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Sample records for glycaemic control decreases

  1. 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...

  2. 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 ...

  3. 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....

  4. 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.

  5. 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.

  6. 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.

  7. 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 ...

  8. 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...

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. 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...

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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....

  20. 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 ...

  1. 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 ...

  2. 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...

  3. 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 ...

  4. 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)...

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. 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...

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. 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....

  2. 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...

  3. 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.

  4. 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.

  5. 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...

  6. 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)

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. 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

  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. 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.

  17. 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...

  18. 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...

  19. 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.

  20. 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.

  1. 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...

  2. 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.

  3. 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.

  4. 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)

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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....

  12. 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).

  13. Sea buckthorn decreases and delays insulin response and improves glycaemic profile following a sucrose-containing berry meal

    DEFF Research Database (Denmark)

    Mortensen, Maria Wichmann; Spagner, Camilla; Cuparencu, Cătălina

    2018-01-01

    PURPOSE: Berries and mixed berry products exert acute effects on postprandial glycaemia and insulinemia, but very few berries have been studied, and primarily in normal weight subjects. Sea buckthorn and strawberry are compositionally widely different berries and may likely produce different...... responses. The effects of strawberry and sea buckthorn on postprandial glycaemia and insulinemia were examined in overweight or obese male subjects. Subjective appetite sensations and ad libitum intake were also examined. METHODS: The study was conducted as a randomised, controlled, single-blinded, three......-way crossover study. Eighteen subjects were studied in three 2-h meal tests followed by a subsequent ad libitum meal. Test meals contained added sucrose and either sea buckthorn, strawberry or no berries with added fructose (control). Blood samples were collected at t = 0, 30, 45, 60, 90 and 120 min. Subjective...

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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....

  1. 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.

  2. 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.

  3. 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.

  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. 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. 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

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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 ...

  19. 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...

  20. 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.

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. 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...

  6. 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...

  7. 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

  8. 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).

  9. 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.

  10. 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...

  11. 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.

  12. 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...

  13. 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.

  14. 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...

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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

  8. 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.

  9. 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.

  10. 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

  11. 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

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. 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....

  17. 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.

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

    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

  19. 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.

  20. 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.

  1. 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...

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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...

  8. 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...

  9. 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

  10. 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 ...

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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...

  19. 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

    Full Text Available Abstract Background Strict glycaemic control (SGC has become a contentious issue in modern intensive care. Physicians and nurses are concerned about the increased workload due to SGC as well as causing harm through hypoglycaemia. The objective of our study was to evaluate our existing degree of glycaemic control, and to implement SGC safely in our ICU through a nurse-led implementation of an algorithm for intensive insulin-therapy. Methods The study took place in the adult general intensive care unit (11 beds of a 44-bed department of intensive care at a tertiary care university hospital. All patients admitted during the 32 months of the study were enrolled. We retrospectively analysed all arterial blood glucose (BG results from samples that were obtained over a period of 20 months prior to the implementation of SGC. We then introduced an algorithm for intensive insulin therapy; aiming for arterial blood-glucose at 4.4 – 6.1 mmol/L. Doctors and nurses were trained in the principles and potential benefits and risks of SGC. Consecutive statistical analyses of blood samples over a period of 12 months were used to assess performance, provide feedback and uncover incidences of hypoglycaemia. Results Median BG level was 6.6 mmol/L (interquartile range 5.6 to 7.7 mmol/L during the period prior to implementation of SGC (494 patients, and fell to 5.9 (IQR 5.1 to 7.0 mmol/L following introduction of the new algorithm (448 patients. The percentage of BG samples > 8 mmol/L was reduced from 19.2 % to 13.1 %. Before implementation of SGC, 33 % of samples were between 4.4 to 6.1 mmol/L and 12 patients (2.4 % had one or more episodes of severe hypoglycaemia ( Conclusion The retrospective part of the study indicated ample room for improvement. Through the implementation of SGC the fraction of samples within the new target range increased from 33% to 45.8%. There was also a significant increase in severe hypoglycaemic episodes. There continues to be potential

  20. 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.

  1. 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.

  2. 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.

  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. 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

  5. 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.

  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. 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

  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. 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.

  14. 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.

  15. Urinary creatinine concentration is inversely related to glycaemic control and the presence of some diabetic complications in patients with newly diagnosed Type 2 diabetes

    DEFF Research Database (Denmark)

    Olivarius, Niels de Fine; Andreasen, Anne H; Vestbo, Else

    2006-01-01

    BACKGROUND: The ratio between urinary albumin concentration (UAC) and urinary creatinine concentration (UCC) is widely used to estimate renal involvement. We examined how UAC and UCC associate with each other, with other risk factors, and with diabetic complications in a population-based sample...... of Type 2 diabetic patients. METHODS: A freshly voided morning urine specimen was provided by 1,284 consecutive, newly diagnosed diabetic patients aged 40 years or over in general practice. Albumin was measured by a polyethyleneglycol radioimmunoassay and creatinine by a modified Jaffe method. RESULTS......: In a multivariate model including UAC, UCC, age, sex, HbA1c, and urinary glucose concentration, UAC increased with both age (P=.042) and HbA1c (P=.014), while UCC decreased (Phigh resting heart...

  16. 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....

  17. Evaluation of knowledge regarding gestational diabetes mellitus and its association with glycaemic level: A Malaysian study.

    Science.gov (United States)

    Hussain, Zahid; Yusoff, Zuraidah Mohd; Sulaiman, Syed Azhar Syed

    2015-06-01

    The aim of this study was to evaluate the knowledge about GDM and its corresponding relation with glycaemic level in GDM patients. A cross-sectional study was conducted in antenatal clinic of Hospital Pulau Pinang, Malaysia from June 2013 to December 2013 using Gestational Diabetes Mellitus Knowledge Questionnaire (GDMKQ) on the sample of 175 GDM patients. Three most recent fasting plasma glucose (FPG) values (mmol/l) were taken from patients profiles and mean was calculated. A total of 166 patients were included in final analysis. A total mean knowledge score of 166 patients was 10.01±3.63 and total mean FPG value was 5.50±1.13. Knowledge had a significant negative association with FPG (r=- 0.306, 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.

  18. Decreased postural control in people with moderate hearing loss

    Science.gov (United States)

    Thomas, Ewan; Martines, Francesco; Bianco, Antonino; Messina, Giuseppe; Giustino, Valerio; Zangla, Daniele; Iovane, Angelo; Palma, Antonio

    2018-01-01

    Abstract Balance is a complex process that involves multiple sensory integrations. The auditory, visual, and vestibular systems are the main contributors. Hearing loss or hearing impairment may induce inappropriate postural strategies that could affect balance and therefore increase the risk of falling. The aim of this study was to understand whether hearing loss could influence balance, cervical posture, and muscle activation in the cervical region. Thirteen patients (61 ± 13 years; 161.8 ± 11.0 cm; 70.5 ± 15.9 kg) with moderate hearing loss (Right ear −60 ± 21 dB; Left ear −61 ± 24 dB) underwent: an audiometric examination, a postural examination (with open and closed eyes) through a stabilometric platform, a cervical ROM examination through a head accelerometer, and a sternocleidomastoid electromyography (EMG) examination. A linear regression analysis has shown a regression coefficient (R2) 0.76 and 0.69 between hearing loss and the posturographic parameters, on the sagittal sway, with open and closed eyes, respectively. The combination of frontal and sagittal sway is able to explain up to 84% of the variance of the audiometric assessment. No differences were found between right and left hemibody between the audiometric, posturographic, cervical ROM parameters, and in EMG amplitude. ROM and EMG parameters have not shown any significant associations with hearing loss, for both right and left head rotation. Hearing loss is associated to increased posturographic measures, especially the sagittal sway, underlining a reduced postural control in people with hearing impairments. No association was found between the heads posture and neck activation with hearing loss. Hearing loss may be associated with an increased risk of falls. PMID:29620637

  19. Decreased postural control in people with moderate hearing loss.

    Science.gov (United States)

    Thomas, Ewan; Martines, Francesco; Bianco, Antonino; Messina, Giuseppe; Giustino, Valerio; Zangla, Daniele; Iovane, Angelo; Palma, Antonio

    2018-04-01

    Balance is a complex process that involves multiple sensory integrations. The auditory, visual, and vestibular systems are the main contributors. Hearing loss or hearing impairment may induce inappropriate postural strategies that could affect balance and therefore increase the risk of falling.The aim of this study was to understand whether hearing loss could influence balance, cervical posture, and muscle activation in the cervical region.Thirteen patients (61 ± 13 years; 161.8 ± 11.0 cm; 70.5 ± 15.9 kg) with moderate hearing loss (Right ear -60 ± 21 dB; Left ear -61 ± 24 dB) underwent: an audiometric examination, a postural examination (with open and closed eyes) through a stabilometric platform, a cervical ROM examination through a head accelerometer, and a sternocleidomastoid electromyography (EMG) examination.A linear regression analysis has shown a regression coefficient (R) 0.76 and 0.69 between hearing loss and the posturographic parameters, on the sagittal sway, with open and closed eyes, respectively. The combination of frontal and sagittal sway is able to explain up to 84% of the variance of the audiometric assessment. No differences were found between right and left hemibody between the audiometric, posturographic, cervical ROM parameters, and in EMG amplitude. ROM and EMG parameters have not shown any significant associations with hearing loss, for both right and left head rotation.Hearing loss is associated to increased posturographic measures, especially the sagittal sway, underlining a reduced postural control in people with hearing impairments. No association was found between the heads posture and neck activation with hearing loss. Hearing loss may be associated with an increased risk of falls.

  20. Flexible guided self-determination intervention for younger adults with poorly controlled Type 1 diabetes, decreased HbA1c and psychosocial distress in women but not in men

    DEFF Research Database (Denmark)

    Zoffmann, V; Vistisen, D; Due-Christensen, M

    2015-01-01

    AIM: To report results from an 18-month randomized controlled trial (RCT) testing the effectiveness of a flexible guided self-determination (GSD) intervention on glycaemic control and psychosocial distress in younger adults with poorly controlled Type 1 diabetes. METHODS: Between January 2010 and...

  1. 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

  2. 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

  3. 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.

  4. 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.

  5. 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...

  6. 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.

  7. 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.

  8. 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 ...

  9. 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.

  10. 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

  11. 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...

  12. A method of reactor power decrease by 2DOF control system during BWR power oscillation

    International Nuclear Information System (INIS)

    Ishikawa, Nobuyuki; Suzuki, Katsuo

    1998-09-01

    Occurrence of power oscillation events caused by void feedback effects in BWRs operated at low-flow and high-power condition has been reported. After thoroughly examining these events, BWRs have been equipped with the SRI (Selected Rod Insertion) system to avoid the power oscillation by decreasing the power under such reactor condition. This report presents a power control method for decreasing the reactor power stably by a two degree of freedom (2DOF) control. Performing a numerical simulation by utilizing a simple reactor dynamics model, it is found that the control system designed attains a satisfactory control performance of power decrease from a viewpoint of setting time and oscillation. (author)

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    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....

  14. 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.

  15. 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.

  16. 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.

  17. Decreasing Internal Focus of Attention Improves Postural Control during Quiet Standing in Young Healthy Adults

    Science.gov (United States)

    Nafati, Gilel; Vuillerme, Nicolas

    2011-01-01

    This experiment was designed to investigate whether and how decreasing the amount of attentional focus invested in postural control could affect bipedal postural control. Twelve participants were asked to stand upright as immobile as possible on a force platform in one control condition and one cognitive condition. In the latter condition, they…

  18. 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

  19. 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

  20. 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.

  1. Decreasing internal focus of attention improves postural control during quiet standing in young healthy adults.

    Science.gov (United States)

    Nafati, Gilel; Vuillerme, Nicolas

    2011-12-01

    This experiment was designed to investigate whether and how decreasing the amount of attentional focus invested in postural control could affect bipedal postural control. Twelve participants were asked to stand upright as immobile as possible on a force platform in one control condition and one cognitive condition. In the latter condition, they performed a short-term digit-span memory task. Decreased center-of-gravity displacements and decreased center-of-foot-pressure displacements minus center-of-gravity displacements were observed in the cognitive condition relative to the control condition. These results suggest that shifting the attentional focus away from postural control by executing a concurrent attention-demanding task could increase postural performance and postural efficiency.

  2. Controlling spatio-temporal extreme events by decreasing the localized energy

    International Nuclear Information System (INIS)

    Du Lin; Xu Wei; Li Zhanguo; Zhou Bingchang

    2011-01-01

    The problem of controlling extreme events in spatially extended dynamical systems is investigated in this Letter. Based on observations of the system state, the control technique we proposed locally decreases the spatial energy of the amplitude in the vicinity of the highest burst, without needs of any knowledge or prediction of the system model. Considering the specific Complex Ginzburg-Landau equation, we provide theoretical analysis for designing the localized state feedback controller. More exactly, a simple control law by varying a damping parameter at control region is chose to achieve the control. Numerical simulations and statistic analysis demonstrate that extreme events can be efficiently suppressed by our strategy. In particular, the cost of the control and the tolerant time delay in applying the control is considered in detail. - Highlights: → We propose a local control scheme to suppress spatio-temporal extreme events. → The control is address by decreasing the spatial energy of the system locally. → The detail control law is to apply localized state feedback based on observations. → The cost of the control increases with the size of the control region exponentially. → The tolerant delay of the control is about 5-6 times of lifetime of extreme events.

  3. 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....

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  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. 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

  10. 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...

  11. The importance of job control for workers with decreased work ability to remain productive at work.

    Science.gov (United States)

    van den Berg, Tilja I; Robroek, Suzan J; Plat, Jan F; Koopmanschap, Marc A; Burdorf, Alex

    2011-08-01

    Workers with decreased work ability are at greater risk of reduced productivity at work. We hypothesized that work-related characteristics play an important role in supporting workers to remain productive despite decreased work ability. The study population consisted of 10,542 workers in 49 different companies in the Netherlands in 2005-2009. Productivity loss at work was defined on a 10-point scale by asking how much work was actually performed during regular hours on the last regular workday when compared with normal. Independent variables in the logistic regression analysis were individual characteristics, work-related factors, and the work ability index. Additive interactions between work-related factors and decreased work ability were evaluated by the relative excess risk due to interaction (RERI). The odds ratios and 95% confidence intervals (CI) for the likelihood of productivity loss at work were 2.03 (1.85-2.22), 3.50 (3.10-3.95), and 5.54 (4.37-7.03) for a good, moderate, and poor work ability, compared with an excellent work ability (reference group). Productivity loss at work was associated with lack of job control, poor skill discretion, and high work demands. There was a significant interaction between decreased work ability and lack of job control (RERI = 0.63 95% CI 0.11-1.16) with productivity loss at work. The negative effects on work performance of decreased work ability may be partly counterbalanced by increased job control. This suggests that interventions among workers with (chronic) disease that cause a decreased work ability should include enlargement of possibilities to plan and pace their own activities at work.

  12. 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...

  13. 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.

  14. 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.

  15. 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

  16. Addiction: Decreased reward sensitivity and increased expectation sensitivity conspire to overwhelm the brain's control circuit

    OpenAIRE

    Volkow, Nora D.; Wang, Gene-Jack; Fowler, Joanna S.; Tomasi, Dardo; Telang, Frank; Baler, Ruben

    2010-01-01

    Based on brain imaging findings, we present a model according to which addiction emerges as an imbalance in the information processing and integration among various brain circuits and functions. The dysfunctions reflect (a) decreased sensitivity of reward circuits, (b) enhanced sensitivity of memory circuits to conditioned expectations to drugs and drug cues, stress reactivity, and (c) negative mood, and a weakened control circuit. Although initial experimentation with a drug of abuse is larg...

  17. 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.

  18. 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; ...

  19. 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...

  20. 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 ...

  1. 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.

  2. 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.

  3. Impulse control disorders in Parkinson's disease: decreased striatal dopamine transporter levels.

    Science.gov (United States)

    Voon, Valerie; Rizos, Alexandra; Chakravartty, Riddhika; Mulholland, Nicola; Robinson, Stephanie; Howell, Nicholas A; Harrison, Neil; Vivian, Gill; Ray Chaudhuri, K

    2014-02-01

    Impulse control disorders are commonly associated with dopaminergic therapy in Parkinson's disease (PD). PD patients with impulse control disorders demonstrate enhanced dopamine release to conditioned cues and a gambling task on [(11)C]raclopride positron emission tomography (PET) imaging and enhanced ventral striatal activity to reward on functional MRI. We compared PD patients with impulse control disorders and age-matched and gender-matched controls without impulse control disorders using [(123)I]FP-CIT (2β-carbomethoxy-3β-(4-iodophenyl)tropane) single photon emission computed tomography (SPECT), to assess striatal dopamine transporter (DAT) density. The [(123)I]FP-CIT binding data in the striatum were compared between 15 PD patients with and 15 without impulse control disorders using independent t tests. Those with impulse control disorders showed significantly lower DAT binding in the right striatum with a trend in the left (right: F(1,24)=5.93, p=0.02; left: F(1,24)=3.75, p=0.07) compared to controls. Our findings suggest that greater dopaminergic striatal activity in PD patients with impulse control disorders may be partly related to decreased uptake and clearance of dopamine from the synaptic cleft. Whether these findings are related to state or trait effects is not known. These findings dovetail with reports of lower DAT levels secondary to the effects of methamphetamine and alcohol. Although any regulation of DAT by antiparkinsonian medication appears to be modest, PD patients with impulse control disorders may be differentially sensitive to regulatory mechanisms of DAT expression by dopaminergic medications.

  4. Controllable pulse width of bright similaritons in a tapered graded index diffraction decreasing waveguide

    Energy Technology Data Exchange (ETDEWEB)

    Prakash, S. Arun [Department of EEE, Anna University, Ramanathapuram 623513 (India); Malathi, V. [Department of EEE, Anna University, Regional office, Madurai (India); Mani Rajan, M. S., E-mail: senthilmanirajanofc@gmail.com [Department of Physics, Anna University, Ramanathapuram 623513 (India); Loomba, Shally [Department of Physics, Panjab University, Chandigarh 160014 (India)

    2016-03-15

    We obtain the bright similariton solutions for generalized inhomogeneous nonlinear Schrödinger equation (GINLSE) which governs the pulse propagation in a tapered graded index diffraction decreasing waveguide (DDW). The exact solutions have been worked out by employing similarity transformations which involve the mapping of the GINLSE to standard NLSE for the certain conditions of the parameters. By making use of the exact analytical solutions, we have investigated the dynamical behavior of optical similariton pairs and have suggested the methods to control them as they propagate through DDW. Moreover, pulse width of similariton is controlled through various profiles. These results are helpful to understand the similaritons in DDW and can be potentially useful for future experiments in optical communications which involve optical amplifiers and long-haul telecommunication networks.

  5. Bioretention storm water control measures decrease the toxicity of copper roof runoff.

    Science.gov (United States)

    LaBarre, William J; Ownby, David R; Rader, Kevin J; Lev, Steven M; Casey, Ryan E

    2017-06-01

    The present study evaluated the ability of 2 different bioretention storm water control measures (SCMs), planter boxes and swales, to decrease the toxicity of sheet copper (Cu) roofing runoff to Daphnia magna. The present study quantified changes in storm water chemistry as it passed through the bioretention systems and utilized the biotic ligand model (BLM) to assess whether the observed D. magna toxicity could be predicted by variations found in water chemistry. Laboratory toxicity tests were performed using select storm samples with D. magna cultured under low ionic strength conditions that were appropriate for the low ionic strength of the storm water samples being tested. The SCMs decreased toxicity of Cu roof runoff in both the BLM results and the storm water bioassays. Water exiting the SCMs was substantially higher than influent runoff in pH, ions, alkalinity, and dissolved organic carbon and substantially lower in total and dissolved Cu. Daphnids experienced complete mortality in untreated runoff from the Cu roof (the SCM influent); however, for planter and swale effluents, survival averaged 86% and 95%, respectively. The present study demonstrated that conventional bioretention practices, including planter boxes and swales, are capable of decreasing the risk of adverse effects from sheet Cu roof runoff to receiving systems, even before considering dilution of effluents in those receiving systems and associated further reductions in copper bioavailability. Environ Toxicol Chem 2017;36:1680-1688. © 2016 SETAC. © 2016 SETAC.

  6. Decreasing harsh discipline in mothers at risk for maltreatment: a randomized control trial.

    Science.gov (United States)

    Pereira, Mariana; Negrão, Mariana; Soares, Isabel; Mesman, Judi

    2014-01-01

    This study tested the effectiveness of the attachment-based program Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD; F. Juffer, M.J. Bakermans-Kranenburg, & M.H. van IJzendoorn, 2008) in decreasing harsh discipline of 43 mothers and their 1- to 4-year-old-children from severely deprived families. Based on previous studies, parenting stress was tested as a potential moderator of intervention effects on harsh discipline. Using a randomized control design, maternal harsh discipline was observed during home visits at the pretest and posttest, and mothers filled in questionnaires at both assessments. The VIPP-SD proved to be effective in decreasing maternal harsh discipline, but only for mothers who experienced higher levels of parenting stress at intake. These findings provide support for the program's ability to improve parenting in families who are most at risk for harsh parenting and for potentially maltreating child-parent interactions. The results are discussed in terms of the VIPP-SD elements most relevant to decreasing harsh discipline, and the challenges of parenting interventions in severely deprived populations. © 2014 Michigan Association for Infant Mental Health.

  7. Warm ambient temperature decreases food intake in a simulated office setting: A pilot randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Molly eBernhard

    2015-08-01

    Full Text Available Background: We hypothesized that exposure to temperatures above the thermoneutral zone would decrease food intake in young adults in a sedentary office environment over a 2-hour period. Methods: Participants wearing standardized clothing were randomized to perform routine office work in either within the thermoneutral zone, considered control (19-20°C, or above the thermoneutral zone considered warmer (26-27°C treatment in parallel-group design (n=11 and 9, respectively. Thermal images of the inner canthus of their eye and middle finger nail bed, representing proxies of core and peripheral temperatures, respectively, were taken at baseline, 1st, and 2nd hour during this lunchtime study. Relative heat dissipation was estimated as peripheral temperature. General linear models were conducted to examine the effects of thermal treatment the calories intake and potential mediation. Researchers conducted the trial registered as NCT02386891 at Clinicaltrials.gov during April- May 2014. Results: During the 2 hours stay in different ambient temperatures, the participants in the control conditions ate 99.5 kcal more than those in the warmer conditions; however, the difference was not statistically significant. Female participants ate about 350 kcal less than the male participants (P=0.024 in both groups and there was no significant association between calories intake and participant’s BMI. After controlling for thermal treatment, gender and BMI, the participant’s peripheral temperature was significantly associated with calories intake (p=0.002, suggesting a mediating effect. Specifically, for every 1°C increase in peripheral temperature indicating reduced heat dissipation, participants ate 85.9 kcal less food. Conclusions: This pilot study provided preliminary evidence of effects of thermal environment on food intake and the decreased food intake in the experimental (warmer environment is potentially mediated through thermoregulatory mechanisms.

  8. Warm Ambient Temperature Decreases Food Intake in a Simulated Office Setting: A Pilot Randomized Controlled Trial.

    Science.gov (United States)

    Bernhard, Molly C; Li, Peng; Allison, David B; Gohlke, Julia M

    2015-01-01

    We hypothesized that exposure to temperatures above the thermoneutral zone (TNZ) would decrease food intake in young adults in a sedentary office environment over a 2-h period. Participants wearing standardized clothing were randomized to perform routine office work in the TNZ, considered control (19-20°C), or above the TNZ considered warmer (26-27°C) using a parallel-group design (n = 11 and 9, respectively). Thermal images of the inner canthus of their eye and middle finger nail bed, representing proxies of core and peripheral temperatures, respectively, were taken at baseline, first, and second hour during this lunchtime study. Heat dissipation was estimated using peripheral temperature. General linear models were built to examine the effects of thermal treatment on caloric intake and potential mediation by heat dissipation. Researchers conducted the trial registered as NCT02386891 at Clinicaltrials.gov during April to May 2014. During the 2-h stay in different ambient temperatures, the participants in the control conditions ate 99.5 kcal more than those in the warmer conditions; however, the difference was not statistically significant. Female participants ate about 350 kcal less than the male participants (p = 0.024) in both groups and there was no significant association between caloric intake and participant's body mass index (BMI). After controlling for thermal treatment, gender and BMI, the participant's peripheral temperature was significantly associated with caloric intake (p = 0.002), suggesting a mediating effect. Specifically, for every 1°C increase in peripheral temperature suggesting increased heat dissipation, participants ate 85.9 kcal less food. This pilot study provided preliminary evidence of effects of thermal environment on food intake. It suggests that decreased food intake in the experimental (warmer) environment is potentially mediated through thermoregulatory mechanisms.

  9. Decreased expression of endogenous feline leukemia virus in cat lymphomas: a case control study.

    Science.gov (United States)

    Krunic, Milica; Ertl, Reinhard; Hagen, Benedikt; Sedlazeck, Fritz J; Hofmann-Lehmann, Regina; von Haeseler, Arndt; Klein, Dieter

    2015-04-10

    Cats infected with exogenous feline leukemia virus (exFeLV) have a higher chance of lymphoma development than uninfected cats. Furthermore, an increased exFeLV transcription has been detected in lymphomas compared to non-malignant tissues. The possible mechanisms of lymphoma development by exFeLV are insertional mutagenesis or persistent stimulation of host immune cells by viral antigens, bringing them at risk for malignant transformation. Vaccination of cats against exFeLV has in recent years decreased the overall infection rate in most countries. Nevertheless, an increasing number of lymphomas have been diagnosed among exFeLV-negative cats. Endogenous feline leukemia virus (enFeLV) is another retrovirus for which transcription has been observed in cat lymphomas. EnFeLV provirus elements are present in the germline of various cat species and share a high sequence similarity with exFeLV but, due to mutations, are incapable of producing infectious viral particles. However, recombination between exFeLV and enFeLV could produce infectious particles. We examined the FeLV expression in cats that have developed malignant lymphomas and discussed the possible mechanisms that could have induced malignant transformation. For expression analysis we used next-generation RNA-sequencing (RNA-Seq) and for validation reverse transcription quantitative PCR (RT-qPCR). First, we showed that there was no expression of exFeLV in all samples, which eliminates the possibility of recombination between exFeLV and enFeLV. Next, we analyzed the difference in expression of three enFeLV genes between control and lymphoma samples. Our analysis showed an average of 3.40-fold decreased viral expression for the three genes in lymphoma compared to control samples. The results were confirmed by RT-qPCR. There is a decreased expression of enFeLV genes in lymphomas versus control samples, which contradicts previous observations for the exFeLV. Our results suggest that a persistent stimulation of host

  10. 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.

  11. 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.

  12. Cryotherapy decreases synovial Doppler activity and pain in knee arthritis: A randomized-controlled trial.

    Science.gov (United States)

    Guillot, Xavier; Tordi, Nicolas; Prati, Clément; Verhoeven, Frank; Pazart, Lionel; Wendling, Daniel

    2017-07-01

    To measure and compare the effects of 2 local cryotherapy techniques on synovial power Doppler activity (primary outcome) and pain in non-septic knee arthritis without any concurrent treatment. 30 patients were randomized (ice: 30min, n=15 or cold CO 2 : 2min, n=15 both applied twice at 8h interval). Contralateral non-treated arthritic knees were used as paired controls (n=11 and n=10 respectively). The PDUS semi-quantitative score (0-3) and pain visual analogic scale were evaluated before/after each cold application, 2min, 2h, 24h after the first application. PDUS scores were checked in double-blind by 2 ultrasonographists. The inter-class effect size of local cryotherapy on the power Doppler score remained significant the day after treatment in local cryotherapy-treated compared to contralateral non-treated knees (Global difference: -1 [95% confidence interval: -1.23; -0.77]; ice: -0.73 [-1.06; -0.4]; CO 2 : -0.7 [-1.18; -0.22]). Both techniques significantly and to the same extent reduced the power Doppler score and pain visual analogic scale at all evaluation times and globally throughout the 24 hour-study period. No dropout nor adverse event was reported. In multivariate analysis, the Power Doppler score decrease was associated with pain decrease, while pain decrease was associated with the female sex and ice technique. Local ice and cold CO 2 applied twice equally reduced synovial Power Doppler activity and pain over 24h in knee arthritis. These effects remained significant the day after treatment. ClinicalTrials.gov identifier: NCT02573298. Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  13. College Binge Drinking Associated with Decreased Frontal Activation to Negative Emotional Distractors during Inhibitory Control

    Directory of Open Access Journals (Sweden)

    Julia E. Cohen-Gilbert

    2017-09-01

    Full Text Available The transition to college is associated with an increase in heavy episodic alcohol use, or binge drinking, during a time when the prefrontal cortex and prefrontal-limbic circuitry continue to mature. Traits associated with this immaturity, including impulsivity in emotional contexts, may contribute to risky and heavy episodic alcohol consumption. The current study used blood oxygen level dependent (BOLD multiband functional magnetic resonance imaging (fMRI to assess brain activation during a task that required participants to ignore background images with positive, negative, or neutral emotional valence while performing an inhibitory control task (Go-NoGo. Subjects were 23 college freshmen (seven male, 18–20 years who engaged in a range of drinking behavior (past 3 months’ binge episodes range = 0–19, mean = 4.6, total drinks consumed range = 0–104, mean = 32.0. Brain activation on inhibitory trials (NoGo was contrasted between negative and neutral conditions and between positive and neutral conditions using non-parametric testing (5000 permutations and cluster-based thresholding (z = 2.3, p ≤ 0.05 corrected. Results showed that a higher recent incidence of binge drinking was significantly associated with decreased activation of dorsolateral prefrontal cortex (DLPFC, dorsomedial prefrontal cortex (DMPFC, and anterior cingulate cortex (ACC, brain regions strongly implicated in executive functioning, during negative relative to neutral inhibitory trials. No significant associations between binge drinking and brain activation were observed for positive relative to neutral images. While task performance was not significantly associated with binge drinking in this sample, subjects with heavier recent binge drinking showed decreased recruitment of executive control regions under negative versus neutral distractor conditions. These findings suggest that in young adults with heavier recent binge drinking, processing of negative emotional

  14. Sleep-disordered breathing decreases after opioid withdrawal: results of a prospective controlled trial.

    Science.gov (United States)

    Schwarzer, Andreas; Aichinger-Hinterhofer, Marie; Maier, Christoph; Vollert, Jan; Walther, Jörg Werner

    2015-11-01

    An increased cardiovascular event rate in elderly patients under opioid medications was recently reported. One reason for this increase could be the occurrence of nocturnal apnea and hypoxia, as a consequence of sleep-disordered breathing (SDB). Using a controlled study, we prospectively analyzed SDB using polysomnography in a total of 18 patients before and after opioid withdrawal (opioid withdrawal group [OG]) and 14 patients before and after comprehensive pain management (without any strong-acting opioids) who served as the control group (CG). To analyze the differences, unpaired/paired t tests and Mann-Whitney U tests/Wilcoxon rank tests were used. At baseline, the OG presented more nocturnal apneas/hypopneas than the CG with an apnea-hypopnea index (AHI) of 41.4 ± 27.8 vs 21.8 ± 15.9 (P = 0.018). After treatment, the AHI decreased significantly only in the withdrawal group (OG: 16.7 ± 8.9; CG: 20.1 ± 12.9) (P opioid withdrawal and in none of the patients after withdrawal (P opioid intake; these findings may explain the opioid-associated cardiovascular morbidity. Thus, SDB may be a risk at lower opioid doses than hitherto described, and particular caution should be exercised in patients with comorbidities that might make them vulnerable to the consequences of SDB.

