted prevalence of diabetes than Italians (females 5.0% vs 3.6%; males 6.5% vs 5.5%). The excess was mostly due to a strong excess in immigrants from Southern Asia (females 9.7%, males 10.2%) and Northern Africa (females 9.3%, males 5.9%). HMPC citizens were cared for by diabetes clinics in a similar proportion than Italians (OR: 1.08; 95% CI: 0.93-1.25), but had a greater odds of not being tested for HbA1c (OR: 1.51; 95% CI: 1.34-1.71), as well as of having HbA1c values equal to or over 9% (OR: 2.06; 95% CI: 1.80-3.14). The outcomes were poorer in HMPC females for the first two outcomes, while there was no difference for the HbA1c values (Wald test for heterogeneity p = 0.0850; p = 0.0156; p = 0.6635, respectively). Our findings highlight the need for gender-oriented actions for

  14. Low glycaemic index, or low glycaemic load, diets for diabetes mellitus.

    Science.gov (United States)

    Thomas, Diana; Elliott, Elizabeth J

    2009-01-21

    The aim of diabetes management is to normalise blood glucose levels, since improved blood glucose control is associated with reduction in development, and progression, of complications. Nutritional factors affect blood glucose levels, however there is currently no universal approach to the optimal dietary treatment for diabetes. There is controversy about how useful the glycaemic index (GI) is in diabetic meal planning. Improved glycaemic control through diet could minimise medications, lessen risk of diabetic complications, improve quality of life and increase life expectancy. To assess the effects of low glycaemic index, or low glycaemic load, diets on glycaemic control in people with diabetes. We performed electronic searches of The Cochrane Library, MEDLINE, EMBASE and CINAHL with no language restriction. We assessed randomised controlled trials of four weeks or longer that compared a low glycaemic index, or low glycaemic load, diet with a higher glycaemic index, or load, or other diet for people with either type 1 or 2 diabetes mellitus, whose diabetes was not already optimally controlled. Two reviewers independently extracted data on study population, intervention and outcomes for each included study, using standardised data extraction forms. Eleven relevant randomised controlled trials involving 402 participants were identified. There was a significant decrease in the glycated haemoglobin A1c (HbA1c) parallel group of trials, the weighted mean difference (WMD) was -0.5% with a 95% confidence interval (CI) of - 0.9 to -0.1, P = 0.02; and in the cross-over group of trials the WMD was -0.5% with a 95% CI of -1.0 to -0.1, P = 0.03. Episodes of hypoglycaemia were significantly fewer with low compared to high GI diet in one trial (difference of -0.8 episodes per patient per month, P low-GI diet compared to measured carbohydrate exchange diet in another study (35% versus 66%, P = 0.006). No study reported on mortality, morbidity or costs. A low-GI diet can improve

  15. The Effect of Dietary Glycaemic Index on Glycaemia in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Ojo, Omorogieva; Ojo, Osarhumwese Osaretin; Adebowale, Fajemisin; Wang, Xiao-Hua

    2018-03-19

    The increasing prevalence of diabetes in the United Kingdom and worldwide calls for new approaches to its management, and diets with low glycaemic index have been proposed as a useful means for managing glucose response. However, there are conflicting reports and differences in the results of studies in terms of their effectiveness. Furthermore, the impact of low-glycaemic index diets and their long-term use in patients with type 2 diabetes remains unclear. The objective of this study was to conduct a systematic review and meta-analysis of the effect of low-glycaemic index diets in patients with type 2 diabetes. Search methods: Randomised controlled studies were selected from a number of databases (EBSCOHost with links to Health Research databases, PubMed, and grey literature) based on the Population, Intervention, Comparator, Outcomes and Study designs (PICOS) framework. The search terms included synonyms and Medical Subject Headings (MeSH) and involved the use of Boolean operators (AND/OR) which allowed the combination of words and search terms. As per the selection criteria, the following types of articles were selected: studies on randomised controlled trials, with year of publication between 2008 and 2018, including patients with type 2 diabetes. Thus, studies involving patients with gestational and type 1 diabetes were excluded, as were observational studies. Nine articles which met the inclusion criteria were selected for the systematic review, whereas only six articles which met the criteria were included in the meta-analysis. Studies were evaluated for quality and risk of bias. In addition, heterogeneity, meta-analysis, and sensitivity tests of the extracted data were carried out using Review Manager 5.3 (Review Manager, 2014). The findings of the systematic review showed that the low-glycaemic index (low-GI) diet resulted in a significant improvement ( 0.05) in four studies compared with the control diet. Four studies showed improvements in fasting blood

  16. Glycaemic, Blood Pressure and Low Density Lipoprotein Cholesterol Control in Adult Patients with Diabetes in Singapore: A Review of Singapore Literature Over Two Decades.

    Science.gov (United States)

    Poh, Zhongxian; Venkataraman, Kavita; Toh, Sue-Anne Es; Low, Lian Leng

    2017-10-01

    Diabetes mellitus is a burgeoning global health epidemic, with an estimated 422 million people living with diabetes in 2014. The number of adult diabetic patients in Singapore is expected to rise to 1 million in 2050. Despite advances made in the management of diabetes and improvements in healthcare accessibility and delivery, the rate and complications of diabetes (myocardial infarction, stroke, kidney failure and lower limb amputation) in Singapore have not decreased. Gaps between guidelines and practice have been reported in several parts of the world. In this narrative review, we aimed to describe the control of diabetes in Singapore over the past 20 years. We reviewed studies describing, or trials intervening in, the glycaemic, blood pressure (BP) and low density lipoprotein cholesterol (LDL-C) control of adult diabetic patients in Singapore published over the past 20 years (1997-2016). Studies selected from comprehensive electronic databases searches were reviewed by 4 reviewers (2 primary care physicians, 1 diabetologist and 1 public health epidemiologist). The GRADE approach was used to evaluate the quality of evidence. We included 23 articles involving 257,097 subjects. There were 9 longitudinal, 12 cross-sectional and 2 case-control studies. All studies reported mean/median HbA1c between 7.2%-8.6%. BP ranged between 126.5-144 mmHg (systolic) and 70-84 mmHg (diastolic) in 9 studies. Nine studies reported LDL-C between 2.4-3.3 mmol/L. Mirroring global patterns, the glycaemic, BP and LDL-C control in adult diabetic patients in Singapore do not appear to be treated to target in the majority of patients.

  17. Effectiveness of smartphone technologies on glycaemic control in patients with type 2 diabetes: systematic review with meta-analysis of 17 trials.

    Science.gov (United States)

    Wu, I X Y; Kee, J C Y; Threapleton, D E; Ma, R C W; Lam, V C K; Lee, E K P; Wong, S Y S; Chung, V C H

    2018-06-01

    Patient education and behavioural interventions for self-management of type 2 diabetes mellitus (T2DM) are effective but place demands on manpower resources. This systematic review aimed to investigate the effectiveness of smartphone technologies (STs) for improving glycaemic control among T2DM patients. CENTRAL, MEDLINE, Embase, CINAHL and ScienceDirect were searched through December 2016. Randomized controlled trials comparing STs with usual diabetes care among T2DM patients and reporting change in glycated haemoglobin (HbA1c) level were included. Seventeen trials (2,225 participants) were included. There was a significant reduction in HbA1c (pooled weighted mean difference: -0.51%; 95% confidence interval: -0.71% to -0.30%; p < 0.001), favouring ST intervention. The pooled weighted mean difference was -0.83% in patients with T2DM <8.5 years and -0.22% in patients with T2DM ≥8.5 years, with significant subgroup difference (p = 0.007). No subgroup differences were found among different follow-up durations, trial locations, patients' age, healthcare provider contract time, baseline body mass index and baseline HbA1c. Compared with usual diabetes care, STs improved glycaemic control among T2DM patients, especially for patients at earlier disease stages (duration of diagnosis <8.5 years). STs could be a complement or alternative to labour-intensive patient education and behavioural interventions, but more studies on up-to-date technologies are needed. © 2018 World Obesity Federation.

  18. Smoking control: challenges and achievements

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Corrêa da Silva

    Full Text Available ABSTRACT 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.

  19. Smoking control: challenges and achievements

    Science.gov (United States)

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

    2016-01-01

    ABSTRACT 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. PMID:27832238

  20. Combination of a structured aerobic and resistance exercise improves glycaemic control in pregnant women diagnosed with gestational diabetes mellitus. A randomised controlled trial.

    Science.gov (United States)

    Sklempe Kokic, Iva; Ivanisevic, Marina; Biolo, Gianni; Simunic, Bostjan; Kokic, Tomislav; Pisot, Rado

    2017-10-18

    Gestational diabetes mellitus, defined as any carbohydrate intolerance first diagnosed during pregnancy, is associated with a variety of adverse outcomes, both for the mother and her child. To investigate the impact of a structured exercise programme which consisted of aerobic and resistance exercises on the parameters of glycaemic control and other health-related outcomes in pregnant women diagnosed with gestational diabetes mellitus. Thirty-eight pregnant women diagnosed with gestational diabetes mellitus were randomised to two groups. Experimental group was treated with standard antenatal care for gestational diabetes mellitus, and regular supervised exercise programme plus daily brisk walks of at least 30min. Control group received only standard antenatal care for gestational diabetes mellitus. The exercise programme was started from the time of diagnosis of diabetes until birth. It was performed two times per week and sessions lasted 50-55min. The experimental group had lower postprandial glucose levels at the end of pregnancy (P<0.001). There was no significant difference between groups in the level of fasting glucose at the end of pregnancy. Also, there were no significant differences in the rate of complications during pregnancy and birth, need for pharmacological therapy, maternal body mass and body fat percentage gains during pregnancy, and neonatal Apgar scores, body mass and ponderal index. Neonatal body mass index was higher in the experimental group (P=0.035). The structured exercise programme had a beneficial effect on postprandial glucose levels at the end of pregnancy. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  1. 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

  2. The Effect of Dietary Glycaemic Index on Glycaemia in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Omorogieva Ojo

    2018-03-01

    Full Text Available Background: The increasing prevalence of diabetes in the United Kingdom and worldwide calls for new approaches to its management, and diets with low glycaemic index have been proposed as a useful means for managing glucose response. However, there are conflicting reports and differences in the results of studies in terms of their effectiveness. Furthermore, the impact of low-glycaemic index diets and their long-term use in patients with type 2 diabetes remains unclear. Objectives: The objective of this study was to conduct a systematic review and meta-analysis of the effect of low-glycaemic index diets in patients with type 2 diabetes. Methods: Search methods: Randomised controlled studies were selected from a number of databases (EBSCOHost with links to Health Research databases, PubMed, and grey literature based on the Population, Intervention, Comparator, Outcomes and Study designs (PICOS framework. The search terms included synonyms and Medical Subject Headings (MeSH and involved the use of Boolean operators (AND/OR which allowed the combination of words and search terms. Selection criteria: As per the selection criteria, the following types of articles were selected: studies on randomised controlled trials, with year of publication between 2008 and 2018, including patients with type 2 diabetes. Thus, studies involving patients with gestational and type 1 diabetes were excluded, as were observational studies. Nine articles which met the inclusion criteria were selected for the systematic review, whereas only six articles which met the criteria were included in the meta-analysis. Data collection and analysis: Studies were evaluated for quality and risk of bias. In addition, heterogeneity, meta-analysis, and sensitivity tests of the extracted data were carried out using Review Manager 5.3 (Review Manager, 2014. Results: The findings of the systematic review showed that the low-glycaemic index (low-GI diet resulted in a significant improvement

  3. 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.

  4. How are metabolic control targets of patients with Type 1 diabetes mellitus achieved in daily practice in the area with high diabetes prevalence?

    Science.gov (United States)

    Kekäläinen, Päivi; Tirkkonen, Hilkka; Laatikainen, Tiina

    2016-05-01

    We assessed the prevalence of Type 1 diabetes mellitus and determined how the targets established in the guidelines for patients with Type 1 diabetes mellitus were achieved in clinical practice in North Karelia, Finland. All adult Type 1 diabetes mellitus patients (n=1075) were identified from the regional electronic patient database. The data for HbA1c and LDL cholesterol measurements during the years 2013 and 2014 were obtained from medical records. The prevalence of Type 1 diabetes mellitus in the adult population in North Karelia was 0.8%, which is among the highest worldwide. HbA1c and LDL cholesterol were measured in 93% and 90% of participants, respectively. Nineteen percent of patients reached the HbA1c target of diabetes achieved glycaemic control targets compared with 13-16% of younger patients with diabetes. Glycaemic control was in line with the recommendations in only one-fifth of Type 1 diabetes mellitus patients and less than half of them had LDL cholesterol levels within the target range. Interestingly, older Type 1 diabetes mellitus patients met the glycaemic control target more often than younger patients with diabetes. The targets established for patients with Type 1 diabetes mellitus are not achieved satisfactorily in daily practice. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. High Prevalence of Autoimmune Diabetes and Poor Glycaemic Control among Adults in Madagascar: A Brief Report from a Humanitarian Health Campaign in Ambanja

    Directory of Open Access Journals (Sweden)

    Ernesto Maddaloni

    2017-01-01

    Full Text Available Madagascar is a geographically isolated country considered a biodiversity hotspot with unique genomics. Both the low-income and the geographical isolation represent risk factors for the development of diabetes. During a humanitarian health campaign conducted in Ambanja, a rural city in the northern part of Madagascar, we identified 42 adult subjects with diabetes and compared their features to 24 randomly enrolled healthy controls. 42.9% (n=18 of diabetic subjects showed HbA1c values ≥ 9.0%. Unexpectedly, waist circumference and BMI were similar in people with diabetes and controls. Different from the healthy controls, diabetic subjects showed a low prevalence of obesity (5.7% versus 30%, p=0.02. Accordingly, we found a high prevalence of autoimmune diabetes as 12% of people with diabetes showed positivity for the autoantibody against glutamic acid decarboxylase. Diabetic subjects with positive autoantibody had higher HbA1c values (11.3 ± 4.1% versus 8.3 ± 2.6%, p=0.03 compared to diabetic subjects with negative autoantibody. In conclusion, here we describe the presence of diabetes and its features in a rural area of Northern Madagascar, documenting poor glycaemic control and a high prevalence of autoimmune diabetes. These data highlight that the diabetes epidemic involves every corner of the world possibly with different patterns and features.

  6. Glycaemic control and risk of incident urinary incontinence in women with Type 1 diabetes: results from the Diabetes Control and Complications Trial and Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study.

    Science.gov (United States)

    Lenherr, S M; Clemens, J Q; Braffett, B H; Dunn, R L; Cleary, P A; Kim, C; Herman, W H; Hotaling, J M; Jacobson, A M; Brown, J S; Wessells, H; Sarma, A V

    2016-11-01

    To study the impact of glycaemic control on urinary incontinence in women who participated in the Diabetes Control and Complications Trial (DCCT; 1983-1993) and its observational follow-up study, the Epidemiology of Diabetes Interventions and Complications (EDIC; 1994-present). Study participants were women who completed, at both years 10 (2003) and 17 (2010) of the EDIC follow-up, the urological assessment questionnaire (UroEDIC). Urinary incontinence was defined as self-reported involuntary leakage of urine that occurred at least weekly. Incident urinary incontinence was defined as weekly urinary incontinence present at EDIC year 17 but not at EDIC year 10. Multivariable regression models were used to examine the association of incident urinary incontinence with comorbid prevalent conditions and glycaemic control (mean HbA 1c over the first 10 years of EDIC). A total of 64 (15.3%) women with Type 1 diabetes (mean age 43.6 ± 6.3 years at EDIC year 10) reported incident urinary incontinence at EDIC year 17. When adjusted for clinical covariates (including age, DCCT cohort assignment, DCCT treatment arm, BMI, insulin dosage, parity, hysterectomy, autonomic neuropathy and urinary tract infection in the last year), the mean EDIC HbA 1c was associated with increased odds of incident urinary incontinence (odds ratio 1.03, 95% CI 1.01-1.06 per mmol/mol increase; odds ratio 1.41, 95% CI 1.07-1.89 per % HbA 1c increase). Incident urinary incontinence was associated with higher HbA 1c levels in women with Type 1 diabetes, independent of other recognized risk factors. These results suggest the potential for women to modify their risk of urinary incontinence with improved glycaemic control. (Clinical Trials Registry no: NCT00360815 and NCT00360893). © 2016 Diabetes UK.

  7. The Effectiveness of Pharmacological and Non-Pharmacological Interventions for Improving Glycaemic Control in Adults with Severe Mental Illness: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Taylor, Johanna; Stubbs, Brendon; Hewitt, Catherine; Ajjan, Ramzi A.; Gilbody, Simon; Holt, Richard I. G.; Hughes, Tom; Kellar, Ian; Mahmoodi, Neda; Smith, Robert D.; Wright, Judy M.; Siddiqi, Najma

    2017-01-01

    People with severe mental illness (SMI) have reduced life expectancy compared with the general population, which can be explained partly by their increased risk of diabetes. We conducted a meta-analysis to determine the clinical effectiveness of pharmacological and non-pharmacological interventions for improving glycaemic control in people with SMI (PROSPERO registration: CRD42015015558). A systematic literature search was performed on 30/10/2015 to identify randomised controlled trials (RCTs) in adults with SMI, with or without a diagnosis of diabetes that measured fasting blood glucose or glycated haemoglobin (HbA1c). Screening and data extraction were carried out independently by two reviewers. We used random effects meta-analysis to estimate effectiveness, and subgroup analysis and univariate meta-regression to explore heterogeneity. The Cochrane Collaboration’s tool was used to assess risk of bias. We found 54 eligible RCTs in 4,392 adults (40 pharmacological, 13 behavioural, one mixed intervention). Data for meta-analysis were available from 48 RCTs (n = 4052). Both pharmacological (mean difference (MD), -0.11mmol/L; 95% confidence interval (CI), [-0.19, -0.02], p = 0.02, n = 2536) and behavioural interventions (MD, -0.28mmol//L; 95% CI, [-0.43, -0.12], pfasting glucose, but not HbA1c (pharmacological MD, -0.03%; 95% CI, [-0.12, 0.06], p = 0.52, n = 1515; behavioural MD, 0.18%; 95% CI, [-0.07, 0.42], p = 0.16, n = 140) compared with usual care or placebo. In subgroup analysis of pharmacological interventions, metformin and antipsychotic switching strategies improved HbA1c. Behavioural interventions of longer duration and those including repeated physical activity had greater effects on fasting glucose than those without these characteristics. Baseline levels of fasting glucose explained some of the heterogeneity in behavioural interventions but not in pharmacological interventions. Although the strength of the evidence is limited by inadequate trial design

  8. Effects of 6 vs 3 eucaloric meal patterns on glycaemic control and satiety in people with impaired glucose tolerance or overt type 2 diabetes: A randomized trial.

    Science.gov (United States)

    Papakonstantinou, E; Kontogianni, M D; Mitrou, P; Magriplis, E; Vassiliadi, D; Nomikos, T; Lambadiari, V; Georgousopoulou, E; Dimitriadis, G

    2018-04-06

    The study aimed to compare the effects of two eucaloric meal patterns (3 vs 6 meals/day) on glycaemic control and satiety in subjects with impaired glucose tolerance and plasma glucose (PG) levels 140-199mg/dL at 120min (IGT-A) or PG levels 140-199mg/dL at 120min and >200mg/dL at 30/60/90min post-oral glucose load on 75-g OGTT (IGT-B), or overt treatment-naïve type 2 diabetes (T2D). In this randomized crossover study, subjects with IGT-A (n=15, BMI: 32.4±5.2kg/m 2 ), IGT-B (n=20, BMI: 32.5±5kg/m 2 ) or T2D (n=12, BMI: 32.2±5.2kg/m 2 ) followed a weight-maintenance diet (45% carbohydrates, 20% proteins, 35% fats) in 3 or 6 meals/day (each intervention lasting 12 weeks). Anthropometrics, diet compliance and subjective appetite were assessed every 2 weeks. OGTT and measurements of HbA1c and plasma lipids were performed at the beginning and end of each intervention period. Body weight and physical activity levels remained stable throughout the study. In T2D, HbA1c and PG at 120min post-OGTT decreased with 6 vs 3 meals (Pmeal intervention also improved post-OGTT hyperinsulinaemia in IGT-A subjects and hyperglycaemia in IGT-B subjects. In all three groups, subjective hunger and desire to eat were reduced with 6 vs 3 meals/day (Pweight loss remains the key strategy in hyperglycaemia management, dietary measures such as more frequent and smaller meals may be helpful for those not sufficiently motivated to adhere to calorie-restricted diets. Our study shows that 6 vs 3 meals a day can increase glycaemic control in obese patients with early-stage T2D, and may perhaps improve and/or stabilize postprandial glucose regulation in prediabetes subjects. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  9. Research: Treatment 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

    2014-01-01

    Aims 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. Methods 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. Summary 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. PMID:24863949

  10. 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.

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

    Science.gov (United States)

    Horan, Mary K.; McGowan, Ciara A.; Gibney, Eileen R.; Byrne, Jacinta; 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 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. PMID:26742066

  12. 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.

  13. 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.

  14. 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.

  15. Switching to multiple daily injection therapy with glulisine improves glycaemic control, vascular damage and treatment satisfaction in basal insulin glargine-injected diabetic patients.

    Science.gov (United States)

    Yanagisawa, Katsuyuki; Ashihara, Junya; Obara, Shinji; Wada, Norio; Takeuchi, Masayoshi; Nishino, Yuri; Maeda, Sayaka; Ishibashi, Yuji; Yamagishi, Sho-ichi

    2014-11-01

    Basal and bolus insulin therapy is required for strict blood control in diabetic patients, which could lead to prevention of vascular complications in diabetes. However, the optimal combination regimen is not well established. Fifty-nine diabetic patients (49 type 1 and 10 type 2; 52.9 ± 13.3 years old) whose blood glucose levels were uncontrolled (HbA1c  > 6.2%) by combination treatment of basal insulin glargine with multiple daily pre-meal injections of bolus short-acting insulin [aspart (n = 19), lispro (n = 37) and regular human insulin (n = 3)] for at least 8 weeks were enrolled in this study. We examined whether glycaemic control and vascular injury were improved by replacement of short-acting insulin with glulisine. Patient satisfaction was assessed with Diabetes Treatment Satisfaction Questionnaire. Although bolus and basal insulin doses were almost unchanged before and after replacement therapy, switching to glulisine insulin for 24 weeks significantly decreased level of HbA1c , advanced glycation end products (AGEs), soluble receptor for AGEs (sRAGE), monocyte chemoattractant protein-1 (MCP-1) and urinary albumin excretion. In multiple stepwise regression analysis, change in MCP-1 values from baseline (ΔMCP-1) was a sole determinant of log urinary albumin excretion. ΔAGEs and ΔsRAGE were independently correlated with each other. The relationship between ΔMCP-1 and ΔsRAGE was marginally significant (p = 0.05). Replacement of short-acting insulin by glulisine significantly increased Diabetes Treatment Satisfaction Questionnaire scores. Our present study suggests that combination therapy of glargine with multiple daily pre-meal injections of glulisine might show superior efficacy in controlling blood glucose, preventing vascular damage and improving treatment satisfaction in diabetic patients. Copyright © 2014 John Wiley & Sons, Ltd.

  16. 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.

  17. 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

  18. 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.

  19. 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 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.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.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.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.

  20. 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)

    Husted, Gitte; Thorsteinsson, Birger; Esbensen, Bente Appel

    2011-01-01

    visits will reduce haemoglobin A1c (HbA1c) concentrations and improve adolescents' life skills compared with a control group. METHODS: 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......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...... 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...

  1. Single, community-based blood glucose readings may be a viable alternative for community surveillance of HbA1c and poor glycaemic control in people with known diabetes in resource-poor settings

    Directory of Open Access Journals (Sweden)

    Daniel D. Reidpath

    2016-08-01

    Full Text Available Background: The term HbA1c (glycated haemoglobin is commonly used in relation to diabetes mellitus. The measure gives an indication of the average blood sugar levels over a period of weeks or months prior to testing. For most low- and middle-income countries HbA1c measurement in community surveillance is prohibitively expensive. A question arises about the possibility of using a single blood glucose measure for estimating HbA1c and therefore identifying poor glycaemic control in resource-poor settings. Design: Using data from the 2011–2012 US National Health and Nutrition Examination Surveys, we examined the relationship between HbA1c and a single fasting measure of blood glucose in a non-clinical population of people with known diabetes (n=333. A linear equation for estimating HbA1c from blood glucose was developed. Appropriate blood glucose cut-off values were set for poor glycaemic control (HbA1c≥69.4 mmol/mol. Results: The HbA1c and blood glucose measures were well correlated (r=0.7. Three blood glucose cut-off values were considered for classifying poor glycaemic control: 8.0, 8.9, and 11.4 mmol/L. A blood glucose of 11.4 had a specificity of 1, but poor sensitivity (0.37; 8.9 had high specificity (0.94 and moderate sensitivity (0.7; 8.0 was associated with good specificity (0.81 and sensitivity (0.75. Conclusions: Where HbA1c measurement is too expensive for community surveillance, a single blood glucose measure may be a reasonable alternative. Generalising the specific results from these US data to low resource settings may not be appropriate, but the general approach is worthy of further investigation.

  2. Effects of Long-Term Exercise Interventions on Glycaemic Control in Type 1 and Type 2 Diabetes: a Systematic Review.

    Science.gov (United States)

    Röhling, M; Herder, C; Roden, M; Stemper, T; Müssig, K

    2016-09-01

    Aim: Physical activity is one of the cornerstones in the prevention and management of diabetes mellitus, but the effects of different training forms on metabolic control still remain unclear. The aims of this review are to summarize the recommendations of 5 selected diabetes associations and to systematically review the effects of long-term supervised exercise interventions without calorie-restriction on glycemic control in people with type 1 and 2 diabetes focusing on resistance, endurance and combined training consisting of both endurance and resistance training. Methods: Literature searches were performed using MEDLINE for articles published between January 1, 2000 and March 17, 2015. Of 76 articles retrieved, 15 randomized and controlled studies met the inclusion criteria and allowed for examining the effect of exercise training in type 1 and 2 diabetes. Results: Diabetes associations recommend volume-focused exercise in their guidelines. In our analysis, all 3 training forms have the potential to improve the glycemic control, as assessed by HbA 1c (absolute changes in HbA 1c ranging from -0.1% to -1.1% (-1.1 to -12 mmol/mol) in resistance training, from -0.2% to -1.6% (-2.2 to -17.5 mmol/mol) in endurance training and from +0.1% to -1.5% (+1.1 to -16.4 mmol/mol) in combined training, respectively). Conclusions: There is evidence that combined exercise training may improve glycemic control to a greater extent than single forms of exercise, especially under moderate-intensive training conditions with equal training durations. In addition, intensity of training appears to be an important determinant of the degree of metabolic improvement. Nonetheless, it is still unknown to what extent exercise effects glycemic homeostasis. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Influence of health locus of control and fear of hypoglycaemia on glycaemic control and treatment satisfaction in people with Type 1 diabetes on insulin pump therapy.

    Science.gov (United States)

    Indelicato, L; Mariano, V; Galasso, S; Boscari, F; Cipponeri, E; Negri, C; Frigo, A; Avogaro, A; Bonora, E; Trombetta, M; Bruttomesso, D

    2017-05-01

    To assess the influence of health locus of control and fear of hypoglycaemia on metabolic control and treatment satisfaction in people with Type 1 diabetes mellitus on continuous subcutaneous insulin infusion. People with Type 1 diabetes on continuous subcutaneous insulin infusion for at least 1 year, sub-classified as an 'acceptable glucose control' group [HbA 1c ≤ 58 mmol/mol (7.5%)] and a 'suboptimum glucose control' group [HbA 1c > 58 mmol/mol (7.5%)], were consecutively enrolled in a multicentre cross-sectional study. Questionnaires were administered to assess health locus of control [Multidimensional Health Locus of Control (MHLC) scale, with internal and external subscales], fear of hypoglycaemia [Hypoglycaemia Fear Survey II (HFS-II)] and treatment satisfaction [Diabetes Treatment Satisfaction Questionnaire (DTSQ)]. We enrolled 214 participants (mean ± sd age 43.4 ± 12.1 years). The suboptimum glucose control group (n = 127) had lower mean ± sd internal MHLC and DTSQ scores than the acceptable glucose control group (19.6 ± 5.2 vs 21.0 ± 5.0, P = 0.04 and 28.8 ± 4.8 vs 30.9 ± 4.5, P locus represents the most important locus of control pattern for achieving good metabolic control. © 2017 Diabetes UK.

  4. Using mobile phone text messages to improve insulin injection technique and glycaemic control in patients with diabetes mellitus: a multi-centre study in Turkey.

    Science.gov (United States)

    Celik, Selda; Cosansu, Gulhan; Erdogan, Semra; Kahraman, Alev; Isik, Sengul; Bayrak, Gulay; Bektas, Belgin; Olgun, Nermin

    2015-06-01

    To improve the knowledge and skills of diabetic patients on insulin injections using mobile phone short message services and to evaluate the association of this intervention with metabolic outcomes. Mobile communication technologies are widely used in Turkey, which maintains a diabetic population of more than 6·5 million. However, there are a limited number of studies using mobile technologies in the challenging and complicated management of diabetes. A one group pretest-posttest design was used in this study. The study sample consisted of 221 people with type 1 and type 2 Diabetes Mellitus from eight outpatient clinics in six cities in Turkey. The 'Demographic and diabetes-related information Form' and 'Insulin Injection Technique and Knowledge Form' were used in the initial interview. Subsequently, 12 short messages related to insulin administration were sent to patients twice a week for six months. Each patient's level of knowledge and skills regarding both the insulin injection technique and glycaemic control (glycated haemoglobin A1c) levels were measured at three months and six months during the text messaging period and six months later (12 months total) when text messaging was stopped. The mean age of the patients with diabetes was 39·8 ± 16·2 years (min: 18; max: 75). More than half of the patients were females with a mean duration of diabetes of 11·01 ± 7·22 years (min 1; max: 32). Following the text message reminders, the patients' level of knowledge and skills regarding the insulin injection technique improved at month 3 and 6 (p 12 compared to the baseline values (p insulin injection sites and the frequency of rotation of skin sites for insulin injections also increased. This study demonstrated that a short message services-based information and reminder system on insulin injection administration provided to insulin-dependent patients with diabetes by nurses resulted in improved self-administration of insulin and metabolic control

  5. Glycaemic control and implementation of the ADA/EASD-2006 consensus algorithm in type 2 diabetes mellitus patients in primary care in Spain.

    Science.gov (United States)

    Alvarez-Guisasola, F

    2014-01-01

    In 2006, the American Diabetes Association and the European Association for the Study of Diabetes established a consensus algorithm (ADA/EASD-2006) for the adjustment of drug therapy for type 2 diabetes mellitus (T2DM). To study glycaemic control in T2DM patients and the implementation of the ADA/EASD-2006 recommendations in primary care centres in Spain. Prospective observational study in 1194 patients with T2DM conducted in 250 primary care centres in Spain. Patients were assessed at study inclusion (V0) and at 3 (V1) and 6 months (V2) post baseline. Information was collected at the level of DM control, HbA(1c) ADA/EASD-2006 guidelines. Type 2 diabetes mellitus patients (53% women; mean age 64.9 years) had a mean (SD) HbA(1c) 7.8 (1.4)% and HbC 25.2% at baseline, 95% of them were receiving oral antihyperglycaemic agents (AAs) only. At V1, HbA(1c) was 7.3 (1.1)% and HbC was 38.1%; 65.0% of patients were receiving oral AAs, 5.6% insulin and 27.9% oral AAs plus insulin. At V2, HbA(1c) was 7.1 (0.9)% and HbC was 48.0%; 57.1% of patients were receiving oral AAs, 5.0% insulin and 36.9% oral AAs plus insulin. The ADA/EASD-2006 algorithm was adhered to in 33% patients up to study month 3, vs. 17.2% throughout the entire 6-month period. In patients with T2DM seen in primary care, the HbA1c target was met in 48.0% after adjusting their AAs. However, this is not reflected in greater implementation of the ADA/EASD-2006 guidelines, which are adhered to in only 17%. © 2013 John Wiley & Sons Ltd.

  6. 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

    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). METHODS: 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...... of AS160 (29.0 ± 10.8%; p arginine injection. CONCLUSIONS/INTERPRETATION: IWT maintains insulin secretion and improves insulin sensitivity and DI, in contrast to energy...

  7. 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

    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...... 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...... 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...

  8. 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...... as enhanced beta-cell responses to an oral glucose load. During euglycaemic, hyperinsulinaemic clamp (2 mU x kg-1 x min-1) in combination with indirect calorimetry, a 35% (p=0.005) increase in whole-body insulin-stimulated glucose disposal rate, predominantly due to an increased non-oxidative glucose....... In conclusion, improved blood glucose control in gliclazide-treated obese NIDDM patients has no impact on the gene expression of muscle glycogen synthase....

  9. Effect of sacubitril/valsartan versus enalapril on glycaemic control in patients with heart failure and diabetes: a post-hoc analysis from the PARADIGM-HF trial.

    Science.gov (United States)

    Seferovic, Jelena P; Claggett, Brian; Seidelmann, Sara B; Seely, Ellen W; Packer, Milton; Zile, Michael R; Rouleau, Jean L; Swedberg, Karl; Lefkowitz, Martin; Shi, Victor C; Desai, Akshay S; McMurray, John J V; Solomon, Scott D

    2017-05-01

    , p=0·073) in the sacubitril/valsartan group. Patients with diabetes and HFrEF enrolled in PARADIGM-HF who received sacubitril/valsartan had a greater long-term reduction in HbA 1c than those receiving enalapril. These data suggest that sacubitril/valsartan might enhance glycaemic control in patients with diabetes and HFrEF. Novartis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Effects of renal sympathetic denervation on blood pressure and glycaemic control in patients with true resistant hypertension: results of Polish Renal Denervation Registry (RDN-POL Registry).

    Science.gov (United States)

    Kądziela, Jacek; Prejbisz, Aleksander; Kostka-Jeziorny, Katarzyna; Dudek, Dariusz; Narkiewicz, Krzysztof; Sadowski, Jerzy; Lekston, Andrzej; Gziut, Aneta; Więcek, Andrzej; Buszman, Paweł; Kleinrok, Andrzej; Kochman, Janusz; Czarnecka, Danuta; Januszewicz, Andrzej; Witkowski, Adam

    2016-01-01

    The assessment of percutaneous renal sympathetic denervation (RDN) efficacy in patients with true-resistant hypertension (true-RH) in a newly established net of Polish centres (RDN-POL Registry). Forty-four patients with true-RH (23 men, mean age 52.3 years) with daytime systolic blood pressure (SBP) in ambulatory blood pressure monitoring (ABPM) ≥ 135 mm Hg, on ≥ three antihypertensive agents, including diuretic, underwent RDN and completed 12-month follow-up. Mean reductions of office SBP/diastolic blood pressure were -23.8/-10.0, -12.5/-4.6, and -12.6/-6.1 mm Hg at 3, 6, and 12 months, respectively (all significant except diastolic at 6 months). Diabetes was the only predictor of office SBP reduction at 6 months (OR 9.6, 95% CI 1.4-66.5, p < 0.05). Mean 24-h SBP change was -8.3 mm Hg at 6 months and -4.6 mm Hg at 12 months. Increased 2 h-glucose in oral glucose tolerance test was the only predictor of 24-h SBP reduction at 6 months (OR 1.24 for 10 mg/dL glucose increase, 95% CI 1.04-1.48, p < 0.05). At 12 months, 24-h SBP change predictors were: baseline office SBP (OR 4.93 for 10 mm Hg SBP increment, 95% CI 1.01-24.1, p < 0.05) and 2 h-glucose (OR 1.47, 95% CI 1.08-2.00, p < 0.05). In ABPM responders, significant reduction of 2 h glucose was found as compared to the non-responders (-45.8 vs. -7.7 mg/dL, p < 0.005). The RDN-POL Registry demonstrated moderate blood pressure decrease after RDN. The predictors of blood pressure reduction were diabetes, 2 h-glucose, and baseline office SBP. Analysis of ABPM responders indicates a probable positive impact of RDN on glycaemic control.

  11. Role of footcare education in diabetic foot status and glycaemic ...

    African Journals Online (AJOL)

    Background: Prevalence of type 2 diabetes among the adult population is rising globally. As the case detection rates of diabetes increase in adult Nigerians, managing the attendant (foot) complications has become an important health challenge. Poor practice of foot care and poor glycaemic control is potential risk for ...

  12. 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.

  13. Replacement of glycaemic carbohydrates by inulin-type fructans from chicory (oligofructose, inulin) reduces the postprandial blood glucose and insulin response to foods: report of two double-blind, randomized, controlled trials.

    Science.gov (United States)

    Lightowler, Helen; Thondre, Sangeetha; Holz, Anja; Theis, Stephan

    2018-04-01

    Inulin-type fructans are recognized as prebiotic dietary fibres and classified as non-digestible carbohydrates that do not contribute to glycaemia. The aim of the present studies was to investigate the glycaemic response (GR) and insulinaemic response (IR) to foods in which sucrose was partially replaced by inulin or oligofructose from chicory. In a double-blind, randomized, controlled cross-over design, 40-42 healthy adults consumed a yogurt drink containing oligofructose or fruit jelly containing inulin and the respective full-sugar variants. Capillary blood glucose and insulin were measured in fasted participants and at 15, 30, 45, 60, 90, and 120 min after starting to drink/eat. For each test food, the incremental area under the curve (iAUC) for glucose and insulin was calculated and the GR and IR determined. Consumption of a yogurt drink with oligofructose which was 20% reduced in sugars significantly lowered the glycaemic response compared to the full-sugar reference (iAUC 120min 31.9 and 37.3 mmol/L/min, respectively; p inulin and containing 30% less sugars than the full-sugar variant likewise resulted in a significantly reduced blood glucose response (iAUC 120min 53.7 and 63.7 mmol/L/min, respectively; p inulin-type fructans (p inulin or oligofructose from chicory may be an effective strategy to reduce the postprandial blood glucose response to foods.

  14. 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

  15. Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes.

    Science.gov (United States)

    Duvivier, Bernard M F M; Schaper, Nicolaas C; Hesselink, Matthijs K C; van Kan, Linh; Stienen, Nathalie; Winkens, Bjorn; Koster, Annemarie; Savelberg, Hans H C M

    2017-03-01

    sitting with standing and light-intensity walking effectively improved 24 h glucose levels and improved insulin sensitivity in individuals with type 2 diabetes to a greater extent than structured exercise. Thus, our results suggest that breaking sitting with standing and light-intensity walking may be an alternative to structured exercise to promote glycaemic control in patients type 2 diabetes. Clinicaltrials.gov NCT02371239 FUNDING: : The study was supported by a Kootstra grant from Maastricht University Medical Centre + , and the Dutch Heart Foundation. Financial support was also provided by Novo Nordisk BV, and Medtronic and Roche made the equipment available for continuous glucose monitoring.

  16. Adding fast‐acting insulin aspart to basal insulin significantly improved glycaemic control in patients with type 2 diabetes: A randomized, 18‐week, open‐label, phase 3 trial (onset 3)

    OpenAIRE

    Rodbard, Helena W.; Tripathy, Devjit; Vidrio Velázquez, Maricela; Demissie, Marek; Tamer, Søren C.; Piletič, Milivoj

    2017-01-01

    Aim To confirm glycaemic control superiority of mealtime fast‐acting insulin aspart (faster aspart) in a basal–bolus (BB) regimen vs basal‐only insulin. Materials and methods In this open‐label, randomized, 18‐week trial (51 sites; 6 countries), adults (n = 236) with inadequately controlled type 2 diabetes (T2D; mean glycosylated haemoglobin [HbA1c] ± SD: 7.9% ± 0.7% [63.1 ± 7.5 mmol/mol]) receiving basal insulin and oral antidiabetic drugs underwent 8‐week optimization of prior once‐daily ba...

  17. 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.

  18. 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.

  19. Improvement of glycaemic control and elevation of C-peptide following a diet free of dairy products in an insulin-treated, patient with type 2 diabetes with ulcerative colitis.

    Science.gov (United States)

    Tandeter, Howard

    2009-01-01

    An insulin-treated patient with type 2 diabetes mellitus started a diet free of dairy products. Unexpectedly, she developed episodes of hypoglycaemia, without any change in her usual medication (insulin NPH at bedtime and Metformin). Laboratory tests showed an improvement of endogenous insulin secretion as demonstrated by the induction of hypoglycaemia and the elevation to normalisation of C-peptide levels. The patient was rechallenged with dairy products, leading to the lowering of the C-peptide levels back to abnormal levels, and an increase in HBA1C levels. The findings in our patient contrast with the insulinotropic effect of milk in healthy subjects described in the literature. The two main "milk debates" on the relation between milk (or its components) and diabetes are presented. Further observations will be needed to clarify the question of whether a diet free of dairy products can improve glycaemic control in other insulin-treated patients with type 2 diabetes.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

    Science.gov (United States)

    Rosenbek Minet, L K; Wagner, L; Lønvig, E M; Hjelmborg, J; Henriksen, J E

    2011-07-01

    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. Patients were eligible if they had type 1 or 2 diabetes mellitus, were over 18 years of age and had participated in a 4 day group education programme offered at a diabetes clinic at a university hospital in Denmark. Exclusion criteria included pregnancy, severe debilitating disease and cognitive deficit. Out of 469 patients who attended the group education programme, 349 patients were randomised to either a usual care control group or an intervention group, which received up to five individual counselling sessions in 1 year based on MI, in addition to usual care. A randomised parallel design was used and open-label allocation was done by random 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 diabetes self-care, compared with usual care. Out of the 176 included in the control group and 173 in the intervention group, 153 and 145 were analysed in the groups, respectively. When using the baseline value as covariate there were no significant differences in change score between the two study groups with regard to mean level of HbA(1c) (0.131, p = 0.221), PAID scores (-1.793, p = 0.191) or PCDS scores (0.017, p = 0.903) at the 24 month follow-up, using a mixed effects regression model. The

  4. 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.

  5. 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 children…

  6. 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

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

    NARCIS (Netherlands)

    Sluik, D.; Atkinson, Fiona S.; Brand-Miller, J.; Fogelholm, M.; Raben, A.; Feskens, E.J.M.

    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)

  8. 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 was o...

  9. Intensive multifactorial treatment modifies the effect of family history of diabetes on glycaemic control in people with Type 2 diabetes: a post hoc analysis of the ADDITION-Denmark randomized controlled trial.

    Science.gov (United States)

    Eliraqi, G M; Vistisen, D; Lauritzen, T; Sandbaek, A; Jørgensen, M E; Faerch, K

    2015-08-01

    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. 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 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, sex, baseline value of the risk factor and general practice (random effect). At baseline, participants with a family history of diabetes were younger and had a 1.1 mmol/mol (0.1%) higher HbA1c concentration at the time of diagnosis than those without a family history of diabetes. Family history of diabetes modified the effect of the intervention on changes in HbA1c levels. In the group receiving routine care, participants with a family history of diabetes experienced an improvement in HbA1c concentration that was 3.3 mmol/mol (0.3%) lower than the improvement found in those without a family history of diabetes after 5 years of follow-up. In the intensive treatment group, however, there was no difference in HbA1c concentrations between participants with and without a family history of diabetes after 5 years of treatment. Intensive treatment of diabetes may partly remove the adverse effects of family history of diabetes on glycaemic control. The effect of this improvement on long-term diabetic complications warrants further investigation. © 2015 The Authors. Diabetic Medicine

  10. Ethylene Production Maximum Achievable Control Technology (MACT) Compliance Manual

    Science.gov (United States)

    This July 2006 document is intended to help owners and operators of ethylene processes understand and comply with EPA's maximum achievable control technology standards promulgated on July 12, 2002, as amended on April 13, 2005 and April 20, 2006.

  11. Glycaemic responses of some legumes in Nigeria using non ...

    African Journals Online (AJOL)

    Background: It is established that legumes generally have a low glycaemic index (GI) which means that they raise blood glucose levels very little. However, the glycaemic responses to normal subjects and the GI of these local legumes are not yet established. Objective: This work determined the postprandial glycaemic ...

  12. Mastication effects on the glycaemic index: impact on variability and practical implications.

    Science.gov (United States)

    Ranawana, V; Leow, M K-S; Henry, C J K

    2014-01-01

    Glycaemic variability challenges the accuracy and use of the glycaemic index (GI). The purpose of the current study was to determine the role of mastication on GI. Using a randomized, controlled, crossover, non-blind design, 15 healthy young subjects returned on 5 separate days for three glucose and two rice test sessions. At the rice sessions, subjects chewed each mouthful either 15 or 30 times. Rice chewed 15 times produced a total glycaemic response (GR; 155 mmol min/l), peak GR (2.4 mmol/l) and GI (68) significantly lower than when chewed for longer (30 times) (184 mmol min/l, 2.8 mmol/l and 88, respectively). The study shows that the GI of rice is affected by the degree of mastication. Chewing 15 times compared with 30 times significantly attenuates the GI, suggesting that mastication may potentially contribute to the glycaemic variability of rice. While future work must establish the extent and limits to which mastication affects glycaemia, it could also explore the potential of using mastication to reduce the glycaemic load of rice.

  13. Comparative study on resistant starch, amilose content and glycaemic index after precooked process in white rice

    Science.gov (United States)

    Pratiwi, V. N.

    2018-03-01

    Rice is a staple food and regarded as a useful carbohydrate source. In general rice is high in glycaemic index (GI) and low colonic fermentation. People are aware of the alterations in blood glucose levels or glycaemic index after consuming rice. Resistant starch (RS) and amylose content play an important role in controlling GI. GI and RS content have been established as important indicators of starch digestibility. The aim of this study was to determine the precooked process with hydrothermal (boiling at 80°C, 10 minutes) and cooling process with low temperature (4°C, 1 h) to increase potential content of RS and decrease of glycaemic index of white rice. There were two stages of this research, 1) preparation of white rice with precooked process; 2) analysis of precooked white rice characteristics (resistant starch, amylose content, and estimated glycaemic index). The result of analysis on precooked white rice showed an increased RS content (1.11%) and white rice (0.99%), but the difference was not statistically significant. The amylose content increased significantly after precooked process in white rice (24.70%) compared with white rice (20.89%). Estimated glycaemic index (EGI) decreased after precooked proses (65.63%) but not significant as compared to white rice (66.47%). From the present study it was concluded that precooked process had no significant impact on increasing RS and decreasing EGI of white rice. This may be due to the relatively short cooling time (1hour) in 4°C.

  14. The Impact of Locus of Control on Language Achievement

    Science.gov (United States)

    Nodoushan, Mohammad Ali Salmani

    2012-01-01

    This study hypothesized that students' loci of control affected their language achievement. 198 (N = 198) EFL students took the Rotter's (1966) locus of control test and were classified as locus-internal (ni = 78), and locus-external (ne = 120). They then took their ordinary courses and at the end of the semester, they were given their exams.…

  15. 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

    2013-01-01

    Background 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. Method An analysis of 40 patients who had had detailed longitudinal studies for 12 months. Results 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. Conclusions The data presented suggest the existance 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

  16. 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.

  17. New achievements in the EAST plasma control system

    Energy Technology Data Exchange (ETDEWEB)

    Yuan, Q.P., E-mail: qpyuan@ipp.ac.c [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei (China); Xiao, B.J. [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei (China); Penaflor, B.G.; Piglowski, D.A. [General Atomics, DIII-D National Fusion Facility, San Diego, CA (United States); Liu, L.Z. [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei (China); Johnson, R.D.; Walker, M.L.; Humphreys, D.A. [General Atomics, DIII-D National Fusion Facility, San Diego, CA (United States)

    2010-07-15

    In order to realize the low latency and distortion-free signal transmission between the plasma control system (PCS) and servo systems, the digital output structure configured with reflective memory board (RFM) was adopted in EAST PCS. And the enhanced performances are reported. Another achievement made in the latest EAST PCS was the implementation of density control algorithm, which controlled the line average density in either voltage or width modulation mode. The new integrated algorithm improved the precision of density calculation and control performance greatly. The details and experiment results are presented in this paper.

  18. The purposes, achievements, and priorities of arms control

    International Nuclear Information System (INIS)

    Brown, P.S.

    1987-09-01

    Arms control purposes include strengthening the framework of deterrence and reducing the threat of the use of nuclear weapons, reducing the dangers of attack and accidental nuclear war, and allowing more resources for the civilian economy. The paper briefly describes achievements in arms control since World War II. These include the Limited Test Ban Treaty (LTBT), Nonproliferation Treaty (NPT), Anti-Ballistic Missile Treaty (ABMT)-SALT I, SALT II, Threshold Test Ban Treaty (TTBT), Peaceful Nuclear Explosions Treaty (PNET), and Nuclear-Free Zones treaties. The author also discusses his views on what the priorities of arms control activities should be

  19. 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.

  20. Protocol for a randomised controlled trial of the effect of dapagliflozin, metformin and exercise on glycaemic variability, body composition and cardiovascular risk in prediabetes (the PRE-D Trial)

    DEFF Research Database (Denmark)

    Færch, Kristine; Amadid, Hanan; Nielsen, Lea Bruhn

    2017-01-01

    INTRODUCTION: The primary aim of this study is to compare the efficacy of three short-term glucose-lowering interventions (exercise, metformin and dapagliflozin) on glycaemic variability in overweight or obese men and women with elevated diabetes risk (ie, prediabetes, defined as haemoglobin A1c...... questions concerning the effect of exercise versus dapagliflozin or metformin in HbA1c-defined prediabetes to be addressed. TRIAL REGISTRATION: NCT02695810....

  1. Control advances for achieving the ITER baseline scenario on KSTAR

    Science.gov (United States)

    Eidietis, N. W.; Barr, J.; Hahn, S. H.; Humphreys, D. A.; in, Y. K.; Jeon, Y. M.; Lanctot, M. J.; Mueller, D.; Walker, M. L.

    2017-10-01

    Control methodologies developed to enable successful production of ITER baseline scenario (IBS) plasmas on the superconducting KSTAR tokamak are presented: decoupled vertical control (DVC), real-time feedforward (rtFF) calculation, and multi-input multi-output (MIMO) X-point control. DVC provides fast vertical control with the in-vessel control coils (IVCC) while sharing slow vertical control with the poloidal field (PF) coils to avoid IVCC saturation. rtFF compensates for inaccuracies in offline PF current feedforward programming, allowing reduction or removal of integral gain (and its detrimental phase lag) from the shape controller. Finally, MIMO X-point control provides accurate positioning of the X-point despite low controllability due to the large distance between coils and plasma. Combined, these techniques enabled achievement of IBS parameters (q95 = 3.2, βN = 2) with a scaled ITER shape on KSTAR. n =2 RMP response displays a strong dependence upon this shaping. Work supported by the US DOE under Award DE-SC0010685 and the KSTAR project.

  2. 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, Pdiet/food values domain and lowest for management of GDM. Educational level seems to be the most significant predictor of GDM knowledge and glycaemic control. Highest mean knowledge score and lowest mean glycaemic levels were recorded for patients aged 25-29 years, Malay ethnicity, working women and family history of DM. Higher Knowledge about GDM is related to better glycaemic control. New educational strategies should be developed to improve the lower health literacy. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  3. Effect of pasta in the context of low-glycaemic index dietary patterns on body weight and markers of adiposity: a systematic review and meta-analysis of randomised controlled trials in adults

    Science.gov (United States)

    Chiavaroli, Laura; Kendall, Cyril W C; Braunstein, Catherine R; Blanco Mejia, Sonia; Leiter, Lawrence A; Jenkins, David J A; Sievenpiper, John L

    2018-01-01

    Objective Carbohydrate staples such as pasta have been implicated in the obesity epidemic. It is unclear whether pasta contributes to weight gain or like other low-glycaemic index (GI) foods contributes to weight loss. We synthesised the evidence of the effect of pasta on measures of adiposity. Design Systematic review and meta-analysis using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Data sources MEDLINE, Embase, CINAHL and the Cochrane Library were searched through 7 February 2017. Eligibility criteria for selecting studies We included randomised controlled trials ≥3 weeks assessing the effect of pasta alone or in the context of low-GI dietary patterns on measures of global (body weight, body mass index (BMI), body fat) and regional (waist circumference (WC), waist-to-hip ratio (WHR), sagittal abdominal diameter (SAD)) adiposity in adults. Data extraction and synthesis Two independent reviewers extracted data and assessed risk of bias. Data were pooled using the generic inverse-variance method and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed (Cochran Q statistic) and quantified (I2 statistic). GRADE assessed the certainty of the evidence. Results We identified no trial comparisons of the effect of pasta alone and 32 trial comparisons (n=2448 participants) of the effect of pasta in the context of low-GI dietary patterns. Pasta in the context of low-GI dietary patterns significantly reduced body weight (MD=−0.63 kg; 95% CI −0.84 to –0.42 kg) and BMI (MD=−0.26 kg/m2; 95% CI −0.36 to –0.16 kg/m2) compared with higher-GI dietary patterns. There was no effect on other measures of adiposity. The certainty of the evidence was graded as moderate for body weight, BMI, WHR and SAD and low for WC and body fat. Conclusions Pasta in the context of low-GI dietary patterns does not adversely affect adiposity and even reduces body weight and BMI compared with higher-GI dietary

  4. Effect of pasta in the context of low-glycaemic index dietary patterns on body weight and markers of adiposity: a systematic review and meta-analysis of randomised controlled trials in adults.

    Science.gov (United States)

    Chiavaroli, Laura; Kendall, Cyril W C; Braunstein, Catherine R; Blanco Mejia, Sonia; Leiter, Lawrence A; Jenkins, David J A; Sievenpiper, John L

    2018-04-02

    Carbohydrate staples such as pasta have been implicated in the obesity epidemic. It is unclear whether pasta contributes to weight gain or like other low-glycaemic index (GI) foods contributes to weight loss. We synthesised the evidence of the effect of pasta on measures of adiposity. Systematic review and meta-analysis using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. MEDLINE, Embase, CINAHL and the Cochrane Library were searched through 7 February 2017. We included randomised controlled trials ≥3 weeks assessing the effect of pasta alone or in the context of low-GI dietary patterns on measures of global (body weight, body mass index (BMI), body fat) and regional (waist circumference (WC), waist-to-hip ratio (WHR), sagittal abdominal diameter (SAD)) adiposity in adults. Two independent reviewers extracted data and assessed risk of bias. Data were pooled using the generic inverse-variance method and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed (Cochran Q statistic) and quantified (I 2 statistic). GRADE assessed the certainty of the evidence. We identified no trial comparisons of the effect of pasta alone and 32 trial comparisons (n=2448 participants) of the effect of pasta in the context of low-GI dietary patterns. Pasta in the context of low-GI dietary patterns significantly reduced body weight (MD=-0.63 kg; 95% CI -0.84 to -0.42 kg) and BMI (MD=-0.26 kg/m 2 ; 95% CI -0.36 to -0.16 kg/m 2 ) compared with higher-GI dietary patterns. There was no effect on other measures of adiposity. The certainty of the evidence was graded as moderate for body weight, BMI, WHR and SAD and low for WC and body fat. Pasta in the context of low-GI dietary patterns does not adversely affect adiposity and even reduces body weight and BMI compared with higher-GI dietary patterns. Future trials should assess the effect of pasta in the context of other 'healthy' dietary patterns. NCT02961088; Results

  5. Effects of green coffee extract supplementation on anthropometric indices, glycaemic control, blood pressure, lipid profile, insulin resistance and appetite in patients with the metabolic syndrome: a randomised clinical trial.

    Science.gov (United States)

    Roshan, Hanieh; Nikpayam, Omid; Sedaghat, Meghdad; Sohrab, Golbon

    2018-02-01

    This study was conducted to elucidate the effects of decaffeinated green coffee bean extract (GCE) on anthropometric indices, glycaemic control, blood pressure, lipid profile, insulin resistance and appetite in patients with the metabolic syndrome (Mets). Subjects were randomly allocated to consume 400 mg GCE or placebo capsules twice per d for 8 weeks. Both groups were advised to follow an energy balanced diet. After GCE supplementation, systolic blood pressure (SBP) significantly reduced compared with the placebo group (-13·76 (sd 8·48) v. -6·56 (sd 9·58) mmHg, P=0·01). Also, GCE treatment significantly reduced fasting blood glucose (FBS) (-5·15 (sd 60·22) v. 29·42 (sd 40·01) mg/dl (-0·28 (SD 3·34) v. 1·63 (SD 2·22) mmol/l); P=0·03) and homoeostatic model of assessment of insulin resistance in comparison to placebo (-1·41 (sd 3·33) v. 1·23 (sd 3·84), P=0·02). In addition, waist circumference (-2·40 (sd 2·54) v. -0·66 (sd 1·17) cm, P=0·009) and appetite score (-1·44 (sd 1·72) v. -0·2 (sd 1·32), P=0·01) of the individuals supplemented with GCE indicated a significant decline. Besides, weight and BMI reduction in the intervention group was almost twice as much as the placebo group; however, this discrepancy was marginally significant (weight: -2·08 (sd 2·11) v. -0·92 (sd 1·30) kg, P=0·05). No difference was observed in terms of glycated Hb (HbA1c) percentage and lipid profile parameters between the two groups. To sum up, GCE administration had an ameliorating effect on some of the Mets components such as high SBP, high FBS and Mets main aetiological factors including insulin resistance and abdominal obesity. Furthermore, GCE supplementation could reduce appetite level.

  6. Effectiveness of insulin glargine in type 2 diabetes mellitus patients failing glycaemic control with premixed insulin: Adriatic countries data meta-analysis.

    Science.gov (United States)

    Cigrovski Berkovic, Maja; Petrovski, Goran; Grulovic, Natasa

    2016-10-01

    Type 2 diabetes mellitus (T2DM) is a progressive disease, often requiring exogenous insulin therapy and treatment intensification. Despite new therapies, most patients do not reach the recommended HbA1c targets, among them a significant proportion of patients on premixed insulins. The aim was to summarize published data in Adriatic countries on effectiveness of insulin glargine based therapy in type 2 diabetic patients suboptimally controlled on premix insulin. A meta-analysis was carried out in major medical databases up to April 2014, focusing on Adriatic region. We searched observational studies with duration of at least 6 months, evaluating effectiveness and safety of insulin glargine (IGlar), in combination with OAD or bolus insulin in patients with T2 failing premixed insulin therapy. Outcomes included values of HbA1c, fasting blood glucose and two hours post-prandial glucose concentration as well as changes in body mass index after at least 6 months of study duration. Three prospective, observational, multicentric trials (698 patients in total) were included. The basal bolus regimen with glargine significantly reduced HbA1c (Mean Difference, MD=2.27, CI [1.76, 2.78]), fasting glucose (MD=5.15, CI [4.86, 5.44]) and 2-hours postprandial glucose concentration (MD=6.94, CI [6.53, 7.34]). No significant changes were found in BMI after switching from premixes to IGlar based treatment. Insulin glargine based therapy following premix failure is efficacious and safe option of type 2 diabetes treatment intensification.

  7. 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...

  8. Effect of fat type in baked bread on amylose-lipid complex formation and glycaemic response.

    Science.gov (United States)

    Lau, Evelyn; Zhou, Weibiao; Henry, Christiani Jeyakumar

    2016-06-01

    The formation of amylose-lipid complexes (ALC) had been associated with reduced starch digestibility. A few studies have directly characterised the extent of ALC formation with glycaemic response. The objectives of this study were to investigate the effect of using fats with varying degree of saturation and chain length on ALC formation as well as glycaemic and insulinaemic responses after consumption of bread. Healthy men consumed five test breads in a random order: control bread without any added fats (CTR) and breads baked with butter (BTR), coconut oil (COC), grapeseed oil (GRP) or olive oil (OLV). There was a significant difference in glycaemic response between the different test breads (P=0·002), primarily due to COC having a lower response than CTR (P=0·016), but no significant differences between fat types were observed. Insulinaemic response was not altered by the addition of fats/oils. Although BTR was more insulinotropic than GRP (Pfats/oils, with coconut oil showing the greatest attenuation of glycaemic response.

  9. The effect of dietary soy intake on weight loss, glycaemic control, lipid profiles and biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome: a randomised clinical trial.

    Science.gov (United States)

    Karamali, M; Kashanian, M; Alaeinasab, S; Asemi, Z

    2018-02-22

    The present study aimed to evaluate the effects of dietary soy intake on weight loss and metabolic status of patients with polycystic ovary syndrome (PCOS). A randomised clinical trial was conducted among 60 women with PCOS. Participants were randomly assigned into two groups to receive either a test diet (n = 30) or a control diet (n = 30) for 8 weeks. Participants in the test group consumed a diet containing 0.8 g protein kg -1 body weight (35% animal proteins, 35% soy protein and 30% vegetable proteins) and participants in the control group consumed a similar diet containing 70% animal proteins and 30% vegetable proteins. Adherence to the test diet, compared with the control diet, resulted in significant decreases [mean (SD)] in body mass index (BMI) [-0.3 (0.6) versus +0.1 (0.5) kg m -2 , P = 0.02], fasting plasma glucose [-0.2 (0.5) versus +0.1 (0.3) mmol L -1 , P = 0.01], total testosterone [-0.3 (0.7) versus +0.3 (0.3) mmol L -1 , P < 0.001], insulin [-15.0 (18.0) versus +4.8 (18.6) pmol L -1 , P < 0.001] and insulin resistance [-0.6 (0.6) versus +0.2 (0.7), P < 0.001], as well as a significant increase in quantitative insulin sensitivity check index [+0.01 (0.01) versus -0.002 (0.02), P = 0.01]. In addition, significant decreases in triglycerides [-0.1 (0.4) versus +0.2 (0.3) mmol L -1 , P = 0.01] and malondialdehyde (MDA) [-1.2 (1.0) versus +0.2 (1.2) μmol L -1 , P < 0.001] and significant increases in nitric oxide (NO) [+13.6 (14.1) versus +0.9 (24.3) μmol L -1 , P = 0.01] and glutathione (GSH) [+170.1 (175.5) versus +24.2 (168.7) μmol L -1 , P = 0.002] were seen in the test group compared to the control. Adherence to test diet among subjects with PCOS significantly decreased BMI, glycaemic control, total testosterone, triglycerides and MDA, and significantly increased NO and GSH compared to the control diet. © 2018 The British Dietetic Association Ltd.

  10. Association between the extent of urinary albumin excretion and glycaemic variability indices measured by continuous glucose monitoring.

    Science.gov (United States)

    Jin, S-M; Kim, T-H; Oh, S; Baek, J; Joung, J Y; Park, S-M; Cho, Y Y; Sohn, S Y; Hur, K Y; Lee, M-S; Lee, M-K; Kim, J H

    2015-02-01

    The contribution of glycaemic variability to the microvascular complication of diabetes has not been established. We examined whether there is an independent association between indices of glycaemic variability in continuous glucose monitoring and extent of albuminuria. A total of 173 patients with Type 2 diabetes (without insulin therapy, n = 96; with insulin therapy, n = 77) who had unexplained large fluctuations in blood glucose values underwent three-day continuous glucose monitoring. We used a multinomial logistic regression model to determine whether the indices of glycaemic variability independently affected the odds of having a spot urine albumin/creatinine ratio of 30-299 mg/g and ≥ 300 mg/g. Higher standard deviation (P = 0.002), mean of daily differences (P = 0.023) and mean amplitude of glycaemic excursion (P = 0.043) significantly increased the odds of having a urine albumin/creatinine ratio of ≥ 300 mg/g. In multivariable analysis, only higher standard deviation, but not mean amplitude of glycaemic excursion and mean of daily differences, independently increased the odds of having a urine albumin/creatinine ratio of ≥ 300 mg/g (P = 0.025). Coefficient of variation (sd/mean) was not associated with the odds of having a urine albumin/creatinine ratio of 30-299 or ≥ 300 mg/g. The independent association between standard deviation and the extent of albuminuria was lost when the measures were normalized by mean glucose level. At least in terms of relative measures of glycaemic variability, we failed to demonstrate an independent association between glycaemic variability and albuminuria extent in patients with inadequately controlled Type 2 diabetes. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  11. Association between depression, glycaemic control and the ...

    African Journals Online (AJOL)

    Purpose: The prevalence of diabetes mellitus is increasing especially in low- and middleincome countries in which 75% of the world's diabetic population reside. The macro- and microvascular complications of diabetes such as diabetic retinopathy are also set to increase in these populations. The relationship between ...

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

    African Journals Online (AJOL)

    C targets but there ... fasting, leading to anomalous lipid values and, in particular, ..... Developed countries ... The link between HbA1c and CVD still remains theoretical. .... federation task force on epidemiology and prevention; national heart,.

  13. 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 defined as ... of conducting this study was to evaluate the glycaemic response of some commonly ... basis was determined according to the Association of Analytic ... medical laboratory scientist using the glucose oxidation method.

  14. Quality Control in Diagnostic Radiology: Experiences and Achievements

    International Nuclear Information System (INIS)

    Mohd Khalid Matori; Husaini Salleh; Muhammad Jamal Md Isa

    2015-01-01

    Malaysian Nuclear Agency through its Medical Physics Group has been providing Quality Control (QC) services for medical X-ray apparatus used in diagnostic radiology to private clinics and hospitals since the year 1997. The Medical Physics Groups services is endorsed by the Malaysian Ministry Of Health (MOH) and is in accordance with the Malaysian Standard MS 838 and the Atomic Energy Licensing Act, 1984. Until today, the scopes of testing services also include all types of medical x-ray apparatus. The quality control (QC) in diagnostic radiology is considered as part of quality assurance program which provide accurate diagnostic information at the lowest cost and the least exposure of the patients to radiation. Many experience and obstacles were faced by Medical Physics Group. This paper will discuss the experiences and achievements of providing QC service from early stage until now so that it can be shared by the citizens of the Malaysian Nuclear Agency. The results of quality assurance inspection of all types of X-ray apparatus for medical conducted by Agency Nuclear Malaysia will be presented in brief. (author)

  15. The effects of corn silk on glycaemic metabolism.

    Science.gov (United States)

    Guo, Jianyou; Liu, Tongjun; Han, Linna; Liu, Yongmei

    2009-11-23

    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. 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 beta-cells, hepatic glycogen and gluconeogenesis in hyperglycemic mice were studied respectively. 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 corn silk extract 15 days later. Also, the body weight of the alloxan-induced hyperglycemic mice was increased gradually. However, ascension of blood glucose induced by adrenalin and gluconeogenesis induced by L-alanine were not inhibited by corn silk extract treatment (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). 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 beta-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.

  16. 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.

  17. A study of glycaemic effects following acute anthocyanin-rich blueberry supplementation in healthy young adults.

    Science.gov (United States)

    Bell, L; Lamport, D J; Butler, L T; Williams, C M

    2017-09-20

    The postprandial response to ingested carbohydrate is recognised as a marker of metabolic health. Postprandial hyperglycaemia is observed in type 2 diabetes mellitus and is a significant risk factor for cardiovascular disease. Cognitive deficits are also associated with type 2 diabetes. Therefore interventions which moderate postprandial glucose profiles are desirable. Here we investigated the impact of anthocyanin-rich wild blueberries on postprandial glucose response. Seventeen healthy young adults consumed a range of doses of freeze-dried wild blueberry powder, in smoothie form, in both sugar-matched and no-added-sugar conditions. Plasma glucose was determined by a capillary sampling method at baseline and at regular intervals up to 2.5 hours postprandially. Blueberries were observed to significantly extend the postprandial glucose response beyond the period observed for a sugar-matched control, characteristic of a beneficial glycaemic response. Furthermore, blueberries were observed to reduce peak postprandial glucose levels, although statistical significance was not achieved. The findings suggest a tempering of the postprandial glucose response in the presence of anthocyanin-rich blueberry, and are discussed with reference to likely glucoregulatory mechanisms of action and their implications for cognitive and type 2 diabetes research.

  18. Adverse glycaemic effects of cancer therapy: indications for a rational approach to cancer patients with diabetes.

    Science.gov (United States)

    Gallo, Marco; Muscogiuri, Giovanna; Felicetti, Francesco; Faggiano, Antongiulio; Trimarchi, Francesco; Arvat, Emanuela; Vigneri, Riccardo; Colao, Annamaria

    2018-01-01

    Diabetes and cancer are common, chronic, and potentially fatal diseases that frequently co-exist. Observational studies have reported an increased risk of cancer in patients with diabetes. Furthermore, many patients with cancer already have diabetes, or develop hyperglycaemia as a consequence of the tumor or of cancer therapies, and coexisting diabetes confers a greater risk of mortality for many malignancies. Managing oncologic patients with diabetes is often complicated, since the co-existence of diabetes and cancer poses several complex clinical questions: what level of glycaemic control to achieve, which therapy to use, how to deal with glucocorticoid therapies and artificial nutrition, how diabetes complications can affect cancer management, which drug-drug interactions should be taken into account, or even how to manage diabetes at the end of life. In the clinical setting, both at hospital and at home, there are little agreed, evidence-based guidelines on the best management and criteria upon which clinical decisions should be based. A practical solution lies in the implementation of care networks based on communication and ongoing collaboration between Oncologists, Endocrinologists, and the nursing staff, with the patient at the centre of the care process. This manuscript aims to review the current evidence on the effect of cancer therapies on glucose metabolism and to address some of the more common challenges of diabetes treatment in patients with cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. 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

    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...... 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...... 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...

  20. 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.

  1. 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

    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...... children at 1, 6 and 12 months after diagnosis. Genotyping for the Glu23Lys variant was by PCR-restriction fragment length polymorphism. RESULTS: Kir6.2 and SUR1 co-localise with GLP-1 in L-cells and with GIP in K-cells in human ileum tissue. Children with type 1 diabetes carrying the hyperactive Glu23Lys...... with type 1 diabetes....

  2. A randomised trial comparing low-fat diets differing in carbohydrate and protein ratio, combined with regular moderate intensity exercise, on glycaemic control, cardiometabolic risk factors, food cravings, cognitive function and psychological wellbeing in adults with type 2 diabetes: Study protocol.

    Science.gov (United States)

    Watson, Nerylee Ann; Dyer, Kathryn Ann; Buckley, Jonathan David; Brinkworth, Grant David; Coates, Alison Mary; Parfitt, Gaynor; Howe, Peter Ranald Charles; Noakes, Manny; Dye, Louise; Chadwick, Helen; Murphy, Karen Joy

    2015-11-01

    Hypocaloric low-fat diets, high in protein with moderate carbohydrate (HP) can enhance weight loss, improve glycaemic control and improve cardiometabolic health risk factors in type 2 diabetes mellitus (T2DM). However, it is unclear whether the metabolic benefits observed during weight loss are sustained during energy-balance and weight maintenance. Furthermore, there is a lack of evidence regarding the effect of HP diets on food cravings, cognitive function and psychological wellbeing in T2DM, despite carbohydrate food cravings, cognitive impairment and depression being associated with hyperglycaemia. Overweight/obese adults with T2DM were randomised to consume either a HP diet (n=32, ~32% protein, 33% carbohydrate, 30% fat) or a higher-carbohydrate diet (HC, n=29, ~22% protein, 51% carbohydrate, 22% fat) for 24 weeks with 30 min of moderate intensity exercise five days/week for the study duration. There were 2 phases: a 12 week weight loss phase followed by a 12 week weight maintenance phase. Primary outcome was glycaemic control (glycosylated haemoglobin; HbA1c). Secondary outcomes were cardiometabolic risk factors (body composition, fasting blood pressure, blood lipids, glucose, insulin and C-reactive protein), food cravings, cognitive function (memory; psychomotor and executive function and psychological well-being. Outcomes were measured at baseline and the end of each 12-week intervention phase. Data will be analysed as intention-to-treat using linear mixed effects models. This study will examine the effects of two dietary interventions on health outcomes in T2DM during weight loss and notably following weight maintenance where there is a paucity of evidence. Copyright © 2015. Published by Elsevier Inc.