  15. Decreasing prevalence of brucellosis in red deer through efforts to control disease in livestock

    Science.gov (United States)

    Serrano, E.; Cross, P.C.; Beneria, M.; Ficapal, A.; Curia, J.; Marco, X.; Lavin, S.; Marco, I.

    2011-01-01

    When a pathogen infects a number of different hosts, the process of determining the relative importance of each host species to the persistence of the pathogen is often complex. Removal of a host species is a potential but rarely possible way of discovering the importance of that species to the dynamics of the disease. This study presents the results of a 12-year programme aimed at controlling brucellosis in cattle, sheep and goats and the cascading impacts on brucellosis in a sympatric population of red deer (Cervus elaphus) in the Boumort National Game Reserve (BNGR; NE Spain). From February 1998 to December 2009, local veterinary agencies tested over 36 180 individual blood samples from cattle, 296 482 from sheep and goats and 1047 from red deer in the study area. All seropositive livestock were removed annually. From 2006 to 2009 brucellosis was not detected in cattle and in 2009 only one of 97 red deer tested was found to be positive. The surveillance and removal of positive domestic animals coincided with a significant decrease in the prevalence of brucellosis in red deer. Our results suggest that red deer may not be able to maintain brucellosis in this region independently of cattle, sheep or goats, and that continued efforts to control disease in livestock may lead to the eventual eradication of brucellosis in red deer in the area.

  16. Liposomal bupivacaine decreases pain following retropubic sling placement: a randomized placebo-controlled trial.

    Science.gov (United States)

    Mazloomdoost, Donna; Pauls, Rachel N; Hennen, Erin N; Yeung, Jennifer Y; Smith, Benjamin C; Kleeman, Steven D; Crisp, Catrina C

    2017-11-01

    Midurethral slings are commonly used to treat stress urinary incontinence. Pain control, however, may be a concern. Liposomal bupivacaine is a local anesthetic with slow release over 72 hours, demonstrated to lower pain scores and decrease narcotic use postoperatively. The purpose of this study was to examine the impact of liposomal bupivacaine on pain scores and narcotic consumption following retropubic midurethral sling placement. This randomized, placebo-controlled trial enrolled women undergoing retropubic midurethral sling procedures with or without concomitant anterior or urethrocele repair. Subjects were allocated to receive liposomal bupivacaine (intervention) or normal saline placebo injected into the trocar paths and vaginal incision at the conclusion of the procedure. At the time of drug administration, surgeons became unblinded, but did not collect outcome data. Participants remained blinded to treatment. Surgical procedures and perioperative care were standardized. The primary outcome was the visual analog scale pain score 4 hours after discharge home. Secondary outcomes included narcotic consumption, time to first bowel movement, and pain scores collected in the mornings and evenings until postoperative day 6. The morning pain item assessed "current level of pain"; the evening items queried "current level of pain," "most intense pain today," "average pain today with activity," and "average pain today with rest." Likert scales were used to measure satisfaction with pain control at 1- and 2-week postoperative intervals. Sample size calculation deemed 52 subjects per arm necessary to detect a mean difference of 10 mm on a 100-mm visual analog scale. To account for 10% drop out, 114 participants were needed. One hundred fourteen women were enrolled. After 5 exclusions, 109 cases were analyzed: 54 women received intervention, and 55 women received placebo. Mean participant age was 52 years, and mean body mass index was 30.4 kg/m 2 . Surgical and

  17. Addiction: decreased reward sensitivity and increased expectation sensitivity conspire to overwhelm the brain's control circuit.

    Science.gov (United States)

    Volkow, Nora D; Wang, Gene-Jack; Fowler, Joanna S; Tomasi, Dardo; Telang, Frank; Baler, Ruben

    2010-09-01

    Based on brain imaging findings, we present a model according to which addiction emerges as an imbalance in the information processing and integration among various brain circuits and functions. The dysfunctions reflect (a) decreased sensitivity of reward circuits, (b) enhanced sensitivity of memory circuits to conditioned expectations to drugs and drug cues, stress reactivity, and (c) negative mood, and a weakened control circuit. Although initial experimentation with a drug of abuse is largely a voluntary behavior, continued drug use can eventually impair neuronal circuits in the brain that are involved in free will, turning drug use into an automatic compulsive behavior. The ability of addictive drugs to co-opt neurotransmitter signals between neurons (including dopamine, glutamate, and GABA) modifies the function of different neuronal circuits, which begin to falter at different stages of an addiction trajectory. Upon exposure to the drug, drug cues or stress this results in unrestrained hyperactivation of the motivation/drive circuit that results in the compulsive drug intake that characterizes addiction.

  18. 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...

  19. Mindful decision making and inhibitory control training as complementary means to decrease snack consumption.

    Science.gov (United States)

    Forman, Evan M; Shaw, Jena A; Goldstein, Stephanie P; Butryn, Meghan L; Martin, Lindsay M; Meiran, Nachshon; Crosby, Ross D; Manasse, Stephanie M

    2016-08-01

    Obesity is largely attributable to excess caloric intake, in particular from "junk" foods, including salty snack foods. Evidence suggests that neurobiological preferences to consume highly hedonic foods translate (via implicit processes) into poor eating choices, unless overturned by inhibitory mechanisms or interrupted by explicit processes. The primary aim of the current study was to test the independent and combinatory effects of a computerized inhibitory control training (ICT) and a mindful decision-making training (MDT) designed to facilitate de-automatization. We randomized 119 habitual salty snack food eaters to one of four short, training conditions: MDT, ICT, both MDT and ICT, or neither (i.e., psychoeducation). For 7 days prior to the intervention and 7 days following the intervention, participants reported on their salty snack food consumption 2 times per day, on 3 portions of their days, using a smartphone-based ecological momentary assessment system. Susceptibility to emotional eating cues was measured at baseline. Results indicated that the effect of MDT was consistent across levels of trait emotional eating, whereas the benefit of ICT was apparent only at lower levels of emotional eating. No synergistic effect of MDT and ICT was detected. These results provide qualified support for the efficacy of both types of training for decreasing hedonically-motivated eating. Moderation effects suggest that those who eat snack foods for reasons unconnected to affective experiences (i.e., lower in emotional eating) may derive benefit from a combination of ICT and MDT. Future research should investigate the additive benefit of de-automization training to standard weight loss interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. 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.

  1. The importance of job control for workers with decreased work ability to remain productive at work

    NARCIS (Netherlands)

    T.I.J. van den Berg (Tilja); S.J.W. Robroek (Suzan); J.F. Plat (Jan); M.A. Koopmanschap (Marc); A. Burdorf (Alex)

    2011-01-01

    textabstractPurpose: Workers with decreased work ability are at greater risk of reduced productivity at work. We hypothesized that work-related characteristics play an important role in supporting workers to remain productive despite decreased work ability. Methods: The study population consisted of

  2. 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.

  3. 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...

  4. The prevalence of lacunar infarct decreases with aging in the elderly: a case-controlled analysis

    Directory of Open Access Journals (Sweden)

    Cai Z

    2016-05-01

    Full Text Available Zhiyou Cai,1 Wenbo He,1 Chuan-yong Peng,2 Jin Zhou,2 Qi-lan Xu,2 Zong-shan Wu2 1Department of Neurology, Renmin Hospital, Hubei University of Medicine, Shiyan Renmin Hospital, Shiyan, Hubei Province, 2The Examination Center of Magnetic Resonance Imaging, the Lu’an Affiliated Hospital of Anhui Medical University, Lu’an People’s Hospital, Lu’an, Anhui Province, People’s Republic of China Background and purpose: Lacunar infarct (LI is well known as a heterogeneous primary disorder of cerebral small vessel. Compelling results have demonstrated that age is a risk factor to the prevalence of LI. However, the relationship between age and the prevalence of LI remains obscure. It is essential to note the relationship between age and the prevalence of LI through more clinical data. Methods: A total of 3,500 patients were included in the case-controlled study. All data were collected from the Examination Center of Magnetic Resonance Imaging, Lu’an People’s Hospital from January 2014 to December 2015. A primary discharge diagnosis of LI was done, and all subjects were evaluated as retrospective data. The relationship between the risk factors and the prevalence of diabetes and the relationship between age and the prevalence of diabetes was analyzed. A chi-square test was used to analyze the associations between different variables. A one-way analysis of variance was used to test the equality of three or more means at one time by using variances. Statistical significance was defined as a P-value of <0.05. Results: The one-way analysis of variance demonstrated that the prevalence of LI increased with age before 60 years and decreased with age after 69 years. The same results were found in both the male and the female subjects. These results showed that the age-related risk factors (hypertension, diabetes, cerebral infarct, cardiovascular diseases, smoking, and drinking have no relationship with the prevalence of LI on the basis of age. There is

  5. 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.

  6. 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

  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. 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.

  9. 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.

  10. 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.

  11. Axial power difference control strategy and computer simulation for GNPS during stretch-out and power decrease

    International Nuclear Information System (INIS)

    Liao Yehong; Xiao Min; Li Xianfeng; Zhu Minhong

    2004-01-01

    Successful control of the axial power difference for PWR is crucial to nuclear safety. After analyzing various elements' effect on the axial power distribution, different axial power deviation control strategies have been proposed to comply with different power decrease scenarios. Application of the strategy to computer simulation shows that our prediction of axial power deviation evolution is comparable to the measurement value, and that our control strategy is effective

  12. 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.

  13. 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 ...

  14. 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.

  15. 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

  16. 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 ...

  17. 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....

  18. 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 ...

  19. Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial.

    Science.gov (United States)

    Sant'Ana, Adriana Campos Passanezi; Campos, Marinele R de; Passanezi, Selma Campos; Rezende, Maria Lúcia Rubo de; Greghi, Sebastião Luiz Aguiar; Passanezi, Euloir

    2011-04-01

    The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes. Pregnant patients during the 1st and 2nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG--"no intervention" (n=17) or IG--"intervention" (n=16). IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP), professional prophylaxis (PROPH) and oral hygiene instruction (OHI). NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD), clinical attachment level (CAL), plaque index (PI) and sulcular bleeding index (SBI) at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (Periodontal treatment resulted in stabilization of CAL and PI (p>0.05) at IG and worsening of all periodontal parameters at NIG (pperiodontal conditions of IG and NIG were observed at 2nd examination (ppregnancy outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy was associated to a decreased risk of developing adverse pregnancy outcomes [OR=13.50; CI: 1.47-123.45; p=0.02]. Periodontal treatment during the second trimester of gestation contributes to decrease adverse pregnancy outcomes.

  20. Decreased functional diversity and biological pest control in conventional compared to organic crop fields.

    Directory of Open Access Journals (Sweden)

    Jochen Krauss

    Full Text Available Organic farming is one of the most successful agri-environmental schemes, as humans benefit from high quality food, farmers from higher prices for their products and it often successfully protects biodiversity. However there is little knowledge if organic farming also increases ecosystem services like pest control. We assessed 30 triticale fields (15 organic vs. 15 conventional and recorded vascular plants, pollinators, aphids and their predators. Further, five conventional fields which were treated with insecticides were compared with 10 non-treated conventional fields. Organic fields had five times higher plant species richness and about twenty times higher pollinator species richness compared to conventional fields. Abundance of pollinators was even more than one-hundred times higher on organic fields. In contrast, the abundance of cereal aphids was five times lower in organic fields, while predator abundances were three times higher and predator-prey ratios twenty times higher in organic fields, indicating a significantly higher potential for biological pest control in organic fields. Insecticide treatment in conventional fields had only a short-term effect on aphid densities while later in the season aphid abundances were even higher and predator abundances lower in treated compared to untreated conventional fields. Our data indicate that insecticide treatment kept aphid predators at low abundances throughout the season, thereby significantly reducing top-down control of aphid populations. Plant and pollinator species richness as well as predator abundances and predator-prey ratios were higher at field edges compared to field centres, highlighting the importance of field edges for ecosystem services. In conclusion organic farming increases biodiversity, including important functional groups like plants, pollinators and predators which enhance natural pest control. Preventative insecticide application in conventional fields has only short

  1. Decreased functional diversity and biological pest control in conventional compared to organic crop fields.

    Science.gov (United States)

    Krauss, Jochen; Gallenberger, Iris; Steffan-Dewenter, Ingolf

    2011-01-01

    Organic farming is one of the most successful agri-environmental schemes, as humans benefit from high quality food, farmers from higher prices for their products and it often successfully protects biodiversity. However there is little knowledge if organic farming also increases ecosystem services like pest control. We assessed 30 triticale fields (15 organic vs. 15 conventional) and recorded vascular plants, pollinators, aphids and their predators. Further, five conventional fields which were treated with insecticides were compared with 10 non-treated conventional fields. Organic fields had five times higher plant species richness and about twenty times higher pollinator species richness compared to conventional fields. Abundance of pollinators was even more than one-hundred times higher on organic fields. In contrast, the abundance of cereal aphids was five times lower in organic fields, while predator abundances were three times higher and predator-prey ratios twenty times higher in organic fields, indicating a significantly higher potential for biological pest control in organic fields. Insecticide treatment in conventional fields had only a short-term effect on aphid densities while later in the season aphid abundances were even higher and predator abundances lower in treated compared to untreated conventional fields. Our data indicate that insecticide treatment kept aphid predators at low abundances throughout the season, thereby significantly reducing top-down control of aphid populations. Plant and pollinator species richness as well as predator abundances and predator-prey ratios were higher at field edges compared to field centres, highlighting the importance of field edges for ecosystem services. In conclusion organic farming increases biodiversity, including important functional groups like plants, pollinators and predators which enhance natural pest control. Preventative insecticide application in conventional fields has only short-term effects on aphid

  2. Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Adriana Campos Passanezi Sant'Ana

    2011-04-01

    Full Text Available OBJECTIVES: The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes. MATERIAL AND METHODS: Pregnant patients during the 1st and 2nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG - "no intervention" (n=17 or IG- "intervention" (n=16. IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP, professional prophylaxis (PROPH and oral hygiene instruction (OHI. NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD, clinical attachment level (CAL, plaque index (PI and sulcular bleeding index (SBI at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (0.05 at IG and worsening of all periodontal parameters at NIG (p<0.0001, except for PI. Signifcant differences in periodontal conditions of IG and NIG were observed at 2nd examination (p<0.001. The rate of adverse pregnancy outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy was associated to a decreased risk of developing adverse pregnancy outcomes [OR=13.50; CI: 1.47-123.45; p=0.02]. CONCLUSIONS: Periodontal treatment during the second trimester of gestation contributes to decrease adverse pregnancy outcomes.

  3. Dynamic increase and decrease of photonic crystal nanocavity Q factors for optical pulse control.

    Science.gov (United States)

    Upham, Jeremy; Tanaka, Yoshinori; Asano, Takashi; Noda, Susumu

    2008-12-22

    We introduce recent advances in dynamic control over the Q factor of a photonic crystal nanocavity system. By carefully timing a rapid increase of the Q factor from 3800 to 22,000, we succeed in capturing a 4ps signal pulse within the nanocavity with a photon lifetime of 18ps. By performing an additional transition of the Q factor within the photon lifetime, the held light is once again ejected from of the system on demand.

  4. 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.

  5. 6-PACK programme to decrease fall injuries in acute hospitals: cluster randomised controlled trial.

    Science.gov (United States)

    Barker, Anna L; Morello, Renata T; Wolfe, Rory; Brand, Caroline A; Haines, Terry P; Hill, Keith D; Brauer, Sandra G; Botti, Mari; Cumming, Robert G; Livingston, Patricia M; Sherrington, Catherine; Zavarsek, Silva; Lindley, Richard I; Kamar, Jeannette

    2016-01-26

    To evaluate the effect of the 6-PACK programme on falls and fall injuries in acute wards. Cluster randomised controlled trial. Six Australian hospitals. All patients admitted to 24 acute wards during the trial period. Participating wards were randomly assigned to receive either the nurse led 6-PACK programme or usual care over 12 months. The 6-PACK programme included a fall risk tool and individualised use of one or more of six interventions: "falls alert" sign, supervision of patients in the bathroom, ensuring patients' walking aids are within reach, a toileting regimen, use of a low-low bed, and use of a bed/chair alarm. The co-primary outcomes were falls and fall injuries per 1000 occupied bed days. During the trial, 46 245 admissions to 16 medical and eight surgical wards occurred. As many people were admitted more than once, this represented 31 411 individual patients. Patients' characteristics and length of stay were similar for intervention and control wards. Use of 6-PACK programme components was higher on intervention wards than on control wards (incidence rate ratio 3.05, 95% confidence interval 2.14 to 4.34; Pcontrol wards. Positive changes in falls prevention practice occurred following the introduction of the 6-PACK programme. However, no difference was seen in falls or fall injuries between groups. High quality evidence showing the effectiveness of falls prevention interventions in acute wards remains absent. Novel solutions to the problem of in-hospital falls are urgently needed. Australian New Zealand Clinical Trials Registry ACTRN12611000332921. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Comparison of different water pollution control methods in decreaseing sediment load from peat mining areas

    International Nuclear Information System (INIS)

    Kloeve, B.

    1997-01-01

    Different water treatment alternatives used to reduce sediment from peat mines were compared with a mathematical model. The simulation tested the benefit of different alternatives to reduce sediment transport during a simulated storm. Traditional structures such as bed ditch pipe barriers, sedimentation ponds were compared against new alternatives such as artificial floodplains, and peak runoff control structures. The results of simulations show that detention of peak discharge is the most efficient way to reduce sediment transport. When runoff peaks are reduced traditional sedimentation ponds seem to have a smaller effect on sediment transport; increased settling is achieved by using shallow settling basins such as artificial floodplains. (orig.) 21 refs

  7. Comparison of different water pollution control methods in decreaseing sediment load from peat mining areas

    Energy Technology Data Exchange (ETDEWEB)

    Kloeve, B.

    1997-11-01

    Different water treatment alternatives used to reduce sediment from peat mines were compared with a mathematical model. The simulation tested the benefit of different alternatives to reduce sediment transport during a simulated storm. Traditional structures such as bed ditch pipe barriers, sedimentation ponds were compared against new alternatives such as artificial floodplains, and peak runoff control structures. The results of simulations show that detention of peak discharge is the most efficient way to reduce sediment transport. When runoff peaks are reduced traditional sedimentation ponds seem to have a smaller effect on sediment transport; increased settling is achieved by using shallow settling basins such as artificial floodplains. (orig.) 21 refs.

  8. Target-nontarget similarity decreases search efficiency and increases stimulus-driven control in visual search.

    Science.gov (United States)

    Barras, Caroline; Kerzel, Dirk

    2017-10-01

    Some points of criticism against the idea that attentional selection is controlled by bottom-up processing were dispelled by the attentional window account. The attentional window account claims that saliency computations during visual search are only performed for stimuli inside the attentional window. Therefore, a small attentional window may avoid attentional capture by salient distractors because it is likely that the salient distractor is located outside the window. In contrast, a large attentional window increases the chances of attentional capture by a salient distractor. Large and small attentional windows have been associated with efficient (parallel) and inefficient (serial) search, respectively. We compared the effect of a salient color singleton on visual search for a shape singleton during efficient and inefficient search. To vary search efficiency, the nontarget shapes were either similar or dissimilar with respect to the shape singleton. We found that interference from the color singleton was larger with inefficient than efficient search, which contradicts the attentional window account. While inconsistent with the attentional window account, our results are predicted by computational models of visual search. Because of target-nontarget similarity, the target was less salient with inefficient than efficient search. Consequently, the relative saliency of the color distractor was higher with inefficient than with efficient search. Accordingly, stronger attentional capture resulted. Overall, the present results show that bottom-up control by stimulus saliency is stronger when search is difficult, which is inconsistent with the attentional window account.

  9. Control of the flow rate in decreasing of the water load of peat production

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    The retention capacity and control of the flow rate was studied in the Aqua-Peat research. The sedimentation ability of solid matter (peat particles), erosion, migration of the solid matter, and the functioning of the retention pipes located in the strip ditches and the sedimentation basins were measured in the research. Detection was also supplemented by laboratory scale models and by measurements made using them. A model, describing the solid matter erosion and migration on the mire, was compiled on the basis of the results. Migration of the solid matter is possible to reduce by pounding the water into the ditching. So there is more time for particles to settle before migration into watercources. By this method it is possible to reduce the solid matter loads caused by heavy rains and power-flows even by 88 %. If the flow control system is equipped with retainers and settling basins, the solid matter retention capacity can rise up to 93-97 %. The results have shown that the retention pipe retainers play more important role in reduction of solid matter load than sedimentation basins. A follow-up study was made using several types of retainers. A 5 cm thick siphon pipe appeared to be the best. The final selection of the retention pipes has, however, to be made as a compromise between the functioning of the drying process, production possibilities and solid matter retention. (1 ref., 2 figs.)

  10. Topical sucralfate decreases pain after hemorrhoidectomy and improves healing: a randomized, blinded, controlled study.

    Science.gov (United States)

    Gupta, P J; Heda, P S; Kalaskar, S; Tamaskar, V P

    2008-02-01

    Oral and topical sucralfate is regularly used in ulcers of gastrointestinal tract, vaginal and perianal excoriations, and radiation burns. This study was designed to determine whether there was any advantage of topical application of sucralfate in reducing postoperative pain and promoting wound healing after open hemorrhoidectomy in patients with Grades III or IV hemorrhoids. A total of 116 patients were randomly assigned to receive sucralfate cream (sucralfate group) or placebo cream (control group) applied to the surgical site. Weekly pain score was evaluated by using Visual Analog Scale. The amount of analgesic tablets consumed in each week also was assessed. At the end of four weeks, two independent surgeons assessed the wound healing. There was no significant difference in age, gender distribution, and number of excised hemorrhoid piles between the two groups. Patients in the topical sucralfate group experienced significantly less pain at Day 7 (Visual Analog Scale +/- standard error of the mean, 3.7+/-0.3 vs. 6.1+/-0.7; P<0.002) and at Day 14 (1.6+/-0.2 vs. 3.1+/-0.6; P<0.01). Likewise patients who received sucralfate cream used less analgesic tablets compared with the placebo group. In the sucralfate group, the overall wound healing ranked significantly better than in controls (P<0.02). Topical sucralfate significantly reduces pain at Days 7 and 14 after hemorrhoidectomy and promotes faster wound healing compared with that of a placebo.

  11. Decreased Modulation of EEG Oscillations in High-Functioning Autism During a Motor Control Task

    Directory of Open Access Journals (Sweden)

    Joshua Benjamin Ewen

    2016-05-01

    Full Text Available Autism spectrum disorders (ASD are thought to result in part from altered cortical excitatory-inhibitory balance; this pathophysiology may impact the generation of oscillations on EEG. We investigated premotor-parietal cortical physiology associated with praxis, which has strong theoretical and empirical associations with ASD symptomatology. 25 children with high-functioning ASD (HFA and 33 controls performed a praxis task involving the pantomiming of tool use, while EEG was recorded. We assessed task-related modulation of signal power in alpha and beta frequency bands. Compared with controls, subjects with HFA showed 27% less left central (motor/premotor beta (18-22 Hz event-related desynchronization (ERD (p = 0.030, as well as 24% less left parietal alpha (7-13 Hz ERD (p = 0.046. Within the HFA group, blunting of central ERD attenuation was associated with impairments in clinical measures of praxis imitation (r = -0.4; p = 0.04 and increased autism severity (r = 0.48; p = 0.016. The modulation of central beta activity is associated, among other things, with motor imagery, which may be necessary for imitation. Impaired imitation has been associated with core features of ASD. Altered modulation of oscillatory activity may be mechanistically involved in those aspects of motor network function that relate to the core symptoms of ASD.

  12. 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

  13. 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)

  14. Kaizen method for esophagectomy patients: improved quality control, outcomes, and decreased costs.

    Science.gov (United States)

    Iannettoni, Mark D; Lynch, William R; Parekh, Kalpaj R; McLaughlin, Kelley A

    2011-04-01

    The majority of costs associated with esophagectomy are related to the initial 3 days of hospital stay requiring intensive care unit stays, ventilator support, and intraoperative time. Additional costs arise from hospital-based services. The major cost increases are related to complications associated with the procedure. We attempted to define these costs and identify expense management by streamlining care through strict adherence to patient care maps, operative standardization, and rapid discharge planning to reduce variability. Utilizing methods of Kaizen philosophy we evaluated all processes related to the entire experience of esophageal resection. This process has taken over 5 years to achieve, with quality and cost being tracked over this time period. Cost analysis included expenses related to intensive care unit, anesthesia, disposables, and hospital services. Quality improvement measures were related to intraoperative complications, in-hospital complications, and postoperative outcomes. The Institutional Review Board approved the use of anonymous data from standard clinical practice because no additional treatment was planned (observational study). Utilizing a continuous process improvement methodology, a 43% reduction in cost per case has been achieved with a significant increase in contribution margin for esophagectomy. The length of stay has been reduced from 14 days to 5. With intraoperative and postoperative standardization the leak rate has dropped from 12% to less than 3% to no leaks in our current Kaizen modification of care in our last 64 patients. Utilizing lean manufacturing techniques and continuous process evaluation we have attempted to eliminate variability, standardized the phases of care resulting in improved outcomes, decreased length of stay, and improved contribution margins. These Kaizen improvements require continuous interventions, strict adherence to care maps, and input from all levels for quality improvements. Copyright © 2011 The

  15. 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.

  16. Do motor control genes contribute to interindividual variability in decreased movement in patients with pain?

    Directory of Open Access Journals (Sweden)

    Mishra Bikash K

    2007-07-01

    Full Text Available Abstract Background Because excessive reduction in activities after back injury may impair recovery, it is important to understand and address the factors contributing to the variability in motor responses to pain. The current dominant theory is the "fear-avoidance model", in which the some patients' heightened fears of further injury cause them to avoid movement. We propose that in addition to psychological factors, neurochemical variants in the circuits controlling movement and their modification by pain may contribute to this variability. A systematic search of the motor research literature and genetic databases yielded a prioritized list of polymorphic motor control candidate genes. We demonstrate an analytic method that we applied to 14 of these genes in 290 patients with acute sciatica, whose reduction in movement was estimated by items from the Roland-Morris Disability Questionnaire. Results We genotyped a total of 121 single nucleotide polymorphisms (SNPs in 14 of these genes, which code for the dopamine D2 receptor, GTP cyclohydrolase I, glycine receptor α1 subunit, GABA-A receptor α2 subunit, GABA-A receptor β1 subunit, α-adrenergic 1C, 2A, and 2C receptors, serotonin 1A and 2A receptors, cannabinoid CB-1 receptor, M1 muscarinic receptor, and the tyrosine hydroxylase, and tachykinin precursor-1 molecules. No SNP showed a significant association with the movement score after a Bonferroni correction for the 14 genes tested. Haplotype analysis of one of the blocks in the GABA-A receptor β1 subunit showed that a haplotype of 11% frequency was associated with less limitation of movement at a nominal significance level value (p = 0.0025 almost strong enough to correct for testing 22 haplotype blocks. Conclusion If confirmed, the current results may suggest that a common haplotype in the GABA-A β1 subunit acts like an "endogenous muscle relaxant" in an individual with subacute sciatica. Similar methods might be applied a larger set of

  17. Air pollution control and decreasing new particle formation lead to strong climate warming

    Directory of Open Access Journals (Sweden)

    R. Makkonen

    2012-02-01

    Full Text Available The number concentration of cloud droplets determines several climatically relevant cloud properties. A major cause for the high uncertainty in the indirect aerosol forcing is the availability of cloud condensation nuclei (CCN, which in turn is highly sensitive to atmospheric new particle formation. Here we present the effect of new particle formation on anthropogenic aerosol forcing in present-day (year 2000 and future (year 2100 conditions. The present-day total aerosol forcing is increased from −1.0 W m−2 to −1.6 W m−2 when nucleation is introduced into the model. Nucleation doubles the change in aerosol forcing between years 2000 and 2100, from +0.6 W m−2 to +1.4 W m−2. Two climate feedbacks are studied, resulting in additional negative forcings of −0.1 W m−2 (+10% DMS emissions in year 2100 and −0.5 W m−2 (+50% BVOC emissions in year 2100. With the total aerosol forcing diminishing in response to air pollution control measures taking effect, warming from increased greenhouse gas concentrations can potentially increase at a very rapid rate.

  18. Air pollution control and decreasing new particle formation lead to strong climate warming

    Science.gov (United States)

    Makkonen, R.; Asmi, A.; Kerminen, V.-M.; Boy, M.; Arneth, A.; Hari, P.; Kulmala, M.