  3. 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.

  4. Glucose-lowering effect and glycaemic variability of insulin glargine, insulin detemir and insulin lispro protamine in people with type 1 diabetes.

    Science.gov (United States)

    Derosa, G; Franzetti, I; Querci, F; Romano, D; D'Angelo, A; Maffioli, P

    2015-06-01

    To compare, using a continuous glucose monitoring (CGM) system, the effect on glycaemic variability of insulin glargine, detemir and lispro protamine. A total of 49 white people with type 1 diabetes, not well controlled by three times daily insulin lispro, taken for at least 2 months before study and on a stable dose, were enrolled. The study participants were randomized to add insulin glargine, detemir or lispro protamine, once daily, in the evening. We used a CGM system, the iPro Digital Recorder (Medtronic MiniMed, Northridge, CA, USA) for 1 week. Glycaemic control was assessed according to mean blood glucose values, the area under the glucose curve above 3.9 mmol/l (AUC(>3.9)) or above 10.0 mmol/l (AUC(>10.0)), and the percentage of time spent with glucose values >3.9 or >10.0 mmol/l. Intraday glycaemic variability was assessed using standard deviation (s.d.) values, the mean amplitude of glycaemic excursions and continuous overlapping of net glycaemic action. Day-to-day glycaemic variability was assessed using the mean of daily differences. The s.d. was found to be significantly lower with insulin lispro protamine and glargine compared with insulin detemir. AUC(>3.9) was higher and AUC(>10.0) was lower with insulin lispro protamine and glargine compared with detemir. The mean amplitude of glycaemic excursions and continuous overlapping net glycaemic action values were lower with insulin lispro protamine and glargine compared with detemir. In addition, the mean of daily differences was significantly lower with insulin lispro protamine and glargine compared with detemir. Fewer hypoglycaemic events were recorded during the night-time with insulin lispro protamine compared with glargine and detemir. The results suggest that insulin lispro protamine and glargine are more effective than detemir in reducing glycaemic variability and improving glycaemic control in people with type 1 diabetes. Insulin lispro protamine seems to lead to fewer hypoglycaemic

  5. Machine throughput improvement achieved using innovative control technique

    International Nuclear Information System (INIS)

    Sharma, V.; Acharya, S.; Mittal, K.C.

    2012-01-01

    In any type of fully or semi automatic machine the control systems plays an important role. The control system on the one hand has to consider the human psychology, intelligence requirement for an operator, and attention needed from him. On the other hand the complexity of the control has also to be understood well before designing a control system that can be handled comfortably and safely by the operator. As far as the user experience/comfort is concerned the design of control system GUI is vital. Considering these two aspects related to the user of the machine it is evident that the control system design is very important because it is has to accommodate the human behaviour and skill sets required/available as well as the capability of the machine under the control of the control system. An intelligently designed control system can enhance the productivity of the machine. (author)

  6. Postprandial lipid responses to standard carbohydrates used to determine glycaemic index values.

    Science.gov (United States)

    Vega-López, Sonia; Ausman, Lynne M; Matthan, Nirupa R; Lichtenstein, Alice H

    2013-11-01

    Prior studies assessing the metabolic effects of different types of carbohydrates have focused on their glycaemic response. However, the response of postprandial cardiometabolic risk indicators has not been considered in these studies. The present study assessed postprandial lipid responses to two forms of carbohydrates used as reference foods for glycaemic index determinations, white bread (50 g available carbohydrate) and glucose (50 g), under controlled conditions and with intra-individual replicate determinations. A total of twenty adults (20–70 years) underwent two cycles of challenges with each pair of reference foods (four challenges/person), administered in a random order on separate days under standard conditions. Serum lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol, TAG and NEFA), glucose and insulin were monitored for 5 h post-ingestion. Oral glucose resulted in greater glycaemic and insulinaemic responses than white bread for the first 90 min and a greater subsequent decline after 120 min (P =0·0001). The initial decline in serum NEFA concentrations was greater after the oral glucose than after the white bread challenge, as was the rebound after 150 min (P = 0·001). Nevertheless, the type of carbohydrate had no significant effect on postprandial total cholesterol, LDL-cholesterol and HDL-cholesterol concentrations. Following an initial modest rise in TAG concentrations in response to both challenges, the values dropped below the fasting values for oral glucose but not for the white bread challenge. These data suggest that the type of carbohydrate used to determine the glycaemic index, bread or glucose, has little or modest effects on postprandial plasma cholesterol concentrations. Differences in TAG and NEFA concentrations over the 5 h time period were modest, and their clinical relevance is unclear.

  7. 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…

  8. Concurrently adjusting interrelated control parameters to achieve optimal engine performance

    Science.gov (United States)

    Jiang, Li; Lee, Donghoon; Yilmaz, Hakan; Stefanopoulou, Anna

    2015-12-01

    Methods and systems for real-time engine control optimization are provided. A value of an engine performance variable is determined, a value of a first operating condition and a value of a second operating condition of a vehicle engine are detected, and initial values for a first engine control parameter and a second engine control parameter are determined based on the detected first operating condition and the detected second operating condition. The initial values for the first engine control parameter and the second engine control parameter are adjusted based on the determined value of the engine performance variable to cause the engine performance variable to approach a target engine performance variable. In order to cause the engine performance variable to approach the target engine performance variable, adjusting the initial value for the first engine control parameter necessitates a corresponding adjustment of the initial value for the second engine control parameter.

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

    International Nuclear Information System (INIS)

    Koch, Christiane P

    2016-01-01

    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. (topical review)

  10. Controlling open quantum systems: Tools, achievements, and limitations

    OpenAIRE

    Koch, Christiane P.

    2016-01-01

    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 to preserve the 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...

  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 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...... with T2D....

  12. 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.

  13. On achieving a uniform approach to radiation control in Australia

    International Nuclear Information System (INIS)

    Swindon, T. N.

    1995-01-01

    Legislation and the associated regulatory processes to control radiation exposure of persons in the workplace, of patients undergoing medical exposures and of members of the public have been in place in all Australian States, including the ACT and NT, for some decades. Most States have completely rewritten their original legislation and all have made minor modifications from time to time. As a consequence, the legislation and the regulatory processes and controls used in all the States differ considerably, although they all have the same intent. For many years now, attempts have been made to overcome problems arising from the differences in the radiation control legislation and practices. These have been through the preparation of recommendations and codes of practice by the Radiation Health Standing Committee (RHSC) of the NHMRC and through discussions by State radiation control officers in the Radiation Control Implementation Panel, which reports to the RHSC. The recommendations and codes of practice can be utilised by the States in their radiation control activities, but this procedure can be restricted by different requirements in State legislation. Despite the efforts to overcome the problems, the main stumbling block to the implementation of uniform control derives from the legislation currently in use in each state. It is seen that changes will take a number of years to implements and that changes to legislation would be a top priority

  14. Prognostic importance of glycaemic variability on hospital mortality in patients hospitalised in Internal Medicine Departments.

    Science.gov (United States)

    Sáenz-Abad, D; Gimeno-Orna, J A; Pérez-Calvo, J I

    2015-12-01

    The objective was to assess the prognostic importance of various glycaemic control measures on hospital mortality. Retrospective, analytical cohort study that included patients hospitalised in internal medicine departments with a diagnosis related to diabetes mellitus (DM), excluding acute decompensations. The clinical endpoint was hospital mortality. We recorded clinical, analytical and glycaemic control-related variables (scheduled insulin administration, plasma glycaemia at admission, HbA1c, mean glycaemia (MG) and in-hospital glycaemic variability and hypoglycaemia). The measurement of hospital mortality predictors was performed using univariate and multivariate logistic regression. A total of 384 patients (50.3% men) were included. The mean age was 78.5 (SD, 10.3) years. The DM-related diagnoses were type 2 diabetes (83.6%) and stress hyperglycaemia (6.8%). Thirty-one (8.1%) patients died while in hospital. In the multivariate analysis, the best model for predicting mortality (R(2)=0.326; P<.0001) consisted, in order of importance, of age (χ(2)=8.19; OR=1.094; 95% CI 1.020-1.174; P=.004), Charlson index (χ(2)=7.28; OR=1.48; 95% CI 1.11-1.99; P=.007), initial glycaemia (χ(2)=6.05; OR=1.007; 95% CI 1.001-1.014; P=.014), HbA1c (χ(2)=5.76; OR=0.59; 95% CI 0.33-1; P=.016), glycaemic variability (χ(2)=4.41; OR=1.031; 95% CI 1-1.062; P=.036), need for corticosteroid treatment (χ(2)=4.03; OR=3.1; 95% CI 1-9.64; P=.045), administration of scheduled insulin (χ(2)=3.98; OR=0.26; 95% CI 0.066-1; P=.046) and systolic blood pressure (χ(2)=2.92; OR=0.985; 95% CI 0.97-1.003; P=.088). An increase in initial glycaemia and in-hospital glycaemic variability predict the risk of mortality for hospitalised patients with DM. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  15. 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.

  16. Problems and achievements of cotton (Gossypium Hirsutum L. weeds control

    Directory of Open Access Journals (Sweden)

    T. Barakova

    2017-09-01

    Full Text Available Abstract. Weed control in the cultivation of cotton is critical to the yield and quality of production. The influence of economically important weeds was studied. Chemical control is the most effective method of weed control in cotton but much of the information on it relates to primary weed infestation. Problems with primary weed infestation in cotton have been solved to a significant extent. The question of secondary weed infestation with annual and perennial graminaceous weeds during the period of cotton vegetation is also determined largely by the use of antigraminaceous herbicides. The data related to herbicides to effectively control secondary germinated broadleaf weeds in conventional technology for cotton growing are quite scarce, even globally. We are still seeking effective herbicides for control of these weeds in cotton crops. Studies on their influence on the sowing characteristics of cotton seed and the quality of cotton fiber are still insufficient. In the scientific literature there is not enough information on these questions. The combinations of herbicides, as well as their tank mixtures with fertilizers or plant growth regulators are more efficient than autonomous application. Often during their combined application higher synergistic effect on yield is produced. There is information about cotton cultivars resistant to glyphosate. These cultivars are GMO and they are banned within the European Union, including Bulgaria.

  17. 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.

  18. 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."

  19. Impact of dietary fibre-enriched ready-to-eat extruded snacks on the postprandial glycaemic response of non-diabetic patients.

    Science.gov (United States)

    Brennan, Margaret A; Derbyshire, Emma J; Brennan, Charles S; Tiwari, Brijesh K

    2012-05-01

    Food intervention is a financially sensible way for prevention and treatment of diabetes. Extruded snack foods are considered high glycaemic products. Our previous research illustrated that postprandial glycaemic responses to snacks are manipulated by altering dietary fibre and starch contents. The current research assessed the effect of psyllium and oat bran on postprandial glycaemia and in vitro digestibility. Addition of psyllium fibre to extruded snack products significantly reduced both the in vitro and in vivo glycaemic responses of products compared to a control snack product recipe. Oat bran inclusion reduced in vitro starch digestibility but not in vivo glycaemic response. The inclusion of oat bran into the snack products appeared to extend the glycaemic response of individuals compared to the control snack, suggesting a possibility of prolonging glucose release and potentially affecting satiety responses. The positive effect in attenuating glucose response means that psyllium fibre could be a target for inclusion by the snack food industry to effectively manipulate postprandial glucose response of individuals. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Achievements in and Challenges of Tuberculosis Control in South Korea.

    Science.gov (United States)

    Kim, Ji Han; Yim, Jae-Joon

    2015-11-01

    After the Korean War (1950-1953), nearly 6.5% of South Korea's population had active tuberculosis (TB). In response, South Korea implemented the National Tuberculosis Program in 1962. From 1965 to 1995, the prevalence of bacteriologically confirmed pulmonary TB in South Korea decreased from 940 to 219 cases per 100,000 population. Astounding economic growth might have contributed to this result; however, TB incidence in South Korea remains the highest among high-income countries. The rate of decrease in TB incidence seems to have slowed over the past 15 years. A demographic shift toward an older population, many of whom have latent TB and various concurrent conditions, is challenging TB control efforts in South Korea. The increasing number of immigrants also plays a part in the prolonged battle against TB. A historical review of TB in South Korea provides an opportunity to understand national TB control efforts that are applicable to other parts of the world.

  1. 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. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Glycaemic indices and non-traditional biochemical cardiovascular disease markers in a diabetic population in Nigeria

    International Nuclear Information System (INIS)

    Okeoghene, O.A.; Azenabor, A.

    2011-01-01

    Objective: To determine the frequency of hyperfibrinogenaemia, elevated C-reactive protein, hyperuricaemia and elevated lipoprotein A in a clinic population of patients with type 2 Diabetes mellitus (DM) compared with healthy controls; and determine the interrelationship between fasting plasma glucose levels and indices of long-term glycaemic control (fructosamine and glycosylated haemoglobin) in DM. Study Design: Cross-sectional, analytical study. Place and Duration of Study: The study was conducted at the Lagos State University Teaching Hospital, Ikeja, from April to June 2009. Methodology: A total of 200 patients with type 2 DM and 100 age and gender matched healthy controls were recruited for the study. Glycaemic control was assessed using fasting blood glucose, fructosamine and glycosylated haemoglobin levels. The non-traditional risk factors studied included C-reactive protein (CRP), Lipoprotein a (Lpa), serum uric acid (SUA), microalbuminuria and fibrinogen. Mann-whitney, chi-square and Pearson's correlation tests were used for analysis as applicable. Results: Hyperfibrinoginaemia, elevated CRP, LPa, microalbuminuria and hyperuricaemia were present in 3.5%, 65%, 12%, 6% and 57% respectively in type 2 DM. The mean levels of these CV risk factors were significantly higher in subjects with type 2 DM than that of the control subject. There was a positive and significant correlation between HbA1c and FBS (r=0.46, p=0.0001) and HbA1c and fructosamine (r=0.49, p=0.0001). All studied CVS risk factors were related to indices of glycaemic control which were found to be interrelated. Fasting blood glucose significantly correlated with both HbA1c and fructosamine but HbA1c showed better correlation to FPG than fructosamine (r=0.51 vs. 0.32). Conclusion: Glycosylated haemoglobin and fasting plasma glucose but not fructosamine are significantly associated with microalbuminuria, fibrinogen SUA and CRP in type 2 DM. HbA1c was found to be better than fructosamine in

  3. 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...

  4. 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

    education programme, 349 patients were randomised to either a usual care control group or an intervention group, which received up to five individual counselling sessions in 1 year based on MI, in addition to usual care. A randomised parallel design was used and open-label allocation was done by random...... diabetes mellitus, were over 18 years of age and had participated in a 4 day group education programme offered at a diabetes clinic at a university hospital in Denmark. Exclusion criteria included pregnancy, severe debilitating disease and cognitive deficit. Out of 469 patients who attended the group...... diabetes self-care, compared with usual care. RESULTS: Out of the 176 included in the control group and 173 in the intervention group, 153 and 145 were analysed in the groups, respectively. When using the baseline value as covariate there were no significant differences in change score between the two...

  5. The effect of functional insulin therapy on glycaemic parameters in children with diabetes mellitus type 1.

    Science.gov (United States)

    Štimjanin-Koldžo, Diana; Alajbegović, Salem; Štimjanin, Ena; Mehinagić, Jasmina

    2017-08-01

    Aim The aim of the study is to evaluate the effect of a prospectively conducted interactive 5-day education programme based on Düsseldorf model on glycated haemoglobin (A1C), and total daily dose of insulin in type 1 diabetes patients. Methods A total of 67 type 1 diabetes patients was analysed; mean age of 11±0.68 years, 43 females and 24 males. The programme was led by a trained team of diabetes specialist doctors and nurses. All subjects and their parents completed a knowledge test about diabetes at beginning, and at the end of education, and after 12 months (30 questions). Subjects were evaluated for total daily insulin, and HbA1c at baseline, as well as 3, 6, 9 and 12 months after the end of the education programme. Results Results of the knowledge test after the education have shown higher knowledge at baseline. At the end of the education programme an average of total daily insulin dose was significantly lower. There was a 3.17% reduction in HbA1c values over 9 months, and 1.8% over 12 months in the comparison to the baseline values (p1). Conclusions Structured education programme of functional insulin therapy was associated with improved glycaemic control in type 1 diabetes patients and their parents. It motivated patients and parents to improve glycaemic control. One year after the follow up, glycaemic control was worsening, due to lack of patients' motivation, therefore, there is a need for yearly re-education. Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

  6. 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.

  7. Glycaemic responses in Asian and non-Asian people with type 2 diabetes initiating insulin glargine 100 units/mL: A patient-level pooled analysis of 16 randomised controlled trials.

    Science.gov (United States)

    Chan, Juliana C N; Bunnag, Pongamorn; Chan, Siew P; Tan, Iris T I; Tsai, Shih-Tzer; Gao, Ling; Landgraf, Wolfgang

    2018-01-01

    To compare outcomes between Asian and non-Asian patients with type 2 diabetes (T2D) inadequately controlled on oral antidiabetic drugs (OADs) initiating insulin glargine 100 units (U)/mL (Gla-100) in randomised controlled clinical trials. Post hoc analysis of patient-level data (Asian n = 235; non-Asian n = 3351) from 16 trials. At baseline, Asian patients were younger with lower body mass index (BMI), fasting C-peptide, and fasting plasma glucose (FPG) than non-Asian patients (all P Asian patients had a higher mean glycosylated haemoglobin (HbA1c) at Week 24 and less reduction in HbA1c from baseline (7.4% vs. 7.2%; -1.3% vs. -1.6%, respectively; P = .0001), and were less likely to achieve HbA1c Asian patients. Reductions in FPG and rates of hypoglycaemia were similar between Asian and non-Asian patients. Asian patients had less weight gain than non-Asian patients (+1.3 vs. +1.9 kg, respectively, P = .013). In our post hoc meta-analysis, Gla-100 effectively lowers HbA1c and FPG in Asian patients with T2D uncontrolled on OADs with similar incidence of hypoglycaemia and less absolute weight gain compared with non-Asian patients. At a similar FPG reduction, fewer Asian patients achieved HbA1c target <7.0%, suggesting that prandial glucose needs to be addressed. Copyright © 2017. Published by Elsevier B.V.

  8. Day-and-night glycaemic control with closed-loop insulin delivery versus conventional insulin pump therapy in free-living adults with well controlled type 1 diabetes: an open-label, randomised, crossover study.

    Science.gov (United States)

    Bally, Lia; Thabit, Hood; Kojzar, Harald; Mader, Julia K; Qerimi-Hyseni, Jehona; Hartnell, Sara; Tauschmann, Martin; Allen, Janet M; Wilinska, Malgorzata E; Pieber, Thomas R; Evans, Mark L; Hovorka, Roman

    2017-04-01

    Tight control of blood glucose concentration in people with type 1 diabetes predisposes to hypoglycaemia. We aimed to investigate whether day-and-night hybrid closed-loop insulin delivery can improve glucose control while alleviating the risk of hypoglycaemia in adults with HbA 1c below 7·5% (58 mmol/mol). In this open-label, randomised, crossover study, we recruited adults (aged ≥18 years) with type 1 diabetes and HbA 1c below 7·5% from Addenbrooke's Hospital (Cambridge, UK) and Medical University of Graz (Graz, Austria). After a 2-4 week run-in period, participants were randomly assigned (1:1), using web-based randomly permuted blocks of four, to receive insulin via the day-and-night hybrid closed-loop system or usual pump therapy for 4 weeks, followed by a 2-4 week washout period and then the other intervention for 4 weeks. Treatment interventions were unsupervised and done under free-living conditions. During the closed-loop period, a model-predictive control algorithm directed insulin delivery, and prandial insulin delivery was calculated with a standard bolus wizard. The primary outcome was the proportion of time when sensor glucose concentration was in target range (3·9-10·0 mmol/L) over the 4 week study period. Analyses were by intention to treat. This study is registered with ClinicalTrials.gov, number NCT02727231, and is completed. Between March 21 and June 24, 2016, we recruited 31 participants, of whom 29 were randomised. One participant withdrew during the first closed-loop period because of dissatisfaction with study devices and glucose control. The proportion of time when sensor glucose concentration was in target range was 10·5 percentage points higher (95% CI 7·6-13·4; pday-and-night hybrid closed-loop insulin delivery under unsupervised, free-living conditions for 4 weeks in adults with type 1 diabetes and HbA 1c below 7·5% is safe and well tolerated, improves glucose control, and reduces hypoglycaemia burden. Larger and longer studies

  9. [Implementation of precision control to achieve the goal of schistosomiasis elimination in China].

    Science.gov (United States)

    Zhou, Xiao-nong

    2016-02-01

    The integrated strategy for schistosomiasis control with focus on infectious source control, which has been implemented since 2004, accelerated the progress towards schistosomiasis control in China, and achieved transmission control of the disease across the country by the end of 2015, which achieved the overall objective of the Mid- and Long-term National Plan for Prevention and Control of Schistosomiasis (2004-2015) on schedule. Then, the goal of schistosomiasis elimination by 2025 was proposed in China in 2014. To achieve this new goal on schedule, we have to address the key issues, and implement precision control measures with more precise identification of control targets, so that we are able to completely eradicate the potential factors leading to resurgence of schistosomiasis transmission and enable the achievement of schistosomiasis elimination on schedule. Precision schistosomiasis control, a theoretical innovation of precision medicine in schistosomiasis control, will provide new insights into schistosomiasis control based on the conception of precision medicine. This paper describes the definition, interventions and the role of precision schistosomiasis control in the elimination of schistosomiasis in China, and demonstrates that sustainable improvement of professionals and integrated control capability at grass-root level is a prerequisite to the implementation of schistosomiasis control, precision schistosomiasis control is a key to the further implementation of the integrated strategy for schistosomiasis control with focus on infectious source control, and precision schistosomiasis control is a guarantee of curing schistosomiasis patients and implementing schistosomiasis control program and interventions.

  10. Glycaemic adverse drug reactions from anti-neoplastics used in ...

    African Journals Online (AJOL)

    235625 records ... Glycaemic adverse drug reactions from anti-neoplastics used in treating pancreatic cancer. ... Based on the emphasized nine antineoplastic drugs with high hyperglycemic ADR incidence, we found: fluorouracil, sorafenib and pemetrexed with high ADR record of metabolism and nutrition disorders; ...

  11. 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...

  12. Glycaemic Index Of Boiled Cocoyam And Stew | Alegbejo | Sahel ...

    African Journals Online (AJOL)

    Cocoyam can be processed in several ways. It contains digestible starch, protein and other valuable nutrients. Consumption of cocoyam is very high all over Nigeria. This study was undertaken to determine the glycaemic response of diabetic and healthy subjects to equal amounts of carbohydrate in the form of boiled ...

  13. A randomized, double-blind, placebo-controlled, phase II clinical trial to investigate the efficacy and safety of oral DA-1229 in patients with type 2 diabetes mellitus who have inadequate glycaemic control with diet and exercise.

    Science.gov (United States)

    Jung, Chang Hee; Park, Cheol-Young; Ahn, Kyu-Joeng; Kim, Nan-Hee; Jang, Hak-Chul; Lee, Moon-Kyu; Park, Joong-Yeol; Chung, Choon-Hee; Min, Kyung-Wan; Sung, Yeon-Ah; Park, Jeong-Hyun; Kim, Sung Jin; Lee, Hyo Jung; Park, Sung-Woo

    2015-03-01

    DA-1229 is a novel, potent and selective dipeptidyl peptidase-4 (DPP-IV) inhibitor that is orally bioavailable. We aimed to evaluate the optimal dose, efficacy and safety of DA-1229, in Korean subjects with type 2 diabetes mellitus suboptimally controlled with diet and exercise. We enrolled 158 patients (mean age, 53 years and a mean BMI, 25.6 kg/m(2) ). The mean baseline fasting plasma glucose level, HbA1c and duration of diabetes were 8.28 mmol/L, 7.6% (60 mmol/mol) and 3.9 years, respectively. After 2 or 6 weeks of an exercise and diet program followed by 2 weeks of a placebo period, the subjects were randomized into one of four groups for a 12-week active treatment period: placebo, 2.5, 5 or 10 mg of DA-1229. All three doses of DA-1229 significantly reduced HbA1c from baseline compared to the placebo group (-0.09 in the placebo group vs. -0.56, -0.66 and -0.61% in 2.5, 5 and 10-mg groups, respectively) but without any significant differences between the doses. Insulin secretory function, as assessed by homeostasis model assessment β-cell, the insulinogenic index, 2-h oral glucose tolerance test (OGTT) C-peptide and post-OGTT C-peptide area under the curve (AUC)0-2h, significantly improved with DA-1229 treatment. The incidence of adverse events was similar between the treatment groups and DA-1229 did not affect body weight or induce hypoglycaemic events. DA-1229 monotherapy (5 mg for 12 weeks) improved HbA1c, fasting plasma glucose level, OGTT results and β-cell function. This drug was well tolerated in Korean subjects with type 2 diabetes mellitus. © 2014 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons, Ltd.

  14. 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 (pglucose metabolism are not detrimental for global episodic memory processes. This enhances our understanding of how metabolic disorders are associated with memory impairments. © 2013.

  15. Achievement goals and emotions: The mediational roles of perceived progress, control, and value.

    Science.gov (United States)

    Hall, Nathan C; Sampasivam, Lavanya; Muis, Krista R; Ranellucci, John

    2016-06-01

    The link between achievement goals and achievement emotions is well established; however, research exploring potential mediators of this relationship is lacking. The control-value theory of achievement emotions (Pekrun, 2006, Educational Psychology Review, 18, 315) posits that perceptions of control and value mediate the relationship between achievement goals and achievement emotions, whereas the bidirectional theory of affect (Linnenbrink & Pintrich, 2002, Educational Psychologist, 37, 69) proposes that perceived progress mediates this relationship. The present study empirically evaluated three hypothesized mediators of the effects of achievement goals on learning-related emotions as proposed in the control-value theory and the bidirectional theory of affect. Undergraduate students (N = 273) from humanities, social science, and STEM disciplines participated. Participants completed web-based questionnaires evaluating academic achievement goals, perceptions of control, perceived task value, and achievement emotions. Results provided empirical support primarily for perceived progress as a mediator of mastery-approach goal effects on positive emotions (enjoyment, hope), showing indirect effects of mastery- and performance-approach goals on outcome-related emotions (hope, anxiety) via perceived control. Indirect effects of mastery- and performance-approach goals were further observed on anxiety via perceived value, with higher value levels predicting greater anxiety. Study findings partially support Linnenbrink and Pintrich's (2002, Educational Psychologist, 37, 69) bidirectional theory of affect while underscoring the potential for indirect effects of goals on emotions through perceived control as proposed by Pekrun (2006, Educational Psychology Review, 18, 315). © 2016 The British Psychological Society.

  16. 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. © 2010 The Author. Journal of Personality © 2010, Wiley Periodicals, Inc.

  17. Gaps and barriers in the control of blood glucose in people with type 2 diabetes.

    Science.gov (United States)

    Blonde, Lawrence; Aschner, Pablo; Bailey, Clifford; Ji, Linong; Leiter, Lawrence A; Matthaei, Stephan

    2017-05-01

    Glycaemic control is suboptimal in a large proportion of people with type 2 diabetes who are consequently at an increased and avoidable risk of potentially severe complications. We sought to explore attitudes and practices among healthcare professionals that may contribute to suboptimal glycaemic control through a review of recent relevant publications in the scientific literature. An electronic search of the PubMed database was performed to identify relevant publications from January 2011 to July 2015. The electronic search was complemented by a manual search of abstracts from key diabetes conferences in 2014/2015 available online. Recently published data indicate that glycaemic control is suboptimal in a substantial proportion (typically 40%-60%) of people with diabetes. This is the case across geographic regions and in both low- and higher-income countries. Therapeutic inertia appears to be an important contributor to poor glycaemic control in up to half of people with type 2 diabetes. In particular, prescribers are often willing to tolerate extended periods of 'mild' hyperglycaemia as well as having low expectations for their patients. There are often delays of 3 years or longer in initiating or intensifying glucose-lowering therapy when needed. Many people with type 2 diabetes are failed by current management, with approximately half not achieving or maintaining appropriate target blood glucose levels, leaving these patients at increased and avoidable risk of serious complications. Review criteria: The methodology of this review article is detailed in the 'Methods' section.

  18. 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…

  19. 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…

  20. Children's Self-Regulation and School Achievement in Cultural Contexts: The Role of Maternal Restrictive Control

    Science.gov (United States)

    Weis, Mirjam; Trommsdorff, Gisela; Muñoz, Lorena

    2016-01-01

    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. PMID:27303318

  1. Influence of bread volume on glycaemic response and satiety.

    Science.gov (United States)

    Burton, Pat; Lightowler, Helen J

    2006-11-01

    The role of carbohydrates in health and disease has received a high profile in recent years, in particular the glycaemic index (GI) as a physiological classification of carbohydrate foods. A common carbohydrate source in the UK is white bread, which is considered to have a high GI value and low satiety value. In the present study, the possibility of favourably altering the GI of white bread by manipulating bread structure (loaf form) was investigated. In a randomised repeated-measures design, ten subjects were tested for glycaemic and satiety responses to four loaves of varying volume, but of consistent macronutrient content. Peak plasma glucose levels and GI values were shown to be significantly reduced by lowering loaf volume (P=0.007, Pbread, which is generally considered to be high-GI and low-SI, can favourably alter metabolic and appetite responses. Relatively small differences in the GI of regularly consumed starch foods have been shown to have beneficial effects on health.

  2. Soups increase satiety through delayed gastric emptying yet increased glycaemic response.

    Science.gov (United States)

    Clegg, M E; Ranawana, V; Shafat, A; Henry, C J

    2013-01-01

    Previous studies have demonstrated the satiating properties of soups compared with solids; however, the mechanisms controlling soup-induced satiety are unknown. This study aimed to understand the physiological mechanisms causing soup to be more satiating. A total of 12 volunteers were tested on three occasions after a solid meal, chunky soup or smooth soup test meal for gastric emptying (GE) using the sodium [1-¹³C] acetate breath test, satiety using visual analog scales (VAS) and glycaemic response (GR) using finger prick blood samples. There was a significant difference in GE half-time (P=0.022) and GE ascension time (P=0.018), with the longest GE times for the smooth soup and the shortest for the solid meal. The GR area under the curve was significantly different between meals (P=0.040). The smooth soup had the greatest GR (87.0 ± 49.5 mmol/l/min), followed by the chunky soup (65.4 ± 48.0 mmol/l/min), with the solid meal having the lowest GR (61.6 ± 36.8 mmol/l/min). Volunteers were fuller after the smooth soup compared with solid meal (P=0.034). The smooth soup induced greater fullness compared with the solid meal because of a combination of delayed GE leading to feelings of gastric distension and rapid accessibility of nutrients causing a greater glycaemic response.

  3. Children's Achievement Moderates the Effects of Mothers' Use of Control and Autonomy Support

    Science.gov (United States)

    Fei-Yin Ng, Florrie; Kenney-Benson, Gwen A.; Pomerantz, Eva M.

    2004-01-01

    Two studies investigated the effects of parents' control and autonomy support on low- and high-achieving children. In Study 1, mothers' (N1=10) involvement with children (7 to 10 years old) in the context of a challenging task was observed. During this interaction, mothers' control predicted diminished engagement and their autonomy support…

  4. Goal Orientations, Locus of Control and Academic Achievement in Prospective Teachers: An Individual Differences Perspective

    Science.gov (United States)

    Bulus, Mustafa

    2011-01-01

    The aim of this study is to investigate the role of the prospective teachers' locus of control in goal orientations and of both orientations in academic achievement. The participants were 270 undergraduate students studying in different majors at the Faculty of Education in Pamukkale University. Goal Orientations and Locus of Control Scales were…

  5. 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…

  6. 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.

  7. Role of Parenting Style in Achieving Metabolic Control in Adolescents With Type 1 Diabetes

    OpenAIRE

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

    2011-01-01

    OBJECTIVE To examine the role of parenting style in achieving metabolic control and treatment adherence in adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS 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 HbA1c values. RESULTS An authoritative paternal parenting style predicted better glycemic control and...

  8. Locus of control, test anxiety, academic procrastination, and achievement among college students.

    Science.gov (United States)

    Carden, Randy; Bryant, Courtney; Moss, Rebekah

    2004-10-01

    114 undergraduates completed the Internal-External Locus of Control scale, the Procrastination Scale, and the Achievement Anxiety Test. They also provided a self-report of their cumulative GPA. Students were divided into two groups by a median-split of 10.5, yielding an internally oriented group of 57 and an externally oriented group of 57. The former students showed significantly lower academic procrastination, debilitating test anxiety, and reported higher academic achievement than the latter.

  9. Affectionless control by the same-sex parents increases dysfunctional attitudes about achievement.

    Science.gov (United States)

    Otani, Koichi; Suzuki, Akihito; Matsumoto, Yoshihiko; Sadahiro, Ryoichi; Enokido, Masanori

    2014-08-01

    The affectionless control parenting has been associated with depression in recipients. The aim of this study was to examine the effect of this parenting style on dysfunctional attitudes predisposing to depression. The subjects were 666 Japanese volunteers. Perceived parental rearing was evaluated by the Parental Bonding Instrument, which has the care and protection subscales. Parental rearing was classified into four types, i.e., optimal parenting (high care/low protection), affectionate constraint (high care/high protection), neglectful parenting (low care/low protection), and affectionless control (low care/high protection). Dysfunctional attitudes were evaluated by the 24-item Dysfunctional Attitude Scale, which has the achievement, dependency and self-control subscales. Males with paternal affectionless control had higher achievement scores than those with paternal optimal parenting (P=.016). Similarly, females with maternal affectionless control had higher achievement scores than those with maternal optimal parenting (P=.016). The present study suggests that affectionless control by the same-sex parents increases dysfunctional attitudes about achievement. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  10. Effects of dietary protein and glycaemic index on biomarkers of bone turnover in children

    DEFF Research Database (Denmark)

    Dalskov, Stine-Mathilde; Müller, Martha; Ritz, Christian

    2014-01-01

    For decades, it has been debated whether high protein intake compromises bone mineralisation, but no long-term randomised trial has investigated this in children. In the family-based, randomised controlled trial DiOGenes (Diet, Obesity and Genes), we examined the effects of dietary protein...... and glycaemic index (GI) on biomarkers of bone turnover and height in children aged 5-18 years. In two study centres, families with overweight parents were randomly assigned to one of five ad libitum-energy, low-fat (25-30 % energy (E%)) diets for 6 months: low protein/low GI; low protein/high GI; high protein....../low GI; high protein/high GI; control. They received dietary instructions and were provided all foods for free. Children, who were eligible and willing to participate, were included in the study. In the present analyses, we included children with data on plasma osteocalcin or urinary N...

  11. 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.

  12. Impact and cost-effectiveness of snail control to achieve disease control targets for schistosomiasis

    OpenAIRE

    Lo, Nathan C.; Gurarie, David; Yoon, Nara; Coulibaly, Jean T.; Bendavid, Eran; Andrews, Jason R.; King, Charles H.

    2018-01-01

    Schistosomiasis is a parasitic disease that affects over 240 million people globally. To improve population-level disease control, there is growing interest in adding chemical-based snail control interventions to interrupt the lifecycle of Schistosoma in its snail host to reduce parasite transmission. However, this approach is not widely implemented, and given environmental concerns, the optimal conditions for when snail control is appropriate are unclear. We assessed the potential impact and...

  13. The impact of a low glycaemic index (GI) diet on simultaneous measurements of blood glucose and fat oxidation: A whole body calorimetric study.

    Science.gov (United States)

    Kaur, Bhupinder; Quek Yu Chin, Rina; Camps, Stefan; Henry, Christiani Jeyakumar

    2016-06-01

    Low glycaemic index (GI) foods are known to minimize large fluctuations in blood glucose levels and have been suggested to increase fat oxidation. The objective of this study was to simultaneously investigate glucose excursion and substrate oxidation in a whole body calorimetre when Chinese male subjects were provided a low or high GI meal. In a randomized, controlled crossover non blind design, 12 healthy Chinese male adults (BMI 21.8 ± 1.3 kgm -2 ) attended two sessions consisting of either four low or high glycaemic meals (LGI vs HGI). Breakfast, lunch and snack were consumed in a whole body calorimetre while dinner was consumed at home. Daily changes in glycaemic response (GR) and postprandial GR responses were measured using a continuous glucose monitoring system. The GR was further calculated to obtain the incremental area under the curve (iAUC) for glucose concentrations. Glycaemic variability was calculated as mean amplitude of glycaemic excursion (MAGE). Substrate oxidation was calculated by measuring respiratory quotient and urine nitrogen excretion. After LGI meals in the whole body calorimetre, iAUC for glucose (P = 0.008) was lower compared to the HGI session. The HGI treatment produced a significantly greater MAGE than the LGI treatment over the 24 hour period (P fat oxidation and lower carbohydrate oxidation were observed following breakfast and lunch when comparing LGI to HGI (P fat oxidation over carbohydrate oxidation when compared to HGI mixed meals. The consumption of low GI meals may be a strategic approach in improving overall glycaemia and increasing fat oxidation in Asians consuming a high carbohydrate diet.

  14. Impact and cost-effectiveness of snail control to achieve disease control targets for schistosomiasis.

    Science.gov (United States)

    Lo, Nathan C; Gurarie, David; Yoon, Nara; Coulibaly, Jean T; Bendavid, Eran; Andrews, Jason R; King, Charles H

    2018-01-23

    Schistosomiasis is a parasitic disease that affects over 240 million people globally. To improve population-level disease control, there is growing interest in adding chemical-based snail control interventions to interrupt the lifecycle of Schistosoma in its snail host to reduce parasite transmission. However, this approach is not widely implemented, and given environmental concerns, the optimal conditions for when snail control is appropriate are unclear. We assessed the potential impact and cost-effectiveness of various snail control strategies. We extended previously published dynamic, age-structured transmission and cost-effectiveness models to simulate mass drug administration (MDA) and focal snail control interventions against Schistosoma haematobium across a range of low-prevalence (5-20%) and high-prevalence (25-50%) rural Kenyan communities. We simulated strategies over a 10-year period of MDA targeting school children or entire communities, snail control, and combined strategies. We measured incremental cost-effectiveness in 2016 US dollars per disability-adjusted life year and defined a strategy as optimally cost-effective when maximizing health gains (averted disability-adjusted life years) with an incremental cost-effectiveness below a Kenya-specific economic threshold. In both low- and high-prevalence settings, community-wide MDA with additional snail control reduced total disability by an additional 40% compared with school-based MDA alone. The optimally cost-effective scenario included the addition of snail control to MDA in over 95% of simulations. These results support inclusion of snail control in global guidelines and national schistosomiasis control strategies for optimal disease control, especially in settings with high prevalence, "hot spots" of transmission, and noncompliance to MDA. Copyright © 2018 the Author(s). Published by PNAS.

  15. 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…

  16. 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.

  17. 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…

  18. Students' Commitment, Engagement and Locus of Control as Predictor of Academic Achievement at Higher Education Level

    Science.gov (United States)

    Sarwar, Muhammad; Ashrafi, Ghulam Muhammad

    2014-01-01

    The purpose of this study was to analyze Students' Commitment, Engagement and Locus of Control as predictors of Academic Achievement at Higher Education Level. We used analytical model and conclusive research approach to conduct study and survey method for data collection. We selected 369 students using multistage sampling technique from three…

  19. Training Theory of Mind and Executive Control: A Tool for Improving School Achievement?

    Science.gov (United States)

    Kloo, Daniela; Perner, Josef

    2008-01-01

    In the preschool years, there are marked improvements in theory of mind (ToM) and executive functions. And, children's competence in these two core cognitive domains is associated with their academic achievement. Therefore, training ToM and executive control could be a valuable tool for improving children's success in school. This article reviews…

  20. In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss.

    Science.gov (United States)

    Guldbrand, H; Dizdar, B; Bunjaku, B; Lindström, T; Bachrach-Lindström, M; Fredrikson, M; Ostgren, C J; Nystrom, F H

    2012-08-01

    The study aimed to compare the effects of a 2 year intervention with a low-fat diet (LFD) or a low-carbohydrate diet (LCD), based on four group meetings to achieve compliance. This was a prospective randomised parallel trial involving 61 adults with type 2 diabetes consecutively recruited in primary care and randomised by drawing ballots. Patients that did not speak Swedish could not be recruited. The primary outcomes in this non-blinded study were weight and HbA(1c). Patients on the LFD aimed for 55-60 energy per cent (E%) and those on LCD for 20 E% from carbohydrate. The mean BMI and HbA(1c) of the participants were 32.7 ± 5.4 kg/m(2) and 57.0 ± 9.2 mmol/mol, respectively. No patients were lost to follow-up. Weight loss did not differ between groups and was maximal at 6 months: LFD -3.99 ± 4.1 kg (n=31); LCD -4.31 ± 3.6 kg (n=30); p carbohydrates is safe with respect to cardiovascular risk compared with the traditional LFD and this approach could constitute a treatment alternative. ClinicalTrials.gov NCT01005498 University Hospital of Linköping Research Funds, Linköping University, the County Council of Östergötland, and the Diabetes Research Centre of Linköping University.

  1. Glycaemic response of proso millet-based (Panicum miliaceum) products.

    Science.gov (United States)

    McSweeney, Matthew B; Ferenc, Agota; Smolkova, Katarina; Lazier, Alexander; Tucker, Amy; Seetharaman, Koushik; Wright, Amanda; Duizer, Lisa M; Ramdath, D Dan

    2017-11-01

    The glycaemic response of millet foods and the effect of processing are not known. Therefore, decorticated proso millet was used to produce four types of common food products (biscuits, couscous, porridge and an extruded snack). Postprandial blood glucose response of these products (all containing 50 g of total starch) was compared to the same foods produced with refined corn, in a crossover human study with 12 healthy male participants (age 26.3 ± 3.8 yr; BMI 23.3 ± 2.8 kg/m 2 ). Capillary blood samples were collected and glycaemic response was determined; differences were assessed using repeat measures ANOVA. Overall, the mean (±SEM) incremental area under the blood glucose response curve (mmol min/l) of the proso millet products was different from the corn products, but individual products (couscous = 66.7 ± 11.6, biscuit = 82.6 ± 13.7, extrudate = 198.7 ± 20.9, porridge = 40.1 ± 5.8) were not significantly lower (couscous = 43.5 ± 5.8, biscuit = 102.0 ± 10.3, extrudate = 198.7 ± 20.9, porridge = 52.2 ± 8.1) (p > .05). Glycaemic response of the products was not dependent on the grain type, but rather product matrix.

  2. 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...

  3. Glycaemic indices of different varieties of rice grown in Sri Lanka.

    Science.gov (United States)

    Hettiarachchi, P; Jiffry, M T; Jansz, E R; Wickramasinghe, A R; Fernando, D J

    2001-03-01

    Varieties of red raw rice are widely believed to have a better nutritional quality. The physiological effects of consuming different varieties of rice may not be so. The glycaemic index has been developed as an indicator of the physiological effect of foods. It is the glycaemic response of a 50 g carbohydrate portion of food expressed as a percentage of that of a standard. The objective of this study was to determine the glycaemic indices of different varieties of rice grown in Sri Lanka. Digestible carbohydrate content of 11 varieties of rice flour and bread were determined. Fasting blood samples followed by half-hourly samples for two hours were drawn after giving portions of either cooked rice or bread containing 50 g carbohydrate each. Fibre mill in Gampaha district. Twenty-two fibre mill workers aged between 25 and 50 years. The area under the blood glucose curve (AUC) for varieties of rice for a subject was calculated. Average AUC of 3 values for bread were calculated. Glycaemic index of each variety of rice was determined from the above variables. Glycaemic indices of varieties of rice differ. The glycaemic indices of varieties of red raw rice varied between 56 and 73 and the variety Bg 350 had the lowest glycaemic index. There was no significant difference between mean glycaemic index of varieties of white raw and some varieties of red raw rice (p = 0.2). Parboiled varieties of red raw rice had a significantly lower glycaemic index than white raw rice (p = 0.04) and some of the red raw rice (p = 0.005). The glycaemic index cannot be predicted from the colour of the rice grain. Red parboiled varieties of rice and Bg 350 can be recommended for patients with diabetes.

  4. Effects of the First Line Diabetes Care (FiLDCare) self-management education and support project on knowledge, attitudes, perceptions, self-management practices and glycaemic control: a quasi-experimental study conducted in the Northern Philippines.

    Science.gov (United States)

    Ku, Grace Marie V; Kegels, Guy

    2014-08-11

    To investigate the effects of implementing a context-adapted diabetes self-management education and support (DSME/S) project based on chronic care models in the Philippines, on knowledge, attitudes, self-management practices, adiposity/obesity and glycaemia of people with diabetes. Prospective quasi-experimental before-after study. 203 people with type 2 diabetes mellitus from two local government units in the Northern Philippines fulfilling set criteria. Context-adapted DSME/S was given to a cohort of people with diabetes by trained pre-existing local government healthcare personnel. Changes in knowledge, attitudes and self-management practices, body mass index, waist circumference, waist-hip ratio (WHR) and glycosylated haemoglobin (HbA1c) were measured 1 year after full project implementation. Non-parametric and parametric descriptive and inferential statistics including logistic regression analysis were done. Complete data were collected from 164 participants. Improvements in glycaemia, waist circumference, WHR, knowledge, some attitudes, adherence to medications and exercise, and an increase in fear of diabetes were significant. Reductions in HbA1c, regardless of level of control, were noted in 60.4%. Significant increase in knowledge (pability to control blood glucose (p=0.004) and adherence to medications (p=0.001) were noted among those whose glycaemia improved. Significant differences between the subgroups whose HbA1c improved and those whose HbA1c deteriorated include male gender (p=0.042), shorter duration of diabetes (p=0.001) and increased perceived ability to control blood glucose (p=0.042). Significant correlates to improved glycaemia were male gender (OR=2.655; p=0.034), duration of diabetes >10 years (OR=0.214; p=0.003) and fear of diabetes (OR=0.490; p=0.048). Context-adapted DSME/S introduced in resource-constrained settings and making use of established human resources for health may improve knowledge, attitudes, self-management practices

  5. 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.

  6. Implementing Lean Six Sigma to achieve inventory control in supply chain management

    Science.gov (United States)

    Hong, Chen

    2017-11-01

    The inventory cost has important impact on the production cost. In order to get the maximum circulation of funds of enterprise with minimum inventory cost, the inventory control with Lean Six Sigma is presented in supply chain management. The inventory includes both the raw material and the semi-finished parts in manufacturing process. Though the inventory is often studied, the inventory control in manufacturing process is seldom mentioned. This paper reports the inventory control from the perspective of manufacturing process by using statistical techniques including DMAIC, Control Chart, and Statistical Process Control. The process stability is evaluated and the process capability is verified with Lean Six Sigma philosophy. The demonstration in power meter production shows the inventory is decreased from 25% to 0.4%, which indicates the inventory control can be achieved with Lean Six Sigma philosophy and the inventory cost in production can be saved for future sustainable development in supply chain management.

  7. 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.

  8. 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.

  9. Relationship between glycaemic levels and arterial stiffness in non-diabetic adults.

    Science.gov (United States)

    Cavero-Redondo, Iván; Martínez-Vizcaíno, Vicente; Álvarez-Bueno, Celia; Recio-Rodríguez, José Ignacio; Gómez-Marcos, Manuel Ángel; García-Ortiz, Luis

    2018-01-23

    To examine, in a non-diabetic population, whether the association between arterial stiffness and glycaemic levels depends on the test used as a glycaemic indicator, fasting plasma glucose (FPG) or glycated haemoglobin A1c (HbA1c). A cross-sectional analysis of a 220 non-diabetic subsample from the EVIDENT II study in which FPG, HbA1c and arterial stiffness-related parameters (pulse wave velocity, radial and central augmentation index, and central pulse pressure) were determined. Mean differences in arterial stiffness-related parameters by HbA1c and FPG tertiles were tested using analysis of covariance. All means of arterial stiffness-related parameters increased by HbA1c tertiles, although mean differences were only statistically significant in pulse wave velocity (p ≤.001), even after controlling for potential confounders (HbA1c <5.30% = 6.88 m/s; HbA1c 5.30%-5.59% = 7.06 m/s; and HbA1c ≥5.60% = 8.16 m/s, p =.004). Conversely, mean differences in pulse wave velocity by FPG tertiles did not reach statistically significant differences after controlling for potential confounders (FPG 4.44 mmol/l = 7.18 m/s; FPG 4.44 mmol/l-4.87 mmol/l = 7.26 m/s; and FPG ≥4.88 mmol/l = 7.93 m/s, p =.066). Glucose levels in a non-diabetic population were associated with arterial stiffness but better when levels were determined using HbA1c. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  10. Achievement of radiative feedback control for long-pulse operation on EAST

    Science.gov (United States)

    Wu, K.; Yuan, Q. P.; Xiao, B. J.; Wang, L.; Duan, Y. M.; Chen, J. B.; Zheng, X. W.; Liu, X. J.; Zhang, B.; Xu, J. C.; Luo, Z. P.; Zang, Q.; Li, Y. Y.; Feng, W.; Wu, J. H.; Yang, Z. S.; Zhang, L.; Luo, G.-N.; Gong, X. Z.; Hu, L. Q.; Hu, J. S.; Li, J.

    2018-05-01

    The active feedback control of radiated power to prevent divertor target plates overheating during long-pulse operation has been developed and implemented on EAST. The radiation control algorithm, with impurity seeding via a supersonic molecular beam injection (SMBI) system, has shown great success in both reliability and stability. By seeding a sequence of short neon (Ne) impurity pulses with the SMBI from the outer mid-plane, the radiated power of the bulk plasma can be well controlled, and the duration of radiative control (feedforward and feedback) is 4.5 s during a discharge of 10 s. Reliable control of the total radiated power of bulk plasma has been successfully achieved in long-pulse upper single null (USN) discharges with a tungsten divertor. The achieved control range of {{f}rad} is 20%–30% in L-mode regimes and 18%–36% in H-mode regimes. The temperature of the divertor target plates was maintained at a low level during the radiative control phase. The peak particle flux on the divertor target was decreased by feedforward Ne injection in the L-mode discharges, while the Ne pulses from the SMBI had no influence on the peak particle flux because of the very small injecting volume. It is shown that although the radiated power increased, no serious reduction of plasma-stored energy or confinement was observed during the control phase. The success of the radiation control algorithm and current experiments in radiated power control represents a significant advance for steady-state divertor radiation and heat flux control on EAST for near-future long-pulse operation.

  11. Snack bar compositions and their acute glycaemic and satiety effects.

    Science.gov (United States)

    Yan, Mary R; Parsons, Andrew; Whalley, Gillian A; Kelleher, John; Rush, Elaine C

    Maintaining blood glucose within homeostatic limits and eating foods that sup-press hunger and promote satiety have beneficial impacts for health. This study investigated the glycaemic re-sponse and satiety effects of a serving size of a healthier snack bar, branded Nothing Else, that met the required nutrient profiling score criteria for a health claim, in comparison to two top-selling commercial snack bars. In an experimental study, 24 participants aged >=50 years were recruited. On three different days blood glucose concentration was measured twice at baseline and 15, 30, 45, 60, 90 and 120 minutes after consumption of a serving size of each bar. Satiety effects were self-reported hunger, fullness, desire to eat, and amount could eat ratings on visual analogue scales. The incremental area under the blood glucose response curve (iAUC) over two hours for the Nothing Else bar was 30% lower than commercial Bar 2 (pbar induced the highest fullness rating and lowest hunger rating among the three snack bars. At two hours, fullness induced by the Nothing Else bar was twice that of Bar 2 (p=0.019), but not different to Bar 1 (p=0.212). The Nothing Else snack bar developed using the nutrient profiling scheme as a guideline, with its high protein and dietary fibre contents, had a lower glycaemic impact and induced a higher subjective satiety than the two commercial snack bars of equal weight.

  12. Dietary glycaemic load associated with cognitive performance in elderly subjects.

    Science.gov (United States)

    Power, Susan E; O'Connor, Eibhlís M; Ross, R Paul; Stanton, Catherine; O'Toole, Paul W; Fitzgerald, Gerald F; Jeffery, Ian B

    2015-06-01

    Ageing is associated with loss of cognitive function and an increased risk of dementia which is expected to place growing demands on health and long-term care providers. Among multiple causative factors, evidence suggests that cognitive impairment in older subjects may be influenced by diet. The objective of this study was to examine the association between dietary patterns, dietary glycaemic load (GL) and cognition in older Irish adults. Community-dwelling subjects (n 208; 94 males and 114 females; aged 64-93 years) were analysed. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire. Cognitive capacity was tested using the Mini-Mental State Examination (MMSE). The data were clustered to derive patterns of dietary intake. Multivariable-adjusted logistic and Poisson regression models were used to examine the relationship between dietary GL and MMSE score. Elderly subjects consuming 'prudent' dietary patterns (high in fruit, vegetables, fish, low-fat dairy and salad dressings and low in red meat and white bread) had higher MMSE scores (better cognitive function) than those consuming 'Western' dietary pattern (high in red meat and white bread and low in fruit and vegetables; P nutritional status, residential property price, cardiovascular medications and energy intake. In this community-dwelling elderly Irish cohort, consumption of a high glycaemic diet is associated with poorer cognitive performance as assessed by the MMSE.

  13. [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.

  14. 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.

  15. 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. PMID:26441758

  16. 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.

  17. The Exploration of the Associations between Locus of Control and 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.

  18. 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

  19. Birds achieve high robustness in uneven terrain through active control of landing conditions.

    Science.gov (United States)

    Birn-Jeffery, Aleksandra V; Daley, Monica A

    2012-06-15

    We understand little about how animals adjust locomotor behaviour to negotiate uneven terrain. The mechanical demands and constraints of such behaviours likely differ from uniform terrain locomotion. Here we investigated how common pheasants negotiate visible obstacles with heights from 10 to 50% of leg length. Our goal was to determine the neuro-mechanical strategies used to achieve robust stability, and address whether strategies vary with obstacle height. We found that control of landing conditions was crucial for minimising fluctuations in stance leg loading and work in uneven terrain. Variation in touchdown leg angle (θ(TD)) was correlated with the orientation of ground force during stance, and the angle between the leg and body velocity vector at touchdown (β(TD)) was correlated with net limb work. Pheasants actively targeted obstacles to control body velocity and leg posture at touchdown to achieve nearly steady dynamics on the obstacle step. In the approach step to an obstacle, the birds produced net positive limb work to launch themselves upward. On the obstacle, body dynamics were similar to uniform terrain. Pheasants also increased swing leg retraction velocity during obstacle negotiation, which we suggest is an active strategy to minimise fluctuations in peak force and leg posture in uneven terrain. Thus, pheasants appear to achieve robustly stable locomotion through a combination of path planning using visual feedback and active adjustment of leg swing dynamics to control landing conditions. We suggest that strategies for robust stability are context specific, depending on the quality of sensory feedback available, especially visual input.

  20. 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.

  1. 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.

  2. Quality of glycaemic control in ambulatory diabetics at the out ...

    African Journals Online (AJOL)

    ... and deteriorating diabetes. There is need to empower patients with knowledge and resources to enhance their individual participation in diabetes self-care. Diabetes care providers and facilities also need capacity building to improve care of patients with diabetes. East African Medical Journal Vol.80(8) 2003: 406-410 ...

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

    African Journals Online (AJOL)

    Uche

    2011-01-15

    Jan 15, 2011 ... Annals of Medical and Health Sciences Research – January 2011 – Vol. 1 N0.1 ... *Department of Medical Biochemistry, College of Medicine, University of Nigeria, Enugu Campus. (UNEC) Enugu ..... 30-32. 16. Baynes JW.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    associated with older age, higher education, higher patient activation, lower diabetes-related emotional distress, better diet and exercise behaviours, lower body mass index, shorter duration of disease and knowledge of HbA(1c) targets (P

  5. 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. Near normal glycaemia will reduce the risk for development of microvascular disease complications, but aggressive management of traditional cardio-vascular risk ...

  6. 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......In addition to the lipid-lowering effect of bile acid sequestrants (BASs), they also lower blood glucose and, therefore, could be beneficial in the treatment of patients with type 2 diabetes mellitus (T2DM). Three oral BASs are approved by the US Food and Drug Administration (FDA) for the treatment...... their potential as glucose-lowering agents in patients with T2DM....

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

    African Journals Online (AJOL)

    Background: Exercise is a major therapeutic tool in diabetes care, with proven benefits including improved metabolic indices and physical wellbeing. However, its effects ... Brisk walking was the most common exercise (44%) and the least common were Table Tennis, Swimming and Weight lifting (2% each). There were no ...

  8. Connecting scales: achieving in-field pest control from areawide and landscape ecology studies.

    Science.gov (United States)

    Schellhorn, Nancy A; Parry, Hazel R; Macfadyen, Sarina; Wang, Yongmo; Zalucki, Myron P

    2015-02-01

    Areawide management has a long history of achieving solutions that target pests, however, there has been little focus on the areawide management of arthropod natural enemies. Landscape ecology studies that show a positive relationship between natural enemy abundance and habitat diversity demonstrate landscape-dependent pest suppression, but have not yet clearly linked their findings to pest management or to the suite of pests associated with crops that require control. Instead the focus has often been on model systems of single pest species and their natural enemies. We suggest that management actions to capture pest control from natural enemies may be forth coming if: (i) the suite of response and predictor variables focus on pest complexes and specific management actions; (ii) the contribution of "the landscape" is identified by assessing the timing and numbers of natural enemies immigrating and emigrating to and from the target crop, as well as pests; and (iii) pest control thresholds aligned with crop development stages are the benchmark to measure impact of natural enemies on pests, in turn allowing for comparison between study regions, and generalizations. To achieve pest control we will need to incorporate what has been learned from an ecological understanding of model pest and natural enemy systems and integrate areawide landscape management with in-field pest management. © 2014 Institute of Zoology, Chinese Academy of Sciences.

  9. 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.

  10. 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.

  11. Insulinaemic and glycaemic responses to three forages in ponies.

    Science.gov (United States)

    Carslake, H B; Argo, C McG; Pinchbeck, G L; Dugdale, A H A; McGowan, C M

    2018-05-01

    Reduction of the hyperinsulinaemic response to feeding is central to the management of insulin dysregulation (ID). The aim of this study was to compare insulinaemic and glycaemic responses to soaked hay, dry hay and haylage in ponies. Twelve ponies of mixed breeds were maintained under identical management conditions. A randomised four-way crossover trial was conducted, in which fasted animals were fed a meal of 0.25% body weight as dry matter intake soaked hay, dry hay or haylage, or administered an oral glucose test (OGT). Blood glucose and serum insulin concentrations were measured before and at 2h following OGT, and regularly for 5h following forage meals. Median and interquartile range (IQR) area under the curve (AUC) for insulin (AUC i ) was greater for haylage (median 6495; IQR 17352) vs. dry hay (2932; IQR 5937; P=0.019) and soaked hay (1066; IQR 1753; P=0.002), and greater for dry hay vs. soaked hay (P=0.002). The AUC for glucose (AUC g ) was lower for soaked hay (1021; IQR 99) vs. dry hay (1075; IQR 105; P=0.002) and haylage (1107; IQR 221; P=0.003). Six ponies were classified as having ID based on the OGT. AUC i was greater in ID vs. non-ID ponies after all forages. In contrast, there was no detectable effect of ID status on AUC g . On an equivalent dry matter basis, soaked hay produced the lowest insulinaemic and glycaemic responses to feeding, while haylage produced the highest responses. The insulinaemic effects of all forages were greater in ponies with ID. These data support the practice of soaking hay with water to reduce postprandial insulinaemic responses in ponies. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. 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…

  13. 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.

  14. Contribution of liver nerves, glucagon, and adrenaline to the glycaemic response to exercise in rats

    NARCIS (Netherlands)

    van Dijk, Gertjan; Balkan, B.; Lindfeldt, J.; Bouws, G.; Scheurink, A.J.W.; Ahrén, B.; Steffens, A.B.

    1994-01-01

    The contribution of hepatic sympathetic innervation, glucagon and adrenaline to the glycaemic response to exercise was investigated in rats. Hepatically denervated (LDX) or sham operated (SHAM) rats with permanent catheters were therefore submitted to swimming with or without infusion of

  15. Effect of glycaemic status on left ventricular diastolic function in normotensive type 2 diabetic patients

    International Nuclear Information System (INIS)

    Hameedullah; Faheem, M.; Bahadar, S.; Hafizullah, M.; Najeeb, S.

    2009-01-01

    Diabetes is associated with Left ventricular diastolic and systolic dysfunction known as diabetic cardiomyopathy. Echocardiography is helpful for the detection of diastolic dysfunction and Echocardiographic screening for asymptomatic diabetic cardiomyopathy should be performed in all asymptomatic diabetic subjects. Identification of diabetic cardiomyopathy should result in the initiation of therapies to prevent the progression of diabetic cardiomyopathy. The objectives of this Descriptive case series was to determine the effect of glycaemic status on left ventricular diastolic function in normotesive type 2 diabetic patients. Methods: This study was performed at Cardiology department, PGMI Lady Reading Hospital, Peshawar from March 2007 to September 2007. Sixty normotesive type 2 diabetic patients were enrolled, 20 well control, 20 moderately control and 20 poorly control (Group- 3). Main outcome measures was Left ventricular diastolic function determined by Echocardiography. Results: Out of 60 patients there were 32 (53.3%) males and 28 (46.7%) females. Mean E/A ratio in Group 1 was 1.38.0.29, in Group 2 was 1.16.0.39 and in Group 3 was 0.60.0.15 (p<0.05). IVRT in Group-1 was 91.7.87 mSec, in Group-2 was 100.7.83 mSec and in Group-3 was 109.6.45 mSec (p<0.05). DT in Group 1 was 207.2 +- 12.6 mSec, in Group 2 was 218.11.3 mSec and in Group 3 was 229.7+- 9.52 mSec (p<0.05). Mean Em at mitral annulus in Group-1 was 0.14 +- 0.04 m/Sec, in Group-2 was 0.11+- 0.04 m/Sec and in Group-3 was 0.10 +- 0.03 m/Sec (p=0.002). Left ventricular diastolic dysfunction was documented in 4 (25%) patients in Group-1, 9 (45%) patients in Group-2 and 16 (80%) patients in Group-3 (p<0.05). There was Strong correlation between HbA1c level and diastolic indexes (p<0.05). Conclusion: Diastolic dysfunction is more frequent in poorly controlled diabetic patients and its severity is correlated with glycaemic control. (author)

  16. Digestive tolerance and postprandial glycaemic and insulinaemic responses after consumption of dairy desserts containing maltitol and fructo-oligosaccharides in adults.

    Science.gov (United States)

    Respondek, F; Hilpipre, C; Chauveau, P; Cazaubiel, M; Gendre, D; Maudet, C; Wagner, A

    2014-05-01

    To evaluate the short-term digestive tolerance and glycaemic response of several associations of maltitol and short-chain fructo-oligosaccharides (scFOS) used to replace sugars (for example, dextrose) in foods. Thirty-six healthy subjects aged 18-60 years were recruited for the study and 32 completed it. The subjects consumed six different mixtures of dextrose, maltitol and scFOS added in a chocolate dairy dessert at a dosage of 35 g. The test days were separated by 2-week washout periods. The subjects reported the intensity of four individual gastrointestinal (GI) symptoms, number of bowel movements and stool frequency for the 48 h following consumption of the dessert. A subgroup of 18 subjects also provided blood samples 2 h after intake to evaluate the postprandial glycaemic and insulinaemic responses. The composite score calculated from the intensity of flatulence, borborygmi, bloating and discomfort was significantly higher (Pdesserts containing maltitol and/or scFOS than for the control dessert containing dextrose, but remains at the level of mild effects. The number of bowel movements was also slightly increased (P=0.0006) and the stools were softer (P=0.0045) for the first 24 h but not after (P=0.1373 and 0.5420, respectively). Blood glycaemic and insulinaemic responses were lower for all the sugar-free recipes containing maltitol and scFOS in comparison to the control one (P<0.0001). This study has shown that maltitol and scFOS can be used jointly when formulating sugar-free foods with the benefit to lower postprandial glycaemic response with only a small and transient increase in non-serious GI symptoms.

  17. Can We Achieve Intuitive Prosthetic Elbow Control Based on Healthy Upper Limb Motor Strategies?

    Directory of Open Access Journals (Sweden)

    Manelle Merad

    2018-02-01

    Full Text Available Most transhumeral amputees report that their prosthetic device lacks functionality, citing the control strategy as a major limitation. Indeed, they are required to control several degrees of freedom with muscle groups primarily used for elbow actuation. As a result, most of them choose to have a one-degree-of-freedom myoelectric hand for grasping objects, a myoelectric wrist for pronation/supination, and a body-powered elbow. Unlike healthy upper limb movements, the prosthetic elbow joint angle, adjusted prior to the motion, is not involved in the overall upper limb movements, causing the rest of the body to compensate for the lack of mobility of the prosthesis. A promising solution to improve upper limb prosthesis control exploits the residual limb mobility: like in healthy movements, shoulder and prosthetic elbow motions are coupled using inter-joint coordination models. The present study aims to test this approach. A transhumeral amputated individual used a prosthesis with a residual limb motion-driven elbow to point at targets. The prosthetic elbow motion was derived from IMU-based shoulder measurements and a generic model of inter-joint coordinations built from healthy individuals data. For comparison, the participant also performed the task while the prosthetic elbow was implemented with his own myoelectric control strategy. The results show that although the transhumeral amputated participant achieved the pointing task with a better precision when the elbow was myoelectrically-controlled, he had to develop large compensatory trunk movements. Automatic elbow control reduced trunk displacements, and enabled a more natural body behavior with synchronous shoulder and elbow motions. However, due to socket impairments, the residual limb amplitudes were not as large as those of healthy shoulder movements. Therefore, this work also investigates if a control strategy whereby prosthetic joints are automatized according to healthy individuals

  18. Locus of Control, Interest in Schooling and Science Achievement of Some Deaf and Typical Secondary School Students in Nigeria

    Science.gov (United States)

    Olatoye, R. Ademola; Aanu, E. Mosunmola

    2010-01-01

    This study compared locus of control, interest in school and science achievement of typical and deaf secondary school students. The study also investigated influence of students' locus of control and interest in school on general science achievement. Seventy two (72) deaf and 235 typical children were purposively selected from eight secondary…

  19. Achieving atomistic control in materials processing by plasma–surface interactions

    International Nuclear Information System (INIS)

    Chang, Jeffrey; Chang, Jane P

    2017-01-01

    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. (topical review)

  20. Coaching to Augment Mentoring to Achieve Faculty Diversity: A Randomized Controlled Trial.

    Science.gov (United States)

    Williams, Simon N; Thakore, Bhoomi K; McGee, Richard

    2016-08-01

    The Academy for Future Science Faculty (the Academy) is a novel coaching intervention for biomedical PhD students designed to address limitations in previous efforts to promote faculty diversity. Unlike traditional research mentoring, the Academy includes both group and individual coaching, coaches have no research or evaluation roles with the students, and it is based on social science theories. The authors present a qualitative case study of one of the coaching groups and provide statistical analyses indicating whether one year in the Academy effects students' perceptions of the achievability and desirability of an academic career. The authors tested (July 2012-July 2013), with Northwestern University ethical approval, the Academy via a longitudinal randomized controlled trial. Participants were 121 latter-stage biomedical PhD students. The authors collected data via questionnaires, interviews, and meeting recordings. The case study shows how group career coaching can effectively supplement traditional one-to-one research mentoring; provide new role models for underrepresented minority students; and provide theory-based lenses through which to engage in open conversations about race, gender, and science careers. Repeated-measures analysis of variance showed that perceived achievability increased in the Academy group from baseline to one-year follow-up (mean, 5.75 versus 6.39) but decreased in the control group (6.58 versus 5.81). Perceived desirability decreased significantly less (P coaching model can effectively supplement traditional research mentoring and promote persistence toward academic careers.

  1. 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.

  2. Glycaemic variability in patients with severe sepsis or septic shock admitted to an Intensive Care Unit.

    Science.gov (United States)

    Silveira, L M; Basile-Filho, A; Nicolini, E A; Dessotte, C A M; Aguiar, G C S; Stabile, A M

    2017-08-01

    Sepsis is associated with morbidity and mortality, which implies high costs to the global health system. Metabolic alterations that increase glycaemia and glycaemic variability occur during sepsis. To verify mean body glucose levels and glycaemic variability in Intensive Care Unit (ICU) patients with severe sepsis or septic shock. Retrospective and exploratory study that involved collection of patients' sociodemographic and clinical data and calculation of severity scores. Glycaemia measurements helped to determine glycaemic variability through standard deviation and mean amplitude of glycaemic excursions. Analysis of 116 medical charts and 6730 glycaemia measurements revealed that the majority of patients were male and aged over 60 years. Surgical treatment was the main reason for ICU admission. High blood pressure and diabetes mellitus were the most usual comorbidities. Patients that died during the ICU stay presented the highest SOFA scores and mean glycaemia; they also experienced more hypoglycaemia events. Patients with diabetes had higher mean glycaemia, evaluated through standard deviation and mean amplitude of glycaemia excursions. Organic impairment at ICU admission may underlie glycaemic variability and lead to a less favourable outcome. High glycaemic variability in patients with diabetes indicates that monitoring of these individuals is crucial to ensure better outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. 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

  4. 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.

  5. 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.

  6. 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. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  7. Harsh parenting and academic achievement in Chinese adolescents: Potential mediating roles of effortful control and classroom engagement.

    Science.gov (United States)

    Wang, Mingzhong; Deng, Xueli; Du, Xiuxiu

    2018-04-01

    This study examined (a) the potential mediating roles of effortful control and classroom engagement in the association between harsh parenting and adolescent academic achievement, and (b) the potential moderating role of gender. Sixth through eighth graders in rural China (n=815, mean age=12.55years) reported on harsh parenting, effortful control, and classroom engagement. Parents also reported on each other's harsh parenting. Academic achievement was assessed by students' test scores and teacher-rated academic performance. Results of structural equation modeling revealed gender differences in patterns of association among the model variables. Harsh parenting was negatively and directly associated with academic achievement for both boys and girls. It was also negatively and indirectly associated with academic achievement via effortful control and classroom engagement sequentially, forming a common indirect "path" for boys and girls. The indirect negative effect of harsh parenting on boys' academic achievement was mainly realized through the mediator of effortful control, whereas this same indirect effect for girls was mainly realized through the mediator of classroom engagement. Jointly, effortful control and classroom engagement precipitates more indirect effects for boys than for girls in the association between harsh parenting and academic achievement. The discussion analyzes the potential "paths" from harsh parenting to adolescent academic achievement, as well as gender differences in these "paths." The current study has implications for teachers and parents eager to improve students' classroom engagement and academic achievement. Copyright © 2017. Published by Elsevier Ltd.