    2012-02-01

    The number concentration of cloud droplets determines several climatically relevant cloud properties. A major cause for the high uncertainty in the indirect aerosol forcing is the availability of cloud condensation nuclei (CCN), which in turn is highly sensitive to atmospheric new particle formation. Here we present the effect of new particle formation on anthropogenic aerosol forcing in present-day (year 2000) and future (year 2100) conditions. The present-day total aerosol forcing is increased from -1.0 W m-2 to -1.6 W m-2 when nucleation is introduced into the model. Nucleation doubles the change in aerosol forcing between years 2000 and 2100, from +0.6 W m-2 to +1.4 W m-2. Two climate feedbacks are studied, resulting in additional negative forcings of -0.1 W m-2 (+10% DMS emissions in year 2100) and -0.5 W m-2 (+50% BVOC emissions in year 2100). With the total aerosol forcing diminishing in response to air pollution control measures taking effect, warming from increased greenhouse gas concentrations can potentially increase at a very rapid rate.

  19. 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.

  20. Use of ventilator associated pneumonia bundle and statistical process control chart to decrease VAP rate in Syria.

    Science.gov (United States)

    Alsadat, Reem; Al-Bardan, Hussam; Mazloum, Mona N; Shamah, Asem A; Eltayeb, Mohamed F E; Marie, Ali; Dakkak, Abdulrahman; Naes, Ola; Esber, Faten; Betelmal, Ibrahim; Kherallah, Mazen

    2012-10-01

    Implementation of ventilator associated pneumonia (VAP) bundle as a performance improvement project in the critical care units for all mechanically ventilated patients aiming to decrease the VAP rates. VAP bundle was implemented in 4 teaching hospitals after educational sessions and compliance rates along with VAP rates were monitored using statistical process control charts. VAP bundle compliance rates were steadily increasing from 33 to 80% in hospital 1, from 33 to 86% in hospital 2 and from 83 to 100% in hospital 3 during the study period. The VAP bundle was not applied in hospital 4 therefore no data was available. A target level of 95% was reached only in hospital 3. This correlated with a decrease in VAP rates from 30 to 6.4 per 1000 ventilator days in hospital 1, from 12 to 4.9 per 1000 ventilator days in hospital 3, whereas VAP rate failed to decrease in hospital 2 (despite better compliance) and it remained high around 33 per 1000 ventilator days in hospital 4 where VAP bundle was not implemented. VAP bundle has performed differently in different hospitals in our study. Prevention of VAP requires a multidimensional strategy that includes strict infection control interventions, VAP bundle implementation, process and outcome surveillance and education.

  1. 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.

  2. RISK DECREASE PROBLEM WITH MAKING ERRORS IN ACTIVITY OF OPERATORS DEALING WITH AUTOMATIC CONTROL SYSTEMS OF GAS-DISTRIBUTION STATIONS

    Directory of Open Access Journals (Sweden)

    V. V. Egorov

    2011-01-01

    Full Text Available The paper contains an analysis of specific features pertaining to the activity of operators dealing with automatic control systems of gas-distribution stations. The professional operator’s activity is presented in the form of the developed data model. Possible conceptual approaches to the research are analyzed in the paper. The paper describes an author’s approach to studying a risk decrease problem in the activity of operators on the basis of the analytical research results. Technology for obtaining  research results is cited in the paper. 

  3. 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.

  4. 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.

  5. Density control of electrodeposited Ni nanoparticles/nanowires inside porous anodic alumina templates by an exponential anodization voltage decrease.

    Science.gov (United States)

    Marquardt, B; Eude, L; Gowtham, M; Cho, G; Jeong, H J; Châtelet, M; Cojocaru, C S; Kim, B S; Pribat, D

    2008-10-08

    Porous alumina templates have been fabricated by applying an exponential voltage decrease at the end of the anodization process. The time constant η of the exponential voltage function has been used to control the average thickness and the thickness distribution of the barrier layer at the bottom of the pores of the alumina structure. Depending on the η value, the thickness distribution of the barrier layer can be made very uniform or highly scattered, which allows us to subsequently fine tune the electrodeposition yield of nickel nanoparticles/nanowires at low voltage. As an illustration, the pore filling percentage with Ni has been varied, in a totally reproducible manner, between ∼3 and 100%. Combined with the ability to vary the pore diameter and repetition step over ∼2 orders of magnitude (by varying the anodization voltage and electrolyte type), the control of the pore filling percentage with metal particles/nanowires could bring novel approaches for the organization of nano-objects.

  6. Healthy dietary patterns decrease the risk of colorectal cancer in the Mecca Region, Saudi Arabia: a case-control study.

    Science.gov (United States)

    Azzeh, Firas S; Alshammari, Eyad M; Alazzeh, Awfa Y; Jazar, Abdelelah S; Dabbour, Ibrahim R; El-Taani, Hani A; Obeidat, Ahmed A; Kattan, Fayrooz A; Tashtoush, Sufyan H

    2017-06-29

    Colorectal cancer (CRC) is the first most common cancer in males and the third most common cancer in females in Saudi Arabia. Dietary habits are strongly associated with the inhibition or proliferation of malignancy. Therefore, this study is aiming to investigate the risks and protective benefits of dietary factors affecting CRC in the Mecca region of Saudi Arabia. A case-control study was conducted from June 2014 to March 2015. One hundred thirty-seven patients with colon and/or rectal cancer were recruited in the case group, while 164 healthy participants were recruited in the control group. A questionnaire was completed with the help of trained dietitians to study the effects of several dietary patterns on the risk of CRC. Dairy product intake of 1-5 servings/day, legume intake of 3-5 servings/week, leafy vegetables intake of 1-5 servings/week, olive oil intake of 1-5 servings/week, black tea intake of three or more cups/day, and coffee intake of one or more cups/day was found to decrease the risk of CRC in participants. This study highlights the importance of changing dietary habits to decrease CRC incidence in the Mecca region.

  7. Healthy dietary patterns decrease the risk of colorectal cancer in the Mecca Region, Saudi Arabia: a case-control study

    Directory of Open Access Journals (Sweden)

    Firas S. Azzeh

    2017-06-01

    Full Text Available Abstract Background Colorectal cancer (CRC is the first most common cancer in males and the third most common cancer in females in Saudi Arabia. Dietary habits are strongly associated with the inhibition or proliferation of malignancy. Therefore, this study is aiming to investigate the risks and protective benefits of dietary factors affecting CRC in the Mecca region of Saudi Arabia. Methods A case-control study was conducted from June 2014 to March 2015. One hundred thirty-seven patients with colon and/or rectal cancer were recruited in the case group, while 164 healthy participants were recruited in the control group. A questionnaire was completed with the help of trained dietitians to study the effects of several dietary patterns on the risk of CRC. Results Dairy product intake of 1–5 servings/day, legume intake of 3–5 servings/week, leafy vegetables intake of 1–5 servings/week, olive oil intake of 1–5 servings/week, black tea intake of three or more cups/day, and coffee intake of one or more cups/day was found to decrease the risk of CRC in participants. Conclusion This study highlights the importance of changing dietary habits to decrease CRC incidence in the Mecca region.

  8. 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

  9. 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

  10. Does des-acyl ghrelin improve glycemic control in obese diabetic subjects by decreasing acylated ghrelin levels?

    Science.gov (United States)

    Özcan, Behiye; Neggers, Sebastian J C M M; Miller, Anne Reifel; Yang, Hsiu-Chiung; Lucaites, Virginia; Abribat, Thierry; Allas, Soraya; Huisman, Martin; Visser, Jenny A; Themmen, Axel P N; Sijbrands, Eric J G; Delhanty, Patric J D; van der Lely, Aart Jan

    2014-06-01

    The objective of this study was to assess the effects of a continuous overnight infusion of des-acyl ghrelin (DAG) on acylated ghrelin (AG) levels and glucose and insulin responses to a standard breakfast meal (SBM) in eight overweight patients with type 2 diabetes. Furthermore, in the same patients and two additional subjects, the effects of DAG infusion on AG concentrations and insulin sensitivity during a hyperinsulinemic-euglycemic clamp (HEC) were assessed. A double-blind, placebo-controlled cross-over study design was implemented, using overnight continuous infusions of 3 and 10  μg DAG/kg per h and placebo to study the effects on a SBM. During a HEC, we studied the insulin sensitivity. We observed that, compared with placebo, overnight DAG administration significantly decreased postprandial glucose levels, both during continuous glucose monitoring and at peak serum glucose levels. The degree of improvement in glycemia was correlated with baseline plasma AG concentrations. Concurrently, DAG infusion significantly decreased fasting and postprandial AG levels. During the HEC, 2.5  h of DAG infusion markedly decreased AG levels, and the M-index, a measure of insulin sensitivity, was significantly improved in the six subjects in whom we were able to attain steady-state euglycemia. DAG administration was not accompanied by many side effects when compared with placebo. DAG administration improves glycemic control in obese subjects with type 2 diabetes through the suppression of AG levels. DAG is a good candidate for the development of compounds in the treatment of metabolic disorders or other conditions with a disturbed AG:DAG ratio, such as type 2 diabetes mellitus or Prader-Willi syndrome. © 2014 European Society of Endocrinology.

  11. Is controlling phosphorus by decreasing dietary protein intake beneficial or harmful in persons with chronic kidney disease?

    Science.gov (United States)

    Shinaberger, Christian S; Greenland, Sander; Kopple, Joel D; Van Wyck, David; Mehrotra, Rajnish; Kovesdy, Csaba P; Kalantar-Zadeh, Kamyar

    2008-12-01

    Dietary restrictions to control serum phosphorus, which are routinely recommended to persons with chronic kidney disease, are usually associated with a reduction in protein intake. This may lead to protein-energy wasting and poor survival. We aimed to ascertain whether a decline in serum phosphorus and a concomitant decline in protein intake are associated with an increase in the risk of death. In a 3-y study (7/2001-6/2004) of 30 075 prevalent maintenance hemodialysis (MHD) patients, we examined changes in serum phosphorus and in normalized protein nitrogen appearance (nPNA), a surrogate of dietary protein intake, during the first 6 mo and the subsequent mortality. Four groups of MHD patients were defined on the basis of the direction of the changes in serum phosphorus and nPNA. Baseline phosphorus had a J-shaped association with mortality, whereas higher baseline nPNA was linearly associated with greater survival. Compared with MHD patients whose serum phosphorus and nPNA both rose over 6 mo, those whose serum phosphorus decreased but whose nPNA increased had greater survival, with a case mix-adjusted death risk ratio of 0.90 (95% confidence limits: 0.86, 0.95; P protein intake may outweigh the benefit of controlled phosphorus and may lead to greater mortality. Additional studies including randomized controlled trials should examine whether nondietary control of phosphorus or restriction of nonprotein sources of phosphorus is safer and more effective.

  12. 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.

  13. 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.

  14. Reduced absorption of glyphosate and decreased translocation of dicamba contribute to poor control of kochia (Kochia scoparia) at high temperature.

    Science.gov (United States)

    Ou, Junjun; Stahlman, Phillip W; Jugulam, Mithila

    2018-05-01

    Plant growth temperature is one of the important factors that can influence postemergent herbicide efficacy and impact weed control. Control of kochia (Kochia scoparia), a major broadleaf weed throughout the North American Great Plains, often is unsatisfactory when either glyphosate or dicamba are applied on hot summer days. We tested effects of plant growth temperature on glyphosate and dicamba phytotoxicity on two Kansas kochia populations (P1 and P2) grown under the following three day/night (d/n) temperature regimes: T1, 17.5/7.5°C; T2, 25/15°C; and T3, 32.5/22.5°C. Visual injury and above-ground dry biomass data from herbicide dose-response experiments indicated greater susceptibility to both glyphosate and dicamba when kochia was grown under the two cooler temperature regimes, i.e. T1 and T2. At T1, the ED 50 of P1 and P2 kochia were 39 and 36 g ha -1 of glyphosate and 52 and 105 g ha -1 of dicamba, respectively. In comparison, at T3 the ED 50 increased to 173 and 186 g ha -1 for glyphosate and 106 and 410 g ha -1 for dicamba, respectively, for P1 and P2. We also investigated the physiological basis of decreased glyphosate and dicamba efficacy under elevated temperatures. Kochia absorbed more glyphosate at T1 and T2 compared to T3. Conversely, there was more dicamba translocated towards meristems at T1 and T2, compared to T3. Reduced efficacy of dicamba or glyphosate to control kochia under elevated temperatures can be attributed to decreased absorption and translocation of glyphosate and dicamba, respectively. Therefore, it is recommended to apply glyphosate or dicamba when the temperature is low (e.g. d/n temperature at 25/15°C) and seedlings are small (less than 12 cm) to maximize kochia control. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  15. Mozart K.448 listening decreased seizure recurrence and epileptiform discharges in children with first unprovoked seizures: a randomized controlled study.

    Science.gov (United States)

    Lin, Lung-Chang; Lee, Mei-Wen; Wei, Ruey-Chang; Mok, Hin-Kiu; Yang, Rei-Cheng

    2014-01-13

    Increasing numbers of reports show the beneficial effects of listening to Mozart music in decreasing epileptiform discharges as well as seizure frequency in epileptic children. There has been no effective method to reduce seizure recurrence after the first unprovoked seizure until now. In this study, we investigated the effect of listening to Mozart K.448 in reducing the seizure recurrence rate in children with first unprovoked seizures. Forty-eight children who experienced their first unprovoked seizure with epileptiform discharges were included in the study. They were randomly placed into treatment (n = 24) and control (n = 24) groups. Children in the treatment group listened to Mozart K.448 daily before bedtime for at least six months. Two patients in the treatment group were excluded from analysis due to discontinuation intervention. Finally, forty-six patients were analyzed. Most of these patients (89.1%) were idiopathic in etiology. Seizure recurrence rates and reduction of epileptiform discharges were compared. The average follow-up durations in the treatment and control groups were 18.6 ± 6.6 and 20.1 ± 5.1 months, respectively. The seizure recurrence rate was estimated to be significantly lower in the treatment group than the control group over 24 months (37.2% vs. 76.8%, p = 0.0109). Significant decreases in epileptiform discharges were also observed after 1, 2, and 6 months of listening to Mozart K.448 when compared with EEGs before listening to music. There were no significant differences in gender, mentality, seizure type, and etiology between the recurrence and non-recurrence groups. Although the case number was limited and control music was not performed in this study, the study revealed that listening to Mozart K.448 reduced the seizure recurrence rate and epileptiform discharges in children with first unprovoked seizures, especially of idiopathic etiology. We believe that Mozart K.448 could be a promising alternative treatment in patients with

  16. Feasibility of Pilates exercise to decrease falls risk: a pilot randomized controlled trial in community-dwelling older people.

    Science.gov (United States)

    Barker, Anna L; Talevski, Jason; Bohensky, Megan A; Brand, Caroline A; Cameron, Peter A; Morello, Renata T

    2016-10-01

    To evaluate the feasibility of Pilates exercise in older people to decrease falls risk and inform a larger trial. Pilot Randomized controlled trial. Community physiotherapy clinic. A total of 53 community-dwelling people aged ⩾60 years (mean age, 69.3 years; age range, 61-84). A 60-minute Pilates class incorporating best practice guidelines for exercise to prevent falls, performed twice weekly for 12 weeks. All participants received a letter to their general practitioner with falls risk information, fall and fracture prevention education and home exercises. Indicators of feasibility included: acceptability (recruitment, retention, intervention adherence and participant experience survey); safety (adverse events); and potential effectiveness (fall, fall injury and injurious fall rates; standing balance; lower limb strength; and flexibility) measured at 12 and 24 weeks. Recruitment was achievable but control group drop-outs were high (23%). Of the 20 participants who completed the intervention, 19 (95%) attended ⩾75% of the classes and reported classes were enjoyable and would recommend them to others. The rate of fall injuries at 24 weeks was 42% lower and injurious fall rates 64% lower in the Pilates group, however, was not statistically significant (P = 0.347 and P = 0.136). Standing balance, lower-limb strength and flexibility improved in the Pilates group relative to the control group (P fall injury rates. A definitive randomized controlled trial analysing the effect of Pilates in older people would be feasible and is warranted given the acceptability and potential positive effects of Pilates on fall injuries and fall risk factors. The protocol for this study is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN1262000224820). © The Author(s) 2015.

  17. 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.

  18. Decreased Fronto-Parietal and Increased Default Mode Network Activation is Associated with Subtle Cognitive Deficits in Elderly Controls

    Directory of Open Access Journals (Sweden)

    Davide Zanchi

    2017-12-01

    Full Text Available Background: Cognitive functions progressively deteriorate during aging and neurodegenerative diseases. The present study aims at investigating differences in working memory performance as well as functional brain changes during the earliest stages of cognitive decline in health elderly individuals. Methods: 62 elderly individuals (41 females, including 41 controls (35 females and 21 middle cognitive impairment subjects (6 females, underwent neuropsychological assessment at baseline and an fMRI examination in a N-back paradigm contrasting 2-back vs. 0-back condition. Upon a 18 months follow-up, we identified stable controls (sCON with preserved cognition and deteriorating controls (dCON with -1SD decrease of performances in at least two neuropsychological tests. Data analyses included accuracy and reaction time (RT for the 2-back condition and general linear model (GLM for the fMRI sequence. Results: At the behavioral level, sCON and dCON performed better than MCI in terms of accuracy and reaction time. At the brain level, functional differences in regions of the fronto-parietal network (FPN and of the Default Mode Network (DFM were observed. Significantly lower neural activations in the bilateral inferior and middle frontal gyri were found in MCI versus both dCON / sCON and for dCON versus sCON. Significantly increased activations in the anterior cingulate cortex and posterior cingulate cortex and bilateral insula were found in MCI versus both dCON / sCON and in dCON versus sCON. Conclusion: The present study suggests that brain functional changes in FPN and DMN anticipate differences in cognitive performance in healthy elderly individuals with subsequent subtle cognitive decline.

  19. Vitamin D Supplementation Decreases TGF-β1 Bioavailability in PCOS: A Randomized Placebo-Controlled Trial.

    Science.gov (United States)

    Irani, Mohamad; Seifer, David B; Grazi, Richard V; Julka, Nitasha; Bhatt, Devika; Kalgi, Bharati; Irani, Sara; Tal, Oded; Lambert-Messerlian, Geralyn; Tal, Reshef

    2015-11-01

    There is an abnormal increase in TGF-β1 bioavailability in women with polycystic ovary syndrome (PCOS), which might play a role in the pathophysiology of this syndrome. Vitamin D (VD) supplementation improves various clinical manifestations of PCOS and decreases TGF-β1 levels in several diseases including myelofibrosis. The objective of the study was to determine the effect of VD supplementation on TGF-β1 bioavailability in VD-deficient women with PCOS and assess whether changes in TGF-β1/soluble endoglin (sENG) levels correlate with an improvement in PCOS clinical manifestations. This was a prospective, randomized, placebo-controlled trial. The study was conducted at an academic-affiliated medical center. Sixty-eight VD-deficient women with PCOS who were not pregnant or taking any exogenous hormones were recruited between October 2013 and January 2015. Forty-five women received 50 000 IU of oral vitamin D3 and 23 women received oral placebo once weekly for 8 weeks. Serum TGF-β1, sENG, lipid profile, testosterone, dehydroepiandrosterone sulfate, and insulin resistance were measured. The clinical parameters were evaluated before and 2 months after treatment. The VD level significantly increased and normalized after VD supplementation (16.3 ± 0.9 [SEM] to 43.2 ± 2.4 ng/mL; P PCOS significantly decreases the bioavailability of TGF-β1, which correlates with an improvement in some abnormal clinical parameters associated with PCOS. This is a novel mechanism that could explain the beneficial effects of VD supplementation in women with PCOS. These findings may support new treatment modalities for PCOS, such as the development of anti-TGF-β drugs.

  20. Photosynthesis Decrease and Stomatal Control of Gas Exchange in Abies alba Mill. in Response to Vapor Pressure Difference.

    Science.gov (United States)

    Guehl, J M; Aussenac, G

    1987-02-01

    The responses of steady state CO(2) assimilation rate (A), transpiration rate (E), and stomatal conductance (g(s)) to changes in leaf-to-air vapor pressure difference (DeltaW) were examined on different dates in shoots from Abies alba trees growing outside. In Ecouves, a provenance representative of wet oceanic conditions in Northern France, both A and g(s) decreased when DeltaW was increased from 4.6 to 14.5 Pa KPa(-1). In Nebias, which represented the dry end of the natural range of A. alba in southern France, A and g(s) decreased only after reaching peak levels at 9.0 and 7.0 Pa KPa(-1), respectively. The representation of the data in assimilation rate (A) versus intercellular CO(2) partial pressure (C(i)) graphs allowed us to determine how stomata and mesophyll photosynthesis interacted when DeltaW was increased. Changes in A were primarily due to alterations in mesophyll photosynthesis. At high DeltaW, and especially in Ecouves when soil water deficit prevailed, A declined, while C(i) remained approximately constant, which may be interpreted as an adjustment of g(s) to changes in mesophyll photosynthesis. Such a stomatal control of gas exchange appeared as an alternative to the classical feedforward interpretation of E versus DeltaW responses with a peak rate of E. The gas exchange response to DeltaW was also characterized by considerable deviations from the optimization theory of IR Cowan and GD Farquhar (1977 Symp Soc Exp Biol 31: 471-505).

  1. 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.

  2. 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%....

  3. Addiction: Decreased reward sensitivity and increased expectation sensitivity conspire to overwhelm the brain’s control circuit

    Energy Technology Data Exchange (ETDEWEB)

    Volkow, N.D.; Wang, G.; Volkow, N.D.; Wang, G.-J.; Fowler, J.S.; Tomasi, D.; Telang, F.; Baler, R.

    2010-07-01

    Based on brain imaging findings, we present a model according to which addiction emerges as an imbalance in the information processing and integration among various brain circuits and functions. The dysfunctions reflect (a) decreased sensitivity of reward circuits, (b) enhanced sensitivity of memory circuits to conditioned expectations to drugs and drug cues, stress reactivity, and (c) negative mood, and a weakened control circuit. Although initial experimentation with a drug of abuse is largely a voluntary behavior, continued drug use can eventually impair neuronal circuits in the brain that are involved in free will, turning drug use into an automatic compulsive behavior. The ability of addictive drugs to co-opt neurotransmitter signals between neurons (including dopamine, glutamate, and GABA) modifies the function of different neuronal circuits, which begin to falter at different stages of an addiction trajectory. Upon exposure to the drug, drug cues or stress this results in unrestrained hyperactivation of the motivation/drive circuit that results in the compulsive drug intake that characterizes addiction.

  4. Appetite - decreased

    Science.gov (United States)

    Loss of appetite; Decreased appetite; Anorexia ... Any illness can reduce appetite. If the illness is treatable, the appetite should return when the condition is cured. Loss of appetite can cause weight ...

  5. A hand hygiene intervention to decrease infections among children attending day care centers: design of a cluster randomized controlled trial.

    Science.gov (United States)

    Zomer, Tizza P; Erasmus, Vicki; Vlaar, Nico; van Beeck, Ed F; Tjon-A-Tsien, Aimée; Richardus, Jan Hendrik; Voeten, Hélène A C M

    2013-06-03

    Day care center attendance has been recognized as a risk factor for acquiring gastrointestinal and respiratory infections, which can be prevented with adequate hand hygiene (HH). Based on previous studies on environmental and sociocognitive determinants of caregivers' compliance with HH guidelines in day care centers (DCCs), an intervention has been developed aiming to improve caregivers' and children's HH compliance and decrease infections among children attending DCCs. The aim of this paper is to describe the design of a cluster randomized controlled trial to evaluate the effectiveness of this intervention. The intervention will be evaluated in a two-arm cluster randomized controlled trial among 71 DCCs in the Netherlands. In total, 36 DCCs will receive the intervention consisting of four components: 1) HH products (dispensers and refills for paper towels, soap, alcohol-based hand sanitizer, and hand cream); 2) training to educate about the Dutch national HH guidelines; 3) two team training sessions aimed at goal setting and formulating specific HH improvement activities; and 4) reminders and cues to action (posters/stickers). Intervention DCCs will be compared to 35 control DCCs continuing usual practice. The primary outcome measure will be observed HH compliance of caregivers and children, measured at baseline and one, three, and six months after start of the intervention. The secondary outcome measure will be the incidence of gastrointestinal and respiratory infections in 600 children attending DCCs, monitored over six months by parents using a calendar to mark the days their child has diarrhea and/or a cold. Multilevel logistic regression will be performed to assess the effect of the intervention on HH compliance. Multilevel poisson regression will be performed to assess the incidence of gastrointestinal and respiratory infections in children attending DCCs. This is one of the first DCC intervention studies to assess HH compliance of both caregivers and

  6. Impact of α-amylase during breadmaking on in vitro kinetics of starch hydrolysis and glycaemic index of enriched bread with bran.

    Science.gov (United States)

    Sanz-Penella, Juan Mario; Laparra, José Moisés; Haros, Monika

    2014-09-01

    Nowadays, the use of enzymes has become a common practice in the bakery industry, as they can improve dough quality and texture of final product. However, the use of α-amylases could have a negative effect in the glycaemic load of product, due to the released sugars from the starch hydrolysis that are not used by yeasts during the fermentation process. This study evaluated the effect of the addition of α-amylase in bakery products with bran on in vitro kinetics of starch hydrolysis. The use of flour with a high degree of extraction or high bran amount could decrease the GI even with the inclusion of α-amylase in the formulation. It should be taken into account the amount of bran and α-amylase when formulating breads in order to obtain products with lower GI than white bread. However, the fact that kinetics of starch hydrolysis remained unaltered indicates that the use of α-amylase in bread-making processes could provide technological advantages improving quality of breads without markedly changes in their glycaemic index.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. Epidural Neostigmine versus Fentanyl to Decrease Bupivacaine Use in Patient-controlled Epidural Analgesia during Labor: A Randomized, Double-blind, Controlled Study.

    Science.gov (United States)

    Booth, Jessica L; Ross, Vernon H; Nelson, Kenneth E; Harris, Lynnette; Eisenach, James C; Pan, Peter H

    2017-07-01

    The addition of opioids to epidural local anesthetic reduces local anesthetic consumption by 20% but at the expense of side effects and time spent for regulatory compliance paperwork. Epidural neostigmine also reduces local anesthetic use. The authors hypothesized that epidural bupivacaine with neostigmine would decrease total hourly bupivacaine use compared with epidural bupivacaine with fentanyl for patient-controlled epidural analgesia. A total of 215 American Society of Anesthesiologists physical status II, laboring parturients requesting labor epidural analgesia consented to the study and were randomized to receive 0.125% bupivacaine with the addition of either fentanyl (2 μg/ml) or neostigmine (2, 4, or 8 μg/ml). The primary outcome was total hourly local anesthetic consumption, defined as total patient-controlled epidural analgesia use and top-ups (expressed as milliliters of 0.125% bupivacaine) divided by the infusion duration. A priori analysis determined a group size of 35 was needed to have 80% power at α = 0.05 to detect a 20% difference in the primary outcome. Of 215 subjects consented, 151 patients were evaluable. Demographics, maternal and fetal outcomes, and labor characteristics were similar among groups. Total hourly local anesthetic consumption did not differ among groups (P = 0.55). The total median hourly bupivacaine consumption in the fentanyl group was 16.0 ml/h compared with 15.3, 14.6, and 16.2 ml/h in the 2, 4, and 8 μg/ml neostigmine groups, respectively (P = 0.55). The data do not support any difference in bupivacaine requirements for labor patient-controlled epidural analgesia whether patients receive epidural bupivacaine with 2 to 8 μg/ml neostigmine or epidural bupivacaine with 2 μg/ml fentanyl.

  12. A bilberry drink with fermented oatmeal decreases postprandial insulin demand in young healthy adults

    Directory of Open Access Journals (Sweden)

    Björck Inger ME

    2011-05-01

    Full Text Available Abstract Background in traditional medicine, blueberries have been used to facilitate blood glucose regulation in type 2 diabetes. Recent studies in diabetic mice have indicated facilitated glycaemic regulation following dietary supplementation with extracts from European blueberries, also called bilberries, (Vaccinium myrtillus. The purpose of the present study was to investigate the impact of fermented oat meal drinks containing bilberries or rosehip (Rosa canina on glycaemic and insulinaemic responses. Methods glycaemic and insulinaemic responses in young healthy adults were measured in two series. In series 1, two drinks based on oat meal (5%, fermented using Lactobacillus plantarum 299v, and added with fruit (10%; bilberries (BFOMD or rose hip (RFOMD respectively, were studied. In series 2, BFOMD was repeated, additionally, a drink enriched with bilberries (47% was tested (BBFOMD. As control a fermented oat meal drink (FOMD was served. Results in series 1 the bilberry- and rosehip drinks, gave high glucose responses similar to that after the reference bread. However, the insulin index (II after the BFOMD was significantly lower (II = 65 (P Conclusion a fermented oat meal drink added with bilberries induced a lower insulin response than expected from the glycaemic response. The mechanism for the lowered acute insulin demand is still unclear, but may be related to some bio-active component present in the bilberries, or to the fermented oat meal base.