  8. Text message-based diabetes self-management support (SMS4BG): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Dobson, Rosie; Whittaker, Robyn; Jiang, Yannan; Shepherd, Matthew; Maddison, Ralph; Carter, Karen; Cutfield, Richard; McNamara, Catherine; Khanolkar, Manish; Murphy, Rinki

    2016-04-02

    Addressing the increasing prevalence, and associated disease burden, of diabetes is a priority of health services internationally. Interventions to support patients to effectively self-manage their condition have the potential to reduce the risk of costly and debilitating complications. The utilisation of mobile phones to deliver self-management support allows for patient-centred care at the frequency and intensity that patients desire from outside the clinic environment. Self-Management Support for Blood Glucose (SMS4BG) is a novel text message-based intervention for supporting people with diabetes to improve self-management behaviours and achieve better glycaemic control and is tailored to individual patient preferences, demographics, clinical characteristics, and culture. This study aims to assess whether SMS4BG can improve glycaemic control in adults with poorly controlled diabetes. This paper outlines the rationale and methods of the trial. A two-arm, parallel, randomised controlled trial will be conducted across New Zealand health districts. One thousand participants will be randomised at a 1:1 ratio to receive SMS4BG, a theoretically based and individually tailored automated text message-based diabetes self-management support programme (intervention) in addition to usual care, or usual care alone (control). The primary outcome is change in glycaemic control (HbA1c) at 9 months. Secondary outcomes include glycaemic control at 3 and 6 months, self-efficacy, self-care behaviours, diabetes distress, health-related quality of life, perceived social support, and illness perceptions. Cost information and healthcare utilisation will also be collected as well as intervention satisfaction and interaction. This study will provide information on the effectiveness of a text message-based self-management support tool for people with diabetes. If found to be effective it has the potential to provide individualised support to people with diabetes across New Zealand (and

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

    Directory of Open Access Journals (Sweden)

    S.H. Hasani

    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.

  10. Boredom in Achievement Settings: Exploring Control-Value Antecedents and Performance Outcomes of a Neglected Emotion

    Science.gov (United States)

    Pekrun, Reinhard; Goetz, Thomas; Daniels, Lia M.; Stupnisky, Robert H.; Perry, Raymond P.

    2010-01-01

    The linkages of achievement-related boredom with students' appraisals and performance outcomes were examined in a series of 5 exploratory, cross-sectional, and predictive investigations. Studies 1 and 2 assessed students' boredom in a single achievement episode (i.e., state achievement boredom); Studies 3, 4, and 5 focused on their habitual…

  11. Locus of Control or Self-Esteem; Which One is the Best Predictor of Academic Achievement in Iranian College Students

    OpenAIRE

    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: demogr...

  12. Evaluating compliance to a low glycaemic index (GI diet in women with polycystic ovary syndrome (PCOS

    Directory of Open Access Journals (Sweden)

    Atiomo William

    2011-03-01

    Full Text Available Abstract Background A low Glycaemic Index (GI diet may decrease some long-term health risks in Polycystic Ovary Syndrome (PCOS such as endometrial cancer. This study was performed to assess compliance to a low GI diet in women with PCOS. Food diaries prospectively collected over 6 months from women on a low GI diet or healthy eating diet were analysed retrospectively. The women were recruited for a pilot randomised control trial investigating whether a low GI diet decreased the risk of Endometrial Cancer. Nine women with PCOS completed 33 food diaries (17 from women on a low GI diet and 16 from women on a healthy eating diet recording 3023 food items (low GI group:n = 1457; healthy eating group:n = 1566. Data was analysed using Foster-Powell international values inserted into an SPSS database as no scientifically valid established nutrition software was found. The main outcome measures were mean item GI and Glyacemic Load (GL, mean meal GL, percentage high GI foods and mean weight loss. Findings Women allocated the low GI diet had a statistically significant lower GI of food items (33.67 vs 36.91, p Conclusion Women with PCOS on a low GI diet consumed food items with a significantly lower mean GI and GL compared to the healthy eating diet group. Longer term compliance needs evaluation in subsequent studies to ascertain that this translates to reduced long term health risks. Trial Registration ISRCTN: ISRCTN86420258

  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; Tao, Chun; Spinrad, Tracy L.; Doane, Leah D.; Thompson, Marilyn S.; Silva, Kassondra M.; Southworth, Jody

    2016-01-01

    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 and AA in young children. One hundred and three 4.5- to 7-year-olds (M = 5.98 years, SD = 0.61) wore a wrist-based actigraph for five continuous weekday nights. Teachers and coders reported on children’s EC. EC was also assessed with a computer-based task at school. Additionally, we obtained a standardized measure of children’s AA. There was a positive main effect of sleep efficiency to AA. Several relations between sleep and AA were moderated by EC and examination of the simple slopes indicated that the negative relation between sleep and AA was only significant at low levels of EC. PMID:28255190

  14. Controllable Organic Resistive Switching Achieved by One-Step Integration of Cone-Shaped Contact.

    Science.gov (United States)

    Ling, Haifeng; Yi, Mingdong; Nagai, Masaru; Xie, Linghai; Wang, Laiyuan; Hu, Bo; Huang, Wei

    2017-09-01

    Conductive filaments (CFs)-based resistive random access memory possesses the ability of scaling down to sub-nanoscale with high-density integration architecture, making it the most promising nanoelectronic technology for reclaiming Moore's law. Compared with the extensive study in inorganic switching medium, the scientific challenge now is to understand the growth kinetics of nanoscale CFs in organic polymers, aiming to achieve controllable switching characteristics toward flexible and reliable nonvolatile organic memory. Here, this paper systematically investigates the resistive switching (RS) behaviors based on a widely adopted vertical architecture of Al/organic/indium-tin-oxide (ITO), with poly(9-vinylcarbazole) as the case study. A nanoscale Al filament with a dynamic-gap zone (DGZ) is directly observed using in situ scanning transmission electron microscopy (STEM) , which demonstrates that the RS behaviors are related to the random formation of spliced filaments consisting of Al and oxygen vacancy dual conductive channels growing through carbazole groups. The randomicity of the filament formation can be depressed by introducing a cone-shaped contact via a one-step integration method. The conical electrode can effectively shorten the DGZ and enhance the localized electric field, thus reducing the switching voltage and improving the RS uniformity. This study provides a deeper insight of the multiple filamentary mechanisms for organic RS effect. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. 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

  16. 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, Andries; 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

  17. Effect of dietary curries on the glycaemic index.

    Science.gov (United States)

    Pirasath, S; Thayaananthan, K; Balakumar, S; Arasaratnam, V

    2010-12-01

    Determination of the glycaemic index (GI) of different basic foods in combination with different curries. METHODS; Healthy volunteers (n = 20) of 21.05 (+/- 0.92) years old, 53.90 (+/- 9.36) kg in body weight, 153.92 (+/- 9.15) cm in height and 20.55 (+/- 2.22) kgm(-2) of body mass index were included. After overnight fasting, 75g of glucose and each test food containing 75g of digestible carbohydrate were administered and blood glucose level measured half hourly for two hours. The GI was calculated and analysed by randomised complete block design using SAS analytical package. The mean GI values of parboiled rice ('Mottaikarupan') either with green leaf curry (Amaranthus) or gravy (soya meat) or green leaf curry and gravy were 47.47 (+/- 11.21), 56.30 (+/- 9.31) and 54.67 (+/- 10.03) % respectively. The mean GI of 'kurakkan pittu' (Eleucine coracana) with the above curries were 57.51 (+/- 5.52), 63.25 (+/- 8.86) and 59.25 (+/- 5.49) % respectively. The mean GI of 'atta pittu' (whole wheat grain flour) with the above curries were 44.40 (+/-14.27), 50.80 (+/- 9.35) and 46.29 (+/- 8.90) % respectively. The GI of parboiled rice or 'kurakkan pittu' or 'atta pittu' with green leaf curry differed significantly (p gravy or green leaf curry and gravy did not differ significantly (p > 0.05) among them. 'Kurakkan pittu' is inferior to 'atta pittu' and parboiled rice. Including curries to basic foods altered the GI. Therefore, when dietary advice is given to diabetic patients, not only the basic foods, but also the curries to be consumed have to be considered.

  18. Breakfast glycaemic index and exercise: combined effects on adolescents' cognition.

    Science.gov (United States)

    Cooper, Simon B; Bandelow, Stephan; Nute, Maria L; Morris, John G; Nevill, Mary E

    2015-02-01

    The aim of the present study was to examine the combined effects of breakfast glycaemic index (GI) and a mid-morning bout of exercise on adolescents' cognitive function. Participants were randomly allocated to a high or low GI breakfast group in a mixed research design, where each participant completed two experimental trials (exercise and resting). Forty-two adolescents (12.4±0.5 years old), undertook a bout of exercise (ten repeats of level one of the multi-stage fitness test; exercise trial) or continued to rest (resting trial) following consumption of either a high or low GI breakfast. A battery of cognitive function tests (visual search test, Stroop test and Sternberg paradigm) was completed 30 min before and 45 min following the exercise. Average heart rate during exercise was 170±15 beats·min(-1). On the complex level of the Stroop test, response times improved across the morning following the low GI breakfast on both the exercise and resting trials, though the improvement was greatest on the exercise trial. However, response times only improved on the resting trial following the high GI breakfast (p=0.012). On the 5 letter level of the Sternberg paradigm, response times improved across the morning following the low GI breakfast (regardless of exercise) and only on the exercise trial following the high GI breakfast (p=0.019). The findings of the present study suggest that the combined effects of breakfast GI and exercise in adolescents depend upon the component of cognitive function examined. A low GI breakfast and mid-morning bout of exercise were individually beneficial for response times on the Sternberg paradigm, whereas they conferred additional benefits for response times on the Stroop test. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. 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…

  20. 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…

  1. 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.…

  2. 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

  3. 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.

  4. 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…

  5. Glycaemic, uricaemic and blood pressure response to beverages with partial fructose replacement of sucrose.

    Science.gov (United States)

    Rodrigues, Natasha; Peng, Mei; Oey, Indrawati; Venn, Bernard Joseph

    2018-03-20

    The European Food Safety Authority approved a health claim (ID558) relating to lowered postprandial glycaemia when fructose replaces 30% of sucrose in foods and beverages. We assessed the effects of partial replacement of sucrose with fructose on serum glucose, uric acid and blood pressure. A randomised, crossover, double blind trial of 12 normoglycaemic participants consuming beverages containing 50 g blends of fructose and sucrose in proportions; 67% sucrose/33% fructose (67%S:33%F); 50% each (50%S:50%F) and 33%S:67%F; a 100% sucrose reference beverage was tested twice. Serum glucose and uric acid concentrations were measured at 0, 15, 30, 45, 60, 90 and 120 min and incremental area-under-the-curve (iAUC) calculated. The geometric mean (95% CI) glycaemic iAUC following the 100% sucrose, 67%S:33%F, 50%S:50%F and 33%S:67%F blended beverages were 96 (63,145), 71 (46,109), 60 (39, 93) and 39 (12, 86) mmol/L min, respectively. At 33% fructose replacement, the proportionally lower iAUC of -28.5% (95% CI: -62.1, 5.2) mmol/L min was not different to sucrose alone. The response was lowered by fructose replacement of 50 and 67% and overall there was an inverse association (p beverages were 1320 (393, 2248), 3062 (1553, 4570), 3646 (2446, 4847), 3623 (2020, 5226) µmol/L min. Uric acid concentration was raised by all fructose-containing beverages with 33% fructose replacement causing an increase of 1741 (95% CI: 655, 2829) µmol/L min compared with sucrose alone. Blood pressure was not different among beverages. Reduced postprandial glycaemia was achieved by the substitution of sucrose with fructose although elevated uricaemic responses should be cautioned.

  6. 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.

  7. Achieving transparency and adaptivity in fuzzy control framework : an application to power transformers predictive overload system

    NARCIS (Netherlands)

    Acampora, G.; Loia, V.; Ippolito, L.; Siano, P.

    2004-01-01

    From a technologic point of view, the problem of fuzzy control deals with the real implementation of a controller on a specific hardware. Today, the market of micro-controller offers different solutions able to implement a fuzzy controller varying from application domains to programming language

  8. Glycaemic index of different coconut (Cocos nucifera)-flour products in normal and diabetic subjects.

    Science.gov (United States)

    Trinidad, Trinidad P; Valdez, Divinagracia H; Loyola, Anacleta S; Mallillin, Aida C; Askali, Faridah C; Castillo, Joan C; Masa, Dina B

    2003-09-01

    The glycaemic index (GI) of commonly consumed bakery products supplemented with increasing levels of coconut (Cocos nucifera) flour was determined in ten normal and ten diabetic subjects. Using a randomized crossover design, the control and test foods were fed in random order on separate occasions after an overnight fast. Blood samples were collected through finger prick before and after feeding and were analysed for glucose levels using a clinical chemistry analyser. The significantly low-GI (cake (GI 51.8 (sem 3.3)), with 200-250 g coconut flour/kg (Pflour/kg had GI ranging from 61.3 to 71.4. Among the test foods, pan de sal (GI 87.2 (sem 5.5)) and multigrain loaf (GI 85.2 (sem 6.8)) gave significantly higher GI with 50 and 100 g coconut flour/kg respectively (Pflour/kg respectively gave a GI ranging from 62.7 to 71.6 and did not differ significantly from the test foods with 150 g coconut flour/kg (Pflour. In conclusion, the GI of coconut flour-supplemented foods decreased with increasing levels of coconut flour and this may be due to its high dietary fibre content. The results of the present study may form a scientific basis for the development of coconut flour as a functional food. However, the fat content of coconut flour-supplemented food should always be considered to optimize the functionality of coconut fibre in the proper control and management of diabetes mellitus.

  9. 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.

  10. 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%....

  11. Improving Aerospace Engineering Students' Achievements by an Open Aero Control Experiment Apparatus

    Science.gov (United States)

    Zeng, QingHua; Zhang, WeiHua; Huang, ZheZhi; Dong, RongHua

    2014-01-01

    This paper describes the development of an aero control experiment apparatus (ACEA) for use in aerospace control practical courses. The ACEA incorporates a systematic multihierarchy learning and teaching method, and was designed to improve aerospace engineering students' understanding of unmanned aerial vehicle (UAV) control systems. It offers a…

  12. Children's Autonomy and Perceived Control in Learning: A Model of Motivation and Achievement in Taiwan.

    Science.gov (United States)

    d'Ailly, Hsiao

    2003-01-01

    Tests a model of motivation and achievement with data from 50 teachers and 806 Grade 4-6 students in Taiwan. Autonomy as a construct was shown to have ecological validity in Chinese children. The proposed model fit the data well, showing that maternal involvement and autonomy support, as well as teachers' autonomy support, are important for…

  13. 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

    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

  14. Pascal software structures achieve definite control of the 24 MFTF sustaining neutral-beam power supplies

    International Nuclear Information System (INIS)

    Anon.

    1982-01-01

    Precise control of large, complex systems is not assured unless there is known to be no unintended interactions in the control system. The software controlling the sustaining neutral-beam power supplies of the Mirror Fusion Test Facility accomplishes this feat. The software structures comprise some 16,000 lines of commented Pascal code, distributed amoung 10 different tasks. Each task may control any of the 24 power supplies. All the tasks are strictly event-driven, and are not subject to any system mode. Since there is no global information in the software, we know that all the power supplies are controlled independently

  15. 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

  16. Gender Differences in Self-Concept, Locus of Control, and Goal Orientation in Mexican High-Achieving Students

    Science.gov (United States)

    Valdés-Cuervo, Angel Alberto; Sánchez Escobedo, Pedro Antonio; Valadez-Sierra, María Dolores

    2015-01-01

    The study compares self-concept, locus of control, and goal orientation characteristics of male and female Mexican high school high-achieving students. Three scales were administered to 220 students; 106 (49%) were males and 114 (51%) females. By means of a discriminant analysis, both groups were compared in relation to the variables such as…

  17. 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.

  18. 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…

  19. 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...

  20. Achieving the same for less: improving mood depletes blood glucose for people with poor (but not good) emotion control.

    Science.gov (United States)

    Niven, Karen; Totterdell, Peter; Miles, Eleanor; Webb, Thomas L; Sheeran, Paschal

    2013-01-01

    Previous studies have found that acts of self-control like emotion regulation deplete blood glucose levels. The present experiment investigated the hypothesis that the extent to which people's blood glucose levels decline during emotion regulation attempts is influenced by whether they believe themselves to be good or poor at emotion control. We found that although good and poor emotion regulators were equally able to achieve positive and negative moods, the blood glucose of poor emotion regulators was reduced after performing an affect-improving task, whereas the blood glucose of good emotion regulators remained unchanged. As evidence suggests that glucose is a limited energy resource upon which self-control relies, the implication is that good emotion regulators are able to achieve the same positive mood with less cost to their self-regulatory resource. Thus, depletion may not be an inevitable consequence of engaging in emotion regulation.

  1. Achievable Performance of Zero-Delay Variable-Rate Coding in Rate-Constrained Networked Control Systems with Channel Delay

    DEFF Research Database (Denmark)

    Barforooshan, Mohsen; Østergaard, Jan; Stavrou, Fotios

    2017-01-01

    This paper presents an upper bound on the minimum data rate required to achieve a prescribed closed-loop performance level in networked control systems (NCSs). The considered feedback loop includes a linear time-invariant (LTI) plant with single measurement output and single control input. Moreover......, in this NCS, a causal but otherwise unconstrained feedback system carries out zero-delay variable-rate coding, and control. Between the encoder and decoder, data is exchanged over a rate-limited noiseless digital channel with a known constant time delay. Here we propose a linear source-coding scheme...

  2. Structural elements in achieving legislative tobacco control in NSW, 1955-95: political reflections and implications.

    Science.gov (United States)

    Hooker, Claire; Chapman, Simon

    2006-02-01

    To analyse structural factors revealed by politicians that shaped legislation on tobacco control in New South Wales, 1955-95. Parliamentary debates and other records were collected. Open-ended interviews were conducted with 17 Members of Parliament (MPs) who were significantly involved, and then analysed for structural elements. Tobacco industry lobbying had a significant but limited influence on policy making, being exerted largely through social interactions with executives and based on concerns about the economic impact on third parties. MPs saw health advocates' chief functions as (1) generating community concern about the issue and support for control measures, and (2) bringing any new information to political attention, providing pro-control arguments and data through the media. Factors that delayed tobacco control policies included: the conservative stance of Premiers and major parties, commitments to unanimous federal action, and rivalry between parties. Factors that facilitated control policies included: reforms that gave the Legislative Council increased power, the use of parliamentary committees, and backbencher and grass roots support. Tobacco control policy and legislation has been the product of political structures that gave power to those MPs in the least powerful positions--minor parties, Members of the Legislative Council (MLCs), backbenchers, women and party rank and file--rather than to major parties and their executives. Advocates should make the most of their access points to the political process, providing information, arguments and support and demonstrating public opinion in favour of further control.

  3. 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

  4. Receiver-Assisted Congestion Control to Achieve High Throughput in Lossy Wireless Networks

    Science.gov (United States)

    Shi, Kai; Shu, Yantai; Yang, Oliver; Luo, Jiarong

    2010-04-01

    Many applications would require fast data transfer in high-speed wireless networks nowadays. However, due to its conservative congestion control algorithm, Transmission Control Protocol (TCP) cannot effectively utilize the network capacity in lossy wireless networks. In this paper, we propose a receiver-assisted congestion control mechanism (RACC) in which the sender performs loss-based control, while the receiver is performing delay-based control. The receiver measures the network bandwidth based on the packet interarrival interval and uses it to compute a congestion window size deemed appropriate for the sender. After receiving the advertised value feedback from the receiver, the sender then uses the additive increase and multiplicative decrease (AIMD) mechanism to compute the correct congestion window size to be used. By integrating the loss-based and the delay-based congestion controls, our mechanism can mitigate the effect of wireless losses, alleviate the timeout effect, and therefore make better use of network bandwidth. Simulation and experiment results in various scenarios show that our mechanism can outperform conventional TCP in high-speed and lossy wireless environments.

  5. Achievements and problems in the weed control in grain sorghum (Sorghum Bicolor Moench.

    Directory of Open Access Journals (Sweden)

    Gr. Delchev

    2017-09-01

    Full Text Available Abstract. Chemical control has emerged as the most efficient method of weed control. Herbicides combinations and tank mixtures of herbicides with adjuvants, fertilizers, growth regulators, fungicides, insecticides are more effective than when applied alone on sorghum crops. Their combined use often leads to high synergistic effect on yield. The use of herbicide antidotes for the treatment of seeds in sorghum is a safe way to overcome its high sensitivity to many herbicides. Data regarding herbicide for chemical control of annual graminaceous weeds in sorghum crops are quite scarce even worldwide. Problem is the persistence of some herbicides used in the predecessors on succeeding crops, which is directly related to the weather conditions during their degradation. Most of the information on sorghum relates to the conventional technology for weed control. There is no information about the new Concep technology in grain sorghum. A serious problem is also the volunteers of the Clearfield and Express sun sunflower. They have resistance to herbicides different from that of conventional sunflower hybrids. There is no information yet in scientific literature on control of these volunteers.

  6. Filtered molasses concentrate from sugar cane: natural functional ingredient effective in lowering the glycaemic index and insulin response of high carbohydrate foods.

    Science.gov (United States)

    Wright, Alison G; Ellis, Timothy P; Ilag, Leodevico L

    2014-12-01

    An aqueous filtered molasses concentrate (FMC) sourced from sugar cane was used as a functional ingredient in a range of carbohydrate-containing foods to reduce glycaemic response. When compared to untreated controls, postprandial glucose responses in the test products were reduced 5-20%, assessed by accredited glycaemic index (GI) testing. The reduction in glucose response in the test foods was dose-dependent and directly proportional to the ratio of FMC added to the amount of available carbohydrate in the test products. The insulin response to the foods was also reduced with FMC addition as compared to untreated controls. Inclusion of FMC in test foods did not replace any formulation ingredients; it was incorporated as an additional ingredient to existing formulations. Filtered molasses concentrate, made by a proprietary and patented process, contains many naturally occurring compounds. Some of the identified compounds are known to influence carbohydrate metabolism, and include phenolic compounds, minerals and organic acids. FMC, sourced from a by-product of sugar cane processing, shows potential as a natural functional ingredient capable of modifying carbohydrate metabolism and contributing to GI reduction of processed foods and beverages.

  7. Contributions of Anopheles larval control to malaria suppression in tropical Africa: review of achievements and potential.

    Science.gov (United States)

    Walker, K; Lynch, M

    2007-03-01

    Malaria vector control targeting the larval stages of mosquitoes was applied successfully against many species of Anopheles (Diptera: Culicidae) in malarious countries until the mid-20th Century. Since the introduction of DDT in the 1940s and the associated development of indoor residual spraying (IRS), which usually has a more powerful impact than larval control on vectorial capacity, the focus of malaria prevention programmes has shifted to the control of adult vectors. In the Afrotropical Region, where malaria is transmitted mainly by Anopheles funestus Giles and members of the Anopheles gambiae Giles complex, gaps in information on larval ecology and the ability of An. gambiae sensu lato to exploit a wide variety of larval habitats have discouraged efforts to develop and implement larval control strategies. Opportunities to complement adulticiding with other components of integrated vector management, along with concerns about insecticide resistance, environmental impacts, rising costs of IRS and logistical constraints, have stimulated renewed interest in larval control of malaria vectors. Techniques include environmental management, involving the temporary or permanent removal of anopheline larval habitats, as well as larviciding with chemical or biological agents. This present review covers large-scale trials of anopheline larval control methods, focusing on field studies in Africa conducted within the past 15 years. Although such studies are limited in number and scope, their results suggest that targeting larvae, particularly in human-made habitats, can significantly reduce malaria transmission in appropriate settings. These approaches are especially suitable for urban areas, where larval habitats are limited, particularly when applied in conjunction with IRS and other adulticidal measures, such as the use of insecticide treated bednets.

  8. Achieving behavioral control with millisecond resolution in a high-level programming environment.

    Science.gov (United States)

    Asaad, Wael F; Eskandar, Emad N

    2008-08-30

    The creation of psychophysical tasks for the behavioral neurosciences has generally relied upon low-level software running on a limited range of hardware. Despite the availability of software that allows the coding of behavioral tasks in high-level programming environments, many researchers are still reluctant to trust the temporal accuracy and resolution of programs running in such environments, especially when they run atop non-real-time operating systems. Thus, the creation of behavioral paradigms has been slowed by the intricacy of the coding required and their dissemination across labs has been hampered by the various types of hardware needed. However, we demonstrate here that, when proper measures are taken to handle the various sources of temporal error, accuracy can be achieved at the 1 ms time-scale that is relevant for the alignment of behavioral and neural events.

  9. Breakfast replacement with a low-glycaemic response liquid formula in patients with type 2 diabetes: a randomised clinical trial.

    Science.gov (United States)

    Stenvers, Dirk J; Schouten, Lydia J; Jurgens, Jordy; Endert, Erik; Kalsbeek, Andries; Fliers, Eric; Bisschop, Peter H

    2014-08-28

    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 with a low-GR liquid meal would reduce postprandial glycaemia and/or improve long-term glycaemia. In the present randomised, controlled, cross-over design, twenty patients with type 2 diabetes consumed either a breakfast replacement consisting of an isoenergetic amount of Glucerna SR or a free-choice breakfast for 3 months. Postprandial AUC levels were measured using continuous glucose measurement at home. After the 3-month dietary period, meal profiles and oral glucose tolerance were assessed in the clinical setting. The low-GR liquid meal replacement reduced the AUC of postprandial glucose excursions at home compared with a free-choice control breakfast (estimated marginal mean 141 (95 % CI 114, 174) v. estimated marginal mean 259 (95 % CI 211, 318) mmol × min/l; P= 0·0002). The low-GR liquid meal replacement also reduced glucose AUC levels in the clinical setting compared with an isoenergetic control breakfast (low GR: median 97 (interquartile range (IQR) 60-188) mmol × min/l; control: median 253 (IQR 162-386) mmol × min/l; Pmeal replacement did not affect fasting plasma glucose, HbA1c or lipid levels, and even slightly reduced oral glucose tolerance. In conclusion, the low-GR liquid meal replacement is a potential dietary approach to reduce postprandial glycaemia in patients with type 2 diabetes. However, clinical trials into the effects of replacing multiple meals on long-term glycaemia in poorly controlled patients are required before a low-GR liquid meal replacement can be adopted as a dietary approach to the treatment of type 2 diabetes.

  10. 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.

  11. Nonlinear Control of an Active Magnetic Bearing System Achieved Using a Fuzzy Control with Radial Basis Function Neural Network

    Directory of Open Access Journals (Sweden)

    Seng-Chi Chen

    2014-01-01

    Full Text Available Studies on active magnetic bearing (AMB systems are increasing in popularity and practical applications. Magnetic bearings cause less noise, friction, and vibration than the conventional mechanical bearings; however, the control of AMB systems requires further investigation. The magnetic force has a highly nonlinear relation to the control current and the air gap. This paper proposes an intelligent control method for positioning an AMB system that uses a neural fuzzy controller (NFC. The mathematical model of an AMB system comprises identification followed by collection of information from this system. A fuzzy logic controller (FLC, the parameters of which are adjusted using a radial basis function neural network (RBFNN, is applied to the unbalanced vibration in an AMB system. The AMB system exhibited a satisfactory control performance, with low overshoot, and produced improved transient and steady-state responses under various operating conditions. The NFC has been verified on a prototype AMB system. The proposed controller can be feasibly applied to AMB systems exposed to various external disturbances; demonstrating the effectiveness of the NFC with self-learning and self-improving capacities is proven.

  12. 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.

  13. 29 CFR 779.219 - Unified operation may be achieved without common control or common ownership.

    Science.gov (United States)

    2010-07-01

    ... Act May Apply; Enterprise Coverage Unified Operation Or Common Control § 779.219 Unified operation may... through “unified operation.” It is clear from the definition that if the described activities are performed through unified operation they will be part of the enterprise whether they are performed by one...

  14. A Study to Investigate the Relationship between Locus of Control and Academic Achievement of Students

    Science.gov (United States)

    Gujjar, Aijaz Ahmed; Aijaz, Rukhma

    2014-01-01

    Motivation is regarded as the alpha and omega of learning. It is the heart of teaching learning process. Motivation is defined as an internal state that arouses, directs, and maintains the behavior over time. Thus motivation is the pivotal component of learning and locus of control which is one of the important factors it stems from. Locus of…

  15. Controlled biomass removal - the key parameter to achieve enhanced biological phosphorus removal in biofilm systems

    DEFF Research Database (Denmark)

    Morgenroth, E.

    1999-01-01

    the influence of the following processes on EBPR in biofilms was evaluated: (1) mass transfer limitation for oxygen (2) mass transfer limitation for organic substrate, (3) lack of controlled removal of biomass from the system. It was shown that mass transfer of soluble components (oxygen and organic substrate...

  16. Achieving Optimal Quantum Acceleration of Frequency Estimation Using Adaptive Coherent Control.

    Science.gov (United States)

    Naghiloo, M; Jordan, A N; Murch, K W

    2017-11-03

    Precision measurements of frequency are critical to accurate time keeping and are fundamentally limited by quantum measurement uncertainties. While for time-independent quantum Hamiltonians the uncertainty of any parameter scales at best as 1/T, where T is the duration of the experiment, recent theoretical works have predicted that explicitly time-dependent Hamiltonians can yield a 1/T^{2} scaling of the uncertainty for an oscillation frequency. This quantum acceleration in precision requires coherent control, which is generally adaptive. We experimentally realize this quantum improvement in frequency sensitivity with superconducting circuits, using a single transmon qubit. With optimal control pulses, the theoretically ideal frequency precision scaling is reached for times shorter than the decoherence time. This result demonstrates a fundamental quantum advantage for frequency estimation.

  17. Determining the impact of computer-aided control of educational achievements for the health of students

    Directory of Open Access Journals (Sweden)

    A.V. Savonova

    2013-07-01

    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. Real time plasma feedback control: An overview of Tore-Supra achievements

    International Nuclear Information System (INIS)

    Martin, G.; Bucalossi, J.; Ekedahl, A.; Gil, C.; Grisolia, C.; Guilhem, D.; Gunn, J.; Kazarian, F.; Moulin, D.; Pascal, J.Y.; Saint-Laurent, F.

    2001-01-01

    Stable and reliable fusion plasma operation requires increasingly advanced control systems. This is especially true for steady-state operation in advanced modes, when several parameters are to be simultaneously optimised: e.g. the current profile, which has been related to the formation of internal transport barrier, and the density, which plays a crucial role both in the fusion power and in the plasma wall interactions. At a more technological level, good management of the power entering and leaving the plasma is required, by efficient additional heating coupling, and with a full control of radiation and convection losses and distribution to the first wall elements. For these goals, several feed-back mechanisms have been developed with success on Tore-Supra, in the past four years. Most of them are based on software, implemented in a set of micro-computers connected through a VME network. (author)

  19. Ebola: a holistic approach is required to achieve effective management and control.

    Science.gov (United States)

    Roca, Anna; Afolabi, Muhammed O; Saidu, Yauba; Kampmann, Beate

    2015-04-01

    The current Ebola outbreak in West Africa has already caused substantial mortality and dire human and economic consequences. It continues to represent an alarming public health threat in the region and beyond and jeopardizes the provision of health care and other services in the affected countries. The scale of the epidemic has accelerated research efforts for diagnostics, treatment, and prevention galvanized through increased availability of funding. Our knowledge relating to the virus, disease pathogenesis, risk factors, dynamics of transmission, and epidemic control is increasing, and sociocultural factors have emerged as critical determinants for the success and failure of control efforts. However, there is a long way to go. In this review we summarize the current knowledge, examine the sociocultural context in West Africa, and outline priority areas for future research. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  20. Operating gains achieved by a new generation of remotely controlled manipulators

    International Nuclear Information System (INIS)

    Djedidi, A.; Selliez-Vandernotte, C.; Malcolm, F.

    2014-01-01

    A high performance remotely controlled mechanical master slave arm with direct transmission via cable and transmission rods has been converted to a new generation manipulator with electrical master slave arm and motion module with integrated software. The redesigned powered manipulator with software control improves efficiency and ergonomics while increasing operating field space. The mechanical master arm has been replaced by an electrical robotic master arm using haptic technology. The movements initiated by the operator are transmitted in real time to the slave arm via the servo-motors inside the motion module. The mechanical link between master and slave is eliminated and some mechanical constraints have been replaced by software applications. The operator benefits from an improved working position and vibration filtering plus full range high performance force feedback with reduced effort requirement. (authors)

  1. 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.

  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. 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.

  4. 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.

  5. 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.

  6. 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 ...

  7. Volumetric modulated arc therapy for lung stereotactic radiation therapy can achieve high local control rates.

    Science.gov (United States)

    Yamashita, Hideomi; Haga, Akihiro; Takahashi, Wataru; Takenaka, Ryousuke; Imae, Toshikazu; Takenaka, Shigeharu; Nakagawa, Keiichi

    2014-11-11

    The aim of this study was to report the outcome of primary or metastatic lung cancer patients undergoing volumetric modulated arc therapy for stereotactic body radiation therapy (VMAT-SBRT). From October 2010 to December 2013, consecutive 67 lung cancer patients received single-arc VMAT-SBRT using an Elekta-synergy system. All patients were treated with an abdominal compressor. The gross tumor volumes were contoured on 10 respiratory phases computed tomography (CT) datasets from 4-dimensional (4D) CT and merged into internal target volumes (ITVs). The planning target volume (PTV) margin was isotropically taken as 5 mm. Treatment was performed with a D95 prescription of 50 Gy (43 cases) or 55 Gy (12 cases) in 4 fractions for peripheral tumor or 56 Gy in 7 fractions (12 cases) for central tumor. Among the 67 patients, the median age was 73 years (range, 59-95 years). Of the patients, male was 72% and female 28%. The median Karnofsky performance status was 90-100% in 39 cases (58%) and 80-90% in 20 cases (30%). The median follow-up was 267 days (range, 40-1162 days). Tissue diagnosis was performed in 41 patients (61%). There were T1 primary lung tumor in 42 patients (T1a in 28 patients, T1b in 14 patients), T2 in 6 patients, three T3 in 3 patients, and metastatic lung tumor in 16 patients. The median mean lung dose was 6.87 Gy (range, 2.5-15 Gy). Six patients (9%) developed radiation pneumonitis required by steroid administration. Actuarial local control rate were 100% and 100% at 1 year, 92% and 75% at 2 years, and 92% and 75% at 3 years in primary and metastatic lung cancer, respectively (p =0.59). Overall survival rate was 83% and 84% at 1 year, 76% and 53% at 2 years, and 46% and 20% at 3 years in primary and metastatic lung cancer, respectively (p =0.12). Use of VMAT-based delivery of SBRT in primary in metastatic lung tumors demonstrates high local control rates and low risk of normal tissue complications.