  13. Decreasing the damage in smart structures using integrated online DDA/ISMP and semi-active control

    International Nuclear Information System (INIS)

    Karami, K; Amini, F

    2012-01-01

    Integrated structural health monitoring (SHM) and vibration control has been considered recently by researchers. Up to now, all of the research in the field of integrated SHM and vibration control has been conducted using control devices and control algorithms to enhance system identification and damage detection. In this study, online SHM is used to improve the performance of structural vibration control, unlike previous research. Also, a proposed algorithm including integrated online SHM and a semi-active control strategy is used to reduce both damage and seismic response of the main structure due to strong seismic disturbance. In the proposed algorithm the nonlinear behavior of the building structure is simulated during the excitation. Then, using the measured data and the damage detection algorithm based on identified system Markov parameters (DDA/ISMP), a method proposed by the authors, damage corresponding to axial and bending stiffness of all structural elements is identified. In this study, a 20 t MR damper is employed as a control device to mitigate both damage and dynamic response of the building structure. Also, the interaction between SHM and a semi-active control strategy is assessed. To illustrate the efficiency of the proposed algorithm, a two bay two story steel braced frame structure is used. By defining the damage index and damage rate index, the input current of the MR damper is generated using a fuzzy logic controller. The obtained results show that the possibility of smart building creation is provided using the proposed algorithm. In comparison to the widely used strategy of only vibration control, it is shown that the proposed algorithm is more effective. Furthermore, in the proposed algorithm, the total consumed current intensity and generated control forces are considerably less than for the strategy of only vibration control. (paper)

  14. Decreasing the damage in smart structures using integrated online DDA/ISMP and semi-active control

    Science.gov (United States)

    Karami, K.; Amini, F.

    2012-10-01

    Integrated structural health monitoring (SHM) and vibration control has been considered recently by researchers. Up to now, all of the research in the field of integrated SHM and vibration control has been conducted using control devices and control algorithms to enhance system identification and damage detection. In this study, online SHM is used to improve the performance of structural vibration control, unlike previous research. Also, a proposed algorithm including integrated online SHM and a semi-active control strategy is used to reduce both damage and seismic response of the main structure due to strong seismic disturbance. In the proposed algorithm the nonlinear behavior of the building structure is simulated during the excitation. Then, using the measured data and the damage detection algorithm based on identified system Markov parameters (DDA/ISMP), a method proposed by the authors, damage corresponding to axial and bending stiffness of all structural elements is identified. In this study, a 20 t MR damper is employed as a control device to mitigate both damage and dynamic response of the building structure. Also, the interaction between SHM and a semi-active control strategy is assessed. To illustrate the efficiency of the proposed algorithm, a two bay two story steel braced frame structure is used. By defining the damage index and damage rate index, the input current of the MR damper is generated using a fuzzy logic controller. The obtained results show that the possibility of smart building creation is provided using the proposed algorithm. In comparison to the widely used strategy of only vibration control, it is shown that the proposed algorithm is more effective. Furthermore, in the proposed algorithm, the total consumed current intensity and generated control forces are considerably less than for the strategy of only vibration control.

  15. How Performance-Contingent Reward Prospect Modulates Cognitive Control: Increased Cue Maintenance at the Cost of Decreased Flexibility

    Science.gov (United States)

    Hefer, Carmen; Dreisbach, Gesine

    2017-01-01

    Growing evidence suggests that reward prospect promotes cognitive stability in terms of increased context or cue maintenance. In 3 Experiments, using different versions of the AX-continuous performance task, we investigated whether this reward effect comes at the cost of decreased cognitive flexibility. Experiment 1 shows that the reward induced…

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. Believe you can and you will : The belief in high self-control decreases interest in attractive alternatives

    NARCIS (Netherlands)

    Hamburg, M.E.; Pronk, T.M.

    2015-01-01

    In the present research, we examined the effects of self-control beliefs on relationship protective behavior. We hypothesized that providing participants with feedback on their level of self-control would help them shield their relationship from attractive alternatives. Study 1 showed that

  3. Believe you can and you will: The belief in high self-control decreases interest in attractive alternatives

    NARCIS (Netherlands)

    Hamburg, M.E.; Pronk, T.M.

    2014-01-01

    In the present research, we examined the effects of self-control beliefs on relationship protective behavior. We hypothesized that providing participants with feedback on their level of self-control would help them shield their relationship from attractive alternatives. Study 1 showed that

  4. Trait Self-esteem Moderates Decreases in Self-control Following Rejection: An Information-processing Account

    Science.gov (United States)

    Vandellen, Michelle; Knowles, Megan L.; Krusemark, Elizabeth; Sabet, Raha F.; Campbell, W. Keith; McDowell, Jennifer E.; Clementz, Brett A.

    2012-01-01

    In the current paper, the authors posit that trait self-esteem moderates the relationship between social rejection and decrements in self-control, propose an information-processing account of trait self-esteem’s moderating influence and discuss three tests of this theory. The authors measured trait self-esteem, experimentally manipulated social rejection and assessed subsequent self-control in Studies 1 and 2. Additionally, Study 3 framed a self-control task as diagnostic of social skills to examine motivational influences. Together, the results reveal that rejection impairs self-control, but only among low self-esteem individuals. Moreover, this decrement in self-control only emerged when the task had no social implications—suggesting that low self-esteem individuals exert effort on tasks of social value and are otherwise preoccupied with belonging needs when completing nonsocial tasks. PMID:22611304

  5. Trait Self-esteem Moderates Decreases in Self-control Following Rejection: An Information-processing Account.

    Science.gov (United States)

    Vandellen, Michelle; Knowles, Megan L; Krusemark, Elizabeth; Sabet, Raha F; Campbell, W Keith; McDowell, Jennifer E; Clementz, Brett A

    2012-03-01

    In the current paper, the authors posit that trait self-esteem moderates the relationship between social rejection and decrements in self-control, propose an information-processing account of trait self-esteem's moderating influence and discuss three tests of this theory. The authors measured trait self-esteem, experimentally manipulated social rejection and assessed subsequent self-control in Studies 1 and 2. Additionally, Study 3 framed a self-control task as diagnostic of social skills to examine motivational influences. Together, the results reveal that rejection impairs self-control, but only among low self-esteem individuals. Moreover, this decrement in self-control only emerged when the task had no social implications-suggesting that low self-esteem individuals exert effort on tasks of social value and are otherwise preoccupied with belonging needs when completing nonsocial tasks.

  6. 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 ...

  7. Application of false discovery rate control in the assessment of decrease of FDG uptake in early Alzheimer dementia

    International Nuclear Information System (INIS)

    Lee, Dong Soo; Kang, Hye Jin; Jang, Myung Jin; Kang, Won Jun; Lee, Jae Sung; Kang, Eun Joo; Lee, Kang Uk; Woo, Jong In; Lee, Myung Chul; Cho, Sang Soo

    2003-01-01

    Determining an appropriate thresholding is crucial for PDG PET analysis since strong control of Type I error could fail to find pathological differences between early Alzheimer' disease (AD) patients and healthy normal controls. We compared the SPM results on FDG PET imaging of early AD using uncorrected p-value, random-field based corrected p-value and false discovery rate (FDR) control. Twenty-eight patients (66±7 years old) with early AD and 18 age-matched normal controls (68±6 years old) underwent FDG brain PET. To identify brain regions with hypo-metabolism in group or individual patient compared to normal controls, group images or each patient's image was compared with normal controls using the same fixed p-value of 0.001 on uncorrected thresholding, random-field based corrected thresholding and FDR control. The number of hypo-metabolic voxels was smallest in corrected p-value method, largest in uncorrected p-value method and intermediate in FDG thresholding in group analysis. Three types of result pattern were found. The first was that corrected p-value did yield any voxel positive but FDR gave a few significantly hypometabolic voxels (8/28, 29%). The second was that both corrected p-value and FDR did not yield any positive region but numerous positive voxels were found with the threshold of uncorrected p-values (6/28, 21%). The last was that FDR was detected as many positive voxels as uncorrected p-value method (14/28, 50%). Conclusions FDR control could identify hypo-metabolic areas in group or individual patients with early AD. We recommend FDR control instead of uncorrected or random-field corrected thresholding method to find the areas showing hypometabolism especially in small group or individual analysis of FDG PET

  8. Aprotinin decreases the incidence of cognitive deficit following CABG and cardiopulmonary bypass: a pilot randomized controlled study.

    LENUS (Irish Health Repository)

    Harmon, Dominic C

    2012-02-03

    PURPOSE: Cognitive deficit after coronary artery bypass surgery (CABG) has a high prevalence and is persistent. Meta-analysis of clinical trials demonstrates a decreased incidence of stroke after CABG when aprotinin is administrated perioperatively. We hypothesized that aprotinin administration would decrease the incidence of cognitive deficit after CABG. METHODS: Thirty-six ASA III-IV patients undergoing elective CABG were included in a prospective, randomized, single-blinded pilot study. Eighteen patients received aprotinin 2 x 10(6) KIU (loading dose), 2 x 10(6) KIU (added to circuit prime) and a continuous infusion of 5 x 10(5) KIU.hr(-1). A battery of cognitive tests was administered to patients and spouses (n = 18) the day before surgery, four days and six weeks postoperatively. RESULTS: Four days postoperatively new cognitive deficit (defined by a change in one or more cognitive domains using the Reliable Change Index method) was present in ten (58%) patients in the aprotinin group compared to 17 (94%) in the placebo group [95% confidence interval (CI) 0.10-0.62, P = 0.005); (P = 0.01)]. Six weeks postoperatively, four (23%) patients in the aprotinin group had cognitive deficit compared to ten (55%) in the placebo group (95% CI 0.80-0.16, P = 0.005); (P = 0.05). CONCLUSION: In this prospective pilot study, the incidence of cognitive deficit after CABG and cardiopulmonary bypass is decreased by the administration of high-dose aprotinin.

  9. NWTC Researchers Field-Test Advanced Control Turbine Systems to Increase Performance, Decrease Structural Loading of Wind Turbines and Plants

    Energy Technology Data Exchange (ETDEWEB)

    2015-08-01

    Researchers at the National Renewable Energy Laboratory's (NREL's) National Wind Technology Center (NWTC) are studying component controls, including new advanced actuators and sensors, for both conventional turbines as well as wind plants. This research will help develop innovative control strategies that reduce aerodynamic structural loads and improve performance. Structural loads can cause damage that increase maintenance costs and shorten the life of a turbine or wind plant.

  10. Association of pioglitazone treatment with decreased bone mineral density in obese premenopausal patients with polycystic ovary syndrome: a randomized, placebo-controlled trial

    DEFF Research Database (Denmark)

    Glintborg, D.; Andersen, Mikael; Hagen, C.

    2008-01-01

    OBJECTIVE: Our objective was to investigate the effect of pioglitazone on bone mineral density (BMD) and bone turnover markers in polycystic ovary syndrome (PCOS). DESIGN AND SETTING: We conducted a randomized, placebo-controlled study at an outpatient clinic at a university hospital. PATIENTS......, sex hormones, and body composition. CONCLUSION: Pioglitazone treatment was followed by decreased lumbar and hip BMD and decreased measures of bone turnover in a premenopausal study population relatively protected from bone mineral loss Udgivelsesdato: 2008/5...

  11. 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.

  12. It is out of my hands: how deferring control to God can decrease quality of life for breast cancer patients.

    Science.gov (United States)

    McLaughlin, Bryan; Yoo, Woohyun; D'Angelo, Jonathan; Tsang, Stephanie; Shaw, Bret; Shah, Dhavan; Baker, Timothy; Gustafson, David

    2013-12-01

    This paper seeks to contribute to the understanding of how and why religion affects psychosocial health outcomes. We propose a theoretical model predicting that when women with breast cancer defer control to God they will experience fewer breast cancer related concerns. Deferring control to God, however, should also reduce the likelihood that they take a proactive coping approach, which will be exacerbated by lowered breast cancer concerns. We therefore predict that this passive coping style will ultimately result in lower levels of quality of life. Data were collected as part of a randomized clinical trial funded by the National Cancer Institute. A total of 192 women with breast cancer participated in a computer-mediated social support group. Deferring control to God statements were captured by using computer-aided content analysis of discussion posts. Psychosocial outcomes were measured using longitudinal survey data. Analysis was performed using structural equation modeling. The results of our analysis largely confirm our mediation model for which we find significant model fit. As predicted, deferring control to God leads to lower levels of breast cancer concerns but also to more passive coping styles. Ultimately, deferring control to God can lead to lower levels of quality of life. Our study demonstrates how and why religious coping can lead to both positive and negative psychosocial health outcomes. Health care practitioners should encourage patients who are relying on religion to keep their end of the bargain and maintain an active coping style. Copyright © 2013 John Wiley & Sons, Ltd.

  13. Participation in a 10-week course of yoga improves behavioural control and decreases psychological distress in a prison population

    NARCIS (Netherlands)

    Bilderbeck, A.C.; Farias, M.; Brazil, I.A.; Jakobowitz, S.; Wikholm, C.

    2013-01-01

    Background Yoga and meditation have been shown to be effective in alleviating symptoms of depression and anxiety in healthy volunteers and psychiatric populations. Recent work has also indicated that yoga can improve cognitive-behavioural performance and control. Although there have been no

  14. Fatty acid desaturase 1 knockout mice are lean with improved glycemic control and decreased development of atheromatous plaque

    Science.gov (United States)

    Powell, David R; Gay, Jason P; Smith, Melinda; Wilganowski, Nathaniel; Harris, Angela; Holland, Autumn; Reyes, Maricela; Kirkham, Laura; Kirkpatrick, Laura L; Zambrowicz, Brian; Hansen, Gwenn; Platt, Kenneth A; van Sligtenhorst, Isaac; Ding, Zhi-Ming; Desai, Urvi

    2016-01-01

    Delta-5 desaturase (D5D) and delta-6 desaturase (D6D), encoded by fatty acid desaturase 1 (FADS1) and FADS2 genes, respectively, are enzymes in the synthetic pathways for ω3, ω6, and ω9 polyunsaturated fatty acids (PUFAs). Although PUFAs appear to be involved in mammalian metabolic pathways, the physiologic effect of isolated D5D deficiency on these pathways is unclear. After generating >4,650 knockouts (KOs) of independent mouse genes and analyzing them in our high-throughput phenotypic screen, we found that Fads1 KO mice were among the leanest of 3,651 chow-fed KO lines analyzed for body composition and were among the most glucose tolerant of 2,489 high-fat-diet-fed KO lines analyzed by oral glucose tolerance test. In confirmatory studies, chow- or high-fat-diet-fed Fads1 KO mice were leaner than wild-type (WT) littermates; when data from multiple cohorts of adult mice were combined, body fat was 38% and 31% lower in Fads1 male and female KO mice, respectively. Fads1 KO mice also had lower glucose and insulin excursions during oral glucose tolerance tests along with lower fasting glucose, insulin, triglyceride, and total cholesterol levels. In additional studies using a vascular injury model, Fads1 KO mice had significantly decreased femoral artery intima/media ratios consistent with a decreased inflammatory response in their arterial wall. Based on this result, we bred Fads1 KO and WT mice onto an ApoE KO background and fed them a Western diet for 14 weeks; in this atherogenic environment, aortic trees of Fads1 KO mice had 40% less atheromatous plaque compared to WT littermates. Importantly, PUFA levels measured in brain and liver phospholipid fractions of Fads1 KO mice were consistent with decreased D5D activity and normal D6D activity. The beneficial metabolic phenotype demonstrated in Fads1 KO mice suggests that selective D5D inhibitors may be useful in the treatment of human obesity, diabetes, and atherosclerotic cardiovascular disease. PMID:27382320

  15. Glycaemic Adverse Drug Reactions from Anti-Neoplastics Used in ...

    African Journals Online (AJOL)

    2017-06-01

    Jun 1, 2017 ... Diabetes mellitus (DM) or hyperglycemia is common in pancreatic ... Fasting hyperglycemia is a dose‑dependent risk factor for .... is primary therapy for solitary pancreatic endocrine tumors. ... well‑known risk factor associated with decreased OS for ... induce peripheral insulin resistance, and thereby,.

  16. 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.

  17. Decreased local control following radiation therapy alone in early-stage glottic carcinoma with anterior commissure extension

    International Nuclear Information System (INIS)

    Zouhair, A.; Azria, D.; Coucke, P.; Matzinger, O.; Mirimanoff, R.O.; Ozsahin, M.; Bron, L.; Moeckli, R.; Do, H.P.

    2004-01-01

    Purpose: to assess the patterns of failure in the treatment of early-stage squamous cell carcinoma of the glottic larynx. Patients and methods: between 1983-2000, 122 consecutive patients treated for early laryngeal cancer (UICC T1N0 and T2N0) by radical radiation therapy (RT) were retrospectively studied. Male-to-female ratio was 106: 16, and median age 62 years (35-92 years). There were 68 patients with T1a, 18 with T1b, and 36 with T2 tumors. Diagnosis was made by biopsy in 104 patients, and by laser vaporization or stripping in 18. Treatment planning consisted of three-dimensional (3-D) conformal RT in 49 (40%) patients including nine patients irradiated using arytenoid protection. A median dose of 70 Gy (60-74 Gy) was given (2 Gy/fraction) over a median period of 46 days (21-79 days). Median follow-up period was 85 months. Results: the 5-year overall, cancer-specific, and disease-free survival amounted to 80%, 94%, and 70%, respectively. 5-year local control was 83%. Median time to local recurrence in 19 patients was 13 months (5-58 months). Salvage treatment consisted of surgery in 17 patients (one patient refused salvage and one was inoperable; total laryngectomy in eleven, and partial laryngectomy or cordectomy in six patients). Six patients died because of laryngeal cancer. Univariate analyses revealed that prognostic factors negatively influencing local control were anterior commissure extension, arytenoid protection, and total RT dose < 66 Gy. Among the factors analyzed, multivariate analysis (cox model) demonstrated that anterior commissure extension, arytenoid protection, and male gender were the worst independent prognostic factors in terms of local control. Conclusion: for early-stage laryngeal cancer, outcome after RT is excellent. In case of anterior commissure extension, surgery or higher RT doses are warranted. Because of a high relapse risk, arytenoid protection should not be attempted. (orig.)

  18. Listening to music during cystoscopy decreases anxiety, pain, and dissatisfaction in patients: a pilot randomized controlled trial.

    Science.gov (United States)

    Yeo, Jeong Kyun; Cho, Dae Yeon; Oh, Mi Mi; Park, Seok San; Park, Min Gu

    2013-04-01

    To determine whether listening to music during cystoscopy decreases anxiety, pain, and dissatisfaction among patients and results in a more comfortable and better-tolerated procedure. Seventy male patients who underwent rigid cystoscopy between May 2011 and December 2011 were randomized into the following: no music (Group I, n=35) or classical music during procedure (Group II, n=35). Before cystoscopy, lidocaine gel was instilled in the urethra, and both groups viewed their procedures on a video monitor. Anxiety levels were quantified according to the State-Trait Anxiety Inventory. A visual analog scale (0-10) was used for a self-assessment of satisfaction, discomfort, and willingness among patients to repeat the cystoscopy. Demographic characteristics, mean age, procedure duration, and procedure indications were statistically similar between the two groups. The mean anxiety level and mean pain score of Group II were significantly lower than those of Group I (pmusic during rigid cystoscopy significantly reduces feelings of pain, discomfort, and dissatisfaction. Music can serve as a simple, inexpensive, and effective adjunct to sedation during cystoscopy. We recommend the application of music during rigid cystoscopy for clinical use.

  19. Glycaemic changes in patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Guillermo De’Marziani

    2016-03-01

    OGTT is suggested for all CKD patients since it is able to detect the full range of unknown dysglycaemias, which avoids underdiagnoses and favours performing treatments to prevent progression in DM risk groups (IFG and/or IGT. It also aids in the selection of the most appropriate medication for transplantation or treatment initiation in new cases of undiagnosed DM to decrease morbidity and mortality.

  20. Higher energy intake at dinner decreases parasympathetic activity during nighttime sleep in menstruating women: A randomized controlled trial.

    Science.gov (United States)

    Tada, Yuki; Yoshizaki, Takahiro; Tanaka, Izumi; Kanehara, Rieko; Kato, Misao; Hatta, Naoko; Hida, Azumi; Kawano, Yukari

    2018-06-09

    Previous studies have found more frequent increases in dietary intake and nonrestorative nocturnal sleep during the luteal phase than in the follicular phase, but few studies have investigated how increased energy intake at dinner influences sleep by considering the correlation between female hormone and cardiac autonomic nervous system (ANS) activity. This study examined the effects of energy intake at dinner on ANS activity during nighttime sleep in order to evaluate restorative sleep in healthy women. We also examined whether ANS activity is associated with female hormone dynamics. Twenty-four healthy collegiate women participated in this randomized crossover trial. Each was assigned to receive a High Energy Dinner (HED) or Low Energy Dinner (LED) treatment. Energy ratios of each test meal (breakfast, lunch, and dinner) to total energy intake were 1:1:2 and 1:2:1 for HED and LED treatments, respectively. Each participant wore an ECG recorder before dinner and removed it upon waking the next morning. Power spectral analysis of heart rate variability was used to calculate low frequency (LF), high frequency (HF), and total spectral power (TP). Cardiac sympathetic (SNS) and parasympathetic (PNS) nervous system activity were evaluated as LF/HF and HF/TP, respectively. Mean HF/TP for the entire sleeping period was lower with HED treatment compared to LED treatment (41.7 ± 11.4 vs. 45.0 ± 12.13, P = .034). Intergroup comparisons of the initial 3-h sleeping period revealed that LF/HF (0.87 ± 0.82 vs. 0.66 ± 0.82, P = .013) and HF/TP (45.6 ± 13.9 vs. 51.5 ± 11.8, P = .002) were higher and lower, respectively, with HED treatment compared to LED treatment. Progesterone levels were positively correlated with LF/HF with LED treatment, and negatively correlated with HF/TP with both HED and LED treatments. Higher energy intake at dinner increases and decreases SNS and PNS activities, respectively, resulting in nonrestorative nocturnal

  1. An Intervention with Mineral Water Decreases Cardiometabolic Risk Biomarkers. A Crossover, Randomised, Controlled Trial with Two Mineral Waters in Moderately Hypercholesterolaemic Adults

    Directory of Open Access Journals (Sweden)

    Laura Toxqui

    2016-06-01

    Full Text Available Water intake is essential for health maintenance and disease prevention. The effects of an intervention with two mineral waters, sodium-bicarbonated mineral water (BW or control mineral water low in mineral content (CW, on cardiometabolic risk biomarkers were studied. In a randomised-controlled crossover-trial, sixty-four moderately hypercholesterolaemic adults were randomly assigned to consume 1 L/day of either BW (sodium, 1 g/L; bicarbonate, 2 g/L or CW with the main meals for eight weeks, separated by an eight-week washout period. Blood lipids, lipid oxidation, glucose, insulin, aldosterone, urine pH, urinary electrolytes, blood pressure, body weight, fluid intake, energy, and nutrients from total diet and beverages were determined. Total cholesterol, LDL cholesterol, and glucose decreased (p < 0.01, oxidised LDL tended to decrease (p = 0.073, and apolipoprotein B increased during the intervention, without water type effect. Energy and carbohydrates from beverages decreased since soft drinks and fruit juice consumptions decreased throughout the trial. BW increased urinary pH (p = 0.006 and reduced calcium/creatinine excretion (p = 0.011. Urinary potassium/creatinine decreased with both waters. Consumption of 1 L/day of mineral water with the main meals reduces cardiometabolic risk biomarkers, likely to be attributed to a replacement of soft drinks by water. In addition, BW does not affect blood pressure and exerts a moderate alkalizing effect in the body.

  2. 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.

  3. Utilisation of preharvest dropped apple peels as a flour substitute for a lower glycaemic index and higher fibre cake.

    Science.gov (United States)

    Jun, Yujin; Bae, In Young; Lee, Suyong; Lee, Hyeon Gyu

    2014-02-01

    Fibre-enriched materials (FEMs) obtained from preharvest dropped apple peels were utilised as a source of dietary fibre in baked cakes and their effects on the textural/nutritional qualities and starch digestibility (glucose release behaviour, starch digestion fraction, predicted glycaemic index) of the cakes were evaluated. When FEMs were incorporated into the cake formulation (3 g and 6 g of dietary fibre per serving (100 g)), the volume of the cakes seemed to be reduced and their texture become harder. However, 3 g of FEMs did not degrade the cake qualities. The use of FEMs in cakes significantly reduced the levels of rapidly digestible starch and slowly digestible starch, while the levels of resistant starch increased. Additionally, the cake samples prepared with FEMs exhibited a lower predicted glycaemic index. This study may give rise to multi-functional bakery products with acceptable quality and low glycaemic index.

  4. Decrease social inequalities return-to-work: development and design of a randomised controlled trial among women with breast cancer.

    Science.gov (United States)

    Vidor, Clémence; Leroyer, Ariane; Christophe, Véronique; Seillier, Mélanie; Foncel, Jérome; Van de Maële, Justine; Bonneterre, Jacques; Fantoni, Sophie

    2014-04-17

    Despite the improvement in the care management, women cancer patients who are still in employment find themselves for the most part obliged to stop working while they are having treatment. Their return-to-work probability is impacted by numerous psychosocial factors. The objective is to describe the development and the content of an intervention aimed to facilitate the return to work of female breast cancer patients and in particular the women in the most precarious situations through early active individualised psychosocial support (APAPI). The intervention proposed is made up of 4 interviews with a psychologist at the hospital, distributed over the year according to the diagnosis and conducted on the same day as a conventional follow-up consultation, then a consultation with a specialist job retention physician. We expect, in the first instance, that this intervention will reduce the social inequalities of the return-to-work rate at 12 months. The EPICES score will enable the population to be broken down according to the level of social precariousness. The other expected results are the reduction of the social inequalities in the quality of the return to work at 18 and 24 months and the disparities between the individual and collective resources of the patients. This intervention is assessed in the context of a controlled and randomised multi-centre study. The patients eligible are women aged between 18 and 55 years with a unilateral breast cancer with local extension exclusively, having received surgery followed by adjuvant chemotherapy, in employment at the time of the diagnosis and dealt with by one of the 2 investigating centres. It is essential to assess this type of intervention before envisaging its generalisation. The study set in place will enable us to measure the impact of this intervention aiming to facilitate the return to work of breast cancer patients, in particular for those who suffer from social fragility, compared with the standard care.

  5. Controlled reperfusion decreased reperfusion induced oxidative stress and evoked inflammatory response in experimental aortic-clamping animal model.

    Science.gov (United States)

    Jancsó, G; Arató, E; Hardi, P; Nagy, T; Pintér, Ö; Fazekas, G; Gasz, B; Takacs, I; Menyhei, G; Kollar, L; Sínay, L

    2016-09-12

    Revascularization after long term aortic ischaemia in vascular surgery induces reperfusion injury accompanied with oxidative stress and inflammatory responses. The hypothesis of this study was that the aortic occlusion followed by controlled reperfusion (CR) can reduce the ischaemia-reperfusion injury, the systemic and local inflammatory response induced by oxidative stress.Animal model was used. animals underwent a 4-hour infrarenal aortic occlusion followed by continuous reperfusion. Treated group: animals were treated with CR: after a 4-hour infrarenal aortic occlusion we made CR for 30 minutes with the crystalloid reperfusion solution (blood: crystalloid solution ratio 1:1) on pressure 60 Hgmm. Blood samples were collected different times. The developing oxidative stress was detected by the plasma levels of malondialdehyde, reduced glutathion, thiol groups and superoxide dismutase. The inflammatory response was measured by phorbol myristate acetate-induced leukocyte reactive oxygen species production and detection of change in myeloperoxidase levels. The animals were anaesthetized one week after terminating ligation and biopsy was taken from quadriceps muscle and large parenchymal organs.CR significantly reduced the postischaemic oxydative stress and inflammatory responses in early reperfusion period. Pathophysiological results: The rate of affected muscle fibers by degeneration was significantly higher in the untreated animal group. The infiltration of leukocytes in muscle and parenchymal tissues was significantly lower in the treatedgroup.CR can improve outcome after acute lower-limb ischaemia. The results confirm that CR might be also a potential therapeutic approach in vascular surgery against reperfusion injury in acute limb ischaemia. Supported by OTKA K108596.

  6. Delayed Dosing of Oral Rotavirus Vaccine Demonstrates Decreased Risk of Rotavirus Gastroenteritis Associated With Serum Zinc: A Randomized Controlled Trial.

    Science.gov (United States)

    Colgate, E Ross; Haque, Rashidul; Dickson, Dorothy M; Carmolli, Marya P; Mychaleckyj, Josyf C; Nayak, Uma; Qadri, Firdausi; Alam, Masud; Walsh, Mary Claire; Diehl, Sean A; Zaman, K; Petri, William A; Kirkpatrick, Beth D

    2016-09-01

    Rotavirus is the world's leading cause of childhood diarrheal death. Despite successes, oral rotavirus vaccines are less effective in developing countries. In an urban slum of Dhaka, we performed active diarrhea surveillance to evaluate monovalent G1P[8] rotavirus vaccine (RV1) efficacy and understand variables contributing to risk of rotavirus diarrhea (RVD). We performed a randomized controlled trial of monovalent oral rotavirus vaccine (RV1). Seven hundred healthy infants received RV1 or no RV1 (1:1) using delayed dosing (10 and 17 weeks) and were followed for 1 year. Intensive diarrhea surveillance was performed. The primary outcome was ≥1 episode of RVD. Nutritional, socioeconomic, and immunologic factors were assessed by logistic regression best-subsets analysis for association with risk of RVD and interactions with vaccine arm. Incidence of all RVD was 38.3 cases per 100 person-years. Per-protocol RV1 efficacy was 73.5% (95% confidence interval [CI], 45.8%-87.0%) against severe RVD and 51% (95% CI, 33.8%-63.7%) against all RVD. Serum zinc level (odds ratio [OR], 0.77; P = .002) and lack of rotavirus immunoglobulin A (IgA) seroconversion (OR, 1.95; P = .018) were associated with risk of RVD, independent of vaccination status. Water treatment and exclusive breastfeeding were of borderline significance. Factors not associated with RVD included height for age at 10 weeks, vitamin D, retinol binding protein, maternal education, household income, and sex. In an urban slum with high incidence of RVD, the efficacy of RV1 against severe RVD was higher than anticipated in the setting of delayed dosing. Lower serum zinc level and lack of IgA seroconversion were associated with increased risk of RVD independent of vaccination. NCT01375647. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  7. 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...

  8. Atorvastatin therapy decreases androstenedione and dehydroepiandrosterone sulphate concentrations in patients with polycystic ovary syndrome: randomized controlled study.

    Science.gov (United States)

    Sathyapalan, Thozhukat; Smith, Karen A; Coady, Anne-Marie; Kilpatrick, Eric S; Atkin, Stephen L

    2012-01-01

    Hyperandrogenaemia in polycystic ovary syndrome (PCOS) represents a composite of raised serum concentrations of testosterone, androstenedione, dehydroepiandrosterone (DHEA) and DHEA sulphate (DHEAS). In patients with PCOS, testosterone and androstenedione are primarily derived from the ovaries and DHEAS is a metabolite predominantly from the adrenals. It has been shown that atorvastatin reduces testosterone concentrations in patients with PCOS. The objective was to study the effect of atorvastatin on serum androstenedione and DHEAS concentrations in patients with PCOS. A randomized, double-blind, placebo-controlled study was performed. Forty medication-naive patients with PCOs were randomized to either atorvastatin 20mg daily or placebo for three months. Subsequently, a three-month extension study for all patients was undertaken with metformin 1500 mg daily. The main outcome measures were change in androstenedione and DHEAS concentrations. The mean (SD) baseline androstenedione (5.7 [0.8] versus 5.6 [1.3] nmol/L; P = 0.69) and DHEAS (7.1 [1.0] versus 7.2 [1.2] μmol/L; P = 0.72) concentrations were comparable between two groups. There was a significant reduction of androstenedione (5.7 [0.8] versus 4.7 [0.7] nmol/L; P = 0.03) and DHEAS (7.1 [1.0] versus 6.0 [0.9] μmol/L; P = 0.02) with three months of atorvastatin while there were no significant changes with placebo. Three months' treatment with metformin maintained the reduction of androstenedione and DHEAS concentrations with atorvastatin compared with baseline. There were no changes in either DHEAS or androstenedione concentrations in the initial placebo group after 12 weeks of metformin. Twelve weeks of atorvastatin significantly reduced both DHEAS and androstenedione contributing to the total reduction of androgen concentrations and indicating that the reduction of the hyperandrogenaemia could be partly due to the action of atorvastatin at both the ovary and the adrenal gland in PCOS.

  9. Using smartphones to decrease substance use via self-monitoring and recovery support: study protocol for a randomized control trial.

    Science.gov (United States)

    Scott, Christy K; Dennis, Michael L; Gustafson, David H

    2017-08-10

    Alcohol abuse, other substance use disorders, and risk behaviors associated with the human immunodeficiency virus (HIV) represent three of the top 10 modifiable causes of mortality in the US. Despite evidence that continuing care is effective in sustaining recovery from substance use disorders and associated behaviors, patients rarely receive it. Smartphone applications (apps) have been effective in delivering continuing care to patients almost anywhere and anytime. This study tests the effectiveness of two components of such apps: ongoing self-monitoring through Ecological Momentary Assessments (EMAs) and immediate recovery support through Ecological Momentary Interventions (EMIs). The target population, adults enrolled in substance use disorder treatment (n = 400), are being recruited from treatment centers in Chicago and randomly assigned to one of four conditions upon discharge in a 2 × 2 factorial design. Participants receive (1) EMAs only, (2) EMIs only, (3) combined EMAs + EMIs, or (4) a control condition without EMA or EMI for 6 months. People in the experimental conditions receive smartphones with the apps (EMA and/or EMI) specific to their condition. Phones alert participants in the EMA and EMA + EMI conditions at five random times per day and present participants with questions about people, places, activities, and feelings that they experienced in the past 30 min and whether these factors make them want to use substances, support their recovery, or have no impact. Those in the EMI and EMA + EMI conditions have continual access to a suite of support services. In the EMA + EMI condition, participants are prompted to use the EMI(s) when responses to the EMA(s) indicate risk. All groups have access to recovery support as usual. The primary outcome is days of abstinence from alcohol and other drugs. Secondary outcomes are number of HIV risk behaviors and whether abstinence mediates the effects of EMA, EMI, or EMA + EMI on HIV

  10. 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.

  11. 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)

  12. 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.

  13. Glycaemic changes in patients with chronic kidney disease.

    Science.gov (United States)

    De'Marziani, Guillermo; Soler Pujol, Gervasio; Obregón, Liliana Miriam; Morales, Elisa Mabel; Gonzalez, Claudio Daniel; Gonzalez Paganti, Luciana; Cacciagiú, Leonardo; Lopez, Graciela; Schreier, Laura; Elbert, Alicia

    2016-01-01

    In Argentina, there have been no studies aimed at establishing the prevalence of dysglycaemia (impaired fasting glucose [IFG], impaired glucose tolerance [IGT] and diabetes mellitus [DM]) in patients with chronic kidney disease (CKD). Our group decided to conduct an observational study to evaluate the frequency with oral glucose tolerance test (OGTT) in CKD patients with no previous data for dysglycaemia in their medical records. OGTT was performed in 254 patients (60.62% male) with stage 3, 4 and 5 CKD under conservative treatment, haemodialysis or transplantation. Results for DM were found in 10 patients according to fasting glucose alone (3.94%; 95% CI: 1.35-6.53%), 11 patients with exclusively the second hour criterion (4.33%; 95% CI: 1.63-7.03%), 15 with both criteria (5.91%; 95% CI: 2.81-9.00%) and 36 patients with at least one criteria (14.17%; 95% CI: 9.69-18.66%). In a multivariate analysis, DM was associated with waist circumference (OR=1.033 per cm; 95% CI, 1.005 to 1.062; P=.019) and with conservative treatment vs. replacement therapy (OR=0.41; 95% CI: 0.19-0.92; P=.028). IGT was evident in 24.6% and 20.3 on conservative vs. replacement therapy, with no statistically significant difference. IFG (ADA criteria) was 19.75 vs. 9.24% in conservative vs. replacement therapy, with a statistically significant difference. OGTT is suggested for all CKD patients since it is able to detect the full range of unknown dysglycaemias, which avoids underdiagnoses and favours performing treatments to prevent progression in DM risk groups (IFG and/or IGT). It also aids in the selection of the most appropriate medication for transplantation or treatment initiation in new cases of undiagnosed DM to decrease morbidity and mortality. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  14. Former Abusers of Anabolic Androgenic Steroids Exhibit Decreased Testosterone Levels and Hypogonadal Symptoms Years after Cessation: A Case-Control Study

    Science.gov (United States)

    Selmer, Christian; Østergren, Peter Busch; Pedersen, Karen Boje; Schou, Morten; Gustafsson, Finn; Faber, Jens; Juul, Anders; Kistorp, Caroline

    2016-01-01

    Aims Abuse of anabolic androgenic steroids (AAS) is highly prevalent among male recreational athletes. The objective of this study was to investigate the impact of AAS abuse on reproductive hormone levels and symptoms suggestive of hypogonadism in current and former AAS abusers. Methods This study had a cross-sectional case-control design and involved 37 current AAS abusers, 33 former AAS abusers (mean (95%CI) elapsed duration since AAS cessation: 2.5 (1.7; 3.7) years) and 30 healthy control participants. All participants were aged 18–50 years and were involved in recreational strength training. Reproductive hormones (FSH, LH, testosterone, inhibin B and anti-Müllerian hormone (AMH)) were measured using morning blood samples. Symptoms of hypogonadism (depressive symptoms, fatigue, decreased libido and erectile dysfunction) were recorded systematically. Results Former AAS abusers exhibited significantly lower median (25th –75th percentiles) total and free testosterone levels than control participants (total testosterone: 14.4 (11.9–17.7) nmol/l vs. 18.8 (16.6–22.0) nmol/l) (P < 0.01). Overall, 27.2% (13.3; 45.5) of former AAS abusers exhibited plasma total testosterone levels below the lower reference limit (12.1 nmol/l) whereas no control participants exhibited testosterone below this limit (P < 0.01). Gonadotropins were significantly suppressed, and inhibin B and AMH were significantly decreased in current AAS abusers compared with former AAS abusers and control participants (P < 0.01). The group of former AAS abusers had higher proportions of participants with depressive symptoms ((24.2%) (11.1; 42.2)), erectile dysfunction ((27.3%) (13.3; 45.6)) and decreased libido ((40.1%) (23.2; 57.0)) than the other two groups (trend analyses: P < 0.05). Conclusions Former AAS abusers exhibited significantly lower plasma testosterone levels and higher frequencies of symptoms suggestive of hypogonadism than healthy control participants years after AAS cessation

  15. Former Abusers of Anabolic Androgenic Steroids Exhibit Decreased Testosterone Levels and Hypogonadal Symptoms Years after Cessation: A Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Jon Jarløv Rasmussen

    Full Text Available Abuse of anabolic androgenic steroids (AAS is highly prevalent among male recreational athletes. The objective of this study was to investigate the impact of AAS abuse on reproductive hormone levels and symptoms suggestive of hypogonadism in current and former AAS abusers.This study had a cross-sectional case-control design and involved 37 current AAS abusers, 33 former AAS abusers (mean (95%CI elapsed duration since AAS cessation: 2.5 (1.7; 3.7 years and 30 healthy control participants. All participants were aged 18-50 years and were involved in recreational strength training. Reproductive hormones (FSH, LH, testosterone, inhibin B and anti-Müllerian hormone (AMH were measured using morning blood samples. Symptoms of hypogonadism (depressive symptoms, fatigue, decreased libido and erectile dysfunction were recorded systematically.Former AAS abusers exhibited significantly lower median (25th -75th percentiles total and free testosterone levels than control participants (total testosterone: 14.4 (11.9-17.7 nmol/l vs. 18.8 (16.6-22.0 nmol/l (P < 0.01. Overall, 27.2% (13.3; 45.5 of former AAS abusers exhibited plasma total testosterone levels below the lower reference limit (12.1 nmol/l whereas no control participants exhibited testosterone below this limit (P < 0.01. Gonadotropins were significantly suppressed, and inhibin B and AMH were significantly decreased in current AAS abusers compared with former AAS abusers and control participants (P < 0.01. The group of former AAS abusers had higher proportions of participants with depressive symptoms ((24.2% (11.1; 42.2, erectile dysfunction ((27.3% (13.3; 45.6 and decreased libido ((40.1% (23.2; 57.0 than the other two groups (trend analyses: P < 0.05.Former AAS abusers exhibited significantly lower plasma testosterone levels and higher frequencies of symptoms suggestive of hypogonadism than healthy control participants years after AAS cessation. Current AAS abusers exhibited severely decreased AMH

  16. [Usefulness of continuous glucose monitoring system (CGMS) in monitoring glycaemic profile in small children with diabetes type 1].

    Science.gov (United States)

    Głowińska-Olszewska, Barbara; Urban, Mirosława; Peczyńska, Jadwiga; Florys, Bozena; Kowalewski, Marek

    2005-01-01

    Improved methods of diabetes therapy result in a near normoglycaemic state in many patients. This leads however unfortunately to more frequent hypoglycaemic incidents. Particularly small children, whose nervous system is not fully mature, are at high risk of central nervous system damage in case of hypoglycaemia. A new method of detail monitoring of glycaemia provides CGMS system. The aim of the study was to compare the glycaemic profile, with high attention to hypoglycaemia in groups of young and older children with diabetes type 1, using CGMS and routine glucose meter. We studied 32 children with diabetes type 1. Children were divided into groups: group I--small children, n=17 (10 years of age), mean age--12 years, with disease duration--3 years, with HbA1c level--7,21%. Continuous glucose monitoring system (CGMS), by MiniMed, was applied in outpatient or hospital conditions, after short training of patient and parents; together with routine glucose meter measurements, 4-8 times/24 hours. In 9 patients from small children group CGMS was repeated after 2 months. Hypoglycaemic incidents detected with CGMS were similar in both groups: 4,6 in I group vs. 4,2 in II group (ns). Hypoglycaemic incidents found with meter were lower in I group--1,6 vs. 2,3 in II group (ns). Mean hypoglycaemic time/24 hour was longer in small children group: 101 min vs. 74 min in group II (p<00,05). In I group we found higher number of hypoglycaemic incidents during the night compared to group II--1,7 vs. 0,8 (p<00,05) and longer duration of night hypoglycaemia: in I group--56 min vs. 32 min in group II (p<00,05). Repeated CGMS study in 9 children from I group revealed decreased mean time of hypoglycaemia/24 hours from 134 min/24 h to 90 min/24 h (p<00,05) and decreased time of night hypoglycaemia from 65 min to 40 min (p<00,05), with a comparable number of hypoglycaemic incidents. Hypoglycaemic incidents found with routine meter measurements in small children were 1,6 vs. 4,6 hypoglycaemia

  17. Alcohol decreases baseline brain glucose metabolism more in heavy drinkers than controls but has no effect on stimulation-induced metabolic increases.

    Science.gov (United States)

    Volkow, Nora D; Wang, Gene-Jack; Shokri Kojori, Ehsan; Fowler, Joanna S; Benveniste, Helene; Tomasi, Dardo

    2015-02-18

    During alcohol intoxication, the human brain increases metabolism of acetate and decreases metabolism of glucose as energy substrate. Here we hypothesized that chronic heavy drinking facilitates this energy substrate shift both for baseline and stimulation conditions. To test this hypothesis, we compared the effects of alcohol intoxication (0.75 g/kg alcohol vs placebo) on brain glucose metabolism during video stimulation (VS) versus when given with no stimulation (NS), in 25 heavy drinkers (HDs) and 23 healthy controls, each of whom underwent four PET-(18)FDG scans. We showed that resting whole-brain glucose metabolism (placebo-NS) was lower in HD than controls (13%, p = 0.04); that alcohol (compared with placebo) decreased metabolism more in HD (20 ± 13%) than controls (9 ± 11%, p = 0.005) and in proportion to daily alcohol consumption (r = 0.36, p = 0.01) but found that alcohol did not reduce the metabolic increases in visual cortex from VS in either group. Instead, VS reduced alcohol-induced decreases in whole-brain glucose metabolism (10 ± 12%) compared with NS in both groups (15 ± 13%, p = 0.04), consistent with stimulation-related glucose metabolism enhancement. These findings corroborate our hypothesis that heavy alcohol consumption facilitates use of alternative energy substrates (i.e., acetate) for resting activity during intoxication, which might persist through early sobriety, but indicate that glucose is still favored as energy substrate during brain stimulation. Our findings are consistent with reduced reliance on glucose as the main energy substrate for resting brain metabolism during intoxication (presumably shifting to acetate or other ketones) and a priming of this shift in HDs, which might make them vulnerable to energy deficits during withdrawal. Copyright © 2015 the authors 0270-6474/15/353248-08$15.00/0.

  18. Alcohol decreases baseline brain glucose metabolism more in heavy drinkers than controls but has no effect on stimulation-induced metabolic increases

    International Nuclear Information System (INIS)

    Volkow, Nora D.; Fowler, Joanna S.; Wang, Gene-Jack; Kojori, Eshan Shokri; Benveniste, Helene; Tomasi, Dardo

    2015-01-01

    During alcohol intoxication the human brain increases metabolism of acetate and decreases metabolism of glucose as energy substrate. Here we hypothesized that chronic heavy drinking facilitates this energy substrate shift both for baseline and stimulation conditions. To test this hypothesis we compared the effects of alcohol intoxication (0.75g/kg alcohol versus placebo) on brain glucose metabolism during video-stimulation (VS) versus when given with no-stimulation (NS), in 25 heavy drinkers (HD) and 23 healthy controls each of whom underwent four PET- 18 FDG scans. We showed that resting whole-brain glucose metabolism (placebo-NS) was lower in HD than controls (13%, p=0.04); that alcohol (compared to placebo) decreased metabolism more in HD (20±13%) than controls (9±11%, p=0.005) and in proportion to daily alcohol consumption (r=0.36, p=0.01) but found that alcohol did not reduce the metabolic increases in visual cortex from VS in either group. Instead, VS reduced alcohol-induced decreases in whole-brain glucose metabolism (10±12%) compared to NS in both groups (15±13%, p=0.04), consistent with stimulation-related glucose metabolism enhancement. These findings corroborate our hypothesis that heavy alcohol consumption facilitates use of alternative energy substrates (i.e. acetate) for resting activity during intoxication, which might persist through early sobriety, but indicate that glucose is still favored as energy substrate during brain stimulation. Our findings are consistent with reduced reliance on glucose as the main energy substrate for resting brain metabolism during intoxication (presumably shifting to acetate or other ketones) and a priming of this shift in heavy drinkers, which might make them vulnerable to energy deficits during withdrawal

  19. 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

  20. 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.

  1. Decreased repopulation as well as increased reoxygenation contribute to the improvement in local control after targeting of the EGFR by C225 during fractionated irradiation

    International Nuclear Information System (INIS)

    Krause, Mechthild; Ostermann, Gernot; Petersen, Cordula; Yaromina, Ala; Hessel, Franziska; Harstrick, Andreas; Kogel, Albert J van der; Thames, Howard D; Baumann, Michael

    2005-01-01

    Background and purpose: Inhibition of repopulation and enhanced reoxygenation has been suggested to contribute to improvement of local tumour control after fractionated irradiation combined with inhibitors of the epidermal growth factor receptor (EGFR). The present study addresses this hypothesis in FaDu human squamous cell carcinoma. For this tumour model marked repopulation and incomplete reoxygenation during fractionated irradiation has previously been demonstrated. Furthermore, the anti-EGFR monoclonal antibody C225 has been shown to significantly improve the results of fractionated irradiation in this tumour. Materials and methods: FaDu tumours in nude mice were irradiated with 18 fractions in 18 days (18f/18d) or 18 fractions in 36 days (18f/36d). Three Gy fractions were given either under ambient or under clamp hypoxic conditions. C225 or carrier was applied four times during the course of treatment. Fractionated irradiations were followed by graded top-up doses to obtain complete dose-response curves for local tumour control. Tumour control dose 50% (TCD 50 ) was determined at day 120 after end of treatment. Results: Significant repopulation and reoxygenation occurred during fractionated irradiation of FaDu tumours (P-values between 0.028 and 50 for 18f/36d under ambient conditions (P=0.04). Bootstrap analysis revealed decreased repopulation and increased reoxygenation after application of C225 (P=0.06 for the combined effect). This was further corroborated by a significant effect of C225 on the 'repopulated' dose under ambient conditions which is influenced by both, reoxygenation and repopulation (P=0.012). Conclusions: Our study provides evidence that both decreased repopulation as well as increased reoxygenation contribute to the improvement of local control after targeting of EGFR by C225 during fractionated irradiation of FaDu tumours

  2. Methadone Detoxification Versus Traditional Gradual Decrease in the Consumed Amount of Refined Opium Dross (Shireh: The Preferred Method for Controlling Withdrawal Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammadreza Farsinejad

    2012-08-01

    Full Text Available Background: The aim of this study was to compare the effectiveness of methadone detoxification with traditional method of gradual decrement in the abused amount of the refined opium dross (Shireh to control withdrawal syndrome in Shireh-addicted patients. Methods: In this study, two groups of Shireh addicts were compared. The first group was treated by methadone and the second group by gradual decrement in the amount of consumed Shireh. Those experiencing the adverse effects of the treatment were excluded from the study. Methadone dose was calculated based on the amount of the Shireh consumed and detoxification was performed during a 21-day period. In the second group, the amount of the consumed Shireh was gradually decreased within 21 days and some of the withdrawal symptoms were selected as indicators for patient evaluation. Results: A total of 35 patients (16 versus 19 patients in the first and second groups were evaluated. Their mean age was 43 ± 4 years and all were male. A statistically significant difference was found between these two groups in terms of severity and duration of withdrawal symptoms within the first five days and their duration after the 21st day of the onset of detoxification (P< 0.05. Conclusion: In comparison with methadone detoxification, traditional method of gradually decreasing the consumed amount of Shireh controls the severity and duration of withdrawal symptoms better in the course of detoxification.

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. Mulberry-extract improves glucose tolerance and decreases insulin concentrations in normoglycaemic adults: Results of a randomised double-blind placebo-controlled study.

    Directory of Open Access Journals (Sweden)

    Mark Lown

    Full Text Available High sugar and refined carbohydrate intake is associated with weight gain, increased incidence of diabetes and is linked with increased cardiovascular mortality. Reducing the health impact of poor quality carbohydrate intake is a public health priority. Reducose, a proprietary mulberry leaf extract (ME, may reduce blood glucose responses following dietary carbohydrate intake by reducing absorption of glucose from the gut.A double-blind, randomised, repeat measure, phase 2 crossover design was used to study the glycaemic and insulinaemic response to one reference product and three test products at the Functional Food Centre, Oxford Brooks University, UK. Participants; 37 adults aged 19-59 years with a BMI ≥ 20kg/m2 and ≤ 30kg/m2. The objective was to determine the effect of three doses of mulberry-extract (Reducose versus placebo on blood glucose and insulin responses when co-administered with 50g maltodextrin in normoglycaemic healthy adults. We also report the gastrointestinal tolerability of the mulberry extract.Thirty-seven participants completed the study: The difference in the positive Incremental Area Under the Curve (pIAUC (glucose (mmol / L x h for half, normal and double dose ME compared with placebo was -6.1% (-18.2%, 5.9%; p = 0.316, -14.0% (-26.0%, -2.0%; p = 0.022 and -22.0% (-33.9%, -10.0%; p<0.001 respectively. The difference in the pIAUC (insulin (mIU / L x h for half, normal and double dose ME compared with placebo was -9.7% (-25.8%, 6.3%; p = 0.234, -23.8% (-39.9%, -7.8%; p = 0.004 and -24.7% (-40.8%, -8.6%; p = 0.003 respectively. There were no statistically significant differences between any of the 4 groups in the odds of experiencing one or more gastrointestinal symptoms (nausea, abdominal cramping, distension or flatulence.Mulberry leaf extract significantly reduces total blood glucose rise after ingestion of maltodextrin over 120 minutes. The pattern of effect demonstrates a classical dose response curve with

  8. Similar decreases in local tumor control are calculated for treatment protraction and for interruptions in the radiotherapy of carcinoma of the larynx in four centers

    International Nuclear Information System (INIS)

    Robertson, Chris; Robertson, A. Gerald; Hendry, Jolyon H.; Roberts, Stephen A.; Slevin, Nicholas J.; Duncan, William B.; MacDougall, R. Hugh; Kerr, Gillian R.; O'Sullivan, B.; Keane, Thomas J.

    1998-01-01

    Purpose: Data on patients with cancer of the larynx are analyzed using statistical models to estimate the effect of gaps in the treatment time on the local control of the tumor. Methods and Materials: Patients from four centers, Edinburgh, Glasgow, Manchester, and Toronto, with carcinoma of the larynx and treated by radiotherapy were followed up and the disease-free period recorded. In all centers the end point was control of the primary tumor after irradiation alone. The local control rates at ≥2 years, P c , were analyzed by log linear models, and Cox proportional hazard models were used to model the disease-free period. Results: T stage, nodal involvement, and site of the tumor were important determinants of the disease-free interval, as was the radiation schedule used. Elongation of the treatment time by 1 day, or a gap of 1 day, was associated with a decrease in P c of 0.68% per day for P c = 0.80, with a 95% confidence interval of (0.28, 1.08)%. An increase of 5 days was associated with a 3.5% reduction in P c from 0.80 to 0.77. At P c = 0.60 an increase of 5 days was associated with an 7.9% decrease in P c . The time factor in the Linear Quadratic model, γ/α, was estimated as 0.89 Gy/day, 95% confidence interval (0.35, 1.43) Gy/day. Conclusions: Any gaps (public holidays are the majority) in the treatment schedule have the same deleterious effect on the disease free period as an increase in the prescribed treatment time. For a schedule, where dose and fraction number are specified, any gap in treatment is potentially damaging

  9. A randomized controlled trial to enhance coping and posttraumatic growth and decrease posttraumatic stress disorder in HIV-Infected men who have sex with men in Beijing, China.

    Science.gov (United States)

    Ye, Zhi; Yu, Nancy Xiaonan; Zhu, Wanling; Chen, Lihua; Lin, Danhua

    2018-06-01

    Although HIV-infected men who have sex with men (MSM) constitute a newly emerged high-risk group in China, little research outside Western countries is available on effective intervention programs to enhance their well-being. The purpose of this randomized controlled trial was to evaluate the efficacy of a group intervention program designed to improve the well-being and adaptive coping strategies of 60 HIV-infected MSM in Beijing, China, randomly assigned either to the intervention group for participation in four weekly sessions or to the control group for placement on a waiting list. They all completed measurements at pre- and postintervention. Compared with the control group, the intervention group reported significantly increased problem-focused coping strategies and levels of posttraumatic growth (PTG) as well as decreased symptoms of posttraumatic stress disorder (PTSD) at the completion of the intervention. In addition, mediation analysis showed that changes in problem-focused coping strategies mediated the intervention effect on increases in PTG; however, the mediating effect of coping strategies on the association of intervention and PTSD was not significant. This study provides empirical evidence for conducting psychological intervention to promote the well-being of HIV-infected MSM. The findings also elucidate the mechanism through which intervention improved PTG.

  10. Goal directed fluid therapy decreases postoperative morbidity but not mortality in major non-cardiac surgery: a meta-analysis and trial sequential analysis of randomized controlled trials.

    Science.gov (United States)

    Som, Anirban; Maitra, Souvik; Bhattacharjee, Sulagna; Baidya, Dalim K

    2017-02-01

    Optimum perioperative fluid administration may improve postoperative outcome after major surgery. This meta-analysis and systematic review has been aimed to determine the effect of dynamic goal directed fluid therapy (GDFT) on postoperative morbidity and mortality in non-cardiac surgical patients. Meta-analysis of published prospective randomized controlled trials where GDFT based on non-invasive flow based hemodynamic measurement has been compared with a standard care. Data from 41 prospective randomized trials have been included in this study. Use of GDFT in major surgical patients does not decrease postoperative hospital/30-day mortality (OR 0.70, 95 % CI 0.46-1.08, p = 0.11) length of post-operative hospital stay (SMD -0.14; 95 % CI -0.28, 0.00; p = 0.05) and length of ICU stay (SMD -0.12; 95 % CI -0.28, 0.04; p = 0.14). However, number of patients having at least one postoperative complication is significantly lower with use of GDFT (OR 0.57; 95 % CI 0.43, 0.75; p infection (p = 0.002) and postoperative hypotension (p = 0.04) are also decreased with used of GDFT as opposed to a standard care. Though patients who received GDFT were infused more colloid (p infection, abdominal complications and postoperative hypotension is reduced.

  11. Horizontal infection control strategy decreases methicillin-resistant Staphylococcus aureus infection and eliminates bacteremia in a surgical ICU without active surveillance.

    Science.gov (United States)

    Traa, Maria X; Barboza, Lorena; Doron, Shira; Snydman, David R; Noubary, Farzad; Nasraway, Stanley A

    2014-10-01

    Methicillin-resistant Staphylococcus aureus infection is a significant contributor to morbidity and mortality in hospitalized patients worldwide. Numerous healthcare bodies in Europe and the United States have championed active surveillance per the "search and destroy" model. However, this strategy is associated with significant economic, logistical, and patient costs without any impact on other hospital-acquired pathogens. We evaluated whether horizontal infection control strategies could decrease the prevalence of methicillin-resistant S. aureus infection in the ICU, without the need for active surveillance. Retrospective, observational study in the surgical ICU of a tertiary care medical center in Boston, MA, from 2005 to 2012. A total of 6,697 patients in the surgical ICU. Evidence-based infection prevention strategies were implemented in an iterative fashion, including 1) hand hygiene program with refresher education campaign, 2) chlorhexidine oral hygiene program, 3) chlorhexidine bathing, 4) catheter-associated bloodstream infection program, and 5) daily goals sheets. The prevalence of methicillin-resistant S. aureus infection fell from 2.66 to 0.69 per 1,000 patient days from 2005 to 2012, an average decrease of 21% per year. The biggest decline in rate of infection was detected in 2008, which may suggest that the catheter-associated bloodstream infection prevention program was particularly effective. Among 4,478 surgical ICU admissions over the last 5 years, not a single case of methicillin-resistant S. aureus bacteremia was observed. Aggressive multifaceted horizontal infection control is an effective strategy for reducing the prevalence of methicillin-resistant S. aureus infection and eliminating methicillin-resistant S. aureus bacteremia in the ICU without the need for active surveillance and decontamination.

  12. Continuous subcutaneous insulin infusion (CSII) therapy at Derby Teaching Hospitals: sustained benefits in glucose control.

    Science.gov (United States)

    Anyanwagu, U; Olaoye, H; Jennings, P; Ashton-Cleary, S; Sugunendran, S; Hughes, D; Idris, I; Wilmot, E G

    2017-08-01

    In the short term, continuous subcutaneous insulin infusion (CSII) has been associated with improved glycaemic control, reduced hypoglycaemia and improved quality of life (QOL). However, limited data are available on its long-term benefits, particularly in the UK. We aimed to assess the impact of CSII on longer term outcomes. Patient-level data were obtained for CSII users at Derby Teaching Hospitals, UK. Patient confidence and satisfaction questionnaires using the Likert scale were used to assess confidence in self-management. Comparative statistics were conducted using Pearson's chi-square and Student's t-tests. Some 258 CSII users were identified (60.1% female, mean age 43.9 ± 13.4 years). Overall, there was significant decrease in HbA 1c from 78 mmol/mol (9.3 ± 2.0%) at baseline, to 69 mmol/mol (8.5 ± 1.3%) at 6 months [mean difference (md): -0.64; 95% confidence interval (95% CI): -0.91 to -0.37; P quality of care received in the insulin pump service. CSII therapy led to a sustained long-term improvement in glycaemic control in addition to a reduction in self-reported hypoglycaemia. © 2017 Diabetes UK.

  13. Prenatal folic acid use associated with decreased risk of myelomeningocele: A case-control study offers further support for folic acid fortification in Bangladesh.