  8. Volumetric modulated arc therapy for lung stereotactic radiation therapy can achieve high local control rates

    International Nuclear Information System (INIS)

    Yamashita, Hideomi; Haga, Akihiro; Takahashi, Wataru; Takenaka, Ryousuke; Imae, Toshikazu; Takenaka, Shigeharu; Nakagawa, Keiichi

    2014-01-01

    The aim of this study was to report the outcome of primary or metastatic lung cancer patients undergoing volumetric modulated arc therapy for stereotactic body radiation therapy (VMAT-SBRT). From October 2010 to December 2013, consecutive 67 lung cancer patients received single-arc VMAT-SBRT using an Elekta-synergy system. All patients were treated with an abdominal compressor. The gross tumor volumes were contoured on 10 respiratory phases computed tomography (CT) datasets from 4-dimensional (4D) CT and merged into internal target volumes (ITVs). The planning target volume (PTV) margin was isotropically taken as 5 mm. Treatment was performed with a D95 prescription of 50 Gy (43 cases) or 55 Gy (12 cases) in 4 fractions for peripheral tumor or 56 Gy in 7 fractions (12 cases) for central tumor. Among the 67 patients, the median age was 73 years (range, 59–95 years). Of the patients, male was 72% and female 28%. The median Karnofsky performance status was 90-100% in 39 cases (58%) and 80-90% in 20 cases (30%). The median follow-up was 267 days (range, 40–1162 days). Tissue diagnosis was performed in 41 patients (61%). There were T1 primary lung tumor in 42 patients (T1a in 28 patients, T1b in 14 patients), T2 in 6 patients, three T3 in 3 patients, and metastatic lung tumor in 16 patients. The median mean lung dose was 6.87 Gy (range, 2.5-15 Gy). Six patients (9%) developed radiation pneumonitis required by steroid administration. Actuarial local control rate were 100% and 100% at 1 year, 92% and 75% at 2 years, and 92% and 75% at 3 years in primary and metastatic lung cancer, respectively (p = 0.59). Overall survival rate was 83% and 84% at 1 year, 76% and 53% at 2 years, and 46% and 20% at 3 years in primary and metastatic lung cancer, respectively (p = 0.12). Use of VMAT-based delivery of SBRT in primary in metastatic lung tumors demonstrates high local control rates and low risk of normal tissue complications

  9. 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

  10. The glycaemic potency of breakfast and cognitive function in school children.

    Science.gov (United States)

    Micha, R; Rogers, P J; Nelson, M

    2010-09-01

    The aim of this study was to assess how the glycaemic potency (blood glucose (BG)-raising potential) of breakfast is associated with cognitive function (CF) in school children, taking into account important confounders, including iron status, underlying physiological adaptations and socio-economic status. Sixty children aged 11-14 years were selected on the basis of having breakfast habitually. Their breakfast and any snacks eaten on the morning of the study were recorded. They were categorized into four groups according to the glycaemic index (GI) and glycaemic load (GL) of the breakfast: low-GI, high-GL; high-GI, high-GL; low-GI, low-GL and high-GI, low-GL above or below the median for GI=61 and GL=27. BG levels were measured in finger-prick blood samples immediately before and immediately after the CF tests. A low-GI, high-GL breakfast was associated with better performance on a speed of information processing (Pbreakfast with better performance on an immediate word recall task (Pbreakfast with better performance on a Matrices task (Pperformance on the majority of the CF tests (4 of 7) used. This study describes the macronutrient composition of breakfast that could have a positive influence on the cognition of school children, proposes the use of both GI and GL to estimate exposure, and discusses future directions in this area of research.

  11. The impact of freezing and toasting on the glycaemic response of white bread.

    Science.gov (United States)

    Burton, P; Lightowler, H J

    2008-05-01

    To investigate the impact of freezing and toasting on the glycaemic response of white bread. Ten healthy subjects (three male, seven female), aged 22-59 years, recruited from Oxford Brookes University and the local community. A homemade white bread and a commercial white bread were administered following four different storage and preparation conditions: (1) fresh; (2) frozen and defrosted; (3) toasted; (4) toasted following freezing and defrosting. They were administered randomized repeated measures design. Incremental blood glucose, peak glucose response, 2 h incremental area under the glucose response curve (IAUC). The different storage and preparation conditions resulted in lower blood glucose IAUC values compared to both types of fresh white bread. In particular, compared to the fresh homemade bread (IAUC 259 mmol min/l), IAUC was significantly lower when the bread was frozen and defrosted (179 mmol min/l, Pbread (253 mmol min/l), IAUC was significantly lower when the bread was toasted (183 mmol min/l, Pbreads. This is the first study known to the authors to show reductions in glycaemic response as a result of changes in storage conditions and the preparation of white bread before consumption. In addition, the study highlights a need to define and maintain storage conditions of white bread if used as a reference food in the determination of the glycaemic index of foods.

  12. The influence of the glycaemic load of breakfast on the behaviour of children in school.

    Science.gov (United States)

    Benton, David; Maconie, Alys; Williams, Claire

    2007-11-23

    The impact of breakfasts of different glycaemic loads on the performance of nineteen children, aged six to seven years, was explored. Over a four week period, children attended a school breakfast club each day and ate one of three meals. Each meal offered a similar amount of energy but differed in their glycaemic load. When working individually, the behaviour of a child was rated in the classroom every ten seconds for 30 min to produce a measure of time spent on task. Memory was assessed by asking for the recall of a series of objects. The ability to sustain attention was measured by asking for a response after various delays. The incidence of negative behaviour was recorded when playing a video game that was too difficult to allow success. Two to three hours after a low glycaemic load breakfast had been consumed, performance on the tests of memory and the ability to sustain attention were better, fewer signs of frustration were displayed and initially more time was spent on task when working individually in class. The importance of the results was discussed in the context of the wide range of factors that influence behaviour in school.

  13. Acute glycaemic load breakfast manipulations do not attenuate cognitive impairments in adults with type 2 diabetes.

    Science.gov (United States)

    Lamport, Daniel Joseph; Dye, Louise; Mansfield, Michael W; Lawton, Clare L

    2013-04-01

    Research on young healthy samples suggests that low glycaemic load foods can confer benefits for cognitive performance. The aim was to examine the effects of type 2 diabetes on cognitive function, and to investigate whether consumption of low glycaemic load breakfasts affects cognitive function in adults with type 2 diabetes. Memory, psychomotor skill and executive function were examined at two morning test sessions in 24 adults with type 2 diabetes and 10 adults with normal glucose tolerance (NGT) aged 45-77 years without dementia after water, low, and high glycaemic load breakfasts were consumed in accordance with a crossover, counterbalanced design. The type 2 diabetes and NGT groups were matched for education, depression, and IQ. Type 2 diabetes was associated with impairments in verbal memory, spatial memory, psychomotor skill, and executive function compared to adults with NGT. Consumption of the three breakfast conditions did not impact on cognitive performance in the type 2 diabetes or NGT participants. Abnormalities in glucose tolerance such as type 2 diabetes can have demonstrable negative effects on a range of cognitive functions. However, there was no evidence that low GL breakfasts administered acutely could confer benefits for cognitive function (ClincalTrials.gov identifier, NCT01047813). Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  14. 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.

  15. Glycaemic responses to liquid food supplements among three Asian ethnic groups.

    Science.gov (United States)

    Tey, Siew Ling; Van Helvoort, Ardy; Henry, Christiani Jeyakumar

    2016-12-01

    A limited number of studies have compared the glycaemic index (GI) and glycaemic responses (GR) to solid foods between Caucasians and Asians. These studies have demonstrated that Asians have greater GI and GR values for solid foods than Caucasians. However, no study has compared the GI and GR to liquids among various Asian ethnic groups. A total of forty-eight males and females (16 Chinese, 16 Indians, and 16 Malay) took part in this randomised, crossover study. Glycaemic response to the reference food (glucose beverage) was measured on three occasions, and GR to three liquids were measured on one occasion each. Liquids with different macronutrient ratio's and carbohydrate types were chosen to be able to evaluate the response to products with different GIs. Blood glucose concentrations were measured in duplicate at baseline (-5 and 0 min) and once at 15, 30, 45, 60, 90, and 120 min after the commencement of beverage consumption. There were statistically significant differences in GI and GR between the three liquids (P Chinese vs. Indian vs. Malay). The GR for three different types of liquid nutritional supplements did not differ between the three main ethnic groups in Asia. It appears that the GI of liquid food derived from one Asian ethnicity can be applicable to other Asian populations.

  16. Tools and Strategies for Malaria Control and Elimination: What Do We Need to Achieve a Grand Convergence in Malaria?

    Directory of Open Access Journals (Sweden)

    Janet Hemingway

    2016-03-01

    Full Text Available 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. Optimal glucose control in type 2 diabetes mellitus – a guide for the ...

    African Journals Online (AJOL)

    vascular complications. The family practitioner plays a significant role in the management of glycaemic control and thereby reducing the related morbidity and mortality. Monitoring of blood glucose control has become an integral part of disease ...

  18. A new boundary control scheme for simultaneous achievement of H-mode and radiative cooling (SHC boundary)

    International Nuclear Information System (INIS)

    Ohyabu, N.

    1995-05-01

    We have proposed a new boundary control scheme (SHC boundary), which could allow simultaneous achievement of the H-mode type confinement improvement and radiative cooling with wide heat flux distribution. In our proposed configuration, a low m island layer sharply separates a plasma confining region from an open 'ergodic' boundary. The degree of openness in the ergodic boundary must be high enough to make the plasma pressure constant along the field line, which in turn separates low density plasma just outside the plasma confining region (the key external condition for achieving a good H-mode discharge) from very high density, cold radiative plasma near the wall (required for effective edge radiative cooling). Examples of such proposed SHC boundaries for Heliotron typed devices and tokamaks are presented. (author)

  19. El difícil camino del control sanitario de la tuberculosis The difficult road to achieve sanitary tuberculosis control

    OpenAIRE

    Carlos Peña M; Victorino Farga C

    2012-01-01

    La tuberculosis (TB) sigue siendo una patología prevalente a nivel mundial. Chile tiene un Programa de Control de la Tuberculosis eficaz desde el año 1973, el que ha permitido disminuir la incidencia anual de la enfermedad en 50% cada década, hasta alcanzar el año 2000 una tasa de 20 x 100.000 habitantes ("umbral de la etapa de eliminación "). Sin embargo, desde entonces el país ha presentado un descenso menor, llegando a una situación estacionaria, con tasas cercanas a 13 x 100.000 los años ...

  20. Association of glycaemic variability evaluated by continuous glucose monitoring with diabetic peripheral neuropathy in type 2 diabetic patients.

    Science.gov (United States)

    Hu, Yu-Ming; Zhao, Li-Hua; Zhang, Xiu-Lin; Cai, Hong-Li; Huang, Hai-Yan; Xu, Feng; Chen, Tong; Wang, Xue-Qin; Guo, Ai-Song; Li, Jian-An; Su, Jian-Bin

    2018-05-01

    Diabetic peripheral neuropathy (DPN), a common microvascular complication of diabetes, is linked to glycaemic derangements. Glycaemic variability, as a pattern of glycaemic derangements, is a key risk factor for diabetic complications. We investigated the association of glycaemic variability with DPN in a large-scale sample of type 2 diabetic patients. In this cross-sectional study, we enrolled 982 type 2 diabetic patients who were screened for DPN and monitored by a continuous glucose monitoring (CGM) system between February 2011 and January 2017. Multiple glycaemic variability parameters, including the mean amplitude of glycaemic excursions (MAGE), mean of daily differences (MODD), standard deviation of glucose (SD), and 24-h mean glucose (24-h MG), were calculated from glucose profiles obtained from CGM. Other possible risks for DPN were also examined. Of the recruited type 2 diabetic patients, 20.1% (n = 197) presented with DPN, and these patients also had a higher MAGE, MODD, SD, and 24-h MG than patients without DPN (p diabetic duration, HOMA-IR, and hemoglobin A1c (HbA1c) were found to be independent contributors to DPN, and the corresponding odds ratios (95% confidence interval) were 4.57 (3.48-6.01), 1.10 (1.03-1.17), 1.24 (1.09-1.41), and 1.33 (1.15-1.53), respectively. Receiver operating characteristic analysis indicated that the optimal MAGE cutoff value for predicting DPN was 4.60 mmol/L; the corresponding sensitivity was 64.47%, and the specificity was 75.54%. In addition to conventional risks including diabetic duration, HOMA-IR and HbA1c, increased glycaemic variability assessed by MAGE is a significant independent contributor to DPN in type 2 diabetic patients.

  1. Achievements, current status and prospects for Russian-American cooperation in nuclear material physical protection, control and accounting - 1998

    International Nuclear Information System (INIS)

    Nikiforov, N.V.

    1999-01-01

    The process of upgrading the material physical protection, control and accounting systems is an ongoing and long-term process that consists of modernization measuring equipment and methodologies, improving, data exchange and processing technologies, and improving administrative procedures. The positive results that was already achieved form a foundation upon which this collaboration may extend into other new and important areas, such as - the second and third lines of defence, which are directed toward countering illegal trafficking not only in nuclear materials, but in other hazardous substances that constitute a threat to the nuclear sites and national security of the countries [ru

  2. 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%) (p<0.01) to day 28 (38%) (p<0.01) of treatment, compared to day 1. Thereafter, a steady increase of up to 57% on day 42 compared to day 28 was observed. A significant decrease in random blood glucose (RBG) levels, were demonstrated on day 42 (24%) (p<0.001), compared to day 1. No significant difference was seen in mean serum levels of insulin across groups. No significant changes in body weights. Evidence of mild lenticular opacity was observed, with no significant effect in pathologic lesions in the retina. The chronic co-administration of sitagliptin and M. oleifera showed a progressive decrease in anti-hyperglycaemic effect of sitagliptin, and although it delayed the onset of

  3. 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.

    2018-01-01

    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......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...... for precise real-time information transmission, without sacrificing system performance. Experimental results obtained from a dc microgrid setup show the robustness of the new proposal under normal, communication failure, communication delay and plug-and-play operation conditions. Finally, communication...

  4. Rationale and design of a randomized controlled trial examining the effect of classroom-based physical activity on math achievement

    Directory of Open Access Journals (Sweden)

    Mona Have

    2016-04-01

    Full Text Available Abstract Background Integration of physical activity (PA into the classroom may be an effective way of promoting the learning and academic achievement of children at elementary school. This paper describes the research design and methodology of an intervention study examining the effect of classroom-based PA on mathematical achievement, creativity, executive function, body mass index and aerobic fitness. Methods The study was designed as a school-based cluster-randomized controlled trial targeting schoolchildren in 1st grade, and was carried out between August 2012 and June 2013. Eligible schools in two municipalities in the Region of Southern Denmark were invited to participate in the study. After stratification by municipality, twelve schools were randomized to either an intervention group or a control group, comprising a total of 505 children with mean age 7.2 ± 0.3 years. The intervention 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 their children’s PA behavior in leisure time. Discussion The results of this randomized controlled trial are expected to provide schools and policy-makers with

  5. Rationale and design of a randomized controlled trial examining the effect of classroom-based physical activity on math achievement.

    Science.gov (United States)

    Have, Mona; Nielsen, Jacob Have; Gejl, Anne Kær; Thomsen Ernst, Martin; Fredens, Kjeld; Støckel, Jan Toftegaard; Wedderkopp, Niels; Domazet, Sidsel Louise; Gudex, Claire; Grøntved, Anders; Kristensen, Peter Lund

    2016-04-11

    Integration of physical activity (PA) into the classroom may be an effective way of promoting the learning and academic achievement of children at elementary school. This paper describes the research design and methodology of an intervention study examining the effect of classroom-based PA on mathematical achievement, creativity, executive function, body mass index and aerobic fitness. The study was designed as a school-based cluster-randomized controlled trial targeting schoolchildren in 1st grade, and was carried out between August 2012 and June 2013. Eligible schools in two municipalities in the Region of Southern Denmark were invited to participate in the study. After stratification by municipality, twelve schools were randomized to either an intervention group or a control group, comprising a total of 505 children with mean age 7.2 ± 0.3 years. The intervention 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 their children's PA behavior in leisure time. The results of this randomized controlled trial are expected to provide schools and policy-makers with significant new insights into the potential of classroom

  6. The Tobacco-Free Village Program: Helping Rural Areas Implement and Achieve Goals of Tobacco Control Policies in India.

    Science.gov (United States)

    Chatterjee, Nilesh; Patil, Deepak; Kadam, Rajashree; Fernandes, Genevie

    2017-09-27

    India has 274 million tobacco users and a tobacco use prevalence of 38% in rural areas. Tobacco consumption causes 1 million deaths and costs the health system nearly US$23 billion annually. Tobacco control policies exist but lack proper implementation. In this article, we review the Tobacco-free Village (TfV) program conducted in Maharashtra state in India and describe its process to help villages in rural India achieve "tobacco-free" status (i.e., the sale and use of tobacco are prohibited by law). We reviewed program documents and conducted 22 qualitative interviews with program staff and village-level stakeholders. From 2008 to 2014, Salaam Mumbai Foundation implemented the TfV program in 60 villages in Maharashtra state. The program used a number of strategies to help villages become tobacco free, including collaborating with a community-based organization, leveraging existing health workers, conducting a situation analysis, training health workers, engaging stakeholders, developing TfV assessment criteria, mobilizing the community, conducting health education, imposing sanctions, and offering incentives. By 2014, 4 villages had achieved tobacco-free status according to 11 assessment criteria. Successful villages demonstrated strong local leader involvement, ownership of the program, and commitment to the cause by residents. The TfV program faced barriers including poor motivation of health workers, difficulty in changing social norms of tobacco use, and refusal of local vendors to stop tobacco sales due to financial losses. This low-cost, community-driven program holds promise for helping public health practitioners and governments implement and achieve the goals of tobacco control policies, especially in resource-scarce settings. © Chatterjee et al.

  7. 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.

  8. Achieving sub-50 nm controlled diameter of aperiodic Si nanowire arrays by ultrasonic catalyst removal for photonic applications

    Science.gov (United States)

    Chaliyawala, Harsh A.; Purohit, Zeel; Khanna, Sakshum; Ray, Abhijit; Pati, Ranjan K.; Mukhopadhyay, Indrajit

    2018-05-01

    We report an alternative approach to fabricate the vertically aligned aperiodic Si nanowire arrays by controlling the diameter of the Ag nanoparticles and tuneable ultrasonic removal. The process begins by sputtering the Ag thin film (t=5 nm) on the Si/SiO2 substrates. Followed by Ag thin film, annealed for various temperature (T=300°C, 400°C, 500°C and 600°C) to selectively achieve a high density, well-spaced and diameter controlled Ag nanoparticles (AgNPs) on the Si/SiO2 substrates. The sacrificial layer of AgNPs size indicates the controlled diameter of the Si nanowire arrays. Image J analysis for various annealed samples gives an indication of the high density, uniformity and equal distribution of closely packed AgNPs. Furthermore, the AgNPs covered with Au/Pd mesh (5 nm) as a template, was removed by ultrasonication in the etchant solution for several times in different intervals of preparation. The conventional and facile metal assisted electroless etching approach was finally employed to fabricate the vertically aperiodic sub-50 nm SiNWAs, can be applicable to various nanoscale opto-electronic applications.

  9. Effect of different milling methods on glycaemic response of foods made with finger millet (Eucenea coracana) flour.

    Science.gov (United States)

    Jayasinghe, M A; Ekanayake, S; Nugegoda, D B

    2013-12-01

    Compare glycaemic response of foods prepared with finger millet flour, using traditional stone grinding and industrial milling. Crossover study. Healthy volunteers (n=11) consisting of five males and six females), aged between 20 and 30 years, with a body mass index of 18.5-23.5 Kgm-2. Blood glucose concentration was measured at fasting and 30, 45, 60, 90, 120 minutes after ingestion of roti and pittu made with stone ground or industrially milled finger millet flour, containing 50 g of available carbohydrates. Glycaemic Index (GI) values were expressed as the average value of the 11 subjects. Significant differences (p0.05) in proximate compositions of the different foods or raw flours. Foods prepared with finger millet (kurakkan) flour with a larger particle size distribution resulted in a lower glycaemic response.

  10. 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.

  11. Improving urban African Americans' blood pressure control through multi-level interventions in the Achieving Blood Pressure Control Together (ACT) study: a randomized clinical trial.

    Science.gov (United States)

    Ephraim, Patti L; Hill-Briggs, Felicia; Roter, Debra L; Bone, Lee R; Wolff, Jennifer L; Lewis-Boyer, LaPricia; Levine, David M; Aboumatar, Hanan J; Cooper, Lisa A; Fitzpatrick, Stephanie J; Gudzune, Kimberly A; Albert, Michael C; Monroe, Dwyan; Simmons, Michelle; Hickman, Debra; Purnell, Leon; Fisher, Annette; Matens, Richard; Noronha, Gary J; Fagan, Peter J; Ramamurthi, Hema C; Ameling, Jessica M; Charlston, Jeanne; Sam, Tanyka S; Carson, Kathryn A; Wang, Nae-Yuh; Crews, Deidra C; Greer, Raquel C; Sneed, Valerie; Flynn, Sarah J; DePasquale, Nicole; Boulware, L Ebony

    2014-07-01

    Given their high rates of uncontrolled blood pressure, urban African Americans comprise a particularly vulnerable subgroup of persons with hypertension. Substantial evidence has demonstrated the important role of family and community support in improving patients' management of a variety of chronic illnesses. However, studies of multi-level interventions designed specifically to improve urban African American patients' blood pressure self-management by simultaneously leveraging patient, family, and community strengths are lacking. We report the protocol of the Achieving Blood Pressure Control Together (ACT) study, a randomized controlled trial designed to study the effectiveness of interventions that engage patient, family, and community-level resources to facilitate urban African American hypertensive patients' improved hypertension self-management and subsequent hypertension control. African American patients with uncontrolled hypertension receiving health care in an urban primary care clinic will be randomly assigned to receive 1) an educational intervention led by a community health worker alone, 2) the community health worker intervention plus a patient and family communication activation intervention, or 3) the community health worker intervention plus a problem-solving intervention. All participants enrolled in the study will receive and be trained to use a digital home blood pressure machine. The primary outcome of the randomized controlled trial will be patients' blood pressure control at 12months. Results from the ACT study will provide needed evidence on the effectiveness of comprehensive multi-level interventions to improve urban African American patients' hypertension control. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Glycaemic Index Of Uwi, Gadung, And Talas Which Were Given On Rat

    OpenAIRE

    Sari, Ika Puspita; Lukitaningsih, Endang; Rumiyati, Rumiyati; Setiawan, Irfan Muris

    2013-01-01

    The aim of the study was the determination of glycaemic index (GI) of local tubers such as Uwi (Dioscorea alata), Gadung (Dioscorea hispida), dan Talas (Colocasia esculenta). Tubers were prepared as raw flour which were administered orally to the rats. Blood were taken at 0; 0,5; 1 and 2 hour after tubers administration. The dose was 2,5 kg/kg body weight (BW) whereas glucose was administered as a standart treatment. Area Under Curve (AUC) was calculated after plotting the graph of time vers...

  13. Achievement report for fiscal 1998. Development of environmentally friendly universal controller; 1998 nendo kankyo taio universal controller no kaihatsu seika hokokusho

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-05-01

    Research and development was carried out for an 'environmentally friendly universal controller (UC)' which would be 'user-friendly and energy-saving' when used with electrical home appliances. An environmentally friendly UC is a remote controller which utilizes an infrared two-way communication function and becomes capable of dealing with any appliance upon downloading remote control information from the appliance involved. Studies were conducted for the development of controller hardware and software therefor and for the development of electrical home appliances to correspond to their specifications. In relation with energy conservation, studies centered about reduction in power consumption while on standby and unnecessary power consumption. As the result, an environmentally friendly UC protocol was newly developed and, based on the protocol, plural numbers of controllers, appliances, and network gateways were tentatively fabricated, and were examined for their function, behavior, and operational interchangeability. Systems aiming at reducing power consumption while on standby and unnecessary power consumption were built by way of experiment, and were checked for performance. It was then concluded that a reduction of several billion kWh might be achieved. (NEDO)

  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 (pmathematics 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. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Kiwifruit Non-Sugar Components Reduce Glycaemic Response to Co-Ingested Cereal in Humans

    Directory of Open Access Journals (Sweden)

    Suman Mishra

    2017-10-01

    Full Text Available Kiwifruit (KF effects on the human glycaemic response to co-ingested wheat cereal were determined. Participants (n = 20 consumed four meals in random order, all being made to 40 g of the same available carbohydrate, by adding kiwifruit sugars (KF sug; glucose, fructose, sucrose 2:2:1 to meals not containing KF. The meals were flaked wheat biscuit (WB+KFsug, WB+KF, WB+guar gum+KFsug, WB+guar gum+KF, that was ingested after fasting overnight. Blood glucose was monitored 3 h and hunger measured at 180 min post-meal using a visual analogue scale. KF and guar reduced postprandial blood glucose response amplitude, and prevented subsequent hypoglycaemia that occurred with WB+KFsug. The area between the blood glucose response curve and baseline from 0 to 180 min was not significantly different between meals, 0–120 min areas were significantly reduced by KF and/or guar. Area from 120 to 180 min was positive for KF, guar, and KF+guar, while the area for the WB meal was negative. Hunger at 180 min was significantly reduced by KF and/or guar when compared with WB. We conclude that KF components other than available carbohydrate may improve the glycaemic response profile to co-ingested cereal food.

  17. Effect of low and high glycaemic index drink on sleep pattern in children

    International Nuclear Information System (INIS)

    Jalilolghadr, S.; Afaghi, A.; Connor, H.O.; Chow, C.M.

    2011-01-01

    Objectives: To evaluate the effect of high and low glycaemic index drinks on children's sleep pattern. Methods: Eight children underwent 3 nights of full polysomnography study, one familiarization and two test nights consecutively. On the test nights, 1 hour before bedtime, the children had a milk drink of either low or high GI in a random order. The glycaemic loads (GL) were 7.4 and 52.8 for low and high GI drink respectively. Results: The mean of total arousal index in the first half of night after the high GI was greater than that of low GI drink. (12.9 +- 4.6 vs. 9.9 +- 2.2, P=0.03). NREM arousal index in the first half of night after the high GI was also higher than that of low GI drink. (12.7+- 4.8 vs. 9.6 +- 2.3, P=0.05). Other sleep parameters did not show any significant difference in low GI and high GI diets. Conclusion: NREM and total arousal indices were higher in those who consumed high GI drinks compared with low GI, one hour before sleep. It seems that the high quantity consumption of carbohydrates close to the bedtime is accompanied by frequent arousals and may affect the sleep quality. (author)

  18. Glycaemic responses after ingestion of some local foods by non-insulin dependent diabetic subjects.

    Science.gov (United States)

    Ayuo, P O; Ettyang, G A

    1996-12-01

    Fifteen non-insulin dependent diabetic volunteers, aged 51 +/- 3.9 years, were studied over a two month period to determine their glycaemic responses to various local foods. They were all on chlorpropamide and one subject was removed from analysis due to concurrent use of insulin. They received on separate occasions two servings of white bread, one serving of: brown bread, white lice, English potatoes, maize meal, millet and cassava each. Each meal contained 50 g of carbohydrate. A total of 107 glucose tolerance tests (GTTs) were performed and the glycaemic index (GI) for each food calculated. The mean blood sugars at 0,60 and 120 minutes were comparable for each food, and the peak rise occurred at 60 minutes. The highest rise (4.0 mmol/I) was seen with millet porridge. The highest GI was seen with white rice and the lowest with English potatoes (159.9 and 34.3 respectively). Overall, the cereals conferred higher GIs than the root vegetables. The GIs of English potatoes, maize meal, millet and cassava significantly differed from that of white bread. It is concluded that, using GIs, dietary guidelines comprising locally available and affordable foods can be made.

  19. THE INFLUENCE OF THE ASSESSMENT MODEL AND METHOD TOWARD THE SCIENCE LEARNING ACHIEVEMENT BY CONTROLLING THE STUDENTS? PREVIOUS KNOWLEDGE OF MATHEMATICS.

    OpenAIRE

    Adam rumbalifar; I. g. n. Agung; Burhanuddin tola.

    2018-01-01

    This research aims to study the influence of the assessment model and method toward the science learning achievement by controlling the students? previous knowledge of mathematics. This study was conducted at SMP East Seram district with the population of 295 students. This study applied a quasi-experimental method with 2 X 2 factorial design using the ANCOVA model. The findings after controlling the students\\' previous knowledge of mathematics show that the science learning achievement of th...

  20. 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.

  1. 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.

  2. 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…

  3. Postprandial glycaemic response of foxtail millet dosa in comparison to a rice dosa in patients with type 2 diabetes

    Science.gov (United States)

    Narayanan, Janani; Sanjeevi, Vimala; Rohini, U.; Trueman, Patricia; Viswanathan, Vijay

    2016-01-01

    Background & objectives: Millets are rich source of dietary fibre and non-starchy polysaccharides with low glycaemic index (GI), hence can be used as a therapeutic diet. This study was conducted to estimate the effects of a millet-based dosa (foxtail dosa) compared to a rice dosa for breakfast on postprandial glucose levels in patients with type 2 diabetes mellitus (T2DM). Methods: The GI of rice dosa and foxtail millet dosa was estimated. A total of 105 T2DM participants were randomly selected for the study. The participants were on oral hypoglycaemic agents (OHA) and not on insulin. In this study, each individual served as their own control and experimental group. The postprandial increase in blood glucose was compared after a breakfast of rice dosa and millet dosa. Single and paired t test was used to note the change in blood glucose levels and the level of the significance. Results: The GI of foxtail millet dosa was 59.25 and rice dosa was 77.96. There was a significant reduction (P<0.001) in the postprandial glucose level of patients who consumed a millet-based dosa when compared to those who consumed a rice-based dosa. No significant reduction was observed in the fasting glucose levels. Interpretation & conclusions: The results suggested that replacing a rice-based breakfast item with a millet-based breakfast item lowers the postprandial blood glucose levels in T2DM patients. Thus, millets may have a protective role in the management of hyperglycaemia. Further studies need to be done in a systematic manner to confirm these findings. PMID:28361824

  4. 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.

  5. Efficacy and safety of vildagliptin in patients with type 2 diabetes mellitus inadequately controlled with dual combination of metformin and sulphonylurea.

    Science.gov (United States)

    Lukashevich, V; Del Prato, S; Araga, M; Kothny, W

    2014-05-01

    The broadly used combination of metformin and sulphonylurea (SU) often fails to bring patients to glycaemic goal. This study assessed the efficacy and safety of vildagliptin as add-on therapy to metformin plus glimepiride combination in patients with type 2 diabetes mellitus (T2DM) who had inadequate glycaemic control. A multicentre, double-blind, placebo-controlled study randomized patients to receive treatment with vildagliptin 50 mg bid (n = 158) or placebo (n = 160) for 24 weeks. After 24 weeks, the adjusted mean change in haemoglobin A1c (HbA1c) was -1.01% with vildagliptin (baseline 8.75%) and -0.25% with placebo (baseline 8.80%), with a between-treatment difference of -0.76% (p vildagliptin achieved the HbA1c target vildagliptin and placebo was -1.13 mmol/l (p vildagliptin reduced HbA1c by 0.74% from baseline 7.82% (between-treatment difference: -0.97%; p Vildagliptin was well tolerated with low incidence of hypoglycaemia, slightly higher than with placebo (5.1% vs. 1.9%) and no clinically relevant weight gain. Vildagliptin significantly improved glycaemic control in patients with T2DM inadequately controlled with metformin plus glimepiride combination. The addition of vildagliptin was well tolerated with low risk of hypoglycaemia and weight gain. This makes vildagliptin an attractive treatment option for patients failing on metformin plus SU particularly in patients with baseline HbA1c ≤8%. © 2013 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

  6. 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.

  7. The application of simple metrics in the assessment of glycaemic variability.

    Science.gov (United States)

    Monnier, L; Colette, C; Owens, D R

    2018-03-06

    The assessment of glycaemic variability (GV) remains a subject of debate with many indices proposed to represent either short- (acute glucose fluctuations) or long-term GV (variations of HbA 1c ). For the assessment of short-term within-day GV, the coefficient of variation for glucose (%CV) defined as the standard deviation adjusted on the 24-h mean glucose concentration is easy to perform and with a threshold of 36%, recently adopted by the international consensus on use of continuous glucose monitoring, separating stable from labile glycaemic states. More complex metrics such as the Low Blood Glucose Index (LBGI) or High Blood Glucose Index (HBGI) allow the risk of hypo or hyperglycaemic episodes, respectively to be assessed although in clinical practice its application is limited due to the need for more complex computation. This also applies to other indices of short-term intraday GV including the mean amplitude of glycemic excursions (MAGE), Shlichtkrull's M-value and CONGA. GV is important clinically as exaggerated glucose fluctuations are associated with an enhanced risk of adverse cardiovascular outcomes due primarily to hypoglycaemia. In contrast, there is at present no compelling evidence that elevated short-term GV is an independent risk factor of microvascular complications of diabetes. Concerning long-term GV there are numerous studies supporting its association with an enhanced risk of cardiovascular events. However, this association raises the question as to whether the impact of long-term variability is not simply the consequence of repeated exposure to short-term GV or ambient chronic hyperglycaemia. The renewed emphasis on glucose monitoring with the introduction of continuous glucose monitoring technologies can benefit from the introduction and application of simple metrics for describing GV along with supporting recommendations. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  8. The glycaemic index values of foods containing fructose are affected by metabolic differences between subjects.

    Science.gov (United States)

    Wolever, T M S; Jenkins, A L; Vuksan, V; Campbell, J

    2009-09-01

    Glycaemic responses are influenced by carbohydrate absorption rate, type of monosaccharide absorbed and the presence of fat; the effect of some of these factors may be modulated by metabolic differences between subjects. We hypothesized that glycaemic index (GI) values are affected by the metabolic differences between subjects for foods containing fructose or fat, but not for starchy foods. The GI values of white bread (WB), fruit leather (FL) and chocolate-chip cookies (CCC) (representing starch, fructose and fat, respectively) were determined in subjects (n=77) recruited to represent all 16 possible combinations of age (40 years), sex (male, female), ethnicity (Caucasian, non-Caucasian) and body mass index (BMI) (25 kg/m2) using glucose as the reference. At screening, fasting insulin, lipids, c-reactive protein (CRP), aspartate transaminase (AST) and waist circumference (WC) were measured. There were no significant main effects of age, sex, BMI or ethnicity on GI, but there were several food x subject-factor interactions. Different factors affected each food's area under the curve (AUC) and GI. The AUC after oral glucose was related to ethnicity, age and triglycerides (r 2=0.27); after WB to ethnicity, age, triglycerides, sex and CRP (r 2=0.43); after CCC to age and weight (r 2=0.18); and after FL to age and CRP (r 2=0.12). GI of WB was related to ethnicity (r 2=0.12) and of FL to AST, insulin and WC (r 2=0.23); but there were no significant correlations for CCC. The GI values of foods containing fructose might be influenced by metabolic differences between -subjects, whereas the GI of starchy foods might be affected by ethnicity. However, the proportion of variation explained by subject factors is small.

  9. Containment-based Distributed Coordination Control to Achieve Both Bounded Voltage and Precise Current Sharing in Reverse-Droop-based DC Microgrid

    DEFF Research Database (Denmark)

    Han, Renke; Wang, Haojie; Jin, Zheming

    2017-01-01

    A highly flexible and reliable control strategy is proposed to achieve bounded voltage and precise current sharing, which is implemented in a reverse-droop-based dc Micro-Grid. To acquire the fast-dynamic response, the reverse droop control is used to replace the V-I droop control in the primary...... sharing among converters. Combined the proposed controllers with the electrical part of the dc Micro-Grid, a model is fully developed to analyze the sensitivity of different control coefficients. Experimental results are presented to demonstrate the effectiveness of the proposed method....

  10. Species-specific prevalence of vaginal candidiasis among patients with diabetes mellitus and its relation to their glycaemic status.