    Science.gov (United States)

    Kancherla, Vijaya; Ibne Hasan, Md Omar Sharif; Hamid, Rezina; Paul, Ligi; Selhub, Jacob; Oakley, Godfrey; Quamruzzaman, Quazi; Mazumdar, Maitreyi

    2017-01-01

    Neural tube defects contribute to severe morbidity and mortality in children and adults; however, they are largely preventable through maternal intake of folic acid before and during early pregnancy. We examined the association between maternal prenatal folic acid supplement intake and risk of myelomeningocele (a severe and common type of neural tube defect) in the offspring. We performed secondary analysis using data from a case-control study conducted at Dhaka Community Hospital, Bangladesh between April and November of 2013. Cases and controls included children with and without myelomeningocele, respectively, and their mothers. Cases were identified from local hospitals and rural health clinics served by Dhaka Community Hospital. Controls were selected from pregnancy registries located in the same region as the cases, and matched (1:1) to cases by age and sex. Myelomeningocele in the offspring was confirmed by a pediatrician with expertise in classifying neural tube defects. Maternal prenatal folic acid supplement intake was the main exposure of interest. We estimated crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) using conditional logistic regression analysis. There were 53 pairs of matched cases and controls in our study. Overall, 51% of case mothers reported using folic acid supplements during pregnancy compared to 72% of control mothers (p = 0.03). Median plasma folate concentrations at the time of study visit were 2.79 ng/mL and 2.86 ng/mL among case and control mothers, respectively (p = 0.85). Maternal prenatal folic acid use significantly decreased the odds of myelomeningocele in the offspring (unadjusted OR = 0.42, 95% CI = 0.18-0.96). The association was slightly attenuated after adjusting for maternal age at the time of pregnancy (adjusted OR = 0.43, 95% CI = 0.18-1.02). Our study confirms the protective association between maternal prenatal folic acid supplement use and myelomeningocele among children born in Bangladesh. Our

  14. Prenatal folic acid use associated with decreased risk of myelomeningocele: A case-control study offers further support for folic acid fortification in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Vijaya Kancherla

    Full Text Available Neural tube defects contribute to severe morbidity and mortality in children and adults; however, they are largely preventable through maternal intake of folic acid before and during early pregnancy. We examined the association between maternal prenatal folic acid supplement intake and risk of myelomeningocele (a severe and common type of neural tube defect in the offspring. We performed secondary analysis using data from a case-control study conducted at Dhaka Community Hospital, Bangladesh between April and November of 2013. Cases and controls included children with and without myelomeningocele, respectively, and their mothers. Cases were identified from local hospitals and rural health clinics served by Dhaka Community Hospital. Controls were selected from pregnancy registries located in the same region as the cases, and matched (1:1 to cases by age and sex. Myelomeningocele in the offspring was confirmed by a pediatrician with expertise in classifying neural tube defects. Maternal prenatal folic acid supplement intake was the main exposure of interest. We estimated crude and adjusted odds ratios (OR and 95% confidence intervals (CI using conditional logistic regression analysis. There were 53 pairs of matched cases and controls in our study. Overall, 51% of case mothers reported using folic acid supplements during pregnancy compared to 72% of control mothers (p = 0.03. Median plasma folate concentrations at the time of study visit were 2.79 ng/mL and 2.86 ng/mL among case and control mothers, respectively (p = 0.85. Maternal prenatal folic acid use significantly decreased the odds of myelomeningocele in the offspring (unadjusted OR = 0.42, 95% CI = 0.18-0.96. The association was slightly attenuated after adjusting for maternal age at the time of pregnancy (adjusted OR = 0.43, 95% CI = 0.18-1.02. Our study confirms the protective association between maternal prenatal folic acid supplement use and myelomeningocele among children born in

  15. 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.

  16. Feeling powerless: Locus of control as a potential target for supportive care interventions to increase quality of life and decrease anxiety in ovarian cancer patients.

    Science.gov (United States)

    Brown, Alaina J; Sun, Charlotte C; Urbauer, Diana L; Bodurka, Diane C; Thaker, Premal H; Ramondetta, Lois M

    2015-08-01

    To evaluate if an individual's locus of control (LOC) predicts various quality of life (QOL) and mental well-being measures. To identify targets that might enhance the overall spiritual well-being and QOL of ovarian cancer patients. Multi-site analysis of women with newly diagnosed stages II-IV ovarian, primary peritoneal or fallopian tube cancer. Patients completed the following surveys: Locus of Control Scale (LOC), Functional Assessment of Chronic Illness Therapy-Ovarian (FACT-O), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp), Edmonton Symptom Assessment score (ESAS), Hospital Anxiety Depression Scale (HADS), Templer's Death Anxiety Scale (DAS), and Herth Hope Index (HHI). Regression models were created to examine the effect of LOC upon QOL, symptoms, and other measures of mental well-being. These models adjusted for the effect of site of care, race, and partnership status as potential confounders. This study enrolled 104 patients from three separate treatment facilities. After adjusting for site, race and partnership status, higher levels of external LOC predicted decreased QOL (FACT-O) (pcontrol over her situation may improve QOL and overall mental well-being. Copyright © 2015. Published by Elsevier Inc.

  17. Severe negative energy balance during 21 d at high altitude decreases fat-free mass regardless of dietary protein intake: a randomized controlled trial.

    Science.gov (United States)

    Berryman, Claire E; Young, Andrew J; Karl, J Philip; Kenefick, Robert W; Margolis, Lee M; Cole, Renee E; Carbone, John W; Lieberman, Harris R; Kim, Il-Young; Ferrando, Arny A; Pasiakos, Stefan M

    2018-02-01

    In this 2-phase randomized controlled study, we examined whether consuming a higher-protein (HP) diet would attenuate fat-free mass (FFM) loss during energy deficit (ED) at high altitude (HA) in 17 healthy males (mean ± sd: 23 ± 6 yr; 82 ± 14 kg). During phase 1 at sea level (SL, 55 m), participants consumed a eucaloric diet providing standard protein (SP; 1.0 g protein/kg,) for 21 d. During phase 2, participants resided at HA (4300 m) for 22 d and were randomly assigned to either an SP or HP (2.0 g protein/kg) diet designed to elicit a 40% ED. Body composition, substrate oxidation, and postabsorptive whole-body protein kinetics were measured. Participants were weight stable during SL and lost 7.9 ± 1.9 kg ( P Berryman, C. E., Young, A. J., Karl, J. P., Kenefick, R. W., Margolis, L. M., Cole, R. E., Carbone, J. W., Lieberman, H. R., Kim, I.-Y., Ferrando, A. A., Pasiakos, S. M. Severe negative energy balance during 21 d at high altitude decreases fat-free mass regardless of dietary protein intake: a randomized controlled trial.

  18. A Randomized Controlled Trial for the Effectiveness of Aromatherapy in Decreasing Salivary Gland Damage following Radioactive Iodine Therapy for Differentiated Thyroid Cancer.

    Science.gov (United States)

    Nakayama, Michihiro; Okizaki, Atsutaka; Takahashi, Koji

    2016-01-01

    Objective. The aim of this study was to investigate effects of aromatherapy in decreasing salivary gland damage for patients undergoing radioactive iodine (RAI) therapy with differentiated thyroid cancer (DTC). Materials and Methods. The subjects were 71 patients with DTC. They were divided into aromatherapy group (group A, n = 35) and a control group (group B, n = 36). We blended 1.0 mL of lemon and 0.5 mL of ginger essential oils. The patients in the inhalation aromatherapy group inhaled this blend oil and those in the control group inhaled distilled water as placebo for 10 min during admission. We statistically compared salivary gland function before and after treatment between groups A and B. Results. In comparison with group B, the rate of change of the accumulation rate was significantly higher in the parotid glands and submandibular glands of group A ( P aromatherapy in the prevention of treatment-related salivary gland disorder. This trial is registered with UMIN Clinical Trial Registry: UMIN000013968.

  19. A Randomized Controlled Trial for the Effectiveness of Aromatherapy in Decreasing Salivary Gland Damage following Radioactive Iodine Therapy for Differentiated Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Michihiro Nakayama

    2016-01-01

    Full Text Available Objective. The aim of this study was to investigate effects of aromatherapy in decreasing salivary gland damage for patients undergoing radioactive iodine (RAI therapy with differentiated thyroid cancer (DTC. Materials and Methods. The subjects were 71 patients with DTC. They were divided into aromatherapy group (group A, n=35 and a control group (group B, n=36. We blended 1.0 mL of lemon and 0.5 mL of ginger essential oils. The patients in the inhalation aromatherapy group inhaled this blend oil and those in the control group inhaled distilled water as placebo for 10 min during admission. We statistically compared salivary gland function before and after treatment between groups A and B. Results. In comparison with group B, the rate of change of the accumulation rate was significantly higher in the parotid glands and submandibular glands of group A (P<0.05. In comparison with group B, a significant increase in rate of secretion change before and after treatment was noted in the bilateral parotid glands in group A (P<0.05. Conclusion. Because an amelioration of salivary gland function was observed in the present study, our results suggest the efficacy of aromatherapy in the prevention of treatment-related salivary gland disorder. This trial is registered with UMIN Clinical Trial Registry: UMIN000013968.

  20. Health benefit from decreasing exposure to heavy metals and metalloid after strict pollution control measures near a typical river basin area in China.

    Science.gov (United States)

    Cao, Suzhen; Duan, Xiaoli; Ma, Yingqun; Zhao, Xiuge; Qin, Yanwen; Liu, Yan; Li, Sai; Zheng, Binghui; Wei, Fusheng

    2017-10-01

    The metal(loid) pollution still is a great concern due to the effects from urbanization and industrialization. While, the health risks from the toxic metal(loid)s could decrease if strict pollution control measures were adopted. However, few studies to date investigate the health risks of heavy metal(loid)s in a systematic river basin for the dependent residents, after taking pollution control measures. Thus, the contents of metal(loid)s (Cu, Pb, Zn, Cd, Mn, As) in surface water along a typical river basin were investigated in this study, and the potential non-carcinogenic and carcinogenic health risks posed to the residents were assessed. Although the soluble contents of Cu, Pb, Zn and Cd exceeded the respective thresholds in two sites located downstream the mine area, they were greatly decreased in comparison with previous contamination levels, and the soluble concentrations of all the metal(loid)s were within the relevant thresholds in the sites far away from the mining area. Moreover, the closer to the mining area, the higher the pollution levels of metal(loid)s. The total hazard index for non-carcinogenic risks of metal(loid)s were basically lower than the threshold (1) for the local population. Whereas, although the content of metal(loid)s were low (such as As), they could pose relative higher non-carcinogenic health risks. The result illustrated that pollution levels, toxicity of the contaminants and exposure behavior patterns all could contribute to the potential detrimental health risks. Additionally, the non-carcinogenic and carcinogenic risks from ingestion exposure were ∼2-∼4 orders of magnitude higher than those from dermal contact. The total carcinogenic risks were basically lower than the maximum tolerable levels (1.0 × 10 -4 ), indicating carcinogenic risks from most areas of the river could also be accepted. Among different population groups, heavy metal(loid)s posed relative higher non-carcinogenic and carcinogenic risks to the children in

  1. 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.

  2. Reduced-Sodium Lunches Are Well-Accepted by Uninformed Consumers Over a 3-Week Period and Result in Decreased Daily Dietary Sodium Intakes: A Randomized Controlled Trial.

    Science.gov (United States)

    Janssen, Anke M; Kremer, Stefanie; van Stipriaan, Willeke L; Noort, Martijn W J; de Vries, Jeanne H M; Temme, Elisabeth H M

    2015-10-01

    Processed foods are major contributors to excessive sodium intake in Western populations. We investigated the effect of food reformulation on daily dietary sodium intake. To determine whether uninformed consumers accept reduced-sodium lunches and to determine the effect of consuming reduced-sodium lunches on 24-hour urinary sodium excretion. A single-blind randomized controlled pretest-posttest design with two parallel treatment groups was used. Participants chose foods in an experimental real-life canteen setting at the Restaurant of the Future in Wageningen, the Netherlands, from May 16 until July 1, 2011. After a run-in period with regular foods for both groups, the intervention group (n=36) consumed foods with 29% to 61% sodium reduction (some were partially flavor compensated). The control group (n=38) continued consuming regular foods. Outcomes for assessment of acceptance were the amount of foods consumed, energy and sodium intake, remembered food liking, and intensity of sensory aspects. Influence on daily dietary sodium intake was assessed by 24-hour urinary sodium excretion. Between and within-subject comparisons were assessed by analysis of covariance. Energy intake and amount consumed of each food category per lunch remained similar for both groups. Compared with the control group, the intervention group's sodium intake per lunch was significantly reduced by -1,093 mg (adjusted difference) (95% CI -1,285 to -901), equivalent to 43 mmol sodium. Remembered food liking, taste intensity, and saltiness were scored similarly for almost all of the reduced-sodium foods compared with the regular foods. After consuming reduced-sodium lunches, compared with the control group, intervention participants' 24-hour urinary sodium excretion was significantly lower by -40 mEq (adjusted difference) (95% CI -63 to -16) than after consuming regular lunches, and this reflects a decreased daily sodium intake of 1 g. Comparing the two treatment groups, consumption of reduced

  3. Risk of Impaired Control of Spacecraft/Associated Systems and Decreased Mobility Due to Vestibular/Sensorimotor Alterations Associated with Space flight

    Science.gov (United States)

    Bloomberg, Jacob J.; Reschke, Millard F.; Clement, Gilles R.; Mulavara, Ajitkumar P.; Taylor, Laura C..

    2015-01-01

    Control of vehicles and other complex systems is a high-level integrative function of the central nervous system (CNS). It requires well-functioning subsystem performance, including good visual acuity, eye-hand coordination, spatial and geographic orientation perception, and cognitive function. Evidence from space flight research demonstrates that the function of each of these subsystems is altered by removing gravity, a fundamental orientation reference, which is sensed by vestibular, proprioceptive, and haptic receptors and used by the CNS for spatial orientation, posture, navigation, and coordination of movements. The available evidence also shows that the degree of alteration of each subsystem depends on a number of crew- and mission-related factors. There is only limited operational evidence that these alterations cause functional impacts on mission-critical vehicle (or complex system) control capabilities. Furthermore, while much of the operational performance data collected during space flight has not been available for independent analysis, those that have been reviewed are somewhat equivocal owing to uncontrolled (and/or unmeasured) environmental and/or engineering factors. Whether this can be improved by further analysis of previously inaccessible operational data or by development of new operational research protocols remains to be seen. The true operational risks will be estimable only after we have filled the knowledge gaps and when we can accurately assess integrated performance in off-nominal operational settings (Paloski et al. 2008). Thus, our current understanding of the Risk of Impaired Control of Spacecraft/Associated Systems and Decreased Mobility Due to Vestibular/Sensorimotor Alterations Associated with Space flight is limited primarily to extrapolation of scientific research findings, and, since there are limited ground-based analogs of the sensorimotor and vestibular changes associated with space flight, observation of their functional

  4. Vitamin D Decreases Serum VEGF Correlating with Clinical Improvement in Vitamin D-Deficient Women with PCOS: A Randomized Placebo-Controlled Trial.

    Science.gov (United States)

    Irani, Mohamad; Seifer, David B; Grazi, Richard V; Irani, Sara; Rosenwaks, Zev; Tal, Reshef

    2017-03-28

    Vascular endothelial growth factor (VEGF) has been suggested to play a role in the pathophysiology of polycystic ovary syndrome (PCOS) and may contribute to increased risk of ovarian hyperstimulation syndrome (OHSS) in affected individuals. Vitamin D (VitD) supplementation improves multiple clinical parameters in VitD-deficient women with PCOS and decreases VEGF levels in several other pathologic conditions. Unveiling the basic mechanisms underlying the beneficial effects of vitamin D on PCOS may enhance our understanding of the pathophysiology of this syndrome. It may also suggest a new treatment for PCOS that can improve it through the same mechanism as vitamin D and can be given regardless of vitamin D levels. Therefore, we aimed to explore the effect of VitD supplementation on serum VEGF levels and assess whether changes in VEGF correlate with an improvement in characteristic clinical abnormalities of PCOS. This is a randomized placebo-controlled trial conducted between October 2013 and March 2015. Sixty-eight VitD-deficient women with PCOS were recruited. Women received either 50,000 IU of oral VitD3 or placebo once weekly for 8 weeks. There was a significant decrease in serum VEGF levels (1106.4 ± 36.5 to 965.3 ± 42.7 pg·mL -1 ; p PCOS. This is a novel molecular explanation for the beneficial effects of VitD treatment. It also suggests the need to investigate a potential role of VitD treatment in reducing the incidence or severity of OHSS in VitD-deficient women with PCOS.

  5. Can sharing experiences in groups reduce the burden of living with diabetes, regardless of glycaemic control?

    DEFF Research Database (Denmark)

    Due-Christensen, Mette; Zoffmann, Vibeke; Hommel, Eva

    2012-01-01

    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...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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.

  13. 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

  14. 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.

  15. Assessment of a novel multi-array normalization method based on spike-in control probes suitable for microRNA datasets with global decreases in expression.

    Science.gov (United States)

    Sewer, Alain; Gubian, Sylvain; Kogel, Ulrike; Veljkovic, Emilija; Han, Wanjiang; Hengstermann, Arnd; Peitsch, Manuel C; Hoeng, Julia

    2014-05-17

    High-quality expression data are required to investigate the biological effects of microRNAs (miRNAs). The goal of this study was, first, to assess the quality of miRNA expression data based on microarray technologies and, second, to consolidate it by applying a novel normalization method. Indeed, because of significant differences in platform designs, miRNA raw data cannot be normalized blindly with standard methods developed for gene expression. This fundamental observation motivated the development of a novel multi-array normalization method based on controllable assumptions, which uses the spike-in control probes to adjust the measured intensities across arrays. Raw expression data were obtained with the Exiqon dual-channel miRCURY LNA™ platform in the "common reference design" and processed as "pseudo-single-channel". They were used to apply several quality metrics based on the coefficient of variation and to test the novel spike-in controls based normalization method. Most of the considerations presented here could be applied to raw data obtained with other platforms. To assess the normalization method, it was compared with 13 other available approaches from both data quality and biological outcome perspectives. The results showed that the novel multi-array normalization method reduced the data variability in the most consistent way. Further, the reliability of the obtained differential expression values was confirmed based on a quantitative reverse transcription-polymerase chain reaction experiment performed for a subset of miRNAs. The results reported here support the applicability of the novel normalization method, in particular to datasets that display global decreases in miRNA expression similarly to the cigarette smoke-exposed mouse lung dataset considered in this study. Quality metrics to assess between-array variability were used to confirm that the novel spike-in controls based normalization method provided high-quality miRNA expression data

  16. Defining Persistent Hotspots: Areas That Fail to Decrease Meaningfully in Prevalence after Multiple Years of Mass Drug Administration with Praziquantel for Control of Schistosomiasis.

    Science.gov (United States)

    Kittur, Nupur; Binder, Sue; Campbell, Carl H; King, Charles H; Kinung'hi, Safari; Olsen, Annette; Magnussen, Pascal; Colley, Daniel G

    2017-12-01

    Preventive chemotherapy with praziquantel for schistosomiasis morbidity control is commonly done by mass drug administration (MDA). MDA regimen is usually based on prevalence in a given area, and effectiveness is evaluated by decreases in prevalence and/or intensity of infection after several years of implementation. Multiple studies and programs now find that even within well-implemented, multiyear, annual MDA programs there often remain locations that do not decline in prevalence and/or intensity to expected levels. We term such locations "persistent hotspots." To study and address persistent hotspots, investigators and neglected tropical disease (NTD) program managers need to define them based on changes in prevalence and/or intensity. But how should the data be analyzed to define a persistent hotspot? We have analyzed a dataset from an operational research study in western Tanzania after three annual MDAs using four different approaches to define persistent hotspots. The four approaches are 1) absolute percent change in prevalence; 2) percent change in prevalence; 3) change in World Health Organization guideline categories; 4) change (absolute or percent) in both prevalence and intensity. We compare and contrast the outcomes of these analyses. Our intent is to show how the same dataset yields different numbers of persistent hotspots depending on the approach used to define them. We suggest that investigators and NTD program managers use the approach most suited for their study or program, but whichever approach is used, it should be clearly stated so that comparisons can be made within and between studies and programs.

  17. The INTERVAL trial to determine whether intervals between blood donations can be safely and acceptably decreased to optimise blood supply: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Moore, Carmel; Sambrook, Jennifer; Walker, Matthew; Tolkien, Zoe; Kaptoge, Stephen; Allen, David; Mehenny, Susan; Mant, Jonathan; Di Angelantonio, Emanuele; Thompson, Simon G; Ouwehand, Willem; Roberts, David J; Danesh, John

    2014-09-17

    Ageing populations may demand more blood transfusions, but the blood supply could be limited by difficulties in attracting and retaining a decreasing pool of younger donors. One approach to increase blood supply is to collect blood more frequently from existing donors. If more donations could be safely collected in this manner at marginal cost, then it would be of considerable benefit to blood services. National Health Service (NHS) Blood and Transplant in England currently allows men to donate up to every 12 weeks and women to donate up to every 16 weeks. In contrast, some other European countries allow donations as frequently as every 8 weeks for men and every 10 weeks for women. The primary aim of the INTERVAL trial is to determine whether donation intervals can be safely and acceptably decreased to optimise blood supply whilst maintaining the health of donors. INTERVAL is a randomised trial of whole blood donors enrolled from all 25 static centres of NHS Blood and Transplant. Recruitment of about 50,000 male and female donors started in June 2012 and was completed in June 2014. Men have been randomly assigned to standard 12-week versus 10-week versus 8-week inter-donation intervals, while women have been assigned to standard 16-week versus 14-week versus 12-week inter-donation intervals. Sex-specific comparisons will be made by intention-to-treat analysis of outcomes assessed after two years of intervention. The primary outcome is the number of blood donations made. A key secondary outcome is donor quality of life, assessed using the Short Form Health Survey. Additional secondary endpoints include the number of 'deferrals' due to low haemoglobin (and other factors), iron status, cognitive function, physical activity, and donor attitudes. A comprehensive health economic analysis will be undertaken. The INTERVAL trial should yield novel information about the effect of inter-donation intervals on blood supply, acceptability, and donors' physical and mental well

  18. Decreasing seroprevalence of herpes simplex virus type 1 and type 2 in Germany leaves many people susceptible to genital infection: time to raise awareness and enhance control.

    Science.gov (United States)

    Korr, Gerit; Thamm, Michael; Czogiel, Irina; Poethko-Mueller, Christina; Bremer, Viviane; Jansen, Klaus

    2017-07-06

    Herpes simplex infections (HSV1/2) are characterized by recurrent symptoms, a risk of neonatal herpes, and the facilitation of HIV transmission. In Germany, HSV1/2 infections are not notifiable and data are scarce. A previous study found higher HSV1/2 seroprevalences in women in East Germany than in women in West Germany. We assessed changes in the HSV1/2 seroprevalences over time and investigated determinants associated with HSV1/2 seropositivity to guide prevention and control. The study was based on the German Health Interview and Examination Survey for Adults (DEGS; 2008-2011) and the German National Health Interview and Examination Survey (GNHIES; 1997-1999). We tested serum samples from DEGS participants for HSV1 and HSV2 immunoglobulin G. We used Pearson's χ 2 test to compare the HSV1/HSV2 seroprevalences in terms of sex, age, and region of residence (East/West Germany) and investigated potential determinants by calculating prevalence ratios (PR) with log-binomial regression. All statistical analyses included survey weights. In total, 6627 DEGS participants were tested for HSV1, and 5013 were also tested for HSV2. Overall, HSV1 seroprevalence decreased significantly from 1997-1999 (82.1%; 95%CI 80.6-83.6) to 2008-2011 (78.4%; 95%CI 77.8-79.7). In the same period, overall HSV2 seroprevalence decreased significantly from 13.3% (95%CI 11.9-14.9) to 9.6% (95%CI 8.6-10.8), notably in 18-24-year-old men (10.4 to 0%) in East Germany. Women were more likely than men to be seropositive for HSV1 (PR 1.1) or HSV2 (PR 1.6). A lower level of education, smoking, and not speaking German were associated with HSV1 in both sexes. Women of older age, who smoked, or had a history of abortion and men of older age or who had not attended a nursery school during childhood were more often seropositive for HSV2. The reduced seroprevalences of HSV1 and HSV2 leave more people susceptible to genital HSV1/2 infections. Practitioners should be aware of HSV infection as a differential

  19. Lesions to the subthalamic nucleus decrease impulsive choice but impair autoshaping in rats: the importance of the basal ganglia in Pavlovian conditioning and impulse control.

    Science.gov (United States)

    Winstanley, Catharine A; Baunez, Christelle; Theobald, David E H; Robbins, Trevor W

    2005-06-01

    Although the subthalamic nucleus (STN) is involved in regulating motor function, and inactivation of this structure relieves the motor symptoms in Parkinsonian patients, recent data indicate that corticosubthalamic connections are involved in both the regulation of attention and the ability to withhold from responding. Considerable evidence suggests that the neural circuitry underlying such behavioural disinhibition or impulsive action can be at least partially dissociated from that implicated in impulsive decision-making and it has been suggested that the tendency to choose impulsively is related to the ability to form and use Pavlovian associations. To explore these hypotheses further, STN-lesioned rats were tested on the delay-discounting model of impulsive choice, where impulsivity is defined as the selection of a small immediate over a larger delayed reward, as well as in a rodent autoshaping paradigm. In contrast to previous reports of increased impulsive action, STN lesions decreased impulsive choice but dramatically impaired the acquisition of the autoshaping response. When the STN was lesioned after the establishment of autoshaping behaviour, lesioned subjects were more sensitive to the omission of reward, indicative of a reduction in the use of Pavlovian associations to control autoshaping performance. These results emphasize the importance of the STN in permitting conditioned stimulus-unconditioned stimulus associations to regulate goal-seeking, a function which may relate to the alterations in impulsive choice observed in the delay-discounting task. These data bear a striking similarity to those observed after lesions of the orbitofrontal cortex and are suggestive of an important role for corticosubthalamic connections in complex cognitive behaviour.

  20. Decreasing adrenergic or sympathetic hyperactivity after severe traumatic brain injury using propranolol and clonidine (DASH After TBI Study: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Patel Mayur B

    2012-09-01

    Full Text Available Abstract Background Severe TBI, defined as a Glasgow Coma Scale ≤ 8, increases intracranial pressure and activates the sympathetic nervous system. Sympathetic hyperactivity after TBI manifests as catecholamine excess, hypertension, abnormal heart rate variability, and agitation, and is associated with poor neuropsychological outcome. Propranolol and clonidine are centrally acting drugs that may decrease sympathetic outflow, brain edema, and agitation. However, there is no prospective randomized evidence available demonstrating the feasibility, outcome benefits, and safety for adrenergic blockade after TBI. Methods/Design The DASH after TBI study is an actively accruing, single-center, randomized, double-blinded, placebo-controlled, two-arm trial, where one group receives centrally acting sympatholytic drugs, propranolol (1 mg intravenously every 6 h for 7 days and clonidine (0.1 mg per tube every 12 h for 7 days, and the other group, double placebo, within 48 h of severe TBI. The study uses a weighted adaptive minimization randomization with categories of age and Marshall head CT classification. Feasibility will be assessed by ability to provide a neuroradiology read for randomization, by treatment contamination, and by treatment compliance. The primary endpoint is reduction in plasma norepinephrine level as measured on day 8. Secondary endpoints include comprehensive plasma and urine catecholamine levels, heart rate variability, arrhythmia occurrence, infections, agitation measures using the Richmond Agitation-Sedation Scale and Agitated Behavior scale, medication use (anti-hypertensive, sedative, analgesic, and antipsychotic, coma-free days, ventilator-free days, length of stay, and mortality. Neuropsychological outcomes will be measured at hospital discharge and at 3 and 12 months. The domains tested will include global executive function, memory, processing speed, visual-spatial, and behavior. Other assessments include

  1. Rationale, design and methods for a randomised and controlled trial to investigate whether home access to electronic games decreases children's physical activity

    Directory of Open Access Journals (Sweden)

    Piek Jan P

    2009-06-01

    Full Text Available Abstract Background Many children are reported to have insufficient physical activity (PA placing them at greater risk of poor health outcomes. Participating in sedentary activities such as playing electronic games is widely believed to contribute to less PA. However there is no experimental evidence that playing electronic games reduces PA. There is also no evidence regarding the effect of different types of electronic games (traditional sedentary electronic games versus new active input electronic games on PA. Further, there is a poor understanding about how characteristics of children may moderate the impact of electronic game access on PA and about what leisure activities are displaced when children play electronic games. Given that many children play electronic games, a better understanding of the effect of electronic game use on PA is critical to inform child health policy and intervention. Methods This randomised and controlled trial will examine whether PA is decreased by access to electronic games and whether any effect is dependent on the type of game input or the child's characteristics. Children aged 10–12 years (N = 72, 36 females will be recruited and randomised to a balanced ordering of 'no electronic games', 'traditional' electronic games and 'active' electronic games. Each child will participate in each condition for 8 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is PA, assessed by Actical accelerometers worn for 7 days on the wrist and hip. Energy expenditure will be assessed by the doubly labelled water technique and motor coordination, adiposity, self-confidence, attitudes to technology and PA and leisure activities will also be assessed. A sample of 72 will provide a power of > 0.9 for detecting a 15 mins difference in PA (sd = 30 mins. Discussion This is the first such trial and will provide critical information to understand whether access to electronic games affects

  2. 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

  3. 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.

  4. 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.

  5. 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...

  6. 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.

  7. Peer support to decrease diabetes-related distress in patients with type 2 diabetes mellitus: design of a randomised controlled trial.

    NARCIS (Netherlands)

    Vries, L. de; Heijden, A.A.W.A. van der; Riet, E. van 't; Baan, C.A.; Kostense, P.J.; Rijken, M.; Rutten, G.E.H.M.; Nijpels, G.

    2014-01-01

    Background: Many type 2 diabetes mellitus patients face difficulties self-managing their illness, which can lead to high levels of diabetes-related distress. Diabetes distress may be decreased by peer support, as peers understand and have dealt with similar problems, and can help motivate each

  8. Peer support to decrease diabetes-related distress in patients with type 2 diabetes mellitus: design of a randomised controlled trial.