    Science.gov (United States)

    Goswami, R; Dadhwal, V; Tejaswi, S; Datta, K; Paul, A; Haricharan, R N; Banerjee, U; Kochupillai, N P

    2000-09-01

    Non- C. albicans Candida species are increasingly being recognized as the cause of vulvo-vaginal candidiasis. These species are often less susceptible to antifungal agents. Patients with diabetes mellitus are at risk for vulvo-vaginal candidasis. We assessed the species-specific prevalence rate and risk of candidiasis in patients with diabetes mellitus and healthy controls. Genital tract examination, direct microscopy and fungal cultures of discharge collected by high vaginal swab were undertaken among 78 consecutive patients with diabetes mellitus (mean (+/-sd) age 32+/-12 years and body mass index (BMI) 22.3+/-5.5kg/m(2)) and 88 age- and BMI-matched healthy females. Glycaemic control in the diabetic cohort was assessed by measuring total glycosylated haemoglobin. Candida species were isolated in 36 of 78 (46%) subjects with diabetes mellitus and in 21 of 88 (23%) healthy subjects (Chi-squared 9.11, P=0.0025). The predominant Candida species isolated in diabetics with vulvo-vaginal candidiasis were Candida glabrata (39%), C. albicans (26%) and C. tropicalis (17%). In contrast, in the control group, C. albicans, C. glabrata and C. hemulonii comprised 30% each, with none having C. tropicalis infection (for C. tropicalis: diabetic vs. control; 17% vs. nil, P=0. 05). Among the diabetic group, subjects with vulvo-vaginal candidiasis had significantly higher mean HbA1 when compared to those who had no such infection (12.8+/-2.6% vs. 9.7+/-1.7% respectively, P=0.001). The overall accuracy of direct microscopy and clinical examination for predicting vulvo-vaginal candidiasis was only 77% and 51%, respectively, in the diabetic group, and 83% and 65% in the control group. Patients with diabetes mellitus had a high prevalence rate (46%) of vulvo-vaginal candidiasis with relative risk of 2.45. The non- C. albicans species such as C. glabrata and C. tropicalis were the predominant species isolated among them. There seems to be a significant link between hyperglycaemia and

  11. 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.

  12. Addition of mushroom powder to pasta enhances the antioxidant content and modulates the predictive glycaemic response of pasta.

    Science.gov (United States)

    Lu, Xikun; Brennan, Margaret A; Serventi, Luca; Liu, Jianfu; Guan, Wenqiang; Brennan, Charles S

    2018-10-30

    This study reports the effects of addition of mushroom powder on the nutritional properties, predictive in vitro glycaemic response and antioxidant potential of durum wheat pasta. Addition of the mushroom powder enriched the pasta as a source of protein, and soluble and insoluble dietary fibre compared with durum wheat semolina. Incorporation of mushroom powder significantly decreased the extent of starch degradation and the area under the curve (AUC) of reducing sugars released during digestion, while the total phenolic content and antioxidant capacities of samples increased. A mutual inhibition system between the degree of starch gelatinisation and antioxidant capacity of the pasta samples was observed. These results suggest that mushroom powder could be incorporated into fresh semolina pasta, conferring healthier characteristics, namely lowering the potential glycaemic response and improving antioxidant capacity of the pasta. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. 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 (PJerusalem 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. Copyright © 2015. Published by Elsevier Ltd.

  14. The Effect of Visual Cueing and Control Design on Children's Reading Achievement of Audio E-Books with Tablet Computers

    Science.gov (United States)

    Wang, Pei-Yu; Huang, Chung-Kai

    2015-01-01

    This study aims to explore the impact of learner grade, visual cueing, and control design on children's reading achievement of audio e-books with tablet computers. This research was a three-way factorial design where the first factor was learner grade (grade four and six), the second factor was e-book visual cueing (word-based, line-based, and…

  15. An Examination of the Influence of Self Efficacy, Locus of Control, and Perceptions of Parent Involvement on Academic Achievement of Urban High School Students

    Science.gov (United States)

    Myree, Claudia

    2011-01-01

    Current research indicates that there is an on-going concern for the graduation rate of African American students in urban settings. This particular study sought to investigate the impact of students' self-efficacy, locus of control, and parental involvement on academic achievement via a targeted sample of urban African American high school…

  16. PI and PID controller tuning rule design for processes with delay, to achieve constant gain and phase margins for all values of delay

    OpenAIRE

    O'Dwyer, Aidan

    2001-01-01

    This paper will discuss the design of PI and PID controller tuning rules to compensate processes with delay, that are modelled in a number of ways. The rules allow the achievement of constant gain and phase margins as the delay varies.

  17. The effects of oat β-glucan incorporation on the quality, structure, consumer acceptance and glycaemic response of steamed bread.

    Science.gov (United States)

    Wang, Lei; Ye, Fayin; Feng, Liyuan; Wei, Fubin; Zhao, Guohua

    2017-12-01

    The objective of this study was to evaluate the effects of the incorporation of oat β-glucan (OβG) on the sensory and nutritional quality of steamed bread. Wheat flour was substituted with OβG at levels varying from 0 g/100 g to 5 g/100 g. The results showed that the products containing 1 g/100 g and 3 g/100 g OβG produced a comparable overall consumer acceptance while a significantly lower score was given to the product with 5 g/100 g. Nutritionally, the presence of OβG impeded in vitro starch hydrolysis by amylolytic enzymes. More importantly, the addition of OβG up to 5 g/100 g did bring about a lower in vitro predicted glycaemic index to steamed bread, but it generated insignificant effects on the in vivo glycaemic response. The current work first demonstrated the feasibility of fabricating OβG-enriched steamed bread and its nutritional superiority compared to the corresponding normal product. Modern methods of food elaboration and processing frequently reduce the content of dietary fiber (DF). Despite the well-known health benefits of DF consumption, average intake levels still fall far below recommended ones. Oat β-glucan (OβG) is a kind of indigestible polysaccharide with diverse bioactivity. This article evaluated the effects of OβG incorporation on quality, structure, consumer acceptance, and glycaemic response of steamed bread. The addition of less than 3 g/100 g of OβG had negligible effects on the consumer acceptance of steamed bread. The enrichment at 5 g/100 g indeed deteriorated the consumer acceptance. Moreover, OβG highly lowered the glycaemic response of steamed bread. The current work first demonstrated the feasibility of fabricating OβG-enriched steamed bread and its nutritional superiority compared to the corresponding normal product. OβG enriched steamed bread may offer an alternative to improve DF intake of residents. © 2017 Wiley Periodicals, Inc.

  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 eff...... to reductions in inner mitochondrial membrane leak and increased efficiency of mitochondria. This change in mitochondrial physiology could contribute to the weight gain seen with antihyperglycaemic treatment....... 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

    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. 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

    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...

  2. Investigations into the Effects of Turmeric, Cinnamon and Green Tea on Glycaemic Control and Liver Enzymes

    OpenAIRE

    Wickenberg, Jennie

    2015-01-01

    Lifestyle changes such as caloric over-consumption and decreased physical activity are causing overweight and obesity, leading to an epidemic increase in type 2 diabetes mellitus (T2DM). Overweight, cardiovascular disease and diabetes are closely linked, and cardio-vascular disease is the most important cause of morbidity and mortality among patients with T2DM. Identifying food that can reduce blood glucose and insulin, and increase satiety can help in the prevention and reduction of diabe...

  3. Glycaemic control in diabetic patients during hospital admission is not optimal

    DEFF Research Database (Denmark)

    Hellquist, Fanny; Budde, Line; Feldt-Rasmussen, Bo Friis

    2011-01-01

    of admission was collected, including: bedside p-glucose readings, scheduled and supplemental insulin treatment. RESULTS: In total, 111 observation days were included from 37 diabetic patients (27 medical and ten surgical). P-glucose was measured on average four and 2.5 times daily at the medical...... was not given despite being indicated in 37% of the elevated glucose episodes. Increments in scheduled insulin dose were rarely observed despite being indicated. CONCLUSION: Despite acceptable median p-glucose levels, hyperglycaemia was frequent. The number of glucose readings was low and clinical inertia...

  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. Low carbohydrate diet and improved glycaemic control in a patient with type one diabetes

    Directory of Open Access Journals (Sweden)

    Mirjam Eiswirth

    2018-03-01

    Full Text Available We present the case of an adult female with type 1 diabetes, whose HbA1c was trending at 58 mmol/mol (7.5% for the past 3 years. In August 2016, she reduced her total daily carbohydrate intake to 30–50 g and adjusted her other macronutrients to compensate for the calorific deficit. Her HbA1c fell to 34 mmol/mol (5.3% by January 2017 and average daily blood glucose readings decreased significantly from 10.4 to 6.1 mmol/L. Moreover, she observed a marked reduction of average daily glucose variability. Notably, there were no significant episodes of hypo- or hyperglycaemia and her lipid profile remained static. Subjectively, she described an improvement in her quality of life and the dietary transition was extremely well tolerated. We discuss these findings in detail and the potential clinical benefits for patients with type 1 diabetes that can be gained by following a low carbohydrate diet.

  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) 0.5 D] was 53.3% [95% confidence...

  7. Personality traits, self-care behaviours and glycaemic control in Type 2 diabetes

    DEFF Research Database (Denmark)

    Skinner, T. C.; Bruce, D. G.; Davis, T. M.E.

    2014-01-01

    Aims: To determine whether the personality traits of conscientiousness and agreeableness are associated with self-care behaviours and glycaemia in Type 2 diabetes. Methods: The Big Five Inventory personality traits Agreeableness, Conscientiousness, Extraversion, Neuroticism and Openness were...... modelling was used to determine whether personality was associated with BMI, smoking, self-monitoring of blood glucose and medication taking. Multivariable regression was used to investigate which traits were independently associated with these self-care behaviours and HbA1c. Results: Patients with higher......, longer diabetes duration, diabetes treatment, self-monitoring of blood glucose (negatively) and less medication taking (P ≤ 0.009), but no personality trait added to the model. Conclusions: Although there was no independent association between personality traits and HbA1c, the relationship between high...

  8. Food consumption, obesity and abnormal glycaemic control in a Canadian Inuit community.

    Science.gov (United States)

    Singer, J; Putulik Kidlapik, C; Martin, B; Dean, H J; Trepman, E; Embil, J M

    2014-12-01

    Dietary and lifestyle factors may contribute to diabetes and obesity in the Canadian Inuit. We documented dietary patterns, physical activity level, obesity, blood glucose abnormalities and diabetes prevalence in a Canadian Inuit community. There were 250 Inuit residents of Repulse Bay, Nunavut, who had an interview about diet and physical activity, measurement of weight and height, and laboratory studies (194 subjects). Children, adolescents and younger adults (aged food and more processed snack foods and sweet drinks than older adults (aged ≥ 48 years). Only 88 of 250 subjects (35%) reported that they went out on the land once or more per week. Of the 85 children and adolescent subjects (aged 7-17 years), 11 (13%) were obese. Average body mass index for adults (aged ≥ 18 years) was 29 ± 6 kg m(-2) , and 61 adults (37%) were obese (body mass index ≥30 kg m(-2) ). In the 140 adults who had laboratory studies, 18 adults (13%) had a blood glucose abnormality, including 10 adults (7%) with impaired fasting glucose, four adults (3%) with impaired glucose tolerance and six adults (4%) with diabetes (five adults previously undiagnosed). Twelve of the 194 subjects tested (6%) had fasting insulin ≥140 pmol L(-1) (mean, 196 ± 87 pmol L(-1) ). In summary, there was a high prevalence of poor dietary choices, limited physical activity, obesity and type 2 diabetes in this Inuit community. Public health programmes are needed to improve the dietary and health status of this community. © 2014 The Authors. Clinical Obesity © 2014 World Obesity.

  9. 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

  10. 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.

  11. Design and implementation of remote robotic control system for nuclear power plant application achieved through kinesthetic force feedback model

    International Nuclear Information System (INIS)

    Roy, D.

    1995-01-01

    The technology of telerobotic control through a universal and transparent Man-Machine Interface is a growing field of robotics research in today's industrial scenario because of its promising application in hazardous and unstructured environments. The joystick, a sophisticated information receiver-translator-transmitter device, serves as a Man-Machine Interface for telerobots. The present paper describes the development paradigms of a remote control system for a planar four degrees-of-freedom joystick following position feed-forward force/torque feedback strategy in a bi-lateral mode. This joystick based control technology is designed to actuate an industrial robot working in nuclear power plant. The remote control system has been illustrated with model, algorithm, electronic hardware and software routines along with experimental results in order to have effective telemanipulation

  12. Achieving DoD's Net Centric Vision of Information Sharing While Overcoming Cultural Biases to Control Information

    National Research Council Canada - National Science Library

    Shaw, Paul M

    2008-01-01

    .... A culture change from a "need to know' to a "need to share" is the desired end state. This culture change is in contrast to known organizational and individual cultural biases to control information...

  13. Analysis of the immune system of multiple myeloma patients achieving long-term disease control by multidimensional flow cytometry

    Science.gov (United States)

    Pessoa de Magalhães, Roberto J.; Vidriales, María-Belén; Paiva, Bruno; Fernandez-Gimenez, Carlos; García-Sanz, Ramón; Mateos, Maria-Victoria; Gutierrez, Norma C.; Lecrevisse, Quentin; Blanco, Juan F; Hernández, Jose; de las Heras, Natalia; Martinez-Lopez, Joaquin; Roig, Monica; Costa, Elaine Sobral; Ocio, Enrique M.; Perez-Andres, Martin; Maiolino, Angelo; Nucci, Marcio; De La Rubia, Javier; Lahuerta, Juan-Jose; San-Miguel, Jesús F.; Orfao, Alberto

    2013-01-01

    Multiple myeloma remains largely incurable. However, a few patients experience more than 10 years of relapse-free survival and can be considered as operationally cured. Interestingly, long-term disease control in multiple myeloma is not restricted to patients with a complete response, since some patients revert to having a profile of monoclonal gammopathy of undetermined significance. We compared the distribution of multiple compartments of lymphocytes and dendritic cells in the bone marrow and peripheral blood of multiple myeloma patients with long-term disease control (n=28), patients with newly diagnosed monoclonal gammopathy of undetermined significance (n=23), patients with symptomatic multiple myeloma (n=23), and age-matched healthy adults (n=10). Similarly to the patients with monoclonal gammopathy of undetermined significance and symptomatic multiple myeloma, patients with long-term disease control showed an expansion of cytotoxic CD8+ T cells and natural killer cells. However, the numbers of bone marrow T-regulatory cells were lower in patients with long-term disease control than in those with symptomatic multiple myeloma. It is noteworthy that B cells were depleted in patients with monoclonal gammopathy of undetermined significance and in those with symptomatic multiple myeloma, but recovered in both the bone marrow and peripheral blood of patients with long-term disease control, due to an increase in normal bone marrow B-cell precursors and plasma cells, as well as pre-germinal center peripheral blood B cells. The number of bone marrow dendritic cells and tissue macrophages differed significantly between patients with long-term disease control and those with symptomatic multiple myeloma, with a trend to cell count recovering in the former group of patients towards levels similar to those found in healthy adults. In summary, our results indicate that multiple myeloma patients with long-term disease control have a constellation of unique immune changes

  14. 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.

  15. 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...

  16. 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.

  17. 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.

  18. Increasing Doses of Inhaled Corticosteroids Compared to Adding Long-Acting Inhaled beta(2)-Agonists in Achieving Asthma Control

    NARCIS (Netherlands)

    O'Byrne, Paul M.; Naya, Ian P.; Kallen, Anders; Postma, Dirkje S.; Barnes, Peter J.

    2008-01-01

    Background: Combination therapy with inhaled corticosteroids (ICSs) and long-acting beta(2)-agonists (LABAs), or treatment with high doses of ICSs alone improves asthma control when therapy with low-dose ICSs is not sufficient. However, it is not known which of these treatment options is more

  19. 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 PM 2.5 ) 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 PM 2.5 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. Copyright © 2016. Published by Elsevier B.V.

  20. Command and Control Rapid Prototyping Continuum (C2RPC): The Framework for Achieving a New C2 Strategy

    Science.gov (United States)

    2011-06-01

    Sync Matrix Assessing J/ADOCS (Fires) TBMCS (ATO) Executing Monitoring (SA) C2 Strategy Objectives • Provide Expanded Mission Management...Computers, and Intelligence T&E Test and Evaluation PMW150 Program Warfare Office Command and Control TBMCS Theater Battle Management Core System POR

  1. 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...

  2. Students' Emotions for Achievement and Technology Use in Synchronous Hybrid Graduate Programmes: A Control-Value Approach

    Science.gov (United States)

    Butz, Nikolaus T.; Stupnisky, Robert H.; Pekrun, Reinhard

    2015-01-01

    Synchronous hybrid delivery (simultaneously teaching on-campus and online students using web conferencing) is becoming more common; however, little is known about how students experience emotions in this learning environment. Based on Pekrun's (2006) control-value theory of emotions, the dual purpose of this study was first to compare synchronous…

  3. A novel temperature control method for shortening thermal cycling time to achieve rapid polymerase chain reaction (PCR) in a disposable polymer microfluidic device

    DEFF Research Database (Denmark)

    Bu, Minqiang; R. Perch-Nielsen, Ivan; Sørensen, Karen Skotte

    steps to achieve a rapid ramping between the temperature steps for DNA denaturation, annealing and extension. The temperature dynamics within the microfluidic PCR chamber was characterized and the overshooting and undershooting parameters were optimized using the temperature dependent fluorescence......We present a new temperature control method capable of effectively shortening the thermal cycling time of polymerase chain reaction (PCR) in a disposable polymer microfluidic device with external heater and temperature sensor. The method employs optimized temperature overshooting and undershooting...

  4. A temperature control method for shortening thermal cycling time to achieve rapid polymerase chain reaction (PCR) in a disposable polymer microfluidic device

    DEFF Research Database (Denmark)

    Bu, Minqiang; Perch-Nielsen, Ivan R.; Sørensen, Karen Skotte

    2013-01-01

    steps to achieve a rapid ramping between the temperature steps for DNA denaturation, annealing and extension. The temperature dynamics within the microfluidic PCR chamber was characterized and the overshooting and undershooting parameters were optimized using the temperature-dependent fluorescence......We present a temperature control method capable of effectively shortening the thermal cycling time of polymerase chain reaction (PCR) in a disposable polymer microfluidic device with an external heater and a temperature sensor. The method employs optimized temperature overshooting and undershooting...

  5. 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

  6. To achieve an earlier IFN-γ response is not sufficient to control Mycobacterium tuberculosis infection in mice.

    Science.gov (United States)

    Vilaplana, Cristina; Prats, Clara; Marzo, Elena; Barril, Carles; Vegué, Marina; Diaz, Jorge; Valls, Joaquim; López, Daniel; Cardona, Pere-Joan

    2014-01-01

    The temporo-spatial relationship between the three organs (lung, spleen and lymph node) involved during the initial stages of Mycobacterium tuberculosis infection has been poorly studied. As such, we performed an experimental study to evaluate the bacillary load in each organ after aerosol or intravenous infection and developed a mathematical approach using the data obtained in order to extract conclusions. The results showed that higher bacillary doses result in an earlier IFN-γ response, that a certain bacillary load (BL) needs to be reached to trigger the IFN-γ response, and that control of the BL is not immediate after onset of the IFN-γ response, which might be a consequence of the spatial dimension. This study may have an important impact when it comes to designing new vaccine candidates as it suggests that triggering an earlier IFN-γ response might not guarantee good infection control, and therefore that additional properties should be considered for these candidates.

  7. 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...... process synthesis (and intensification) because it allows the association of tasks (functions) with the processing route to be followed. At the unit operations scale (Jaksland et al., 1995) and task scale (Siirola, 1996) alternatives are limited to existing (well-known) unit operations and therefore, may...

  8. 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 (CA......-frequency range. CABS has been simulated and measured in two different standard listening rooms with satisfactory results....

  9. Radiative heat transfer enhancement using geometric and spectral control for achieving high-efficiency solar-thermophotovoltaic systems

    Science.gov (United States)

    Kohiyama, Asaka; Shimizu, Makoto; Yugami, Hiroo

    2018-04-01

    We numerically investigate radiative heat transfer enhancement using spectral and geometric control of the absorber/emitter. A high extraction of the radiative heat transfer from the emitter as well as minimization of the optical losses from the absorber leads to high extraction and solar thermophotovoltaic (STPV) system efficiency. The important points for high-efficiency STPV design are discussed for the low and high area ratio of the absorber/emitter. The obtained general guideline will support the design of various types of STPV systems.

  10. Achievement report for fiscal 1998 in developing environment corresponding universal controller (Individual report edition); 1998 nendo kankyo taio universal controller no kaihatsu seika hokokusho. Kobetsu hokokuhen

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-05-01

    Research and development has been performed on an 'environment corresponding universal controller (UC)' that realizes 'easiness of use and energy conservation' in correspondence with household electric appliances. This paper summarizes the reports by themes. The summarized development themes include: 'development of a bi-directional controller and TV interface', 'development of a bi-directional remote controller, an infrared ray to radio converter, and an air conditioner corresponding to the bi-directional remote controller', 'development of a UC corresponding air conditioner, and electric power cable transporting gateway', 'development of a universal controller and a control box', and 'development of an energy saving wiring system for the UC remote controller'. This paper also summarizes the works done by research participating departments of each corporation, such as development of UC corresponding video and TV sets (Sanyo Electric), development of UC corresponding TV sets (Toshiba), development of a UC corresponding DVD player (Japan Victor and Victor Techno-brain), and development of a UC relay box and a control box for the existing HA system (PANA R and D). (NEDO)

  11. 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

  12. 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

  13. Achieving blood pressure control among renal transplant recipients by integrating electronic health technology and clinical pharmacy services.

    Science.gov (United States)

    Migliozzi, Daniel R; Zullo, Andrew R; Collins, Christine; Elsaid, Khaled A

    2015-11-15

    The implementation and outcomes of a program combining electronic home blood pressure monitoring (HBPM) and pharmacist-provided medication therapy management (MTM) services in a renal transplantation clinic are described. Patients enrolled in the program were provided with a computer-enabled blood pressure monitor. A dedicated renal transplantation pharmacist was integrated into the renal transplantation team under a collaborative care practice agreement. The collaborative care agreement allowed the pharmacist to authorize medication additions, deletions, and dosage changes. Comprehensive disease and blood pressure education was provided by a clinical pharmacist. In the pretransplantation setting, the pharmacist interviewed the renal transplant candidate and documents allergies, verified the patient's medication profile, and identified and assessed barriers to medication adherence. A total of 50 renal transplant recipients with at least one recorded home blood pressure reading and at least one year of follow-up were included in our analysis. A significant reduction in mean systolic and diastolic blood pressure values were observed at 30, 90, 180, and 360 days after enrollment in the program (p services implemented in a renal transplant clinic was associated with sustained improvements in blood pressure control. Incorporation of a pharmacist in the renal transplant clinic resulted in the detection and resolution of medication-related problems. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  14. 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. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Greater Glycaemic Response to an Oral Glucose Load in Healthy, Lean, Active and Young Chinese Adults Compared to Matched Caucasians

    Directory of Open Access Journals (Sweden)

    Trevor Simper

    2018-04-01

    Full Text Available There are ethnic differences recorded in glycaemic response and rates of type 2 diabetes mellitus (DM between Chinese and Caucasian populations. Whether these differences are evident in matched healthy, lean, active, young adults is unclear. This study compares the postprandial glycaemic response of a group of Chinese participants (n = 49 with a group of similar Caucasians, (n = 48 aged 23.8 (±4.35 years, body mass index (BMI 22.7 (±2.6 kg/m2, healthy (free from non-communicable disease, and lean (body fat % 23.28% (±5.04. Participants undertook an oral glucose tolerance test to identify any significant differences in postprandial blood glucose response. Body fat percentage, body mass, age, physical activity, baseline glucose and HbA1c did not significantly differ between groups. Data from food frequency questionnaires indicated that the Chinese participants consumed less starchy foods, candy and “other” sweets and sugary drinks, and more rice than the Caucasians (all p ≤ 0.001, but not a greater overall intake of carbohydrates or any other macronutrient (all p > 0.05. The two groups’ postprandial blood glucose responses and 2-h incremental area under the curve values (iAUC—156.67 (74.12 mmol/L 120 min for Caucasians versus 214.03 (77.49 mmol/L 120 min for Chinese—indicate significant differences (p = 0.003 and p < 0.001 respectively between groups. Findings suggest that the difference between the two groups’ iAUC values do not relate to obvious lifestyle factors. The Chinese group were eating the least sugary and starchy food but had the highest iAUC. It is argued that the Chinese group in this investigation have the most favourable BMI, body fat percentage, and body mass, yet “poorest” glycaemic response.

  16. Comparison of two approaches in achieving smoking abstinence among patients in an outpatient clinic: a phase 2 randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ka Yan Ho

    2018-03-01

    Full Text Available Background Having a disease and requiring medical attention present an excellent 'teachable moment' for smoking cessation interventions. However, nicotine is addictive and quitting is difficult, with a high rate of relapse, particularly among chronic smokers. Our previous smoking cessation projects in the community have revealed that many smokers who are reluctant to quit are interested in reducing the number of cigarettes they smoke per day. Therefore, smoking reduction may be an important alternative strategy for promoting smoking cessation. This Phase 2 randomized controlled trial of smokers who had medical follow-ups in an outpatient clinic compared the effectiveness of two approaches to smoking cessation: quitting immediately and cutting down to quit. Methods A total of 100 subjects were randomized into two groups, 50 in the quit immediately group, who received an intervention on abruptly quitting, and 50 in the cut down to quit group, who received an intervention on gradual reduction. All subjects were followed up at 6 and 12 months via telephone, and their smoking status was assessed. The primary outcomes were self-reported 7-day point prevalence of abstinence at 6 and 12 months. Intention-to-treat analysis was employed. Results On average, subjects had smoked 11.31 cigarettes per day over 37 years and 96% had mild nicotine dependence. At the 6-month follow-up, the self-reported quit rate of subjects in the quit immediately group was significantly higher than in the cut down to quit group (18.0% vs. 4.0%, p = 0.04. However, this difference was not significant at the 12-month follow-up (12.0% vs. 4.0%, p = 0.16. Conclusions These data suggest that quitting immediately might be more effective than cutting down to quit in smokers who need to quit sooner, such as those with diseases requiring medical attention. Nevertheless, the effectiveness of the cut down to quit approach requires further testing.

  17. Limited Margin Radiation Therapy for Children and Young Adults With Ewing Sarcoma Achieves High Rates of Local Tumor Control

    Energy Technology Data Exchange (ETDEWEB)

    Talleur, Aimee C.; Navid, Fariba [Department of Oncology, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Spunt, Sheri L. [Department of Pediatrics, Stanford University School of Medicine, Stanford, California (United States); McCarville, M. Beth [Department of Diagnostic Imaging, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Wu, John; Mao, Shenghua [Department of Biostatistics, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Davidoff, Andrew M. [Department of Surgery, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Department of Surgery, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee (United States); Neel, Michael D. [Department of Surgery, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Krasin, Matthew J., E-mail: matthew.krasin@stjude.org [Department of Radiation Oncology, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States)

    2016-09-01

    Purpose: To determine the rate of local failure using focal conformal, limited margin radiation therapy (RT) and dose escalation for tumors ≥8 cm (greatest dimension at diagnosis) in children and young adults with Ewing sarcoma (EWS). Methods and Materials: Eligible patients with EWS were treated on a phase 2 institutional trial of focal conformal, limited margin RT using conformal or intensity modulated techniques. The treatment volume incorporated a 1-cm constrained margin around the gross tumor. Unresected tumors, <8 cm at diagnosis, received a standard dose of 55.8 Gy and tumors ≥8 cm, an escalated dose to 64.8 Gy. Patients with microscopic residual disease after resection received adjuvant RT to 50.4 Gy. Adjuvant brachytherapy was permitted in selected patients. Results: Forty-five patients were enrolled: 26 with localized and 19 with metastatic disease. Median (range) age, tumor size, and follow-up were 13.0 years (2.9-24.7 years), 9.0 cm (2.4-17.0 cm), and 54.5 months (1.9-122.2 months), respectively. All patients received systemic chemotherapy. The median (range) RT dose for all patients was 56.1 Gy (45-65.5 Gy). Seventeen patients received adjuvant, 16 standard-dose, and 12 escalated-dose RT. Failures included 1 local, 10 distant, and 1 local/distant. The estimated 10-year cumulative incidence of local failure was 4.4% ± 3.1%, with no statistical difference seen between RT treatment groups and no local failures in the escalated-dose RT treatment group. Conclusions: Treatment with focal conformal, limited margin RT, including dose escalation for larger tumors, provides favorable local tumor control in EWS.

  18. Limited Margin Radiation Therapy for Children and Young Adults With Ewing Sarcoma Achieves High Rates of Local Tumor Control

    International Nuclear Information System (INIS)

    Talleur, Aimee C.; Navid, Fariba; Spunt, Sheri L.; McCarville, M. Beth; Wu, John; Mao, Shenghua; Davidoff, Andrew M.; Neel, Michael D.; Krasin, Matthew J.

    2016-01-01

    Purpose: To determine the rate of local failure using focal conformal, limited margin radiation therapy (RT) and dose escalation for tumors ≥8 cm (greatest dimension at diagnosis) in children and young adults with Ewing sarcoma (EWS). Methods and Materials: Eligible patients with EWS were treated on a phase 2 institutional trial of focal conformal, limited margin RT using conformal or intensity modulated techniques. The treatment volume incorporated a 1-cm constrained margin around the gross tumor. Unresected tumors, <8 cm at diagnosis, received a standard dose of 55.8 Gy and tumors ≥8 cm, an escalated dose to 64.8 Gy. Patients with microscopic residual disease after resection received adjuvant RT to 50.4 Gy. Adjuvant brachytherapy was permitted in selected patients. Results: Forty-five patients were enrolled: 26 with localized and 19 with metastatic disease. Median (range) age, tumor size, and follow-up were 13.0 years (2.9-24.7 years), 9.0 cm (2.4-17.0 cm), and 54.5 months (1.9-122.2 months), respectively. All patients received systemic chemotherapy. The median (range) RT dose for all patients was 56.1 Gy (45-65.5 Gy). Seventeen patients received adjuvant, 16 standard-dose, and 12 escalated-dose RT. Failures included 1 local, 10 distant, and 1 local/distant. The estimated 10-year cumulative incidence of local failure was 4.4% ± 3.1%, with no statistical difference seen between RT treatment groups and no local failures in the escalated-dose RT treatment group. Conclusions: Treatment with focal conformal, limited margin RT, including dose escalation for larger tumors, provides favorable local tumor control in EWS.

  19. 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 2...... that to white bread (P type 2 diabetic...... 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...

  20. 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

  1. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2014-01-01

    International e-Customs is going through a standardization process. Driven by the need to increase control in the trade process to address security challenges stemming from threats of terrorists, diseases, and counterfeit products, and to lower the administrative burdens on traders to stay...

  2. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2016-01-01

    International e-Customs is going through a standardization process. Driven by the need to increase control in the trade process to address security challenges stemming from threats of terrorists, diseases, and counterfeit products, and to lower the administrative burdens on traders to stay...

  3. 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

    A common problem with Chinese district heating systems is that they supply more heat than the actual heat demand. The reason for this excess heat supply is the general failure to use control devices to adjust the indoor temperature and flow in the building heating systems in accordance with the a......A common problem with Chinese district heating systems is that they supply more heat than the actual heat demand. The reason for this excess heat supply is the general failure to use control devices to adjust the indoor temperature and flow in the building heating systems in accordance...... 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...... 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...

  4. The Impact of Achieve3000 on Elementary Literacy Outcomes: Randomized Control Trial Evidence, 2013-14 to 2014-15. Eye on Evaluation. DRA Report No. 16.02

    Science.gov (United States)

    Hill, Darryl V.; Lenard, Matthew A.

    2016-01-01

    In 2013-14, the Wake County Public School System (WCPSS) launched Achieve3000 as a randomized controlled trial in 16 elementary schools. Achieve3000 is an early literacy program that differentiates non-fiction reading passages based on individual students' Lexile scores. Twoyear results show that Achieve3000 did not have a significant impact on…

  5. Educational intervention together with an on-line quality control program achieve recommended analytical goals for bedside blood glucose monitoring in a 1200-bed university hospital.

    Science.gov (United States)

    Sánchez-Margalet, Víctor; Rodriguez-Oliva, Manuel; Sánchez-Pozo, Cristina; Fernández-Gallardo, María Francisca; Goberna, Raimundo

    2005-01-01

    Portable meters for blood glucose concentrations are used at the patients bedside, as well as by patients for self-monitoring of blood glucose. Even though most devices have important technological advances that decrease operator error, the analytical goals proposed for the performance of glucose meters have been recently changed by the American Diabetes Association (ADA) to reach nurses in a 1200-bed University Hospital to achieve recommended analytical goals, so that we could improve the quality of diabetes care. We used portable glucose meters connected on-line to the laboratory after an educational program for nurses with responsibilities in point-of-care testing. We evaluated the system by assessing total error of the glucometers using high- and low-level glucose control solutions. In a period of 6 months, we collected data from 5642 control samples obtained by 14 devices (Precision PCx) directly from the control program (QC manager). The average total error for the low-level glucose control (2.77 mmol/l) was 6.3% (range 5.5-7.6%), and even lower for the high-level glucose control (16.66 mmol/l), at 4.8% (range 4.1-6.5%). In conclusion, the performance of glucose meters used in our University Hospital with more than 1000 beds not only improved after the intervention, but the meters achieved the analytical goals of the suggested ADA/National Academy of Clinical Biochemistry criteria for total error (<7.9% in the range 2.77-16.66 mmol/l glucose) and optimal total error for high glucose concentrations of <5%, which will improve the quality of care of our patients.

  6. 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

  7. Improvement in C-reactive protein and advanced glycosylation end-products in poorly controlled diabetics is independent of glucose control.

    Science.gov (United States)

    Md Isa, S H; Najihah, I; Nazaimoon, W M Wan; Kamarudin, N A; Umar, N A; Mat, N H; Khalid, B A K

    2006-04-01

    We studied the efficacy of four different treatment regimens (sulphonylurea and metformin+/-acarbose versus glimepiride and rosiglitazone versus glimepiride and bedtime NPH insulin versus multiple actrapid and NPH insulin injections) in poorly controlled type 2 diabetes subjects on hs-CRP, VCAM-1 and AGE at 4, 8 and 12 weeks of treatment. Multiple insulin injections rapidly improved HbA(1c) by 0.6+/-0.9% (pimprovement in blood glucose. AGE improved in all groups irrespective of type of treatment, glycaemic control and CRP levels. Our data indicate rapid glycaemic control alone does not necessarily result in improvement in markers of inflammation in type 2 diabetes patients.

  8. Ethiopia and its steps to mobilize resources to achieve 2020 elimination and control goals for neglected tropical diseases webs joined can tie a lion.