    NARCIS (Netherlands)

    de Vries, L.; van der Heijden, A.A.; van 't Riet, E.; Baan, C.A.; Kostense, P.J.; Rijken, M.; Rutten, G.E.H.M.; Nijpels, G.

    2014-01-01

    BACKGROUND: Many type 2 diabetes mellitus patients face difficulties self-managing their illness, which can lead to high levels of diabetes-related distress. Diabetes distress may be decreased by peer support, as peers understand and have dealt with similar problems, and can help motivate each

  9. Peer support to decrease diabetes-related distress in patients with type 2 diabetes mellitus: design of a randomised controlled trial

    NARCIS (Netherlands)

    de Vries, L.; van der Heijden, A.A.W.A.; van 't Riet, E.; Baan, C.A.; Kostense, P.J.; Rijken, M.; Rutten, G.E.H.M.; Nijpels, G.

    2014-01-01

    Background: Many type 2 diabetes mellitus patients face difficulties self-managing their illness, which can lead to high levels of diabetes-related distress. Diabetes distress may be decreased by peer support, as peers understand and have dealt with similar problems, and can help motivate each

  10. Effectiveness of environmental control measures to decrease the risk of invasive aspergillosis in acute leukaemia patients during hospital building work.

    Science.gov (United States)

    Combariza, J F; Toro, L F; Orozco, J J

    2017-08-01

    Invasive aspergillosis (IA) is a significant problem in acute leukaemia patients. Construction work near hospital wards caring for immunocompromised patients is one of the main risk factors for developing invasive pulmonary aspergillosis (IPA). To assess the impact of environmental control measures used during hospital construction for the prevention of IA in acute leukaemia patients. A retrospective cohort study was developed to evaluate the IA incidence in acute leukaemia patients with different environmental control measures employed during hospital construction. We used European Organisation for the Research and Treatment of Cancer (EORTC) criterial diagnosis parameters for definition of IA. A total of 175 episodes of inpatient care were evaluated, 62 of which did not have any environmental control measures (when an outbreak occurred), and 113 that were subject to environmental control measures directed to preventing IA. The study showed an IA incidence of 25.8% for the group without environmental control measures vs 12.4% for those who did receive environmental control measures (P=0.024). The relative risk for IA was 0.595 (95% confidence interval: 0.394-0.897) for the group with environmental control measures. The current study suggests that the implementation of environmental control measures during a hospital construction has a positive impact for prevention of IA in patients hospitalized with acute leukaemia. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  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. An interesterified palm olein test meal decreases early-phase postprandial lipemia compared to palm olein:a Randomized Controlled Trial

    OpenAIRE

    Hall, Wendy; Fiuza Brito, Marcela; Huang, Junlan; Wood, Lucy; Filippou, Androulla; Sanders, Thomas A. B.; Berry, Sarah

    2014-01-01

    Palm oil that has been interesterified to produce a higher proportion of palmitic acid (16:0) in the sn-2 position reduces postprandial lipemia in young, normolipidemic men and women, but effects in older subjects with higher fasting triacylglycerol (TAG) concentrations are unknown. We tested the hypothesis that high-fat meals rich in interesterified palm olein (IPO) decrease lipemia and alter plasma lipoprotein fraction composition compared to native palm olein (NPO) in men aged 40–70 years ...

  13. Decreased repopulation as well as increased reoxygenation contribute to the improvement in local control after targeting of the EGFR by C225 during fractionated irradiation.

    NARCIS (Netherlands)

    Krause, M.; Ostermann, G.; Petersen, C.; Yaromina, A.; Hessel, F.; Harstrick, A.; Kogel, A.J. van der; Thames, H.D.; Baumann, M.

    2005-01-01

    BACKGROUND AND PURPOSE: Inhibition of repopulation and enhanced reoxygenation has been suggested to contribute to improvement of local tumour control after fractionated irradiation combined with inhibitors of the epidermal growth factor receptor (EGFR). The present study addresses this hypothesis in

  14. 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.

  15. 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

  16. 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.

  17. Proton-Pump inhibitors decrease the risk of bleeding and perforated gastroduodenal ulcers attributable to non-steroidal anti-inflammatory drugs: A nested case-control study

    NARCIS (Netherlands)

    Vonkeman, Harald Erwin; Fernandes, Robert W.; van der Palen, Jacobus Adrianus Maria; van Roon, Eric N.; van de Laar, Mart A F J

    2006-01-01

    Purpose: To determine which patients are especially at risk for serious NSAID attributable gastroduodenal ulcers and to compare the effectiveness of different preventive strategies in these patients. Methods: A case - control study was conducted in a large teaching hospital serving a population of

  18. Detecting Mutations in the Mycobacterium tuberculosis Pyrazinamidase Gene pncA to Improve Infection Control and Decrease Drug Resistance Rates in Human Immunodeficiency Virus Coinfection

    Science.gov (United States)

    Dudley, Matthew Z.; Sheen, Patricia; Gilman, Robert H.; Ticona, Eduardo; Friedland, Jon S.; Kirwan, Daniela E.; Caviedes, Luz; Rodriguez, Richard; Cabrera, Lilia Z.; Coronel, Jorge; Grandjean, Louis; Moore, David A. J.; Evans, Carlton A.; Huaroto, Luz; Chávez-Pérez, Víctor; Zimic, Mirko

    2016-01-01

    Hospital infection control measures are crucial to tuberculosis (TB) control strategies within settings caring for human immunodeficiency virus (HIV)–positive patients, as these patients are at heightened risk of developing TB. Pyrazinamide (PZA) is a potent drug that effectively sterilizes persistent Mycobacterium tuberculosis bacilli. However, PZA resistance associated with mutations in the nicotinamidase/pyrazinamidase coding gene, pncA, is increasing. A total of 794 patient isolates obtained from four sites in Lima, Peru, underwent spoligotyping and drug resistance testing. In one of these sites, the HIV unit of Hospital Dos de Mayo (HDM), an isolation ward for HIV/TB coinfected patients opened during the study as an infection control intervention: circulating genotypes and drug resistance pre- and postintervention were compared. All other sites cared for HIV-negative outpatients: genotypes and drug resistance rates from these sites were compared with those from HDM. HDM patients showed high concordance between multidrug resistance, PZA resistance according to the Wayne method, the two most common genotypes (spoligotype international type [SIT] 42 of the Latino American-Mediterranean (LAM)-9 clade and SIT 53 of the T1 clade), and the two most common pncA mutations (G145A and A403C). These associations were absent among community isolates. The infection control intervention was associated with 58–92% reductions in TB caused by SIT 42 or SIT 53 genotypes (odds ratio [OR] = 0.420, P = 0.003); multidrug-resistant TB (OR = 0.349, P < 0.001); and PZA-resistant TB (OR = 0.076, P < 0.001). In conclusion, pncA mutation typing, with resistance testing and spoligotyping, was useful in identifying a nosocomial TB outbreak and demonstrating its resolution after implementation of infection control measures. PMID:27928075

  19. Effects of repetitive transcranial magnetic stimulation on arm function and decreasing unilateral spatial neglect in subacute stroke: a randomized controlled trial.

    Science.gov (United States)

    Cha, Hyun Gyu; Kim, Myoung Kwon

    2016-07-01

    The objective of this study is to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the functional recovery of stroke patients with unilateral neglect. Randomized controlled experimental study. Outpatient rehabilitation hospital. Thirty patients with stroke were randomly assigned to two groups: an rTMS group (experimental) and a control group. Stroke patients in the experimental group underwent comprehensive rehabilitation therapy and rTMS. Stroke patients in the control group underwent sham therapy and comprehensive rehabilitation therapy. Participants in both groups received therapy 5 days per week for 4 weeks. Line bisection, Albert, Box and block and Grip strength tests were assessed before and after the four-week therapy period. A significant difference in the post-training gains in Line bisection (16.53 SD 9.78 vs. 3.60 SD 5.02), Albert (14.13 SD 4.92 vs. 3.26 SD 2.01), Box and block (15.06 SD 9.68 vs. 6.93 SD 7.52), and Grip strength tests (3.60 SD 2.66 vs 0.80 SD 1.26) was observed between the experimental group and the control group (P<0.05). In addition, the effect size for gains in the experimental and control groups was very strong in AT, BBT (effect size=2.15, 0.77 respectively). We conclude that rTMS might be effective in improvement in reduction of the unilateral neglect and motor function. © The Author(s) 2015.

  20. 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.

  1. Omega-3 fatty acid supplementation decreases liver fat content in polycystic ovary syndrome: a randomized controlled trial employing proton magnetic resonance spectroscopy.

    Science.gov (United States)

    Cussons, Andrea J; Watts, Gerald F; Mori, Trevor A; Stuckey, Bronwyn G A

    2009-10-01

    There is an association between nonalcoholic fatty liver disease (NAFLD) and the polycystic ovary syndrome (PCOS). Marine-derived omega-3 fatty acids have favorable effects on cardiovascular risk and could reduce liver fat in NAFLD. The primary aim of this study was to examine the effects of omega-3 fatty acids on liver fat in PCOS. The secondary aim was to assess their effects on traditional cardiovascular risk factors. We conducted a randomized, crossover study at a tertiary cardiovascular research center. Twenty-five women with PCOS (mean age, 32.7 yr; mean body mass index, 34.8 kg/m(2)) participated in the study. We compared 4g/d of omega-3 fatty acids with placebo over 8 wk. The primary outcome measure was hepatic fat content quantified using proton magnetic resonance spectroscopy. Secondary outcome measures included fasting lipids and blood pressure. Omega-3 fatty acids significantly decreased liver fat content compared with placebo [10.2 (1.1) vs. 8.4 (0.9)%; P = 0.022]. There was also a reduction in triglycerides [1.19 (1.03-1.47) vs. 1.02 (0.93-1.18) mmol/liter; P = 0.002], systolic blood pressure [124.1 (12.1) vs. 122.3 (14.5) mm Hg; P = 0.018], and diastolic blood pressure [73.2 (8.4) vs. 69.7 (8.3) mm Hg; P = 0.005] with omega-3 fatty acids compared with placebo. Omega-3 fatty acids particularly decreased hepatic fat in women with hepatic steatosis, defined as liver fat percentage greater than 5% [18.2 (11.1) vs. 14.8 (9.3)%; P = 0.03]. Omega-3 fatty acid supplementation has a beneficial effect on liver fat content and other cardiovascular risk factors in women with PCOS, including those with hepatic steatosis. Whether this translates into a reduction in cardiometabolic events warrants further study.

  2. 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.

  3. A conceptual model for worksite intelligent physical exercise training - IPET - intervention for decreasing life style health risk indicators among employees: a randomized controlled trial

    Science.gov (United States)

    2014-01-01

    Background Health promotion at the work site in terms of physical activity has proven positive effects but optimization of relevant exercise training protocols and implementation for high adherence are still scanty. Methods/Design The aim of this paper is to present a study protocol with a conceptual model for planning the optimal individually tailored physical exercise training for each worker based on individual health check, existing guidelines and state of the art sports science training recommendations in the broad categories of cardiorespiratory fitness, muscle strength in specific body parts, and functional training including balance training. The hypotheses of this research are that individually tailored worksite-based intelligent physical exercise training, IPET, among workers with inactive job categories will: 1) Improve cardiorespiratory fitness and/or individual health risk indicators, 2) Improve muscle strength and decrease musculoskeletal disorders, 3) Succeed in regular adherence to worksite and leisure physical activity training, and 3) Reduce sickness absence and productivity losses (presenteeism) in office workers. The present RCT study enrolled almost 400 employees with sedentary jobs in the private as well as public sectors. The training interventions last 2 years with measures at baseline as well as one and two years follow-up. Discussion If proven effective, the intelligent physical exercise training scheduled as well as the information for its practical implementation can provide meaningful scientifically based information for public health policy. Trial Registration ClinicalTrials.gov, number: NCT01366950. PMID:24964869

  4. A conceptual model for worksite intelligent physical exercise training--IPET--intervention for decreasing life style health risk indicators among employees: a randomized controlled trial.

    Science.gov (United States)

    Sjøgaard, Gisela; Justesen, Just Bendix; Murray, Mike; Dalager, Tina; Søgaard, Karen

    2014-06-26

    Health promotion at the work site in terms of physical activity has proven positive effects but optimization of relevant exercise training protocols and implementation for high adherence are still scanty. The aim of this paper is to present a study protocol with a conceptual model for planning the optimal individually tailored physical exercise training for each worker based on individual health check, existing guidelines and state of the art sports science training recommendations in the broad categories of cardiorespiratory fitness, muscle strength in specific body parts, and functional training including balance training. The hypotheses of this research are that individually tailored worksite-based intelligent physical exercise training, IPET, among workers with inactive job categories will: 1) Improve cardiorespiratory fitness and/or individual health risk indicators, 2) Improve muscle strength and decrease musculoskeletal disorders, 3) Succeed in regular adherence to worksite and leisure physical activity training, and 3) Reduce sickness absence and productivity losses (presenteeism) in office workers. The present RCT study enrolled almost 400 employees with sedentary jobs in the private as well as public sectors. The training interventions last 2 years with measures at baseline as well as one and two years follow-up. If proven effective, the intelligent physical exercise training scheduled as well as the information for its practical implementation can provide meaningful scientifically based information for public health policy. ClinicalTrials.gov, number: NCT01366950.

  5. V-TIME: a treadmill training program augmented by virtual reality to decrease fall risk in older adults: study design of a randomized controlled trial.

    Science.gov (United States)

    Mirelman, Anat; Rochester, Lynn; Reelick, Miriam; Nieuwhof, Freek; Pelosin, Elisa; Abbruzzese, Giovanni; Dockx, Kim; Nieuwboer, Alice; Hausdorff, Jeffrey M

    2013-02-06

    Recent work has demonstrated that fall risk can be attributed to cognitive as well as motor deficits. Indeed, everyday walking in complex environments utilizes executive function, dual tasking, planning and scanning, all while walking forward. Pilot studies suggest that a multi-modal intervention that combines treadmill training to target motor function and a virtual reality obstacle course to address the cognitive components of fall risk may be used to successfully address the motor-cognitive interactions that are fundamental for fall risk reduction. The proposed randomized controlled trial will evaluate the effects of treadmill training augmented with virtual reality on fall risk. Three hundred older adults with a history of falls will be recruited to participate in this study. This will include older adults (n=100), patients with mild cognitive impairment (n=100), and patients with Parkinson's disease (n=100). These three sub-groups will be recruited in order to evaluate the effects of the intervention in people with a range of motor and cognitive deficits. Subjects will be randomly assigned to the intervention group (treadmill training with virtual reality) or to the active-control group (treadmill training without virtual reality). Each person will participate in a training program set in an outpatient setting 3 times per week for 6 weeks. Assessments will take place before, after, and 1 month and 6 months after the completion of the training. A falls calendar will be kept by each participant for 6 months after completing the training to assess fall incidence (i.e., the number of falls, multiple falls and falls rate). In addition, we will measure gait under usual and dual task conditions, balance, community mobility, health related quality of life, user satisfaction and cognitive function. This randomized controlled trial will demonstrate the extent to which an intervention that combines treadmill training augmented by virtual reality reduces fall risk

  6. Rationale and methods for a randomized controlled trial of a movement-to-music video program for decreasing sedentary time among mother-child pairs.

    Science.gov (United States)

    Tuominen, Pipsa P A; Husu, Pauliina; Raitanen, Jani; Luoto, Riitta M

    2015-10-05

    Measured objectively, under a quarter of adults and fewer than half of preschool children meet the criteria set in the aerobic physical activity recommendations of the Centers for Disease Control and Prevention. Moreover, adults reportedly are sedentary (seated or lying down) for most of their waking hours. Importantly, greater amounts of sedentary time on parents' part are associated with an increased risk of more sedentary time among their children. A randomized controlled trial targeting mother-child pairs has been designed, to examine whether a movement-to-music video program may be effective in reducing sedentary time and increasing physical activity in the home environment. Mother-child pairs (child age of 4-7 years) will be recruited from among NELLI lifestyle-modification study five-year follow-up cohort participants, encompassing 14 municipalities in Pirkanmaa region, Finland. Accelerometer and exercise diary data are to be collected for intervention and control groups at the first, second and eighth week after the baseline measurements. Background factors, physical activity, screen time, motivation to exercise, and self-reported height and weight, along with quality of life, will be assessed via questionnaires. After the baseline and first week measurements, the participants of the intervention group will receive a movement-to-music video program designed to reduce sedentary time and increase physical activity. Intervention group mother-child pairs will be instructed to exercise every other day while watching the video program over the next seven weeks. Information on experiences of the use of the movement-to-music video program will be collected 8 weeks after baseline. Effects of the intervention will be analyzed in line with the intention-to-treat principle through comparison of the changes in the main outcomes between intervention and control group participants. The study has received ethics approval from the Pirkanmaa Ethics Committee in Human

  7. Method of decreasing nuclear power

    International Nuclear Information System (INIS)

    Masuda, Hiromi

    1987-01-01

    Purpose: To easily attain the power decreasing in a HWLWR type reactor and improve the reactor safety. Method: The method is applied to a nuclear reactor in which the reactor reactivity is controlled by control rods and liquid posions dissolved in moderators. Means for forecasting the control rod operation amount required for the reactor power down and means for removing liquid poisons in the moderators are provided. The control rod operation amount required for the power down is forecast before the power down and the liquid poisons in the moderators are removed. Then, the control rods are inserted into a deep insertion position to reduce the reactor power. This invention can facilitate easy power down, as well as provide effects of improving the controllability in the usual operation and of avoiding abrupt power down which leads to an improved availability. (Kamimura, M.)

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

    DEFF Research Database (Denmark)

    Winding, Kamilla Munch; Munch, Gregers Winding; Iepsen, Ulrik Winning

    2018-01-01

    AIM: 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. MATERIALS AND METHODS: 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...... 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...

  9. Decreasing Relative Risk Premium

    DEFF Research Database (Denmark)

    Hansen, Frank

    relative risk premium in the small implies decreasing relative risk premium in the large, and decreasing relative risk premium everywhere implies risk aversion. We finally show that preferences with decreasing relative risk premium may be equivalently expressed in terms of certain preferences on risky......We consider the risk premium demanded by a decision maker with wealth x in order to be indifferent between obtaining a new level of wealth y1 with certainty, or to participate in a lottery which either results in unchanged present wealth or a level of wealth y2 > y1. We define the relative risk...... premium as the quotient between the risk premium and the increase in wealth y1–x which the decision maker puts on the line by choosing the lottery in place of receiving y1 with certainty. We study preferences such that the relative risk premium is a decreasing function of present wealth, and we determine...

  10. Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and impact prolactin levels during the subsequent day: a case control study.

    Science.gov (United States)

    Chang, Yu-San; Chen, Hsiang-Lan; Wu, Yu-Hsuan; Hsu, Chung-Yao; Liu, Ching-Kuan; Hsu, Chin

    2014-08-05

    We investigated circadian changes and effects on mood, sleep-related hormones and cognitive performance when nurses worked consecutive night shifts in a rapidly rotating shift system. Daytime cognitive function, sleep propensity and sleep-related hormones (growth hormone, cortisol, prolactin, thyrotropin) were compared after participants worked two and four consecutive night shifts. Twenty-three off-duty nurses, 20 nurses working two consecutive night shifts and 16 nurses working four consecutive night shifts were enrolled. All participants completed the Maintenance of Wakefulness Test, State-Trait Anxiety Inventory, Stanford Sleepiness Scale, visual attention tasks (VAT), Wisconsin Card Sorting Test, and modified Multiple Sleep Latency Test. Hormone levels were also measured four times throughout the day, at 2-h intervals. During the day, the participants in the night shift groups were less able to maintain wakefulness, had poor performance on VAT, and higher thyrotropin levels than did those in the off-duty group. Participants who worked two night shifts were better able to maintain wakefulness, had higher anxiety scale scores, poorer initial performance and lack of learning effect on VAT, and higher prolactin levels compared with those who worked four night shifts. There were no differences in cortisol levels between the two- and four- shift groups. Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and may impact daytime prolactin levels after night shifts. It is possible that the two-shift group had a higher cortisol level than did the four-shift group, which would be consistent with the group's higher state anxiety scores. The negative findings may be due to the small sample size. Further studies on the effects of consecutive night shifts on mood and cortisol levels during the daytime after sleep restriction would be valuable.

  11. Controlling firearms use in Australia: has the 1996 gun law reform produced the decrease in rates of suicide with this method?

    Science.gov (United States)

    Klieve, Helen; Barnes, Michael; De Leo, Diego

    2009-04-01

    Observed reductions in firearm suicides in Australia have been linked to the 1997 national firearms agreement (NFA) introduced following the 1996 Port Arthur massacre. The NFA placed strong access restrictions on firearms. To assess the impact of legislative restrictions on the incidence of firearm suicide in Queensland and explore alternative or contributory factors behind observed declines. The Queensland suicide register (QSR) provided detailed information on all male suicides in Queensland (1990-2004), with additional data for Australia (1968-2004) accessed from other official sources. Trends in suicide rates pre/post NFA, and in method selection, were assessed using negative binomial regressions. Changing method selection patterns were examined using a cohort analysis of 5 years of age classes for Australian males. The observed reduction in firearms suicides was initiated prior to the 1997 introduction of the NFA in Queensland and Australia, with a clear decline observed in Australian figures from 1988. No significant difference was found in the rate pre/post the introduction of the NFA in Queensland; however, a significant difference was found for Australian data, the quality of which is noticeably less satisfactory. A marked age-difference in method choice was observed through a cohort analysis demonstrating both time and age influences. Within sequential birth cohorts, rates of firearms suicides decreased in younger males but increased in hanging suicides; this trend was far less marked in older males. The implemented restrictions may not be responsible for the observed reductions in firearms suicide. Data suggest that a change in social and cultural attitudes could have contributed to the shift in method preference.

  12. Listening to music during transrectal ultrasound-guided prostate biopsy decreases anxiety, pain and dissatisfaction in patients: a pilot randomized controlled trial.

    Science.gov (United States)

    Chang, Yun Hee; Oh, Tae Hoon; Lee, Jae Whan; Park, Seung Chol; Seo, Ill Young; Jeong, Hee Jong; Kwon, Whi-An

    2015-01-01

    To determine whether listening to music during transrectal ultrasound (TRUS)-guided 12-core needle prostate biopsy decreases anxiety, pain and dissatisfaction among patients and results in a more comfortable and better tolerated procedure. 76 male patients who underwent TRUS-guided prostate biopsy between March 2013 and June 2014 were randomized into the following groups: no music (group I, n = 38) or classical music (group II, n = 38) during the procedure. Before TRUS-guided prostate biopsy, lidocaine gel was instilled into the rectum. Patient anxiety levels were quantified using the State-Trait Anxiety Inventory. A visual analog scale (0-10) was used for self-assessment of satisfaction, discomfort and willingness among patients to have a repeat TRUS-guided prostate biopsy. Demographic characteristics, mean age, procedure duration and procedure indications did not differ statistically between the two groups. The mean anxiety level and mean pain score of group II were significantly lower than those of group I (p = 0.001 and p = 0.003, respectively). Group II also had a significantly higher mean satisfaction score than group I (p = 0.007). Before the procedure, heart rate and systolic blood pressure were similar in groups I and II; however, after the procedure, levels were lower in group II than in group I (heart rate, p = 0.014; systolic blood pressure, p = 0.011). Listening to music during TRUS-guided prostate biopsy significantly reduced patients' feelings of pain, discomfort and dissatisfaction. Music can serve as a simple, inexpensive and effective adjunct to sedation during TRUS-guided prostate biopsy. We recommend playing music during TRUS-guided prostate biopsy. 2014 S. Karger AG, Basel

  13. Decreasing Serial Cost Sharing

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter

    The increasing serial cost sharing rule of Moulin and Shenker [Econometrica 60 (1992) 1009] and the decreasing serial rule of de Frutos [Journal of Economic Theory 79 (1998) 245] have attracted attention due to their intuitive appeal and striking incentive properties. An axiomatic characterization...... of the increasing serial rule was provided by Moulin and Shenker [Journal of Economic Theory 64 (1994) 178]. This paper gives an axiomatic characterization of the decreasing serial rule...

  14. Decreasing serial cost sharing

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter Raahave

    2009-01-01

    The increasing serial cost sharing rule of Moulin and Shenker (Econometrica 60:1009-1037, 1992) and the decreasing serial rule of de Frutos (J Econ Theory 79:245-275, 1998) are known by their intuitive appeal and striking incentive properties. An axiomatic characterization of the increasing serial...... rule was provided by Moulin and Shenker (J Econ Theory 64:178-201, 1994). This paper gives an axiomatic characterization of the decreasing serial rule....

  15. Association of pioglitazone treatment with decreased bone mineral density in obese premenopausal patients with polycystic ovary syndrome: a randomized, placebo-controlled trial

    DEFF Research Database (Denmark)

    Glintborg, D.; Andersen, Mikael; Hagen, C.

    2008-01-01

    OBJECTIVE: Our objective was to investigate the effect of pioglitazone on bone mineral density (BMD) and bone turnover markers in polycystic ovary syndrome (PCOS). DESIGN AND SETTING: We conducted a randomized, placebo-controlled study at an outpatient clinic at a university hospital. PATIENTS......: Thirty premenopausal patients with PCOS and 14 age- and weight-matched healthy females participated. INTERVENTIONS: Pioglitazone (30 mg/d) or placebo was given for 16 wk. MAIN OUTCOME MEASURES: Measurements of BMD [hip (neck and total) and lumbar spine (L2-L4)], bone metabolic parameters [alkaline...... phosphatase (ALP), 25-hydroxyvitamin D, C-telopeptide of type I collagen (ICTP), osteocalcin, and PTH], endocrine profiles (testosterone, estradiol, and insulin), and body composition (waist to hip ratio, body mass index, and whole-body dual-energy x-ray absorptiometry scans) were performed. RESULTS: Patients...

  16. Home telemonitoring of non-invasive ventilation decreases healthcare utilisation in a prospective controlled trial of patients with amyotrophic lateral sclerosis.

    Science.gov (United States)

    Pinto, Anabela; Almeida, José Pedro; Pinto, Susana; Pereira, João; Oliveira, António Gouveia; de Carvalho, Mamede

    2010-11-01

    Non-invasive ventilation (NIV) is an efficient method for treating respiratory failure in patients with amyotrophic lateral sclerosis (ALS). However, it requires a process of adaptation not always achieved due to poor compliance. The role of telemonitoring of NIV is not yet established. To test the advantage of using modem communication in NIV of ALS patients. Prospective, single blinded controlled trial. Population and methods According to their residence, 40 consecutive ventilated ALS patients were assigned to one of two groups: a control group (G1, n=20) in which compliance and ventilator parameter settings were assessed during office visits; or an intervention group (G2, n=20) in which patients received a modem device connected to the ventilator. The number of office and emergency room visits and hospital admissions during the entire span of NIV use and the number of parameter setting changes to achieve full compliance were the primary outcome measurements. Demographic and clinical features were similar between the two groups at admission. No difference in compliance was found between the groups. The incidence of changes in parameter settings throughout the survival period with NIV was lower in G2 (p<0.0001) but it was increased during the initial period needed to achieve full compliance. The number of office or emergency room visits and inhospital admissions was significantly lower in G2 (p<0.0001). Survival showed a trend favouring G2 (p=0.13). This study shows that telemonitoring reduces health care utilisation with probable favourable implications on costs, survival and functional status.

  17. Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial.

    Science.gov (United States)

    Xu, Yangying; Nisenblat, Victoria; Lu, Cuiling; Li, Rong; Qiao, Jie; Zhen, Xiumei; Wang, Shuyu

    2018-03-27

    Management of women with reduced ovarian reserve or poor ovarian response (POR) to stimulation is one of the major challenges in reproductive medicine. The primary causes of POR remain elusive and oxidative stress was proposed as one of the important contributors. It has been suggested that focus on the specific subpopulations within heterogeneous group of poor responders could assist in evaluating optimal management strategies for these patients. This study investigated the effect of anti-oxidant treatment with coenzyme Q10 (CoQ10) on ovarian response and embryo quality in young low-prognosis patients with POR. This prospective, randomized controlled study included 186 consecutive patients with POR stratified according to the POSEIDON classification group 3 (age reserve parameters). The participants were randomized to the CoQ10 pre-treatment for 60 days preceding IVF-ICSI cycle or no pre-treatment. The number of high quality embryos was a primary outcome measure. A total of 169 participants were evaluated (76 treated with CoQ10 and 93 controls); 17 women were excluded due to low compliance with CoQ10 administration. The baseline demographic and clinical characteristics were comparable between the groups. CoQ10 pretreatment resulted in significantly lower gonadotrophin requirements and higher peak E2 levels. Women in CoQ10 group had increased number of retrieved oocytes (4, IQR 2-5), higher fertilization rate (67.49%) and more high-quality embryos (1, IQR 0-2); p reserve in IVF-ICSI cycles. Further work is required to determine whether there is an effect on clinical treatment endpoints.