    Science.gov (United States)

    Mengitsu, Belete; Shafi, Oumer; Kebede, Biruck; Kebede, Fikreab; Worku, Dagemlidet T; Herero, Merce; French, Michael; Kebede, Biruk; Mackenzie, Charles; Martindale, Sarah; Kebede, Zeyede; Hirpa, Tigist; Frawley, Hannah; Crowley, Kathryn; O'Neil, Maggie; McPherson, Scott

    2016-03-01

    In June 2013, at the launch of its National Neglected Tropical Disease (NTD) Master Plan, the Ethiopian government pledged to achieve WHO NTD elimination and control targets by 2020. With an estimated 80 million people living in areas where one or more NTDs are endemic, this goal presented an enormous challenge for the Federal Ministry of Health. However, as of September 2015, the Federal Ministry of Health has managed to mobilize support to implement mass drug administration in 84% of the trachoma endemic districts and 100% of the endemic districts for onchocerciasis, lymphatic filariasis, soil-transmitted helminthes and schistosomiasis. The national program still is facing large gaps in its podoconiosis and leishmaniasis programs, and it faces significant other challenges to stay on track for 2020 targets. However, this unprecedented scale-up in support was achieved through significant government investment in NTD interventions and creative coordination between donors and implementing partners, which may provide valuable lessons for other national NTD programs trying to achieve nationwide coverage. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Estimating achievable signal-to-noise ratios of MRI transmit-receive coils from radiofrequency power measurements: applications in quality control

    International Nuclear Information System (INIS)

    Redpath, T.W.

    2000-01-01

    The inverse relationship between the radiofrequency (RF) power needed to transmit a 90 deg. RF pulse, and the signal-to-noise ratio (SNR) available from a transmit-receive RF coil is well known. The theory is restated and a formula given for the signal-to-noise ratio from water, achievable from a single-shot MRI experiment, in terms of the net forward RF power needed for a rectangular 90 deg. RF pulse of known shape and duration. The result is normalized to a signal bandwidth of 1 Hz and a sample mass of 1 g. The RF power information needed is available on most commercial scanners, as it is used to calculate specific absorption rates for RF tissue heating. The achievable SNR figure will normally be larger that that actually observed, mainly because of receiver noise, but also because of inaccuracies in setting RF pulse angles, and relaxation effects. Phantom experiments were performed on the transmit-receive RF head coil of a commercial MRI system at 0.95 T using a projection method. The measured SNR agreed with that expected from the formula for achievable SNR once a correction was made for the noise figure of the receiving chain. Comparisons of measured SNR figures with those calculated from RF power measurements are expected to be of value in acceptance testing and quality control. (author)

  10. 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 [pmusic lessons as public policy.

  11. 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.

  12. Probability of Achieving Glycemic Control with Basal Insulin in Patients with Type 2 Diabetes in Real-World Practice in the USA.

    Science.gov (United States)

    Blonde, Lawrence; Meneghini, Luigi; Peng, Xuejun Victor; Boss, Anders; Rhee, Kyu; Shaunik, Alka; Kumar, Supriya; Balodi, Sidhartha; Brulle-Wohlhueter, Claire; McCrimmon, Rory J

    2018-06-01

    Basal insulin (BI) plays an important role in treating type 2 diabetes (T2D), especially when oral antidiabetic (OAD) medications are insufficient for glycemic control. We conducted a retrospective, observational study using electronic medical records (EMR) data from the IBM ® Explorys database to evaluate the probability of achieving glycemic control over 24 months after BI initiation in patients with T2D in the USA. A cohort of 6597 patients with T2D who started BI following OAD(s) and had at least one valid glycated hemoglobin (HbA1c) result recorded both within 90 days before and 720 days after BI initiation were selected. We estimated the changes from baseline in HbA1c every 6 months, the quarterly conditional probabilities of reaching HbA1c < 7% if a patient had not achieved glycemic control prior to each quarter (Q), and the cumulative probability of reaching glycemic control over 24 months. Our cohort was representative of patients with T2D who initiated BI from OADs in the USA. The average HbA1c was 9.1% at BI initiation, and decreased robustly (1.5%) in the first 6 months after initiation with no further reductions thereafter. The conditional probability of reaching glycemic control decreased rapidly in the first year (26.6% in Q2; 17.6% in Q3; 8.6% in Q4), and then remained low (≤ 6.1%) for each quarter in the second year. Cumulatively, about 38% of patients reached HbA1c < 7% in the first year; only approximately 8% more did so in the second year. Our study of real-world data from a large US EMR database suggested that among patients with T2D who initiated BI after OADs, the likelihood of reaching glycemic control diminished over time, and remained low from 12 months onwards. Additional treatment options should be considered if patients do not reach glycemic control within 12 months of BI initiation. Sanofi Corporation.

  13. 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 (AUC 120 , glucose: 997 ± 41.6 vs. 1015 ± 41.63 mmol/l per minute, insulin: 49 ± 6.3 vs. 42 ± 6.3 nmol/l per minute; AUC 300 , 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.

  14. An opioid-based pain control program for head and neck cancer patients undergoing chemoradiation therapy achieves a high completion rate of radiation

    International Nuclear Information System (INIS)

    Kato, Kengo; Matsuura, Kazuto; Zenda, Sadamoto

    2011-01-01

    Appropriate supportive care is essential for intensive chemoradiation therapy (CRT), and pain management is an important supportive care for CRT for head and neck cancer. We developed an opioid-based pain control program for head and neck cancer patients undergoing CRT, and assessed its efficacy and safety. 110 head and neck cancer patients undergoing platinum-based concomitant CRT were enrolled from 10 cancer centers or university hospitals. Their pain caused by CRT was managed with a four-step opioid-based pain control program, and adverse events and usage of opioid were analyzed. 101 suitable cases of 110 patients were analyzed. 53% of cases suffered grade 3-4 mucositis. The rate of completion of radiotherapy was 99% and the rate of unplanned breaks in radiotherapy was 13%. The usage rate of opioid was 83% and the rate of compliance with the pain control program was 92%. The median maximum quantity of morphine used per day was 35 mg. No patient had to stop the opioid program or radiotherapy due to adverse effects of opioids. An opioid-based pain control program for head and neck cancer patients undergoing CRT achieves a high completion rate of radiation. (author)

  15. 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

    International Nuclear Information System (INIS)

    Zhang, Lipeng; Gudmundsson, Oddgeir; Thorsen, Jan Eric; Li, Hongwei; Li, Xiaopeng; Svendsen, Svend

    2016-01-01

    A common problem with Chinese district heating systems is that they supply more heat than the actual heat demand. The reason for this excess heat supply is the general failure to use control devices to adjust the indoor temperature and flow in the building heating systems in accordance 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, and stabilize indoor temperatures. The feasibility and the energy consumption reduction of this approach were verified by means of simulation and a field test. By moving the system from centrally planned heat delivery to demand-driven heat delivery, excess heat loss can be significantly reduced. Results show 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 CO_2, 0.1 kg SO_2, and 0.03 kg NO_x per heating square meter for a typical case in Harbin. - Highlights: • Two real cases reflect the temperature and flow control situation of heating systems in China. • Pre-set radiator valves with automatic balancing valves create dynamic hydraulic balance. • IDA-ICE simulation shows 17% heat saving and 48% pump electricity saving. • This approach can improve the comfort level of multi-storey/high-rise residential buildings. • This approach can reduce excess heat supply and bring out positive environmental impacts.

  16. Repeated testing improves achievement in a blended learning approach for risk competence training of medical students: results of a randomized controlled trial.

    Science.gov (United States)

    Spreckelsen, C; Juenger, J

    2017-09-26

    Adequate estimation and communication of risks is a critical competence of physicians. Due to an evident lack of these competences, effective training addressing risk competence during medical education is needed. Test-enhanced learning has been shown to produce marked effects on achievements. This study aimed to investigate the effect of repeated tests implemented on top of a blended learning program for risk competence. We introduced a blended-learning curriculum for risk estimation and risk communication based on a set of operationalized learning objectives, which was integrated into a mandatory course "Evidence-based Medicine" for third-year students. A randomized controlled trial addressed the effect of repeated testing on achievement as measured by the students' pre- and post-training score (nine multiple-choice items). Basic numeracy and statistical literacy were assessed at baseline. Analysis relied on descriptive statistics (histograms, box plots, scatter plots, and summary of descriptive measures), bootstrapped confidence intervals, analysis of covariance (ANCOVA), and effect sizes (Cohen's d, r) based on adjusted means and standard deviations. All of the 114 students enrolled in the course consented to take part in the study and were assigned to either the intervention or control group (both: n = 57) by balanced randomization. Five participants dropped out due to non-compliance (control: 4, intervention: 1). Both groups profited considerably from the program in general (Cohen's d for overall pre vs. post scores: 2.61). Repeated testing yielded an additional positive effect: while the covariate (baseline score) exhibits no relation to the post-intervention score, F(1, 106) = 2.88, p > .05, there was a significant effect of the intervention (repeated tests scenario) on learning achievement, F(1106) = 12.72, p blended learning approach can be improved significantly by implementing a test-enhanced learning design, namely repeated testing. As

  17. Cross-sectional study of area-level disadvantage and glycaemic-related risk in community health service users in the Southern.IML Research (SIMLR) cohort.

    Science.gov (United States)

    Cross, Roger; Bonney, Andrew; Mayne, Darren J; Weston, Kathryn M

    2017-09-19

    Objectives The aim of the present study was to determine the association between area-level socioeconomic disadvantage and glycaemic-related risk in health service users in the Illawarra-Shoalhaven region of New South Wales, Australia. Methods HbA1c values recorded between 2010 and 2012 for non-pregnant individuals aged ≥18 years were extracted from the Southern.IML Research (SIMLR) database. Individuals were assigned quintiles of the Socioeconomic Indices for Australia (SEIFA) Index of Relative Socioeconomic Disadvantage (IRSD) according to their Statistical Area 1 of residence. Glycaemic risk categories were defined as HbA1c 5.0-5.99% (lowest risk), 6.0-7.49% (intermediate risk) and ≥7.5% (highest risk). Logistic regression models were fit with glycaemic risk category as the outcome variable and IRSD as the study variable, adjusting for age and sex. Results Data from 29064 individuals were analysed. Higher disadvantage was associated with belonging to a higher glycaemic risk category in the fully adjusted model (most disadvantaged vs least disadvantaged quintile; odds ratio 1.74, 95% confidence interval 1.58, 1.93; Pdisadvantage was a significant correlate of increased glycaemic-related risk. Geocoded clinical data can inform more targeted use of health service resources, with the potential for improved health care equity and cost-effectiveness. What is known about the topic? The rapid increase in the prevalence of Type 2 diabetes (T2D), both globally and nationally within Australia, is a major concern for the community and public health agencies. Individual socioeconomic disadvantage is a known risk factor for abnormal glucose metabolism (AGM), including T2D. Although small-area-level socioeconomic disadvantage is a known correlate of AGM in Australia, less is known of the association of area-level disadvantage and glycaemic-related risk in individuals with AGM. What does this paper add? This study demonstrates a robust association between small

  18. Do non-glycaemic markers add value to plasma glucose and hemoglobin a1c in predicting diabetes? Yuport health checkup center study.

    Directory of Open Access Journals (Sweden)

    Saori Kashima

    Full Text Available Many markers have been indicated as predictors of type 2 diabetes. However, the question of whether or not non-glycaemic (blood biomarkers and non-blood biomarkers have a predictive additive utility when combined with glycaemic (blood biomarkers is unknown. The study aim is to assess this additive utility in a large Japanese population.We used data from a retrospective cohort study conducted from 1998 to 2002 for the baseline and 2002 to 2006 for follow-up, inclusive of 5,142 men (mean age of 51.9 years and 4,847 women (54.1 years at baseline. The cumulative incidence of diabetes [defined either as a fasting plasma glucose (FPG ≥7.00 mmol/l or as clinically diagnosed diabetes] was measured. In addition to glycaemic biomarkers [FPG and hemoglobin A1c (HbA1c], we examined the clinical usefulness of adding non-glycaemic biomarkers and non-blood biomarkers, using sensitivity and specificity, and the area under the curve (AUC of the receiver operating characteristics.The AUCs to predict diabetes were 0.874 and 0.924 for FPG, 0.793 and 0.822 for HbA1c, in men and women, respectively. Glycaemic biomarkers were the best and second-best for diabetes prediction among the markers. All non-glycaemic markers (except uric acid in men and creatinine in both sexes predicted diabetes. Among these biomarkers, the highest AUC in the single-marker analysis was 0.656 for alanine aminotransferase (ALT in men and 0.740 for body mass index in women. The AUC of the combined markers of FPG and HbA1c was 0.895 in men and 0.938 in women, which were marginally increased to 0.904 and 0.940 when adding ALT, respectively.AUC increments were marginal when adding non-glycaemic biomarkers and non-blood biomarkers to the classic model based on FPG and HbA1c. For the prediction of diabetes, FPG and HbA1c are sufficient and the other markers may not be needed in clinical practice.

  19. [Study on interventions based on urban - rural integration system construction to consolidate achievements of schistosomiasis control in hilly schistosomiasis endemic areas].

    Science.gov (United States)

    Rong-Zhi, Li; Yang, Liu; Hui, Zhang; Yi, Zhang; Bo, Zhong; Jian-Jun, Wu; Chun-Xia, Yang

    2017-09-28

    To explore the effectiveness of comprehensive schistosomiasis control interventions based on urban-rural integration system construction to carry out the schistosomiasis control in hilly schistosomiasis endemic areas, so as to offer a new mode to consolidate the achievements of schistosomiasis control in the new situation. Shouan Town and Changqiu Township in Pujiang County in hilly schistosomiasis endemic regions were selected as demonstration areas. The comprehensive schistosomiasis control interventions based on urban-rural integration system construction were implemented, including the land consolidation, centralized residence and so on. The effectiveness the interventions was evaluated. In Shouan Town and Changqiu Township, the transformed environments with Oncomelania hupensis snail habitats were 1 330.61 hm 2 and 1 456.84 hm 2 , the areas with snails decreased from 94.31 hm 2 and 83.00 hm 2 in 2000 to both 0 in 2015, the positive rates of serological tests for schistosomiasis decreased from 11.8% and 7.53% in 2000 to 1.01% and 1.86% in 2015, and the positive rates of parasitological tests decreased from 0.18% and 0.15% in 2000 to both 0 in 2015 respectively. The numbers of cattle decreased from 358 and 368 in 2000 to 4 and 6 in 2015 respectively. In 2000, the schistosome infection rates of cattle were 3.63% and 6.51% in Shouan Town and Changqiu Township respectively, and from 2004, no infected cattle were found. The comprehensive schistosomiasis control interventions based on urban-rural integration system construction can decrease the schistosome infection rate and area with snails effectively, providing a new mode for schistosomiasis elimination.

  20. Undisturbed stance control in healthy adults is achieved differently along anteroposterior and mediolateral axes: evidence from visual feedback of various signals from center of pressure trajectories.

    Science.gov (United States)

    Rougier, Patrice R

    2009-05-01

    Provided through the screen of a monitor, the participant's resultant center of pressure (CPRes) movements from a force platform device, modified the postural performance of a healthy individual. However, these effects could largely vary with the axis that researchers consider (mediolateral [ML] or anteroposterior [AP]), because they know these controls are involved in 2 distinct ankle and hip mechanisms. To demonstrate this organization, the author tested a group of healthy adults in several conditions that gave the whole or some part of the information in the CPRes displacements. Compared with the CPRes feedback, left and right plantar CP or body weight distribution feedback deteriorated the control of the vertically projected center of gravity (CGv) along the ML and AP axes, whose amplitudes increased, respectively. These data highlight the primary role of loading or unloading and pressure variations in the achievement of postural control along each ML or AP axis, respectively. It is interesting that merging these 2 pieces of information (CPRes displacements) helped participants optimize their postural performance.

  1. Treatment choices for the glycaemic management of patients with type 2 diabetes and chronic kidney disease: Analysis of the SAIL patient linked dataset.

    Science.gov (United States)

    Min, Thinzar; Davies, Gareth I; Rice, Sam; Chess, James; Stephens, Jeffrey W

    Chronic kidney disease (CKD) is common in type 2 diabetes and limits the treatment choices for glycaemic control. Our aim was to examine real-world prescribing for managing hyperglycaemia in the presence of CKD. The SAIL (Secure Anonymised Information Linkage) databank was used to examine prescribing during the period from the 1st of January to 30th December 2014. CKD was defined as:- none or mild CKD, eGFR ≥60mL/min/1.73m 2 ; moderate CKD eGFR <60mL/min/1.73m 2 ; and severe CKD eGFR <30mL/min/1.73m 2 or requiring dialysis. We identified 9585 subjects who received any form of glucose lowering therapy (8363 had no/mild CKD; 1137 moderate CKD; 85 severe CKD). There was a linear association between insulin use and CKD severity with approximately 54% of those with severe CKD receiving insulin. Sulphonylureas use did not differ among the CKD groups and was approximately 40%. Metformin showed a linear decrease across the groups, however approximately 21% in the severe CKD group received metformin. The use of dipeptidyl peptidase 4 inhibitors (DPP-4i) was approximately 20% and did not differ among groups. The DPP-4 inhibitor choice was:- 1% vildagliptin, 9% saxagliptin, 58% sitagliptin, and 32% linaglitpin. With respect to sitagliptin and saxagliptin, 72% and 62% received an inappropriately high dose in the setting of CKD. We observed that a considerable proportion of patients with type 2 diabetes and CKD were receiving metformin and non dose-adjusted DPP-4 inhibitors. Careful consideration of medication use and dosaging is required in the setting of CKD and type 2 diabetes. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  2. Effectiveness of music education for the improvement of reading skills and academic achievement in young poor readers: a pragmatic cluster-randomized, controlled clinical trial.

    Directory of Open Access Journals (Sweden)

    Hugo Cogo-Moreira

    Full Text Available 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 [p<0.001] and slope of math = 0.25 [p<0.001]. As for CACE estimation (i.e., complier children versus non-complier children, more promising effects were observed in terms of the rate of correct words read 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

  3. Lowering dietary glycaemic index through nutrition education among Malaysian women with a history of gestational diabetes mellitus.

    Science.gov (United States)

    Sangeetha-Shyam; Fatimah, A; Rohana, A G; Norasyikin, A W; Karuthan, C; Nik, Shanita S; Mohd, Yusof B N; Nor, Azmi K

    2013-04-01

    Gestational diabetes mellitus (GDM) increases risks for type 2 diabetes and cardiovascular diseases. Low glycaemic index (GI) diets improve cardio-metabolic outcomes in insulin-resistant individuals. We examined the feasibility of lowering GI through GI-based-education among Asian post-GDM women. A 3-month investigation was carried out on 60 Malaysian women with a mean age of 31.0 +/- 4.5 years and a history of GDM. Subjects were randomised into two groups: LGIE and CHDR. The CHDR group received conventional healthy dietary recommendations only. The LGIE group received GI based-education in addition to conventional healthy dietary recommendations. At baseline and after 3-months, dietary intake of energy and macronutrient intakes including GI diet and glycaemic load was assessed using 3-day food records. Diabetes-Diet and GI-concept scores and physical activity levels were assessed using a questionnaire. Adherence to dietary instructions was measured at the end of 3 months. At the end of 3 months, the LGIE group had significant reductions in energy intake (241.7 +/- 522.4Kcal, P = 0.037, ES=0.463), total carbohydrate (48.7 +/- 83.5g, P = 0.010, ES = 0.583), GI (3.9 +/- 7.1, P = 0.017, ES = 0.549) and GL (39.0 +/- 55.3, P = 0.003, ES = 0.705) and significant increases in protein (3.7 +/- 5.4g, 0.003, ES = 0.685) and diet fibre (4.6 +/- 7.3g, P = 0.06). The CHDR group had a significant reduction in fat only (5.7 +/- 9.4g, P = 0.006, ES = 0.606). There was a 30% increase in GI-concept scores in the LGIE group (p < 0.001). Changes in GI-concept scores correlated significantly to the reduction in dietary GI (r = -0.642, P = 0.045). Dietary adherence was comparable in both groups. GI-education improves GI-concept knowledge and helps lower dietary glycaemic index among women with a history of GDM.

  4. Control of Risk Factors For Nephropathy Among Nigerian Outpatients

    African Journals Online (AJOL)

    Zamzar

    54.7%) had diabetes between 1 and 5 years, and 95% were on antidiabetic drugs, most commonly both a ... (3.1%) had the combination of good glycaemic control, good blood pressure ... and the average of the three readings was used as an.

  5. Controlling for Prior Attainment Reduces the Positive Influence that Single-Gender Classroom Initiatives Exert on High School Students' Scholastic Achievements.

    Science.gov (United States)

    Pennington, Charlotte R; Kaye, Linda K; Qureshi, Adam W; Heim, Derek

    2018-01-01

    Research points to the positive impact that gender-segregated schooling and classroom initiatives exert on academic attainment. An evaluation of these studies which reveal positive effects highlights, however, that students are typically selectively assigned to single- or mixed-gender instructional settings, presenting a methodological confound. The current study controls for students' prior attainment to appraise the efficacy of a single-gender classroom initiative implemented in a co-educational high school in the United Kingdom. Secondary data analysis (using archived data) was performed on 266 middle-ability, 11-12 year-old students' standardized test scores in Languages (English, foreign language), STEM-related (Mathematics, Science, Information and Communication Technology), and Non-STEM subjects (art, music, drama). Ninety-eight students (54, 55% female) were taught in single-gender and 168 (69, 41% female) in mixed-gender classrooms. Students undertook identical tests irrespective of classroom type, which were graded in accordance with U.K national curriculum guidelines. Controlling for students' prior attainment, findings indicate that students do not appear to benefit from being taught in single-gender relative to mixed-gender classrooms in Language and STEM-related subjects. Young women benefitted from being taught in mixed-gender relative to single-gender classes for Non-STEM subjects. However, when prior ability is not controlled for, the intervention appears to be effective for all school subjects, highlighting the confounding influence of selective admissions. These findings suggest that gender-segregated classroom initiatives may not bolster students' grades. It is argued that studies that do not control for selection effects may tell us little about the effectiveness of such interventions on scholastic achievement.

  6. Discovery and Fine-Mapping of Glycaemic and Obesity-Related Trait Loci Using High-Density Imputation.

    Directory of Open Access Journals (Sweden)

    Momoko Horikoshi

    2015-07-01

    Full Text Available Reference panels from the 1000 Genomes (1000G Project Consortium provide near complete coverage of common and low-frequency genetic variation with minor allele frequency ≥0.5% across European ancestry populations. Within the European Network for Genetic and Genomic Epidemiology (ENGAGE Consortium, we have undertaken the first large-scale meta-analysis of genome-wide association studies (GWAS, supplemented by 1000G imputation, for four quantitative glycaemic and obesity-related traits, in up to 87,048 individuals of European ancestry. We identified two loci for body mass index (BMI at genome-wide significance, and two for fasting glucose (FG, none of which has been previously reported in larger meta-analysis efforts to combine GWAS of European ancestry. Through conditional analysis, we also detected multiple distinct signals of association mapping to established loci for waist-hip ratio adjusted for BMI (RSPO3 and FG (GCK and G6PC2. The index variant for one association signal at the G6PC2 locus is a low-frequency coding allele, H177Y, which has recently been demonstrated to have a functional role in glucose regulation. Fine-mapping analyses revealed that the non-coding variants most likely to drive association signals at established and novel loci were enriched for overlap with enhancer elements, which for FG mapped to promoter and transcription factor binding sites in pancreatic islets, in particular. Our study demonstrates that 1000G imputation and genetic fine-mapping of common and low-frequency variant association signals at GWAS loci, integrated with genomic annotation in relevant tissues, can provide insight into the functional and regulatory mechanisms through which their effects on glycaemic and obesity-related traits are mediated.

  7. Discovery and Fine-Mapping of Glycaemic and Obesity-Related Trait Loci Using High-Density Imputation.

    Science.gov (United States)

    Horikoshi, Momoko; Mӓgi, Reedik; van de Bunt, Martijn; Surakka, Ida; Sarin, Antti-Pekka; Mahajan, Anubha; Marullo, Letizia; Thorleifsson, Gudmar; Hӓgg, Sara; Hottenga, Jouke-Jan; Ladenvall, Claes; Ried, Janina S; Winkler, Thomas W; Willems, Sara M; Pervjakova, Natalia; Esko, Tõnu; Beekman, Marian; Nelson, Christopher P; Willenborg, Christina; Wiltshire, Steven; Ferreira, Teresa; Fernandez, Juan; Gaulton, Kyle J; Steinthorsdottir, Valgerdur; Hamsten, Anders; Magnusson, Patrik K E; Willemsen, Gonneke; Milaneschi, Yuri; Robertson, Neil R; Groves, Christopher J; Bennett, Amanda J; Lehtimӓki, Terho; Viikari, Jorma S; Rung, Johan; Lyssenko, Valeriya; Perola, Markus; Heid, Iris M; Herder, Christian; Grallert, Harald; Müller-Nurasyid, Martina; Roden, Michael; Hypponen, Elina; Isaacs, Aaron; van Leeuwen, Elisabeth M; Karssen, Lennart C; Mihailov, Evelin; Houwing-Duistermaat, Jeanine J; de Craen, Anton J M; Deelen, Joris; Havulinna, Aki S; Blades, Matthew; Hengstenberg, Christian; Erdmann, Jeanette; Schunkert, Heribert; Kaprio, Jaakko; Tobin, Martin D; Samani, Nilesh J; Lind, Lars; Salomaa, Veikko; Lindgren, Cecilia M; Slagboom, P Eline; Metspalu, Andres; van Duijn, Cornelia M; Eriksson, Johan G; Peters, Annette; Gieger, Christian; Jula, Antti; Groop, Leif; Raitakari, Olli T; Power, Chris; Penninx, Brenda W J H; de Geus, Eco; Smit, Johannes H; Boomsma, Dorret I; Pedersen, Nancy L; Ingelsson, Erik; Thorsteinsdottir, Unnur; Stefansson, Kari; Ripatti, Samuli; Prokopenko, Inga; McCarthy, Mark I; Morris, Andrew P

    2015-07-01

    Reference panels from the 1000 Genomes (1000G) Project Consortium provide near complete coverage of common and low-frequency genetic variation with minor allele frequency ≥0.5% across European ancestry populations. Within the European Network for Genetic and Genomic Epidemiology (ENGAGE) Consortium, we have undertaken the first large-scale meta-analysis of genome-wide association studies (GWAS), supplemented by 1000G imputation, for four quantitative glycaemic and obesity-related traits, in up to 87,048 individuals of European ancestry. We identified two loci for body mass index (BMI) at genome-wide significance, and two for fasting glucose (FG), none of which has been previously reported in larger meta-analysis efforts to combine GWAS of European ancestry. Through conditional analysis, we also detected multiple distinct signals of association mapping to established loci for waist-hip ratio adjusted for BMI (RSPO3) and FG (GCK and G6PC2). The index variant for one association signal at the G6PC2 locus is a low-frequency coding allele, H177Y, which has recently been demonstrated to have a functional role in glucose regulation. Fine-mapping analyses revealed that the non-coding variants most likely to drive association signals at established and novel loci were enriched for overlap with enhancer elements, which for FG mapped to promoter and transcription factor binding sites in pancreatic islets, in particular. Our study demonstrates that 1000G imputation and genetic fine-mapping of common and low-frequency variant association signals at GWAS loci, integrated with genomic annotation in relevant tissues, can provide insight into the functional and regulatory mechanisms through which their effects on glycaemic and obesity-related traits are mediated.

  8. Report on achievements in fiscal 1999. Research and development of nanometer controlled optical disk system; 1999 nendo nanometer seigyo hikari disk system no kenkyu kaihatsu seika hokokusho

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-03-01

    Organizational strengthening is urged in industrial technological power in information recording area which is comparable with information communications being the main pillar of the innovation in the information technology in Japan. Extremely large expectations and heavy responsibilities are placed on the next generation optical memory technology, which is one of the strong points of Japan who plays a part in the above information recording area. The present project has been performing organizational research and development to achieve creation of new industries, with the following research themes as the main subjects: (1) nanometer controlled optical memory technology, (2) magnetic section responsive and three-dimensional optical memory, (3) ultra precision pit depicting technology, and (4) ultra precision pit measuring technology. The project is two years old this year, in which it was aimed to 'develop an optical memory technology with recording density of 100 Gb/in{sup 2} or more, transfer velocity of 100 Mbps or higher, and access time of 10 ms or less'. In order to achieve and establish the interim target set for fiscal 2000 among the above aims, intending 'trial fabrication of a disk having recording density of 40 to 50 Gb/in{sup 2}, the technical problem extraction and the specifications to realize a 100 Gb/in{sup 2} system', fiscal 1999 has performed researches on 'density and accuracy improvement on the prototype disk by improving the existing devices and introducing new devices'. This paper reports the developmental research theme No. 1. (NEDO)

  9. Estimation of Most Favorable Optical Window Position Subject to Achieve Finest Optical Control of Lateral DDR IMPATT Diode Designed to Operate at W-Band

    Directory of Open Access Journals (Sweden)

    A. Acharyya

    2014-06-01

    Full Text Available The optimum position of the optical window (OW of illuminated lateral double-drift region (DDR impact avalanche transit time (IMPATT device has been determined subject to achieve the finest optical control of both DC and RF properties of the device. The OW is a tiny hole that has to be created on the oxide layer through which the light energy of appropriate wavelength can be coupled to the space charge region of the device. A non-sinusoidal voltage is assumed to be applied across the diode and the corresponding terminal current response is obtained from a two-dimensional (2-D large-signal (L-S simulation technique developed by the authors for illuminated lateral DDR IMPATT diode. Both the DC and L-S properties of the illuminated device based on Si, designed to operate at W-band frequencies (75 – 110 GHz are obtained from the said L-S simulation. Simulation is carried out for different incident optical power levels of different wavelengths (600 – 1000 nm by varying the position of the fixed sized OW on the oxide layer along the direction of electrical conduction of the device. Results show that, the most favorable optical tuning can be achieved when the OW is entirely created over the p-type depletion layer, i.e. when the photocurrent is purely electron dominated. Also the 700 nm wavelength is found to be most suitable wavelength for obtaining the maximum optical modulation of both DC and RF properties of the device.

  10. Working Together to Promote Diabetes Control: A Practical Guide for Diabetes Health Care Providers in Establishing a Working Alliance to Achieve Self-Management Support.

    Science.gov (United States)

    Jones, Allan; Vallis, Michael; Cooke, Debbie; Pouwer, François

    2016-01-01

    The quality of the "patient-carer" relationship is the foundation of self-management support and has been shown to influence treatment outcome in relation to psychological and somatic illness, including diabetes. It has long been accepted within applied psychology that the quality of the client-therapist relationship--termed the working alliance--is of central importance to treatment outcome and may account for a significant degree of the overall treatment effect. Diabetes healthcare providers have recently expressed a need for further training in communication techniques and in the psychological aspects of diabetes. Could we take a page from the psychological treatment manual on working alliance in therapy to guide the diabetes healthcare provider in their role of supporting the person with diabetes achieve and maintain better metabolic control? This paper examines the role of the working alliance in diabetes care and offers a practical guide to the diabetes healthcare provider in establishing a working alliance with the person with diabetes in managing diabetes.

  11. Liraglutide as adjunct to insulin treatment in type 1 diabetes does not interfere with glycaemic recovery or gastric emptying rate during hypoglycaemia

    DEFF Research Database (Denmark)

    Frandsen, Christian S.; Dejgaard, Thomas F.; Andersen, Henrik U.

    2017-01-01

    significantly between groups (P =.96), with no significant changes from baseline, whether evaluated from AUCs or time to peak. The secondary endpoints, glycaemic recovery, counter-regulatory hormone responses, systolic blood pressure and GLP-1 and PP responses, were also similar. Heart rate increased...... 1.2 mg once daily or placebo as add-on to insulin treatment. Before and at end of treatment a hypoglycaemic clamp (plasma glucose target 2.5 mmol/L) was carried out, followed by a liquid meal. Primary endpoint was change in GE rate (evaluated by area under the paracetamol curve and time to peak......). Secondary endpoints included changes in glycaemic recovery, counter-regulatory hormones, pancreatic polypeptide (PP), GLP-1, blood pressure and heart rate. Results: During the period June 2013 to October 2014, 20 patients were enrolled. After 12 weeks of treatment, changes in GE rates did not differ...

  12. Liraglutide as adjunct to insulin treatment in type 1 diabetes does not interfere with glycaemic recovery or gastric emptying rate during hypoglycaemia

    DEFF Research Database (Denmark)

    Frandsen, Christian Seerup; Dejgaard, Thomas Fremming; Andersen, Henrik Ullits

    2017-01-01

    groups (p = 0.96), with no significant changes from baseline whether evaluated from AUCs or time to peak. The secondary endpoints: glycaemic recovery, counterregulatory hormone responses, systolic blood pressure and GLP-1 and PP responses were also similar. Heart rate increased with liraglutide from 69.......2 mg once daily or placebo as add-on to insulin treatment. Before and at end of treatment a hypoglycaemic clamp (plasma glucose target 2.5 mmol/l) was carried out followed by a liquid meal. Primary endpoint was change in GE rate (evaluated by area under the paracetamol curve and time to peak......). Secondary endpoints included changes in glycaemic recovery, counterregulatory hormones, pancreatic polypeptide (PP), GLP-1, blood pressure, and heart rate. RESULTS: During June 2013-October 2014, 20 patients were enrolled. After 12 weeks' treatment, changes in GE rates did not differ significantly between...

  13. Postprandial glycaemic and insulinaemic responses in adults after consumption of dairy desserts and pound cakes containing short-chain fructo-oligosaccharides used to replace sugars.

    Science.gov (United States)

    Lecerf, J M; Clerc, E; Jaruga, A; Wagner, A; Respondek, F

    2015-01-01

    The present studies aimed to evaluate the glycaemic and insulinaemic responses, in healthy adults, to short-chain fructo-oligosaccharides (scFOS) from sucrose used to replace sugars in foods. Two study populations aged 18-50 years were recruited and they consumed dairy desserts or pound cakes containing either standard sugar content or scFOS to replace 30 % of the sugar content. For each study, the two products were tested once under a double-blind and cross-over design with at least 7 d between the two tests. Glucose and insulin were measured using standard methods in blood samples collected with a venous catheter for 120 min during a kinetic test. For the dairy desserts, replacing 30 % of the sugars with scFOS significantly reduced postprandial glycaemic (AUC0-120 min; P = 0·020) and insulinaemic (AUC0-120 min; P = 0·003) responses. For the pound cakes, the glycaemic response was not altered (AUC0-120 min; P =  0·322) while the insulinaemic response tended to be lower (AUC0-120 min; P = 0·067). This study showed that scFOS can be used to replace sugars with the benefit of lowering the postprandial glycaemic response without increasing the insulinaemic response. The effect might be modulated by other parameters (e.g. fat content) of the food matrices.

  14. Impact of metformin versus repaglinide on non-glycaemic cardiovascular risk markers related to inflammation and endothelial dysfunction in non-obese patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Lund, Søren S; Tarnow, Lise; Stehouwer, Coen D A

    2008-01-01

    -month washout between interventions. RESULTS: Levels of tumour necrosis factor-alpha, plasminogen activator inhibitor-1 antigen, tissue-type plasminogen activator antigen, von Willebrand factor, soluble intercellular adhesion molecule-1 and soluble E-selectin were significantly lower during metformin...... versus repaglinide treatments. In contrast, Amadori albumin and heart rate were higher during metformin versus repaglinide. Levels of interleukin-6, fibrinogen, soluble vascular cell adhesion molecule-1, asymmetric dimethylarginine and advanced glycation end products as well as glycaemic levels...

  15. Effectiveness of a self-management intervention with personalised genetic and lifestyle-related risk information on coronary heart disease and diabetes-related risk in type 2 diabetes (CoRDia): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Davies, Anna K; McGale, Nadine; Humphries, Steve E; Hirani, Shashivadan P; Beaney, Katherine E; Bappa, Dauda A S; McCabe, John G; Newman, Stanton P

    2015-12-02

    Many patients with type 2 diabetes fail to achieve good glycaemic control. Poor control is associated with complications including coronary heart disease (CHD). Effective self-management and engagement in health behaviours can reduce risks of complications. However, patients often struggle to adopt and maintain these behaviours. Self-management interventions have been found to be effective