  18. Plasma 25-hydroxyvitamin D3 is associated with decreased risk of postmenopausal breast cancer in whites: a nested case–control study in the multiethnic cohort study

    International Nuclear Information System (INIS)

    Kim, Yeonju; Henderson, Brian E; Kolonel, Laurence N; Goodman, Marc T; Franke, Adrian A; Shvetsov, Yurii B; Wilkens, Lynne R; Cooney, Robert V; Lurie, Galina; Maskarinec, Gertraud; Hernandez, Brenda Y; Le Marchand, Loïc

    2014-01-01

    Higher sunlight exposure is correlated with lower incidence of breast cancer in ecological studies, but findings from prospective studies regarding the association of circulating levels of vitamin D with the risk of breast cancer have been null. The objective of this study was to examine the relation between plasma levels of vitamin D and the risk of postmenopausal breast cancer. We conducted a nested case–control study within the Multiethnic Cohort Study of five race/ethnic groups (white, African-American, Native Hawaiian, Japanese, and Latino) from Hawaii and Los Angeles between 2001 and 2006. Pre-diagnostic plasma levels of 25-hydroxyvitamin D2 [25(OH)D 2 ], 25-hydroxyvitamin D3 [25(OH)D 3 ] and 25(OH)D (sum of 25(OH)D 2 and 25(OH)D 3 ) were examined among 707 postmenopausal breast cancer cases and matched controls. Using conditional logistic regression models, 20 ng/mL increases of plasma 25(OH)D 3 (odds ratio (OR) 0.28; 95% confidence interval (CI) 0.14-0.56) and 25(OH)D (OR 0.43; 95% CI 0.23-0.80) were inversely associated with breast cancer risk among white women, but not among women in other race/ethnic groups. Using two-segmented, piecewise-linear logistic regression models, the change-points of the ORs, either for 25(OH)D 3 or for 25(OH)D, were detected as 20 ng/mL among whites. Circulating 25(OH)D 3 and 25(OH)D were associated with a reduced risk of postmenopausal breast cancer among whites, but not in other ethnic groups, who reside in low latitude regions

  19. A new mother-child play activity program to decrease parenting stress and improve child cognitive abilities: a cluster randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Yoshiyuki Tachibana

    Full Text Available BACKGROUND: We propose a new play activity intervention program for mothers and children. Our interdisciplinary program integrates four fields of child-related sciences: neuroscience, preschool pedagogy, developmental psychology, and child and maternal psychiatry. To determine the effect of this intervention on child and mother psychosocial problems related to parenting stress and on the children's cognitive abilities, we performed a cluster randomized controlled trial. METHODOLOGY/PRINCIPAL FINDINGS: Participants were 238 pairs of mothers and typically developing preschool children (ages 4-6 years old from Wakakusa kindergarten in Japan. The pairs were asked to play at home for about 10 min a day, 5 days a week for 3 months. Participants were randomly assigned to the intervention or control group by class unit. The Parenting Stress Index (PSI (for mothers, the Goodenough Draw-a-Man intelligence test (DAM, and the new S-S intelligence test (NS-SIT (for children were administered prior to and 3 months after the intervention period. Pre-post changes in test scores were compared between the groups using a linear mixed-effects model analysis. The primary outcomes were the Total score on the child domain of the PSI (for child psychosocial problems related to parenting stress, Total score on the parent domain of the PSI (for maternal psychosocial problems related to parenting stress, and the score on the DAM (for child cognitive abilities. The results of the PSI suggested that the program may reduce parenting stress. The results of the cognitive tests suggested that the program may improve the children's fluid intelligence, working memory, and processing speed. CONCLUSIONS/SIGNIFICANCE: Our intervention program may ameliorate the children's psychosocial problems related to parenting stress and increase their cognitive abilities. TRIAL REGISTRATION: UMIN Clinical Trials Registry UMIN000002265.

  20. A new mother-child play activity program to decrease parenting stress and improve child cognitive abilities: a cluster randomized controlled trial.

    Science.gov (United States)

    Tachibana, Yoshiyuki; Fukushima, Ai; Saito, Hitomi; Yoneyama, Satoshi; Ushida, Kazuo; Yoneyama, Susumu; Kawashima, Ryuta

    2012-01-01

    We propose a new play activity intervention program for mothers and children. Our interdisciplinary program integrates four fields of child-related sciences: neuroscience, preschool pedagogy, developmental psychology, and child and maternal psychiatry. To determine the effect of this intervention on child and mother psychosocial problems related to parenting stress and on the children's cognitive abilities, we performed a cluster randomized controlled trial. Participants were 238 pairs of mothers and typically developing preschool children (ages 4-6 years old) from Wakakusa kindergarten in Japan. The pairs were asked to play at home for about 10 min a day, 5 days a week for 3 months. Participants were randomly assigned to the intervention or control group by class unit. The Parenting Stress Index (PSI) (for mothers), the Goodenough Draw-a-Man intelligence test (DAM), and the new S-S intelligence test (NS-SIT) (for children) were administered prior to and 3 months after the intervention period. Pre-post changes in test scores were compared between the groups using a linear mixed-effects model analysis. The primary outcomes were the Total score on the child domain of the PSI (for child psychosocial problems related to parenting stress), Total score on the parent domain of the PSI (for maternal psychosocial problems related to parenting stress), and the score on the DAM (for child cognitive abilities). The results of the PSI suggested that the program may reduce parenting stress. The results of the cognitive tests suggested that the program may improve the children's fluid intelligence, working memory, and processing speed. Our intervention program may ameliorate the children's psychosocial problems related to parenting stress and increase their cognitive abilities. UMIN Clinical Trials Registry UMIN000002265.

  1. Metformin as an initial adjunct to low-dose liraglutide enhances the weight-decreasing potential of liraglutide in obese polycystic ovary syndrome: Randomized control study.

    Science.gov (United States)

    Jensterle, Mojca; Goricar, Katja; Janez, Andrej

    2016-04-01

    Liraglutide (LIRA) treatment is associated with the dose-dependent reduction of weight. Higher doses are more effective than lower doses, although higher doses are also more poorly tolerated. Metformin may enhance the weight-lowering potential of LIRA via the stimulatory modulation of incretin in addition to its direct beneficial effects in PCOS. The aim of the present study was to evaluate whether metformin as an adjunct to low-dose LIRA affects body weight with increased efficacy compared with low-dose LIRA alone in obese patients with PCOS. In a 12-week study, 44 obese women with PCOS were randomly offered either combined treatment (COMBO) with 1,000 mg metformin twice a day and 1.2 mg LIRA once a day, or treatment with 1.2 mg LIRA alone. The primary outcome of treatment was an alteration in the levels of obesity. A total of 43 patients [aged 30.3±4.4 years; body mass index (BMI) 37.2±4.5 kg/m 2 ; mean ± standard deviation] completed the study. The subjects treated with COMBO lost on average 6.2±2.4 kg compared with a 3.8±3.5 kg weight loss in the patients treated with LIRA alone (P=0.024). The BMI decreased by 2.2±0.8 kg/m 2 in patients treated with COMBO and by 1.4±1.2 kg/m 2 in patients treated with LIRA alone (P=0.024). A clinically significant ≥5% weight reduction was achieved in 59.1% of patients treated with COMBO and 42.9% of patients treated with LIRA alone. Reductions in glucose levels following oral glucose tolerance testing, as well as in androstenedione levels in the COMBO group were significantly greater compared with those in the LIRA group. The side effects were mild and transient in the two treatment groups. A combination of metformin and low-dose LIRA was more effective than low-dose LIRA alone in reducing body weight in obese patients with PCOS.

  2. The effects of Internet-based exercise compared with supervised group exercise in people with type 2 diabetes: a randomized controlled study.

    Science.gov (United States)

    Akinci, Buket; Yeldan, Ipek; Satman, Ilhan; Dirican, Ahmet; Ozdincler, Arzu Razak

    2018-06-01

    To compare the effects of Internet-based exercise on glycaemic control, blood lipids, body composition, physical activity level, functional capacity, and quality of life with supervised group exercise in patients with type 2 diabetes. Single-blind, randomized controlled study. A Faculty of Health Sciences. A total of 65 patients with type 2 diabetes (47 women, 18 men). Group A ( n = 22), control group - physical activity counselling once with a brochure. Group B ( n = 22), supervised group-based exercise, three days per week for eight weeks. Group C ( n = 21), Internet-based exercise following the same programme via a website. Primary outcomes - glycosylated haemoglobin, fasting blood glucose, high-density and low-density lipoprotein, triglyceride, and cholesterol. Secondary outcomes - waist and hip circumferences, body mass index, number of steps, six-minute walking test, and Euro-Quality of Life-5 Dimension. After treatment, glycaemic control (mean change for Group B; Group C; -0.80%, -0.91%, P = 0.003), waist circumference (-4.23 cm, 5.64 cm, P = 0.006), and quality of life (0.26, 0.15, P = 0.013) significantly improved in both training groups compared with the control group. Fasting blood glucose (-46.86 mg/dL, P = 0.009) and hip circumference (-2.7 cm, P = 0.011) were significantly decreased in Group B and total cholesterol (-16.4 mg/dL, P = 0.028), six-minute walking distance (30.5 m, P = 0.01), and number of steps (1258.05, P = 0.023) significantly improved in Group C compared with control group. Group B and Group C changed with equal magnitude. In type 2 diabetes, supervised group-based and Internet-based exercise can improve equally glycaemic control, waist circumference, and quality of life, and both are better than simply counselling.

  3. 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.

  4. 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.

  5. EFFICACY OF TRANEXAMIC ACID IN DECREASING BLOOD LOSS DURING AND AFTER CAESAREAN SECTION IN MULTIGRAVIDA PARTURIENTS: A CASE CONTROLLED PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Gunavathi Kandappan

    2016-06-01

    Full Text Available OBJECTIVES To study the efficacy of Tranexamic acid in reducing blood loss during and after the lower segment caesarean section in Multigravida parturients. METHODOLOGY A case controlled prospective study was conducted in 50 multigravida parturient women undergoing elective lower segment caesarean section in our hospital after getting Institutional Ethical Committee approval, over a period of two months. 25 of them were given Tranexamic acid 15 mg/kg immediately before caesarean section. Blood loss was collected and measured during two periods. The first period was from placental delivery to end of LSCS and the second from the end LSCS to 2 hours postpartum. RESULTS Tranexamic acid significantly reduces the quantity of blood loss from the end of LSCS to 2 hours post-partum in multigravida parturients. No complications or side effects are noted in both the groups. CONCLUSION Tranexamic acid significantly reduces the amount of blood loss during and after the lower segment caesarean section in multigravida parturients and its use was not associated with any side effects or complications.

  6. Andrographis paniculata decreases fatigue in patients with relapsing-remitting multiple sclerosis: a 12-month double-blind placebo-controlled pilot study.

    Science.gov (United States)

    Bertoglio, J C; Baumgartner, M; Palma, R; Ciampi, E; Carcamo, C; Cáceres, D D; Acosta-Jamett, G; Hancke, J L; Burgos, R A

    2016-05-23

    Andrographis paniculata (A. paniculata), a medicinal plant, has shown anti-inflammatory, neuroprotective and antifibrotic effects in animal models as well as clinical efficacy in different studies, including an anti-fatigue effect in autoimmune diseases such as rheumatoid arthritis. In multiple sclerosis (MS), fatigue is rated as one of the most common and disabling symptoms. In the present trial, we investigated the effect of A. paniculata on relapse rate and fatigue in relapsing-remitting MS (RRMS) patients receiving interferon beta. A randomised double-blind placebo-controlled trial assessed the effects of 170 mg of A. paniculata dried extract tablet b.i.d. p.o. on relapse rate and fatigue using the Fatigue Severity Scores (FSS) over 12 months in RRMS patients receiving interferon. The Expanded Disability Status Scale (EDSS) score, inflammatory parameters and radiological findings were also investigated. Twenty-five patients were enrolled, and twenty-two patients were ultimately analysed and randomised to the active or placebo group. Patients treated with A. paniculata showed a significant reduction in their FSS score as compared to the placebo, equivalent to a 44 % reduction at 12 months. No statistically significant differences were observed for relapse rate, EDSS or inflammatory parameters, with a trend in reducing new lesions among the A. paniculata group. One patient in the A. paniculata group presented with a mild and transient skin rash, which was alleviated with anti-histamine treatment for three weeks. A. paniculata was well tolerated in patients and no changes in clinical parameters were observed. A. paniculata significantly reduces fatigue in patients with RRMS receiving interferon beta in comparison to placebo and only interferon beta treatment. ClinicalTrials.gov Identifier: NCT02280876 ; Trial registration date: 20.10.2014.

  7. Peri-apatite coating decreases uncemented tibial component migration: long-term RSA results of a randomized controlled trial and limitations of short-term results.

    Science.gov (United States)

    Van Hamersveld, Koen T; Marang-Van De Mheen, Perla J; Nelissen, Rob G H H; Toksvig-Larsen, Sören

    2018-05-09

    Background and purpose - Biological fixation of uncemented knee prostheses can be improved by applying hydroxyapatite coating around the porous surface via a solution deposition technique called Peri-Apatite (PA). The 2-year results of a randomized controlled trial, evaluating the effect of PA, revealed several components with continuous migration in the second postoperative year, particularly in the uncoated group. To evaluate whether absence of early stabilization is diagnostic of loosening, we now present long-term follow-up results. Patients and methods - 60 patients were randomized to PA-coated or uncoated (porous only) total knee arthroplasty of which 58 were evaluated with radiostereometric analysis (RSA) performed at baseline, at 3 months postoperatively and at 1, 2, 5, 7, and 10 years. A linear mixed-effects model was used to analyze the repeated measurements. Results - PA-coated components had a statistically significantly lower mean migration at 10 years of 0.94 mm (95% CI 0.72-1.2) compared with the uncoated group showing a mean migration of 1.72 mm (95% CI 1.4-2.1). Continuous migration in the second postoperative year was seen in 7 uncoated components and in 1 PA-coated component. All of these implants stabilized after 2 years except for 2 uncoated components. Interpretation - Peri-apatite enhances stabilization of uncemented components. The number of components that stabilized after 2 years emphasizes the importance of longer follow-up to determine full stabilization and risk of loosening in uncemented components with biphasic migration profiles.

  8. Pharmacogenetics-based warfarin dosing algorithm decreases time to stable anticoagulation and the risk of major hemorrhage: an updated meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Wang, Zhi-Quan; Zhang, Rui; Zhang, Peng-Pai; Liu, Xiao-Hong; Sun, Jian; Wang, Jun; Feng, Xiang-Fei; Lu, Qiu-Fen; Li, Yi-Gang

    2015-04-01

    Warfarin is yet the most widely used oral anticoagulant for thromboembolic diseases, despite the recently emerged novel anticoagulants. However, difficulty in maintaining stable dose within the therapeutic range and subsequent serious adverse effects markedly limited its use in clinical practice. Pharmacogenetics-based warfarin dosing algorithm is a recently emerged strategy to predict the initial and maintaining dose of warfarin. However, whether this algorithm is superior over conventional clinically guided dosing algorithm remains controversial. We made a comparison of pharmacogenetics-based versus clinically guided dosing algorithm by an updated meta-analysis. We searched OVID MEDLINE, EMBASE, and the Cochrane Library for relevant citations. The primary outcome was the percentage of time in therapeutic range. The secondary outcomes were time to stable therapeutic dose and the risks of adverse events including all-cause mortality, thromboembolic events, total bleedings, and major bleedings. Eleven randomized controlled trials with 2639 participants were included. Our pooled estimates indicated that pharmacogenetics-based dosing algorithm did not improve percentage of time in therapeutic range [weighted mean difference, 4.26; 95% confidence interval (CI), -0.50 to 9.01; P = 0.08], but it significantly shortened the time to stable therapeutic dose (weighted mean difference, -8.67; 95% CI, -11.86 to -5.49; P pharmacogenetics-based algorithm significantly reduced the risk of major bleedings (odds ratio, 0.48; 95% CI, 0.23 to 0.98; P = 0.04), but it did not reduce the risks of all-cause mortality, total bleedings, or thromboembolic events. Our results suggest that pharmacogenetics-based warfarin dosing algorithm significantly improves the efficiency of International Normalized Ratio correction and reduces the risk of major hemorrhage.

  9. PIRATE project: point-of-care, informatics-based randomised controlled trial for decreasing overuse of antibiotic therapy in Gram-negative bacteraemia.

    Science.gov (United States)

    Huttner, Angela; Albrich, Werner C; Bochud, Pierre-Yves; Gayet-Ageron, Angèle; Rossel, Anne; Dach, Elodie von; Harbarth, Stephan; Kaiser, Laurent

    2017-07-13

    Antibiotic overuse drives antibiotic resistance. The optimal duration of antibiotic therapy for Gram-negative bacteraemia (GNB), a common community and hospital-associated infection, remains unknown and unstudied via randomised controlled trials (RCTs). This investigator-initiated, multicentre, non-inferiority, informatics-based point-of-care RCT will randomly assign adult hospitalised patients receiving microbiologically efficacious antibiotic(s) for GNB to (1) 14 days of antibiotic therapy, (2) 7 days of therapy or (3) an individualised duration determined by clinical response and 75% reduction in peak C reactive protein (CRP) values. The randomisation will occur in equal proportions (1:1:1) on day 5 (±1) of efficacious antibiotic therapy as determined by antibiogram; patients, their physicians and study investigators will be blind to treatment duration allocation until the day of antibiotic discontinuation. Immunosuppressed patients and those with GNB due to complicated infections (endocarditis, osteomyelitis, etc) and/or non-fermenting bacilli ( Acinetobacter spp, Burkholderia spp, Pseudomonas spp) Brucella spp, Fusobacterium spp or polymicrobial growth with Gram-positive organisms will be ineligible. The primary outcome is incidence of clinical failure at day 30; secondary outcomes include clinical failure, all-cause mortality and incidence of Clostridiumdifficile infection in the 90-day study period. An interim safety analysis will be performed after the first 150 patients have been followed for ≤30 days. Given a chosen margin of 10%, the required sample size to determine non-inferiority is roughly 500 patients. Analyses will be performed on both intention-to-treat and per-protocol populations. Ethics approval was obtained from the cantonal ethics committees of all three participating sites. Results of the main trial and each of the secondary endpoints will be submitted for publication in a peer-reviewed journal. This trial is registered at www

  10. Anemia: friend or foe? Low hemoglobin is associated with decreased survival, loco-regional control and late complications: a secondary analysis of RTOG 85-27

    International Nuclear Information System (INIS)

    Lee, W. Robert; Berkey, B.; Marcial, V.; Fu, K.K.; Cooper, J. S.; Vikram, B.; Coia, L.R.; Rotman, M.; Ortiz, H.

    1997-01-01

    Purpose: Classical teaching holds that hypoxia reduces the lethal effects of ionizing radiation. Many reports have correlated low hemoglobin (Hgb) levels with reduced loco-regional control (LRC) following radiotherapy (RT) suggesting that anemia may be associated with tumor hypoxia. If hypoxia protects tumors from the lethal effects of ionizing radiation then it might protect normal tissues in a similar fashion. The purpose of the present study was to examine the effect of Hgb level on the LRC, survival and late complications in patients with advanced head and neck cancer treated with conventional radiotherapy with or without a hypoxic cell sensitizer. Methods: From March 1988 to September 1991, 521 patients with Stage III or IV squamous cell carcinoma of the head and neck were entered onto a randomized trial examining the addition of etanidazole (SR 2508) to conventional RT (66 Gy in 33 fractions to 74 Gy in 37 fractions, 5 days a week). Hgb levels were stratified as high (≥ 14.5 grams-percent for men, ≥ 13.0 grams-percent for women) or low (<14.5 for men, <13.0 for women). Loco-regional failure rates were calculated using the cumulative incidence approach. Overall survival was estimated according to the Kaplan-Meier method. Late RT toxicity was scored according to the RTOG morbidity scale. Differences in rates of LRC, survival and late complications were tested by the Cox proportional hazard model. The median follow-up of surviving patients was 57 months with a range of 1-7.5 years. Results: Of 504 eligible patients, 451 had Hgb measured prior to the second week of RT. One hundred and sixty-two patients (35.9%) were classified as having a high Hgb (HH) and 289 (64.1%) patients were classified as having a low Hgb (LH). Patients in the LH group had significantly lower survival and a trend towards lower LRC and late RT complications (see Table). Conclusion: Low Hgb levels are associated with a statistically significant reduction in survival and a trend towards

  11. Decreasing relative risk premium

    DEFF Research Database (Denmark)

    Hansen, Frank

    2007-01-01

    such that the corresponding relative risk premium is a decreasing function of present wealth, and we determine the set of associated utility functions. We find a new characterization of risk vulnerability and determine a large set of utility functions, closed under summation and composition, which are both risk vulnerable...

  12. Decreasing asthma morbidity

    African Journals Online (AJOL)

    1994-12-12

    Dec 12, 1994 ... Apart from the optimal use of drugs, various supplementary methods have been tested to decrease asthma morbidity, usually in patients from reiatively affluent socio-economic backgrounds. A study of additional measures taken in a group of moderate to severe adult asthmatics from very poor socio- ...

  13. 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...

  14. 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...

  15. 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.

  16. 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...

  17. On the importance of processing conditions, product thickness and egg addition for the glycaemic and hormonal responses to pasta: a comparison with bread made from 'pasta ingredients'.

    Science.gov (United States)

    Granfeldt, Y; Björck, I; Hagander, B

    1991-10-01

    The importance of processing conditions, product thickness and effect of egg addition for the glycaemic and hormonal responses to pasta was studied. Healthy subjects were given test meals with an equivalent amount of available carbohydrate from extruded high-temperature dried spaghetti and three varieties of fresh roll-sheeted linguine (thick, thin, thin with egg) made from the same ingredients (durum wheat, water and monoglycerides). As a reference bread was baked from the same ingredients as in the pasta products. Glucose, insulin and C-peptide levels were measured over a 3 h period. Glycaemic, insulin and C-peptide indexes (GI, II, CI) were calculated using 120 min areas under the curves. Glycaemic index was also calculated using the 90 min area. Also studied were the rates of in vitro starch digestion. The four pasta products produced significantly lower peak values (glucose, insulin, C-peptide) and lower GI (90 min), II (120 min) and CI (120 min) than the corresponding bread. The rate of in vitro starch digestion in pasta was also slower than in bread. In contrast to the pasta products, bread resulted in a prominent hypoglycaemia in the late phase, that is a drop below fasting blood glucose level. Minor differences in metabolic responses also appeared in the pasta products. In particular, the insulin and C-peptide response to the thin linguine was accentuated in the phase around 120 min.

  18. Improving risk factor management for patients with poorly controlled type 2 diabetes: a systematic review of healthcare interventions in primary care and community settings.

    LENUS (Irish Health Repository)

    Murphy, Mark E

    2017-08-04

    Poorly controlled type 2 diabetes mellitus (T2DM) is a major international health problem. Our aim was to assess the effectiveness of healthcare interventions, specifically targeting patients with poorly controlled T2DM, which seek to improve glycaemic control and cardiovascular risk in primary care settings.

  19. Glycaemic index values and physicochemical properties of five brown rice varieties cooked by different domestic cooking methods

    Directory of Open Access Journals (Sweden)

    Madan Kumar Chapagai

    2016-08-01

    Full Text Available Background: The prevalence of diabetes has increased dramatically in recent decades in the regions where people excessively consume white rice. Due to higher nutritional values and bioactive components, low to medium glycaemic index (GI brown rice could be a potential alternative to white rice in these regions. Methods: Five varieties, Chiang (CH, Sungyod (SY, Lepnok (LP from Thailand, Long grain specialty 1 (LS 1 and Long grain specialty 2 (LS 2 from Malaysia were tested for GI. Ten test foods were prepared from 5 varieties by 2 cooking techniques (pressure cooker, PC and rice cooker, RC. Overnight fasted 10 healthy subjects were fed with 25 g glucose as a reference food (RF on 3 occasions and amount equivalent to 25 g available carbohydrate portion of test food (TF on 1 occasion in separate days. Fasting and post-prandial capillary blood glucose was measured via finger-prick methods at 0, 15, 30, 45, 60, 90 and 120 min, and the incremental area under curve (iAUC was determined. The GI of each TF was calculated as percentage of incremental area under curve (iAUC of TF over RF. Results: The mean GI values of SY (72 – 81, high, CH and LP (59 – 65, medium and LS 1 and LS 2 (64 – 73, medium to high for cooking were discovered by PC and RC methods. The GI did not vary significantly (p>0.05 among varieties as well as between cooking methods. GI showed a significant negative correlation with the amylose content (r = –0.70, p<0.05 and significant positive correlation with cold peak viscosity (r = 0.80, p<0.01. Conclusions: All five rice varieties irrespectively of the cooking method used are classified as medium to high GI foods. Medium GI varieties could have potential of being used in diabetic diet. Cooking methods did not significantly alter the glycaemic characteristics of the studied varieties. Amylose content and pasting properties can be used for predicting GI of brown rice. It is urgent to explore low GI brown rice varieties in these

  20. The future of population registers: linking routine health datasets to assess a population's current glycaemic status for quality improvement.

    Science.gov (United States)

    Chan, Wing Cheuk; Jackson, Gary; Wright, Craig Shawe; Orr-Walker, Brandon; Drury, Paul L; Boswell, D Ross; Lee, Mildred Ai Wei; Papa, Dean; Jackson, Rod

    2014-04-28

    To determine the diabetes screening levels and known glycaemic status of all individuals by age, gender and ethnicity within a defined geographic location in a timely and consistent way to potentially facilitate systematic disease prevention and management. Retrospective observational study. Auckland region of New Zealand. 1 475 347 people who had utilised publicly funded health service in New Zealand and domicile in the Auckland region of New Zealand in 2010. The health service utilisation population was individually linked to a comprehensive regional laboratory repository dating back to 2004. The two outcomes measures were glycaemia-related blood testing coverage (glycated haemoglobin (HbA1c), fasting and random glucose and glucose tolerance tests), and the proportions and number of people with known dysglycaemia in 2010 using modified American Diabetes Association (ADA) and WHO criteria. Within the health service utilisation population, 792 560 people had had at least one glucose or HbA1c blood test in the previous 5.5 years. Overall, 81% of males (n=198 086) and 87% of females (n=128 982) in the recommended age groups for diabetes screening had a blood test to assess their glycaemic status. The estimated age-standardised prevalence of dysglycaemia was highest in people of Pacific Island ethnicity at 11.4% (95% CI 11.2% to 11.5%) for males and 11.6% (11.4% to 11.8%) for females, followed closely by people of Indian ethnicity at 10.8% (10.6% to 11.1%) and 9.3% (9.1% to 9.6%), respectively. Among the indigenous Maori population, the prevalence was 8.2% (7.9% to 8.4%) and 7% (6.8% to 7.2%), while for 'Others' (mainly Europeans) it was 3% (3% to 3.1%) and 2.2% (2.1% to 2.2%), respectively. We have demonstrated that the data linkage between a laboratory repository and national administrative datasets has the potential to provide a systematic and consistent individual level clinical information that is relevant to medical auditing for a large geographically defined

  1. 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.

  2. The effect of using isomaltulose (Palatinose™) to modulate the glycaemic properties of breakfast on the cognitive performance of children.

    Science.gov (United States)

    Young, Hayley; Benton, David

    2015-09-01

    Although previous research has associated the glycaemic load (GL) of a meal with cognitive functioning, typically the macro-nutrient composition of the meals has differed, raising a question as to whether the response was to GL or to the energy, nutrients or particular foods consumed. Therefore, the present study contrasted two breakfasts that offered identical levels of energy and macro-nutrients, although they differed in GL. Using a repeated-measures, double-blind design, 75 children aged 5-11 years, from socially deprived backgrounds, attended a school breakfast club and on two occasions, at least a week apart, they consumed a meal sweetened with either isomaltulose (Palatinose™) (GL 31.6) or glucose (GL 59.8). Immediate and delayed verbal memory, spatial memory, sustained attention, reaction times, speed of information processing and mood were assessed 1 and 3 h after eating. The nature of the meals did not influence any measure of cognition or mood after an hour; however, after 3 h, children's memory and mood improved after the lower-GL breakfast. If children had eaten the lower-GL meal on the second day of testing, they were able to process information faster and had better spatial memory later in the morning. Towards the end of a morning in school, having consumed a lower-GL breakfast resulted in better mood and aspects of cognitive functioning.

  3. Food processing methods influence the glycaemic indices of some commonly eaten West Indian carbohydrate-rich foods.

    Science.gov (United States)

    Bahado-Singh, P S; Wheatley, A O; Ahmad, M H; Morrison, E Y St A; Asemota, H N

    2006-09-01

    Glycaemic index (GI) values for fourteen commonly eaten carbohydrate-rich foods processed by various methods were determined using ten healthy subjects. The foods studied were round leaf yellow yam (Dioscorea cayenensis), negro and lucea yams (Dioscorea rotundata), white and sweet yams (Dioscorea alata), sweet potato (Solanum tuberosum), Irish potato (Ipomoea batatas), coco yam (Xanthosoma spp.), dasheen (Colocasia esculenta), pumpkin (Cucurbita moschata), breadfruit (Artocarpus altilis), green banana (Musa sapientum), and green and ripe plantain (Musa paradisiaca). The foods were processed by boiling, frying, baking and roasting where applicable. Pure glucose was used as the standard with a GI value of 100. The results revealed marked differences in GI among the different foods studied ranging from 35 (se 3) to 94 (se 8). The area under the glucose response curve and GI value of some of the roasted and baked foods were significantly higher than foods boiled or fried (P<0.05). The results indicate that foods processed by roasting or baking may result in higher GI. Conversely, boiling of foods may contribute to a lower GI diet.

  4. Low-fat, high-carbohydrate (low-glycaemic index) diet induces weight loss and preserves lean body mass in obese healthy subjects: results of a 24-week study.

    Science.gov (United States)

    Bahadori, B; Yazdani-Biuki, B; Krippl, P; Brath, H; Uitz, E; Wascher, T C

    2005-05-01

    The traditional treatment for obesity which is based on a reduced caloric diet has only been partially successful. Contributing factors are not only a poor long-term dietary adherence but also a significant loss of lean body mass and subsequent reduction in energy expenditure. Both low-fat, high-carbohydrate diets and diets using low-glycaemic index (GI) foods are capable of inducing modest weight loss without specific caloric restriction. The purpose of this study was to investigate the feasibility and medium-term effect of a low-fat diet with high (low GI) carbohydrates on weight loss, body composition changes and dietary compliance. Obese patients were recruited from two obesity outpatient clinics. Subjects were given advise by a dietician, then they attended biweekly for 1-hour group meetings. Bodyweight and body composition were measured at baseline and after 24 weeks. One hundred and nine (91%) patients completed the study; after 24 weeks the average weight loss was 8.9 kg (98.6 vs. 89.7 kg; p fat mass (42.5 vs. 36.4 kg; p vs. 53.3 kg; p low-fat, low-GI diet led to a significant reduction of fat mass; adherence to the diet was very good. Our results suggest that such a diet is feasible and should be evaluated in randomized controlled trials.

  5. 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 cance